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

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

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.
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

We reviewed surgical specimens from 11 patients with diffuse neurofibroma to define the specific clinicopathologic characteristics. Ten cases were cutaneous neurofibromas and one case was an uncommon gastrointestinal neurofibroma involving the rectum. The most frequent sites of involvement were the head and neck, especially the eyelids and the periorbital areas. They usually presented as a plaque-like elevation of the skin. They primarily occured in children and young adults and positive family histories of von Recklinghausen's neurofibromatosis were obtained in 45.4%. Pathologically, the involved skin & rectum were diffusely thickened by an infiltrative growing mass, showing proliferation of short fusiform cells in the uniform matrix of fine fibrillary collagen. The characteristic prominence of Wagner-Meissner bodies (45.4%) suggests they could be associated with pathogenesis of diffuse neurofibroma. On the basis of these findings, we could confirm diffuse neurofibroma to be a distinct form of neurofibroma.
Child ; Adult ; Male ; Female ; Humans

PURPOSE: We report clinical charateristics of percutaneous central venous catheteriza- tion(PCVC) that is performed commonly as a vascular access procedure in the neonatal intensive care unit(NICU) including comparision between the success rate and com- plication rate of groups performed by a doctor and by nurses who were accustomed to the IV procedure. METHODS: We evaluated a total of 158 PCVC cases performed in the NICU of Soonchunhyang Chunan hospital over 2 years 5 rnonths from May, 1995 to September, 1997. The 24 cases of PCVC were performed by doctors and 134 cases of this proce- dures were performed by well trained nurses. We have compared success rates, clinical characteristics, insertion sites, indwelling time, causes of removal of the catheters, and associated complication of both doctor performed group (D) and nurse performed group (N) retrospectively. RESULTS: The mean gestational age, birth weight, weight at the time of insertion were significantly lower in the doctor performed group than in the nurse group(P<0.001). There were significant differences in postnatal age and mean duration per catheter in both groups. The overall success rate of insertions was 89.9%(142/158), the success rate of doctor performed group was 54.2%(13/24) and nurse group was 96.3%(129/134) and there was significant difference(P<0.001). In the doctor performed group, 100% were axillary however in the nurse group 43.4% were axillary, 38.8% were antecubital, 9.4% were temporal, and 5.4% were hand. The most common cause of the removal of the catheter was elective in both groups but there was also substantial spontaneous removal by the patients and mechanical complication. Cultures of catheter tips were done after removal in 110 cases, among then were positive in 36 cases(33.6%), the most common causes were Staphylococcus aureus and Candida albicans. CONCLUSION: In this report, the authors emphasize that percutanous central venous catheterization performed by well trained nurses has a higher success rates than the doctor performed group and can be considered safe. We would also like to emphasize that more attention should be paid to the maintanace of PCVC.
Birth Weight ; Candida albicans ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Chungcheongnam-do ; Gestational Age ; Hand ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Retrospective Studies ; Staphylococcus aureus

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*