We present an autopsy case of signet ring cell carcinoma of urinary bladder which underwent widespread metastsis through nearly entire organ. The patient, 45-year old male, suffered from hematuria, dysuria and flank pain for 6 months. Under the diagnosis of the signet ring cell carcinoma by the cystoscopic biopsy, radical cystectomy and ileocutaneous ureteral division were performed. But he died after 11-months after the diagnosis. The autopsy confirmed the widespread metastasis at the lung, kidney, adrenal gland, parathyroid gland, heart, stomach, ileum, spine, rib and meninges. The preveously resected urinary bladder discolosed the well defined fungating mass at the dome and anterio-lateral portion without apparent evidence of the remnant of the urachus. Histologically, the signet ring cells were predominent and focally mucinous pool floating the signet ring cells was noted. We could find several foci of the well differentiated adenocarcinoma and poorly differentiated adenocarcinomas. The above findings may reflect that the origin of carcinoma may be from the multipotential transitional cell epithelium.
Adenocarcinoma ; Neoplasm Metastasis

No abstract available.
Adolescent* ; Humans ; Parents* ; Smoking* ; Tobacco Products*

Hodgkin's disease, as a poly-morphous group of lymphoma, is a disease of reticuloendothelial system, skin and usually affects the lymph node and so primarily, predominantly by proliferation of lymphocyte and histiocyte. This patient is a 42 years old Housewife who was suffered from severe itching sensation on the entire body since she had illed with exfoliative decmatitis, 7 years ago. Skin lesion showed brownish colored hyperpigmentation on entire body, scattered or grouped lichenified patch with scale on extremities and hypertrophy on the palms and soles. On physical examination, she had a egg-sized, right cervical lymph node swelling and chestnut sized, left cervical lymph node swelling without pain. On laboratory findings showed within normal limits. Sternal bone marrow aspiration revealed nonspecifie findings. A chest X-Ray revealed mass shadow on right upper mediastinum. Histologically finding of the skin revealed nonspecific dermatitis picture. On diagnostic excisional biopsy of left cervical lymph node showed numerous Hodgkin's cell Liver scanning didn't show space occeuying lesion. Above as a result, by clinical manifestation, X-ray findings and histological findings of cervical lymph-node, the diagnosis of Hodgkins disease with nonspecific dermatitis was confirmed. Literature was briefly reviewed for the discussion of clinical and histological findings of this dlsease.
Adult ; Biopsy ; Bone Marrow ; Dermatitis* ; Diagnosis ; Extremities ; Histiocytes ; Hodgkin Disease* ; Humans ; Hyperpigmentation ; Hypertrophy ; Liver ; Lymph Nodes ; Lymphocytes ; Lymphoma ; Mediastinum ; Mononuclear Phagocyte System ; Physical Examination ; Pruritus ; Sensation ; Skin ; Thorax

No abstract available.
Neck*

As flow cytometric analysis using paraffin-embedded tissue was developed by Hedley et al in 1983, retrospective study with large amount of archival material was possible. Many literatures reported that the result of paraffin embedded tissue was compatible with that of fresh tissue. We compared the DNA histograms of 26 cases of colorectal adenocarcinoma in which the analysis was done in both fresh and paraffin-embedded tissues. Aneuploidy in fresh and paraffin-embed-ded tissues was 73.0% and 50.0%, respectively. The concordance rate of fresh and paraffin-em-bedded tissues was 76.8% and six interpreters were agreed in 73.0% of the cases. Because flow cytometric DNA analysis using fresh tissues can detect more aneuploid population than in paraffin-embedded tissue, the former is strongly recommeded in DNA ploidy study. Also careful observation using standard criteria may improve the interpretation of DNA histogram.
Adenocarcinoma

This study was condicted to construct a hypothetical model of depression in Korean adolescent women and validate the fit of the model to the empiricla data. The data were collected from 345 high school girls in Seoul, from May 1 to June 30, 1998. The instruments were the Body Mass Index, Physical Satisfaction Scale, Family Adaptatibility and Cohesion Evaluation Scale III, Family Satisfaction Scale, CES-D and School Adaptation Scale. The data were analyzed using descriptive statistics with the pc-SAS program. The Linear Structural Relationship(LISREL) modeling process was used to find the best fit model which would predict the causal relationships among the variables. The overall fit of the hypothetical model to the data was moderate [X2=69.6(df=17, p=.000), GFI=0.95, AGFI=0.90, RMR=0.087, NNFI=0.86, NFI=0.90]. The predictable variables, especially menstrual symptoms, physical symptoms and family function, had a significant direct effect on depression, but school life adaptation did not have a significant direct effect. These variables explained 18.1% of the total variance.
Adolescent* ; Body Mass Index ; Depression* ; Female ; Humans ; Seoul

No abstract available.
Aneurysm, False* ; Embolization, Therapeutic* ; Hepatic Artery*

PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance

Rigid ureteroscopy is new one of established technique for the management of ureteral stones. Manipulation of calculi can be done under direct vision using flexible forceps or stone baskets with increased safety and efficacy. We have used a 5Fr. electrohydraulic lithotripsy to disintegrate stones that were two large to b removed by manipulation. Between May 1988 and October 1989. 140 ureteroscopies were performed for removal of ureteral stones. In 119 cases(85 %) the stone was removed successfully. Electrohydraulic lithotripsy was used successfully to remove the stone in 25 among 28 cases(89.3%). We conclude that ureteroscopic removal of ureteral stone under direct vision is a safe and effective method for treatment of ureteral stone.
Calculi ; Lithotripsy* ; Surgical Instruments ; Ureter* ; Ureteral Calculi* ; Ureteroscopy

Fluid resuscitation is a basic treatment in hemorrhagic shock. We compared the circulatory responses to fluid resuscitation of 10% pentastarch with those of fresh whole blood and plasmanate in hemorrhagic shock. Eighteen mongrel dogs were bled 24 ml/kg and replaced by equivalent amounts of fresh whole blood(n=6, group B), pentastarch(n=6, group P) and plasmanate(n=6, group PL). Hemodynamic measurements and calculations were performed before and after bleeding and after volume therapy. The decrease of hematocrit and platelet count after volume replacement indicate that hemodilutional effect was maximum 30 min after volume therapy and significantly greater in group P than PL(p<0.05). Central venous pressure(CVP), pulmonary capillary wedge pressure(PCWP) and cardiac index(CI) were increased to 146-189%, 146-172% and 146-175% in group P, respectively during 60 min. These changes were significantly greater than group B and PL(p<0.05). There was delayed recovery of mean arterial pressure in group PL(92% 30 min after volume therapy) compared with group B and P(92% and 93% 5 min). Also group P and PL showed significant prolongation in prothrombin time and partial thromboplastin time during experiment(120 min) and these were significantly more prolonged in group P than PL(P<0.05). And group P showed similar O transport and O extraction ratio to those of group B. The increases in plasma catecholamine were observed after hemorrhage, but no significant changes 5 and 30 min after volume therapy. This suggests that the neurohumoral response to hemodilution was not marked. Mixed venous O2 saturation(SvO2) was directly proportional to CI during experiment(r=0.69, p<0.01), indicating that SvO2 can represent CI during shock and volume therapy. In conclusion, l0% pentastarch is useful as a substitute for fresh whole blood or plasmanate.
Animals ; Arterial Pressure ; Blood Transfusion, Autologous* ; Capillaries ; Dogs* ; Hematocrit ; Hemodilution ; Hemodynamics ; Hemorrhage ; Hydroxyethyl Starch Derivatives ; Partial Thromboplastin Time ; Plasma ; Platelet Count ; Prothrombin Time ; Resuscitation* ; Shock ; Shock, Hemorrhagic*