With advance of diagnostic imaging technics, the detection rate of small hepatocellular carcinoma (HCC) has become much increased, but the questions whether the growth pattern and histologic nature of the HCC keep maintain the original gross and microscopic features with its advancement of tumor size remain still unclear. We reviewed 39 surgically resected hepatocellular carcinomas(HCCs) with a tumor size less than or equal to 3 cm in diameter(s-HCC), and their gross and microscopic features were compared with the HCCs bigger than 3 cm (i-HCC, 199 cases). Single nodular type(SN) was the most common gross type(60%) in s-HCCs, and was followed by single nodular type with perinodular extension(SNPE; 15.4%), multinodular-discrete type(10.3%) and multinodular-confluent type(5.1%). These figures contrasted to SNPE(42.2%) and SN(20.6%) in the i-HCCs. Of the 39 s-HCCs, 25 cases(64.1%) were encapsulated, and 14 cases(36%) demonstrated intratumoral fibrous septations, being contrasted to the i-HCCs in which fibrous septa formation was mord prominent but complete capsule formation was found only in 40.2% of the larger ones. Microscopically, the trabecular type was the most frequent one(53.9%), and increased with their size while the compact type transformed into trabecular one. Thirty three cases(84.6%) were associated with macronodular cirrhosis. Seropositivity for HBsAg was found in 26 cases(66.6%), and high serum alpha-fetoprotein level over 500 IU/L was found in 15 s-HCC cases(38.4%), while 53.3% in i-HCC. The above results suggest that HCCs change their pathologic features by increase of their size, and a comparison of the details with regard to the possible mechanisms involved is discussed.
Carcinoma, Hepatocellular

No abstract availble.
Adult ; Carcinoma, Squamous Cell/*diagnosis/pathology/surgery ; Esophageal Neoplasms/*diagnosis/pathology/surgery ; Esophagectomy ; Esophagus/*pathology/ultrasonography ; Humans ; Male ; Mucous Membrane/pathology

BACKGROUND: The purpose of this study was to measure and compare the optimum depth of the internal jugular venous catheterization between the right and left side. METHODS: Forty-four patients were enrolled for this study and divided into two groups (22 patients each). The optimum depth of the catheterization was calculated using the sum of two component (A and B); the advanced length of the catheter from the level of the cricoid cartilage (A) and the distance from the catheter tip to the junction of the superier vena cava and right atrium (B). RESULT: The optimum depths of the internal jugular venous catheterization were 16.0 1.0 cm (right) and 18.4 1.5 cm (left) respectively. Left side was significantly longer than right side (p<0.05). In this study, we experienced some complications; arterial punctures (5 cases) and migration of the catheter to the opposite subclavian vein (1 case). Five complications were associated with left internal jugular venous cannulation and one was associated with the right side cannulation. CONCLUSION: We concluded that the optimum depth of the internal jugular venous catheterization was longer in the left side than in the right side.
Catheterization* ; Catheters* ; Cricoid Cartilage ; Heart Atria ; Humans ; Punctures ; Subclavian Vein

This study was performed to evaluate the titer of serum acetylcholine receptor antibody (AChR-Ab), the correlation between AChR-Ab titer and clinical state, clinical response to thymectomy and histopathologic finding of thymus in myasthenia gravis. Twenty-seven patients with various clinical grades of myasthenia gravis and twenty-three norrnal controls were included in this study. Mean AChR-Ab titers were 4.21+4.27nM in myasthenia gravis and 0.05+0.06nM in control group(p<0.05). Mean AChR-Ab titers of each clinical grade were 0.80+1.67nM in grade I, 5.05+3.42nN in grade Iia, 8.37+4.50nM in grade Iib, 6.67nM in grade m and 10.89nM in grade IV. There were significant correlation between clinical grade and level of AChR-AB titer. There were no correlation between degree of clinical improvement and changes of serum AChR-Ab titer after thymectomy in myasthenia gravis. There were also no correlation between level of AChR-Ab titers and histopathologic findings of thymus.
Acetylcholine ; Humans ; Myasthenia Gravis* ; Thymectomy ; Thymus Gland

This study was performed to evaluate the titer of serum acetylcholine receptor antibody (AChR-Ab), the correlation between AChR-Ab titer and clinical state, clinical response to thymectomy and histopathologic finding of thymus in myasthenia gravis. Twenty-seven patients with various clinical grades of myasthenia gravis and twenty-three norrnal controls were included in this study. Mean AChR-Ab titers were 4.21+4.27nM in myasthenia gravis and 0.05+0.06nM in control group(p<0.05). Mean AChR-Ab titers of each clinical grade were 0.80+1.67nM in grade I, 5.05+3.42nN in grade Iia, 8.37+4.50nM in grade Iib, 6.67nM in grade m and 10.89nM in grade IV. There were significant correlation between clinical grade and level of AChR-AB titer. There were no correlation between degree of clinical improvement and changes of serum AChR-Ab titer after thymectomy in myasthenia gravis. There were also no correlation between level of AChR-Ab titers and histopathologic findings of thymus.
Acetylcholine ; Humans ; Myasthenia Gravis* ; Thymectomy ; Thymus Gland

OBJECTIVE: The purpose of this study was to review the clinical features, treatments and prognosis of the borderline malignant tumors of the ovary. METHODS: Thirty-two patients with borderline malignant tumors of the ovary were admitted, operated and confirmed with postoperative histopathological study at department of obstetrics and gynecology, Yonsei University Wonju Christian Hospital. The data were collected retrospectively and all charts were reviewed. RESULTS: The incidence of borderline malignant ovarian tumor was 19.2% (32/167). Age distribution revealed between 18 and 77 years old, the mean age was 43.1 years old. As for the parity distribution of borderline malignant tumor, nulliparity was most common (43.8%). The most common chief complaint was abdominal distension (34.4%). Histologic subtypes were mucinous in 19 cases (59.4%), serous in 13 cases (40.6%). According to FIGO classification, 28 cases (87.5%) were stage I, 1 case (3.1%) was stage II, 3 cases (9.4%) were stage III. Sixteen cases (50%) underwent conservative surgery (unilateral salpingooophorectomy or cystectomy). Sixteen cases (50%) were treated with total abdominal hysterectomy and bilateral salpingooophorectomy. Fifteen cases (46.9%) received adjuvant postoperative chemotherapy. Excluding 5 cases lost to follow up, patients were alive and were followed from 9 months to 100 months. (mean 36 months).
Age Distribution ; Aged ; Classification ; Drug Therapy ; Female ; Gangwon-do ; Gynecology ; Humans ; Hysterectomy ; Incidence ; Lost to Follow-Up ; Mucins ; Obstetrics ; Ovary* ; Parity ; Prognosis ; Retrospective Studies

OBJECTIVE: The purpose of this study was to review the clinical features, treatments and prognosis of the borderline malignant tumors of the ovary. METHODS: Thirty-two patients with borderline malignant tumors of the ovary were admitted, operated and confirmed with postoperative histopathological study at department of obstetrics and gynecology, Yonsei University Wonju Christian Hospital. The data were collected retrospectively and all charts were reviewed. RESULTS: The incidence of borderline malignant ovarian tumor was 19.2% (32/167). Age distribution revealed between 18 and 77 years old, the mean age was 43.1 years old. As for the parity distribution of borderline malignant tumor, nulliparity was most common (43.8%). The most common chief complaint was abdominal distension (34.4%). Histologic subtypes were mucinous in 19 cases (59.4%), serous in 13 cases (40.6%). According to FIGO classification, 28 cases (87.5%) were stage I, 1 case (3.1%) was stage II, 3 cases (9.4%) were stage III. Sixteen cases (50%) underwent conservative surgery (unilateral salpingooophorectomy or cystectomy). Sixteen cases (50%) were treated with total abdominal hysterectomy and bilateral salpingooophorectomy. Fifteen cases (46.9%) received adjuvant postoperative chemotherapy. Excluding 5 cases lost to follow up, patients were alive and were followed from 9 months to 100 months. (mean 36 months).
Age Distribution ; Aged ; Classification ; Drug Therapy ; Female ; Gangwon-do ; Gynecology ; Humans ; Hysterectomy ; Incidence ; Lost to Follow-Up ; Mucins ; Obstetrics ; Ovary* ; Parity ; Prognosis ; Retrospective Studies

Authors report the first autopsy case of acquired immune deficiency syndrome in Korea. The patient was a 26 years old Korean male who died of respiratory failure due to mixed pulmonary infections. He had history of homosexual contacts with partners of both domestic and foreign nationalities. Initial presentation was unexplained fever for two months. Serological test and western blot test for anti-HIV were positive and T-cell subset analysis revealed T3/T4/T8 to be 73/8/67%. Pulmonary tuberculosis with mediastinal lymphadenopathy and esophagonadal fistula and oral candidiasis were presented. Respiratory infection progressed gradually and he died seven months after the initial symptom. Autopsy findings were generalized severe lymphoid cell depletion, especially of T-cell population and mixed pulmonary infections with Pneumocystis carinii and cytomegalovirus (CMV). The CMV infection involved lungs and adrenals. Oral candidiasis was also demonstrated.
AIDS-Related Complex/complications/diagnosis/pathology ; Acquired Immunodeficiency Syndrome/complications/*diagnosis/pathology ; Adult ; Autopsy ; Candidiasis/complications/diagnosis/pathology ; Humans ; Male ; Pneumonia, Pneumocystis/complications/diagnosis/pathology ; Tuberculosis, Pulmonary/complications/diagnosis/pathology

OBJECTIVE: p63 is a member of the p53 gene family. The main aim of this study was to compare p63 and p53 expression in precancerous lesions and invasive squamous cell carcinoma of the uterine cervix. METHODS: Total 81 formalin-fixed, paraffin-embedded sections of low-grade squamous intraepithelial lesion (22 cases), high-grade squamous intraepithelial lesion (42 cases) and invasive squamous cell carcinomas (17 cases) in the uterine cervix were stained by immunohistochemistry for expression of p63, p53 and topoisomerase II-alpha. RESULTS: p63 was statistically significant higher immunoreactivity according to progression of uterine cervical squamous lesions, but p53 was not significant. No statistical correlation was found between p63 and p53. Topoisomerase II-alpha index was statistically significant higher according to increase of p63 expression. CONCLUSION: These findings suggest that the expression of p63 protein may play a roles in progression and proliferative activities of the uterine cervical squamous lesions.
Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Genes, p53 ; Humans ; Immunohistochemistry

We report magnetic resonance image (MRI) and magnetic resonance spectroscopy (MRS) findings in a patient of cerebral fat embolism (CFE) occurred in a 26-year-old woman after an autologous fat injection into the face. After initial neurologic symptom onset, MRI and MRS data were obtained two times to investigate repeated CFE. We obtained the MRS data in the two different time intervals and two different echo times to compare the lesions with normal brain parenchyma. The results of MRS data showed that a decrease in N-acetyl-aspartate, an increase in lactate and a very high early peak of free lipids between 0.9 and 1.4 ppm were obtained at the acute infarcted lesion as compared with normal brain parenchyma. In addition, these findings were more clearly detected on short echo time spectrum rather than long spectrum. A close relationship between the clinical manifestations and MRI and MRS findings of the brain can helpful to distinguish CFE with other conditions and to evaluate the cause materials of infarctions rather than conventional MRI or diffusion-weighted imaging.
Adult ; Brain ; Embolism, Fat ; Female ; Humans ; Infarction ; Lactic Acid ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Neurologic Manifestations