The Kikuchi's disease is a distinctive type of histiocytic necrotizing lymphadenitis that affects primarily the cervical lymphadenites of young adults and has a self-limited clinical course. Authors report the case of a 77-year old patient who presented with axillary and cervical, tender lymphadenopathy and who was diagnosed as having Kikuchi's disease upon excisional biopsy.
Aged ; Biopsy ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymphatic Diseases ; Young Adult

Crystalline retinopathy is a tapetoretinal degeneration characterized by glistening yellow intraretinal crystals in the posterior pole, chorioidal sclerosis, and corneal crystalline dystrophy. We have recently encountered a 36 year-old female patient with bilateral intraretinal crystalline depositions who presented with a complaint of visual disturbance in her right eye for the last six months. Typical fundus findings of crystalline deposition in the posterior pole, tapetoretinal dysfunctions in the electrophysiologic tests and choriocapillaris filling defects in the fluorescein angiogram suggest that this the disorder is a widespread choriocapillaris and tapetoretinal disorder. There are no significant abnormal findings in serologic and radiologic examinations.
Adult ; Crystallins* ; Female ; Fluorescein ; Humans ; Retinitis Pigmentosa ; Sclerosis

Although the ultlrasonography has been regarded as a main procedure in the diagnosis of bile duct andgallbladder diseases, a few reports concerning the ultrasonographic findings of biliary ascariasis appeared in theliterature. Seven cases of real-time ultrasonographic diagnosis of biliary ascariasis were made in our hospitalduring last 15 months. In six, the diagnosis was confirmed by surgery or radiographic examination. The resultswere as follows; 1. The characteristic long, thick, highly reflective echo without distal acoustic shadowing inthe extra and/or in tra-hepatic ducts were seen in all six proven cases. 2. The echogenic, nonshadowing images ofthe worms were seen as single stripe in five cases(containing a central longitudinal, anechoic tube, suggestingits digestive tract in three cases ) or multiple stripes in one case. But so-called coiled appearance or amorphousfragments were not seen in our cases. 3. Associated findings were as follows; mild to moderate dilatation of theextrahepatic duct in all six duct in 1 case, intrahepatic stone in 1 case, contracted gallbladder containingsingle stone in 1 case and evidence of cholecystitis in 4 cases. 4. One false positive diagnosis of ascariasis inthe gallbladder is considered due to reverberation artefact. No false negative was seen.
Acoustics ; Artifacts ; Ascariasis ; Bile Ducts ; Cholecystitis ; Diagnosis ; Dilatation ; Gallbladder ; Gastrointestinal Tract ; Shadowing (Histology)

There are two types of retinal macroglia: astrocyte and Muller cell. The major component of iintermediate filament in astrocyte is GFAP, recognized as the primary marker of astrocyte. Muller cells do not physiologically express GFAP in normal developing retina. A striking increase in GFAP expression. however, is observed in Muller cells under certain pathological condition. It is also suggested that this kind of changes of Muller cells in human retina is related with aging, and may be an early feature of pathogenesis of Age related macular degeneration. The goal of this study is to investigate the involvement of the human retinal macroglia in normal aging by immunogold labeling for electron. The goal of this study is to investigate the involvement of the human retinal macroglia in normal aging by immunogold labeling for electron microscopy. The sections of aged neurosensory retina showed the evidence of expression of GFAP by Muller cells. The results suggest, therefore, that Muller cells are induced to express GFAP during aging.
Aging ; Astrocytes ; Ependymoglial Cells ; Glial Fibrillary Acidic Protein* ; Humans* ; Macular Degeneration ; Microscopy, Electron ; Retina ; Retinaldehyde* ; Strikes, Employee

BACKGROUND: The prevalence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is increasing rapidly worldwide. Treatment options for ESBL-producing E. coli are limited, and infections caused by this organism are associated with improper antibiotic use, a long hospital stay, and increased mortality. Thus, the assessment and early recognition of the risk factors of nosocomial infections due to ESBL-producing E. coli are important for the infection control and proper treatment. METHODS: A case-control study was performed that included nosocomial episodes of ESBL-producing E. coli bacteremia at a tertiary care hospital from January 2004 to December 2007. For each case patient, three controls were randomly selected and data on predisposing factors were collected. RESULTS: Fifty-five cases of nosocomial ESBL-producing E. coli bacteremia were studied. Carbapenem usage (OR: 11.3, 95% CI: 1.1-115.9, p=0.041), quinolone usage (OR: 4.5, 95% CI: 1.1-18.8, p=0.042), biliary obstructive disease (OR: 11.8, 95% CI: 3.0-46.7, p<0.001) and the APACHE II score (OR: 1.3, 95% CI: 1.2- 1.5, p<0.001) were analyzed as independent risk factors of nosocomial ESBL-producing E. coli bacteremia. CONCLUSION: Our results showed that physicians caring for patients with risk factors of nosocomial bacteremia should consider ESBL-producing E. coli as the causative organisms of the disease.
APACHE ; Bacteremia* ; beta-Lactamases* ; Case-Control Studies ; Causality ; Cross Infection ; Escherichia coli* ; Escherichia* ; Humans ; Infection Control ; Length of Stay ; Mortality ; Prevalence ; Risk Factors* ; Tertiary Healthcare

BACKGROUND: The prevalence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is increasing rapidly worldwide. Treatment options for ESBL-producing E. coli are limited, and infections caused by this organism are associated with improper antibiotic use, a long hospital stay, and increased mortality. Thus, the assessment and early recognition of the risk factors of nosocomial infections due to ESBL-producing E. coli are important for the infection control and proper treatment. METHODS: A case-control study was performed that included nosocomial episodes of ESBL-producing E. coli bacteremia at a tertiary care hospital from January 2004 to December 2007. For each case patient, three controls were randomly selected and data on predisposing factors were collected. RESULTS: Fifty-five cases of nosocomial ESBL-producing E. coli bacteremia were studied. Carbapenem usage (OR: 11.3, 95% CI: 1.1-115.9, p=0.041), quinolone usage (OR: 4.5, 95% CI: 1.1-18.8, p=0.042), biliary obstructive disease (OR: 11.8, 95% CI: 3.0-46.7, p<0.001) and the APACHE II score (OR: 1.3, 95% CI: 1.2- 1.5, p<0.001) were analyzed as independent risk factors of nosocomial ESBL-producing E. coli bacteremia. CONCLUSION: Our results showed that physicians caring for patients with risk factors of nosocomial bacteremia should consider ESBL-producing E. coli as the causative organisms of the disease.
APACHE ; Bacteremia* ; beta-Lactamases* ; Case-Control Studies ; Causality ; Cross Infection ; Escherichia coli* ; Escherichia* ; Humans ; Infection Control ; Length of Stay ; Mortality ; Prevalence ; Risk Factors* ; Tertiary Healthcare

Retinal horizontal cell is second-order neuron that integrates the information from photoreceptors over large retinal areas, mediating the lateral spread of visual signals to distant retina. The Neurofilament proteins, considered as neuronal markers, have been imunolocalized to mammalian retinal horizontal cess. However, the immunolabeling of Neurofilament in human, has been focused on the studies of visual pathway and large ganglion cells The goal of this study is to see whether human retinal horizontal cells are indeed neuronal nature or glial nature by immunogold labeling for electron microscopy. The sections of 65 year-old human retina showed the expression of Neurofilament by horizontal cells, which confirms the evidence of human retinal horizontal cell as neuronal nature.
Aged ; Ganglion Cysts ; Humans* ; Microscopy, Electron ; Negotiating ; Neurofilament Proteins ; Neurons ; Retina ; Retinal Horizontal Cells* ; Retinaldehyde* ; Visual Pathways

No abstract available.
Breast Neoplasms* ; Tamoxifen*

Although the characteristic cytologic features of melanoma have been well described, the diagnosis of metastatic melanoma by fine needle aspiration cytology (FNAC) may be difficult in the case of amelanotic melanoma and in the absence of awareness of clinical history. Furthermore, when the breast is the site of initial presentation, it could simulate a primary breast carcinoma leading to misdiagnosis. The recognition of metastatic malignant melanoma in FNAC material is essential to avoid an unnecessary mastectomy and to ensure appropriate chemotherapy. We experienced a case of metastatic melanoma of breast which presented as solitary breast mass in a 56-year-old woman. She had a history of surgical excision of right foot for melanoma one year ago. The cytologic smears were composed of noncohesive epithelioid cells with round or eccentric nuclei, bi-or multi-nucleation, prominent nucleoli, fine chromatin, and intranuclear inclusions. The cytoplasm of tumor cells had scanty melanin pigment but were diffusely positive for S-100 protein.
Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Chromatin ; Cytoplasm ; Diagnosis ; Diagnostic Errors ; Drug Therapy ; Epithelioid Cells ; Female ; Foot ; Humans ; Intranuclear Inclusion Bodies ; Mastectomy ; Melanins ; Melanoma* ; Melanoma, Amelanotic ; Middle Aged ; S100 Proteins

Extramammary Pagets disease(EMPD) of the vulva is an uncommon neoplasm which accounting for 2.5% of all vulvar malignancies and 0.02% of all female cancer. Several hundred cases have been reported worldwide since the first description by sir James Paget in 1874, It generally affects postrnenopausal age poup and presents high rate of recurrence but the precise incidence remines unclear, Although Paget's disease of the breast and the vulva are histologically similar, their histogenesis and biological behavior are considered to be significantly different and EMPD has gcnerally perceived rnore benign compared to that of the breast. Four histologic forms of vulvar EMPD have been recognized and treated vulvar EMPD in according to the 4 histologic classification. The high rate of recurtence disease remains a challenge for optimal management. Recently we experienced a case of Paget's disease of the vulva, diagnosed as an intraepithelial Pagets disease preoperatively and underwent radical vulvectomy and superiomedial thigh(SMT) flap, and present with a brief review of literature.
Breast ; Classification ; Female ; Humans ; Incidence ; Paget's Disease, Mammary ; Recurrence ; Vulva*