No abstract available.
Colorectal Neoplasms, Hereditary Nonpolyposis*

We present the cytologic features of a case of solid and papillary neoplasm of the pancreas. Cytologically, the tumor was composed of a monotonous population of polygonal cells containing eccentrically located round nuclei with one or two distinct small nucleoli and a finely stippled chromatin pattern. The tumor cells were similar to those of the islet cell tumor and showed isolated loosely aggregated and solid sheets or large cell clumps. The large cell clumps revealed a branching papillary structure containing fibrovascular central core, which is characteristic histologic feature of solid and papillary neoplasm of the pancreas. This case was confirmed by tissue examination including histochemical, immunohistochemical and electron microscopical studies. Ultrastructurally, the tumor cells contained a few membrane-bound electron dense granules.
Adenoma, Islet Cell ; Chromatin ; Pancreas ; Urinary Tract*

PURPOSE: There have been numerous retrospective and uncontrolled study of laparoscopic appendectomy. Although most of these have concluded that the laparoscopic appendectomy is at least as good as open appendectomy, there has been considerable controversy as to whether laparoscopic appendectomy is superior. METHODS: We performed total 47 cases of laparoscopic appendectomy (LA) during one year from January 1997 to December 1997 and these were compared with 50 cases of open appendectomy (OA) in same period to assess the clinical usefulness. RESULTS: The sex, male to female ratio and severity of appendicitis were similar in both groups. The anesthetic time was longer in the LA group (P<0.05) but operative time was similar. Gas-passing time and diet-intake time in postoperative period were earlier in LA group (P<0.05). The LA group required less analgesics in postoperative period. In LA group, no case was converted to open appendectomy and overall complication rate was lower in LA group but this was not statistically significant. Among the postoperative complication, the wound infection rate was absolutely lower in LA group (P<0.05). The diagnostic rate for acute abdomen including acute appendicitis was superior in LA group, especially in reproductive women. The hospital stay was shorter in LA group (P<0.05) and hospital charges was not different in both group. CONCLUSION: Laparoscopic appendectomy offers considerable advantages over open appendectomy because this has ability to reduce postoperative complications and shorten recovery times and is useful for detecting the cause of acute abdomen other than acute appendicitis. So we expect this technique will be alternative operation or new standard operation in selected cases for suggestive acute appendicitis.
Abdomen, Acute ; Analgesics ; Appendectomy* ; Appendicitis ; Female ; Hospital Charges ; Humans ; Length of Stay ; Male ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Wound Infection

We report herein a case of perforating pseudoxanthoma elasticum in a 44-year-old female who was suffered from yellowish, crepelike, lax, redundant patches on her neck, axilla, antecubital area, groin, popliteal area bilaterally and serpiginous erythernatous plaqus in yellowish redundant patch of right axillary area. Asymptomatic erythematous papule developed on the previous biopsy site 20 days after taking biopsy. Histopathologically, short and gnarled abnormal elastic fibers, which are basophilic stained, are clumped in middle and lower dermis, and some fibers extend through epidermal channel to the surface of skin.
Adult ; Axilla ; Basophils ; Biopsy ; Dermis ; Elastic Tissue ; Female ; Groin ; Humans ; Neck ; Pseudoxanthoma Elasticum* ; Skin

No abstract available.
Heart Defects, Congenital* ; Plasma*

In the last few moments of life before death, a more adequate health care system must be established in order for suffering patients to have their dignity respected. To this point, Korea's health care system does not possess additional health insurance reimbursement covering hospice care. Until recently, the existing fee for service system consists of an informal hospice care service that has been developed and supplied. Due to society's increasing expectation of hospice reimbursement in regard to development and in reality, progression is currently being undertaken which we have welcomed. However, there has been a tendency for over expectation in financial reduction by hospice reimbursement introduction in which there were evidence from cases in other nations. In practice, supplementation of per diem type of hospice coverage will be the mainstream and fee for service in some areas must be explored in order to compensate for the negative aspects of per diem type of hospice coverage.
Delivery of Health Care ; Fee-for-Service Plans ; Hospice Care ; Hospices ; Humans ; Insurance, Health, Reimbursement ; Stress, Psychological

With the increase of frequency and the recent development of surgical treatment in brachial plexus injury, the requirement for accurate assessment between supra and infraganglionic injury is increased. Cervical myelography has been the popular tool in evaluating the root lesion since the first introduction of Murphey et al. in 1947. However, the invasiveness of procedure has been the impediment to the common-use. But with the utilization of water-soluble contrast media, Metrizamide, such impediment can be alleviated. Author has performed myelography in 27 patients along with surgical exploration in 18 patients since 1984. And the results were as follows. 1. 85% of 27 patient revealed anomaly of root in myelography. 2. Traumatic menimgoceles were typical findings and most of them were located at C7 and C5. 3. Myelography reaveled 70%(28 root) of anomalies among 40 root lesions, confirmed by surgical explorations. 4. Myelography is considered to be very effective in evaluating supra and infraganglionic root lesions when its results is correlated with physical and other neurological examination.
Brachial Plexus ; Contrast Media ; Humans ; Metrizamide ; Myelography ; Neurologic Examination

PURPOSE: The purpose of this study is to assist the optimal placement of sacroiliac screw by evaluating the anatomic and radiologic features of upper sacrum. MATERIALS AND METHODS: Fourteen fresh-frozen cadaveric pelvises and 13 normal adults were studied for the evaluation of morphology of first sacrum and dysplastic patterns. Measurement of anatomic parameters and CT imaging of pelvis were performed. Thirty-two patients with complicated pelvic fracture were evaluated for detection of variations in the sacral alar anatomy and slope found in upper sacral segmentation. RESULTS: The mean distance between midpoint of sacrum and sacroiliac joint was 52.75 mm. The height of first sacral body was 21.71 mm. The longest antero-posterior distance in sacral alar was 52.36 mm. The mean angle between the coronal plane of S1 vertebra and anterior aspect of the alar was 29.3 degree. The mean angle between the superior aspect of S1 vertebral body and superior edge of the alar was 34.8 degree. The mean angle between the superior aspect of S1 vertebral body and supero-posterior edge of the alar was 12.5 degree. The studies revealed about 28 to 33% of cases as dysplastic sacrum. CONCLUSIONS: We studied anatomic and radiologic features of upper sacrum in cadaveric and clinical cases to gain information on the optimal placement of sacroiliac screw.
Achilles Tendon* ; Adult ; Cadaver ; Humans ; Pelvis ; Rupture* ; Sacroiliac Joint ; Sacrum ; Spine

No abstract available.
Animals ; Inositol* ; Kidney* ; Liver* ; Phospholipases* ; Rats* ; Type C Phospholipases*

Purpose: This study was performed to evaluate changes in Achilles tendon (AT) characteristics of asymptomatic tendons in patients with acute AT ruptures on the contralateral side by using ultrasonography. Methods: From January 2016 to December 2018, 31 patients were enrolled. The contralateral asymptomatic ATs were assessed: (1) fluid collection of paratenon, (2) echogenicity, and (3) thickness. The ATs were divided into the distal, middle, and proximal thirds for evaluation and were assessed before the surgery, as well as at 6 weeks, 3 months, 6 months, and 12 months after the surgery. At each time, pain in the tendons was recorded. Results: In all cases, it was observed that there was a hypoechoic lesion or fluid collection of the paratenon, which did not show a significant change over time. There was no significant difference in tendon thickness according to the period in the distal and proximal areas, and significant differences were observed only in the middle area (p＜ 0.05). A new pain around the tendon occurred most often at 6 weeks after surgery (eight cases of 31 cases, 25.8%). Eight cases of pain (47.1%) remained at 12 months after surgery. Conclusion In patients with acute AT rupture, ultrasonographic hypoechoic lesions or fluid collections of the paratenon were initially observed on the contralateral tendon, but this did not show significant changes over time. A significant change in tendon thickness was observed in the middle area, but this did not show a close association with pain.