Stomach of 34 year old man showed an early stage of the cancer with slight involvement of the superficial part of the inner muscle layer and accompanied with one metastatic lymph node. The cancer is that of medium differentiated adenocarcinoma. There is an heavy infiltration of lymphocytes mixed with histiocytic mononuclear cells and multinucleated giant cells. Some giant cells appear as Langhans' type suggesting phagocytic cells of their origin containing PAS positive materials in the cytoplasma. In other places, they appear as atrophic cancer nests suggesting that these tumor nests were arrested and undergone to regressive cellular process because of the over-whelming immunological pressure by the host.
Male ; Humans ; Neoplasm Metastasis ; Stomach Neoplasms

Epidemiology, pathology, diagnosis and treatment of gastric carcinoma has been revised recently. The authors analysed 3,170 cases of gastric carcinoma which were diagosed with fiberoptic biopsy or resected specimens from 1968 to 1988 in Pusan area. The specimen were collected from Pusan National University Hospital, Pusan Paik Hospital and other general hospitals in Pusan city. The results obtained were summarized as follows; 1) The time trend indicated that difference in the annual fluctuation of requency of gastric carcinoma during last 21 years was not statistically significant. But it was noticed that by comparing the following the two decades (1970~1979 and 1980~1988) the frequency of gastric carcinoma decreased in male, in middle age and in intestinal type. 2) Morbidity of gastric carcinoma increased in both sexes by aging, and this tendency was more marked in male and in intestinal type in female and in diffuse type. 3) In general the gastric carcinoma involved more frequently distal portion than proximal portion of the stomach was characterized predominantly by male, older patients and intestinal type. 4) Carcinoma with Borrmann type I and II were characterized predominantly by male, older patients and intestinal type. With Borrmann type III and IV, female, young patients and diffuse type were found more frequently. From the above results, the authors concluded that the pathological and epidemiological findings of gastric carcinoma among Koreans in Pusan area showed a transition moving from high risk to low risk area of gastric carcinoma.
Female ; Male ; Humans ; Biopsy

BACKGROUND: There are many reports about the correlation between cardiovascular disorders and estrogen deficiency in postmenopausal women. The purpose of current study is to know that postmenopausal estrogen therapy may affect the lipid metabolism and endogenous fibrinolytic system and exercise tolerance. METHOD: We investigated the relation of estrogen treatment (srogen 0.625 mg/day) to serum lipid levels, angiotensin converting enzyme activity, plasminogen activator inhibitor-1 and parameters of treadmill test in 22 postmenopausal women of normal coronary artery with abnormal exercise test complained with chest pain accompanied by postmenopausal symptoms. RESULTS: Estrogen treatment significantly elevated the serum HDL-cholesterol level (42.8 to 50.1 mg/dl, p<0.05) and reduced the PAI-1 level (16.2 to 10.4 ng/dl, p<0.01) without considerable side effects. During the exercise test, the positivity appearance time and total exercise duration is significantly increased after estrogen treatment. CONCLUSION: The postmenopausal use of estrogen favorably changed the lipid level, fibrinolytic system and might improve the microcirculation which may protect against the ischemic heart disease risk without significant side effects.
Chest Pain ; Coronary Vessels ; Estrogens* ; Exercise Test ; Exercise Tolerance ; Female ; Humans ; Lipid Metabolism ; Microcirculation ; Myocardial Ischemia ; Peptidyl-Dipeptidase A ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Postmenopause

OBJECTIVE: This study aims at investigating the incidence, clinical nature and associated clinical characteristics of the clozapine-induced fever. METHODS: Retrospective review of hospital records was performed for 56 inpatients who had started to take clozapine and stayed at the hospital for four or more weeks after the initiation of clozapine treatment. RESULTS AND CONCLUSION: Clozapine-induced fever was developed in 31% of the patients. The mean peak temperature was 39degrees C and the mean duration of the fever was 3 days. Fever was developed average of 11 days after the initiation of clozapine treatment. All the patients were recovered without discontinuation of clozapine. Demographic variables, the clinical response to clozapine, other drugs administered with clozapine, and the presence of other adverse effects of clozapine were not associated with the clozapine-induced fever.
Clozapine* ; Fever* ; Hospital Records ; Humans ; Incidence* ; Inpatients ; Retrospective Studies ; Schizophrenia

OBJECTIVES: The purpose of this study was to investigate demographic, clinical, behavioral and metabolic-endocrine factors related to weight gain in patients with schizophrenia treated with serotonin-dopamine antagonists(SDA). METHODS: Forty-two in-patients with DSM-IV schizophrenia were recruited from Samsung Seoul Hospital and St. Andrew Neuropsychiatric Hospital. The subjects were first-episode patients or patients who did not take any antipsychotics for the previous two months. All the patients were administered with one of the SDAs for 8 weeks. Body weights and body mass index (BMI) were measured weekly during the treatment period. The mean levels of daytime activities were evaluated at baseline and 4 weeks and 8 weeks after the treatment. To assess the clinical response to the medication, the Krawiecka Rating Scale (KRS) and Clinical Global Impression (CGI) were applied before and after the treatment. Fasting blood levels of glucose, cholesterol, triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL), and serum level of prolactin were measured before and after the treatment. RESULTS: The body weight and BMI were significantly increased through the treatment periods. There were significant increases in the blood levels of cholesterol, TG and prolactin after 8 weeks. KRS total score showed significant decrease and the mean level of daytime activities showed significant increase by the treatment. Significant negative correlations were observed between the weight gain indices and the baseline BMI. The level of clinical improvement was significantly correlated with the degree of weight gain. Gender, age, smoking, daily dosages of antipsychotics, level of daytime activity and changes in appetite did not show any association with the weight gain indices. Neither the baseline biochemical variables nor their changes after the treatment were significantly correlated with the indices of weight gain. CONCLUSION: This result implies that low baseline BMI could be a risk factor of weight gain in short-term treatment of schizophrenia with SDAs. And it is also suggested that the effects of SDAs on weight gain and the clinical improvement might be developed through the same pharmacodynamic pathway.
Antipsychotic Agents ; Appetite ; Body Mass Index ; Body Weight ; Cholesterol ; Diagnostic and Statistical Manual of Mental Disorders ; Fasting ; Glucose ; Humans ; Lipoproteins ; Prolactin ; Risk Factors ; Schizophrenia* ; Seoul ; Smoke ; Smoking ; Triglycerides ; Weight Gain*

OBJECTIVES: Primary, enduring negative symptoms have been used to define the deficit syndrome of schizophrenia, and the diagnostic validity of the deficit syndrome has been demonstrated by clinical, biological and neuropsychological studies. This study aims at evaluating the long-term stability of the diagnostic category of deficit syndrome using direct patient assessments. METHODS: The subjects were thirty-two patients with schizophrenia who were categorized into deficit or non-deficit subgroup using the Schedule for the Deficit Syndrome (SDS) in their remission or partial remission state maintained by long-term treatments with antipsychotics (mostly atypical drugs). These patients were re-assessed based on the same deficit syndrome criteria an average of 5.6 years after having been initially categorized. Lifetime presence of clinical symptoms were evaluated using the Krawiecka Scale. RESULTS: The majority (87.5%) of the patients who were classified as non-deficit at the initial assessment continued to remain non-deficit during the follow-through period. However, only 37.5% of the patients classified as deficit at the initial assessment remain classified as showing deficit syndrome. Compared to the non-deficit group, patients of the deficit group at the final assessment showed significantly higher scores of positive symptoms at their previous psychotic states. Among the individual items of SDS, 'poverty of speech' was the most predictable of the long-lasting deficit syndrome. CONCLUSION: This study showed insufficient long-term stability of the deficit syndrome categorized by SDS criteria. This could be explained by low validity of SDS criteria for the identification of the trait-dependent deficit syndrome. It might also suggest that deficit symptoms could be improved by optimal long-term treatment with atypical antipsychotics.
Antipsychotic Agents ; Appointments and Schedules ; Diagnosis* ; Follow-Up Studies* ; Humans ; Schizophrenia*

OBJECTIVES: Differential diagnosis based on descriptive psychopathology between bipolar and unipolar depression in the clinical setting is a still huge challenge. Projective psychological tests might provide additional clues. This study aimed to find distinct Rorschach test characteristics of bipolar depression in comparison with unipolar depression. METHODS: Medical records and raw data of the Rorschach Inkblot test applied using standardized procedure for the Exner Comprehensive System were retrospectively reviewed for patients with bipolar disorder or unipolar depression. Individual variables of the Rorchach test were compared among three groups, i.e., (hypo) mania (n=59), bipolar depression (n=56) and unipolar depression (n=25). RESULTS: Bipolar depression group, in accordance with (hypo) manic group, showed more color reponses (WSumC), more extroverted and intuitive decision-making (EBright), and higher emotional expression (CF+C) and instability (ebright), compared to unipolar deperssion group. On the contrary, the (hypo) mania group displayed more cognitive errors (Sum6, WSum6) compared to both depression groups. CONCLUSION: This study suggests that Rorchach test might provide valuable markers for differential diagnosis between bipolar and unipolar depression, and that some of those markers could be regarded as trait markers of bipolar disorder.
Bipolar Disorder ; Depression ; Depressive Disorder ; Diagnosis, Differential ; Humans ; Medical Records ; Psychological Tests ; Psychopathology ; Retrospective Studies ; Rorschach Test

The purpose of the present study was to identify the factor structure of neurocognitive tests used on schizophrenia patients by using the confirmative factor analysis, and to assess the factor score differences of schizophrenia patients and healthy controls. Comprehensive neurocognitive tests were administered to stabilized schizophrenia patients (N=114) and healthy controls (N=120). In the results of factor analyses on patients, the multifactorial-6-factor model, which included the speed of processing, working memory, verbal learning and memory, visual learning and memory, attention/vigilance, and reasoning/problem solving as suggested by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS), showed the better goodness of fit than any of the other models tested. And assessing the group differences of factor scores, we found the patients performed worse than the controls in all factors, but the result showed meaningful variations of impairments across the cognitive factors. Our study identifies the six major domains with multifactorial structure of cognitive abilities in schizophrenia patients and confirms the distinctive impairment patterns of each cognitive domain. These results may have utility in better understanding the pathology of schizophrenia as well as in genetic studies.
Adolescent ; Adult ; Attention ; Cognition Disorders/etiology ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Memory ; Middle Aged ; Models, Psychological ; Neuropsychological Tests ; Problem Solving ; Schizophrenia/*diagnosis/etiology ; Severity of Illness Index ; Verbal Behavior ; Verbal Learning

As a technique mainly hiring in forensic investigation field to identify the descents, craniofacial reconstruction (CFR) is also used in archaeology to create the faces from ancient or medieval human remains, when there is little information about his/her appearance. Eung-Cheok Ko (1531–1605) was a writer and scholar in the mid Joseon period. In January of 2019, His mummified body was found at Gumi, Kyeonsangbuk-do, Korea. The remains were anthropologically examined, and archaeological CFR was also requested for this case. This report reveals the case’s facial reconstruction process and his portrait that is drawn based on the 3-dimensional CFR result.

OBJECTIVES : Whether bipolar II disorder (BP-II) is simply a milder form of bipolar I disorder (BP-I) or a valid diagnostic category that could be separated from BP-I, is an issue still under consideration. Investigations exploring differential clinical and biological features of the two conditions are needed to resolve the controversies. This study aimed to obtain a comprehensive view of differences in clinical course and symptoms characteristics between BP-I and BP-II. METHODS : 44 BP-I and 26 BP-II patients were assessed using the Diagnostic Interview for Genetic Studies (DIGS), Korean version. Demographic data, age at onset, number of (hypo) manic/ depressive episodes, the duration of illness, polarity at onset, seasonality, rapid cycling, atypical depression and symptom profiles of each episode were evaluated. RESULTS : BP-II patients experienced depressive episodes more frequently than BP-I patients after illness onset (U=240.5, p=0.008). More BP-II patients showed seasonality (34.9% vs. 61.5%) and a rapid cycling course (4.5% vs. 18.2%). When comparing symptom profiles of manic/hypomanic episodes, irritable mood, decreased sleep need, inattention, reckless behavior, arrogant/provocative attitude and frequent outbursts of anger were less encountered in BP-II patients. In depressive episodes, leaden paralysis and psychomotor agitation were more frequently observed in BP-II patients. There was no significant difference between the two groups in psychotic symptoms of depressive episode. CONCLUSION : BP-I and BP-II disorders showed differences in clinical courses and symptom profiles. BP-II disorder seems to be less severe than BP-I disorder with regard to the intensity of manic symptoms, but more severe with respect to frequencies of depressive episodes. These results provide additional evidence supporting the distinction of BP-I and BP-II as separate diagnos-tic categories that might have different genetic profiles and/or biological mechanisms.
Anger ; Depression ; Humans ; Irritable Mood ; Paralysis ; Psychomotor Agitation ; Seasons