Myometrial pregnancy developing in an previous cesarean section scar is the rarest of all ectopic pregnancy and provavly one of the most dangerous because of the risk of rupture and hemorrhage. For a young patient wanting to maintain her fertility, an earlier diagnosis and more conservative treatment are highly desirable. We present a case of an ectopic pregnancy embedded in the myometrium of a previous cesarean section scar in which the patient preserved her fertility through more noninvasive method, transvaginal ultrasound-guided Methotrexate injection.
Animals ; Cesarean Section* ; Cicatrix* ; Diagnosis ; Female ; Fertility ; Hemorrhage ; Humans ; Methotrexate* ; Mice ; Myometrium* ; Pregnancy ; Pregnancy, Ectopic* ; Rupture

This study was performed with the purpose of histochemical comparison of CEA and EMA localization between adenoma and well-differentiated adenocarcinoma of the stomach. The specimen was 12 lesions of adenoma and 15 foci of well-differentiated adenocarcinoma of the stomach. The markers in neoplastic tissue and neighbouring mucosa of the tumors were examined in paraffin sections using peroxidase-antiperoxidase method. The data obtained were evaluated statistically. The results were summarized as follows: 1) In 12 lesions of stomach adenoma, the positive reaction to CEA was seen in 3 lesions (20.0%), and to EMA in 10 lesions (83.3%). The positive rate of CEA in adenoma was lower than that of the neighbouring normal mucosa, but the positive rate of EMA was similar between the two. 2) In 15 foci of well-differentiated adenocarcinoma of the stomach, the positive reaction to CEA was seen in 13 foci (86.7%), and to EMA in 12 foci (80.0%). The positive rate of CEA in well-differentiated adenocarcinoma was higher than that of the neighbouring normal mucosa, while the positive rate of EMA was similar to each other. 3) Immunoreactivity to CEA in adenocarcinoma showed good positive correlation with the development of cuticular border of the neoplastic glands, while reactivity to EMA in adenocarcinoma was not related with the development of cuticular border. 4) The positive rate and intensity of CEA reaction in adenocarcinoma were higher than those in adenoma, but the positive rate and reactiveity of EMA were similar to those of adenoma. 5) The positive rate of CEA or EMA in the neighbouring mucosa of adenoma was not different compared with those in the neighbouring mucosa of adenocarcinoma. With the above results, it is concluded that adenoma and adenocarcinoma of the stomach may be different each other, biologically, and further more, it is presumable that adenoma may not be a premalignant lesions. It is considered that examination of CEA immunoreactivity may be helpful in differentiated of adenoma from well-differentiated adenocarcinoma, in most cases.
Adenocarcinoma ; Adenoma

The incidence of adenocarcinoma of the uterine cervix had shown an increasing tendency, and which is related to the increased use of oral contraceptives or prevalent in human papillomavirus infection. Endocervical glandular dysplasia or adenocarcinoma in situ are occasionally associated with squamous neoplasms of the uterine cervix. This study was aimed to evaluate the histologic features and the incidence of endocervical glandular lesions associated with squamous neoplasms, the presence of human papillomavirus infection-suggesting histologic findings in adjacent squamous neoplasms and the immmunohistochemical findings of endocervical glandular lesions for carcinoembryonic antigen. The materials used were 105 cases of microinvasive and invasive squamous cell carcinoma, and 83 cases of squamous intraepithelial lesions which are consisted of 142 radical or total hystrectomy products and 46 conization or loop excision products. The results are as follows; 1. Among 188 cases, six cases(3.2%) had shown foci of high grade glandular dyaplasia, and 19 cases(10.1%) revealed the areas of low grade glandular dysplasia. There was no adenocarcinoma in situ case. 2. In four of six high grade glandular dysplasia cases, microinvasive or invasive squamous cell carcinomas were associated. In low grade glandular dysplasias, sqaumous intraepithelial lesions were occcupying 68.4%. 3. HPV infection-suggesting histologic findings had accompanied all high grade glandular dysplasia cases and in 17 cases(89.5%) of 19 low grade glandular dysplasias. 4. In 2 of 5 high grade glandular dysplasias and in 1 of 19 low grade glandular dysplasias, the immunohistochemical reaction for carcinoembryonic antigen was similar to that of adenocarcinoma. In conclusion, the clinicopathologic importance of endocervical glandular lesions associated with squamous neoplasms of the uterine cervix should be kept in mind, and further study for the relationship between endocervical glandular lesions and human papillomavirus infection or hormonal influence will be continued.
Humans ; Incidence ; Adenocarcinoma

BACKGROUND: This study researched the relationship between shift work and one of its relevant health problems, functional gastrointestinal disorders. The study targeted nurses working at a university hospital, and compared the differences in gastrointestinal disorders of shift workers and non-shift workers and identified causes that significantly influence these symptoms. METHODS: In August 2013, a self-report survey was conducted on nurses working at a university hospital. Among those sent out, 1,201 responded and 851 were used for the final analysis. RESULTS: It was shown that the frequency of gastrointestinal disorders in shift workers was 1.881 times higher than that of non-shift workers. Factors that influenced gastrointestinal disorders included age, marital status, work duration, type of employment, job satisfaction, and perceived health status. Gastrointestinal disorders were seen more often with older age, being married, longer duration of employment, non-regular worker, low job satisfaction, bad perceived health status, and shift works. CONCLUSIONS: To prevent gastrointestinal disorders in nurses who work shifts, a health checkup system should be in place for clinical nurses who are of older age and have longer employment records. To decrease the causes of gastrointestinal disorders, campaigns suggesting regular diet and quitting alcohol use should be held consistently. Also, a category related to gastrointestinal disorders should be added to the employee health checkup for nurses with long work experience.
Diet ; Employment ; Gastrointestinal Diseases ; Job Satisfaction ; Marital Status ; Occupational Health

Cytokeratins are a family of polypeptides of intermediate filaments which in diverse epithelia are expressed in diffeent, yet specific combinations. To evaluate the diagnostic value of keratin, immunohistochemical staining was done in formalin-fixed, paraffin-embedded normal and neoplastic tissues by PAP and StreptABC methods. The antiserum for cytokeratin in monoclonal antibody which gives the specificity for 40, 46, 50, 52, 56, 58, and 65-67 Kd keratin classes. The results are as follows: 1) The staining was positive for cytokeratin in all of the squamous epithelium, ductular epithelial cells of various glands, respiratory and urinary tract epithelium, and mesothelial cells. 2) No staining for cytokeratin was ovserved in respiratory alveolar epithelium, acinar cells of various glands, renal glomeruli, hepatocytes, and many mesoderm-derived tissues such as muscle, hematopoieitc and lymphoid tissues, nerve, bone, cartilage, and fibroblasts. 3) Squamous cell carcinomas, transitional cell carcinomas, mesotheliomas, and some of the adenocarcinomas (stomach, colon, uterine cervix, biliary tract and breast) exhibited positive staining for cytokeratin. Epithelial cells of thymoma, adenomatoid tumor, plemorphic adenoma of salivary gland, papillary carcinoma of thyroid, lymphoepithelioma, and craniopharyngioma were also positive. 4) Some of the adenocarcinomas (prostate and pancreas), renal cell carcinoma, ovarian stromal and germ cell tumors, hepatocellular carcinoma, malignant melanoma, and mesoderm-derived tumors including malignant lymphoma were uniformly negative for staining. 5) From the above results, the immunohistochemical study in paraffin-embedded tissues using monoclonal antibody for cyto keratin may be useful to differentiate various tumors, especially in differential of hepatocellular carcinoma from bile duct adenocarcinoma, lymphoepithelioma and other undifferentiated carcinomas from lymphoma, thymoma from lymphoma, and squamous cell carcinoma from melanoma. It will be helpful in the diagnosis of transitional cell carcinoma in which the differentiation from renal cell carcinoma and prostatic adenocarcinoma be difficult.
Adenocarcinoma ; Adenoma ; Carcinoma, Hepatocellular

BACKGROUND: Peripheral T cell lymphoma (PTCL), a prevalent form of non Hodgkin lymphomas in East Asia, can manifest fever, hepatomegaly, lymphadenopathy, pancytopenia and hemophagocytic histiocytosis (HPH). Similar clinicopathologic findings are also frequently encountered in reactive hemophagocytic syndrome (HPS) and malignant histiocytosis (MH) , thus diagnoses could be confused among them. With recent advancement of immunohistochemlal techniques, diagnostic accuracies have been improved and most cases of MH could have been reclassified as PTCL. In this study, we intended to delineate the lineage of atypical malignant cells in bone marrow of subjects which were previously diagnosed as MH or HPS with immunohlstochemical analysis and characterize clinlcophathologic findings of PTCL associated with HPH in the bone marrow. METHODS: Five cases dignosed as HPS, 3 as MH, 3 as presumed MH, and 7 as PTCL on bone marrow examination were enrolled in this study. We performed immunohistochemical stain for CD45, CD3, CD43, CD2O and CD68, then revised the diagnoses and summarized the clinical and morphologic features of PTCL associated with HPH. RESULTS: Eleven out of 18 cases were confirmed as PTCL which were previously diagnosed as MH(1), presumed MH(3) and PTCL(7). Eight cases of 11 PTCL showed HPH mimicking MH with infiltration of the atypical malignant cells, even if the proportion of atypical malignant cells was small on bone marrow aspirates. They manifested fever and hepatomegaly but didn't have lymphadenopathy at the early stage of disease. Subtypes of PTCL with HPH were PTCL, unspecifed (3), angioimmunoblastic T cell lymphoma (1) and undetermined (4). They showed poorer outcome in 3-month survival rate (25%) than in those with PTCL without HPH(100%). CONCLUSION: These results suggest that PTCL associated with HPH should be excluded from MH by immunohistochemical analysis. Considering that prognosis of PTCL with HPH is very poor, accurate and rapid diagnosis is needed for prompt treatment.
Bone Marrow ; Bone Marrow Examination ; Diagnosis ; Far East ; Fever ; Hepatomegaly ; Histiocytic Sarcoma* ; Histiocytosis* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Pancytopenia ; Prognosis ; Survival Rate

The purpose of this study is to build up the foundation to prepare the effective nursing intervention devices for the seriously ill patient's families nursing through the nurse understanding of the experiences of the seriously ill patient's families in the field by setting up grounded theory. In this study, the subjects is the 6 families members of ICU patients, who were being cared in university hospital and the data were collected from 4.15 to 5, 1996 by the recordings and transcring the interview. The intervention lasted from 2 hours to 2 and a half hours. The data were analyzed in the framework of grounded theory as mapped out by Strauss & Corbin. The core category in the analysis of the experiences of the families of the seriously ill patients was the process of setting the "distress". In the process of datas analysis, the categories were 19 conceptions-'serious', 'bad', 'fear', 'press', 'hearburn', 'impatient', 'insufficient', 'change of patients' status', 'economic ability', 'family relationship', 'whilled power', 'request', 'direct caring', 'passive effort', 'control', 'receive', 'tired', 'blame'. These categories were again grouped into 12 categories, including 'exigency', 'overwhelming', 'worry', 'change of status', 'economic ability', 'relationship', 'caring will' 'active caring', 'passive response', 'accept', 'exhaustion', 'blame'. In the above mentioned categories, 'overwhelming' and 'worry' were categorized into the "distress!". On the basis of the patterns that have emerged on process of data analysis, the five below were confirmed. (1) When the patient's status is worse and economic ability is bad and the family relation to the patient is close and the distress is expressed with active caring willness is strong, the distress is expressed with active caring and brings about accept and blame. (2) When the family relation to the patient is distant and the distress decrease and the subject's caring willness is weak, the distress is expressed with passive response and brings about accept and exhaustion in spite of the patient's status is worse and bad economic ability. (3) When the patient's status is worse and economic ability is bad and the family relation to the patient is close and the distress increase, the subject's caring willness is strong, the distress is subject's caring willness is strong, the distress is expressed with passive response and brings about accept and exhaustion. (4) When the patient's status is improve and economic ability is good and the distress decrease and the subject's caring willing is strong, the distress is expressed with active caring and brings about accept and blame in spite of the family relation to the patient is close. (5) When the patient's status is improve and economic ability is bad and the family relation to the patient is close and the distress increase, the subject's caring willness is strong, the distress is expressed with active caring and brings about accept and blame.
Family Relations ; Humans ; Nursing ; Statistics as Topic

Pathologists play an important role in proper evaluation of endoscopically removed polyps of the gastrointestinal tract. This study is purposed to reclassify the polyps and review the clinicopathologic features of each histologic subtypes and their malignant potential. Our material consists of total 345 gastrointestinal polyps obtained from Jan. 1986 to Dec. 1987. The results are as follows: 1) A total of 345 gastrointestinal polyps was removed from stomach is 151 cases, from colon in 180 cases, and from small intestine in 14 cases. 2) Hyperplastic polyps were the most common type of polyps I stomach (53.6%) whereas neoplastic polyps were the most common in colon (56.1%). 3) Hyperplastic polyps of the stomach occur in any age after the 3rd decade of life and neoplastic polyps predominantly developed between the 5th and 8th decades. Juvenile retention polyps were frequently noted before the 3rd decade of age. 4) Approximately 267 cases (77.4%) of patients had a single polyp and the remainders had multiple polyps. The gastric polyps were usually located at the antrum and the colonic polyps were at the sigmoid colon and rectum. 5) Epithelial atypia was exclusively noted in the neoplastic polyps of stomach (72.7%) and colon (72.3%). Malignancy in the polyp was observed in the neoplastic polyps only (13 cases). 6) Different types of polyp may occur in the same organ.

Pathologists play an important role in proper evaluation of endoscopically removed polyps of the gastrointestinal tract. This study is purposed to reclassify the polyps and review the clinicopathologic features of each histologic subtypes and their malignant potential. Our material consists of total 345 gastrointestinal polyps obtained from Jan. 1986 to Dec. 1987. The results are as follows: 1) A total of 345 gastrointestinal polyps was removed from stomach is 151 cases, from colon in 180 cases, and from small intestine in 14 cases. 2) Hyperplastic polyps were the most common type of polyps I stomach (53.6%) whereas neoplastic polyps were the most common in colon (56.1%). 3) Hyperplastic polyps of the stomach occur in any age after the 3rd decade of life and neoplastic polyps predominantly developed between the 5th and 8th decades. Juvenile retention polyps were frequently noted before the 3rd decade of age. 4) Approximately 267 cases (77.4%) of patients had a single polyp and the remainders had multiple polyps. The gastric polyps were usually located at the antrum and the colonic polyps were at the sigmoid colon and rectum. 5) Epithelial atypia was exclusively noted in the neoplastic polyps of stomach (72.7%) and colon (72.3%). Malignancy in the polyp was observed in the neoplastic polyps only (13 cases). 6) Different types of polyp may occur in the same organ.

Page 31. The size of conidia of Alternatia brassicicola should be 20~80x8~25 microm instead of 20~120x8~30 microm.
Alternaria* ; Korea* ; Spores, Fungal