Granulocytic sarcoma is a rare localized tumor composed of granulocytic precusor cells. Granu-locytic sarcoma occurs in a variety of clinical conditions and it is often misdiagnosed histologically. Differential diagnosis frorh lymphoma or nonhematopoietic malignancies such as undifferentiated carcinoma or sarcoma is difficult in the routing histologic examination. An evaluation of clinical and histopathologic features was done on 4 cases of granulocytic sarcoma which were diagnosed at Pusan Paik Hospital from 1988 to 1992. During the period, 282 cases of myelogenous leukemia were diagnosed. Immunohistochemical reaction for lysozyme, myelopero-xidase, leukocyte common antigen, epthelial membrane antigen and cytokeratin was assessed comparing to lymphoma and undifferentiated carcinoma. The histologic features of the granulocytic sarcoma revealed thin nuclear membrane, fine chromatin pattern and one or two small nucleoli. It also often involved the vascular wall and infiltrated the native structures without destruction. Immunohistochemical stain revealed that all(4 cases) of granulocytic sarcoma showed diffuse and strong positivity for myeloperoxidase, and partial but strong positivity for lysozyme. One case of granulocytic sarcoma was negative and 3 cases revealed focal positive reaction for LCA, and all 4 cases was negative for cytokeratin and EMA. In summary, careful observation under light microscopy with immunohistochemical stain for myeloperoxidase, lysozyme, and LCA is helpful in the differential diagnosis of granulocytic sarcoma from malignant lymphoma and cytokeratin and EMA is useful for differential diagnosis from undifferentiated carcinoma.
Diagnosis, Differential

Malignant transformation of benign cystic teratomas of the ovary is rare, with an incidence rate of 1-3%. The most common malignancy associated with benign cystic teratoma of the ovary is squamous cell carcinoma, which represents 90% of malignant transformations, followed by adenocarcinoma and carcinoid. Primary malignant neuroectodermal tumor in a mature cystic teratoma is extremely rare and microscopically can be subclassified as differentiated, primitive, and anaplatic. We experienced a case of primitive neuroectodermal tumor (PNET) associated with mature cystic teratoma of the ovary in a 11-year-old girl. Grossly, the ovary was a unilocular cyst which contained sebum material and disclosed several large, yellow to gray-tan polypoid excresences attached to the inner cystic wall. Except a large, fish-flesh, soft mass, the other polypoid masses were covered with sebum and contained small pieces of cartilage and tooth, and microscopically represented as mature teratoma. The large, fish-flesh, soft mass disclosed sheets and lobules of closely packed small cells with thin fibrovascular septa, which frequently replacing and encroaching the mature cystic teratoma. The small tumor cells were uniform and made up of round to oval nuclei with coarse chromatin and prominent nucleoli, very similar to those of PNET of the central nervous system.
Incidence ; Cysts ; Adenocarcinoma

Fractures of the zygoma are rarely encountered in pediatric patients. This report presents a case of a 3-year-old child who presented with a vertically split fracture of the marginal tubercle of the zygoma. The marginal tubercle, a bony portion present on the posterior border of the frontal process, assists in attaching the temporalis fascia. This patient was treated surgically with bony fixation using tissue glue. To the best of our knowledge, no cases of fracture of the marginal tubercle of the zygoma have been reported in the literature. Fractures of the marginal tubercle of the zygoma in pediatric patients may be overlooked because of their anatomic location and the musculoskeletal characteristics of these patients. Here, we discuss the clinical features of marginal tubercle fractures of the zygoma.

To evaluate the platelet activation in vivo in the patients with coronary artery disease Indium-111 labeled autologus platelet survival time was measured. Platelet survival determinations were made according to a modified method for radioisotope platelet survival studies recommended by the Panel on Diagnostic Application of Radioisotopes in Hematology of the International Committee for Standardization in Hematology. Autologous platelets were labeled with 111 In-oxine utilizing a similar method used at the Mallinckrodt Institute of Radiology. The results are summarized as follows : 1) In the patients with coronary artery disease, especially acutemyocardial infarction, the mean platelet survival time was significantly shorter than that of the normal controls(P<0.05). 2) The mean platelet survival time did not differ significantly between patients with acute myocardial infarction and angina pectoris. 3) The mean platelet survival time did not differ significantly between nonsmoker and smoker in the patients with coronary artery disease.
Angina Pectoris ; Blood Platelets* ; Coronary Artery Disease* ; Coronary Vessels* ; Hematology ; Humans ; Infarction ; Myocardial Infarction ; Platelet Activation ; Radioisotopes

BACKGROUND AND OBJECTIVES: Chronic sinusitis with nasal polyposis, asthma and aspirin sensitivity characterize Samter's triad. The sinusitis associated with the triad is often difficult to treat and aggravates the asthmatic symptoms. This study was conducted to evaluate the feature of the triad and the outcome of endoscopic sinus surgey (ESS) as a treatment for chronic paranasal sinusitis with nasal polyposis in patients with Samter's triad. MATERIALS AND METHOD: The study group contained 16 patients with the triad who were compared with the control group (60 patients). The study was conducted in retrospective fashion focusing clinical characteristics, recurrence and re-operation rate of sinusitis and severity of asthma. RESULTS: ESS in Samter's triad patients was effective on the improvement of nasal symptoms. Fourteen of 16 patients recurred after ESS. Seven patients of 14 patients received systemic steroid therapy. Four patients of 7 patients underwent revision surgery. Three patients had asthmatic attack after postoperative use of analgesics. There was no significant improvement of asthmatic symptoms after ESS. CONCLUSION: This study suggests that the surgical intervention was less effective on Samter's triad patients. The recurrence and reoperation rate of nasal polyposis in Samter's triad patients were high. The use of NSAID should be avoided after ESS in asthmatics with nasal polyposis.
Analgesics ; Aspirin ; Asthma ; Endoscopy ; Humans ; Recurrence ; Reoperation ; Retrospective Studies ; Sinusitis

Pseudomyxoma peritonei may result from implantation of benign or malignant tumor in peritoneal cavity and is filled with gelatinous material (termed "Jelly Belly") in abdominal cavity. Its origin is usually an appendiceal or ovarian mucinous adenoma or cystadenocarcinoma, but other primary origin such as uterus, intestine, pancreas and stomach umor have been reported. Generally, pseudomyxoma peritonei is slowly progressive and has low grade malignant potential. This report presents a unusual long term survival after evacuation of 15,000 cc of gelatinous material from abdominal cavity which was the low grade mucinous adenocarcinoma and a review of the current literature, management and new its concept. The origin of pseudomyxoma peritonei of this case was most likely from appendiceal mvcinous adenocarcinoma.
Abdominal Cavity ; Adenocarcinoma ; Adenocarcinoma, Mucinous ; Adenoma ; Cystadenocarcinoma ; Gelatin ; Intestines ; Mucins ; Pancreas ; Peritoneal Cavity ; Pseudomyxoma Peritonei* ; Stomach ; Uterus

To get basic data for the development of health care toward the staff of a university, an evaluation study of the risk factors for the cardiovascular disease utilizing data from questionnaire and health examination performed in 1994 for 1233 staff of Chosun University and its affiliated Hospital. The results are as follows: 1. The mean values of systolic blood pressure was 122.0+/-14.7mmHg for the male and 111.8+/-12. lmmHg for the female. The mean values of diastolic blood pressure was 82. 5+/-12.0mmHg for the male and 73.7+/-10.0mmHg for the female. The mean values of serum total cholesterol was 185.6+/-33.4mg/dl for the male and 173.5+/-32.6mg/dl for the female. The mean values of body mass index(BMI) was 23. l+/-2.4kg/m2 for the male and 21.5+/-2.3kg/m2 for the female. The smoking rate of the male was 47. 6% and that of the female was 0.4%. 2. The systolic and diastolic blood pressure levels increased with age in both sexes. Under 55 years of age the mean blood pressures of the male were higher than that of the female, but the levels of both sexes at 55-64 year old group did not show any big difference. The mean values of serum total cholesterol and BMI also increased with age in both sexes. Under 45 years of age, the serum cholesterol and BMI levels of the male were higher than that of the female, but on the contrary, levels of the male were lower than that of the female at 55-64 year old groups. The mean cholestrol and BMI levels of both sexes at 45-54 year old group was similar. As the age increases, the rate of exsmoker increased and the rate of current smoker decreased among the male. 3. The additive cardiovascular risk scores were calculated considering the values of blood pressure, serum total cholesterol level and the smoking status. The distribution curve of risk scores for the male showed 39. 1% under 4 points and 60.9% above 4 points with the peak at 4 points. 61.7% of the female showed that the risk scores were under 4 points and the rest was more than 4 points with maximum 9 points. As a whole the risk scores of the female were lower than that of the male. 4. By the analysis of association between the risk score of cardiovascular disease and the subjective symptom under the stratification of age and sex, the prevalence of exertional dyspnea was significantly higher at 35-44 year male group and prevalence of dizziness was significantly higher at 45-64 year male group as the risk score of cardiovascular disease increased. Among 25 34 year and 45-64 year female group persons with lower risk score of cardiovascular disease showed higher prevalence of dizziness than persosns with higher risk score.
Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Delivery of Health Care ; Dizziness ; Dyspnea ; Female ; Humans ; Male ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Surveys and Questionnaires

As is well known, myxoma of the heart is very rare(incidence 0.03%), constituting nearly 50% of all primary cardiac tumors. It is important because it can be abolished by surgical removal but usually fatal if unrecognized or untreated. Recently a wider use of echocardiogram as the screening test of valve lesions can be expected to increase the number of myxomas found preoperatively. We have experienced a case of bilateral atrial myxoma which simulated mitral valvular disease clinically and had typical three cardinal manifestations such as obstructive, embolic and constitutional symptoms. The patients was 39 years old woman. The left atrial myxoma was diagnosed preoperatively by echocardiography and cardiac angiography and the remainder during open heart surgery under the E.C.C. Both of them were removed successfuly and confirmed as typical myxoma microscopically. This is the first case report of bilateral atrial myxoma in Korea to our knowledge.
Adult ; Angiography ; Echocardiography ; Female ; Heart ; Heart Neoplasms ; Humans ; Korea ; Mass Screening ; Myxoma* ; Thoracic Surgery

Recently, the Korean Medical Association (KMA) launched the KMA Policy system based upon the American Medical Association (AMA) Policy system. The KMA's official positions on health issues and medical ethics, as well as its constitution, bylaws, and directives, will be included in the KMA Policy system. The AMA's organizational structure and decision making process provided essential information for developing the KMA Policy system. Through the KMA Policy system, hereafter, the KMA should introduce a procedure not only to decide upon positions on various health issues but also a means to open them to the public. In addition, the KMA can expect the continuity and transparency of work, enhanced benefits to members, public credibility, and growth of its social reputation by means of KMA Policy. Furthermore, the system would be beneficial for both KMA members and the public, as they can easily access KMA Policy, and, in turn, access the healthcare systems of Korea and its medical knowledge. To achieve a successful KMA Policy system, the definite authority and responsibility should be granted to the organizational bodies of the KMA, for example, the House of Delegates and Board of Trustees, and the regional societies and other sections. These various groups must then efficiently divide up their work and cooperate systematically. Moreover, it is crucial that each individual member of the KMA pay much more attention to health issues and participate in the decision making process on KMA Policy.
American Medical Association ; Constitution and Bylaws ; Decision Making ; Delivery of Health Care ; Ethics, Medical ; Financing, Organized ; Humans ; Korea ; Power (Psychology)* ; Trustees

Retroperitoneal teratoma is comparatively rare and yet difficult to treat and predict the prognosis. Recently we experienced 2 cases of retroperitoneal teratoma in the infancy, which was suspected by radiologic investigation and confirmed by exploration and microscopic examination.
Prognosis ; Teratoma*