Frozen Cytology of Meningeal Malignant Solitary Fibrous Tumor/Hemangiopericytoma

A 51-year-old woman presented with severe dizziness. The brain magnetic resonance image revealed a 5.5 cm multiloculated mass with a thick rim in the left temporal lobe. Cytological examination of frozen diagnosis of the mass showed hypercellular sheets of round and rhabdoid cells in a hemorrhagic background, and two mitotic figures were observed. Histologically, the excised dura-based mass consisted of predominantly round cells with small foci of rhabdoid tumor cells in a pseudoalveolar pattern in a hemorrhagic background, and the cells showed nuclear positivity for signal transducer and activator of transcription 6 as well as frequent mitosis. The mass was diagnosed as a grade 3 solitary fibrous tumor (SFT)/hemangiopericytoma (HPC). The cytological diagnosis of SFT/HPC is challenging because of the heterogeneous cytological findings, such as histological heterogeneity, and because there are no standardized cytological criteria for malignant SFT/HPC. Cytological findings, such as singly scattered small cells, hypercellularity, rare ropy collagen, and round and rhabdoid cells with pseudoalveolar pattern, may assist in the diagnosis of malignant SFT/HPC

Development of an approximate construction duration prediction model during the project planning phase for general office buildings

Accurate prediction of the construction duration is imperative to the reliable cash flow analysis during the project planning phase when feasibility analysis is carried out. However, lack of information and frequent changes that occur as a result of a negotiation process between the owner and the designer in defining the project scope make it difficult to compute real-time construction duration. Domestic and foreign models for calculating the construction durations cannot be readily applied to computation of construction duration for general office buildings in Korea specifically during the project planning phase as there is a limit in its applicability due to numerous restrictions. Moreover, there are no preceding studies suggesting different computational approaches to predict the entire construction duration for office buildings with the approximate construction duration concept during planning phase. Therefore, based on the collected performance data, this study proposes a multiple linear regression model that facilitates reliable prediction of approximate construction duration for office buildings in the project planning phase. The model will allow the owner and other stakeholders to predict the real-time construction duration using the basic information on office buildings and to assess the construction durations incorporating frequent changes during the project planning phase

Intramedullary Clear Cell Ependymoma in the Thoracic Spinal Cord: A Case with Its Crush Smear and Ultrastructural Findings

Clear cell ependymoma was included in the World Health Organization classification of the nervous system in 1993, and all the reported cases, except for two in the spinal cord, were located in the brain, mainly in the supratentorial compartment. Astrocytomas outnumber ependymomas in the spinal cord, and the two entities partly share cytologic findings such as long, bipolar glial processes and oval to round nuclei resembling those seen in pilocytic astrocytoma. Here, we report the first Korean case of intramedullary clear cell ependymoma of the spinal cord, which is the third case situated in the spinal cord in the literature. The crush smear revealed round-to-oval nuclei with occasional nuclear eosinophilic inclusion and rare nuclear grooves. Cytoplasm had fluffy eosinophilic glial processes, and acellular fibrillary zone. On hematoxylin-eosin stain, oval to round tumor cells had large central nuclei with indistinct nucleoli and a moderate amount of clear cytoplasm, i.e. perinuclear halo, mimicking oligodendroglioma. Perivascular pseudorosettes and ependymal clefts were rarely found. In retrospect, perinuclear halo was absent on crush smears. Ultrastructurally, they had extensive surface microvilli and edematous cytoplasm filled with abundant glial filaments and microlumens with or without microvilli. Intercellular long cell junctions of the zipper-like zonula adherens type were found

Strongyloidiasis Presenting as Yellowish Nodules in Colonoscopy of an Immunocompetent Patient

Strongyloides stercoralis is endemic to tropical and subtropical regions, and infections are usually asymptomatic. However, immunocompromised patients, such as those receiving immunosuppressive therapy, high-dose steroids, or chemotherapy, can develop fatal hyperinfections. An 84-year-old man without any symptoms was diagnosed with strongyloidiasis during a regular screening colonoscopy. His medical history only involved a gastric endoscopic submucosal dissection for early gastric cancer 6 months previously. Few cases have been published about asymptomatic strongyloidiasis diagnosed in an immunocompetent host via endoscopic mucosal resection with characteristic colonoscopic findings. We report a case of colon-involved asymptomatic strongyloidiasis with specific colonic findings of yellowish-white nodules. This finding may be an important marker of S. stercoralis infection, which could prevent hyperinfections

Successful Treatment of Small-Cell Lung Cancer With Irinotecan in a Hemodialysis Patient With End-Stage Renal Disease

The prognosis of patients with end-stage renal disease has improved with advances in hemodialysis techniques. However, many patients who undergo hemodialysis suffer from various types of cancer. Limited data is available to guide clinical management of these patients who may have impaired renal function. Here, we report our experience with the use of irinotecan for the treatment of a hemodialysis patient with small-cell lung cancer and end-stage renal disease

A Case of Focal Segmental Glomerulosclerosis Associated with Aplastic Anemia

The pathogenic mechanism of focal segmental glomerulosclerosis (FSGS) and aplastic anemia are associated with immunologic events which lead to glomerular cell injury or hematopoietic cell destruction. We present an extremely rare case of FSGS with aplastic anemia in a 30-yr-old woman. The laboratory examination show-ed hemoglobin 7.2 g/dL, white blood count of 4,200/µl, platelet count 70,900/µl. Proteinuria (2+, 3.6 g/day) and microscopic hematuria were detected in urinalysis. The diagnosis of FSGS and aplastic anemia were confirmed by renal and bone marrow biopsy. She was treated with immunosuppressive therapy of prednisone 60 mg/day orally for 8 weeks and cyclosporine A 15 mg/kg/day orally. She responded with gradually improving her clinical manifestation and increasing peripheral blood cell counts. Prednisone was maintained at the adequate doses with tapering after 8 weeks and cyclosporine was given to achieve trough serum levels of 100-200 ng/mL. At review ten month after diagnosis and initial therapy, the patient was feeling well and her blood cell counts increased to near normal (Hb 9.5 g/dL, Hct 32%, WBC 8,300/µl, platelet 123,000/µl) and renal function maintains stable with normal range proteinuria (0.25 g/day)

Marginal Zone B-cell Lymphoma of MALT in Small Intestine Associated with Amyloidosis: A Rare Association

A 62-yr-old man presented with a 5-yr history of intermittent abdominal distention and pain. These symptoms persisted for several months and subsided without treatment. A diagnosis of suspected small bowel lymphoma was made based on plain radiograph and computerized tomogram findings, and he was referred to our institution for further evaluation. Segmental resection of the small intestine was performed and the diagnosis of marginal zone B-cell lymphoma associated with amyloidosis was made. This is the first case of marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) in the small intestine associated with amyloidosis in Korea

A case of amoxicillin-induced hepatocellular liver injury with bile-duct damage

Amoxicillin, an antibiotic that is widely prescribed for various infections, is associated with a very low rate of drug-induced liver injury; hepatitis and cholestasis are rare complications. Here we present a case of a 39-year-old woman who was diagnosed with abdominal actinomycosis and received amoxicillin treatment. The patient displayed hepatocellular and bile-duct injury, in addition to elevated levels of liver enzymes. The patient was diagnosed with amoxicillin-induced cholestatic hepatitis. When amoxicillin was discontinued, the patient's symptoms improved and her liver enzyme levels reduced to near to the normal range

Clinical Characteristics of Coronary Drug-Eluting Stent Fracture: Insights from a Two-Center DES Registry

Stent fracture (SF) has been implicated as a risk factor for in-stent restenosis, but its incidence and clinical characteristics are not well established. Therefore we investigated the conditions associated with stent fracture and its clinical presentation and outcome. Between 2004 and 2007, consecutive cases of SF were collected from the Seoul National University Hospital. Clinical characteristics and outcome of patients with fractured stents were compared with a ten-fold cohort of age and gender matched controls (n = 236). A total of 4,845 patients received percutaneous coronary intervention and 3,315 patients (68.4%) underwent angiographic follow-up. Twenty-eight fractured stents were observed in 24 patients. The incidence of SF was 0.89% for sirolimus-eluting stents (SES) and 0.09% for paclitaxel-eluting stents. Chronic kidney disease, stent implantation in the right coronary artery (RCA), and SES use were independent predictors of drug-eluting stent fracture by multivariate analysis. SF was significantly associated with binary restenosis (11.4% vs 41.7%, P < 0.001) and increased risk of target lesion revascularization (8.1% vs 33.3%, P = 0.001). Patients with SF but without significant restenosis showed excellent outcome despite only medical treatment. In conclusion, SF is associated with increased rates of restenosis and repeat revascularization. Significant risk factors include chronic kidney disease, RCA intervention, and SES use