No abstract available.
Antibody Formation* ; Humans*

We describe a case of fine needle aspiration cytology of metastatic nasopharyngeal carcinoma in the lymph node of the neck presenting a predominantly spindle cell pattern. A 36 year-old male patient complained of dysesthesia on the right face and a palpable neck mass. Fine needle aspiration was done on the neck mass. Tumor cells were present in syncytial groups or singly with mainly spindle shaped nuclei, vesicular chromatin, thin and regular nuclear membrane, occasional prominent nucleoli and a few foci of cellular cohesiveness. The cytoplasm was scant and pale with ill-defined borders. Mature lymphocytes were present in the background of aspirates and within the tumor cell clusters. Histologically, the tumor of nasopharynx showed several areas of spindle cell pattern. Because the tumor cells showed a predominantly spindle shape with vesicular nuclear chromatin, the differential diagnosis of spindle cell sarcoma or granuloma of epithelioid cells were considered, but the characteristic morphology of the nuclei with vesicular chromatin and prominent nucleoli, and cellular cohesiveness were important in making the diagnosis of nasopharyngeal carcinoma. The possibility of metastatic carcinoma should always be considered in fine needle aspiration cytology of the lymph node in the neck because the incidence of metastatic carcinoma, particularly of the nasopharyngeal carcinoma in the lymph nodes of the neck is relatively high.
Child ; Male ; Female ; Humans ; Diagnosis, Differential ; Incidence ; Neoplasm Metastasis

No abstract available.
Bowen's Disease*

OBJECTIVES: The critical pathways provide high quality of medical services in a cost-effective manner. To investigate the decrease in length of hospital stay and increase of cost effectiveness by using critical pathways, we compared hospital stay, cost of treatment, and the patient's satisfaction before and after critical pathway use. METHODS: We made a critical pathway team, which consisted of obstetric staff members, a resident, two nurses, a pharmacist, two clerical staff members. We made critical pathways for the medical team and patients. A prospective evaluation of a critical pathway for cesarean section was used as a comparison for control patients. RESULTS: The data for 305 patients with a critical pathway were compared to those of 136 control patients. The mean hospital stay is shorter in critical pathway patients than control patients. The cost of treatment decreased and differences between DRG (Diagnosed Related Groups) and cost of treatment increased in critical pathway patients. CONCLUSIONS: Using critical pathways in cesarean section decreased the duration of hospital stay and increased cost effectivesess. The critical pathways were useful as a means to minimize cost while increasing patient satisfaction.
Cesarean Section* ; Cost-Benefit Analysis ; Critical Pathways* ; Diagnosis-Related Groups ; Female ; Humans ; Length of Stay ; Patient Satisfaction ; Pharmacists ; Pregnancy ; Prospective Studies

OBJECTIVE: To determine the changes of nitric oxide production in preeclampsia, the concentration of nitric oxide metabolite, nitrite, was measured in umbilical vein after perfusing plasma from normal pregnant women and preeclamptic pregnant women. MATERIAL AND METHOD: 15 normal and 15 preeclamptic umbilical cords were obtained at the time of cesarean section. Two pieces of umbilical cord in equal length(20 cm in length) were prepared from each umbilical cord. Two pieces of umbilical cord were connected in parallel in a perfusion chamber. One piece of umbilical cord was perfused sequentially for 20-minutes' interval with the perfusates in the order of cord buffer, cord buffer including 15% normal pregnant serum, 15% normal pregnant serum with histamine(10-5mol/L), 15% normal pregnant serum with calcium ionophore A23187(5 mol/L) and the other one was perfused exactly same way using 15% preeclamptic serum instead of 15% normal pregnant serum. All the perfusates used were gassed with 95% O2 and 5% CO2 and warmed to 37degree C. Perfusates were collected in eppendorf tube and freezed at -70degree C until assayed. NO was measured by means of Greiss reaction. one way ANOVA and paired t-test were used where appropriate and p-value < 0.05 was considered significant. RESULTS: NO production in normal umbilical cords was not different regardless of perfusate. Although adding histamine and calcium ionophore, the NO production was slightly increased but statistically not significant in both groups. NO production in preeclamtic umbilical cords was significantly increased with 15% preclamptic serum(15% normal serum vs. 15% preeclamptic serum; 0.060+/-0.016microgram/ml/min vs 0.075+/-0.014microgram/ml/min, p<0.05). CONCLUSION: The preeclamptic sera may not affect the production of NO in the human umbilical vein endothelial cells. The biologic significance of increased NO production in preeclamptic umbilical cord with perfusing preeclamptic serum is unknown, but it might be compensation for the vasoconstriction of preeclampsia.
Calcium ; Cesarean Section ; Compensation and Redress ; Female ; Histamine ; Human Umbilical Vein Endothelial Cells ; Humans ; Nitric Oxide* ; Perfusion ; Plasma ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Umbilical Cord ; Umbilical Veins ; Vasoconstriction

Cerebrocostomandibular syndrome is characterized by micrognathia, cleft palate, multiple thorax deformity and frequently, mental deficiency. Respiratory compromise is a common cause of death. We experienced a case of cerebrocostomandibular syndrome with congenital heart disease in a 2 day old female baby with the chief complaint of cyanosis and respiratory difficulty since birth. She was delivered by cesarian section due to delayed labor at IUP 42 weeks. The diagnosis was made on the basis of clinical features, radiologic findings and echocardiogram, which showed micrognathia, deformity of 3rd finger Lt, hemivertebrae of T1-T6 Lt., absence of 1-6th rib Lt., dextrocardia, tetralogy of fallot, atrial septal defect secondum. We reported this case and reviewed related litertures briefly.
Cause of Death ; Cleft Palate ; Congenital Abnormalities ; Cyanosis ; Dextrocardia ; Diagnosis ; Female ; Fingers ; Heart Defects, Congenital* ; Heart Septal Defects, Atrial ; Humans ; Intellectual Disability ; Parturition ; Ribs ; Tetralogy of Fallot ; Thorax

A case of primary gastric carcinoma with patterns resembling those of hepatocellular carcinoma(HCC) is reproted. This patient who represented high serum alpha-fetoprotein(AFP) underwent a subtotal gastrectomy for stomach cancer and lobectomy of liver metastasis. The hepatoid component of the tumor was characterized by solid nests of large polygonal cells arranged in cords and trabeculae, with central nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm; single-nuclear giant cells were frequently noted. These tumor cells of stomach stained positive immunohistochemically for AFP, ACT(alpha-1-antitrypsin), AACT(alpha-1-antichy-motrypsin). Thus, this hepatoid gastric adenocarcinoma tumor cells demonstrated both morphologic and immunohistochemical features of partial differentiation to the HCC. Careful histologic examination in conjunction with the immunohistochemical demonstration of AFP can provide a useful contribution to the diagnosis of this rare histological type of gastric carcinoma And the presence of metastatic hepatoid adenocarcinoma from the stomach should be considered in a patient with hepatic tumor mimicking HCC. Because of frequent venous and lymphatic invasion, as well as liver metastasis, prognosis appears to be poor. The authors reviewed 45 cases of hepatoid adenocarcinoma of stomach reported in the literature, also.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Neoplasm Metastasis ; Stomach Neoplasms

No abstract available.
Nephrotic Syndrome*

OBJECTIVE: The changes of the production of nitric oxide in preeclampsia are still controversial. To determine the changes of nitric oxide production in preeclamptic pregnancies, NOS activity and eNOS and iNOS expression in preeclamptic placentae were compared with those in normal placentae, and to determine the changes of nitirc oxide production according to the sites of placenta, NOS activity and eNOS expression in preeclamptic placentae were also compared with those in normal placentae. METHODS: Human placentae were obtained from 15 normal and 15 preeclamptic pregnant women at the time of cesarean section. NOS activity was assessed by measuring the conversion of [3H]-arginine into [3H]-citrulline. The eNOS and iNOS expression were assessed by using western blot analysis. Data were analyzed by Student t-test and paired t-test where appropriate. RESULTS: The NOS activity(judged by measurement of [3H]-citrulline production) was significantly increased in preeclamptic placentae compared to normal(P<0.05). In normal and preeclamptic pregnant placentae, the NOS activity in main stem villi was increased compared to that in terminal villi. However, the difference of NOS activity between main stem villi and terminal villi was not significant(P>0.05). Quantification of the autoradiographic images demonstrated that the integrated optical density of the immunoreactive bands of eNOS were significantly lower in preeclamptic placentae compared to normal(p<0.05). Conversely, the integrated optical densities of the bands of iNOS were significantly higher in preeclamptic placentae compared to normal(p<0.05). CONCLUSIONS: Although the eNOS expression in preeclamptic placentae was lower than that in normal placentae, the NOS activity was significantly higher in preeclamptic placentae than that in normal in this study. These are result from increased production of iNOS in the compensatory mechanisms for the decreased nitric oxide production in pre-eclamptic placentae.
Blotting, Western ; Cesarean Section ; Female ; Humans* ; Nitric Oxide Synthase* ; Nitric Oxide* ; Placenta* ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women

No abstract available.
Hemolytic-Uremic Syndrome* ; Mycoplasma Infections* ; Mycoplasma*