The term juxta-facet cyst has been used to characterize two types of periarticular cystic alterations, synovial and ganglion, that can occur in the paraspinal region. Synovial cysts arise from synovial outpouchings through the weakened or destroyed capsular tissue.Ganglion cysts are commonly found about the wrist and hand.But theoretically they can occur at any site in the body where periarticular connective tissue is present. In spinal canal these cysts may cause pressure on adjacent nerve root to produce a variety of neurological symptoms. The clinical features indicated an acute onset of symptoms favoring a diagnosis of disc herniation, so differential diagnosis is important.We have experienced two cases of the intraspinal extradural cysts connected to posterior longitudinal ligament by a sheath, causing nerve root compression. those were managed with excision of the cyst, and no recurrence has been identified during follow up evaluation.
Connective Tissue ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Ganglion Cysts ; Longitudinal Ligaments ; Radiculopathy ; Recurrence ; Spinal Canal ; Synovial Cyst ; Wrist

Chronic cavities of the dorsum of the foot often have bare bone and are unsuitable for free skin grafting. Local Flaps are often impossible because of surrounding scar tissue and dead space. A simple method is presented; it consists of the excision of the lesion, filling the cavity by a two staged random-pattern de-epithelialised turn over flap, and skin graft.
Cicatrix ; Foot ; Methods ; Skin ; Skin Transplantation ; Transplants

Though basal cell carcinoma is the most frequent and increasing malignant tumor of the skin in Korea, its pathological analysis has been done only on the small numbers. So, we did a comprehensive pathologic study on the 283 patients with basal cell carcinoma diagnosed in the Department of Pathology, Seoul National(233cases) and Chung-Ang(50cases) University Hospital during 1975-1992. The age distribution was ranged from 15 to 84 years with highest incidence rate in the age group of 5th-8th decades and 83.7% of all patients were over 40 years of age. Sex difference was not noted. The most common site was face occuring in 235 out of 283cases(83.0%) especially in the eyelid(25.5%), nose(17.9%) and cheek(16.6%). The most frequent histopathologic type was solid type(54.0%) followed by mixed(23.9%), adenoid(7.5%), and metatypical(4.7%). Among 51 mixed type, all showed solid components with adenoid(51.0%) followed by morphea(25.5%) and metatypical type(13.7%). And among 14 recurrent cases, solid type is found in 50% of cases. The characteristic clinicopathological findings are solid arrangement of tumor cells with various histological pattern and predominant occurence on the face.
Incidence

The concept of bipolar disorder is an ongoing process, still in evolution, although its roots can be found from ancient Greek. Until recently, it was believed that no more than 1% of the general population has bipolar disorder. But literature on the lifetime prevalence of the bipolar spectrum disorder suggests rates of 4-5%. Bipolar spectrum disorder is a longitudinal diagnosis characterized by abnormal mood swings comprising some of the following cross-sectional clinical states: mania, hypomania, mixed states, hyperthymic temperament, major depressive episode, and depressive mixed state. Failure to recognize subthreshold expressions of mania, such as hypomania, cyclothymia, and hyperthymia, contributes to the frequent under-diagnosis of bipolar disorder. There are several reasons for the lower rate of recognition of subthreshold manic symptoms, when compared to the analogous pure depressive one. These include the lack of subjective suffering, enhanced productivity, egosyntonicity, diurnal and seasonal rhythmicity associated with many of the manic and hypomanic symptoms, and the psychiatrists' difficulty in differentiating with personality disorders. In addition, most patients with bipolar spectrum disorder seek treatment for depression, rather than mania or hypomania. Therefore clinicians often miss the diagnosis of bipolar spectrum disorder. The recent 10 years of researches have suggested that 30-55% of patients with major depressive disorder are actually identified with broader spectrum of bipolar disorders. However, 48% of patients of bipolar disorder consulted 3 or more professionals before receiving a correct diagnosis, and 10% consulted 7 or more for their first diagnosis of bipolar disorder. Several studies have documented that patients often wait as long as 10 years for the correct diagnosis of bipolar spectrum disorder. This delay in diagnosis often has substantial adverse results. Patients do not get the appropriate treatment to alleviate their symptoms. They may even get treatments that exacerbate their symptoms, such as prescription of antidepressants precipitating mania and producing rapid cycling. The concepts of hypomania, cyclothymia, mixed state, depressive mixed states, hyperthymic temperament are the new areas of studying mood disorders in recent 20 years. The authors will review the studies on various subtypes of bipolar spectrum disorder with their historic aspects, and introduce the suggested screening tests for bipolar spectrum disorder in clinical practice.
Antidepressive Agents ; Bipolar Disorder ; Classification ; Depression ; Depressive Disorder, Major ; Diagnosis ; Efficiency ; Humans ; Mass Screening ; Mood Disorders ; Periodicity ; Personality Disorders ; Prescriptions ; Prevalence ; Seasons ; Temperament

Based on the 10 domestic theses which conducted a case-control study of elderly gra-vida over 35, meta analysis was made of the postpartum maternal outcome and fetal-neon-atal outcome with elderly gravida over 35 as cases and with gravida under 35 as controls. The findings are as follows: As for fetal-neonatal outcomes, the frequency of low birth weight was twice as high for cases , compared with controls, intrauterine growth retardation 2.4 times as high, macrosomia about 30% higher , congenital anomaly 16% higher , intrauterine fetal death 2.6 times as high, admission to newborn intensive care unit twice as high , and perinatal mortality twice as high. In case of neonatal sex , cases produced 28% more male babies than controls. As for postpartum maternal outcomes , the frequency of cesarean delivery was 2.9 times as high, compared with controls and postpartum hemorrhage 62% higher. Vaginal wall laceration, 3rd degree laceration, 4th degree laceration and cervix laceration all didn`t happen to cases as frequently as controls, while postpartum anemia was observed in cases 2.3 times as often as controls, wound infection 57% more often , bladder dysfunction 32% more , urinary tract infection 72% more and DIC about twice as often. In case of postpartum cardiomyopathy, pulmonary edema, respiratory infection, hepatitis and sepsis respectively, cases showed 7.4 times higher rate of an attack. Finally , it should be admitted that there are some problems in this study such as controversial hospital data used in analysis, the lack of clear operational definition , the lack of precise P-value, omitted standard deviation and uncontrolled confounding variables.
Aged* ; Anemia ; Cardiomyopathies ; Case-Control Studies ; Cervix Uteri ; Confounding Factors (Epidemiology) ; Dacarbazine ; Female ; Fetal Death ; Fetal Growth Retardation ; Hepatitis ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care Units ; Lacerations ; Male ; Perinatal Mortality ; Postpartum Hemorrhage ; Postpartum Period* ; Pulmonary Edema ; Sepsis ; Urinary Bladder ; Urinary Tract Infections ; Wound Infection

No abstract available.

No abstract available.
Aviation* ; Nursing*

A histopathological study of erythema nodosum-like lesions in Behcet's disease was performed on 55 patients with incomplete and suspect types of Behcet's disease. Relatively common characteristics in histopathology of erythema nodosum-like lesions could be found in the patients with incomplete type of Behcet's disease. The histopathologic findings of erythema nodosum-like lesions in 21 patients with incomplete type of Behcet's disease were as follows : l. A moderate lymphocytic infiltration was found around the blood vessels and the sweat glands in the dermis. In the subcutaneous tissue, besides lymphohistiocytic infiltration, neutrophils were present in significant number in 9 cases (42.9%) 2. Vasculitis of small vessels was found within the periphery of fat lobules in 7 cases (81.0%), Five cases (23.8%) also showed thrombophlebitis. Seven cases (33.3%) showed histiocytic granuloma formation within the fat lobules. Microabscess formation in the subcutaneous tissue was seen in 5 cases (23.8 %), but it was not certain whether this was the charateristic feature.
Blood Vessels ; Dermis ; Erythema Nodosum* ; Erythema* ; Granuloma ; Humans ; Neutrophil Infiltration ; Subcutaneous Tissue ; Sweat Glands ; Thrombophlebitis ; Vasculitis

Multiple cerebral infarction developed in a 36-year-old woman with adenocarcinoma of the right lung with direct cardiac invasion. Neurological examination and brain MRI showed findings of ordinary infarction. Transesophageal echocardiography showed left atrial pedunculated mass which was the potential source of embolism. We report a rare case who had such multiple spontaneous tumor emboli large enough to result in clinically detectable cerebral infarction.
Adenocarcinoma ; Adult ; Brain ; Cerebral Infarction* ; Echocardiography, Transesophageal ; Embolism ; Female ; Humans ; Infarction ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Neoplastic Cells, Circulating ; Neurologic Examination

A clinico-pathological study on the true skin appendage tumors was carried on the accumulated cases during pat 11 years from 1976 to 1986 years in the Department of Pathology, Seoul National University Hospital. The results was as follows; 1) Among various benign skin appendage tumors pilomatricoma was the most common benign tumor consisting of 72 out of 244 cases (30.1%), followed by dermoid cyst 48 cases (20.0%), steatocystoma multiplex 37 cases (15.5%), syringoma 33 cases (13.8%) and trichilemmal cyst 19 cases (0.8%). Other benign skin appendage tumors were rarely noted under 3%. Sebaceous carcinoma was most common among malignant skin appendage tumors and no malignant tumor of sweat gland origin was noted. 2) The sex ratio of male to female of the pilomatricoma was 1 : 2.6 and on the face, neck, and extremeties in 1st and 2nd decades. The sex ratio of dermoid cyst was 1 : 1.2 on the face in 1st decade. The sex ratio of steatocystoma multiplex was 1 : 1.9 and on the trunk in 3rd decade. The sex ratio of syringoma was 1 : 7 and on the face in 5th decade. The sex ratio of trichilemmoma was 1 : 1.6 and on the trunk in 5th decade. Other tumors were not avaiable for analysis because of small number. The sex ratio of sebaceous carcinoma was 1 : 2 and on the eyelid in 6th decade
Female ; Male ; Humans ; Cysts