Spindle cell carcinoma of the upper aerodigestive tract mucosa was usually presented as polypoid mass and shows squamous cell carcinoma or dysplasia in the surface and underlying spindle cell proliferation. The spindle cell area discloses a variable pattern of sarcoma including rare osteosarcoma of 0~20% incidence. The histogenetic origin of the spindle cell component is now considered a metaplasia of squamous cell carcinoma. We experienced a case of spindle cell carcinoma of larynx showing massive underlying bone formation with proliferation of osteoclast-like cells in 75 year-old man. The immunohistochemical study demonstrates positive reaction with cytokeratin in area of squamous cells and with vimentin in area of spindle cells and osteoclasts. There are very focal reactivity for high molecular weight cytokeratin in spindle cell area.
Incidence

The purpose of this study was to develope and test the structural model for depression in middle-aged women. A hypothetical model was constructed on the basis of previous studies and a review of literatures. The conceptual framework was built around eight constructs. Exogenous variables included in this model were volunteer activity, health status & economic status. Endogenous variables were meaning of life, self-esteem, perceived life stress & depression. Empirical data for testing the hypothetical model was collected using a self-report questionnaire from 216 middle-aged women in Pusan City. The Data was collected from May to June, 1999. Reliability of the seven instruments tested with Cronbach's alpha was ranged from .86-.94. For the data analysis, SPSS 7.5 WIN Program and LISREL 8.12 WIN Program were used for descriptive statistics and covariance structural analysis. The results of covariance structure analysis were as follows: 1. The hypothetical model showed a good fit with the empirical data. [chi2/df =2.87(p=.72), GFI=1.00, AGFI=.98, RMSR=.025, NFI=.99, standardized residuals (-1.44~1.44) ]. 2. To heighten for the parsimony and fitness of the model, a modified model was constructed by deleting according to the criteria of statistical significance and meaning. 3. The modified model also showed a good fit with the data. [chi2 =5.26(01=7,p=.63), GFI=.99, AGFl=.97, RMSR=.025, NFI=.99, standardized reslduals (-1.50~1.45) ] Results of the testing of the hypothesis were as follows : 1. Self-esteem(beta42=-.48, t=-5.64) had a negative and perceived life stress(beta43 =.20, t=3.21)had a positive direct effect on depression. Meaning of life had a negative direct(beta41=-.17, t=-2.19) and a negative indirect effect through self- esteem on depression. Volunteer activity had a negative indirect effect through meaning of life, meaning of life and self-esteem on depression. Health status had a negative direct and a negative indirect effect through meaning of life, meaning of life and self-esteem on depression. Economic status had a negative indirect effect through perceived life stress on depression. Self-esteem was the most significant variable. 2. Volunteer activity(gamma11=.43, t=6.78) and health status(gamma12=.35, t=4.88) had positive direct effect on meaning of life. 3. Meaning of life(beta21=.50, t=6.53) had a positive direct effect on self-esteem. Volunteer activity had a positive indirect effect through meaning of life on self-esteem. Health status had a positive direct(gamma22=.18, t=2.23) and a indirect effect through meaning of life on self-esteem. Meaning of life was the most significant variable.
Busan ; Depression* ; Female ; Humans ; Models, Structural* ; Surveys and Questionnaires ; Statistics as Topic ; Stress, Psychological ; Volunteers

Patients with AIDS frequently present with pulmonary complications which are associated with a high mortality rate and infections are the most important cause of lung infiltrates. In addition to pneumonia caused by Pneumocystis carinii, which was noted in early reports of the syndrome, a variety of other severe pulmonary disorders may occur. Frequently more than one organism is found in a single patient and among these, combined infections of Pneumocystis carinii and cytomegalovirus are the most common. We experienced a case of combined Pneumosytis carinii and Mycobacterium tuberculosis infection as a pulmonary manifestation of AIDS in a 38-year-old man. In bronchoalveolar larvage, bronchial washing and brushing, and sputum smear specimens, Pneumocystis carinii organisms were recognized, especially in Gomori's methenamine silver stains. Transbronchial lung biopsy specimen revealed intra-alveolar frothy exudates composed of collections of Pneumocystis carinii organisms as well as several granulomas with central caseous necroses.
Mortality ; Biopsy

No abstract available.
Child* ; Humans ; Roxithromycin* ; Scrub Typhus*

No abstract available.
Blood Platelets* ; Fetal Growth Retardation* ; Platelet Count* ; Pregnancy*

Cellular schwaninoma is a variant of schwannoma, which is characterized by predominance of cellular Antoni A area, presence of mitotic activity, nuclear hyperchromasia, pleomorphism, and absence of Verocay body. These pathologic features often prompted a misdiagnosis of malignancy. However, the clinical outcome has indicated the benignity of the tumor. We have experienced a case of cellular schwannoma arising from right facial nerve with right hemifacial weakness and erosion of mastoid process. Grossly, it was a 3.5 x 3 cm sized and relatively well encapsulated mass with yellowish, friable cut surface. Microscopically, cellular growth with moderate cellular pleomorphism and some mitotic activity (5/40 HPFS, up to 2/HPF) were noted. Immunostaining for S-100 protein showed diffuse strong positive reaction.
Diagnostic Errors ; Facial Nerve* ; Mastoid ; Neurilemmoma* ; S100 Proteins

To evaluate the relationship between the expression of CA 125, CA 19-9, and CA 15-3 and ovarian epithelial tumors, immunohistochemical stainings were performed and analyzed to the types of tumor, and the degree o malignancy and differentiation in the total 42 cases. The results were summarized as follows: 1) The expression of CA 19-9 and CA 15-3 was demonstrated in most cases of benign, borderline and malignant mucinous tumors. All types tumors were negative for CA 125. 2) All types of serous tumors including benign, borderline and malignant revealed strong positive reaction for CA 125 and CA 15-3 in contrast to some weak positivity for CA 19-9. Expression of CA 125 was significantly increased in high grade serous adenocarcinomas compared with low of grade. 3) Endometrioid carcinomas revealed strong positive reaction for CA 15-3 in contrast to some positivity for CA 125 and CA 19-9. One case of Brenner tumor expressed CA 19-9 and CA 15-3 without expression of CA 125. 4) Serum CA 125 levels were elevated in 80% and CA 15-3 levels in 100% of ovarian epithelial malignancy. The correlation between serum levels and staining intensities was moderate.
Adenocarcinoma

No abstract available.
Myocutaneous Flap* ; Pressure Ulcer*

Detailed mechanism of uterine cervical cancer progression still remains unclear. Altered programmed cell death (apoptosis) and cellular proliferation are associated with the development of neoplasia. The authors investigated the expressions of bcl-2, which inhibit apoptosis, and caspase-3, which is involved in the induction of apoptosis and has been considered to be correlated with apoptosis, and proliferating activity according to the degree of malignancy in the squamous neoplasia of the uterine cervix. Correlation between bcl-2 and caspase-3 expression and proliferating activity was done. The materials were low grade squamous intraepithelial lesions (LSIL, n=15), high-grade squamous intraepithelial lesions (HSIL, n=15), microinvasive squamous cell carcinoma (n=15), and squamous cell carcinoma (n=15). Immunohistochemical stainings for bcl-2, caspase-3, and MIB-1 were done. bcl-2 and MIB-1 expressions were progressively increased in accordance with the increasing degree of malignancy, but caspase-3 immunoreactivity was higher in LSIL than invasive cancers. There was an inverse relationship between bcl-2 and caspase-3 expression, but the difference did not reach statistical significance. No significant correlation between MIB-1, bcl-2, and caspase-3 expressions was observed. These results suggest that an inhibition of apoptosis and the augmentation of proliferating activity of tumor cells might be separately involved in the development of the cervical squamous neoplasia.
Apoptosis ; Carcinoma, Squamous Cell ; Caspase 3* ; Cell Death ; Cell Proliferation ; Cervix Uteri* ; Female ; Uterine Cervical Neoplasms

Recent development in thepolymerase chain reaction (PCR) has brought an extraordinary opportunity for the rapid detection of M. tuberculosis in clinical specimens for the diagnosis of tuberculosis. Pneumoconiosis is a sort of pulmonary fibrosis consequent to inhalation of the respirable dust. The association between pulmonary tuberculosis and pneumoconiosis is well recognized. There is a 10-fold increase in the tuberculosis risk among the workers who have pneumoconiosis demonstrated by chest roentgenogram. The physicians managing the patients with pneumoconiosis have to maintain a high index of suspicion for the development of mycobacterial infection, since the diagnosis of tuberculosis is often difficult. Mycobacterium tuberculosis is a very slow growing organism and acid-fast bacillus (AFB) staining frequently shows false negative results, and therefore PCR would be a very rapid, easy and sensitive diagnostic method for the diagnosis of Mycobacterium tuberculosis in pneumoconiotic patients. To compare the PCR method with the conventional methods in diagnosing Mycobacterium tuberculosis in sputum, we used the sputa of 115 pneumoconiosis patients in Munkyeong Cheil Hospital. Of 32 pulmonary tuberculosis in the pneumoconiosis patients, 29 were PCR positive and were higher than 28, 20 positive by culture and AFB stain. Overall sensitivity, specificity, and which were 90.6, 91.5 % respectively for the PCR assay, 87.5, 100 % for the culture method ; 62.5, 98.7 % for the AFB stain. The PCR assay is a rapid, efficient, sensitive method which can detect M. tuberculosis directly in pneumoconiosis patients, and further study should be followed for the development of the easier method.
Bacillus ; Diagnosis* ; Dust ; Humans ; Inhalation ; Mycobacterium tuberculosis ; Pneumoconiosis ; Polymerase Chain Reaction* ; Pulmonary Fibrosis ; Sensitivity and Specificity ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*