PURPOSE: To evaluate morphologic characteristics of the microcalcifications on mammography that were confirmed pathologically. MATERIALS AND METHODS: Forty five cases of microcalcifications on mammography (fifteen cases of benign lesion, thirty cases of maiignancy) were retrospectively reviewed. RESULTS: The number of microcalcifications within 1 cm2 were more than 5 in 22 cases (73%) of 30 malignancy and less than 5 in 11 cases (73%) of 15 benignity. The heterogeneity of microcalcifications were seen in 26 cases of malignancy (87%) and the homogeneity of microcaicifications were 11 cases of benignity (73%). The morphologic characteristics of the microcalcifications were linear-V shape in 9 cases (30%), punctate shape in 8 cases (27%), fine stippled shape in 7 cases (23%), and round dot shape in 6 cases (20%) of malignancy and, round dot shape in 11 cases (73%), punctate shape in 2 cases (13%), and linear-V shape in 2 cases (13%) of benignity. CONCLUSION: Numerous irregular microcalcifications that are heterogenous in size and morphology were strong indicators of malignancy.
Mammography ; Population Characteristics ; Retrospective Studies

Behcet's disease (BD) involves multisystem vasculitis of unknown origin. Ocular manifestations of BD mostly include bilateral panuveitis and retinal vasculitis, which are very challenging to treat. Interferon alfa-2a (IFN) has been recently introduced for treating refractory Behcet uveitis, mainly in Germany and Turkey. Nonetheless, there is so far no consensus about the ideal treatment regimen of IFN for Behcet uveitis. We report our experience of IFN treatment in five Korean BD patients with refractory uveitis. All patients complained of oral ulcers; one patient had a positive pathergy test and 2 showed the presence of HLA-B51. Immunosuppressive agents used prior to IFN treatment included cyclosporine and methotrexate. The IFN treatment was commenced with a dose of 6-9 MIU/day for 7 days, adjusted according to individual ocular manifestations, tapered down to 3 MIU three times in a week, and then discontinued. All patients showed positive response to IFN treatment; 50% of them showed complete response without additional major ocular inflammation during the follow-up period. Other BD symptoms also improved after IFN treatment in most cases. After treatment, the relapse rate and the required dose of oral corticosteroid were decreased in most cases, showing a significant steroid-sparing effect. However, the visual acuity was not improved in most cases due to irreversible macular sequelae. Despite the small sample size of this study, we suggest that, in Korean patients, IFN is an effective treatment modality for BD uveitis as was observed in German and Turkish patients.
Adult ; Behcet Syndrome/complications/diagnosis/*drug therapy ; Chronic Disease ; Cyclosporine/therapeutic use ; Female ; Humans ; Immunosuppressive Agents/administration & dosage ; Interferon-alpha/*therapeutic use ; Male ; Recombinant Proteins/therapeutic use ; Recurrence ; Remission Induction ; Treatment Outcome ; Turkey ; Uveitis/diagnosis/*drug therapy/etiology ; Visual Acuity

PURPOSE: The aim of this study was to investigate the changes in and implications of preoperative and postoperative serum uric acid levels in patients with living donor nephrectomy. MATERIALS AND METHODS: We studied 207 patients between 1998 and 2007 at our hospital undergoing living-donor nephrectomy for kidney transplantation. The serum uric acid level and estimated glomerular filtration rate (eGFR) were measured preoperatively and at 1 year postoperatively. We also analyzed multiple independent variables such as age, sex, blood pressure, body mass index (BMI), serum total cholesterol, hemoglobin, hematocrit, total protein, albumin, calcium, and phosphorus. RESULTS: The mean age of the study patients was 38.3+/-10.8 years. The mean serum uric acid concentration at 1 year after kidney donation was higher than preoperatively (5.05+/-1.39 mg/dl preoperatively vs. 5.85+/-1.14 mg/dl postoperatively) and was significantly greater in patients with hyperuricemia (uric acid> or =6.8 mg/dl) than in patients without hyperuricemia (uric acid < 6.8 mg/dl): 1.63+/-0.75 mg/dl vs. 0.69+/-0.66 mg/dl, respectively. The multivariate analysis showed that preoperative serum uric acid was the primary predictive factor of postoperative serum uric acid (r=1.136, p=0.001), and preoperative GFR was an independent secondary predictive factor (r=-0.004, p=0.047). The receiver operator characteristics (ROC) curves for the preoperative serum uric acid cutoff of 5.7 mg/dl showed the highest sensitivity and specificity of 96% and 86%, respectively. CONCLUSIONS: These results suggest that preoperative serum uric acid and GFR were important predictive factors of postoperative serum uric acid after living-donor nephrectomy. Therefore, in the selection and management of kidney donors, not only patients with a low GFR but also those with high uric acid (serum uric acid > or =5.7 mg/dl) require careful observation before and after living-donor nephrectomy.
Blood Pressure ; Body Mass Index ; Calcium ; Cholesterol ; Glomerular Filtration Rate ; Hematocrit ; Hemoglobins ; Humans ; Hyperuricemia ; Kidney ; Kidney Transplantation ; Living Donors ; Multivariate Analysis ; Nephrectomy ; Sensitivity and Specificity ; Tissue Donors ; Uric Acid

PURPOSE: To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. MATERIALS AND METHODS: We retrospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involvingthe greater trochanter and ischium. In each case, the following were analyzed : morphology of bone destruction, including cortical erosion; periosteal reaction ; presence or abscence of calcific shadows in adjacent softtissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. RESULTS: Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. Inaddition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. CONCLUSION: Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that the selesions result from an extrinsic pathophysiologic cause such as adjacent bursitis.
Bursitis ; Femur* ; Ischium* ; Osteitis* ; Osteomyelitis

PURPOSE: To investigate whether subfoveal choroidal thickness, measured using enhanced depth imaging optical coherence tomography (EDI-OCT), is an indicator of subclinical ocular or systemic inflammation in eyes with Behçet disease (BD) without active ocular inflammation. METHODS: A retrospective analysis was used to examine clinical features of non-uveitic patients with BD (NUBD group), patients with a previous history of Behçet uveitis in an inactive state (IUBD group), and healthy controls were evaluated from October 2014 to September 2015. Subfoveal choroidal thickness was measured using EDI-OCT. RESULTS: The NUBD group included 46 eyes in 24 patients; the IUBD group included 16 eyes in 11 patients; and the control group included 35 eyes in 23 individuals. The mean subfoveal choroidal thicknesses differed significantly among these groups. Choroidal thickness was significantly greater in the NUBD (310.5 ± 81.0 µm) than in the IUBD (263.1 ± 56.6 µm, p = 0.013) and control (256.9 ± 67.9 µm, p = 0.002) groups. The disease activity score was significantly higher in the NUBD than in the IUBD group (p < 0.001), while the use of cyclosporine was significantly associated with choroidal thickness in eyes with NUBD (p = 0.039). CONCLUSIONS: Subfoveal choroidal thickness, as measured by EDI-OCT, may be a clinical indicator of subclinical ocular inflammation and systemic inflammation in BD patients without active ocular inflammation.
Behcet Syndrome* ; Choroid* ; Cyclosporine ; Humans ; Inflammation* ; Retrospective Studies ; Tomography, Optical Coherence ; Uveitis

Recombinant human parathyroid hormone 1-34 (rHPTH; 1-34, teriparatide) increases bone mass and increases osteoporotic fracture by stimulating new bone formation. It was approved in the United States for treatment of osteoporosis in men and women, and its effectiveness and safety was proved. Mild hypercalcemia was observed, but persistent and severe hypercalcemia was not observed in the studies of teriparatide. In this case, severe hypercalcemia was developed from patient having gait disturbance who was treated with vitamin D, calcium and teripartide for two months to treat osteoporosis after subtrochanteric fracture. Hypercalcemia was resolved with discontinuation of teriparatide. Severe hypercalcemia is not a common complication of teriparatide and monitoring of serum calcium level is routinely not recommended. But it is necessary to pay close attention to patients who were treated with teriparatide, especially in immobilized patients.
Calcium ; Female ; Gait ; Humans ; Hypercalcemia ; Male ; Osteogenesis ; Osteoporosis ; Osteoporotic Fractures ; Parathyroid Hormone ; Teriparatide ; United States ; Vitamin D

Recombinant human parathyroid hormone 1-34 (rHPTH; 1-34, teriparatide) increases bone mass and increases osteoporotic fracture by stimulating new bone formation. It was approved in the United States for treatment of osteoporosis in men and women, and its effectiveness and safety was proved. Mild hypercalcemia was observed, but persistent and severe hypercalcemia was not observed in the studies of teriparatide. In this case, severe hypercalcemia was developed from patient having gait disturbance who was treated with vitamin D, calcium and teripartide for two months to treat osteoporosis after subtrochanteric fracture. Hypercalcemia was resolved with discontinuation of teriparatide. Severe hypercalcemia is not a common complication of teriparatide and monitoring of serum calcium level is routinely not recommended. But it is necessary to pay close attention to patients who were treated with teriparatide, especially in immobilized patients.
Calcium ; Female ; Gait ; Humans ; Hypercalcemia ; Male ; Osteogenesis ; Osteoporosis ; Osteoporotic Fractures ; Parathyroid Hormone ; Teriparatide ; United States ; Vitamin D

Gallbladder carcinoma is an uncommon neoplasm, and hemobilia caused by this disease is rare. We present a case of hemobilia in a patient with gallbladder carcinoma, which was recognized at forward duodenoscopy. A 42-year-old man visited our hospital due to intermmittent right upper quadrant pain. Duodenoscopy revealed blood clots with bile juice around the ampulla of Vater and the second portion of the duodenum. Endoscopic ultrasonography for the gallbladder showed a dumbell-shaped mass with a homogenous internal echogenicity on the body of the gallbladder. MR cholangiography showed a lobulated mass with low-signal intensity in the T1-weighted and T2-weighted images. Subsequently, laparoscopic cholecystectomy with regional lymph node dissection was performed, and adenocarcinoma was confirmed.
Adenocarcinoma ; Adult ; Ampulla of Vater ; Bile ; Cholangiography ; Cholecystectomy, Laparoscopic ; Duodenoscopy ; Duodenum ; Endosonography ; Gallbladder* ; Hemobilia* ; Humans ; Lymph Node Excision

We herein report a case of ectopic prostate tissue involving the posterior wall of the bladder. A 33-year-old man was referred to our hospital because of a bladder tumor that was incidentally discovered on abdominal ultrasonography (US). US and computed tomography (CT) showed a 1.5x2.0cm sized tumor in the posterior wall of the bladder. Cystoscopic examination revealed a sessile tumor, covered with normal bladder mucosa in the posterior wall of the bladder. Transurethral resection of the bladder tumor was carried out and the origin of the tissue was confirmed by immunohistochemical staining for prostate specific antigen. The histopathological examination revealed benign prostate tissue that was situated ectopically.
Adult ; Humans ; Mucous Membrane ; Prostate* ; Prostate-Specific Antigen ; Ultrasonography ; Urinary Bladder Neoplasms ; Urinary Bladder*

Myxofibrosarcoma is also known as a myxoid variant of malignant fibrous histiocytoma, and this is one of the most common sarcomas in the extremities of elderly people; it is characterized by a high frequency of local recurrence. We herein report on a case of myxofibrosarcoma of the bladder. A 58-year-old man was referred to our hospital because of microscopic hematuria. Computed tomography(CT) and intravenous pyelography(IVP) showed a 12x7cm sized bladder mass in the pelvic cavity. The cystoscopic finding shows a protruding mass at the dome and posterior wall of the bladder. After exploratory laparotomy and tissue frozen biopsy were done, radical cystectomy and uretero-ileo-cutaneous anastomosis were then carried out. The diagnosis of the tumor was confirmed by histopathological examination. The myxofibrosarcoma of the bladder was completely excised, and there was no evidence of recurrence after 10 months of follow-up.
Male ; Humans ; Biopsy