Immunohistochemical staining on paraffin sections for S-100 protein improved diagnostic accuracy for melanocytic tumor. But specificity of S-100 protein in the diagnosis of melanocytic tumor is very low, because S-100 protein was also expressed in neurogenic tumor and salivary gland tumor. To investigate a specific tumor marker for the malignant melanoma, immunohistochemical staining for HMB-45 and S-100 protein was performed on the paraffin sections of 25 cases of malignant melanoma and 46 cases of nevi. Positive reaction for HMB-45 and S-100 protein was diffusely identified in the cytoplasm of tumor cells. Positive ratio for HMB-45 was 100% in malignant melanoma, 92% in junctional component of compound nevus and 0% in intradermal nevus. Positive ratio for S-100 protein was 92% in malignant melanoma, 100% in compound nevus and 100% in intradermal nevus. The sensitivity and specificity for HMB-45 in malignant melanoma were 100%, but those for S-100 protein were 92% in sensitivity and 86.7% in specificity. These results indicate that HMB-45 has a high sensitivity and specificity for malignant melanoma cells and it can be quite useful for the histopathological diagnosis of malignant melanoma.
Sensitivity and Specificity ; Tumor Markers, Biological

Gastrointestinal cytomegalovirus(CMV) infection in adults is observed as a part of a generalized or localized infection in patients who are immunocompromized. We report a case of CMV infection of the small intestine. The patient is a 34 year-old woman who has complained of palpable purpura in the lower extremities and buttocks, and arthralgia of large joints. The skin biopsy showed fibrinoid necrosis and neutrophils with leukocytoclasis, which findings are compatible with hypersensitivity angiitis. The patient received steroid and cyclophosphamide. During the follow-up period, generalized edema and bloody stool were detected. Resected specimen of small bowel has multiple aphthous ulcer. Microscopically, cytomegalic cells are observed along the endothelial cells and mesenchymal cells. In situ hybridization using DNA probes against CMV revealed positive staining in the cytomegalic inclusions in vascular endothelial and mesenchymal cells.
Adult ; Male ; Female ; Humans ; Biopsy

No abstract available.
Chorionic Gonadotropin* ; Fertilization in Vitro* ; Humans*

Although urinary tract infections are common in adults, pyelonephritis is rarely considered in the differential diagnosis of acute renal failure. Acute pyelonephritis without urinary tract obstruction, previous renal diseases or septic shock is a rare cause of acute renal failure. Despite appropriate antibiotic therapy, recovery of renal function could be slow and incomplete. We experienced a 45 year-old woman with diabetes who developed bilateral acute pyelonephritis followed by acute renal failure. The renal biopsy revealed diffuse edematous and focal fibrotic inters- titium with infiltration of lymphocytes compatible with interstitial nephritis. Although her renal function improved gradually with antimicrobial treatment, the process was incomplete and renal dysfunction persisted at about 10-month follow-up, suggesting permanent renal damage. Therefore, we report this case with brief review of related literature.
Acute Kidney Injury* ; Adult ; Biopsy ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Lymphocytes ; Middle Aged ; Nephritis, Interstitial ; Pyelonephritis* ; Shock, Septic ; Urinary Tract ; Urinary Tract Infections

No abstract available.
Pregnancy*

Fibrohistiocytic tumors are a diverse group of benign and malignant soft tissue lesions, including dermatofibroma, dermatofibrosarcomaprotuberans, and malignant fibrous histiocytoma. On the clinical point of view, the distinction between benign and malignant lesions and malignancy grading is far more important. Therefore, we investigated 23 fibrohistiocytic tumors, using PCNA (PC10) which was a useful marker of proliferating activity, to differentiate the benign lesions from the malignant and correlate with other prognostic factors including tumor necrosis. cellularity, histologic grade, and mitotic counts. The results obtained were as follows 1) Positive tumor cells were clearly identified by the characteristic diffuse or granular nuclear staining. 2) The number of PCNA-positive tumor cells were 2.16+/-2.39% in dermatofibroma, 16.12+/-7.38% in dermatofibrosacoma protuberans, and 28.02+/-17.47% in the malignant fibrous histiocytoma. The numbers of PCNA-positive tumor cells in the malignant lesions higher than in the benign (p<0.001). 3) Deep seated, large size (>5 cm) and recurred or metastatic cases of MFH were more the high PCNA index (more than 20%) than the low index (less than 20%) groups. 4) PCNA index in MFHs had positive correlation with the number of mitotic counts (r=0.7582, p<0.001), cellularity (r=0.5908, p<0.05) and histologic grade (r=0.4164, p<0.05). These results suggested that reactivity on PCNA might assist in the distinction between benign and malignant lesions in fibrohistiocytic tumors, and could be a useful prognostic factor in the patients with malignant fibrous histiocytoma.
Neoplasm Metastasis

PURPOSE: To evaluate the role of CT in the diagnosis of bowel and mesenteric injury we studied the CT findings and its usefulness in patients of abdominal trauma. MATERIALS AND METHODS: CT scans of 27 patients who were confirmed to have bowel and/or mesenteric injury due to abdominal trauma were analyzed retrospectively. Of these 27 patients 15 had bowel injury only and 12 had both bowel and mesenteric injury. CT findings analysed were bowel wall thickening, presence or absence of highly attenuated bowel wall, sentinel clot, mesenteric infiltration, peritoneal fluid collection and free intraabdominal air in cases with bowel injury only and with both bowel and mesenteric injury respectively. Ten patients had other accompanying abdominal injuries, such as liver, spleen, pancreas, kidney, bladder injuries, intraperitoneal abscess or retroperitoneal hemorrhage. RESULTS: Findings observed were bowel wall thickening in 23 cases(85%), peritoneal fluid collection in 21 (78%), highly attenuated bowel wall in 19(70%), mesenteric infiltration in 17(63%), free intraperitoneal air in 10 (37%) and sentinel clot in 7(26%). Pneumoperioneum were observed in 10 of 24 patients(41.7%) having bowel perforation. Two cases did not show any CT findings suggesting bowel and/or mesenteric injury. There was no significant difference in the prevalence of the CT findings between the patient group with bowel injury only and the patient group with both bowel and meseneric injury. CONCLUSION: CT scan is a useful tool in evaluating the degree and extent of bowel and/or mesenteric injury as well as in planning the patient's management.
Abdominal Injuries ; Abscess ; Ascitic Fluid ; Diagnosis ; Hemorrhage ; Humans ; Kidney ; Liver ; Pancreas ; Prevalence ; Retrospective Studies ; Spleen ; Tomography, X-Ray Computed ; Urinary Bladder

A clinical observation was made on the injuring of genitourinary tract of in-patients in the Department of Urology, Soon-Chun-Hyang College Hospital during the period from January. 1977 to December, 1980 for 4 years. There results were as follows; 1. Of 505 cases hospitalized, 86 cases have shown injuries of genitourinary tract, giving a ratio of 17%. 2. The age ranged from 4 to 67 years, and of these cases the favorable ages were those from 11 to 40 years for 73.3%. 3. Traffic accident was the most frequent cause of the injuries it 54.7%. 4. The kidney was involved most frequently (41.9%) and the involvement of the urethra was 27.9%. 5. Nephrectomy was performed in 6 cases (16.7%) of 36 renal injuries. 6. The ureteral injuries were occurred by traffic accident in 1 case and during uterine surgery in 1 case. 7. Six cases of 15 bladder injuries and 14 cases of 24 urethral injuries were accompanied with pelvic bone fracture.
Accidents, Traffic ; Kidney ; Nephrectomy ; Pelvic Bones ; Ureter ; Urethra ; Urinary Bladder ; Urology

Tuberculomas in the spine are estimated to be 15 to 50 times less common than those occurring in the cranium. We experienced a case of intramedullary spinal tuberculoma and brain tuberculoma associated with pulmonary tuberculosis. A 39-year-old male was referred to the National Medical Center via emergency room because of urinary difficulty and lower limb weakness for 3 days. He had been treated with anti-tuberculosis regimens against pulmonary tuberculosis for 20 days. Spinal MRI revealed intradural intramedullary tuberculoma at T5. On the 21st day at the hospital, a generalized seizure attacked him. Brain MRI revealed multiple tuberculoma in both hemispheres, brainstem and cerebellum. He was treated anti-tuberculosis regimens and corticosteroids for 9 months. His condition improved clinically and radiologically. We report this case with a review of the literature.
Adrenal Cortex Hormones ; Adult ; Brain Stem ; Brain* ; Cerebellum ; Emergency Service, Hospital ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Seizures ; Skull ; Spine ; Tuberculoma* ; Tuberculosis, Pulmonary*

BACKGROUND: Hemoptysis is a common clinical symptom responsible for 11% of admission to the hospital chest service. In KOREA pulmonary tuberculosis is still the most common cause of hemoptysis and the incidence of hemoptysis due to neoplasia has increased. Bronchoscopy and high resonance CT are essential for diagnosis of the cause of hemoptysis. We studied the causes, diagnostic tools and treatment treatment of hemoptysis. METHODS: We conducted a retrospective analysis of clinical profiles, radiologic and bronchoscopy findings and treatments of hemoptysis for 220 patients who were admitted to our hospital with hemoptysis between 1994 and 1998. RESULTS: The mean age at diagnosis was 49.3 years and male to female ratio was 2.1:1. The main causes were active pulmonay pulmonary tuberculosis in 72 cases(32.7%), inactive pulmonary tuberculosis with sequlae in 69 cases(31.4%) lung cancer in 43 cases(19.5%), bronchiectasis in 10 cases(4.5%), and chronicbronchitis in 10 cases(4.5%). The mean amount of hemoptysis for 24hrs was 120cc. The mean duration of bleeding was 25 days. The number of cases with a past history of pulmonary tuberculosis were 128 cases, in which 24 were relapsed tuberculosis cases, 25 chronic tuberculosis cases, 69 inactive tuberculosis cases, and 10 lung cancer cases. High resonance CT was the most useful method for structural etiologic evaluation of hemoptysis developed in patients with inactive tuberculosis, bronchiectasis and aspergilloma. sputum study and bronchofiberscopy were the confirmative diagnostic tools for active pulmonary tuberculosis and lung cancer. The treatments of hemoptysis medical in 152 cases(71.7%), bronchial artery embolization in 39 cases(17.8%), and operation in 9 cases(4.0%). The mean following up duration was 22.4 months. The overall outcomes of hemoptysis were controlled in 77 cases (43.5%), rebleeding in 100 cases (56.5%) and expired in 9 cases (4.0%). The outcomes of hemoptysis in pulmonary tuberculosis were controlled in 21.6%, rebleeding in 78.4%, and expire in 14.7%. CONCLUSION: The most common cause of hemoptysis was related with pulmonary tuberculosis. HRCT was an important diagnostic tool in AFB smear negative active pulmonary tuberculosis and inactive tuberculosis with sequelae. Early, proper management of pulmonary tuberculosis is important for prevention of hemoptysis in Korea.
Bronchial Arteries ; Bronchiectasis ; Bronchoscopy ; Diagnosis ; Female ; Hemoptysis* ; Hemorrhage ; Humans ; Incidence ; Korea ; Lung Diseases* ; Lung Neoplasms ; Lung* ; Male ; Retrospective Studies ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary