A case of primary non-clear-cell adenocarcinoma of the vagina is reported occurring in a 65-year-old woman without exposure to diethylstilbestrol (DES) in utero. The adenocarcinoma did not appear to be associated with vaginal adenosis. It lacked clear cell component and interestingly composed of columnar epithelial cells of endocervical-type. Cytologically round to oval nuclei revealed one or more small nucleoli and fine granular chromatin pattern. Cytoplasm was plump, faintly basophilic and homogeneously stained. Histologically well differentiated columnar epithelial cells were arranged in trabecular pattern mainly, and also occasional glandular lumina and small solid sheets were found. Mitoses were hardly found.
Adenocarcinoma ; Aged ; Basophils ; Cellular Structures ; Chromatin ; Cytoplasm ; Diethylstilbestrol ; Epithelial Cells ; Female ; Glomerulonephritis* ; Humans ; Mitosis ; Purpura, Schoenlein-Henoch* ; Vagina

Between Jan. 1983 and Dec. 1990, 17 Patients with distal anterior cerebral artery(DACA) aneurysms were admitted to our institute and underwent microsurgical neck clipping of their aneurysms. This group comprised 3.7% of the 437 aneurysms managed surgically during this period. There were 11 females and 6 males. The mean age was 48.5 years. Most of DACA aneurysms were located at the genu portion of the anterior cerebral artery. Three cases were at the proximal protion of A2 close to the anterior communicating artery. Two cases were at the dista pericallosal artery and distal callosomarginal artery. Eight patients had additional vascular anomalies documented by angiography such as multiple aneurysms, azygos DACA and duplication of DACA. Direct neck clipping was possible in all cases through the interhemispheric approach or the frontotemporal approach according to the location. For the interhemispheric apporach preoperative evaluation of the exact location and direction of the aneurysms on the angiogram was important for operative planning. The surgical outcome was good or excellent without any neurological deficits in 17 of the cases. Operative management, clinical features and incidence of vascular anomalies associated with DACA aneurysms are discussed.
Aneurysm ; Angiography ; Anterior Cerebral Artery* ; Arteries ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Neck

No abstract available.
Child* ; Humans

OBJECTIVES: Our aims of this study is to analyze the clinical characteristics and the prognos is of the disease which develops in patient swith chronic liver disease as acutely exacerbated hepat it is accompanied by myosit is. Finally we try to identify and is olate the causative agent. METHODS: The patient swith chronic liver diseases, who developed muscle weakness and paralysis, were classified to group A or group B, according to the level of creatinine kinase ( CK) activity. The group A consists of patients with less than 3-fold increase of normal CK activity and the group B includes patients with over 3-fold increase of it. We evaluated clinical characteristics, blood chemistry, clinical course, and causes of deathin patients of study groups, compared with those of patients with chronic liver disease with normal CK activity as controls. The causative agent was suggested by conventional culture and RT-PCR analysis in two cases of group B. RESULTS: 1. There was no significant differences in age, sex, underlying disease, or liver function test bet ween control and study group ( control and group A or B) before entry. 2. The clinical symptoms and signs , such as drowsy mental state, generalized weakness/myalgia caused by hepatic encephalopathy and myositis , occurred frequently in the study group. 3. Significant elevation of aspartic acid transaminase (AST ) and alaninetr ans aminase ( ALT ) was noted in Group B. AST / ALT ratio is over 2 in group A or B. Synthetic function of the liver such as prothrombin time ( PT ) or serum albumin level is significantly decreased. Blood urea nitrogen ( BUN) and creatinine were increased as a result of impaired renal function. 4. Culture of coxs ackievirus was positive by immunofluor escence as say IFA) as a caus ative agent and also was positive in reverse transcription-polymerase chain reaction (RT-PCR) analys is using universal primer of enterovirus in two recent cases of group B. 5. Death rate increased significantly in study group, compared with that of control group ( 20.7% versus 5.6%). Major cause of death, 12 patients died of which, is hepatic failure. CONCLUSION: The patients with chronic liver disease abruptly developed a exacerbated hepaticdys function and muscle paralysis and/or weakness. This exacerbated hepatitis accompanied by myositis was suggested to be caused by coxsackie B viral infection. Furthermore, this infection increase deathrate and resulted in poor prognosis. Thus, further study should be continue to confirm the causative agent and classify the subtype.
Aspartic Acid ; Blood Urea Nitrogen ; Cause of Death ; Chemistry, Clinical ; Creatinine ; Enterovirus ; Hepatic Encephalopathy ; Hepatitis* ; Humans ; Liver Diseases* ; Liver Failure ; Liver Function Tests ; Liver* ; Mortality ; Muscle Weakness ; Myositis* ; Paralysis ; Phosphotransferases ; Prognosis ; Prothrombin Time ; Serum Albumin

No abstract available.
Hematology* ; Humans ; Thyroid Gland*

No abstract available.
Congenital Abnormalities* ; Osteotomy* ; Recurrence*

We present the cytologic features of a case of solid and papillary neoplasm of the pancreas. Cytologically, the tumor was composed of a monotonous population of polygonal cells containing eccentrically located round nuclei with one or two distinct small nucleoli and a finely stippled chromatin pattern. The tumor cells were similar to those of the islet cell tumor and showed isolated loosely aggregated and solid sheets or large cell clumps. The large cell clumps revealed a branching papillary structure containing fibrovascular central core, which is characteristic histologic feature of solid and papillary neoplasm of the pancreas. This case was confirmed by tissue examination including histochemical, immunohistochemical and electron microscopical studies. Ultrastructurally, the tumor cells contained a few membrane-bound electron dense granules.
Adenoma, Islet Cell ; Chromatin ; Pancreas ; Urinary Tract*

Fifty-one consecutive 186 patients with aneurysmal subarachnoid hemorrhage were treated from the day of admission with nimodipine which was given first as an IV infusion at 30ug/kg/hr for 1 week and then orally in a dose of 360mg/day for 2 weeks and compared with 135 patients which were treated without nimodipine for the past 2 years. A comparision based on clinical and radiological variables influencing both the coruse and the outcome of the disease showed no significant difference between the nimodipine treated group and the control group except the delayed timing of surgery in the control group. There was no significant difference in the outcome between the nimodipine treated patients and the patients treated without nimodipine, however in Hung & Hess grade IV patients nimodipine treatment was associated with a significantly better outcome. Nimodipine treatment reduced the occurrence of delayed ischemic deficts(DID) in grade III, IV patients. Significant improvement in the outcome occurred in the nimodipine treated patients with subarachnoid hemorrhage of large amount(Fisher classification III).
Aneurysm* ; Classification ; Humans ; Intracranial Aneurysm ; Nimodipine* ; Subarachnoid Hemorrhage*

This study was to investigate the clinical difference between the normal and abnormal EEG group of psychomotor epileptic patients. Selected for this study were 75 subjects who was diagnosed as the psychomotor epilepsy at the Seoul National Mental Hospital during the period from March, 1980 to June 1983 . 1. In the distribution of age group, 61.33% of total patients belonged under the ages between 20 and 29. 2. As to the precipitating factors, the unknown or none occupied 32.0% of total paeitnts. In normal EEG groups the unknown or none was the most frequent one and in abnormal EEG groups sleep and psychogenic factors were the most frequent one. 3. As to the frequency of psychomotor attack, the patient who had the frequency of ""less than one two weeks but more than one a month"" occupied 34.67% of the total. The abnormal EEG groups tended to have the attacks more frequent than the normal EEG groups. 4. As to the age of onset, 50.67% of total patients had their first attack at the ages between 10 and 19. The abnormal EEG groups had the attacks at the earlier than the normal EEG groups. 5. As to the personality trait, the aggressive personality trait was rated 29.33%, the next came the dependent personality trait. 6. As to the psychiatric symptoms and manifestations which were associated with the convulsion, the compound type was rated 38.67% of the total patients. 7. In the proportion of wave patterns of abnormality, paroxysmal slow wave was 40.74% of the abnormality and isolated spike or sharp wave was 22.22% spikes and slow wave was 14.81%. 8. The abnormality which was facalized or localized on the temporal leads was 64.86% of the abnormal EEGs. The aggressive personality trait was 37.5% of them.
Age of Onset ; Electroencephalography* ; Epilepsy, Complex Partial* ; Hospitals, Psychiatric ; Humans ; Precipitating Factors ; Seizures ; Seoul

This study was to investigate the clinical difference between the normal and abnormal EEG group of psychomotor epileptic patients. Selected for this study were 75 subjects who was diagnosed as the psychomotor epilepsy at the Seoul National Mental Hospital during the period from March, 1980 to June 1983 . 1. In the distribution of age group, 61.33% of total patients belonged under the ages between 20 and 29. 2. As to the precipitating factors, the unknown or none occupied 32.0% of total paeitnts. In normal EEG groups the unknown or none was the most frequent one and in abnormal EEG groups sleep and psychogenic factors were the most frequent one. 3. As to the frequency of psychomotor attack, the patient who had the frequency of ""less than one two weeks but more than one a month"" occupied 34.67% of the total. The abnormal EEG groups tended to have the attacks more frequent than the normal EEG groups. 4. As to the age of onset, 50.67% of total patients had their first attack at the ages between 10 and 19. The abnormal EEG groups had the attacks at the earlier than the normal EEG groups. 5. As to the personality trait, the aggressive personality trait was rated 29.33%, the next came the dependent personality trait. 6. As to the psychiatric symptoms and manifestations which were associated with the convulsion, the compound type was rated 38.67% of the total patients. 7. In the proportion of wave patterns of abnormality, paroxysmal slow wave was 40.74% of the abnormality and isolated spike or sharp wave was 22.22% spikes and slow wave was 14.81%. 8. The abnormality which was facalized or localized on the temporal leads was 64.86% of the abnormal EEGs. The aggressive personality trait was 37.5% of them.
Age of Onset ; Electroencephalography* ; Epilepsy, Complex Partial* ; Hospitals, Psychiatric ; Humans ; Precipitating Factors ; Seizures ; Seoul