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

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

BACKGROUND: Cystic neoplasms of pancreas comprise pathologically heterogeneous groups of tumors with many shared clinical features. Although relatively uncommon, they have a very important place in the surgical pathology of the pancreas because of their high cure rate and their potential confusion with far more common pancreatic pseudocysts. METHODS: We analysed clinical features of 23 patients with pancreatic cystic neoplasm that we treated within 8-years` period (13 women, 10 men, mean age; 47.2 years old) The cystic neoplasms of pancreas comprise 5 serous cystadenoma, 3 benign mucinous cystic tumor, 3 borderline malignancy of mucinous cystic tumor and 4 mucinous cystadenocarcinoma, 4 papillary cystic tumor, 1 cystic teratoma, 1 cystic mesothelioma, 1 lymphoepithelial cyst. 1 mucinous ductal ectasia. RESULTS: Mean tumor size was 6.8cm(3 to 15cm). 73.9 percent had abdominal pain and 26.1 percent had abdominal mass. Computed tomography, ultrasonography and MRI were useful in detecting cystic mass in all cases but was not reliable to distinguish serous from mucinous tumor, benign from malignant. For the treatment of the tumor, 17 distal pancreatectomy with splenectomy, 1 distal pancreatectomy with spleen preserving, 1 proximal pancreatic resection, 2 local excision of pancreas and 1 PPPD were performed. During the period of follow up (mean: 29 months) after surgical resection, 1 recurrence occurred in the patient who underwent local excision for mucinous cystic tumor showing borderline malignancy on histologic finding. All the patients are alive except 2 patients who were lost to follow-up. CONCLUSION: Pancreatic cystic neoplasms are rare and their prognosis are acceptable when they are treated early and properly. So early detection and surgical treatment is the mainstay of management of cystic neoplasm of pancreas.
Abdominal Pain ; Cystadenocarcinoma, Mucinous ; Cystadenoma, Serous ; Dilatation, Pathologic ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Magnetic Resonance Imaging ; Male ; Mesothelioma, Cystic ; Mucins ; Pancreas* ; Pancreatectomy ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Pathology, Surgical ; Prognosis ; Recurrence ; Spleen ; Splenectomy ; Teratoma ; Ultrasonography

Hantavirus pulmonary syndrome(HPS) is a systemic disease that is caused by a newly discorved and characterized virus of the Hantavirus genus, which is most frequently referred to as the sin nombre virus. The clinical syndrome resembles other hantavirus syndromes worldwide, except that it is characterized by a brief prodromal illness followed by rapidly progressive, noncardiogenic edema, and that it is more deadly than any previously recognized hantavirus infection. The clinical manifestations of HPS are characterized by four clinical phases prodrome, pulmonary edema and shock, diuresis, and convalescence. Mortality is greatest in the first 24 hours of the pulmonary edema and shock phase of the illness. These phases are strikingly similar to the clinical phases of Hemorrhagic fever with renal syndrome(HFRS) induced by Hantaan virus, except that HPS has not been associated with renal failure and Disseminated intravascular coagulation(DIC). We here report a case of hantavirus pulmonary syndrome developed in a 58 year-old man. He had a flu-like illness followed by the rapid onset of respiratory failure due to noncardiogenic pulmonary edema. HPS was diagnosed by clinical manifestations, identification of high titer antibody to Hantaan virus antigen and histologic finding of transbronchial lung biopsy (TBLB) specimen. The patient was treated with mechanical ventilation and initial corticosteroid pulse therapy resulting in successful outcome.
Biopsy ; Convalescence ; Diuresis ; Edema ; Fever ; Hantaan virus ; Hantavirus Infections ; Hantavirus Pulmonary Syndrome* ; Hantavirus* ; Humans ; Lung ; Middle Aged ; Mortality ; Pulmonary Edema ; Renal Insufficiency ; Respiration, Artificial ; Respiratory Insufficiency ; Shock ; Sin Nombre virus

BACKGROUND: Post-Herpetic Neuralgia(PHN) is the most common and serious complication of herpes zoster(H-Z). Especially in the elderly, intractable chronic pain is caused by PHN and it affects the quality of life severely. The study examined the predictive factors of PHN for its prevention and treatment. METHODS: 691 cases of patients with herpes zoster who visited department of dermatology were studied of Kwang Ju Christian Hospital during the five years from Jan. 1991 to Dec. 1995 Retrospective chart review was used to compare occurrence of PHN according to age, sex, residential area of patients, inpatients or outpatients status, nerve dermatome, interval of treatment, methods of treatment associated conditions and duration of PHN. The authors compared the incidence of patients with PHN and patients with H-Z according to above variables. For statistical analysis, we used Chi-square and t-test through SPSS/PC+ (P<0.05). RESULTS: The incidence of PHN was 22.9% (159/691) and increased with age. The incidence of patients under 60 years of age was 16.5%, more than 60 was 30.7% (P<0.05). There was no statistical significance concerning sex, residential area of patients, dermatome, method of treatment, associated conditions in the incidence of PHN compared to patients with H-Z. The significant difference In the incidence of PHN was shown between inpatients and outpatients status(20.5%, 27.3% respectively) (P<0.05). Anatomical site of PHN of the highest incidence was the opthalmic branch of trigeminal nerve(27.1%), followed by cervical(26.0%), thoracic(24.4%) and sacral(22.2%) in order of sequence. Associated conditions or diseases of PHN were observed in 80 patients(24.7%) including hypertension(39.5%), tuberculosis(39.3%), malignancy (34.5%), COPD(33.3%), Chronic hepatitis(22.7%), DM(15.4%). The interval between the onset of H-Z and the initiation of treatment showed that significant difference in the incidence of PHN was on the fourth day with less than and more than 4 days showing 18.5% : 25.1% respectively(P<0.05). CONCLUSIONS: The important factors affecting the incidence of PHN were interval between the onset of H-Z and the initiation of treatment age and inpatients or outpatients status. The methods of treatment(acyclovir or steroid), sex, residential area of patients, associated conditions and nerve distribution were not significant factors.
Aged ; Chronic Pain ; Dermatology ; Gwangju ; Herpes Zoster* ; Humans ; Incidence ; Inpatients ; Neuralgia* ; Outpatients ; Quality of Life ; Retrospective Studies

BACKGROUND: Rifampicin (RFP) is one of the principal first-line drugs used in combination chemotherapies against Mycobacterium tuberculosis, and its use has greatly shortened the duration of chemotherapy for the successful treatment of drug-susceptible tuberculosis. Compensatory mutations have been identified in rpoC that restore the fitness of RFP-resistant M. tuberculosis strains with mutations in rpoB. To investigate rpoC mutation patterns, we analyzed 93 clinical M. tuberculosis isolates from patients in South Korea. METHODS: Drug-resistant mycobacterial isolates were cultured to determine their susceptibility to anti-tubercular agents. Mutations in rpoC were identified by sequencing and compared with the relevant wild-type DNA sequence. RESULTS: In total, 93 M. tuberculosis clinical isolates were successfully cultured and tested for drug susceptibilities. They included 75 drug-resistant tuberculosis species, of which 66 were RFP-resistant strains. rpoC mutations were found in 24 of the 66 RFP-resistant isolates (36.4%). Fifteen different types of mutations, including single mutations (22/24, 91.7%) and multiple mutations (2/24, 8.3%), were identified, and 12 of these mutations are reported for the first time in this study. The most frequent mutation involved a substitution at codon 452 (nt 1356) resulting in amino acid change F452L. CONCLUSION: Fifteen different types of mutations were identified and were predominantly single-nucleotide substitutions (91.7%). Mutations were found only in dual isoniazid- and RFP-resistant isolates of M. tuberculosis. No mutations were identified in any of the drug-susceptible strains.
Base Sequence ; Codon ; Drug Resistance, Multiple ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Rifampin ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

OBJECTIVES: The purpose of this study was to assess the associations between oral health, activity of daily living, and cognitive impairment among elderly people who live at home in a rural area. METHODS: A total of 183 participants older than 70 years of age were recruited from a public health center in a rural Korean city. Trained examiners conducted questionnaire surveys and at-home oral exams to assess oral health, geriatric function, and cognitive impairment. Oral health was assessed by counting remaining teeth and examining salivary flow. Geriatric function and cognitive impairment were assessed using the Mini-Nutritional Assessment (MNA), the Mini-Mental State Examination for Dementia Screening (MMSE-DS), and an activity of daily living (ADL) questionnaire. RESULTS: Mean age (SD) of the participants was 83.77 (5.99) years and 68.9% of them were women. The participants who had a lower number of remaining teeth were significantly older, had severe cognitive impairment, and poor ADL and MNA results. The participants with severe cognitive impairment were significantly older and had fewer remaining teeth and low salivary flow. Simple linear regression analysis showed an association between remaining teeth and cognitive impairment with a P-value of 0.000, which disappeared after adjusting for sex and age or sex, age, denture use, and salivary flow, respectively. CONCLUSIONS: Possible associations between remaining teeth and salivary flow, activity of daily living, and cognitive impairment were discovered among some elderly people living in a rural area.
Activities of Daily Living ; Aged* ; Dementia ; Dentures ; Female ; Humans ; Linear Models ; Mass Screening ; Oral Health ; Pilot Projects* ; Public Health ; Tooth*

Cortical Dysplasia(CD) is increasingly recognized as a cause of intractable epilepsy since it can be easily diagnosed with high resolution magnetic resonance imaging(MRI). We analyzed 24 consecutive cases with cortical dysplasia who underwent resective surgery at our institute between September, 1992 and December, 1995. MRI was demonstrated to be a decisive tool to identify CD in 16 cases(66.7%). However, the remaining 8 cases(33.3%) were confirmed to have CD based on histological examination. Location of the lesion included temporal(n=9), central(n=5), multilobar(n=5), and frontal(n=5). Intracranial EEG recording was performed to delineate the epileptogenic zone in 16 cases:subdural grid(10 cases) and depth electrode(6 cases). Resection was performed in temporal(n=9), frontal(n=7), central(n=6), parietal(n=1), and multilobar(n=1). Complete resection was possible in 15(62.5%) and partial resection in 9(37.5%). Histological examination revealed dyslamination of cortical layers only(n=9), additional dysplastic neurons(n=7), and additional balloon cells(n=8). Surgical outcome was graded as seizure free(n=14:58.3%), rare seizures(n=3:12.5%), <50% reduction of seizure frequency(n=2:8%), and no change(n=5:20.8%) after mena follow-up of 12.7 months. The most influencing factor on the surgical outcome was the degree of completeness of resection(p<0.05). However, detectability of CD on MRI, severity of histological findings, age of seizure onset, and duration of seizure were not significantly related with the surgical outcome. High suspicion is required to detect the CD among the patients with intractable epilepsy and surgical strategies should be well-planned to improve the surgical outcome in the patients with CD.
Electroencephalography ; Epilepsy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Malformations of Cortical Development* ; Seizures

BACKGROUND: Pyrazinamide (PZA) is an effective antitubercular drug that becomes toxic to Mycobacterium tuberculosis when converted to pyrazinoic acid by pyrazinamidase (PZase), encoded by mycobacterial pncA. A strong association was noted between the loss of PZase activity and PZA resistance. The causative organisms in extrapulmonary tuberculosis are rarely cultured and isolated. To detect pncA mutations in specimens from extrapulmonary tuberculosis as confirmative diagnosis of mycobacterial infection and alternative susceptibility test to PZA. METHODS: Specimens were collected from clinically proven extrapulmonary tuberculosis. pncA was sequenced and compared with wild-type pncA. RESULTS: pncA from 30 specimens from 23 donors were successfully amplified (56.6% in specimens, 59% in donors). Six mutations in pncA were detected (20.0% in amplified specimens, 26.1% in specimen donors) at nucleotide positions of 169, 248 and 419. The mutation at position 169 results in substitution of aspartic acid for histidine, a possible allelic variation of M. bovis that have intrinsic PZA resistance. The mutation at position 248 changes proline into arginine and that at position 419, arginine into histidine. CONCLUSION: DNA-based diagnosis using pncA may be simultaneously useful for the early diagnosis of mycobacterial infection and the rapid susceptibility to PZA in extrapulmonary tuberculosis. A potential implication of pncA allelic variation at 169 might be suggested as a rapid diagnostic test for M. bovis infection or Bacille Calmette-Guerin (BCG) reactivation.
Amidohydrolases ; Antitubercular Agents ; Arginine ; Aspartic Acid ; Diagnostic Tests, Routine ; Early Diagnosis ; Histidine ; Humans ; Mycobacterium bovis ; Mycobacterium tuberculosis ; Proline ; Pyrazinamide ; Tissue Donors ; Tuberculosis