Secondary tumor of the stomach is rare when metastatic involvement is defined as an extragastric tumor invading the muscularis, submucosa or mucosa and the only serosal implant is excluded. Recently, authors experienced a case of metastatic squamous cell carcinoma of the stomach in the pyloric antrum from the uterine cervix. The patient was a 57-year-old female who received a simplified Wertheim's operation followed by irradiation for squamous cell carcinoma of uterine cervix in stage IIb, and 2-1/2 years later she presented gastric symptoms, for which subtotal gastrectomy was carried out. The gastric lesion simulated primary adenocarcinoma of Borrmann type III, but differed in the following macroscopic characteristics. Firstly, Bormann classification is not applicable; secondly, mucosal ulcerations appear irregular and multicentric; thirdly, flaskshaped ulceration and broad based penetration are evidet; fourthly, submucosal tumor-growth pattern is conspicuous in bulk of areas; and fifthly, circumferential/semicircumferential growth is manifested. The above features should also be differentiated from those of malignant lymphoma and leiomyosarcoma.
Female ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

A case of papillary adenoma of the gallbladder in a sixty seven-year-old female with varietise of epithelial components in metaplastic nature is presented. This adenoma was bordered by hyperplastic epithelium with intervening Paneth cells and enterochromaffin cells, but goblet cells were rarely participated, as with focal epithelial change resembling gastric foveolar epithelium and aggregation of antral type mucous glands. Based on its morphologically distinct type of gallbladder adenoma and histogenetic point of view, we propose this neoplasm to be designated as a metaplastic adenoma or polyp, and the relationship of various metaplastic changes to adenoma or carcinoma is discussed.
Female ; Humans ; Adenoma

Unstable Colles' fractures have an inherent capacity for loss of reduction or shortening, or both. The istability can be recognized by the presence of much comminution, severe dorsal angulation(20 degrees or more), or extensive intra-articular involvement. It is difficult to align the fracture fragments and to maintain the reduction. In twenty-nine patients with unstable Colles' fracture from Jan. 1982 to Mar. 1984, several invasive methods were used. The results were as follows: 1. Among 147 patients with Colles' fractures 29 patients(19.7%) had unstable fractures. 2. Colles' fracture was occurred more frequently in women(77%) and in 6th and 7th decades(56%). Unstable fractures showed no significant age and sex related propencity. 3. Mechanism of injury caused unstable Colles' fractures were fall on the outstretched hand(25 patients), traffic accident(3 patients) and crushing injury(1 patient). Open fractures were shown in 4 patients among the unstable fractures. 4. Most of the unstable fractures were comprised of type VII and VIII(49%) but type I and II fractures with marked comminution or displacement also showed instability. 5. Complications were such as, redisplacement of the fractures, temporary neuropathy of the median nerve, compartment syndrome, Sudeck's atrophy, and shoulder-hand syndrome. 6. Overall assessments showed excellent in 4 patients, good in 16 patients, fair in 7 patients and poor in 2 patients. 7. Overall results were mainly correlated with initial severity of the injury and anatomical restoration of the fractures.
Atrophy ; Colles' Fracture ; Compartment Syndromes ; Fractures, Open ; Humans ; Median Nerve ; Radius ; Reflex Sympathetic Dystrophy

Sixty amputees who had traumatic amputations due to industrial accidents were examined on their phantom limb and phantom pain phenomena and the following results were obtained. 1. Fifty-three (93%) of sixty amputees experienced phantom limb and twenty-four (40%) experienced phantom pain. The incidence of phantom pain in the lower limb amputation (59%) is greater than that of upper limb amputation (29%). 2. Amputees with asthenic body status gave higher incidence (56%) of phantom pain than those with muscular body status (20%). None of amputees with obese body status experienced phantom pain. 3. The sensation of strong current and cramping were most predominant sensations in the phantom pain. 4. Twenty-eight (93%) of thirty amputees had experienced painless phantom limb longer than four months. 5. Six (55%) of eleven upper limb amputees with phantom pain experienced pain sensation at the tips of fingers and nine (69%) of thirteen lower limb amputees with phantom pain experienced pain at the great toe. 6. Fifty-three (88%) of sixty amputees experienced telescoping of the lost limb and twenty-three (38%) of sixty amputees experienced jerking movement of the stump. 7. In fifty-four (90%) of sixty amputees, trigger zones triggering pain in the phantom limb were found in the healthy part of the body. 8. Twenty-two (40%) of fifty-five male amputees experienced burning sensation in the phantom limb associated with urination, defecation or ejaculation. 9. Cold temperature was predominant, aggrevating factor of the phantom pain. Fitting prosthesis and alcohol intake were predominant, relieving factor of the phantom pain.
Accidents, Occupational ; Amputation ; Amputation, Traumatic ; Amputees ; Burns ; Cold Temperature ; Defecation ; Ejaculation ; Extremities ; Fingers ; Humans ; Incidence ; Lower Extremity ; Male ; Muscle Cramp ; Phantom Limb ; Prostheses and Implants ; Sensation ; Toes ; Upper Extremity ; Urination

Squamous cell carcinomas and adenosquamous carcinomas are rarely originated from the stomach, thus the limited and sporadic informations about their clinico-pathologic characteristics as well as histogenesis have been elucidated. Six cases of primary squamous cell carcinoma (3 cases) and adenosquamous carcinoma(3 cases) in the stomach were examined during a period of 4 years from 1981 to 1984. After pertinent review of both clinical data and morphology through extended histotopographic study performed on 4 cases, their clinicopathologic characteristics were described. Male to female sex ratio was 4 : 2 and average age was 58.6 years. Clinical presentations or physical findings were not different from those of adenocarcinoma. Tumor masses of all cases were located in the body or phloric antrum. In all cases except for the early gastric carcinoma, each tumor was larger than 8 cm in long axis, and showed expansile and intraluminal endophytic growing tendencies with sharp margin. Simple Borrmann's macroscopic classification was applicable to none of 6 cases because of irregular and multicentric ulceration pattern and occasional submucosal growth which were reminiscent of those in submucosal tumors such as malignant lymphoma and leiomyosarcoma. Virtually four out of all six cases were diagnosed as submucosal tumor at the time of radiological examination. Microscopically three cases were composed of pure squamous cell carcinoma and remaining three contained both adeno and squamous components. Metastatic regional lymph nodes revealed only squamous element in case of pure squamous cell carcinoam, while both components were identified in adenosquamous carcinomas. Surrounding non-tumors mucosa exhibited moderate to severe degree of intestinal metaplasia accompanied by multifocal mucin pool formation. Growth pattern and surrounding mucosal changes as with older age prevalence of these tumors might express the biological behavior of intestinal type of gastric carcinoma.
Female ; Male ; Humans ; Neoplasm Metastasis

Cutaneous protothecosis sometimes poses diagnostic and therapeutic problems. Isolation of the causative organism may not be successful and spores may be mistaken for other skin diseases unless the characteristic sporangia are detected in tissue sections. Because there are few cases, the optimal therapy is still being debated. On Liebs crystal violet staining we found charateristic purplish dots in Prototheca spores; these correspond to the amyloplasts or dense bodies found under electron microscopy. The isolated organisms were inhibited in vitro by itraconazole, amphotericin B, ketoconazole, and amorolfine and we were able to successfully treat two patients with itraconazole.
Amphotericin B ; Gentian Violet* ; Humans ; In Vitro Techniques ; Itraconazole* ; Ketoconazole ; Microscopy, Electron ; Plastids ; Prototheca ; Skin Diseases ; Sporangia ; Spores

Thermography is a sensitive and reliable method for diagnosis of radiculopathy. Skin temperature alterations of the involved dermatome named thermatone are diagnostic for sensory root involvement in radiculopathy which can be demonstrated by thermography. Digital infrared thermographic imaging system using computer is development and could measure thermal difference more exactly without hazards or discomforts to patient. Authors present 186 cases of thermographic evaluation in herniated lumbar disc disease by digital infrared thermographic imging system and the results are evaluated with literature review.
Diagnosis ; Humans ; Radiculopathy ; Skin Temperature ; Thermography

Various clinical and pathologic parameters in order to determine the prognosis of gastric carcinoma have been proposed. Among them "carcinoma with lymphoid stroma" has been proven to show good prognosis. But the criteria of lymphoid stroma in this condition remain vague and not clear. A total of 7 cases of gastric carcinoma with heavy lymphoid stromal response out of 947 surgically resected gastric carcinomas was reviwed with histotopographic analysis. They were all advanced carcinoma, Borrmann type I and II. Histologically, the lymphoid stromal response could be divided into three patterns; nodular (3 cases), diffuse (3 cases) and mixed (1 case). The nodular pattern was characterized by massive lymphoid cell infiltration with many follicle formation and little desmoplastic reaction, while the diffuse pattern showed diffuse permeative type of inflammatory cell infiltration with scarce lymphoid follicle formation and mild desmoplasia. Regional lymph node metastasis was found in 2 cases; one in diffused and another one in mixed pattern. The stromal reaction was not directly related with the depth of tumor invasion. We propoose that the term GCLS should be used in the cases of nodular pattern with complete follicle formation of lymphoid stroma.
Neoplasm Metastasis

This study was conducted to analyze the relations among nutritional knowledge, nutritional attitude eating practice and total nutritional diagnosis and also to find the influencing factors of them. The survey was done during the period from April 1990 to June 1990 and the target population were Ewha Woman's University students (freshmen and senior) of whom 1,354 peoples were surveyed. The summarized results are as follows ; 1. For the learning environment, the percentage of completion on nutritional knowledge course was 28.6% and among them the department of foods and nutrition had the highest score(100.0%) and the next was dept. of medicine(53.4%). 2. To find the relation which the nutritional knowledge, nutritional attitude, eating practice and the total nutritional diagnosis influence on one another, the multiple correlation analysis was done. The attitude the practice were highly correlated with total nutritional diagnosis, but the correlation between nutritional knowledge and total nutritional diagnosis was not significant. The correlation between the practice and nutritional knowledge which were positively and significantly correlated with attitude respectively was positive but not significant. 3. The difference which were analyzed by department, grade and completion on knowledge course on the nutritional knowledge, attitude, eating practice were significant (p<0.01) by ANOVA. 4. The significant variables on nutritional diagnosis are the eating practice points, the grade, the knowledge course, the breakfast and the attitude (r2=10.3%) by multiple regression analysis. This study has the limitation that it did not consider the environmental factors of dietary life such as dietary culture, family environment, cultural habit. Therefore important points of these dietary studies are to extend to the practical nutritional education and dietary improvement for the national health not restricted to the local area or local population.
Attitude ; Breakfast ; Diagnosis ; Eating* ; Education ; Female ; Health Services Needs and Demand ; Humans ; Learning

Based on the theory that benign prostatic hypertrophy may be induced by androgenic effect of testosterone derivatives, especially 5-alpha - dihydrotestosterone, on prostatic tissue, Chlormadinone acetate(CMA), potent oral synthetic antiandrogen was investigated in the treatment of benign prostatic hypertrophy. Twenty-two patients of prostatic hypertrophy were studied over six months period with a special reference to uroflowmetry and following results were obtained : 1) Chlormadinone acetate induced improvement of obstructive urinary symptoms in terms of uroflowmetric measurement. 2) It is very worthwhile to initiate medical treatment before undergoing any surgical intervention or when surgery is contraindicated.
Chlormadinone Acetate* ; Dihydrotestosterone ; Humans ; Prostatic Hyperplasia* ; Testosterone