Esophagogastroduodenoscopy for cancer screening was performed in a 55-year-old woman as part of a health screening program, and revealed a depressed lesion approximately 20 mm in diameter in the lesser curvature of the mid-gastric body. Several biopsy specimens were collected as the lesion resembled early gastric cancer; however, histopathologic evaluation revealed chronic active gastritis with an ulcer and amorphous eosinophilic material deposition. Congo red staining identified amyloid proteins, and apple-green birefringence was shown using polarized light microscopy. Immunohistochemical staining revealed the presence of kappa and lambda chain-positive plasma cells. There was no evidence of underlying plasma cell dyscrasia or amyloid deposition in other segments of the gastrointestinal tract. Echocardiography and computed tomography of the chest, abdomen, and pelvis did not show any significant findings. Thus, the patient was diagnosed with localized gastric amyloidosis with kappa and lambda light chain coexpression.
Abdomen ; Amyloidogenic Proteins ; Amyloidosis* ; Biopsy ; Birefringence ; Congo Red ; Early Detection of Cancer ; Echocardiography ; Endoscopy, Digestive System ; Eosinophils ; Female ; Gastritis ; Gastrointestinal Tract ; Humans ; Mass Screening ; Microscopy, Polarization ; Middle Aged ; Paraproteinemias ; Pelvis ; Plaque, Amyloid ; Plasma Cells ; Stomach Neoplasms ; Thorax ; Ulcer

Amyloidosis is defined as the extracellular deposition of non-branching fibrils composed of a variety of serum-protein precursors. Secondary amyloidosis is associated with several chronic inflammatory conditions, such as rheumatologic or intestinal diseases, familial Mediterranean fever, or chronic infectious diseases, such as tuberculosis. Although the association of amyloidosis with inflammatory bowel disease is known, amyloidosis secondary to ulcerative colitis (UC) is rare. A 36-year-old male patient with a 15-year history of UC presented with nausea, vomiting, and abdominal pain. He had been treated with infliximab for 6 years. At the time of admission, he had been undergoing treatment with mesalazine and adalimumab since the preceding 5 months. Esophagogastroduodenoscopy showed mucosal erythema, edema, and erosions with geographic ulcers at the 2nd and 3rd portions of the duodenum. Duodenal amyloidosis was diagnosed using polarized light microscopy and Congo red stain. Monoclonal gammopathy was not detected in serum and urine tests, while the serum free light chain assay result was not specific. An increase in plasma cells in the bone marrow was not found. Secondary amyloidosis due to UC was suspected. The symptoms were resolved after glucocorticoid therapy.
Abdominal Pain ; Adalimumab ; Adult ; Amyloidosis ; Bone Marrow ; Colitis, Ulcerative ; Communicable Diseases ; Congo Red ; Duodenum ; Edema ; Endoscopy, Digestive System ; Erythema ; Familial Mediterranean Fever ; Humans ; Inflammatory Bowel Diseases ; Infliximab ; Intestinal Diseases ; Male ; Mesalamine ; Microscopy, Polarization ; Nausea ; Paraproteinemias ; Plasma Cells ; Tuberculosis ; Ulcer ; Vomiting

In assisted reproductive techniques, the operator attempts to select morphologically best embryos to predict embryo viability. Development of polarized light microscope, which evaluates the oocytes' spindles according to birefringence of living cells, had been helpful in oocyte selection. The aim of this study is evaluating the relationship between meiotic spindles visualization and intracytoplasmic sperm injection (ICSI) outcomes in human oocytes. In this study, 264 oocytes from 24 patients with an average age of 30.5±7.5 years with infertility duration of 1 to 10 years were collected. The oocytes were randomly allocated to the control injection group (n=126) and the oocyte imaging group (spindle-aligned group) (n=138). In the spindle-aligned group, the meiotic spindle was identified by means of polarized light microscope to align the spindle at 6 or 12 o'clock. Then the spindle-aligned group was divided into three sub-groups based on spindle morphology: fine, average, and (poor). After ICSI, embryos were checked every 24 hours and scored; 72 hours later, high-grade embryos were transferred intravaginally to uterus. This study showed that the fertilization rate in the spindle-aligned group was higher than the control group (P<0.05). After cleavage, a positive correlation was observed between spindle morphology and embryo morphology. Among the sub-groups of spindle-aligned group, the embryos' morphology of the fine group was better than the other subgroups and embryos of the poor group had lower quality and more fragmentation. The results revealed that the selection of oocytes based on meiotic spindle imaging can significantly improve the rate of fertilization and embryo cleavage and certainly increase the rate of implantation.
Birefringence ; Embryonic Structures ; Fertilization ; Humans* ; Infertility ; Microscopy, Polarization ; Oocytes* ; Reproductive Techniques, Assisted ; Sperm Injections, Intracytoplasmic* ; Spindle Apparatus* ; Uterus

BACKGROUND: Epidermal thickness is a useful quantitative histopathological parameter to predict different skin conditions. For accurate diagnosis, the reference values of normal skin histology are essential. Until now, little data regarding epidermal thickness in normal Korean skin have been available. OBJECTIVE: To investigate the thickness of the epidermis, stratum corneum, and cellular epidermis by skin biopsy and to compare their regional, age, and sex variations in Koreans. METHODS: A total of 119 normal human skin tissues from 117 subjects were included. Skin specimens were preserved in sections by formalin-paraffin techniques and measured by performing light microscopy and using a calibrated ruler. RESULTS: The mean thickness of the epidermis was 140.6±32.6 µm (mean±standard deviation). Significant regional variations of epidermal thickness were found (p<0.01): the leg was the region with the thickest epidermis in both males and females (153.3 µm and 183.4 µm, respectively), while the neck was the region with the thinnest epidermis (96.3 µm and 115.4 µm, respectively). However, epidermal thickness did not show any significant difference according to age (p>0.5) or sex (p>0.05, except for the thickness of the stratum corneum of the legs [p=0.007]). CONCLUSION: Regional variations of epidermal thickness were demonstrated. These variations were mostly independent of age or sex, which conflicts somewhat with previous studies. We present this research as a preliminary study, which may provide reference values for skin histopathology and epidermal thickness in normal Korean skin.
Biopsy ; Diagnosis ; Epidermis ; Female ; Humans ; Leg ; Male ; Microscopy ; Microscopy, Polarization ; Neck ; Reference Values* ; Skin

This commentary presents the regulatory backgrounds and development of the national proficiency testing (PT) scheme on asbestos analysis in the Republic of Korea. Since 2009, under the amended Occupational Safety and Health Act, the survey of asbestos in buildings and clearance test of asbestos removal works have been mandated to be carried out by the laboratories designated by the Ministry of Employment and Labor (MOEL) in the Republic of Korea. To assess the performance of asbestos laboratories, a PT scheme on asbestos analysis was launched by the Korea Occupational Safety and Health Agency (KOSHA) on behalf of the MOEL in 2007. Participating laboratories are evaluated once a year for fiber counting and bulk asbestos analysis by phase contrast microscopy and polarized light microscopy, respectively. Currently, the number of laboratory enrollments is > 200, and the percentage of passed laboratories is > 90. The current status and several significant changes in operation, sample preparations, and statistics of assigning the reference values of the KOSHA PT scheme on asbestos analysis are presented. Critical retrospect based on the experiences of operating the KOSHA PT scheme suggests considerations for developing a new national PT scheme for asbestos analysis.
Asbestos* ; Employment ; Korea* ; Microscopy, Phase-Contrast ; Microscopy, Polarization ; Occupational Health ; Reference Values ; Republic of Korea

Calcium pyrophosphate dihydrate deposition disease most commonly presents with acute arthritis of the peripheral joints. Infrequently, a mass effect of this disease can cause axial symptoms, such as spinal stenosis, radiculopathy, or myelopathy. Herein, we report on the first Korean case of acute arthritis in the lumbar facet joint due to calcium pyrophosphate dihydrate crystal deposition disease. A 73-year-old female presented with acute fever, severe lumbago, and knee arthralgia, 11 days after partial parathyroidectomy. Plain radiographs showed multiple chondrocalcinosis, while a bone scan, computed tomography, and magnetic resonance imaging showed right L5-S1 facet arthritis. In synovial fluid from the facet and knee joints, positively birefringent calcium pyrophosphate dihydrate crystals were observed under polarized light microscopy. Under the diagnosis of acute calcium pyrophosphate dihydrate crystal arthritis (formerly known as 'pseudogout') in the facet joint, an intra-articular triamcinolone injection was administered, which resulted in dramatic improvement of the symptoms within 24 hours.
Aged ; Arthralgia ; Arthritis* ; Calcium Pyrophosphate* ; Calcium* ; Chondrocalcinosis ; Diagnosis ; Female ; Fever ; Humans ; Joints ; Knee ; Knee Joint ; Low Back Pain ; Magnetic Resonance Imaging ; Microscopy, Polarization ; Parathyroidectomy ; Radiculopathy ; Spinal Cord Diseases ; Spinal Stenosis ; Synovial Fluid ; Triamcinolone ; Zygapophyseal Joint*

BACKGROUND/AIMS: To investigate the rate of detection of monosodium urate (MSU) crystals in the synovial fluid (SF) of patients with acute gouty arthritis and factors associated with false-negative results. METHODS: A total of 179 patients with acute gouty arthritis who had undergone SF crystal examination were identified from the data warehouse of two university hospitals. Clinical and laboratory data were obtained from the medical records. RESULTS: The overall rate of detection of MSU crystals was 78.8%. In univariate analyses, the only significant differences between the variables of crystal-negative and crystal-positive patients were a lower C-reactive protein level (p = 0.040) and fewer patients undergoing emergent surgery in the crystal-positive group (p = 4.5 x 10(-6)). In logistic regression analyses, MSU crystal-negative results were significantly associated with the interval from arthritis onset to crystal examination (p = 0.042), and this was the most significant risk factor for arthroscopic surgery (p = 2.1 x 10(-4)). Seventeen patients who underwent arthroscopic surgery had a significantly longer hospital stay (p = 0.007) and a significant delay in gout treatment (p = 8.74 x 10(-5)). The distribution of crystal-negative patients differed significantly between the SF samples that were evaluated by both the laboratory medicine and the rheumatology departments (p = 1.2 x 10(-14)), and the kappa value was 0.108. CONCLUSIONS: Although several clinical features were associated with detection failure, SF MSU crystal identification was critically dependent on the observer. Considering the impact on the treatment outcomes, implementation of a quality control program is essential.
Acute Disease ; Aged ; Arthritis, Gouty/diagnosis/*metabolism/*surgery ; Arthroscopy ; Biological Markers/metabolism ; Crystallization ; False Negative Reactions ; Female ; Hospitals, University ; Humans ; Length of Stay ; Logistic Models ; Male ; Microscopy, Polarization ; Middle Aged ; Observer Variation ; Predictive Value of Tests ; Reproducibility of Results ; Republic of Korea ; Retrospective Studies ; Synovial Fluid/*metabolism ; Time Factors ; Time-to-Treatment ; Treatment Outcome ; Uric Acid/*metabolism

To test the efficacy of two calcium phosphate pastes compared to that of fluoride toothpaste on remineralizing artificial caries in situ, this study had a double-blind crossover in situ design, involving three experimental phases of 14 days each, with an 8-day washout period between phases. Nine healthy subjects participated in the study. The subjects wore removable palatal appliances mounted with six human enamel slabs with artificial caries lesions, and in each of the experimental phases, used one of the following methods two times/day: group A, brushing with 1.0 g of Colgate Regular Flavor, followed by applying 0.25 g of Tooth Mousse Plus; group B, brushing with 0.25 g of Clinpro Tooth Crème; and group C, brushing with 1.0 g of Colgate Regular Flavor. After 14 days, the enamel slabs (54 slabs/group) were embedded in resin, sectioned and examined with a polarized-light microscope, and the lesion areas were quantified using Image-Pro Plus. All experimental groups showed a significant reduction in lesion area compared to the initial lesion area (paired t-test, P<0.001). The mean reduction in lesion area of Groups A, B and C were (0.029±0.010), (0.030±0.009) and (0.027±0.009) mm(2), respectively. There were no statistical differences between groups (Kruskal-Wallis test, P>0.05). All three groups remineralized the enamel slab lesions, indicating model sensitivity to fluoride. Given the differences in usage amounts and treated regimens, Clinpro Tooth Crème provided similar benefits to the fluoride toothpaste; however, no additional benefit of Tooth Mousse Plus was observed when used in conjunction with the fluoride toothpaste.
Calcium Phosphates ; therapeutic use ; Cariostatic Agents ; therapeutic use ; Caseins ; therapeutic use ; Cross-Over Studies ; Dental Caries ; prevention & control ; Dental Enamel ; drug effects ; Dentifrices ; therapeutic use ; Double-Blind Method ; Female ; Fluorides ; therapeutic use ; Humans ; Image Processing, Computer-Assisted ; methods ; Male ; Microscopy, Polarization ; Tooth Remineralization ; methods ; Toothbrushing ; methods ; Toothpastes ; therapeutic use ; Treatment Outcome ; Young Adult

The present study aims to evaluate the effect of Galla chinensis compounds on the remineralization of two artificial root lesions morphous in vitro. Sixty bovine dentine blocks were divided into two groups and individually treated with two levels of demineralization solutions to form erosive and subsurface artificial carious lesions in vitro. Each group was then divided into three subgroups, each of which were treated with a remineralization solution (positive control), deionized water (negative control), or 4 000 mg⋅L(-1) aqueous solutions of Galla chinensis extract. The dentine blocks were then subjected to a pH-cycling regime for 7 days. During the first 4 days, the daily cycle included 21-h deal and 3-h demineralization applications. The dentine blocks were dealt with the entire day during the remaining 3 days. Two specimens from each of the treatment groups were selected and observed under a polarized light microscope. Data collected using a laser scanning confocal microscope were computerized and analyzed. Galla chinensis extract clearly enhanced the remineralization of both erosive lesion and subsurface lesion patterns in the specimens (P<0.05). The level of remineralization of the erosive lesion by Galla chinensis extract was lower than that of the subsurface lesion (P<0.05). In addition, the remineralization of the subsurface lesion by Galla chinensis extract was higher than that of the remineralization solution (P<0.05). No significant difference between the remineralization of erosive lesions by Galla chinensis extract and the remineralization solution was observed (P>0.05). So Galla chinensis extract has the potential to improve the remineralization of artificial root lesions under dynamic pH-cyclic conditions, indicating its potential use as a natural remineralization medicine.
Animals ; Cariostatic Agents ; therapeutic use ; Cattle ; Dentin ; pathology ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Gallic Acid ; therapeutic use ; Hydrogen-Ion Concentration ; Hydrolyzable Tannins ; therapeutic use ; Microscopy, Confocal ; Microscopy, Polarization ; Polyphenols ; therapeutic use ; Random Allocation ; Root Caries ; drug therapy ; Tooth Remineralization

Amorphous drugs have higher solubility, better oral bioavailability and are easier to be absorbed than their crystalline counterparts. However, the amorphous drugs, with weak stability, are so easy to crystallize that they will lose the original advantages. Polarization microscope, scanning electron microscope, differential scanning calorimetry, X-ray diffractomer and Raman spectroscopy were used to study the microcosmic crystallization mechanisms of amorphous indometacin and the performance of the drug crystals. The results showed that the growth rate of amorphous indometacin crystals at the free surface was markedly faster than that through the bulk, and that the crystal growth rate decreased observably after spraying an ultrathin melting gold (10 nm) at the free surface of the drug. These results indicated that the high growth rates of amorphous drugs crystals at the free surface were the key to their stability and that an ultrathin coating could be applied to enhance the stability of amorphous drugs.
Calorimetry, Differential Scanning ; Crystallization ; Gold ; chemistry ; Indomethacin ; chemistry ; Microscopy, Electron, Scanning ; Microscopy, Polarization ; Nanotechnology ; methods ; Particle Size ; Solubility ; Spectrum Analysis, Raman ; Surface Properties ; X-Ray Diffraction