We report a case of 53-year-old man with plasmacytoid transitional cell carcinoma of the urinary bladder, which may be confused with plasmacytoma. The patient initially presented with gross hematuria and dysuria for two months. Cystoscopy and radiologic studies revealed multiple intraluminal protruding masses on the urinary bladder invading perivesical fat tissue. After urinary cytologic examination and cystoscopic biopsy, radical cystectomy and pelvic lymph node dissections were done. Urine cytology showed single cells and poorly cohesive cells with round eccentric nuclei, bi-or multi-nucleation, indistinct nucleoli, coarse chromatin, and abundant basophilic cytoplasm within relatively clear background. The cytologic findings of tumor cells were similar to the plasma cells seen in plasmacytoma. The tumor of the bladder was composed of discohesive, individual cancer cells with diffuse pattern that simulated lymphoma or plasmacytoma. Immunohistochemical and electron microscopic studies clearly established the epithelial nature of the neoplasm. Recognition of this plasmacytoid type of transitional cell carcinoma of the urinary bladder can avoid the misdiagnosis.
Child ; Male ; Female ; Humans ; Biopsy

BACKGROUND AND OBJECTIVE: AT-1 cells have been derived from the left atrial tissue in which the ANF promoter targeted SV40 large T antigen expression. When cultured, clusters of spontaneously contracting cells were observed after 4-5 days and contiguous sheets of synchronously beating cardiomyocytes were formed after 10 days. In this study, expression of several cell cycle regulatory genes were monitored through Northern blot analyses in AT-1 cells during beating and after formation of beating sheets (BS). MATERIALS AND METHOD: AT-1 RNAs were obtained in 3 days after plating, during beating and after formation of BS, and used for Northern blot analyses. RESULTS: alpha-Cardiac myosin heavy chain expression was prominent in beating cells, as would be expected for this contractile protein isoform but ANF was decreased after beating. Gax was not expressed in cultured AT-1 cells but in AT-1 tumor and murine heart. p53 and p21 were decreased after beating which indicate transcription level of p53 and p21 correlated well in AT-1 cells. In contrast, pRB and p107 were increased after beating but p68 (2.4 kb) which arose by alternative splicing of p107 and lacks the pocket domain B was decreased in beating cells. pTCS2, murine tuberous sclerosis gene, represented similar levels during beating but a little was decreased after formation of BS. mRAD50, the murine homologue of yeast DNA recombinational repair gene RAD50, was increased in beating cells, a similar pattern to p107 and pRB. But the p50 arose by alternative splicing of mRAD50 and has 3' half of mRAD50 had unexpectedly appeared and maintained after beating. CONCLUSION: The expression of cell cycle regulatory genes after beating and formation of BS in AT-1 cells showed gene-specific pattern and the p50 which has homology to the mRAD50 may participate in differentiation of cardiomyocytes.
Alternative Splicing ; Antigens, Viral, Tumor ; Atrial Natriuretic Factor ; Blotting, Northern ; Cell Cycle* ; Genes, Regulator* ; Heart ; Myocytes, Cardiac* ; Myosin Heavy Chains ; Recombinational DNA Repair ; RNA ; Tuberous Sclerosis ; Yeasts

Hinman syndrome is a condition caused by an incoordination between the detrusor and external urethral sphincter during bladder contraction. Manifestations include day-and-night wetting, residual urine, infected urine, vesicoureteral reflux, christmas-tree shaped bladder-wall change, and upper tract damage without neurologic lesion or anatomical obstruction. Recently, this incoordination was postulated to be due to over-compensation of the external sphincter which compensates the uninhibitory detrusor contraction and pathological persistence of this "detrusor-sphincter dyssynergia" habit after brain cortical maturation. Accordingly, this syndrome is an acquired psychosocial-behavioral problem, reversible by bladder training and does not necessitate surgical intervention. We report a case of nonneurogenic neurogenic bladder who was successfully treated by biofeedback training, anticholinergic drugs and intermittent catheterization.
Ataxia ; Biofeedback, Psychology ; Brain ; Catheterization ; Catheters ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Vesico-Ureteral Reflux

BACKGROUND: Endoscopic Ultrasonography(EUS), a combination of endoscopy and ultrasonography is one of the most useful tools for diagnosis of digestive system diseases. EUS is useful in staging the primary tumor invasion and regional lymph node metastasis because of its ability to image the gut wall and adjacent structures in unique detail. We performed a study preoperatively for assessing the accuracy and limitation of EUS in gastric carcinoma. METHODS: In 75 patients(Male 54, Female 21, Mean age 62.3 years) with a gastric carcinoma confirmed by endoscopic biopsy, we performed EUS preoperatively. The results were compared with the postoperative histopathologic staging. RESULTS: 1) In assessing the depth of tumor invasion, EUS accuracy on depth of invasion was 76.0% and overstaging and understaging were 14.7% and 9.3%, respectively. 2) In assessing the lymph node metastasis, the accuracy rate of EUS was 65.3%. A rate of false-positive diagnosis was 27.3%, and a rate of false-negative diagnosis was 24.5%.3) In assessing the incidence of lymph node metastasis for each T stage, the involve rate was 10.5% in pT1, 36.4% in pT2, 95.7% in pT3, 100% in pT4. CONCLUSIONS: EUS is the most accurate diagnostic methods presently available to determine tumor infiltration depth and lymph node metastasis.
Biopsy ; Diagnosis ; Digestive System Diseases ; Endoscopy ; Endosonography* ; Esophagus* ; Female ; Humans ; Incidence ; Intestines* ; Lymph Nodes ; Neoplasm Metastasis ; Stomach* ; Ultrasonography

PURPOSE: This study was done to see whether neonates born to unmarried mothers have higher rates of prematurity, low birth weight, perinatal morbidity and mortality than normal married group. METHODS: 88 neonates of unmarried mothers who were admitted in our NICU during the 5-year period from January 1987 through December 1991 were evaluated, and as the control group served 276 neonates of married mothers in 12 randomly selected weeks extended over the year during the same period. In statistical analyses, all data were analyzed by x2 test, Student t-test, and regression equation. RESULTS: 1) Unmarried mothers were 19.9+/-2.5(SD) year-old, with the majority(64.8%) falling into to age group between 16 and 20 years, whereas the control group was significantly older with 28.8+/-3.9 years. 2) Sex ratio was 1.38 : 1, with male prepondering, mean gestational age 35.5+/-3.7 weeks and mean birth weight 2,240+/-640g, in the unmarried group, differing significantly from the control group with 38.5+/-37 weeks and 2,910+/-750g. 3) Incidences of prematurity and low birth weight (LBW) were 70.5% and 75.0%, and total mortality was 28.4%. These values were significantly higher than in the control group, with 22.5%, 32.2%, 7.2%, respectively, and prematurity and LBW rate were also significantly higher in both groups of the same maternal age. Birth weight of unmarried group was significantly lower than control group in the same gestational age. Gestational age, birth weight, mortality rate were not significantly correlated to maternal age in both unmarried and control groups. 4) For the neonates of unmarried mothers, the majority was delivered either by midwife or in local obstetric clinics, and most of them(57.9%) were delivered by induction. 5) Neonatal diseases were jaundice, respiratory distress syndrome(RDS) and infection in the decreasing order, and incidence of RDS was significantly higher than in control group. But the death rate of RDS only tended to be higher in the unmarried-group. CONCLUSIONS: The neonates born to unmarried mothers have significantly higher rates of prematurity, LBW and mortality, and lower birth weight than the control group in the same gestational age. For neonatal diseases, incidence of RDS was significantly higher, and its mortality was significantly higher in the unmarried-group. Awareness on the seriousness of the problems leading to preventive measures against juvenile and unmarried child births, along with improved managements of babies born to unmarried mothers are urgently advocated.
Birth Weight ; Child ; Gestational Age ; Humans ; Illegitimacy ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn* ; Jaundice ; Male ; Maternal Age ; Midwifery ; Mortality ; Mothers ; Parturition ; Sex Ratio ; Single Person*

No abstract available.
HLA-DR Antigens* ; Thyroid Gland* ; Thyroid Neoplasms*

Depressed skull fractures in newborn babies mainly result from birth injury and rarely occurr in intrauterine life without any definable etiology. We present 4 cases of congenital intrauterine depressed skull fractures which were discovered at birth in neonates. Three babies (case 1, 2, 3) had round shallow depressions without adjacent soft tissue injury except the last one (case 4), showing sharp angulation in the center of the depression. They had neither birth trauma nor forceps applications and they were healthy without neurologic symptoms. We performed nonsurgical reduction using vacuum extractor in all cases. Three cases were reduced successfully, but the last one failed due to sharp angulation in the center of the depression. It was reduced successfully by surgical elevation using a Freer elevator. Reduction should be performed in congenital depressed skull fractures without neurologic symptoms, because brain compression by depressed fracture results in brain injury or epileptic focus. Nonsurgical reduction should be prior to surgical reduction because of its technical feasability, safety and good results, but surgical reduction should be attempted in the case of sharp angulation in the center of the depression.
Birth Injuries ; Brain ; Brain Injuries ; Depression ; Elevators and Escalators ; Humans ; Infant, Newborn* ; Neurologic Manifestations ; Parturition ; Skull Fracture, Depressed* ; Soft Tissue Injuries ; Surgical Instruments ; Vacuum

Pachydermodactyly is a rare distinct form of fibromatosis characterized by acquired, asymptomatic dense fibrosis and fibroblastic proliferation around one or more proximal interphalangeal joints. Intralesional triamcinolone injection may be helpful in improving the clinical appearance. A 20-year-old unemployed female patient gave a four years history of progressive swelling of the fingers affecting predominantly the proximal interphalangeal joints of index fingers of left hand and index, middle fingers of right hand. There was no pain and tenderness. Physical examination, complete blood count, antinuclear antibody, rheumatoid factor were unremarkable and radiograph of both hands showed soft tissue swelling only without bony abnormality. We excised the redundant soft tissue from the both sides of proximal interphalangeal joint with longitudinal elliptical fashion. After operation, the fingers of the patient showed marked improvement cosmetically. There were no motor or sensory changes. Pachydermodactyly was first reported in 1996 in Korea. Histologic features include an increased dermal accumulation of collagen and occasionally an increased number of fibroblast. We report for one patient with pachydermodactyly treated with longitudinal elliptical excision and obtained an improvement of clinical appearance.
Antibodies, Antinuclear ; Blood Cell Count ; Collagen ; Female ; Fibroblasts ; Fibroma ; Fibrosis ; Fingers ; Hand ; Humans ; Joints ; Korea ; Physical Examination ; Rheumatoid Factor ; Triamcinolone ; Young Adult

BACKGROUND/AIMS: Electrohydraulic lithotrypsy(EHL) under cholangioscopic control has been performed for difficult bile duct stones. The percutaneous transhepatic approach is technically easy and useful in diagnosis and treatment of bile duct obstruction and stones. Biliary stenting with self expanding metal stent is gaining increasingly wider acceptance as a palliative treatment of bile duct obstruction. METHODS: Between Sep. 1994 and Sep. 1996, EHL under choledochoscopy by percutaneous transhepatic approach was performed in 30 cases(Male: 13, Female: 17). After PTBD with 7F pig tail catheter, the percutaneous transhepatic passage was dilated over guide wire with dilaters of increasing size up to 16Fr in 3-Sdays. In one week, after fistula had been estabilished, choledochoscopy was performed. RESULTS: (1) Mean age was 61.3 years. Mean stone number was 2.5. And mean stone size was 1.6 X 2.3 cm. (2) Com.plete removal of the stone was achieved in all patients(100%). (3) There were no serious complications. (4) In six cases, Endocoils were implanted with successful decompression of obstructions and simultaneous removal of biliary stones located at both side of stricutre. CONCLUSIONS: Percutaneous transhepatic choledochoscopy is easy and safe and assists in the diagnosis and treatment of biliary stricture and the management of difficult CBD stone.
Bile Ducts ; Catheters ; Cholestasis ; Common Bile Duct* ; Constriction, Pathologic ; Decompression ; Diagnosis ; Female ; Fistula ; Humans ; Palliative Care ; Stents

We have analyzed paired samples of genomic DNA from peripheral leukocyte and primary tumor tissue from nine patients with retinoblastoma (RB) and from two RB cell lines, WERI-Rb-1 and Y79, to detect the molecular alterations of the retinoblastoma susceptibility gene (RB-1) and N-myc gene. In Southern analysis, RB-1 deletions in tumor tissues were detected in five patients (56%), one of these revealed a total loss of RB-1. N-myc amplification was found only in one (11.1%) out of nine patients. We also observed a total loss of RB-1 in WERI-Rb-1, and a more than 100-fold amplification of N-myc in Y79. The analysis of the relationship between molecular events and clinical characteristics such as age, sex, tumor laterality did not reveal any specific correlation. These results suggest that genetic backgrounds of RB in Korean patients are quite similar to those of reported cases elsewhere. The high sensitivity of our method in detecting the RB-1 loss indicates that this method can be a useful tool for initially screening a large number of tumors.
Child ; Child, Preschool ; Eye Neoplasms/*genetics ; Female ; *Gene Amplification ; *Gene Deletion ; *Genes, Retinoblastoma ; *Genes, myc ; Humans ; Infant ; Male ; Retinoblastoma/*genetics ; Tumor Cells, Cultured