Decubitus ulcer is often seen in the skin and underlying tissue of debilitated or immobilized patients as the result of prolonged pressure and impaired circulation. It manifests chiefly as an ulcer over bony prominences, but tumefaction is an extremely unusual presentation. A 53-year old male, a paralytic of the lower extremity for 18 years, developed a recurrent decubital ulcer despite repeated surgical repair, from which a rapidly growing, large fungating mass grew within a month. The last resected mass was bosselated and measured 15x9x3 cm with a major area of cicatrix-like induration, interdigitated with skeletal muscle bundles at the central area. Microscopically, the mass was composed of an upper half of active granulation tissue layer and a deeper half of dense, poorly cellular, fibrocollagenous bundles admixed with florid proliferation of atypical fibroblasts, but the absence of mitosis and the multifocal admixture of active inflammatory process-granulation tissue formation seemed to help exclude genuine fibromatosis, nodular fasciitis or proliferative myositis. We assume that this rapidly growing pseudofibromatosis is an additional manifestation of a prolonged decubitus ulcer, possibly related to the modified reparative process of decubitus ulcer following repeated excisions, for which we propose a term of decubitoma.

We performed a histopathologic and immunohistochemical study of 23 cases of surgically resected large cell undifferentiated carcinoma(LCUC) of the lung. The relative incidence of LCUC was 7.6% among the total resected cases of primary lung cancer over 7 years(1987-1993). The mean age of the patients was 56 years and 21 cases were male. The mean size of the mass was 5 cm and 11 cases were located peripherally. According to the histologic features, LCUC could be divided into three groups: squamous cell carcinoma-like(6 cases), adenocarcinoma-like(13 cases), and small cell carcinoma-like(4 cases) groups. The histologic differences were related to the variations of the immunohistochemical properties, but there were no differences in prognosis among these groups. Immunoreactivity to cytokeratin(CAM 5.2) was demonstrated in 22/23(96%). Carcinoembryonic antigen was positive in 13/23(57%). Neuron specific enolase and chromogranin were positive in 11/23(48%) and 5/23(22%), respectively. Vimentin was seen in 11/23(48%). From these observations, we could subclassify them by their immunologic phenotypes; exocrine features in 6/23(26%), neuroendocrine(NE) features in 4/23(17%), both exocrine and NE phenotypes in 7/23(30%), and 6 cases(26%) showed neither phenotype. The group with NE features showed a worse prognosis(P<0.05) and immunoreactivity for vimentin was also related to a worse prognosis(P<0.05). These findings imply that the immunohistochemical properties of LCUC are closely related to the histopathologic features. The groups, subdivided by histology and immunoreactivity, showed no prognostic difference except for the NE differentiation and reaction for vimentin.
Incidence ; Lung Neoplasms

OBJECTIVE: The purpose of this study was to determine the important factors affecting survival and pregnancy rate in frozen-thawed embryo transfer cycles. METHODS: we performed reprospective analysis in 738 cycles of frozen-thawed embryo transfers, in relation to the insemination methods, the freezing stage of embryo, patient's age, infertility factors and the origin of injected sperm in ICSI cycles. After conventional IVF or ICSI, the supernumerary PN stage zygotes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propandiol (PROH) as a cryoprotectant. RESULTS: The survival rates of thawed embryos were 69.3% (1585/2287) in conventional IVF group and 71.7&% (1645/2295) in ICSI group. After frozen-thawed embryo transfers, 27.0% (92/341) and 32.0% (109/341) of pregnancy rates were achieved in conventional IVF and ICSI group, respectively. There were no significant difference in the survival and pregnancy rates according to the insemination methods, the freezing stage and patient's age. However, the pregnancy rate (36.2%) of male factor infertility (22.9%). In ICSI group, the origin of injected sperm did not affect the outcome of frozen-thawed embryo transfer cycles. CONCLUSION: The present study demonstrates that acceptable clinical outcomes can be achieved after the transfer of frozen-thawed embryos regardless of the stage of embryos for freezing, the patient's age and the origin of injected sperm.
Embryo Transfer* ; Embryonic Structures* ; Freezing ; Humans ; Infertility ; Insemination ; Male ; Pregnancy Rate* ; Pregnancy* ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Survival Rate ; Zygote

No abstract available.
Drainage* ; Prognosis*

Kikuchi's disease is a self-limiting lymphadenitis, predomin;intly of young women who present with cervical lymphadenopathy. We present a case of Kikuchis disease in a 18-year-old female, representing multiple tender subcutaneous mass on her neck, left eyelid and posteriarcuricle. Histopathologically, the biopsied mass was a lymph node showing architectural effacement by necrotic focicomposed of nucear karyorrhexis and mononucl ar cell proliferation.
Adolescent ; Cell Proliferation ; Eyelids ; Female ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases ; Neck

PURPOSE: To evaluate the macular function by a multifocal electroretinogram (mfERG) in patients with diabetic retinopathy (DR), and to assess the correlation between responses of mfERG and the threshold of the visual field test (VF). METHODS: The records of patients with DR (16 eyes, 16 patients) and control subjects (14 eyes, 14 subjects) were retrospectively reviewed. mfERG and VF were divided into Ring 1, Ring 2 and Ring 3 at 6-degree intervals from the central macula. The correlation between the amplitude/peak time and the threshold of each ring was analyzed. RESULTS: In patients with DR, the amplitude was decreased in all areas, the peak time was delayed in Ring 2 and the threshold was decreased in Rings 2 and 3, compared to control subjects. The amplitude of mfERG and the threshold of VF showed statistically significant positive correlations in Rings 2 and 3 (p < 0.05). The peak time of mfERG and the threshold of VF showed statistically significant negative correlations in Ring 3 (p < 0.05). CONCLUSIONS: The threshold of VF was more significantly correlated with the amplitude than with the peak time of mfERG in patients with DR. mfERG and VF were useful tests to assess the macular function, and alteration of macular function was early detected because two tests were conducted at the same time.
Diabetic Retinopathy* ; Humans ; Retrospective Studies ; Visual Field Tests* ; Visual Fields*

PURPOSE: To Compare treatment results on silicone tube insertion according to the region and severity of resistance in lacrimal probing for functional nasolacrimal duct obstruction patients who complained of epiphora but are shown to be normal in lacrimal syringing and dacryocystography. METHODS: A retrospective study was conducted with 40 subjects (42 eyes) who had silicone tube insertion because of functional nasolacrimal duct obstruction. A comparison was made of post-operational patient satisfaction by grading (0~3) according to the region and the severity of resistance and whether the resistance region was singular or multiple resistance regions were found on probing. Success was defined as a grade of more than one point. RESULTS: Two eyes had no resistance regions, 28 eyes had one resistance region, and 12 eyes had more than two resistance regions on lacrimal probing. There was no statistical significance in the ranking of post-operative satisfaction among theses groups. There was also no difference among the groups for post-operative satisfaction according to obstruction site. CONCLUSIONS: Most functional nasolacrimal duct obstruction patients showed partial obstruction of the nasolacrimal duct on probing. Since functional nasolacrimal duct obstruction is not possible, we must treat patients for partial nasolacrimal duct obstruction, for wihch silicone tube insertion is thought to be effective.
Eye ; Humans ; Intubation ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct ; Patient Satisfaction ; Retrospective Studies ; Silicones

The postpartum period is generally considered to be increased risk of various cerebral disorders, such as reversible cerebral vasoconstriction syndrome (RCVS), posterior reversible encephalopathy syndrome (PRES), and eclampsia. They manifest as an isolated syndrome or overlapped. Emergent diagnosis and appropriate treatment are mandatory because of the risk of permanent cerebral damage. Here, we report a case presenting with the overlap of RCVS, PRES, and transient splenial lesion of corpus callosum after delivery.

PURPOSE: To report a case of white-centered retinal hemorrhage in infective endocarditis. CASE SUMMARY: A 45-year-old patient complained of acute visual loss. The patient had a history of epidural anesthesia for the relief of back pain. On the day of admission the patient showed no light perception and had a white-centered retinal hemorrhage and cotton wool spot in the left eye upon fundus examination. Other ocular manifestations were not specific and there were no specific findings on a brain MRI and visual evoked potential. The patient was diagnosed with pyogenic spondylitis and was treated by abscess drainage and systemic antibiotics therapy. The patient's near vision improved up to 0.4/0.5. He was diagnosed with infective endocarditis based on the echocardiogram with epidural and subarachnoid hemorrhage. CONCLUSIONS: Roth spot can occur in many diseases such as diabetes, leukemia, anemia, and trauma, but most commonly in sepsis due to infective endocarditis. Therefore, medical evaluation and an echocardiogram for patients with white-centered retinal hemorrhage should be considered.
Abscess ; Anemia ; Anesthesia, Epidural ; Anti-Bacterial Agents ; Back Pain ; Brain ; Drainage ; Endocarditis* ; Evoked Potentials, Visual ; Humans ; Leukemia ; Magnetic Resonance Imaging ; Middle Aged ; Retinal Hemorrhage* ; Retinaldehyde* ; Sepsis ; Spondylitis ; Subarachnoid Hemorrhage ; Wool

N/AWe evaluate the regenerating capacity of rat liver according to the severity and duration of the obstructive jaundice. Also we evaluate the regenerating capacity of hepatectomized rat liver according to the duration of the obstructive jaundice. The 10 week-old Sprague-Dawley rats were used. Common bile duct ligation and sequential partial hepatectomies were done. The regenerating capacity was measured by tritiated thymidine incorporation into rat liver DNA. The rate of incorporation of thymidine into DNA in the jaundiced livers increased significantly compared with that in the sham-operated liver on day 3.In jaundiced rats, the regenerating capacity after partial epatectomy decreased markedly without a return toward normal on day 3 and kept low thereafter. The duration of obstructive jaundice may be a key factor in the regeneration of rat liver after partial hepatectomy.
Animals ; Bile Ducts* ; Bile* ; Common Bile Duct ; DNA ; Hepatectomy ; Jaundice, Obstructive ; Ligation* ; Liver Regeneration* ; Liver* ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Thymidine