Chromomycosis is a chronic cutaneous fungal infection characterized by the presence of dark brown parasitic forms of fungi in biopsied tissues. It is usually resulted from the entry of the causative organism through a minor trauma, and therefore, most lesions are found on the exposed part of the body, such as limbs or face, and occurrence on the nasolacrimal duct is extremely rare. We report a case of chromomycosis of the right nasolacrimal duct, which was presented with clinical symptoms of nasolacrimal duct obstruction. The patient was a 40 year-old male who had had minor injuries on his left eye twice by paper and branches of the tree two months prior to epiphora in right eye. On dacryocystorhinostomy, right nasolacrimal duct was obstructed by pinkish brown mucoid ball. Microscopically, the mucoid ball revealed eosinophilic, amorphous, necrotic materials admixed with brown pigmented fungi. The organism showed characteristic dark brown, round, thick-walled, often septated, sclerotic bodies and brown pigmented long bead-like hyphae. The adjacent mucosa shows marked chronic nonspecific inflammation with fibrosis.
Male ; Humans

It is not clear whether glomerular hypertrophy is related to the pathogenesis of focal segmental glomerulosclerosis (FSGS). We analyzed renal biopsies from 20 adults with FSGS by morphometry, and the data were compared with those from age- and sex-matched patients with minimal lesion. Mean glomerular volume in the FSGS group was significantly larger than that in the minimal lesion group[(3.4 + 1.1 vs 2.5 0.5)x10(6) micrometer3, P<0.01]. The percentage of glomeruli with global and segmental sclerosis in FSGS group was significantly correlated with the mean glomerular volume (r=+0.66, P<0.001). Relative interstitial volume of renal cortex in the FSGS group was correlated with the serum creatinine concentration(r=+0.5, P<0.05). These results suggest that glomerular hypertrophy observed in our patients with FSGS was related to nephron loss caused by glomerulosclerosis. The interstitial fibrosis may lead to obliteration of postglomerular interstitial capillary network with secondary elevation of glomerular capillary pressure resulting in progressive loss of renal function.
Adult ; Male ; Female ; Humans ; Biopsy

We reviewed five cases of Uterine leiomyomas, each with a conspicuously, yellow cut surface, among 198 consecutive cases of surgically removed uterine leiomyomas. Their gross findings were not significantly different from ordinary leiomyomas except for their pale to bright Yellowish cut surface. Microscopically, multiple small clusters of clear cells were widely scattered in otherwise hypercellular leiomyornas in 4 of the 5 cases. Of those, one case gave a positive reaction of Oil-Red O stain. Ultrastructurally, clear cells corresponded to the degenerating smooth muscle cells with intracytoplasmic lipid vacuoles. The rest of cells showed myofibers undergoing varying degrees of degeneration. Focal accumulation of foamy histiocytes was associated with carneous degeneration in one case. We conclude that the yellowish leiomyoma of the uterus seems, in part, to reflect accumulation of a lipid substance in degenerating hypercellular leiornyoma, or possibly collections of xanthoma cells in secondary degeneration.

We described a case of well differentiated papillary mesothelioma (WDPM) of the peritoneum in a 68-year-old man because of its rarity. It was incidentally found during operation for renal cell carcinoma. Grossly, the tumor appeared as multiple small granules or nodules on the entire peritoneal surface, including serosa of the intestine, omentum and mesentery. Microscopically, characteristic features are papillary, tubulopapillary or solid architecture lined by single layer of uniform, cytologically bland, cuboidal or polygonal mesothelial cells. The tumor cells were positive for EMA, cytokeratin and vimentin, but negative for CEA on immunohistochemical staining. Ultrastructural study showed characteristic long slender microvilli on the surface and intercellular junctions.
Male ; Humans

BACKGROUND/AIMS: Although the mechanism of hepatocellular carcinogenesis still remains to be clarified, it has been suggested that persistent hepatic necrosis and resultant irregular regeneration might cause genetic mutations, such as activation of protooncogenes, inactivation of tumor suppressor genes and modulation of apoptosis-related genes, finally leading to hepatocellular carcinoma (HCC). To elucidate the role of cell proliferative activity and apoptosis, a major mechanism of cell death, in hepatocellular carcinogenesis, we analyzed expression of proliferation cell nuclear antigen (PCNA), p53 protein and apoptotic cells in HCC and surrounding nonneoplastic hepatic parenchyma. METHODS: We performed immunohistochemical staining to detect P CAN, p53 protein, and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labelling (TUNEL) method for the detection of apoptosis in 52 hepatocellular carcinomas and their adjacent nonneoplastic liver. We scored the expression of PCNA and p53, and apoptotic index by a 5 point scale' 0, 0%,1, 1-25%', 2, 25-50%, 3, 50-75%', 4, >76%, and analyzed the results with other clinicopathologic characteristics. RESULTS: p53 protein was expressed in 42.3% of the HCC, but was not evident in nonneoplstic liver. P53 overexpression was correlated with the histologic grade of HCC (p<0.05). PCNA labelling indices (LI) of HCC were correlated with those of liver cell dysplasia and normal liver (p<0.05). Leading edges of HCCs showed higher proliferative activity than the central part of HCC. Four cases of HCCs with high TUNEL also showed high proliferative activity. There was no difference of the TUNEL between HCC and surrounding nonneoplastic liver. Expression of p53, PCNA LI and TUNEL had no relationship with clinicopathologic parameters including viral markers, aFP elevation, tumor size and underlying cirrhosis. CONCLUSION: p53 overexpression in HCC and absence of p53 mutation in nonneoplastic liver indicates the active participation of p53 in hepatocellular carcinogenesis. Invasiveness and metastatic potential appear to be related with the strong expression of PCNA, but apoptosis in HCC has no direct implication in hepatocellular carinogensis.
Apoptosis* ; Biomarkers ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Cell Death ; Fibrosis ; Genes, Tumor Suppressor ; In Situ Nick-End Labeling ; Liver* ; Necrosis ; Proliferating Cell Nuclear Antigen ; Regeneration

PURPOSE: An adjustable fadenoperation is recently developed surgical procedure which was designed to use adjustable suture by combining resection and recession of a single rectus muscle. An inferior rectus recession, especially on an adjustable suture, has a drawback which allows slippage of the muscle and may cause an postoperative overcorrection. Therefore, we performed so called "Reinforced adjustable fadenoperation", a procedure that added the reinforced fixation suture to the new insertion site of the sclera, and hereby we report the case. METHODS: A fifty three year-old man with right inferior rectus muscle palsy was treated with reinforced adjustable fadenoperation. Under the topical anesthesia, we performed 11 mm resection and adjustable 12 mm recession until diplopia was diappeared. To prevent postoperative slippage of the new insertion, reinforced suture was fixed at the sclera using 5-0 Polyester (Dacron(R)). RESULTS: On postoperative 1 month, ocular motility examination showed an orthophoria in primary gaze and also in down gaze by 25 degrees. Binocular diplopia-free field was expanded except in extreme down gaze. CONCLUSIONS: The reinforced adjustable fadenoperation is a modification of the conventional fadenoperation or the adjustable fadenoperation. It may be applied to the inferior rectus muscle surgery which is known for the slippage of the muscle.
Anesthesia ; Diplopia ; Paralysis ; Polyesters ; Sclera ; Sutures ; Telescopes

We report a case of solitary congenital calcified nodule of the ear in a 1-year-old female. The lesion was a 2 X 2mm-sized, elevated, slightly erythematous and whitish-centered nodule located since birth on the superior helical rim of her left ear. Histopathological findings fram the totally excised lesion showed calcium deposits as amorphous, basophilic masses in the upper dermis and focal discharge of calcium by means of transepidermal elimination. Surrounding the calcium deposits, lymphohistiocytic infiltrations were present.
Basophils ; Calcium ; Dermis ; Ear* ; Female ; Humans ; Parturition

The survival rate of neonates with aberrations of chromosome 16 is very low because they are incompatable with life. We encountered a case of a chromosome 16 aberration in a female neonate who showed multiple congenital malformations suggestive of chromosomal anomaly including round face, hypertelorism, low-set ears, cleft palate, multiple heart anomalies, bilateral hearing loss, right multicystic dysplastic kidey, proximally located thumbs, planovalgus, and muscle hypotonia. We report the case with a brief review of the literature.
Chromosomes, Human, Pair 16* ; Cleft Palate ; Ear ; Female ; Hearing Loss, Bilateral ; Heart ; Humans ; Hypertelorism ; Infant, Newborn ; Kidney* ; Multicystic Dysplastic Kidney ; Muscle Hypotonia ; Survival Rate ; Thumb

INTRODUCTION: The phenomenon related to sign & symptom management for end of life of the patients is of interest to researchers in nursing society today. This study was conducted to clarify and to conceptualize the factors of sign & symptom management in end of life care though nurses' perceptions on this phenomena. METHODS: The qualitative study method was used to explore the experienced nurses' perceptions related to sign & symptom management in end of life care. It included a field study carried out in South Korea using in-depth interviews with 30 experienced nurses from three nursing home facilities. RESULTS: This study identified the following categories related to end of life care with sub-categories for each category: (1) nurses' modes in identifying the signs related to patients' end of life, (2) nurses' perceived directions on patients' end of life care, (3) nurses' perceived strategies in end of life care and (4) nurses' perceived barriers in end of life care. CONCLUSION: Through this study, characteristics of the way nurses' provide for patients' end of life care are identified, along with how nursing decisions are made to manage the sign & symptom indicating patients' end of life.
Humans ; Nursing Homes ; Republic of Korea ; Societies, Nursing ; Terminal Care

PURPOSE: This study was conducted to compare in vivo biofilm formation on titanium surface and zirconia surface. MATERIALS AND METHODS: For biofilm formation on titanium and zirconia in oral cavity, after producing oral appliances using acrylic resin and orthodontic wire tailored to 9 subjects, we made titanium and zirconia specimens (6 mm x 6 mm x 2 mm), fixed them on oral appliances and maintained them in oral cavity of test subjects for 24 and 72 hours. Test subjects who have equipped two pairs of specimens maintained oral hygiene not by using toothpaste but only by tooth brushing. After 24 and 72 hours, we removed and observed specimens through scanning electron microscopy (SEM). RESULTS: Biofilm formation showed large deviation depending on individuals. For formation comparison between titanium and zirconia for 24 hours, zirconia showed less biofilm formation than titanium. Biofilm formation showed large deviation depending on individuals. As for formation comparison between zirconia and titanium, the degree of biofilm formation in zirconia was less than it was in titanium after a lapse of 24 hours. The result of biofilm formation in 72 hours trial show that zirconia has an inclination to formate less biofilm than it was in titanium. CONCLUSION: Based on the above results, we can conclude that early biofilm formation in oral cavity was influenced by difference of abutment materials.
Biofilms* ; Microscopy, Electron, Scanning ; Mouth ; Oral Hygiene ; Orthodontic Wires ; Titanium* ; Tooth ; Toothpastes ; Zirconium