Actinomyces meyeri is a Gram positive, strict anaerobic bacterium, which was first described by Meyer in 1911. Primary actinomycotic osteomyelitis is rare and primarily affects the cervicofacial region, including mandible. We present an unusual case of osteomyelitis of a long bone combined with myoabscess due to A. meyeri. A 70-year-old man was admitted for pain and pus discharge of the right elbow. Twenty-five days before admission, he had hit his elbow against a table. MRI of the elbow showed a partial tear of the distal triceps tendon and myositis. He underwent open debridement and partial bone resection for the osteomyelitis of the olecranon. Biopsy showed no sulfur granules, but acute and chronic osteomyelitis. The excised tissue grew A. meyeri and Peptoniphilus asaccharolyticus. Intravenous ceftriaxone was administered and switched to oral amoxicillin. Infection of the extremities of actinomycosis often poses diagnostic difficulties, but it should not be neglected even when the characteristic pathologic findings are not present.
Actinomyces* ; Actinomycosis ; Aged ; Amoxicillin ; Biopsy ; Ceftriaxone ; Debridement ; Elbow ; Extremities ; Humans ; Magnetic Resonance Imaging ; Mandible ; Myositis ; Olecranon Process* ; Osteomyelitis* ; Sulfur ; Suppuration ; Tears ; Tendons

The purpose of this study was to investigate the eating behaviors, the self-perception of body images, the hematological indices and the nutrient intake of adolescent female athletes in Incheon. The subjects were 112 female athletes (track and field: n = 32, target shooting: n = 27, fencing: n = 29, swimming: n = 14, badminton: n = 10) from middle and high schools in Incheon. This cross-sectional study was conducted by means of a self-administered questionnaire. Fasting blood samples were obtained and analyzed for hemoglobin (Hb), hematocrit (Hct), ferritin, serum iron, mean cor-puscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), unsaturated iron binding capacity (UIBC), total iron binding capacity (TIBC) and transferrin saturation (TS). Nutrient intakes obtained by means of the 3 day-recall method were analyzed using the Computer Aided Nutritional Analysis Program. Statistical analysis was conducted using the SPSS 10.0 program. Most of the female athletes had dietary problems such as eating unbalanced meals, skipping meals, and preferences for processed foods. More than 60% of the female athletes skipped breakfast. As for perception of their body images, track and field athletes in particular, controlled their weights significantly better than the other athletes (p < 0.05). With regard to their physical exertion during exercise, 56.3% of the swimmers and 31.3% of the track and field athletes answered "very hard", which was a significant difference (p < 0.001). More than 80% of the female athletes experienced vertigo during exercise (p < 0.01). Also more than 50% of the female athletes, with the exception of the badminton players, had experienced irregular menstruation (p < 0.05). The average serum iron levels (p < 0.05), the serum ferritin levels (p < 0.05) and TS (p < 0.05) of the track and field athletes was significantly lower as compared to that of the other athletes. The nutrient intakes of the female athletes, with the exception of Vitamin B6, niacin and phosphorus were lower than the Korean Recommended Daily Allowances (RDA). In particular, the calcium and iron intakes of the female athletes were under 50% of the Korean RDA. Therefore, proper nutritional education and supplementation are required for female athletes to encourage desirable eating habits, as well as to improve their nutritional status and exercise performances.
Adolescent* ; Athletes* ; Body Image* ; Breakfast ; Calcium ; Cross-Sectional Studies ; Eating* ; Education ; Erythrocyte Indices ; Fasting ; Feeding Behavior* ; Female* ; Ferritins ; Hematocrit ; Humans ; Incheon* ; Iron ; Meals ; Menstruation ; Niacin ; Nutritional Status ; Phosphorus ; Physical Exertion ; Racquet Sports ; Recommended Dietary Allowances ; Self Concept ; Swimming ; Track and Field ; Transferrin ; Vertigo ; Vitamin B 6 ; Weights and Measures ; Surveys and Questionnaires

Hepatic angiomyolipoma is a rare benign lipomatous tumor of the liver. Radiologic studies usually reveal a fat component, but since this may be minimal, such a component is not always detected. We report a case of atypical hepatic angiomyolipoma which because of the non-visualization of fat at CT and MR imaging, was difficult to differentiate from other hypervascular tumors.
Angiomyolipoma* ; Liver ; Liver Neoplasms ; Magnetic Resonance Imaging

Gachon Medical School used an oral examination in the pathology course taught during the 2nd semester of the 2000 school year as a performance assessment of students abilities in three areas: comprehension, logic and problem solving. The evaluation instrument was designed in four stages: assessment objectives were determined, abilities to be measured were selected, the assessment instrument was designed, and the examiners' checklist was drafted. The assessment instrument included two gross and two microscopic cases and the checklist was developed using 5 Likert type scales. The students were divided into three groups of 12 to 13 students and two examiners were allocated to each group. The mean score on the oral examination was 3.56(the highest possible score is 5.00). The correlation between examiners was 0.952 while the correlation of gross and microscopic cases was 0.979. Obviously, these data are statistically significant. The correlation between the written examination pathologic-laboratory examination was the highest, that between the oral examination and pathologic-laboratory examination was in the middle, and that between the oral examination and the written examination was the lowest. Students expressed doubts about the objectivity of individual examiners. The high correlation between the examiners' scores and how students scored on other tasks shows that students fears can be assuaged. It is concluded that the oral examination is a powerful tool in measuring students ability, and can be used in a basic medical science course. As an assessment instrument, it is both valid and reliable.
Checklist ; Comprehension ; Diagnosis, Oral ; Humans ; Logic ; Pathology* ; Problem Solving ; Schools, Medical ; Weights and Measures

Short rib-polydactyly syndrome (SRPS) is a rare type of skeletal dysplasia characterized by short limb dysplasia, thoracic hypoplasia, polydactyly and multiple visceral anomalies. It is transmitted as a autosomal recessive trait. There have been 4 classic types of SRPS, of which Saldino-Noonan type is the most common, and is characterized by very narrow thorax, short limb, postaxial polydactyly, striking metaphyseal dysplasia of tubular bones, pelvic abnormalities, hypoplasia of iliac bones, flat acetabulae, and abnormalities of urogenital, anorectal and cardiovascular system. We report a newborn infant who had typical features of Saldino-Noonan type SRPS, clinically and radiologically and had compatible autopsy findings.
Acetabulum ; Autopsy ; Cardiovascular System ; Extremities ; Humans ; Infant, Newborn ; Pelvic Bones ; Polydactyly ; Short Rib-Polydactyly Syndrome* ; Strikes, Employee ; Thorax

Pulmonary alveolar proteinosis(PAP) is a rare disease in which the alveolar spaces are filled with an eosinophilic, PAS-positive material, whereas the interstitial architecture of the lung usually remains unaffected. Although a definitive diagnosis is usually made by an open lung biopsy, bronchoalveolar lavage(BAL) cytology may play a decisive role in the diagnosis and therapy of these patients and may spare a patient a more invasive diagnostic procedure. The author presents a patient in whom BAL cytology specimen contained the characteristic globules of amorphous proteinaceous PAS-positive material accompanied by background of rare macrophages and inflammatory cells. Ultrastructural study using BAL specimen can confirm the diagnosis of PAP.
Biopsy ; Bronchoalveolar Lavage* ; Diagnosis ; Eosinophils ; Humans ; Lung ; Macrophages ; Pulmonary Alveolar Proteinosis* ; Rare Diseases

Pulmonary amyloid deposition generally occurs with concurrent primary systemic amyloidosis. Localized forms of pulmonary amyloidosis are rare and appear most frequently as an incidental finding on chest radiographs. We present a case of nodular pulmonary amyloid tumor suggested by fine needle aspiration cytology (FNAC) and confirmed by histologic examination with the polarizing light microscopy. A 41-year-old woman presented with ill-defined nodules in the middle and lower lobes of both lungs. FNAC of the nodules revealed waxy, acellular amorphous fragments. Thoracotomy for diagnosis may be avoided by FNAC diagnosis of this unusual lesion.
Adult ; Amyloid ; Amyloidosis* ; Biopsy, Fine-Needle* ; Diagnosis ; Female ; Humans ; Incidental Findings ; Lung ; Microscopy ; Plaque, Amyloid ; Radiography, Thoracic ; Thoracotomy

BACKGROUND: Although abnormalities of p53 gene and their relation to clinicopathologic parameters have been identified in some human malignancies, there is little published data on their prevalence and clinical significance in ampullary adenocarcinoma (AAC). The aim of this study is to determine the prevalence of p53 abnormalities in AAC and to evaluate their relation to clinicopathologic features. METHOD:35 formaline-fixed paraffin-embedded tissues of AAC were examined for detection of p53 abnormalities by both single-strand conformation polymorphism (SSCP) analysis of polymerase chain reaction- amplified DNA fragments corresponding to exons 5-8 and immunohistochemistry (IHC) using monoclonal antibody to p53 protein (Novocastra, DO7), and the association between the p53 abnormalities and clinicopathologic parameters was analyzed. RESULT: In 22.9% of AAC, p53 gene muation was demonstrated by SSCP analysis, mainly at PCR-amplified exon 8 and exon 7. The p53 protein overexpression by IHC was 48.6% of AAC. Six SSCP and IHC-positive (17.2%) cases and 16 normal (45.7%) cases showed concordant results between the methods, although 13 cases (37.1%) showed discordance, including 11 IHC-positive (31.4%) and 2 SSCP-positive (5.7%) cases. Overall, the prevalence of p53 abnormalities was 54.3%. No significant associations between the p53 abnormalities and clinicopathological parameters such as clinical manifestations, histologic differentiation, and tumor stage were observed. CONCLUSION: The p53 abnormalities detected in 55% of AAC are not associated with prognostic factor, suggesting that abnormal p53 gene may play a role in the development of AAC, but not in its invasiveness.
Adenocarcinoma* ; DNA ; Exons ; Genes, p53* ; Humans ; Immunohistochemistry ; Polymorphism, Single-Stranded Conformational ; Prevalence*

Although the peritoneum is rare site for a primary neoplasm, certain malignant neoplasms may arise from it. A case of 63-year-old woman who had a serous papillary carcinoma of peritoneal origin is reported. Extraovarian peritoneal serous papillary carcinoma was characterized by ascites, malignant washings, and omental involvement with bulky infiltration and/or multiple tumor nodules. The symptoms caused by diffuse spreading of the neoplasm over the peritoneum are the most important manifestation for clinical diagnosis of malignant primary neoplasm of peritoneum, especially serous papillary carcinoma. This behaving tumor was at least partially responded to therapy. In this report, we describe a case of serous papillary carcinoma of peritoneum carring on proper management with brief review.
Ascites ; Carcinoma, Papillary* ; Diagnosis ; Female ; Humans ; Middle Aged ; Peritoneum*

The mutations that occur in the p53 tumor suppressor gene have been studied in various human malignant tumors. However, little is known about this gene in meningiomas. To investigate the relationship and frequency of p53 gene mutations, the p53 polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) and immunohistochemical study were performed on the 41 intracranial meningiomas (21 benign, 11 atypical, and 9 malignant). The higher the p53 protein expression rate, the poorer the histologic grade (9.5%, 72.7%, and 88.9% in benign, atypical and malignant meningioma, respectively) (p=0.000). The p53 protein expression rate was higher in recurrent meningioma (71.4%) than in nonrecurrent meningioma (10.5%) (p=0.002). PCR-SSCP method was performed in positive p53 protein immunoreactivity cases. p53 gene mutation rate was higher in the atypical (62.5%) and malignant (25%) meningiomas than in the benign meningioma (0%) (p=0.232). Also, the rate was higher in recurrent menigioma (20%) than in nonrecurrent meningioma (0%) (o=0.495). Among five to eight exons of the p53 gene, the mutation was observed on exon 7 more frequently. In conclusion, p53 immunoreactivity and p53 gene mutation are closely correlated with histologic grade and histologic atypia of intracranial meningiomas. p53 gene mutation would be considered as a useful marker to detect the progression of intracranial meningiomas.
Brain Neoplasms/pathology ; Brain Neoplasms/genetics* ; Human ; Meningioma/pathology ; Meningioma/genetics* ; Mutation* ; Neoplasm Invasiveness ; Protein p53/genetics*