Hepatoblastoma(HB) is a rare embryonic malignant tumor of the liver. Most morphological studies on HB have limited to the histological characteristics and only 3 cases of HB have been described in the cytology literature. We present 2 cases of HB occurring in children aged 1 year and 3 years, respectively. The distinctive cytologic features of fine needle aspiration of HB were clusters of tumor cells showing acinar and trabecular pattern, smaller tumor cells with a high nuclear-cytoplasmic ratio and hyperchromatic nuclei having prominent nucleoli, and the presence of extramedullary hematopoiesis and osteoid material. These features were also found in the cell block and the biopsy specimen, and appeared very useful in the differentiation of HB from hepatocellular carcinoma.
Biopsy ; Biopsy, Fine-Needle* ; Carcinoma, Hepatocellular ; Child ; Hematopoiesis, Extramedullary ; Hepatoblastoma* ; Humans ; Liver

We analyzed the clinical results of 58 patients who had undergone bilateral medial rectus muscle recession from January, 1988 to June, 1991 at St. Mary's Hospital, Catholic University Medical College. The results were as follows; 1. Mean preoperative deviation, mean recession amount, and mean postoperative deviation were 51PD, 5.8mm and 4PD respectively in suspension recession group and 53PD, 5.7mm and 4PD respectively in conventional recession group. 2. Overall success rate was 81% in suspension recession and 84% in conventional recession at 6 weeks postoperatively, and 67% and 76% respectively at the time of most recent follow-up. The statistical difference in the success rate of recession over 6.0mm and recession under 5.5mm as well as overall success rate between suspension and conventional recession group was not found. 3. Overcorrection was 5% in suspension recession and 2% in conventional recession at 6 weeks postoperatively, and 14% and 3% respectively at the time of most recent follow-up. 4. Undercorrection were 14% in suspension recession and 14% in conventional recession at 6weeks postoperatively, and 19% and 21% respectively at the time of most recent follow-up.
Esotropia* ; Follow-Up Studies ; Humans

Local cutaneous reactions have been reported at injection sites of interferon therapy, but these are usually erythema or rarely induration. Skin necrosis at the injection site is rare. We describe here a patient with multiple sclerosis who presented with cutaneous necrosis at the injection sites of interferon-β. Biopsy of the necrotic lesion showed dermal vessel thrombosis and complete ischemic coagulative necrosis of epidermis and dermis.
Biopsy ; Dermis ; Epidermis ; Erythema ; Humans ; Interferon-beta* ; Interferons ; Multiple Sclerosis ; Necrosis* ; Skin* ; Thrombosis

We compared the clinical results of 37 patients who had undergone bilateral lateral rectus muscle suspension recession and conventional recession from July, 1989 to Decem ber, 1991 at St. Mary's Hospital, Catholic University Medical College. The results were as follows; 1. Mean preoperative deviation, mean recession amount, and mean postoperative deviation were 40PD, 6.9mm and 8PD respectively in suspension recession group and 36PD, 6.3mm, and 4PD respectively in conventional recession group. 2. Success rate was 67% in suspension recession and 86% in conventional recession at 6 weeks postoperatively, and 60% and 82% respectively at the time of most recent follow-up. The statistical difference in the success rate between suspension and conventional recession group was not found. 3. Undercorrection were 33% in suspension recession and 14% in conventional recessoin at 6 weeks postoperatively, and 40% and 18% respectively at the time of most recent follow-up. It appears that high number of undercorrections occurred in suspension recession. But statistical difference in undercorrection between suspension and conventional recession was not found. 4. Overcorrection was not found in suspension recession and conventional recession group at 6 weeks postoperatively and the time of most recent follow-up.
Exotropia* ; Follow-Up Studies ; Humans

Hepatocellular carcinoma(HCC) is malignant tumor frequently occurring in Koreans. There have been few reports regarding the cytologic findings of fine needle aspiration(FNA) of HCC. Most have suggested a diagnostic problem in the cytology distinguishing HCC from some benign hepatic lesion-for example, a regeneration nodule in cirrhosis and liver cell adenoma. In spite of its high frequency in Korea, no cytologic study has been reported, concerning the FNA of HCC. In an attempt to achieve cytologic criteria for the diagnosis of HCC, the authors studied retrospectively cytopathologic findings of 247 cases of HCC. These cases were confirmed either by histologic examination including lobectomy, biopsy, or cell block material, or, when tissue diagnosis was unavailable, by a high serum alpha-fetoprotein level(over 400 I. U.). All aspiration smears were stained by the Papainicolaou method. In each case, the smears were analyzed for cell patterns and various cytomorphology of the tumor cells. The smear background was assessed for the presence of tumor cell necrosis and inflammatory components and compared to that of metastatic carcinomas. The cell patterns were classified as trabecular, acinar, dispersed, and irregular. The cytologic parameters analyzed included the degree of nuclear atypia and the presence of mitoses, intranuclear cytoplasmic inclusions, nucleolar prominency, endothelial lining, multinucleated giant cells, eosinophilc, globules bile and Mallory body. Most of the FNA of HCC showed markedly cellular smears. The tumor cells were most frequently arranged in a trabecular pattern(80.3%). The irregular(12.6%), the acinar(5.5%), and the dispersed patterns(1.7%) followed in decreasing frequency. Individual hepatoma cells were larger than normal liver cells. However, they had morphologic features characteristic of the hepatic cells : the cells were round or polygonal, their cytoplasm was abundant and granular with eosinophilic or amphophilic stainability, and their nuclei were round to oval, located centrally, and tended to have prominent nucleoli. Anaplasia and pleomorphism of tumor cells were generally mild to moderate. These findings existed even in very well differentiated cases. Mitotic figures were present in about 85% of the cases. Prominent nucleoli were observed only in about half the cases. The frequency of other cytologic features was as follows : intranuclear cytoplasmic inclusion in 86.8% ; endothelial lining in 56.1% ; bile in 19.8% ; and giant cells in 60.1%. Clear cells were often present in 11.7%, Most aspiration smears of HCC displayed clean background without necrosis or inflammatory material in contrast to the dirty, necrotic background of metastatic cancers and cholangiocarcinomas. Based on the above mentioned features, it is suqqested that the cytologic critieria most important for the diagnosis of HCC include a markedly cellular smear, trabecular pattern. hepatocytoid appearance of tumor cells, endothelial lining, the presence of bile, giant cells, intranuclear cytoplasmic inclusions, and prominent nucleoli, Among these, trabecular pattern, endothelial lining, giant cells and clean smear background are points to be considered in differentiating HCC from metastatic and cholangiocellular carcinoma.
Adenoma, Liver Cell ; alpha-Fetoproteins ; Anaplasia ; Bile ; Biopsy ; Biopsy, Fine-Needle* ; Carcinoma, Hepatocellular* ; Cholangiocarcinoma ; Cytoplasm ; Diagnosis ; Endothelial Cells ; Eosinophils ; Fibrosis ; Giant Cells ; Hepatocytes ; Inclusion Bodies ; Korea ; Liver ; Mitosis ; Necrosis ; Needles ; Regeneration ; Retrospective Studies

Pulmonary blastoma are a family of tumors in which the glands or mesenchyme composing the neoplasm are primitive or embryonal in appearance. We report a pulmonary blastoma occurring in a 31 years old man. An abnormal shadow was detected in the right lower lung field in a routine chest X-ray film. The preoperative imaging films showed about a 5cm sized well circumscribed solid tumor of the right lung. A preoperative clinical diagnosis of primary lung cancer was considerd. The operative field showed that the hard, round mass, 6 x 5 x 4cm in diameter was localized in middle lobe of the right lung, and partially adhered to the upper lobe, pericardium and diaphragm. Right middle lobe lobectomy, right upper lobe wedge resection, partial pericardiectomy and diaphragm resection with plication was performed with radical lymph node dissection. Histopathologic diagnosis was pulmonary blastoma (Biphasic blastoma). It is considered that the prognosis of biphasic blastoma is worse than WDFA(well differentiated fetal adenocarcinoma). There are no other available treatments except for surgical resection. It is suggested that it is necessary to collect as many cases as possible, to make definite classifications and to examine the clinical course and prognosis of pulmonary blastoma.
Adult ; Classification ; Diagnosis ; Diaphragm ; Humans ; Lung ; Lung Neoplasms ; Lymph Node Excision ; Mesoderm ; Pericardiectomy ; Pericardium ; Prognosis ; Pulmonary Blastoma* ; Thorax ; X-Ray Film

BACKGROUND: Many ophthalmic procedures can be performed using a retrobulbar regional anesthetic technique. However, retrobulbar block is painful and most of patients express anxiety about the procedure. In addition, several life-threatening complications may occur. We compared the effects of midazolam and midazolam-ketamine as a sedative during retrobulbar block in cataract surgery. METHODS: Thirty patients undergoing cataract surgery were randomly allocated into two groups, group I (n=15) was received midazolam and group II (n=15), midazolam-ketamine. Mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO2) were compared before administration of drugs and 1, 2, 3, 4, 5, 10, 20, and 30 min after administration of drugs. Patients' movement requiring restraint were also checked. In the recovery room, postoperative nausea and vomiting, recall, delirium and/or hallucinations, and ocular complications were recorded. RESULTS: There were no significant differences in MAP and SpO2 between groups but heart rates were significantly increased at 1, 2, 3, 4, and 5 min than baseline in group II. Movement score was significantly lower in Group II than in Group I during the block (p<0.05). Recall during performance of the nerve block occured more often in Group I than in Group II (p<0.05). CONCLUSION: Low-dose midazolam-ketamine sedation sequence was superior to a midazolam technique regarding patients' movement and recall.
Anxiety ; Arterial Pressure ; Cataract* ; Delirium ; Hallucinations ; Heart Rate ; Humans ; Midazolam* ; Nerve Block ; Oxygen ; Postoperative Nausea and Vomiting ; Recovery Room