A retrospective quality assurance study of intraoperative consultation (frozen section) was carried out to assess the accuracy and to determine the reasons of discordance. Of 14,977 surgical pathology cases accessioned over a 6-month period in Asan Medical Center, frozen sections were done on 1,270 (8.5%) patients and 2,392 frozen sections (1.88 frozen sections/case) were performed. Discordance was noted in 106 cases (4.4%) and diagnosis was deferred in 26 cases (1.1%). All deferred cases were reviewed with the result of 53.8% justified and 46.2% unjustified. The discordant cases were divided into three categories as to their clinical significances: category A (no affect on patient care) 61.3%, B (minimal affect) 9.4%, and C (major affect) 29.2%. Of 31 category C cases, 7 cases were false positive and 24 cases were false negative. Misinterpretation (70.8%) was the leading cause of discordance, followed by sampling error (15.1%), failure to identify lesion (8.5%), and technical problem (5.7%). More than one-third (35.8%) of all discordances were of central nervous system cases. Total central nervous system cases were 403 (16.8%) with a significantly higher disordance rate (9.8%) and deferral rate (2.5%) in comparison to the other cases with 3.4% discordance rate and 0.8% deferral rate. There were 43 colorectal cancer cases of intraoperative consultation for adequacy of resectional margins. The surgical margins were between 0.4 cm and 28 cm (mean: 6.7 cm) away from the tumor and there was no tumor-positive case. The study indicates surgical pathology should 1) promote interpretative skills in cases involving minute fragments of neurosurgical cases, 2) defer the diagnosis and ask for more tissue on inadequate or inappropriate specimens and 3) give only gross opinions without unnecessary frozen section procedures in the event of simple, clear-cut cases.
Abscess ; Anti-Bacterial Agents ; Biopsy ; Central Nervous System ; Chungcheongnam-do ; Colitis, Ulcerative ; Colorectal Neoplasms ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Enterocolitis, Pseudomembranous* ; Frozen Sections* ; Humans ; Mucous Membrane ; Necrosis ; Pathology ; Pathology, Surgical ; Retrospective Studies ; Selection Bias

The analysis of 48 infants of congenital torticollis and the result of their conservative treatment are reported. The abnormalities of their neck were noticed by mothers within three months of infant life but mostly at three to four weeks. The ratio of male to female was 9:7 and incidence of right and left was 30 to 18. The mass located mostly(50%) at middle third of the sternocleidomastoid muscle belly. The prominence of incidence were noticed on the abnormality of fetal position in the uterus, mode of delivery and also on the baby of elderly primipara. About 67% of cases were breech(46%) and transverse(21%) position prenatally and 67% were delivered by forceps(41.7%), vacum and induction(12.5%each). The age of mother at delivery has close relationship between congenital torticollis with about two third of them are born of 29–34 year old mother and primipara infants were 61%. For the treatment, daily stretch exercises of affected sternocleidomastoid muscle was done by physical therapist for 20–30 times in two separate session. The effect can be noticed by the gradual correction of rotation deformity first and then the mass become soften and smaller. The next change is the correction of deviation deformity but the mass remain last. However, the mass remaining one fourth of original size was absorbed spontaneously without further treatment. The result of complete cure in ten weeks of treatment were 43(90%) out of 48 patients and the remianing five cases required for 15 weeks of treatment. In conclusion the congenital torticollis can be treated effectively by stretch exercises when it began within three months of age of the patient. A hundred per cent effect of cure may be obtained in ten weeks of treatment in case of initial treatment is begin within four weeks of age and required for 15 weeks of treatment on 4–12 weeks old infants.
Aged ; Congenital Abnormalities ; Exercise ; Female ; Humans ; Incidence ; Infant ; Male ; Mothers ; Neck ; Physical Therapists ; Torticollis ; Uterus

The occurrence of fistulous tract between the thoracic subarachnoid space and the pleural cavity due to injury is uncommon. The one was developed after traffic accident and treated by surgical repair of the fistula : The other was post-operative complication of costotransversectomy for T2 sympathectomy. The complication was realized by the surgeon who was aware of the small leakage of cerebrospinal fluid from the dura propria of the T2 nerve root at the time of surgery. Intermittent pleural punctures for drainage and semisitting position were followed by spontaneous closure of the fistula. These cases were reported so that the uncommon condition might be added to the differential diagnosis of pleural effusion.
Accidents, Traffic ; Cerebrospinal Fluid ; Diagnosis, Differential ; Drainage ; Fistula* ; Pleural Cavity ; Pleural Effusion ; Punctures ; Subarachnoid Space ; Sympathectomy

BACKGROUND: The present study was undertaken to know health-related lifestyles of Republic of Korea Air Force (ROKAF) pilots and to investigate prevalence of obesity of them.METHODS: 1284 KAF pilots were checked their height, weight, and body composition (% body fat). We also tried questionnaires on their health-related lifestyles which included the effort to be healthy, whether they know weight training is beneficial to G-tolerance, exercise habit and smoking history. RESULTS: Pilots' attitude for health promotion was relatively passive. Many of them know that weight training is good for their G-tolerance, but only 8.1% of the pilots carried out that training. They engaged much more in aerobic training, and also fighter pilots are less participated in weight training than transport pilots. The prevalence of obesity (29.4%) determined by bioelectrical impedance analysis was much higher than that assessed on the basis of height and weight (BMI, body mass index). It is suggested that many pilots who were normal in BMI have abdominal or visceral obesity. CONCLUSION: The health promotion program and physical conditioning program related to increasing G tolerance of KAF pilots flying high-performance aircraft are very important. These programs must be organized and progressed with flight surgeon and Aeromedical center in Chung-ju as leaders.
Aircraft ; Body Composition ; Chungcheongbuk-do ; Diptera ; Electric Impedance ; Health Promotion ; Life Style* ; Obesity ; Obesity, Abdominal ; Prevalence ; Republic of Korea ; Smoke ; Smoking ; Surveys and Questionnaires

No abstract available.
Anemia, Hemolytic, Autoimmune* ; Hepatitis B* ; Hepatitis*

No abstract available.
Infectious Mononucleosis*

No abstract available.

No abstract available.
Cerebrospinal Fluid* ; Immunoglobulin G* ; Meningitis, Aseptic*

Clinical studies were performed that the patient with angina pectoris having no responses to Ca++ antagonist and beta-blocker had been taken nicorandil 5mg bid daily with, beta-blokade and Ca++ antagonists for 3 weeks. The results after the use of nicorandil were as follows; 1) The clinical symptoms after the use of nicorandil were improved in 20(80%) of 25 patients, specially marked improved in 16 of 25 patients. There was no significant changes of BP and heart rate after the use of nicorandil. 2) The results of CBC, urinalysis, serum chemistry exa. and chest P-A were within normal range before and after the use of nicorandil. 3) After the use of nicorandil, ST segments depressed in 13 of 25 patients before use of nicorandil was elevated in 8(61.6%) of 13 cases after the use of that. QT interval, P-R interval and T wave in 25 cases were within normal range before and after the use of that. The M mode echocardiography showed the decreased movement of ventricular septum in 19 of 25 patients before the use of Nicorandil, and there was no changes after the use of that. 4) The adverse effects after the use of nicorandil to 25 patients were as follows: headache in 3(12%), nausea and vomiting 2(8%), palpitation 1(4%), upper abdominal discomfort 1(4%), and facial flushing 1(4%).
Angina Pectoris* ; Chemistry ; Echocardiography ; Flushing ; Headache ; Heart Rate ; Humans ; Nausea ; Nicorandil* ; Reference Values ; Thorax ; Urinalysis ; Ventricular Septum ; Vomiting

CD44, also known as the Hermes antigen, H-CAM, pgp-1 antigen, and extracellular matrix receptor ECM-III, is a widely distributed integral membrane protein that exists in a variety of forms with different molecular sizes ranging from 85kd to 160kd. A number of evidence implicates CD44 as a cell adhesion molecule with a possible role in tumor progression. To evaluate the possible roles of CD44 in the metastatic process of gastric carcinoma to the regional lymph nodes, we applicated immunohistochemical stains with the CD44H and CD44v6 primary antibodies onto the 2 groups of gastric adenocarcinomas. Each group was comprised of 22 primary tumors extending to the subserosa, and one group showed nodal metastasis, while the other group did not. Seventeen primary tumors (77%) out of the 22 cases with the nodal metastasis demonstrated positivity to the CD44v6, while only 9 primary tumors (41%) out of the 22 cases without nodal metastasis did. However CD44H immunoreactivity was demonstrated in tumor cells of all cases (100%) of both groups as well as in the normal cell components. These results suggest that CD44H form is not related to the metastasis to the regional lymph nodes of gastric carcinoma. However, the expression of CD44v6 seems to play a certain role in the metastatic process of the gastric carcinoma.
Adenocarcinoma* ; Antibodies ; Cell Adhesion ; Cellular Structures ; Coloring Agents ; Extracellular Matrix ; Lymph Nodes ; Membrane Proteins ; Neoplasm Metastasis