Neoplasms showing both carcinomatous and sarcomatous features are well established, and have been reported in practically every organ where carcinoma can occur. But the difference in terminology and difficulties in histopathologic interpretation have hampered adequate understanding of these neoplasms. We report a case of carcinosarcoma in the recurrent form of serous cystadenocarcinoma of the ovary. The patient was a 64-year-old female who underwent total hysterectomy and bilateral salpingoophorectomy three years ago, due to perforated papillary serous cysta denocarcinoma of the right ovary. Recurrent pelvic masses contained both carcinomatous and sarcomatous components. Morphological transition between carcinomatous and sarcomatous components, and epithelial characteristics in the sarcomatous component by immunohistochemistry were recognized. We postulate the histopathogenetic mechanism based on the phenotypic conversion of carcinoma into sarcoma in the carcinosarcoma.
Carcinosarcoma* ; Cystadenocarcinoma, Serous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Middle Aged ; Ovary* ; Sarcoma

A case of an ovarian mucinous cystadenocarcinoma with mural nodules of anaplastic carcinoma is reported. The patient was a 46-year-old female with a right ovarian cystic mass and underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The patient died of the disease in five months. Macroscopically, the right ovarian cyst wall contained numerous well-demarcated mural nodules. Histologically, the cysts were mucinous cystadenocarcinoma, and the nodules were composed of sarcoma-like spindle and polygonal cells with atypia and numerous mitoses. Spindle cells in the mural nodule showed epithelial characteristics by electron microscopy and immunohistochemistry. This case supports an epithelial origin of the mural nodule of anaplastic carcinoma in ovarian mucinous tumors.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Microscopy, Electron ; Middle Aged ; Mitosis ; Mucins* ; Ovarian Cysts ; Ovary

There have been many debates concerning operative decompression of treatment of thoracolumbar burst fractures with retropulsed bone fragment. From March 1988 to February 1992, authors treated thirty-three thoracolumbar burst fractures by using transpedicular screw fixation and posterior fusion via the posterior approach. We attempted to reduce retropulsed fragment by ligamentotaxis alone and not to do posterolateral nor anterior decompression. After the reduction of fractured spine by posterior instrumentation, we tried to determine the efficiency of reduction of the retropulsed fragment by ligamentaxis along. As a method, we compared the change of anteroposterior, transverse to diameter and area of spinal canal of fractured spine between preoperative and the postoperative situation. The results were as follows; 1. The mean anteroposterior and transverse diameter of the spinal canal on computed tomogram film was 10.1mm & 21.8mm preoperatively & 12.4mm & 23.2mm postoperatively, showing an increase. 2. The area of spinal canal of involved spine on CT film was evaluated preoperatively & post-operatively, the mean spinal canal invasion rate decreased from 36.3% preoperatively to 14.3% postoperatively. 3. The degree of reduction of middle height on plain x-ray and reduction of spinal canal invasion on computed tomogram were statistically correlated(p < 0.01). 4. There was no correlation between the degree of canal narrowing and degree of neurologic impairment. also, there was no correlation between the reduction of retropulsed fragments and subsequent neurologic impairment. 5. There was the relatively satisfactory enlargement of the spinal canal on computed tomogram at the follow-up So we suggest that it is possible to get enough decompression through reduction of retropulsed fragment by ligamen to taxis alone without posterolateral decompression.
Decompression ; Follow-Up Studies ; Methods ; Spinal Canal ; Spine

This study was undertaken to know the extent of apoptosis, expression of bcl-2 and proliferating cell nuclear antigen (PCNA) in uterine cervical intraepithelial neoplasia (CIN; 15 cases) and invasive carcinoma (27 cases) and to evaluate them as a prognostic marker. Apoptosis was analysed by using the in situ apoptosis detection kit and bcl-2 and PCNA were detected by the immunohistochemical method. The results were as follows: Apoptotic indices (AI) in the invasive carcinoma (mean: 4.3) were 10-times higher than that in the CIN (mean: 0.43). Bcl-2 was expressed 60% of the cases in the dysplastic cells of the CIN II and CIN III, 33.3% of cases in the invasive carcinoma and not expressed in the CIN I except basal cells. The expression of the PCNA was increased by the grades of CIN and was strong in invasive carcinoma. The mean survival time of the patient with invasive carcinoma was significantly decreased in the higher AI index (above 4.3) than in the lower AI index (below 4.3). There was no significant correlation between the extent of apoptosis and the expression of bcl-2. According to the above results, AI are able to be used as an independent prognostic marker in the invasive cervical carcinoma, and bcl-2 and PCNA have an important role in the tumorigenesis of uterine cervical carcinoma.
Apoptosis* ; Carcinogenesis ; Cervical Intraepithelial Neoplasia* ; Humans ; Proliferating Cell Nuclear Antigen* ; Survival Rate

Human papillomavirus (HPV) 16/18 is a causative agent of uterine cervical carcinoma. HPV 16/18 can alter cell cycle regulation through apoptosis. Bcl-2 is an important regulatory gene of apoptosis. A study was done to evaluate the relation between HPV 16/18 and bcl-2 and apoptosis in 21 cases of carcinoma in-situ (CIS), 5 cases of microinvasive carcinoma and 23 cases of invasive squamous cell carcinoma. HPV 16/18 was detected by hybrid capture system (HCS), bcl-2 protein by immunohistochemical method and apoptosis by using the hematoxylin-eosin stained slide. The results were as follows: Expression of the bcl-2 protein was 43% (9/21) in CIS and 26% (6/23) in invasive carcinoma. Expression of the bcl-2 protein was 42% (5/12) in CIS with HPV 16/18 infection, 44% in CIS without HPV 16/18 infection, 20% (2/10) in invasive carcinoma with HPV 16/18 infection and 31% (4/13) in invasive carcinoma without HPV 16/18 infection. Mean apoptotic index (mAI) was 3.36 in CIS, 5.23 in microinvasive and 6.25 in invasive carcinoma. mAI was 3.66 in CIS with HPV 16/18 infection, 2.86 in CIS without HPV 16/18 infection, 6.18 in invasive carcinoma with HPV 16/18 infection and 6.30 in invasive carcinoma without HPV 16/18 infection. Based on these results, we conclude that there are no correlation between HPV infection and bcl-2, and between HPV infection and apoptosis in invasive and in situ carcinoma of the uterine cervix, and apoptosis is increased according to tumor progression.
Apoptosis* ; Carcinoma, Squamous Cell* ; Cell Cycle ; Cervix Uteri* ; Female ; Genes, Regulator ; Humans

We report a case of prenatal diagnosis of fetal congenital goiter at 31weeks of gestation by ultrasonogram and fetal hypothyroidism confirmed at birth as thyroid function test by umbilical cord blood sampling. Maternal Graves' disease and the drugs used to treat hyperthyroidism in pregnant women can affect the fetus, causing hyperthyroidism or hypothyroidism and goiter. Fetal hypothyroidism may be caused by transplacental passage of either maternal thyrotropic-binding inhibitory immunoglobulin(TBII) antibodies or maternal treatment with propylthiouracil(PTU). Untreated fetal hypothyroidism may result in mental retardation, perceptual-motor, visual-spatial, and language developmental problems. In this article fetal thyroid function was not assessed by cordocentesis, but fetal congenital goiter was detected ultrasound. Ultrasound should be used to detect fetal goiter from 20 weeks onward. Fetal goiter should resolve when maternal PTU treatment is decreased. We have diagnosed fetal hypothyroidism in utero by ultrasonography. Significance of in utero management of fetal hypothyroidism is discussed.
Antibodies ; Congenital Hypothyroidism ; Cordocentesis ; Female ; Fetal Blood ; Fetus ; Goiter* ; Graves Disease ; Humans ; Hyperthyroidism* ; Hypothyroidism ; Intellectual Disability ; Language Development ; Mothers* ; Parturition ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis* ; Thyroid Function Tests ; Thyroid Gland ; Ultrasonography

No abstract available.
Arm

The distal thigh atrophy is a frequently associated sigh in the presence of knee pathology, and it is usually proved by the difference of the distal thigh circumference using tapeline measurement. But the proper position of measurement is known at this moment. From January of 1988 to December of 1991, we have 320 patients who had knee problems. Among them, 50 patients were selected as a sample of this study. We measured distal thigh circumference of normal and abnormal side by patella and also real circumference and area by taking cross sectional C-T image at each point of measurement. The obtained data are analysed by SPSS for statistical treatment. And the results are as follows: 1) We notice the largest difference on the point of 10cm above superior pole of patella. 2) The vastus medialis is the most conspicuously atrophied muscle among quadriceps and the atrophy of hamstring is minimal. 3) We have experienced the largest difference in cruciate ligament injury but a little difference in meniscus pathology. 4) There is no significantly difference between tapeline measurement and real circumference. As a conclusion of study, The position of 10cm above from the patella upper pole is the best site of clinical measurement of distal thigh circumference, and the muscle mainly associated with artophy is vastus medialis.
Atrophy ; Humans ; Knee ; Ligaments ; Patella ; Pathology ; Quadriceps Muscle ; Thigh

No abstract available.
Carcinoma, Basal Cell ; Paget Disease, Extramammary

There are many procedures for the treatment of acute A-C injury which have many complications such as limitation of shoulder motion, post traumatic arthritis, recurrence of dislocation etc. From September 1985 to February 1992 at Haesung Hospital, Ulsan, 62 patients with grade I complete A-C dislocation had been treated surgically by modified Phemister method. We report 42 cases with at least 1 year follow up. The following results are obtained. 1. There are no limitation of shoulder motion in all cases. 2. The comparision of coraco-clavicular interval after surgery(1.43mm) with that of follow up (2.13mm) shows no significant difference. 3. We experience 15 cases who have resorption of distal clavicle or arthritic change in x-ray film. 4. Clinical results shows that excellent in 20 cases, good in 10 cases, fair in 11 cases, poor in 1 case. From the above result, we suggest the modified phemister method is good procedure in the treatment of acute A-C dislocation.
Arthritis ; Clavicle ; Dislocations ; Follow-Up Studies ; Humans ; Methods ; Recurrence ; Shoulder ; Ulsan ; X-Ray Film