Due to an author error the National Research Foundation of Korea Grant Number was incorrectly listed in the original online publication of this article.

The trichofolliculoma is a rare tumor of the hair follicle occuring most often on the head and neck. We have experienced a case of 24-year-old female who had a small, dome-shaped, tan brown firm nodule on the nose. Under the clinical impression of a granuloma, an excisional biopsy of the nodule was done. Microscopically the lesion was composed of a large central cystic hair follicle with many srhall but well differenciated secondary hair follicles branching from the wall. Well developed secondary hair follicles were often grouped and were surrounded by a prominent stroma.
Female ; Humans ; Biopsy

Lymphoid tumors of the orbit are rare, and sometimes it is not possible either clinically or histologically to differentiate between lymphoid tumor and pseudolymphoma. Some authors assert that the degree of cytologic differentiation appears to be the single most important factor for determining the prognosis of patients with orbital lymphoid lesions. However, the cytomorphologic basis is not so helpful to diagnose and classify our case, which shows some discrepancy between pathological findings and clinical and radiological findings. At first we misdiagnosed our case as orbital malignant lymphoma on the basis of cytomorphology and immunohistochemical study. But no responce to local intensive radiotherapy and the follow up study of the patient suggest orbital pseudolymphoma.
Follow-Up Studies

Strumal carcinoma of the ovary is rare tumor of germ cell origin characterized by intimate mixture of thyroid tissue and carcinoid. We report a strumal carcinoid tumor associated with ipsilateral follicular cyst and contralateral mature cystic teratoma of the ovary in a 47-year-old woman. Histologically it was composed largely of trabeculae partly of insular carcinoid and focally of individual thyroid follicles. Many cells in the carcinoid areas and even some follicular areas contained abundant argyrophile granules, and they also, in the corresponding areas, demonstrated thyroglobulin. Electron microscopic findings revealed abundant neurosecretory granules and colloid material in the same cell. We agree that this tumor is derived from hybrid showing thyroid and neuroendocrine differenciation.
Female ; Humans ; Cysts

Even though malignant potential of vaginal intraepithelial neoplasia(VaIN) may be low, the prevalence is increasing and the mean age at diagnosis is decreasing. Various treatment options have been used for the eradication of ValN, but most effective standard protocol is not present because it is a rare disease. Laser vaporization was used to treat 7 patients with VaIN diagnosed at Department of Obstetrics and Gynecology, Seoul National University Hospital between 1992 to 1996. The patients were from 40 to 70 years of age with a mean 57 of years. All patients had a history of radical or simple hysterectomy, and final pathologic diagnosis were as follows : cervical cancer(n=5), cervical intraepithelial neoplasia(n=l), leiomyoma(n=l). Vaginal intrae-pithelial neoplasia(VaIN) was identified between 4 months and 8 years after first operation. All lesions were unifocal disease and found at the upper one third of the vagina. Treatment was performed with a CO2 laser unit and colposcope. Four(57%) out of seven patients had general anesthesia for the purpose of treatment. Patients were followed up for an average of 16.8 months with regular cytologic evaluation, colposcopy and biopsy. Failure of therapy was defined as evidence of intraepithelial neoplasia in any one of these three parameters. Only one patients showed persistent disease and the others remain free of disease. The success rate of therapy was 85.7%(6/7). (continue)
Anesthesia, General ; Biopsy ; Colposcopes ; Colposcopy ; Diagnosis ; Gynecology ; Humans ; Hysterectomy ; Laser Therapy ; Lasers, Gas* ; Obstetrics ; Prevalence ; Rare Diseases ; Seoul ; Vagina ; Volatilization*

Cytomegalovirus (CMV) is the most common agent of congenital infections and opportunistic infections in an immunocompromised host. CMV in an immunocompetent host has inapparent infections, which are usually asymptomatic or cause mild mononucleosis-like symptoms. However, severe CMV diseases, such as pneumonia, hepatitis, gastrointestinal disease, often occur in a healthy infant. The association of CMV pneumonia with the development of pneumothorax has rarely been reported. We experienced a case of CMV pneumonia presenting as pneumothorax in a 4-month-old healthy infant, who was successfully treated with supportive care. CMV was confirmed by using CMV polymerase chain reaction of tracheal aspirates. This case suggested that CMV should be considered as a cause of viral pneumonia during the infant period.

The nfa1 gene was cloned from a cDNA library of pathogenic Naegleria fowleri by immunoscreening; it consisted of 360 bp and produced a 13.1 kDa recombinant protein (rNfa1) that showed the pseudopodia-specific localization by immunocytochemistry in the previous study. Based on the idea that the pseudopodia-specific Nfa1 protein mentioned above seems to be involved in the pathogenicity of N. fowleri, we observed the effect of an anti-Nfa1 antibody on the proliferation of N. fowleri trophozoites and the cytotoxicity of N. fowleri trophozoites on the target cells. The proliferation of N. fowleri trophozoites was inhibited after being treated with an anti-Nfa1 polyclonal antibody in a dose-dependent manner for 48 hrs. By a light microscope, CHO cells co-cultured with N. fowleri trophozoites (group I) for 48 hrs showed severe morphological destruction. On the contrary, CHO cells co-cultured with N. fowleri trophozoites and anti-Nfa1 polyclonal antibody (1: 100 dilution) (group II) showed less destruction. In the LDH release assay results, group I showed 50.6% cytotoxicity, and group II showed 39.3%. Consequently, addition of an anti-Nfa1 polyclonal antibody produced a decreasing effect of in vitro cytotoxicity of N. fowleri in a dosedependent manner.
Animals ; Antibodies, Protozoan/*immunology ; Antigens, Protozoan/genetics/*immunology ; CHO Cells ; Dose-Response Relationship, Immunologic ; Female ; Hamsters ; Mice ; Mice, Inbred BALB C ; Naegleria fowleri/growth & development/immunology/*pathogenicity ; Protozoan Proteins/genetics/*immunology ; Recombinant Proteins/immunology ; Support, Non-U.S. Gov't

Richer's syndrome is a development of a high grade malignant lymphoma in a patient with preexisting chronic 1ymphocytic leukemia, small lymphocytic lymphoma or Waldenstrom's macroglobulinemia. A rare case of Richer's syndrome arising in the spleen of a 35-year-old-man was studied by morphology, immunohistochemistry and gene rearrangement study. He has had weight loss and night sweat for last 6 months. Hepatosplenomegaly and abdominal lymphadenopathy were noted on CT scanning. Especially an ovoid radiolucent mass was found within the image of splenomegaly. Lymph nodes and liver biopsy, bone marrow aspiration and splenectomy were done. In the lymph nodes, liver and bone marrow, well differentiated small lymphocytic infiltrations were found but, in the spleen, pleomorphic, large cells with occasional multinucleated giant cells formed a nodular mass surrounded by diffuse, extensive infiltration of small well differentiated lymphocytes. The two distinctive areas in the spleen had positive staining for B-cell marker (HLA-DR and L26), negative staining for T-cell marker (UCLH1), and positive staining for IgM heavy chain and kappa light chain by immuohistochemical study. so this case was diagnosed as a diffuse large cell 1ymphoma transformed from small lymphocytic lymphoma. We made an another effort to clarify their clonality. Gene rearrangement method usingcomplementarity.determining region 3(CDR3) of immunoglobulin heavy chain (IgH) gene and T-cell receptor gamma (TCRgamma) gene by polymerase chain reaction (PCR) technique was done. The two lymphomas in the spleen demonstrated the same rearrangement pattern in both IgH and TCRgamma gene. We think these findings strongly suggest that the large cell lymphoma has the same clonality with that of the small lymphocytic lymphoma.
Male ; Humans

PURPOSE: To evaluate the accuracy of preoperative keratometers used in cataract surgery with toric intraocular lens (IOL). METHODS: Twenty-five eyes received an AcrySof toric IOL implantation. Four different keratometric methods, a manual keratometer, an IOL master, a Pentacam and an auto keratometer, were performed preoperatively in order to evaluate preexisting corneal astigmatism. Differences between the true residual astigmatism and the anticipated residual astigmatism (keratometric error) were compared at one and three months after surgery by using a separate vector analysis to identify the keratometric method that provided the highest accuracy for astigmatism control. RESULTS: The mean keratomeric error was 0.52 diopters (0.17-1.17) for the manual keratometer, 0.62 (0-1.31) for the IOL master, 0.69 (0.08-1.92) for the Pentacam, and 0.59 (0.08-0.94) for the auto keratometer. The manual keratometer was the most accurate, although there was no significant difference between the keratometers (p > 0.05). All of the keratometers achieved an average keratometric error of less than one diopter. CONCLUSIONS: Manual keratometry was the most accurate of the four methods evaluated, although the other techniques were equally satisfactory in determining corneal astigmatism.
Analysis of Variance ; Astigmatism/complications/*surgery ; *Cataract Extraction ; Female ; Humans ; Lens Implantation, Intraocular/*methods ; *Lenses, Intraocular ; Magnetic Resonance Imaging ; Male ; Prospective Studies ; Refraction, Ocular ; Reproducibility of Results ; Treatment Outcome ; Visual Acuity

PURPOSE: This was a methodological research to develop an instrument to assess the emotional response of family members of physically restrained patients. METHODS: A primary instrument with 68 questions was developed based on literature review and semi-structured interviews with family members. A group of experts revised individual questions and removed 4 irrelevant questions. This secondary instrument, then, was tested with 199 family members of physically restrained patients in intensive care units of a university hospital. The validity and reliability of the instrument were tested by factor analysis. RESULTS: After item analysis, 3 questions with a correlation coefficient under .30 were discarded and the questions with a factor loading under .45 on Varimax Rotation were also removed. After factor analysis on the final 37 questions, 7 factors were identified; avoidance, shock, helplessness, grudge, depression, anxiousness, and acceptance. The total variance explained was 55.63%. The reliability of this instrument was 0.93 of Cronbach's alpha. CONCLUSION: This instrument was statistically reliable and valid to measure family's emotional response to physical restraints of the patients. This instrument can be useful in assessing the effects of nursing interventions for family members of restrained patients.
Adolescent ; Adult ; Child ; Emotions ; Family/*psychology ; Female ; Humans ; Intensive Care Units ; Interviews as Topic ; Male ; Middle Aged ; *Program Development ; Questionnaires ; Reproducibility of Results ; *Restraint, Physical