Hepatoid adenocarcinoma of the stomach has been designated to a primary gastric adenocarcinoma with minimum criteria of elevated serum alpha-fetoprotein and its histological resemblance to neoplastic liver cells. Of the 1,500 consecutive cases of surgically resected gastric carcinomas during a period of 4 years, we retrieved 14 cases of adenocarcinoma which met the histologic features of hepatoid growth and compared them histologically with 400 consecutive cases of non-hepatoid gastric adenocarcinomas. The patient's age ragned from 32 to 80 years(non-hepatoid group: 25 to 81 years) and their male to female ratio was 3.7 : 1(non-hepatoid group: 1.8 : 1). Grossly, five case were Borrmann type II and another five cases type III. All three cases of early gastric carcinomas were the submucosal type IIc. The remaining one was an advanced gastric carcinoma mimicking early gastric carcinoma. Microscopically, the hepatoid portions varied in growing patterns and arranged in either compact, trabecular or pseudoglandular pattern and gave an immunoreactivity to alpha-fetoprotein and alpha-1-antichymotrypsin. Regardless of the tumor stage, the hepatoid areas were located in the deeper portion of the tumor mass and grew in an expanding/nodular pattern. The associated adenocarcinomatous areas were mostly papillotubular, moderately to well differentiated, and frequently revealed clear PAS-negative cytoplasm reminiscent of the differentiated embryonal carcinoma. Tumor emboli and nodal metastasis were the frequent associations. We assume that the hepatoid adenocarcinoma may develop from gastric'adenocarcinoma through embryonal carcinomatous growth.
Female ; Male ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

It has been well known that liver cirrhosis, regardless of its etiology, is an important predisposing factor in hepatocarcinogenesis. However, the type of cirrhosis in hepatocellular carcinoma(HCC)-bearing liver varies not only by geographic areas but also with the cirteria applied for morphological classification of cirrhosis. To elucidate the relationship between the nodule size of HCC-bearing cirrhotic liver and clinicopathologic features, we measured cirrhotic nodule areas of 49 surgically resected HCC cases using image analyzer. The morphological type of cirrhosis was predominantly macronodular(49%), and followed by mixed(37%) and micronodular(14%). Seventy percent of the cases showed seropositivity for HBsAg. The average area of cirrhotic nodules was significantly larger in HBsAg-positive cases(mean: 6.14 mm2) than that of HBsAg-negative cases(mean: 2.5 mm2)(p<0.05), and their size was bigger in cases with grossly expansile pattern of HCC than those cases with infiltrative ones(p<0.05). Based on the above findings, we assume that seropositivity of HBsAg may influence on the regenerative activity of cirrhotic nodules and also subsequent increase of risk for further development of HCC. The presence of cirrhohsis and nodule size seem to be the important contributing factors to determine the growing patterns of HCC.
Carcinoma, Hepatocellular

A 56-year-old man received subtotal gastrectomy for an early gastric carcinoma type IIa+IIc with submucosal invasion. The tumor was made up of mixed papillo-tubular adenocarcinoma and solid carcinomatous portion, the latter comprising approximately four-fifths of the total tumor mass. The solid portion was confined within the submucosa and revealed a mixture of trabecular, compact and pelioid patterns of large polyhedra cells, resembling hepatocellular carcinoma of the liver(Edmondson-Steiner grade 2). Sinusoid-like vascular stroma of classical trabecular hepatocellular carcinoma intervened the tumor cell nests but was not associated with endothelial-cell lining. Immunohistochemical stainings with alpha-fetoprotein and alpha1-antitrypsin gave a strong reactivity in those areas of hepatoid differentiation and in the adjacent minute portion of adenocarcinoma. The findings suggest that a portion of gastric carcinoma may transdifferentiate into cells with hepatoid features along the line of endodermal lineage.
Male ; Humans ; Adenocarcinoma ; Carcinoma, Hepatocellular

A case of cystic lymphangioma of the mesentery with severe and persistent abdominal pain in a 22-year-old man is presented. The cyst was filled with chylous fluid. Microscopically, numerous nerve bundles were incorporated within the lymphangiomatous walls, and some protruded into the lumen. The above findings lead to a suggestion that mesenteric lymphangioma may differ from those in the other sites by its abundance of incorporation of nerve bundles into the lymphangiomatous walls, and that increase of tumor size by intracystic accumulation of chylous fluid may subsequently result in increase of intraluminal pressure to compress the nerve bundles with which abdominal pain is much enhanced.
Male ; Humans ; Cysts

We experienced an unusual case of acute encephalopathy in a 4 month-old boy He was admitted to our hospital because of lethargy and seizures after preceding symptoms of upper respiratory tract infection a few days before admission. On admission, he was in semicomatous mental state with decorticated rigidity. Laboratory tests showed normal blood sugar, ammonia, and transaminase levels. CSF was acellular and sterile. Brain MRI in both 71 and 72 weighted-image showed high signal density in both thalami and caudate nucleus head. After recovery, neurologic sequales of developmental delay, mental retardation, right hemiplegia and seizure remained. We report a case of acute encephalopathy that have clinical course similar to Reye syndrome but have specific brain image.
Ammonia ; Blood Glucose ; Brain ; Caudate Nucleus ; Head ; Hemiplegia ; Humans ; Infant ; Intellectual Disability ; Lethargy ; Magnetic Resonance Imaging ; Male ; Respiratory Tract Infections ; Reye Syndrome ; Seizures

No Abstract Available.
Tinea Capitis* ; Trichophyton*

Contact urticaria refers to a wheal-and-flare response after cutaneous exposure to certain chemicals. If contact urticaria is accompanied by systemic symptoms, it is referred to as contact urticaria syndrome. Herein we report two cases of contact urticaria syndrome occur-ring in nurses due to occupational exposure to cefotiam.
Cefotiam ; Occupational Exposure ; Urticaria*

Purpose: This study was conducted to investigate the current status of the biological nursing curriculum and faculties’ perceptions on biological nursing subjects in South Korea. Methods: Biological nursing subjects’ titles and credits were searched through the nursing schools’ website. Perceived adequacy of subjects’ title and credit in each biological nursing subject and the degree of perceived importance and satisfaction of learning contents by subjects were collected from 30 professors of biological nursing subjects. Results: Many schools still use the titles of medical subjects for those of biological nursing subjects. The perceived importance and satisfaction of genetics-related learning contents, “nursing case study” or “project team presentation,” were lower than other learning contents. Conclusion Standardization of biological nursing subjects’ titles and learning contents is needed.

Purpose: This study was conducted to investigate the current status of the biological nursing curriculum and faculties’ perceptions on biological nursing subjects in South Korea. Methods: Biological nursing subjects’ titles and credits were searched through the nursing schools’ website. Perceived adequacy of subjects’ title and credit in each biological nursing subject and the degree of perceived importance and satisfaction of learning contents by subjects were collected from 30 professors of biological nursing subjects. Results: Many schools still use the titles of medical subjects for those of biological nursing subjects. The perceived importance and satisfaction of genetics-related learning contents, “nursing case study” or “project team presentation,” were lower than other learning contents. Conclusion Standardization of biological nursing subjects’ titles and learning contents is needed.

Tsutsugamushi disease cases occur throughout the rural area in Korea, and the number of the reported cases has been increased recently. Tsutsugamushi disease is a kind of rickettsiosis, and causative organism of that is Rickettsia tsutsugamushi. The field rodents, especially Apodemus agrarius, are the animal hosts, and main vector is chigger, Leptotrombidium pallidum. The pathogen is transmitted to human via this chigger bite. We experienced 60 cases of tsutsugamushi disease at Uijungbu Saint Mary's Hospital from January 1993 to December 1996. A group(study group) consists of 8 patients. They complained of abdominal (RUQ or epigastric) pain and had a finding of GB wall thickening by ultrasonogram and computerized tomogram. B group (control group) consists of 52 patients. They had no abnormal findings of GB by that. A clinical analysis of those patients was done retrospectively. Then A group was compared to B group. The obtained results were as follows. 1) All patients(A group and B group) those visited emergency room from October to December complaining of fever had lived at north area of Kyonggi-Do and had experienced outdoor play in field two weeks before expression of symptoms. 2) Percentage of leukocytopenia was 26%(2/8 cases) and 10%(5/52 cases) in A and B group respectively. Thrombocytopenia was found in many patients, and serum AST and ALT level was elevated in all patients of A and B group. 3) Percentage of patients with hypoalbuminemia was 87%(7/8 cases) and 67%(35/52 cases) in A and B group respectively. 4) Mean age of A group patients was higher than that of B group patients(A:62.4, B:49-years-old), and only all patients of A group had abdominal pain and hyperbilirubinemia. 5) Mean thickness of GB wall in A group patients was 7.3 mm(range 4~14 mm) by ultrasonogram. Conclusively, tsutsugamushi disease should be considered as differential diagnosis when old patient with fever and abdominal pain visits ER in endemic area of that despite jaundice, leukocytopenia, thrombocytopenia, and GB wall thickening founded by ultrasonogram.
Abdominal Pain* ; Animals ; Diagnosis, Differential ; Emergency Service, Hospital ; Fever ; Gyeonggi-do ; Humans ; Hyperbilirubinemia ; Hypoalbuminemia ; Jaundice ; Korea ; Leukopenia ; Murinae ; Orientia tsutsugamushi ; Retrospective Studies ; Rodentia ; Saints ; Scrub Typhus* ; Thrombocytopenia ; Trombiculidae ; Ultrasonography