Authors report a typical case of congenital fiber type disproportion (CFTD) with unique clinicopathologic characteristics. The patient was a 13-year-old boy who presented with weakness of lower extremities, especially proximal muscle, since his infancy. He has suffered from severe scoliosis which got worse since the age of 12. He showed mild dysarthria, high arched palate, and fish face. All routine laboratory data were within normal limits. EMG findings suggested myopathy. The muscle biopsy revealed fiber type disproportion with type 1 predominance. While most of the type 1 myofibers were atrophic or normal in size, the type 2 fibers showed universal hypertrophy. The difference of mean diameter between the larger and the smaller fibers was 27.9%. The patient's clinicopathologic settings fulfilled the criteria of CFTD.
Adolescent ; Biopsy ; Dysarthria ; Humans ; Hypertrophy ; Lower Extremity ; Male ; Muscular Diseases* ; Myopathies, Structural, Congenital* ; Palate ; Scoliosis

The variations of the occipital sinus were studied in 50 Korean adult cadavers. The morphology of the sinus was classified into 5 types accordingo to its number and the connection with the marginal sinus. These results were compared with the data of the occipital sinus of bones (Sir and Chung, 1907). And the opening of the occipital sinus in the confluens sinuum was observed. 1. A single small occipital sinus was found in 40%. Single occiital sinus with two large marginal sinuses was observed in 8%. The single sinus with a left marginal sinus (6%) and with a right marginal sinus(4%) were present. Double occipital sinuses were observed in 10% of the cadavers. No occipital sinus was discernible in 32%. 2. There were 39 openings of the occipital sinus including the double sinuses. The occipital sinuses communicated with the confluence sinuum in 35 cases (89.7%), with the straight sinus in 5.1% and with the right or left transverse sinus in 1 case, respectively. The openings in the confluens sinuum were found on the left side(51.3%), on the right side (10.3%) and in the center(28.2%). 3. The diameters of the occipital sinus were variable according to the connection with the sigmoid sinus. 4. The difference was found between the data of the morphological types of the occipital sinus that were studied in cadavers and in dry bones.
Adult* ; Cadaver ; Colon, Sigmoid ; Humans

Stomach of 34 year old man showed an early stage of the cancer with slight involvement of the superficial part of the inner muscle layer and accompanied with one metastatic lymph node. The cancer is that of medium differentiated adenocarcinoma. There is an heavy infiltration of lymphocytes mixed with histiocytic mononuclear cells and multinucleated giant cells. Some giant cells appear as Langhans' type suggesting phagocytic cells of their origin containing PAS positive materials in the cytoplasma. In other places, they appear as atrophic cancer nests suggesting that these tumor nests were arrested and undergone to regressive cellular process because of the over-whelming immunological pressure by the host.
Male ; Humans ; Neoplasm Metastasis ; Stomach Neoplasms

Purpose: : The purpose of this study is to examine the relationship between burnout, nursing work environment, patient-centered communication, and person-centered care nursing among intensive care unit (ICU) nurses and to identify factors related to person-centered care nursing. Methods: : This is a descriptive study involving 156 ICU nurses. A structured questionnaire was used to assess burnout, nursing work environment, patient-centered communication, and person-centered critical care nursing performance. Data were collected from February to March 2020, and descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression analysis were conducted using SPSS/WIN 25.0 program. Results: : The mean scores for person-centered care nursing, burnout, nursing work environment, and patient-centered communication of ICU nurses were 3.52±0.42, 3.00±0.76, 2.62±0.34, 4.06±0.64, respectively. Person-centered nursing showed a statistically significant negative correlation with burnout (r=-.20, p=.013) and a statistically significant positive correlation with patient-centered communication (r=.49, p<.001). In addition, patient-centered communication (β=.47, p<.001) was significantly correlated with person-centered nursing. Conclusion : The results of this study showed that the factors affecting the person-centered care nursing of ICU nurses were patient-centered communication. Therefore, it is necessary to develop and apply patient-centered communication programs for improving the person-centered nursing performance of ICU nurses.

Endocrine adrenal tumors are uncommon but clinically significant because they can be managed successfully by surgical therapy. During pregnancy, adrenal tumors can be a cause of death for both mother and baby, unless they diagnoses antenatally and managed properly. To investigate clinical characteristics of endocrine adrenal tumors, we analyzed 26 cases of adrenal tumor diagnosed and managed in Chung Ang Gil Hospital including cases associated with pregnancy and also a rare case of paraganglioma in liver. 1) There were 7 cases of Cushing's syndrome among which two cases were due to Cushing's disease and five cases were due to adrenal adenoma. Six cases were managed successfully by appropriate surgery. Another one case was associated with pregnancy but the patient expired due to sudden development of pulmonary edema and hypotension during preoperative preparation.2) Among 9 cases of primary aldosteronism, 8 cases were aldosterone-producing adenoma(APA) and 1 case was idiopathic hyperaldosteronism(IHA). In differential diagnosis between APA and IHA, diagnostic accuracy of postural study and adrenal CT was 86%, 78% respectively. In each one case of APA and IHA, adrenal venous aldosterone sampling was used for the differential diagnosis. Six cases of APA were managed by appropriate surgery. One patient with APA who refuses surgery and one patient with IHA were placed on spironolactone with good response.3) Among 10 cases of pheochromocytoma, seven cases were from adrenal gland and three cases were paragangliomas including one case originating from liver and two cases from abdominal ganglia. One patient with pheochromocytoma was diagnosed in 1st trimester of pregnancy and she was successfully treated by surgery.We observed 26 cases of endocrine adrenal tumors which were successfully managed except one case. We think that it is important to pay attention to adrenal tumor for early diagnosis particulary when associated with pregnancy. Paraganglioma in liver, although very rare, should be included in the differential diagnosis of space occupying lesion in liver.
Adenoma ; Adrenal Glands ; Aldosterone ; Cause of Death ; Cushing Syndrome ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Ganglia ; Humans ; Hyperaldosteronism ; Hypotension ; Liver ; Mothers ; Paraganglioma ; Pheochromocytoma ; Pregnancy ; Pulmonary Edema ; Spironolactone

Clear cell sarcoma of kidney(CCSK) is a rare pediatric neoplasm characterized by a predominating component of clear cells, a predilection for metastases to bone, and a poor prognosis. The incidence of CCSK peaks during the 2nd year of life and adult cases are very rare. We report a case of CCSK encountered in the right kidney of a 39-year-old man. Grossly, it was a lobulated mass showing infiltrative margin, measured 7x5.5x5cm and had a homogeneous gray-tan color with a soft, fish-flesh consistency. Microscopically, about half of the tumor revealed the classic pattern of CCSK, having tumor cell cords or nests separated by the characteristic alveolar capillary networks. The tumor cells had clear pale cytoplasm, bland looking round nuclei and inconspicuous nucleoli. The other half showed the epithelioid-trabecular pattern forming pseudorosette or cord-like structures. Immunohistochemically, there was only a focal positive reaction to vimentin. Ultrastructurally, the tumor cells showed the primitive nephrogenic mesenchymal differentiation such as electron lucent cytoplasm, a small amount of organelles, scanty heterochromatin, inconspicuous nucleoli, and a lack of flocculant basal lamina material around the cytoplasmic membrane. We consider that this is a case of CCSK occuring in the oldest patient ever reported, confirmed by both immunohistochemistry and electron microscopy.
Adult ; Male ; Female ; Humans ; Incidence ; Neoplasm Metastasis

Protozoa of the genus Cryptosporidium are small coccidian parasite known to infect the mucosal epithelium of a variety of animals including human, causing fatal course in immunodeficient patients as well as self-limited illness in healthy individuals. Various life cycle stages including trophozoite, meront, merozoite, gametocyte and oocyst in infected mucosa are a diagnostic feature. Electron microscopy (EM) provides sufficient findings for genus and species identification of this parasitic organism. The authors presented scanning and transmission EM findings of Cryptosporidium parvum infection in two children: one with acute lymphoblastic leukemia and the other without any evidence of immune compromise.
Animals ; Child ; Cryptosporidium parvum ; Cryptosporidium* ; Epithelium ; Humans* ; Intestines* ; Life Cycle Stages ; Merozoites ; Microscopy, Electron ; Mucous Membrane ; Oocysts ; Parasites ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Trophozoites

Multicore myopathy is a rare congenital myopathy. The multicores consist of numerous small areas of decreased oxidative enzyme activity. The long axis of the lesion is perpendicular or parallel to the long axis of the muscle fiber. These cores are usually smaller than central cores. For this reason they are also called minicores. Although the multicores represent a nonspecific change in that they can be observed in malignant hyperthermia, muscular dystrophy, inflammatory myopathy, etc. Muscular weakness dating from early infancy is combined large proportion of the muscle fibers. In about half of the reported cases the muscular weakness has not been progressive, while in the others a slow progression has occurred. This 9-year-old boy presented with congenital nonprogressive myopathy associated with thoracic scoliosis and bilateral equinovarus deformity. The serum creatine phosphokinase and lactic dehydrogenase levels were normal. Electromyography showed "myopathic" features. The biopsy revealed a marked size variation in myofibers, ranging from 10 microns to 100 microns. A few small angular fibers and slight endomyseal fibrosis were also noted. There was type I fiber predominance. NADH-TR reaction disclosed more well-defined cores with loss of intermyofibrillary mitochondrial activity. These cores were usually located with loss of intermyofibrillary mitochondrial activity. These cores were usually located in the peripheral portions of the myofibers and the core size measured 10-30 microns in diameter. Electron microscopic examination revealed circumscribed areas of disintegrated Z band material and disorganized sarcomeric units near the sarcolemma. A decrease in the number of mitochondria and glycogen particles was noted.
Biopsy ; Child ; Histocytochemistry ; Humans ; Korea ; Male ; Microscopy, Electron ; Muscles/pathology/ultrastructure ; Muscular Diseases/*pathology

No abstract available.
Hemoptysis*

No abstract available.
Female ; Ovulation*