The secretary meningioma is a distinct variant of meningioma that revealed characteristic light microscopic, immunohistochemical and ultrastructural features of epithelial and secretary differentiation, which was named as a distinct subtype of meningioma by Alguacil-Garcia et al in 1986. We experienced 2 cases of secretary meningioma. One was a 53-year-old female who had suffered from sudden onset of dizziness for I day. The computerized tomography revealed a sharply marginated well enhanced mass in temporal lobe. The other was a 59-year-old female who had suffered from dizziness for 8 years. The computerized tomography revealed a well demarcated lobulated mass in petrosal ridge. In both cases, multiple hyaline inclusions were scattered in the background of meningothelial meningioma. They were PAS positive, diastase resistant, stained yellow with van Gieson, and did not stain with reticulin in contrast to Psammoma bodies. The immunohistochemistry revealed positive reaction for EMA, CEA, a-FP and cytokeratin. T'he electron microscopic study revealed interdigitation with desmosomes and abundant intracellular lumina. They were lined by numerous microvilli and filled with granular material which was composed of electron dense homogenous material, me branous material, and small membrane-bound vesicles. Microvilli were filled with electron dense material identical to the material in the lumina, and some of them were interconnected with electron dense material in the lumina. It was concluded that secretary activity of the meningothelial cells and degenerated microvilli were involved in the pathogenesis of hyaline inclusions.
Female ; Humans ; Meningioma

Nucleolar organizer regions (NORs) are loops of DNA which occur in the nucleoli of cells which possess ribosomal RNA genes. The numbers and areas of NORs have been thought to be related to cellular activities. We aimed to investigate the direct relationship between the parameters of AgNORs and cellular proliferative activity using immunohistochemical method with the monoclonal antibody Ki-67, which demonstrates proliferating nuclei. The sequential technique for the simultaneous Ki-67 immunostaining and NOR staining was applied to the same slides of a series of non-Hodgkin's lymphomas (NHL) of the low, intermediate, and high grade type. The number of AgNOR per cell was counted and mean NOR percentage nuclear area (NPNA) was measured by morphometry in both the Ki-67 positive and Ki-67 negative nuclei. The increased immunoreactivity for Ki-67 was found in the high grade than in the low grade non-Hodgkin's lymphoma. This was reflected in the two areas of the palatine tonsils and lymph nodes, the positive cell counts being higher in the follicle center nuclei than in those in the interfollicular compartment. In general the numbers and NPNA of AgNORs were higher in the Ki-67 positive nuclei than in those lacking the antigen in malignant lymphomas as well as in control. The AgNORs numbers and NPNA in controls were the highest in the Ki-67 positive cells in the follicular area and the lowest in the Ki-67 negative cells in the perifollicular area. In malignant lymphomas the numbers and NPNA of AgNORs tended to increase in proportion to their grade in both the Ki-67 positive and negative cells. The numbers of AgNORs of the high grade and the NPNA of the intermediate and the high grade were significantly higher in Ki-67 positive cells than in Ki-67 negative ones. With this double staining method it was now possible to confirm that numbers and NPNA of AgNORs were directly related to the cellular proliferative activity. In maligant lymphoma, among the several parameters of the AgNORs, NPNA in Ki-67 positive cells is proposed to be the most useful marker in determining the prognosis of the patient.
Cell Count ; DNA ; Genes, rRNA ; Humans ; Lymph Nodes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Nucleolus Organizer Region* ; Palatine Tonsil ; Prognosis

It has been reported that beta-HCG is produced in the transitional cell carcinoma of the bladder and measuring of its level can be used as a tumor marker. We measured the serum and urinary levels of beta-HCG in the patients with the transitional cell carcinoma of the bladder and analysed the relationship to the clinical stage and histological grade and its significance as a tumor marker. The levels of the beta-HCG in the serum and early morning urine were measured in 40 cases of transitional cell carcinoma of the bladder and 37 cases of control group. Double-antibody immunometric assay (Coat-A-Count HCG IRMA) using I-labeled anti HCG antibody and monoclonal anti HCG antibody were used. The mean levels of the serum and urinary f-HCG in control group were 1.2mIU/ml, 1.4mIU/ ml and 3.6mIU/ml, 6.0mIU/ml in patient group, which showed a statistically significant difference between the two groups(p<0.05). In patient group, the levels of the serum and urinary beta- HCG were 2.9mIU/ml and 3.5mIU/ml in the superficial tumor, 2.6mIU/ml and 7.0mIU/ml in the invasive tumor and 7.5mIU/ml and 9.9mIU/ml in the metastatic tumor, showing a statistically significant increase as the clinical stage was advanced(p <0.05). The levels of the serum and urinary beta-HCG were 3.3mIU/ml and 1.3mIU/ml in grade I, 2.9mIU/ml and 5.9mIU/ml in grade II and 4.7mIU/ml and 7.6mIU/ml in grade III, which did not demonstrate a significant relationship to the histological grade(p>0.05). We think that the serum and urinary levels of beta-HCG in the transitional cell carcinoma of the bladder are related to the tumor stage but not to the histological grade and in the metastatic tumor urinary beta-HCG level can be used as a reliable tumor marker.
Carcinoma, Transitional Cell* ; Humans ; Urinary Bladder*

PURPOSE: The aim of our study was to evaluate the value of coronal reformatted images using multi-detector computed tomography (MDCT) imaging in non small cell lung cancer (NSCLC) for the determination of lymph node (LN) metastasis. MATERIALS AND METHODS: Chest CT scans using MDCT were performed in 43 patients with pathologically proven NSCLC. The images were reconstructed with a 3 mm thickness in the axial and coronal planes. The axial images were examined for LN metastasis with and without the coronal reformatted images by the consensus of two radiologists on two separate occasions. RESULTS: In total, 214 nodal groups were dissected, of which, 33 (15.4%) were pathologically proven as LN metastasis. The sensitivity of diagnosis was higher when assessing both the axial and coronal reformatted images compared to the axial images alone (51.5% vs. 33.3%), whereas the specificity and accuracy was lower when examining both the axial and coronal reformatted images (65.7% vs. 87.8% and 63.6% vs. 79.4%). Despite this, the additional coronal reformatted images provided additional anatomical information which was helpful in the assessment of accurate nodal stations and the decline of the pitfalls. CONCLUSION: The value of coronal reformatted images for the diagnosis of nodal metastasis in NSCLC may still be unclear; however, the coronal reformatted images may lend support to the axial images in being able to provide additional anatomical information.
Carcinoma, Non-Small-Cell Lung ; Consensus ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Radiographic Image Interpretation, Computer-Assisted ; Sensitivity and Specificity ; Small Cell Lung Carcinoma ; Thorax

PURPOSE: To assess the postoperative CT findings of aortic aneurysms or dissections treared by resection- and-graft replacement or continuous-suture graft-inclusion technique MATERIALS AND METHODS: We reviewed postoperative follow-up CT findings of 14 patients, 19 cases. There were 8 patients(10 cases) of aortic aneurysm and 6 patients(9 cases) of aortic dissecton which involved the thoracic aorta in 9 patients(13 cases) and abdominal aorta in 5 patients(6 cases). The interval of follow-up after operation was from 9 days to 2 year 9 months. On CT scans, we analyzed the appearance of graft materials, differences of CT findings between two surgical techniques, and normal or abnormal postoperative CT findings. RESULTS: Most of grafts appeared as hyperdense ring on precontrast scan, and all of them were not seperated from aortic lumen on postcontrast scan. On CT findings of patients who were operated by continuous-suture graft-inclusion technique, perigraft thrombus was concentrically located with sharp demarcation by native aortic wall and its density was homogeneous, but in cases of those operated by resection-and-graft replacement, perigraft hematoma was eccentrically located with indistinct margin and its density was heterogeneous and native aortic wall could not be delineated. In patients without complication, perigraft thrombus or hematoma(15 cases), perigraft calcification(11 cases), residual intimal flap(6 cases), graft deformity(4 cases), perigraft air(2 cases) and reconstructed vessels(1 case) were noted. And in one patient with complication, perigraft flow was noted with more increased perigraft hemaroma. CONCLUSION: Precise knowledge of the differences of CT findings between two surgical techniques and nor- mal postoperative CT findings is crucial to evaluate the postoperative CT findings in aortic aneurysm and dissection.
Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm* ; Follow-Up Studies ; Hematoma ; Humans ; Thrombosis ; Tomography, X-Ray Computed ; Transplants

Pulmonary hamartoma is an uncommon benign tumor consisting of a mixture of loose fibromyxoid tissue, cartilage, fat, and cleft-like spaces lined by cuboidal or ciliated epithelium. Cytologically, the presence of a mesenchymal component is essential for the diagnosis of pulmonary hamartoma. We report the fine needle aspiration cytologic findings of two cases of pulmonary hamartoma. Case 1 was a 71-year-old woman with a mass, measuring 1.8X1.5 cm in the upper lobe of the right lung. Case 2 was a 51-year-old woman with a mass, measuring 2.3 x 2.0 cm in the lower lobe of the right lung. Fine needle aspiration cytology of both pulmonary masses revealed several sheets of loose fibromyxoid tissue fragments with focal cartilaginous differentiation and a few clusters of bland cuboidal epithelial cells on the bloody background. The diagnosis was histologically confirmed by needle biopsy.
Aged ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Cartilage ; Diagnosis ; Epithelial Cells ; Epithelium ; Female ; Hamartoma* ; Humans ; Lung ; Middle Aged

A case of retroperitoneal paraganglioma is presented with fine needle aspiration cytologic features.
Biopsy, Fine-Needle* ; Paraganglioma*

A primary squamous cell carcinoma of the breast was evaluated by fine needle aspiration cytology in a 60 year-old female. Squamous cell carcinoma is a rarely encountered lesion in the breast and nine cases of cytologic findings of mammary squamous cell carcinomahave been reported in the world literature. Our case appears to be one of these rare pure squamous cell tumors. The cytologic diagnosis was possible because of the well defined characteristics of the malignant squamous cells, similar to those found in other locations. Thorough examination of the patient did not reveal squamous cell carcinoma elsewhere.
Biopsy, Fine-Needle* ; Breast* ; Carcinoma, Squamous Cell* ; Diagnosis ; Female ; Humans ; Middle Aged

BACKGROUND: During nasotracheal intubation it is important to have proper pretreatment for nasal mucosa constriction and nasal cavity expanding. Nasal packing of epinephrine gauze is widely used as well as xylometazoline. The aim of this study was to compare and evaluate the efficacy of prophylactic intranasal spray of xylometazoline against epinephrine gauze packing in expanding the nasal cavity. METHODS: Volunteers (n = 32) in their twenties without nasal disease such as septal deviation or rhinitis were enrolled in the study. The more patent nostril in each subject was measured by acoustic rhinometry as the base value. After intranasal spray of xylometazoline, the same nostril was remeasured by same method. Twenty four hours later, intranasal packing of epinephrine gauze was done and the same treatment was done. Subject preferences about the procedures were asked. RESULTS: There were significant difference among treatments (base value: 0.582 +/- 0.164 cm2, xylometazoline spray: 0.793 +/- 0.165 cm2, epinephrine gauze packing: 0.990 +/- 0.290 cm2) in acoustic rhinometry. While the epinephrine gauze packing showed more efficient mucosa constriction, subjects preferred xylometazoline spray. CONCLUSIONS: Even though xylometazoline spray was less effective than epinephrine gauze packing, the simplicity and convenience compensated. In patients undergoing nasotracheal intubation, xylometazoline spray can be an alternative to epinephrine gauze packing.
Constriction ; Epinephrine ; Humans ; Imidazoles ; Intubation ; Mucous Membrane ; Nasal Cavity ; Nasal Mucosa ; Nose Diseases ; Rhinitis ; Rhinometry, Acoustic

OBJECTIVES: This study was attempted to offer the foundation data to develop a specific and practical social service of caregiver-centered. For this purpose we assessed the cognitive functions of a group aged 65 or more using the Korean version of Mini Mental State Examination(MMSE-K) in a Dong area of urban community. And then we reassessed the relationships between the caring burdens of caregivers and the psychopathology of in-home demented elderlies, and the needs of caregivers for the social services. METHODS: Subjects in this study were over the age of 65 and resided in a Dong area of urban community. At first, their cognitive functions were screened by MMSE-K. Subjects, whose total score of MMSE-K were below 24 and met the diagnostic criteria of DSM-IV for dementia, were enrolled in this study and defined to be the patients with dementia. Their psychiatric symptoms were assessed by Brief Psychiatric Rating Scale(BPRS), Hamilton's Rating Scale for Depression(HDRS) and Hamilton's Rating Scale for Anxiety(HARS). At the same time, the caring burdens of caregivers and their needs for social services were assessed by caregiver`s burden inventory(CBI). Total 23 subjects completed all of the assessments and their data were analysed statistically by ANOVA, chi2-test, and Duncan's multiple range test using SAS program. RESULTS: 1) The mean total score of BPRS tended to be correlated positively with the mean score of social activity restriction subscale of caring burden dimensions. 2) Some of religions of the caregivers could affect differently and significantly on the negative changes of relationships between the demented elderlies and their caregivers(p<.05). Especially, the Christians experienced less negative changes of relationships between them than the others did. 3) When the demented elderlies were males, total burdens of caregivers and negative changes of relationships between the demented elderlies and their caregivers, and between the caregivers and their relatives were significantly higher than the other burden dimensions were(p<.05). 4) When the demented elderlies were more educated, the psychological burdens of their caregivers were more severe(p<.05). 5) The more were the total burdens of the caregivers, they wanted more social services for them(p<.05). 6) The more were the psychological and financial burdens of the caregivers, their needs for the education and counselling services were more than the needs for the other social services(p<.05). CONCLUSION: Caregivers living with male demented elderlies, who had more severe psychopathology, had more burdens of caregiving and restricted the social activities of the in-home demented elderlies more severely. As a result, the relationships between them became more worse. Our results suggested that free-home helper services for the severely demented elderlies and education counselling services including information-referral service for their caregivers were in needs. Consequently, we should develop more specific services for in-home demented elderlies and their caregivers according to the needs in their family environments.
Caregivers* ; Dementia ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Male ; Psychopathology* ; Social Work*