Hypersensitivity pneumonitis due to the inhalation of oyster mushroom(pleurotos ostreatus) was demonstrated in a 44-year-old man who had cultiviated for 4 years. He had suffered from dyspnea, cough, myalgia and fever in the evening after working at first. After them he has experienced dyspnea aggravated. He showed not only positive reaction to the intradermal test but also to the bronchial challenge test such as 6 hr after inhalation falling down of FVC, FEV p, and DLCO in pulmonary function test and leukocytosis with fever upto 38.2C with antigenic extract of oyster mushroom spore. The size of spore was approximately 3.5 when measured by transmission electron microscopy.
Adult ; Alveolitis, Extrinsic Allergic* ; Bronchial Provocation Tests ; Cough ; Dyspnea ; Fever ; Humans ; Hypersensitivity* ; Inhalation ; Intradermal Tests ; Leukocytosis ; Microscopy, Electron, Transmission ; Myalgia ; Ostreidae* ; Pleurotus* ; Respiratory Function Tests ; Spores*

Polyvesicular vitelline tumor of the ovary is an extremely rare variant of yolk sac tumor. We present a case of pure polyvesicular vitelline tumor in a 43-year-old woman. Light microscopy revealed a predominantly polyvesicular pattern embedded in mesoblastic stroma with the cysts showing two type of lining; tall columnar and cuboidal, or mesothelioid cells. The lining atypical cells showed occasional mitoses and intracytoplasmic PAS positive hyaline globules. In some areas, the cystic space contained a large amount of intraluminal hyaline material. Immunohistochemically, alpha- fetoprotein and alpha-1-antitrypsin were detected as a fine granular deposit in the cytoplasm of epithelial cells and hyaline globules. Electron microscopically, marked specialization of the vesicular lining cells suggested a differentiation toward gut structures and mature yolk sac.
Adult ; Cytoplasm ; Endodermal Sinus Tumor ; Epithelial Cells ; Female ; Fetal Proteins ; Humans ; Hyalin ; Microscopy ; Mitosis ; Ovary* ; Vitellins* ; Yolk Sac

Polyvesicular vitelline tumor of the ovary is an extremely rare variant of yolk sac tumor. We present a case of pure polyvesicular vitelline tumor in a 43-year-old woman. Light microscopy revealed a predominantly polyvesicular pattern embedded in mesoblastic stroma with the cysts showing two type of lining; tall columnar and cuboidal, or mesothelioid cells. The lining atypical cells showed occasional mitoses and intracytoplasmic PAS positive hyaline globules. In some areas, the cystic space contained a large amount of intraluminal hyaline material. Immunohistochemically, alpha- fetoprotein and alpha-1-antitrypsin were detected as a fine granular deposit in the cytoplasm of epithelial cells and hyaline globules. Electron microscopically, marked specialization of the vesicular lining cells suggested a differentiation toward gut structures and mature yolk sac.
Adult ; Cytoplasm ; Endodermal Sinus Tumor ; Epithelial Cells ; Female ; Fetal Proteins ; Humans ; Hyalin ; Microscopy ; Mitosis ; Ovary* ; Vitellins* ; Yolk Sac

Degenerative arthritis of the lumbar spine is one of the main causes of the low back pain over the fifth decade of life. Nowadays, it seems that the number of obese person increases gradually and the role of Obesity in the development of articular degeneration remains controversial. The authors studied 100 cases of the primary degenerative arthritis of the lumbar spine clinically and statistically and compared 50 cases among these with 2 control groups, with and without low back pain, from Mar. 1982 to Sep. 1982. The results were as follows: 1. Among the patients with the degenerative arthritis of the lumbar spine, the ratio of male to female was 1:4, and the age group with the highest frequency was the 6th decade (47%) 2. 44% was obese in the arthritis group and 26% in the control group with low back pain and 12% in the control group without low back pain. 3. The relative risk of the hypothesis that the arthritic patient is obeser than the patient with low back pain but without degenerative changes on X-ray was 2.3, but the hyposthesis was proved to be statistically insignificant. The relative risk of the hypothesis that the arthriticpatient was obeser than the patient without low back pain and degenerative changes on X-ray was 6.3 and proved to be statistically significant.
Arthritis ; Female ; Humans ; Low Back Pain ; Male ; Obesity ; Osteoarthritis ; Spine

Neoplasms showing both carcinomatous and sarcomatous features are well established, and have been reported in practically every organ where carcinoma can occur. But the difference in terminology and difficulties in histopathologic interpretation have hampered adequate understanding of these neoplasms. We report a case of carcinosarcoma in the recurrent form of serous cystadenocarcinoma of the ovary. The patient was a 64-year-old female who underwent total hysterectomy and bilateral salpingoophorectomy three years ago, due to perforated papillary serous cysta denocarcinoma of the right ovary. Recurrent pelvic masses contained both carcinomatous and sarcomatous components. Morphological transition between carcinomatous and sarcomatous components, and epithelial characteristics in the sarcomatous component by immunohistochemistry were recognized. We postulate the histopathogenetic mechanism based on the phenotypic conversion of carcinoma into sarcoma in the carcinosarcoma.
Carcinosarcoma* ; Cystadenocarcinoma, Serous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Middle Aged ; Ovary* ; Sarcoma

A case of an ovarian mucinous cystadenocarcinoma with mural nodules of anaplastic carcinoma is reported. The patient was a 46-year-old female with a right ovarian cystic mass and underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The patient died of the disease in five months. Macroscopically, the right ovarian cyst wall contained numerous well-demarcated mural nodules. Histologically, the cysts were mucinous cystadenocarcinoma, and the nodules were composed of sarcoma-like spindle and polygonal cells with atypia and numerous mitoses. Spindle cells in the mural nodule showed epithelial characteristics by electron microscopy and immunohistochemistry. This case supports an epithelial origin of the mural nodule of anaplastic carcinoma in ovarian mucinous tumors.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Microscopy, Electron ; Middle Aged ; Mitosis ; Mucins* ; Ovarian Cysts ; Ovary

No abstract available.
Hydronephrosis*

No abstract available.
Encephalitis, Herpes Simplex* ; Herpes Simplex*

No abstract available.
Encephalitis, Herpes Simplex* ; Herpes Simplex*

Urea reduction ratio (URR) and Kt/Vurea are objective parameters of dialysis delivery in hemodialysis patients and correlate with nutritional status and patient outcome. URR and Kt/Vurea depend on postdialysis blood urea nitrogen (BUN). In patients with severe postdialysis urea rebound (PDUR), these parameters do not accurately reflect dialysis adequacy. We measured PDUR 30 minutes after dialysis in 26 chronic stable hemodialysis patients. The impact of PDUR on dialysis delivery assessed by URR and Kt/Vurea and the independent factors affecting on PDUR were evaluated. All patients had been dialyzed for 4 hours thrice a week using hemophan membrane. 1) The mean age of patients was 48.6+/-14.8 years and sex ratio was 1:2.3. The mean duration of hemodialysis was 42.7+/-45.0 months. Primary renal diseases were chronic glomerulonephritis 11 (42.3%), diabetic nephropathy 7 (26.9%), and hypertension 4 (15.4%). 2) The mean blood flow was 209.2+/-17.4ml/min. URR, Kt/Vurea, and nPCR using immediate postdialysis BUN were 60+/-7%, 1.13+/-0.21, 1.09+/-0.28g/kg/ day, respectively. The mean recirculation rate was 4.4+/-2.3%. 3)The mean PDUR was 12.2+/-4.6% (range:6-22 %). URR, Kt/Vurea, and nPCR using BUN 30 minutes after dialysis were 55+/-7%, 0.99+/-0.18, and 1.02+/-0.25 g/kg/day, respectively and were significantly lower than those using immediate postdialysis BUN (P<0.05). 4) When the patients were divided according to the degree of PDUR (low PDUR group:<12%, high PDUR group: > or = 12%), high PDUR group was significantly higher than low PDUR group in hematocrit (27.0+/-2.6 vs. 23.5+/-3.6%, P=0.008), URR (64.3+/-5.4 vs. 55.8+/-6.8%, P=0.002), Kt/Vurea (1.26+/-0.17 vs. 1.03+/-0.18, P=0.002), and total recirculation rate (5.6+/-2.7 vs. 3.6+/-1.7%, P=0.05). There were no differences in age, sex, postdialysis body weight, ultrafiltration rate, blood flow, serum albumin, predialysis BUN, creatinine, and nPCR. 5) In multiple regression analysis, the independent factors affecting on PDUR were Kt/Vurea (beta=0.546, P<0.001), recirculation rate (beta=0.422, P<0.001), and hematocrit (beta=0.366, P=0.0017). In conclusion, we think that PDUR should be considered in hemodialysis patients when estimating dialysis delivery, especially if they had high Kt/ Vurea, recirculation rate, and hematocrit.
Blood Urea Nitrogen ; Body Weight ; Creatinine ; Diabetic Nephropathies ; Dialysis* ; Glomerulonephritis ; Hematocrit ; Humans ; Hypertension ; Membranes ; Nutritional Status ; Renal Dialysis* ; Serum Albumin ; Sex Ratio ; Ultrafiltration ; Urea*