A case of pulmonary alveolar proteinosis is reported. Most of the alveolar spaces were filled with amorphous deep eosinohilic material which revealed strong positive reaction to periodic acid-Schiff staining. Electron microscopic observation of this material showed numerous lamellar bodies in the alveolar spaces and cytoplasms of alveolar macrophages. A part of them were concentric multilamellated type A lamellar bodies and the other were finger printlike type B bodies. Combined type A and type B lamellar bodies were rarely present. From the above features it is suggested that both type A and B lamellar bodies could be transformed one another and those lamellar bodies may be originated from pulmonary surfactant.

We performed surgery for correction of abnormal head turn in 10 patients with congenital nystagmus. For 3 patients with a head turn of 30 degrees, a 40% augmented modified kestenbaum operation was performed. For 4 patients with a head turn of 45 degrees, a 40% augmented modified kestenbaum operation combined with a 3 - 4 mm recession of conjunctival and subconjunctival tissues was performed. Finally, for 3 patients with a head turn of 60 degrees, a 60% augmented modified kestenbaum procedure combined with a 3 - 4 mm recession of conjunctival and subconjunctival tissues was performed. At the final follow-up visit(averaging 5.9 months), 7 patients showed complete corrections of previous head turn and 3 patients showed a small residual head turn of less than 10 degrees to the same side of the preoperative head turn. The average amount of correction we obtained from the surgery described above were 26.7, 42.5 and 56.7 degrees for the patients who had had a preoperative head turn of 30, 45 and 60 degrees respectively. Among the 10 patients, 4 showed no change in corrected visual acuity, but 6 showed increased corrected visual acuity by over 1 Snellen line. From the above results, we concluded that if recession procedure of the conjunctival and subconjunctival tissues was combined with augmented modified Kestenbaum procedure, its effect for correction of abnormal head turn in a patient with congenital nystagmus could be enhanced.
Follow-Up Studies ; Head* ; Humans ; Nystagmus, Congenital* ; Visual Acuity

Cutaneous leishmaniasis (oriental sore) is usually a self-limited infection of the skin caused by the protozoan Leishmania tropica. The disease is endemic to the Mediterranean, Asia, Africa, and the Middle East. It has been seen in this country among many Korean technical experts and labourers working in the endemic areas of the disease. Our patient had acquired cutaneous leishmaniasis in Saudi Arabia and it had remained active for six months. He had been treated with antimony and metronidazole but failed because of severe side effects. And then we treated the patient witb cryosurgery and the skin lesions were followed by resolution with cosmetically acceptable scar in 4 months. The brief review of literature on the treatment of cutaneous leishmaniasis was undertaken.
Africa ; Antimony ; Asia ; Cicatrix ; Cryosurgery ; Eczema* ; Humans ; Leishmania tropica ; Leishmaniasis, Cutaneous ; Metronidazole ; Middle East ; Saudi Arabia ; Skin

No abstract available.
Dislocations* ; Elbow*

No abstract available.
Vibration*

OBJECTIVES: Careful evaluation about mediastinal involvement is important in the management of patients with non-small cell lung cancer. Invasive staging procedure such as mediastinoscopy is advocated because of the unreliability of noninvasive staging methods such as CT, MRI. We compared differences between pre- and postoperative staging in non-small cell lung cancer without lymphadenopathy on CT scan and investigated the methods for more accurate preoperative staging. METHODS & RESULTS: 1) Records of a total of 41 patients with preoperative T1-3N0M0 non-small cell lung cancer were reviewed and the histologic types of tumors were squamous cell carcinoma in 32 cases, adenocarcinoma in 6 cases and large cell carcinoma in 3 cases. Twenty-four cases were central lesions and seventeen cases were peripheral lesions. 2) Among the 32 cases with preoperative T2, 2 cases were identified postoperatively as T3 with invasion of chest wall and among 6 cases with preoperative T1-3, 1 case was identified postoperatively as T4 with invasion of aorta and pulmonary arteries. 3) After the operation of 35 cases with T1-2, 5 cases wore N1 and 3 cases were N2 postoperatively. After the operation of 6 cases with T3, 2 cases were N1 and 3 cases were N2 postoperatively Preoperative T3 showed more intrathoracic lymph node metastases and higher N2/N1 involvement ratio than preoperative T1-2. 4) Complete surgical resections were done in 34 out of 41 cases. Incomplete resection were done in all postoperative N2 tumors. CONCLUSION: Invasive staging procedures such as mediastinoscopy should be considered in the case of preoperative T3 non-small cell lung cancer even though mediastinal lymphadenopathy is not recognized on the CT scan of the chest.
Adenocarcinoma ; Aorta ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Magnetic Resonance Imaging ; Mediastinoscopy ; Neoplasm Metastasis ; Pulmonary Artery ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: It is necessary for most effective treatment of neoplasms to detect it in early stage. For the purpose we use many screening tests currently, however, the tumor marker have many limitations as a screening test for neoplasm. Nevertheless most of Health screening centers are using CEA as a screening test for neoplasm. So, we began this study for the assessment of validity of CEA as a screening test for neoplasm. METHODS: The subjects were 4265 persons who visited Health screening center of Kyung hee Medical Center from July 1995 to June 1996. The number of elevated CEA among the subjects was 156. We evaluated the frequencies of factors known as etiologies of increased CEA. We followed up whether neoplasms were developed in normal CEA group. Through the random sampling of normal CEA group, 391 subjects were obtained for statistical analysis by SPSS/PC+. Immunoradiometric assay kit, of Eiken company was used for gauging CEA level and normal level was less than 2.4ng/ml according to manual of manufacturer. RESULTS: There was no significant difference of CEA according to sex, age. The factors that significantly affect CEA were neoplasms, chronic lung disease, liver cirrhosis. In t,his study, smoking, hypertension, diabetes mellitus, fibrocystic disease, chronic renal failure, alcohol drinking, hepatitis, peptic ulcer disease known as etiologies of elevated CEA in other studies did not show statistical significance. 9 cases of neoplasms were developed in both elevated CEA and normal CEA group during follow up. In former, 4 cases of 9 neoplasms were early stage. In latter, all cases were stage IV and inoperable. Specificity and sensitivity of CEA were each 96.5%, 50.0%. Positive & negative predictive value of CEA were each 5.8%, 99.8%. CONCLUSIONS: CEA was increased in various benign conditions and even if any neoplasm exists, CEA was not elevated in most of all in early stage. It showed high false positive rate and low sensitivity. Thus, this study showed that it was not valid to use CEA as a screening test for early detection of neoplasms.
Alcohol Drinking ; Diabetes Mellitus ; Follow-Up Studies ; Hepatitis ; Humans ; Hypertension ; Immunoradiometric Assay ; Liver Cirrhosis ; Lung Diseases ; Mass Screening* ; Peptic Ulcer ; Renal Insufficiency, Chronic ; Sensitivity and Specificity ; Smoke ; Smoking

A retrospective study of 2,603 patients with gastric cancer who underwent a gastric resection at Yonsei University Hospital from 1987 to 1994 was performed to evaluate the clinicopathological characteristics and survival rates of patients with gastric cancer. There were 1721 males and 882 females (ratio=2:1) with a mean age of 54 years (range=22~85 years). All patients underwent gastric resection with curative intent, but 199 patients (7.6%) had a palliative resection. The types of operations were a subtotal gastrectomy in 1,917 patients (73.6%) and a total gastrectomy in 686 patients (26.4%). A D2 or a more extended lymph-node dissection was performed in 2530 patients (97.2%), and only 73 patients (2.8%) had less extensive surgery. The postoperative mortality was 0.9%. The mean diameter of a tumor was 5.6 cm. The most common location of a tumor was the lower third of the stomach (49.4%). Borrmann type III (64.7%) was the most common gross type. The major histologic type was a tubular adenocarcinoma (76.3%). The overall 5-year survival rate was 66.5%. The 5-year survival rates according to the stage were 94.3% in IA, 90.5% in IB, 76.6% in II, 60.1% in IIIA, 38.7% in IIIB, and 12.9% in IV. In the univariate analysis, poor survival was closely related to increasing age, tumor location in the upper one third, larger tumor size, Borrmann type IV tumors, increasing pT and pN classifications, an advanced tumor stage, and perforance of a total gastrectomy. The multivariate analysis revealed that distant metastasis, lymph-node metastasis, depth of invasion, gross type, age, and type of resection were significant prognostic factors. In conclusion, the prognosis for gastric cancer after a gastrectomy has remarkably improved, and the most significant prognostic factors were distant metastasis, lymph node metastasis, and depth of invasion. Therefore, early diagnosis of gastric cancer and aggressive multimodal therapy, especially in patients with stage IIIB and IV tumors might improve the quality of life and the survival of the patients with gastric cancer.
Adenocarcinoma ; Classification ; Early Diagnosis ; Female ; Gastrectomy* ; Humans ; Lymph Nodes ; Male ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Quality of Life ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; Survival Rate*

Changes of bone turnover with aging are responsible for bone loss and play a major role in osteoporosis. Among the early postmenopausal women, as are known by previous study, there are about 35% ""fast bone losers and bone turnover is more uncoupled in osteoporotic group than in normal control. So, early detection of such fast losers"" and women who have high turnover rate is important to prevent postmenopausal osteoporosis and spontaneous fracture. Dual-energy X-Ray absorptiometry (DEXA), however, cannot reflect current bone loss because changes in bone mineral density (BMD) are only seen after 1 or more years of bone densities declining. In this study, we have measured a battery of new sensitive and specific markers of bone turnover which reflect current bone loss. To investigate the changing pattern of those markers, 674 healthy women including 451 postmenopausal women were classified, according to their menopausal period (less than 5 years, 5-10 years, more than 10 years). Bone formation was assessed by serum osteocalcin (OC), bone-specific alkaline phosphatase (BSAP) and bone resorption by the urinary excretion of deoxypyridinoline (DPD), cross-linked N-telopeptide of type I collagen (NTX). All Biochemical markers, except OC, significantly increased after menopause (p < 0.05). NTX and BSAP remained elevated after 10 years of menopause. These data indicated that the overall rates of both bone formation and bone tesorption increased after menopause and remained high in elderly women.
Absorptiometry, Photon ; Aged ; Aging ; Alkaline Phosphatase ; Biomarkers ; Bone Density ; Bone Resorption ; Collagen Type I ; Female ; Fractures, Spontaneous ; Humans ; Menopause ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal

There has been considerable controversy over the prognosis of mucinous gastric enocarcinoma (MGC). In this study we analyzed the clinicopathologic fferences between MGC and non-mucinous gastric carcinoma (NMGC). In addition, e relationship between mucin content and other clinicopathologic variables, cluding prognosis in MGC, was also investigated. We reviewed 2118 patients th pathologically-confirmed gastric cancer who underwent gastrectomy at the partment of Surgery, Yonsei University College of Medicine, during the period tween Jan. 1987 and Dec. 1993. Among them, 130 patients had gastric carcinoma th extracellular mucin (MGC) and 1988 patients had gastric carcinoma without tracellular mucin (NMGC). We placed the MGC patients into two groups according mucin content: mucin content involving over 50% of the tumor (dominant type, = 94) and mucin content involving less than 50% of the tumor area (partial pe, n = 36). The results were as follows: MGC was more common in males than GC. The size of the tumor in MGC (mean 5.3 cm) was larger than that of NMGC ean 4.4 cm). The patients with MGC had a higher incidence of Borrmann type IV GC: 16.1%, NMGC: 9.9%), more frequent serosal invasion (MGC: 75.4%, NMGC: .6%), lymph-node metastasis (MGC: 75.4%, NMGC: 50.7%), and peritoneal tastasis (MGC: 10.0%, NMGC: 3.5%) than patients with NMGC. The patients with C were more advanced in stage at the time of diagnosis and had a worse overall -year survival rate (44.9%) than patients with NMGC (54.7%). However, the -year survival rate according to the stage of MGC was similar to that of NMGC. ere were no significant differences between the mucin content and other thologic variables, including prognosis, i.e. similar biologic behavior tween dominant type MGC and partial type MGC. In conclusion, we suggest that C was more frequently diagnosed in advanced stage than NMGC with a poorer ognosis and that it is reasonable to consider the carcinoma with mucin content volving more than 30% of the tumor area as MGC.
Adenocarcinoma/pathology ; Adenocarcinoma/metabolism ; Adenocarcinoma, Mucinous/pathology* ; Adenocarcinoma, Mucinous/metabolism* ; Adult ; Aged ; Aged, 80 and over ; Female ; Human ; Male ; Middle Age ; Mucins/metabolism ; Neoplasm Staging ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/metabolism*