Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations. To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carcinomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. All cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas (67%) and 7 papillomas (58%). Single cells were present in 5 carcinomas (83%) and 8 papillomas (67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma. Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas (67%). Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma. Malignant lesions tended to show higher cellularity and more single isolated cells. The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases of papillary lesions of the breast to further characterize the tumor
Breast ; Carcinoma, Papillary ; Central Nervous System* ; Cyclosporine* ; Epithelial Cells ; Macrophages ; Metaplasia ; Needles ; Papilloma ; Papilloma, Intraductal ; Retrospective Studies

No abstract available.
Neurons* ; Reflex*

No abstract available.
Humans ; Siblings* ; Thrombasthenia*

It has been suspected that various infections, including cytomegalovirus(CMV) infection, are associated with IgA nephropathy. In case of CMV infection, ganciclovir is known to be a treatment of choice for severe CMV infection in general. But ganciclovir has a lot of severe toxicity, so children with normal immunity are seldom treated by ganciclovir when CMV infection is suspected. On the other hand, intravenous immunoglobulin can also be used to treat CMV infection.
Child ; Cytomegalovirus ; Ganciclovir ; Glomerulonephritis, IGA ; Hand ; Humans ; Immunoglobulin A ; Immunoglobulins ; Pregnenediones

BACKGROUND: Vancomycin-dependent enterococci (VDE) are clinically equivalent to vancomycin-resistant enterococci (VRE), but more difficult to detect. This study was purposed to characterize VDE microbiologically and epidemiologically. METHODS: The patients from whom VDE were detected from April 2007 to March 2008 were investigated. For available isolates, minimal inhibitory concentrations (MICs) of and the levels of dependence on vancomycin and teicoplanin were measured by E test (AB Biodisk, Sweden), and a test for reversion of VDE to non-dependent VRE (NDVRE) and pulsed field gel electrophoresis (PFGE) were performed. Patients' demographic and clinical findings were reviewed via electronic medical records. RESULTS: VDE were recovered from 6 (2.2%) of 272 patients carrying VRE during this study period. All patients were already colonized or infected by VRE and treated with vancomycin for 13 to 107 days. VDE were isolated from pleural fluid (one), urine (four), and stool (one). All isolates carried vanA with vancomycin MICs of >256 microgram/mL, but two of them had intermediate susceptibilities to teicoplanin. Because 4 VDE isolates were reverted to NDVRE with single passage, vancomycin dependence was measurable for only two isolates as equal and above 0.064 and 0.5 microgram/mL respectively, and was reverted after 5 and 7 passages, respectively. Six VDE isolates showed no related clones in PFGE analysis, and 3 of 4 available pairs of initial VRE isolates and subsequent VDE isolates were identical clones. CONCLUSIONS: VDE were not rare and seemed to emerge independently from VRE with a prolonged use of vancomycin. Vancomycin-dependence was reverted within several passages.
Adult ; Aged ; Electrophoresis, Gel, Pulsed-Field ; Enterococcus/classification/drug effects/*isolation & purification ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Urinary Tract Infections/diagnosis/microbiology ; Vancomycin/*pharmacology ; Vancomycin Resistance

PURPOSE: Most patients suffer from croup only once in a life time. However, a small group of patients suffer from it several times. A type of croup from which they suffer more than 3 times is called recurrent croup. The cause of recurrent croup has not been clearly described, but in recent years the allergic reaction is considered as a cause of recurrent croup. ECP is one of the 4 major basic proteins of eosinophil, means eosinophil activation, and has been reported as a clinical indicator of bronchial asthma and other an allergic diseases. We measured serum ECP levels in recurrent croup patients in order to evaluate the roles of ECP as a diagnostic tools and eosinophil activation as part of the pathophysiology of recurrent croup. METHODS: 25 patients with 1st croup episode were enrolled in the study between April and August 1994. We phoned the 22 patients if they had ever caught any respiratory and allergic diseases including croup about 2 years since their discharge from the hospital. Three patients could not be connected. We divided these patients into two groups according to the recurrent rate of attack after discharge. The patients with more than three times of episode were diagnosed as recurrent croup patients, and others with one time of episode were diagnosed as single croup patients. The patients with two times episode were dropt out. Non-allergic 10 patients of the same age with acute viral enteritis were enrolled as a control group. Blood sampling was done at admission. Serum ECP levels were measured by ECP radioimmunosorbent assay kit (Phamarcia, Sweden). RESULTS: 1) Recurrent croup (n=9): The ECP level was 52.1+/-17.3 g/L. Single croup (n=12): The ECP level was 11.6+/-7.0 g/L. Control (n=10): The ECP level was 6.3+/-3.2 g/L. 2) There was no meaningful difference between the control and the single croup patients (p>0.05). 3) There was a meaningful difference between the control and the recurrent croup patients (p<0.05). 4) There was a meaningful difference between the single croup and the recurrent croup patients (p<0.05). 5) There was a linear correlation between eosinophil count and serum ECP levels (r=0.63, p<0.01). 6) For 2 years after discharge, pneumoniae was developed in 2 single croup patients. The recurrent rate of croup was 3-6 times in recurrent croup patients. Asthma was developed in 4 recurrent croup patients. And bronchiolitis was developed in 2 recurrent croup patients. CONCLUSIONS: The investigation of serum ECP levels enables us to distinguish recurrent croup patients from single croup patients. It suggests that eosinophil activation may play an important role in the pathophysiology of recurrent croup.
Asthma ; Bronchiolitis ; Croup* ; Enteritis ; Eosinophil Cationic Protein* ; Eosinophils ; Humans ; Hypersensitivity ; Pneumonia

OBJECTIVES: Tardive dyskinesia (TD) is a movement disorder that is characterized by hyperkinetic movements. Previous studies have suggested that the serotonergic systems are correlated with TD vulnerability. In this study, the association between a single-nucleotide polymorphism (SNP) of the serotonin 1A receptor gene (HTR1A) rs6295 and TD was investigated. METHODS: We investigated whether HTR1A rs6295 SNP is associated with antipsychotic-induced TD in 280 Korean patients with schizophrenia. Patients with schizophrenia having TD (n=105) and those without TD (n=175) were matched for their antipsychotic exposures and other relevant variables. The HTR1A rs6295 SNP was analyzed using polymerase chain reaction (PCR)-based methods. RESULTS: There was no significant difference in the distribution of genotypic (χ2=2.70, p=0.26) and allelic (χ2=1.87, p=0.17) frequencies between the patient groups with TD and without TD. There was no significant difference in total abnormal involuntary movement scale score (F=0.39, p=0.68) among the genotype group either. CONCLUSION Although there were no differences in genotypic and allelic frequency between patient groups with and without TD, further studies on association of TD with other SNPs of HTRA1 are needed to understand the pathophysiological mechanism of TD.

Laparoscopic cholecystectomy has resulted in various bile duct injuries. Treatment of these injuries is usually difficult and often leads to an intractable clinical course. We herein present a case of isolated right anterior sector (RAS) duct injury induced by laparoscopic cholecystectomy. The bile duct injury was successfully treated by hepatic atrophy induction. Imaging studies revealed that the RAS duct was severed, probably due to rare anatomical variations. Considering the difficulty in surgical reconstruction, atrophy induction of the involved hepatic parenchyma was attempted. This treatment consisted of embolization of the RAS portal branch to inhibit bile production, induction of heavy adhesion at the bile leak site to ensure percutaneous pigtail clamping, and sequential clamping and removal of pigtail catheters. This procedure took 3 months prior to pigtail catheter removal. She was free from other complications during the first 12 months and to date. She will be followed up for 5 years overall including surveillance for hepatobiliary complications. Although this therapeutic induction of atrophy approach is not universally applicable, it can be considered to be a feasible option in unique situations such as this one.
Atrophy ; Bile ; Bile Ducts ; Catheters ; Cholecystectomy, Laparoscopic ; Constriction ; Dietary Sucrose

The authors want to correct the title because this article.

Rothia dentocariosa, a pleomorphic gram-positive branching bacillus, is a common inhabitant of the nose and throat. It is a well-known causative agent of dental plaques and periodontal diseases. Although generally regarded as having a low virulence to humans, R. dentocariosa has been recognized as causative agents of infective endocarditis and bacteremia with increasing frequency. Consequently, it can be a very serious pathogen when isolated from usually sterile sites such as blood or cerebrospinal fluid. We report a case of Rothia dentocariosa bacteremia without endocarditis in a 17-month-old male patient with fever, vomiting and diarrhea.
Bacillus ; Bacteremia ; Endocarditis ; Fever ; Humans ; Infant ; Male ; Nose ; Periodontal Diseases ; Pharynx ; Vomiting