Peutz-Jeghers syndrome is an autosomal dominant disease characterized by gastrointestinal ployposis and mucocutaneous melanin pigmentation involving the lip, oral mucosa, digits, palms and soles. The polyps are almost hamartomatous. The relationship of gastrointestinal carcinoma and the Peutz-Jeghers syndrome has been discussed for many years. The question is unsettled whether gastrointestinal carcinoma arise in hamartomatous polyps itself. Recently, there are a few reports that adenomatous and carcinomatous changes were superimposed upon the background of the hamartoma. Occasionally epithelial misplacement of the epithelium is found in the small intestinal polyps. Since the epithelial misplacement may involve submucosa, muscularis propria and serosa, a difficulty of histopathologic differential diagnosis between the epithelial misplacement and invasive adenocarcinoma cause overdiagnosis of cancer in the gastrointestinal polyps of Peutz-Jeghers syndrome. We present a case of Peutz-Jeghers syndrome of 39-year-old woman with multiple gastrointestinal polyps, two of which showed extensive epithelial misplacement even into the pancreas and another one at the colon showed carcinomatous change at the tip portion. Areas of hamartoma, adenoma and in situ carcinoma were noted in this colonic hamartomatous polyp. This case support that adenoma and carcinomatous changes may evolve directly within a hamartomaous polyp itself.
Female ; Humans ; Diagnosis, Differential ; Adenocarcinoma ; Adenoma

No abstract available.
Biopsy, Fine-Needle* ; Breast*

No abstract available.
Biopsy, Fine-Needle* ; Histiocytosis, Langerhans-Cell*

When coexistence of carcinoma with similar histologic type is present in female genital tract, it is difficult to differentiate independent primary tumor from metastasis. Most of them are endometrial and ovarian tumors, but coexistence of uterine cervical and ovarian tumor with similar histologic type is rare. We experienced an independent primary tumor of ovarian mucinous cystadenocarcinoma associated with mucinous adenocarcinoma of uterine cervix. The patient was a 50-year-old woman. She had a lower abdominal mass which was detected as a huge cyst on ultrasonography. Although the ovarian lesions were bilateral, features that preferred to consider independent primary tumor are listed as; absence of lymphatic or vascular invasion, absence of ovarian surface implant, superficial invasion of cervical tumor, absence of tumor in abdominal cavity, and disease free follow-up after removal of the tumor.
Female ; Humans ; Cysts ; Adenocarcinoma

Pseudopolyps represent discrete areas of mucosal inflammation and regeneration that are seen in a variety of inflammatory bowel disease including ulcerative colitis and Crohn's disease. These polyps are typically short, measuring less than 1.5 cm in height. Rarely, localized giant pseudopolyposis can occur, i.e., a collection of larger inflammatory pseudopolyps giving rise to a mass lesion within the colon. The most serious problem concerned with pseudopolyposis is a confusion with carcinoma. We experienced a case of localized giant pseudopolyposis causing partial large bowel obstruction. Right hemicolectomy was done for a preoperative diagnosis of ascending colon carcinoma. The resected specimen contained a circumferential lesion, which was composed of numerous interconnecting cylindrical villi, measuring 12 cm in length and 3 cm in height. Microscopically, these polypoid lesions were inflammatory pseudopolyps. Several deep fissure-like ulcerations were noted with multifocal microabscess, lymphoid hyperplasia and an area of noncaseating granuloma.

Pneumocystis carinii is the most common cause of diffuse pulmonary infiltrates in the immunocompromised patients. Microscopically, Pneumocystis carinii pneumonia(PCP) shows characteristic frothy intraalveolar exudate and interstitial lymphocytic and plasma cell infiltrate. However, sometimes the only histologic finding of PCP on routine hematoxylin-eosin stain is that of diffuse alveolar damage(DAD), when we can miss the diagnosis without aid of special stains. We report a case of Pneumocystis carinii pneumonia presenting as DAD in a 50-year old man after chemotherapy due to malignant lymphoma. Open lung biopsy specimen reveals the early stage of DAD without any characteristic findings, such as foamy exudate. However many cysts of Pneumocystis carinii were found on Gomori's methenamine silver(GMS) stain. Therefore, GMS stain should be routinely performed on all biopsy specimens obtained from immunocompromised patients.
Male ; Humans ; Cysts ; Biopsy

No abstract available.
Biopsy, Fine-Needle*

The present study was conducted to examine metabolic risk factors and total antioxidant capacity (TAC) of Korean females living in Seoul and to investigate the relationship between the metabolic risk factors and serum TAC. A total of 353 females aged between 20 and 64 participated in the study. Obesity indicators, blood pressure, serum lipid profile and fasting blood glucose were measured as metabolic risk factors. Ferric reducing antioxidant power (FRAP) assay was employed to determine serum TAC of subjects. Obesity indicators such as body mass index, waist circumference and waist-hip ratio were significantly higher in the participants aged > or = 50 y (older group) than in the participants aged 20-49 y (younger group) (p < 0.001). Blood pressure, serum total cholesterol (TC), riglyceride (TG) and fasting blood glucose were also significantly higher in the older group than in the younger group (p < 0.001), demonstrating significant positive correlations between age and MS risk factors. The association between FRAP and MS risk factors were also investigated. FRAP values showed significant positive correlations with age (p = 0.001), serum TG (p = 0.002) and TC (p = 0.03). A tendency of positive association between FRAP and waist circumference was observed without any significant difference (p = 0.06). Increased serum FRAP with central obesity and serum lipids may be interpreted as results of activation of antioxidant defense system against oxidative stress induced by metabolic syndrome (MS) constituent factors. However, to verify the function of FRAP as a potential biomarker of susceptibility to MS various contributors to the plasma antioxidant capacity and their biological relevance related to MS should be elucidated further.
Aged ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Fasting ; Female ; Humans ; Obesity ; Obesity, Abdominal ; Oxidative Stress ; Plasma ; Risk Factors ; Waist Circumference ; Waist-Hip Ratio

A total 48 cases of tuberculous lesion in the lymph nodes(43 cases), lung (3 cases) and soft tissue(2 cases), was subjected to fine needle aspiration cytology(FNAC). The age of the patients ranged from 19 to 77 year-old(average 33.6 years in age) and the male to female ratio was 1:4. Thirty-four cases (70.8%) demonstrated distinct granulomatous reaction with or without caseastion necrosis, nine cases(18.8%) showed no granulomas, but large amount of necrotic debris with numerous polymorphonuclear cells and histiocytes, and five cases (10.4%) revealed acellular material only. The overall AFB positivity in smears was 62.5%. In areas associated with granulomatous reaction and necrosis, AFB positivity was 55.8%, while it was 80.0% in cases with acellular necrotic material. There were 2 cases of parasitic infestation which could not be easilty differentiated from tuberculosis based on aspiration smears only.
Biopsy, Fine-Needle* ; Diagnosis* ; Female ; Granuloma ; Histiocytes ; Humans ; Lung ; Male ; Necrosis ; Tuberculosis*

OBJECTIVES: The objective of this study was to identify the factors associated with suicidal ideation among the elderly living alone received the elderly care service in a rural area. METHODS: This study was surveyed 206 the elderly living alone who received the elderly care service in G-gun, Jeollanamdo. The collected data were socio-demographic and health-related characteristics, family support and suicidal ideation. The used methods for statistical analysis were used t-test, analysis of variance, Pearson's correlational analysis and the multiple logistic regression analysis. RESULTS: In univariate analysis, the suicidal ideation of the elderly living alone was statistically significant associated with age, monthly income, sufficiency of sleeping, depression, stress, activities of daily living, instrumental activities of daily living, perceived health status and family support. As a result of multiple regression analysis, the associated factors with suicidal ideation were age, depression, stress and the activities of daily living. CONCLUSIONS: The suicidal ideation of the elderly living alone in the rural area was associated with age, mental health and independency of living. It will be needed the multidisciplinary approaches to prevent the suicidal ideation and attempts of the elderly living alone.
Activities of Daily Living ; Aged* ; Depression ; Family Characteristics ; Humans ; Jeollanam-do ; Logistic Models ; Mental Health ; Suicidal Ideation*