Chronic ulcerative colitis is a systemic inflammatory disease with uncertain etiology primarily involving the colonic mucosa. The mucosal biopsy interpretation is important for an evaluation of the disease state and further medical or surgical treatment. However, few clinical and pathological studies of the endoscopic diagnosis of this disease are available in Korea. Therefore, we evaluated the clinical and pathological characteristics of it diagnosed by endoscopic biopsy and analysed the reasons for the discrepancy between clinical and pathologic diagnosis for a more accurate endoscopic mucosal biopsy diagnosis in the future. A total of 702 cases of colonic mucosal biopsy specimens during Feb. 1994 and Jan. 1995 at Severance hospital, Yonsei University College of Medicine were reevaluated for the study. A clinical diagnosis of ulcerative colitis, after endoscopic examination, was made in 61(8.7%) cases. A pathological diagnosis was made when there is an increased inflammatory cell infiltration in the mucosa with evidences of a chronic crypt injury in the biopsy specimens. Using this criteria, a diagnosis was made in 32(52.3%) cases. In 29 cases the diagnosis was made in the first biopsy specimen and in the remaining 3 cases the diagnosis was made in the second or third biopsy specimens. No pathologic diagnosis of ulcerative colitis was made in the cases that clinical diagnosis was not. In the 32 cases diagnosed as ulcerative colitis, 14 cases were involved the rectum and sigmoid colon, 9 cases were involved up to the descending colon, 1 case was involved up to the transverse colon and 8 cases showed pancolonic involvement. In 29 cases, which ulcerative colitis was suspected clinically but was not consistent with it pathologically, 8 cases were proved to be ischemic colitis, 5 cases were acute infectious colitis and one case was Crohn's disease by repeat examination and follow up. Ten cases were histologically within normal range and lesions subsided spontaneously with no recurrence. A conclusive diagnosis could not be made in 5 cases during this study period. From these results, we conclude that ulcerative colitis can be diagnosed accurately by endoscopic biopsy, and clinical follow up and repeat examination are valuable in the differential diagnosis of this disease.
Diagnosis, Differential ; Biopsy

Barrett's esophagus is a metaplastic process in which the squamous epithelium of the lowet esophagus is replaced by columnar epithelium. Most cases are believed to be related to prolonged gastroesophageal reflux. Detection of Barretts esophagus is important in that it results in adenocarcinoma in about 10% of patients. We report a case of adenocarcinoma arising from Barrett's esophagus in a 56 year-old man, diagnosed incidentally at a physical check-up. Grossly, the esophagogastric junction was irregular and there were two small ulcers in the lower esophagus. Microscopically, ihe squamous epithelium of the lower hagus was replaced by specialized intesinal mucosa with a small focus of adenocarcinona confined to the submucosa in one area. Many separate dysplastic foci were also present in the nearby esophageal mucosa.
Adenocarcinoma* ; Barrett Esophagus* ; Epithelium ; Esophagogastric Junction ; Esophagus* ; Gastroesophageal Reflux ; Humans ; Intestines* ; Middle Aged ; Mucous Membrane ; Stomach* ; Ulcer

No abstract available.
Drug Therapy* ; Humans ; Retreatment*

This study was conducted to integrate the results of previous studies which evaluated hypertension as a risk factor for cerebrovascular disorders (CVD) in Koreans. We retrieved the Korean literature using a manual search and the English literature using the MEDLINE database concerning the relationship between hypertension and CVD in Koreans from 1980 to 1997. The overall effect size of hypertension as a risk factor of CVD was represented by common odds ratio (OR). Before the integration of each effect size, a heterogeneity test and a sensitivity test was conducted. The materials were nine published epidemiologic studies with a total of 2,271 cases of CVD. The common ORs (95% confidence interval) of overall CVD, hemorrhagic CVD and ischemic CVD associated with hypertension were 4.10 (3.56-4.71), 6.56 (4.92-8.80) and 3.28 (2.77-3.90), respectively. Thus, the common OR of hemorrhagic CVD associated with hypertension was significantly higher than that of overall or ischemic CVD. This suggests that hypertension is an important risk factor for overall CVD and its subtypes in Koreans. Due to the lack of reliable prospective studies, however, longitudinal study is required in this area.
Cerebrovascular Accident/etiology* ; Human ; Hypertension/complications* ; Randomized Controlled Trials ; Risk Factors

Although there has not yet been a clear determination of the structures responsible for nasal tip support, it is generally agreed that for Caucasians the components of nasal tip support include the attachment between the upper and lower lateral cartilage, the attachment between the lateral crus and the pyriform aperture, the attachment between the paired domes of the lower lateral cartilages, and the medial crural attachments of the caudal septum. To our knowledge, there has been no anatomical study of the nasal tip supporting structures for Asian patients. The purpose of this study is to determine these structures and how they differ from those of Caucasian patients. Ten noses of fresh cadavers were investigated. Dissection was performed and the above-mentioned nasal tip supporting structures were observed and excised. Histological examination was done with hematoxylin and eosin stains and Van Gieson elastin stains. Based on our results, we propose that the structures between upper and lower lateral cartilages, between lateral crus and pyriform aperture, between the paired domes of lower lateral cartilages should referred to as an intercartilaginous ligament, sesamoid fibromuscular tissure, and interdomal loose connective tissue, respectively. There is no identified specific tissue between medial crus and caudal septum. We consider that the loose connection between the domes of the middle crura and the lack of a specific structure between the medial crus and caudal septum might be the reasons why the nasal tips of Asian patients tend to be broad and unprojected with a wide base.
Asian Continental Ancestry Group ; Cadaver ; Cartilage ; Coloring Agents ; Connective Tissue ; Elastin ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Ligaments ; Nose

BACKGROUND AND METHODS: The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists developed a standardized pathology reporting format for gastric cancer in collaboration with the Korean Gastric Cancer Association. RESULTS: The diagnostic parameters are divided into two part: the standard part and the optional part. The standard part contains most of the items listed in the Japanese classification, the TNM classification by UICC, the WHO classification, and the Korean Gastric Cancer Association classification. Therefore, the standard part is adequate for routine surgical pathology service. We included detailed descriptions on each item. CONCLUSIONS: The authors anticipate that this standardization can improve the diagnostic accuracy and decrease the discrepancies that occur in the pathologic diagnosis of gastric cancer. Furthermore, the standard format can encourage large scale multi-institutional collaborative studies.
Asian Continental Ancestry Group ; Classification ; Cooperative Behavior ; Diagnosis ; Humans ; Neoplasm Staging ; Pathology* ; Pathology, Surgical ; Stomach Neoplasms*

Sertoli-Leydig cell tumors belong to the group of sex-cord stromal tumors of the ovary. They account for less than 0.5% of all ovarian tumor. They occur predominantly at premenopausal women and rarely at postmenopausal and prepubertal. Most common symptom is menstrual disorder including vaginal bleeding. This symptom is the results of excessive testosterone production of Leydig cell. Masculinization is occasionally accompanied by this symptom. but approximately 50% of patients with SLCT have no endocrine manifestations. Prognosis prove generally favorable with 5-year survival rate of 70-90%. Recurrence is rare.The majority of these tumors are benign and are unilaterally (97-98%) localized. Surgery varies with patient age, tumor stage, and differentiation from unilateral salpingo-oophorectomy to bilateral salpingo-oophorectomy and total hysterectomy concomitant with pelvic lymph node dissection. Herewith, we experienced a case of treatment advanced-stage Sertoli-Leydig cell tumor with poorly differentiation in that is ascitic and metastatic in a 53 years old menopause woman who has no virilizing symptom. After all the tumor has resulted in fatal outcome despite of surgery and aggressive chemotherapy. Therefore we present it with review of literature.
Drug Therapy ; Fatal Outcome ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Menopause ; Middle Aged ; Ovary ; Prognosis ; Recurrence ; Sertoli-Leydig Cell Tumor* ; Survival Rate ; Testosterone ; Uterine Hemorrhage

Sertoli-Leydig cell tumors belong to the group of sex-cord stromal tumors of the ovary. They account for less than 0.5% of all ovarian tumor. They occur predominantly at premenopausal women and rarely at postmenopausal and prepubertal. Most common symptom is menstrual disorder including vaginal bleeding. This symptom is the results of excessive testosterone production of Leydig cell. Masculinization is occasionally accompanied by this symptom. but approximately 50% of patients with SLCT have no endocrine manifestations. Prognosis prove generally favorable with 5-year survival rate of 70-90%. Recurrence is rare.The majority of these tumors are benign and are unilaterally (97-98%) localized. Surgery varies with patient age, tumor stage, and differentiation from unilateral salpingo-oophorectomy to bilateral salpingo-oophorectomy and total hysterectomy concomitant with pelvic lymph node dissection. Herewith, we experienced a case of treatment advanced-stage Sertoli-Leydig cell tumor with poorly differentiation in that is ascitic and metastatic in a 53 years old menopause woman who has no virilizing symptom. After all the tumor has resulted in fatal outcome despite of surgery and aggressive chemotherapy. Therefore we present it with review of literature.
Drug Therapy ; Fatal Outcome ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Menopause ; Middle Aged ; Ovary ; Prognosis ; Recurrence ; Sertoli-Leydig Cell Tumor* ; Survival Rate ; Testosterone ; Uterine Hemorrhage

OBJECTIVES: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. METHODS: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. RESULTS: In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. CONCLUSIONS: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.
Adult ; Asian Continental Ancestry Group ; Blood Glucose ; Blood Pressure ; Blood Transfusion ; Body Mass Index ; Case-Control Studies ; Cholesterol ; Coffee ; Cohort Studies ; Glucose ; Humans ; Insurance ; Korea ; Logistic Models ; Mortality* ; Obesity ; Odds Ratio ; Surveys and Questionnaires ; Retrospective Studies ; Risk Factors ; Sex Distribution ; Smoking

BACKGROUND AND METHODS: For standardizing the pathology report and diagnosis of colorectal cancers, the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists has developed a pathology reporting format for colorectal cancer in collaboration with the Korean Society of Coloproctology. RESULTS: The diagnostic parameters are divided into two parts: the standard part and the optional part. The standard part contains most of the items listed in the Japanese classification, the TNM classification by AJCC, and the WHO classification. We included detailed descriptions on each item. CONCLUSIONS: The standardized pathology report for colorectal cancers is adequate for its application to routine surgical pathology reports, and it is also helpful to decrease the discrepancies that occur during the pathologic diagnosis of colorectal cancer. Furthermore, this reporting format could encourage nationwide multi-center collaborative studies.
Asian Continental Ancestry Group ; Classification ; Colorectal Neoplasms* ; Cooperative Behavior ; Diagnosis ; Humans ; Neoplasm Staging ; Pathology* ; Pathology, Surgical