We describe cytologic findings of two cases of pilomatrixoma which had been cytologically misdiagnosed as suspicious malignant and malignant lesions in 35 year-old and 22 year-old females who presented a palpable neck mass. The cytologic smears showed many basaloid cells with a high nuclear-cytoplasmic ratio, nuclear hyperchromatism and prominent nucleoli, keratinized squamous cells with pyknotic nuclei, foreign body giant cells, and chronic inflammatory cells in necrotic background. Retrospective view of this aspiration smear revealed that these findings were characteristic features of pilomatrixoma, and the evenly distributed chromatin pattern as well as the lack of nuclear pleomorphism were considered to be the differential points from malignant neoplasm. Pilomatrixoma is a benign neoplasm which should be included in differential diagnosis if the fine needle aspiration cytologic smear of a neck mass or subcutaneous mass of any site showed these features.
Female ; Humans ; Diagnosis, Differential

PURPOSE: Sexual differences in the incidence and crystalline composition of urinary stones in humans are well-known, but it is unclear why men have a higher incidence of calcium oxalate stones than women. We investigated the effects of male sex hormones on stone formation using an ethylene glycol (EG) - induced urolithiasis model in rats. MATERIALS AND METHODS: Adult male Sprague-Dawley rats were divided into 4 groups, each containing 10 rats. One group of rats was left untreated and served as control. The other 3 groups were fed a 1% ethylene glycol (EG) lithogenic diet for 4 weeks. Among these, one group was non-castrated, one group was castrated and one group was non-castrated and given finasteride orally. Serum testosterone, creatinine, electrolytes, 24-hour urine levels of oxalate and citrate, and creatinine clearance were measured. The crystal deposits were examined by light and polarizing microscopes. RESULTS: Testosterone promoted calcium oxalate stone formation in EG - treated rats. Finasteride administration significantly decreased urinary oxalate excretion and calcium oxalate deposition, compared with controls. Urinary citrate was significantly decreased in EG-treated rats, but was not influenced by castration or administration of finasteride. There were no significant differences in serum concentrations of creatinine, sodium, or potassium among the control and experimental groups. CONCLUSIONS: Our data suggest that testosterone promotes calcium oxalate stone formation, and that dihydrotestosterone may be partially responsible for the exaggerated hyperoxaluria in EG-treated rats. Additionally, male sex hormones have a lesser influence on urinary citrate than oxalate.
Adult ; Animals ; Calcium Oxalate* ; Calcium* ; Castration ; Citric Acid ; Creatinine ; Crystallins ; Diet ; Dihydrotestosterone ; Electrolytes ; Ethylene Glycol ; Female ; Finasteride ; Gonadal Steroid Hormones* ; Humans ; Hyperoxaluria ; Incidence ; Male* ; Nephrolithiasis* ; Potassium ; Rats* ; Rats, Sprague-Dawley ; Sodium ; Testosterone ; Urinary Calculi ; Urolithiasis

The objective of this study is to examine the correlation between the tolylene concentration in the work environment of organic solvents and the concentration of hippuric acid in urine of workers exposed toluene, and to acquire the fundamental materials of workers' health care and to assist the assessment of the biological permissible exposure limit. The control groups are 72 workers who had never been exposed to toluene and the case groups are 101 workers who had been exposed to toluene. This study was conducted to examine the correlation between the concentration of toluene in work environment and workers' hippuric acid concentration, to investigate the complaint difference of subjective symptoms by means of questionnaire, between the case groups and control groups. The results and conclusions are as follows: 1) The highest mean concentration of toluene in the air is 544.13+/-7.75 ppm in the Printing Department of mixing organic solvents. The concentrations of the others are 463.27+/-5.24 ppm in Department of mixture for organic solvents, and 393.56+/-45.69 ppm in the Printing Department(1), and 248.38+/-45.16 ppm in the Printing Department(2), and 159.38+/-18.51 ppm in the Printing Department(3). 2) The highest mean concentration of hippuric acid in urine is 6034.84+/-1298.35 mg/l in the Printing Department with mixing organic solvents. The concentrations of the others are 4798.44+/-784.53 mg/l in Department of mixture of organic solvents, and 2883.06+/-701.90 mg/l in the Printing Department(1), and 1449.98+/-905.19 mg/l in the Printing Department(2), and 598.52+/-299.43 mg/l in the Printing Department(3). 3) As the toluene concentration in the work environment becomes higher, the concentration of hippuric acid in urine also becomes higher. It is found that the coefficient of correlation between toluene concentration and the concentration of hippuric acid are positive (r=0.868, Y=7.18X+349.57). 4) It is found that the case groups complain of much more subjective symptoms than the control groups.
Delivery of Health Care ; Surveys and Questionnaires ; Solvents ; Toluene*

Complicated hepatic microabscess secondary to ascending cholangitis following ERCP (Endoscopic retrograde cholangiopancreatogram) is rare, and needs to be differentiated from other microabscesses, metastasis or Caroli's disease. We experienced a case of hepatic microabscess associated with septic cholangitis following ERCP. Cholangiogram showed multiple sac-like abscess pockets with characteristic biliary communication, and CT scan revealed multiple low attenuated lesions. At the resolving stage of chotangitic microabscess, CT scan showed partial rim enhancement of the abscesses and disproportional dilatation of intrahepatic ducts. The residual parenchymal enhancement surrounding the resolved microabscess pockets and dilatated biliary ducts, however, remained even after clinical recovery.
Abscess ; Caroli Disease ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis* ; Dilatation ; Neoplasm Metastasis ; Tomography, X-Ray Computed

No abstract available.
Polyps*

Phthalates and bisphenol A (BPA) are synthetic chemicals widely used in daily life. This study investigated urinary phthalate and BPA levels in Korean children and their associations with obesity. Methods: A total of 2,351 children aged 3 to 17 years who participated in the Korean National Environmental Health Survey 2015 to 2017 were included. Urinary dilution was corrected using covariate-adjusted standardization (CAS). We examined the geometric mean (GM) concentrations of urinary phthalate metabolites, including di (2-ethylhexyl) phthalate (DEHP) metabolites (mono [2-ethyl-5-hydroxyhexyl] phthalate, mono [2-ethyl-5-oxohexyl] phthalate, and mono [2-ethyl-5-carboxypentyl] phthalate [MECPP]), mono-benzyl-phthalate (MBzP), mono (carboxyoctyl) phthalate (MCOP), mono (carboxy-isononyl) phthalate (MCNP), mono (3-carboxypropyl) phthalate, and mono-n-butyl-phthalate (MnBP), and BPA. We also analyzed the odds ratio (OR) for obesity according to the quartiles of each analyte. Results: The urinary GM levels of DEHP metabolites and MnBP were notably higher among Korean children than among American, Canadian, and German children. The CAS-applied GM concentrations of most analytes, except for MBzP, MCOP, and MCNP, were higher in children aged 3 to 5 years than in those aged 6 to 17 years. The OR for obesity in the highest quartile of MECPP was significantly higher than in the lowest quartile after adjusting for covariates. However, the other phthalate metabolites and BPA were not significantly associated with obesity. Conclusion: The concentrations of urinary DEHP metabolites and MnBP were higher in Korean children than in children in Western countries. Urinary MECPP exposure, but not other phthalates or BPA, showed a positive association with obesity in Korean children. Further studies are required to elucidate the causal relationships.

Intra- and extrahepatic bile duct can be invaded by hepatocellular carcinoma (HCC). This is infrequent in HCC, but it can directly affect the clinical manifestation and prognosis. We present eight cases of HCCs with emphasis on the incidence and features of bile duct invassion on computed tomography (CT). Over a period of 22 months, abdominal CT was performed in 186 with HCC patients. Out of these, five cases of bile duct invasion by HCC were confirmed in our hospital and three in other hospitals. The eight cases were evaluated for the type, size and location. CT features of intraductal mass and ductal dilatation were evaluated. The incidence of bile duct invasion in HCC was 2.6%. Infiltrative type of HCC was seen in seven cases and six of these had mass 5-11 cm in size. The characteristic CT findings of bile duct invasion in HCC are mass in common hepatic duct with bulging contour(8/80, multiple intraductal masses in the intrahepatic ducts (5/8), and diffuse dilatation of intrahepatic ducts (7/8).
Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Carcinoma, Hepatocellular* ; Dilatation ; Hepatic Duct, Common ; Humans ; Incidence ; Prognosis ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to examine the presenteeism and absenteeism in relation to the health problems of nurses. METHOD: Informed consent was provided before study. Data was collected from January 7 to March 6, 2008 by Stanford Presenteeism Scale-13. Data was collected from 3 hospitals in Seou l.Gyeonggi area. The response rate of the questionnaires was 96.2%. Incomplete data was analyzed using SPSS program. RESULTS: Shoulder, back and neck pain were the highest reported health problems and primary health problem of nurses. Impaired presenteeism was ranked in this order: depression or anxiety, cold, and uterus or ovary disorder. Absenteeism was ranked in this order: uterus or ovary disorder, cold, and dermatological problem. Impaired presenteeism was significantly increasing according to the number of health problems. But Absenteeism was not. Presenteeism was significantly different by age, educational level, religion, whether or not the worker lived with their family, marital status, whether or not the worker has children, time spent in the workforce, experience of turnover, shift work, night work, and level of satisfaction with salary. But absenteeism was not significantly different given these criteria. CONCLUSIONS: Health problems of nurses can negatively effect the quality of nursing service and productivity at hospital. Therefore the hospital administrator should control the presenteeism and absenteeism through the management of health problems of nurses.
Absenteeism* ; Anxiety ; Child ; Depression ; Efficiency ; Female ; Hospital Administrators ; Humans ; Informed Consent ; Marital Status ; Neck Pain ; Nursing Services ; Ovary ; Salaries and Fringe Benefits ; Shoulder ; Uterus ; Surveys and Questionnaires

PURPOSE: The role of MRI in the detection of cholangiocarcinoma of the common hepatic duct has rarely been described. This study was attempted to ascertain characteristic MR features of cholangiocarcinoma. MATERIALS AND METHODS: The T1(500/30, TRs/TEs) and T2 weighted(200/80, TRs/TEs) MR images were obtained from nine patients with cholangiocarcinoma of the common hepatic duct. The common hepatic lesions were detected in seven cases. MR features of cholangiocarcinoma were analysed according to the signal intensity and associated findings. RESULTS: The seven cases showed lower signal intensity than the surrounding normal liver parenchyma on T1 weighted image. On T2 weighted image, the tumor showed isosignal intensity and hyperintensity in four and three patients, respectively. T2 image also revealed diffusely increased signal intensity in some hepatic lobe or segment in four cases, and Intrahepatic periductal high signal intensity in one case. Other associated MR findings were intrahepatic metastasis, and intratumoral hemorrhage, each noted in a different case. CONCLUSION: T2 weighted Image appears to be effective in the detection of cholangiocarcinoma of the common hepatic duct and evaluation of its associated intrahepatic lesions.
Cholangiocarcinoma* ; Hemorrhage ; Hepatic Duct, Common* ; Humans ; Liver ; Magnetic Resonance Imaging ; Neoplasm Metastasis

BACKGROUND: With increase of antibiotics use and invasive procedures, infections caused by multi-resistant Acinetobacter baumannii (MRAB) are increasing. Recently, we experienced the outbreak of- nosocomial infections caused by MRAB resistant to imipenem and cefoperazone/sulbactam in intensive care units (ICU) and general ward. We analyzed the clinical characteristics of the infected patients and antibiotic susceptibility of the organisms. And surveillance cultures and IRS-PCR were performed to find out the transmission route. METHODS: We collected data from physical examination and clinical records. We performed surveillance cultures of environment, patients not infected with MRAB in ICU, and hands of health care workers. RESULTS: Between November 1996 and June 1997, 49 strains of MRAB were isolated from the 26 patients hospitalized in Kangnam St. Mary' s Hospital. The lower respiratory infection (13 cases) was the most common infection and sputum was the most common sources (47.1%). All strains of MRAB showed the same genotype. In disk diffusion test, all strains were resistant to piperacillin, gentamicin, amikacin, ceftazidime, cefoperazone/sulbactam, aztreonam, imipencm, ciprofloxacin. From the surveillance cultures, the genotypically identical strains were isolated from ventilator Y-piece, the floor of ICU, and hands of health care workers. It suggested that this strain was transmitted through ventilatory device or hands of health care workers. We instructed all the health care workers to wash hands, to disinfect hospital environment completely. Since July 1997, no further case has occurred. CONCLUSIONS: Since A. baumannii could be transmitted through ventilatory devices and the hands of health care workers, it is important to wash hands and to disinfect hospital environment completely.
Acinetobacter baumannii* ; Acinetobacter* ; Amikacin ; Anti-Bacterial Agents ; Aztreonam ; Ceftazidime ; Ciprofloxacin ; Cross Infection* ; Delivery of Health Care ; Diffusion ; Genotype ; Gentamicins ; Hand ; Humans ; Imipenem* ; Critical Care Units ; Patients' Rooms ; Physical Examination ; Piperacillin ; Sputum ; Ventilators, Mechanical