Acute Tubulointerstitial Nephritis with Renal Failure Complicated by Typhoid Fever

Typhoid fever is a systemic infectious disease which affects many organs. In children, few cases have been reported of acute nephritic syndrome in typhoid fever. We report an immunocompetent 9-year old girl with typhoid fever complicated by acute tubulointerstitial nephritis who presented with prolonged fever and acute renal failure.

Tumoral Calcinosis in Inguinal Region

A tumoral calcinosis is considered a rare disorder with a poorly understood etiology. This uncommon soft tissue calcification is characterized clinically by the presence of an irregular, painless, periarticular soft tissue calcifying mass. People from African decent are mainly affected with the disease, which typically occurs in the periarticular regions. We report a case of a middle aged woman who complained a left inguinal subcutaneous mass. The characteristic clinical features, radiological and pathological findings are described. A diagnosis of a tumoral calcinosis can be difficult to make due to the unfailiarity of its clinical and radiological features. This presented report will help surgeons to easily diagnose this condition.

Two Cases of Adenocarcinoma Arising from Short Segment Barrett's Esophagus / 대한소화기내시경학회지

Barrett's esophagus is considered as a premalignant condition in which columnar epithelium replaces the normal esophageal squamous epithelium. The diagnosis of Barrett's esophagus is based on the endoscopic finding of columnar epithelium lining the distal esophagus and histologic confirmation of the presence of specialized intestinal metaplasia. According to the extent of the metaplastic lining from the esophagogastric junction, Barrett's esophagus has been divided into long-segment (> or =3 cm in length) and short-segment (<3 cm in length). Long-segment Barrett's esophagus can be easily identified at endoscopy, but it is difficult to separate short-segment Barrett's esophagus from intestinal metaplasia of cardia. It has been reported that Barrett's CK 7/20 pattern is an objective marker of Barrett's mucosa, and can differentiate Barrett's mucosa from gastric intestinal metaplasia. We report here two cases of adenocarcinoma of esophagus arising from short-segment Barrett's esophagus, diagnosed by endoscopic and histologic findngs, and treated by endoscopic mucosal resection.

Paleopathologic Analysis of a Mummified Pregnant Woman of Papyung Yoon's Family

BACKGROUND: A mummy is a dead body of a human being or an animal that has been preserved artificially or naturally from decaying. Because the natural environment of Korea isn't appropriate for mummification and Korean people haven't artificially made mummies, mummies were rarely studied in Korea. METHODS: On September 6, 2002, a well-preserved female mummy was found in the grave of a family in Kyunggi-do. She was submitted to a thorough autopsy examination along with the review of genealogical documents. RESULTS: The mummy died in winter. She was pregnant and the fetal head was observed at the vaginal orifice. The uterine wall was ruptured, and the peritoneum was discolored, probably by hemorrhage. Histologically, the gastric mucosa was well preserved. On the smear cytology of gastrointestinal material and the fluid from the coffin, pollens and parasitic eggs were observed. The woman seemed to be death from hypovolemic shock due to uterine rupture during the 2nd phase of labor. CONCLUSION: From this case, we concluded the causes of the woman's mummification included the cold and dry circumstance at the time of her death, and the thick mortared wall of the grave that completely isolated the body from the outside.

Quantitative Nuclear Characteristics of Lung Cancer Cells Using Image Analysis

BACKGROUND: The usefulness of quantitative nuclear image analysis in the classification of lung carcinoma is widely investigated and published. In this study, we tried to measure the nuclear characteristics of primary lung carcinomas by image analysis and to find the possibility of differential diagnoses. METHODS: Seventeen cases of adenocarcinomas (not including bronchioloalveolar carcinoma), seven of bronchioloalveolar carcinomas, eight of large cell neuroendocrine carcinomas, five of small cell carcinamas, and 26 of squamous cell carcinomas were analysed. Three different images of each case were captured by digital camera, and we analyzed the nuclear area, perimeter, circularity, and density using the Optimas 6.5 Image Analyser software package. Statistical analyses were done using the statistical program STATISTICA kernel release 5.5. RESULTS: The mean nuclear area was 0.52+/-0.25micrometer2 in the adenocarcinomas, 0.50+/-1.82micrometer2 in the squamous cell carcinomas, 0.45+/-0.20micrometer2 in the large cell neuroendocrine carcinomas, 0.42+/-0.16micrometer2 in the bronchioloalveolar carcinomas, and 0.31+/-0.12micrometer2 in the small cell carcinamas. The nuclear area was significantly different between the small cell carcinomas and the non-small cell carcinomas (p<0.01) and between the adenocarcinomas and the bronchioloalveolar carcinomas (p=0.02). The mean nuclear perimeter was 3.36+/-0.92micrometer2 in the adenocarcinomas, 3.24+/-0.67micrometer2 in the squamous cell carcinomas, 3.16+/-0.82micrometer2 in the large cell neuroendocrine carcinomas, 3.05+/-0.80micrometer2 in the bronchioloalveolar carcinomas, and 2.54+/-0.62micrometer2 in the small cell carcinamas. The nuclear perimeter was significantly different between the small cell carcinomas and the non-small cell carcinomas (p<0.04). The nuclear circularity showed no statistical difference. Nuclear density was the highest in the squamous cell carcinomas, and the lowest in the small cell carcinomas. The large cell neuroendocrine carcinomas showed the lowest standard deviation in nuclear density. CONCLUSION: The analysis of nuclear characteristics using an image analyser can be used as an objective method in the classification of lung carcinoma.

Submucosal CD4+ and CD8+ T Lymphocyte Infiltrations in Asthma and Eosinophilic Bronchitis / 결핵

BACKGROUND: Asthma and eosinophilic bronchitis(EB) are eosinophilic inflammatory diseases of the airway. However, EB differs from asthma in that there is no variable airway obstruction or airway hyper-responsiveness. Pathologically, asthma is characterized by the accumulation of eosinophils and CD4+ T lymphocytes in the submucosa. A recent study showed that there was no significant difference between asthma and EB in terms of the submucosal eosinophil and T lymphocyte count. However, it is not known whether or not an infiltration of CD4+ and CD8+ T lymphocytes occurs in the airways of EB patients. The aim of this study was to identify the difference between the two conditions by measuring the submucosal CD4+ and CD8+ T lymphocyte count. METHODS: Immunohistochemical analysis of bronchial-biopsy specimens was performed in 17 subjects with asthma and 24 subjects with EB. RESULTS: The CD4+ T lymphocytes count in the asthma subjects and the EB subjects was similar (median, 58.6 vs 50.0 cells/mm2, respectively; P=0.341). In contrast, the number of CD8+ T lymphocytes in the EB subjects was higher than that in the asthma subjects (median, 46.7 vs 11.8 cells/mm2, respectively; P=0.003). CONCLUSION: The infiltration of submucosal CD8+ T lymphocytes may be associated with the pathophysiology of EB.