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.

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

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

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

Primary biliary cirrhosis (PBC) is characterized by histological findings of an immunoinflammatory destruction of small- and medium-sized bile ducts with progressive portal fibrosis, and the presence of anti-mitochondrial antibody (AMA) with a laboratory evidence of chronic cholestasis. The term "autoimmune cholangitis" (AIC) is used for a disease with the clinical and pathologic features of primary biliary cirrhosis (PBC) but with negative AMA and positive anti-nuclear antibody (ANA) tests. Eight cases of AIC and ten cases of PBC were reviewed in order to determine whether there was any difference between two diseases in clinico-pathologic aspects. All of the patients were female and the mean ages of AIC and PBC patients were 48 and 47 years, respectively. ANA test was positive in six of ten PBC paients and their mean titer was lower than that of AIC patients. IgM level was significantly higher in PBC group than in AIC group. No significant difference was found between two groups with respect to biochemical and histopathological features. Since the only consistently distinguishing features between these two conditions are the autoantibody profile (AMA vs ANA) and immunoglobulin level (IgM), these two conditions might be part of a spectrum. PBC can be considered to be the same as AMA-positive AIC or alternatively AIC to be the same as AMA-negative PBC.
Bile Ducts ; Cholangitis* ; Cholestasis ; Female ; Fibrosis ; Humans ; Immunoglobulin M ; Immunoglobulins ; Liver Cirrhosis, Biliary*

Presacral ganglioneuromas are extremely rare benign tumors and fewer than 20 cases have been reported in the literature. Ganglioneuromas are difficult to be differentiated preoperatively from tumors such as schwannomas, meningiomas, and neurofibromas with imaging modalities. The retroperitoneal approach for resection of presacral ganglioneuroma was performed for gross total resection of the tumor. Recurrence and malignant transformation of these tumors is rare. Adjuvant chemotherapy or radiation therapy is not indicated because of their benign nature. We report a case of a 47-year-old woman with a presacral ganglioneuroma.
Chemotherapy, Adjuvant ; Female ; Ganglioneuroma* ; Humans ; Meningioma ; Middle Aged ; Neurilemmoma ; Neurofibroma ; Recurrence ; Sacrum*

PURPOSE: The purpose of this study was to present our thoughts on the medical student evaluation of the courses via online at Konkuk University School of Medicine (KUSM) and to prompt us to improve the course evaluation system. METHODS: Electronic questionnaire for computer-aided course evaluation via online was completed by 93 medical students who attended 32 block lectures at KUSM in 2007. The questionnaire consisted of 21 evaluation items. Frequency analysis of response on the evaluation items was conducted to find out the key features. RESULTS: Evaluation forms for 32 lectures were received from the attendees via online. An average response rate was 63.8%. Among 17 Likert-scaled items, more negative response was observed in class quantity, studying method guidance, lecture note, teaching methods, and relevance of final examination. CONCLUSION: The current course evaluation at KUSM includes more questions that request students to state the overall quality of course modules than the detailed quality or skill of each lecturer. As the objective of the course evaluation is to promote students' learning and to give a feedback to the lecturer, the current consideration on the course evaluation prompted us to reorganize the design of the questionnaire according to the objective.
Educational Measurement ; Electronic Mail ; Electronics ; Electrons ; Humans ; Learning ; Lectures ; Program Evaluation ; Students, Medical ; Teaching ; Surveys and Questionnaires

Complications increases when crown height space is excessive and one should be careful of choosing type of fixed prosthesis in case crown height space is over 12 mm. In this condition, tooth seems to be longer, therefore, it is needed to use gingival shade in aesthetically important area for fixed prosthesis. In this case, fixed prosthesis which has inappropriate maintenance and hygiene could hold food, plaque, calculus, thus increase incidence of inflammation and infection. Moreover, it could lead to chronic inflammation and infection and in that case surgical improvement could be necessary. In present case report, gingival inflammation and swelling developed around prosthesis after having made it considering articulation and aesthetic view in patient who had excessive crown height space. Finding out that design of prosthesis is a factor to make it hard to maintain oral hygiene, a temporary prosthesis which has enough interproximal space and proper emergence profile was fabricated. After two months of observation, significant abnormal symptoms are not found and oral reconstruction is performed using fixed prosthesis with zircornia infrastructure and porcelain build-up based on convenient self hygiene design. Through serial treatment, inappropriate soft tissue response is not observed and satisfactory result in functional aspect comes out.
Calculi ; Crowns ; Dental Porcelain ; Humans ; Hygiene ; Incidence ; Inflammation ; Oral Hygiene ; Prostheses and Implants ; Tooth

Patients with Sjögren's syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a Sjögren's syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.
Dental Occlusion ; Humans ; Methods* ; Rehabilitation* ; Tooth* ; Xerostomia

Patients with Sjögren's syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a Sjögren's syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.
Dental Occlusion ; Humans ; Methods* ; Rehabilitation* ; Tooth* ; Xerostomia