BACKGROUND: The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center. METHODS: Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status. RESULTS: Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients' B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum. CONCLUSIONS: Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.
Basal Ganglia ; Brain* ; Cerebellum ; Cerebral Cortex ; Emergencies ; Hand ; Humans ; Hypoxia-Ischemia, Brain ; Intensive Care Units ; Magnetic Resonance Imaging* ; Neuroimaging ; Out-of-Hospital Cardiac Arrest* ; Putamen ; Retrospective Studies ; Survivors

No abstract available.

Serous cystadenoma of the pancreas, also known as microcystic adenoma or glycogen-rich cystadenoma, is an unusually benign tumor. It is usually large and composed microscopically of many small cysts lined by small, cuboidal or flattened cells containing abundant glycogen. It has been suggested that serous cystadenoma probably arise from the ductular cells or centroacinar cells. Herein, we report on a case of serous cystadenoma of the pancreas in a 55-year-old female. The tumor, measuring 13.5x11.5x10.0 cm, was located in the head of the pancreas and the cut surface revealed a sponge-like appearance due to innumerable tiny cysts containing clear serous fluid. Microscopic analysis showed cystic spaces lined by cuboidal cells with intracytoplasmic glycogen.
Female ; Humans ; Cysts ; Adenoma

Angiomatoid fibrous histiocytoma is a rare soft tissue tumor that generally affects children and young adults. We report a case of angiomatoid fibrous histiocytoma in an 11-year-old boy who complained of a back mass for 3 years. Surgical excision was performed. The excised specimen showed a 4.0 x 3.6 x 3.0 cm, well circumscribed, grayish white tumor, with multicystic changes. Histological examination showed proliferation of spindle or round shaped tumor cells. There was a dense fibrous pseudocapsule with prominent chronic inflammatory cell infiltrates.
Child ; Histiocytoma, Benign Fibrous* ; Humans ; Immunohistochemistry ; Male ; Young Adult

The expression of p62"' and p2l can be seen in many solid tumor, but the pattern and incidence of expression were different according to organ, countries, and examiners, thus it is not definitely defined. Total 67 colorectal carcinoma in paraffin sections are analysed by immunohistochemically for evaluation of the p62and p21- expression according to the age, sex, chief complaints, location, differentiation, modified Dukes stage, using the specific monoclonal antibodies. The results were summarized as follows : The age of patients ranged from 32 years to 82 years. The mean age was 57.6 years. The expression of p 62y' and p21 was not correlated with age. Male was 29 cases(43.3%) and female was 38 cases(56.7%). The male to female ratio was 1:1.31. The and 95.0% in moderately differentiated adenocarcinoma, 90.0% and 90.0% in poorly differentiated <,;, adenocarcmoma, 100.0% and 100.0% in mucinous carcinoma. The positive rate of p62!and and p2l' was 94.1% and 88.2% in Dukes stage B,, 96.0% and 96.0% in Dukes stage B,, 100.0% and 100.0% in Dukes stage C,, 100.0% and 88.9% in Dukes stage C, and 100.0% and 100. o% in Dukes stage D. The expression of p62 y' in metastatic colorectal carcinoma showed diffuse and strongly positive reaction than primary colorectal carcinoma. The expression of p21 in primary colorectal carcinoma showed diffuse and strongly positive reaction than metastatic colorectal carcinoma.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Antibodies, Monoclonal ; Colorectal Neoplasms* ; Female ; Humans ; Immunohistochemistry ; Incidence ; Male ; Oncogene Proteins* ; Oncogenes* ; Paraffin

A total of 672 surgically resected gastric carcinomas were reviewed, and fourteen cases(2.1%) of "gastric carcinoma with lymphoid stroma" were identified. The tumor was located mostly in cardia and body portion(86%). Thirteen patients one was lost to follow up were alive without recurrence of tumor. Grossly, this carcinoma was characterized by an expanding growth pattern or a multinodular pattern. Histologically, this carcinoma showed an irregular trabecular and alveolar arrangement and densely infiltrated lymphoid cells with lymph follicles. The tumor cell nests were widely separated by non-desmoplastic lymphoid stroma. On immunohistochemical study, T cells were evenly distributed throughout the tumor lesion with intimate contact with individual carcinoma cells, but B cells were mainly present within the germinal centers of lymph follicles. Thus, the organized immune response combined with cell mediated and humoral immunities against the carcinoma cells may be a defense mechanism of the host in this type of gastric carcinoma.

To fine out the changes of DNA ploidy and cellular proliferation activity during carcinogenesis and evaluate correlation between flow cytometrically determined S-phase fraction and proportion of proliferation cell nuclear antigen(PCNA, PC10) immunoreactive cells, the authors studied on malignant fibrous histocytoma induced by intra-articular injection of 9, 10-dimethy1-1, 2-benzanthracene(DMBA) in the rats. Forty Wistar rats were used. The results obtained were as follows. 1) Firstly, tumors were palpated 5 weeks after the last injection of DMBA and formed in 27 rats at sacrificed. Histologically, these lesions showed storiform, indicative of malignant fibrous histiocytoma. 2) Three cases of DNA aneuploidy were observed at 4 and 5 months after the last injection of DBMA and one of them, which was DNA diploidy at main mass, was found at daughter mass. 3) Flow cytometrically determined S-phase fraction and proportion of PCNA(PC10) immunoreactive cells in malignant fibrous histiocytoma induced by DMBA were much higher than in control groups and slightly increased according to sequential changes after formation of mass. The comparison of flow cytometrically determined S-phase fraction and proportion of PCNA(PC10) immunoreactive cells showed significant correlation(r=0.6092, p<0.001). Above results strongly suggest that ploidy pattern may evolve into aneuploid type during the development of tumor and proliferation activity increases during the carcinogenesis.
Rats ; Animals

Leiomyosarcoma is a malignant tumor showing smooth muscle differentiation, and it accounts for 2% to 8% of soft tissue sarcoma. Clinically, substantial mortality and morbidity are related to the propensity for distant metastasis and local recurrence, respectively. Microscopic findings characteristically reveal intersecting bundles of spindle-shaped cells having fibrillar cytoplasm and blunt-ended nuclei. Immunohistochemistry for intermediate filaments is helpful in establishing a definitive diagnosis. We experienced a case of large protruding leiomyosarcoma that developed on an old burn scar of the medial calf of a 45-year-old man. On preoperative evaluation, we recommended amputation due to a distant metastasis to the lung(stage IV). As the patient refused amputation of his lower leg, the tumor was radically excised and immediate reconstruction was done using free latissimus dorsi muscle flap and skin graft. Four months after excision despite adjuvant chemotherapy, amputation was performed due to local recurrence.
Amputation ; Burns ; Chemotherapy, Adjuvant ; Cicatrix ; Cytoplasm ; Diagnosis ; Humans ; Immunohistochemistry ; Intermediate Filaments ; Leg ; Leiomyosarcoma* ; Middle Aged ; Mortality ; Muscle, Smooth ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Skin ; Superficial Back Muscles ; Transplants ; Ulcer*

BACKGROUND: Domestic violence once considered an infrequently occurring event existing only in deviant relationships, it has been more recently recognized as a widely distributed phenomenon resulting from multiple cultural, social, psycological factors. According to declining world economics, family violence rises with a simultaneous curtailment of agencies available to assist battered persons and there is increasing pressure on emergency departments to serve those who might otherwise have sought help from public agency. In Korea, we don't have any clinical data about domestic violence, and authors analysed clinical pictures of domestic violence victims who came to the emergency department of Korean University medical center. METHOD: We reviewed the victims of the domestic violence retrospectively, who visited in ED, Korean Univ. Hospital from Jan. 1996 to the Dec. 1996. We Analysed data to Age, sex, Injury severity score, location of injury, mechanism, perpetrator. RESULTS: During the study period, total 134 domestic violence victims were identified. The young, females were predominantly victimized. And married women were more commonly violated. (about 70%). ISS was relatively mild (2.491), face and head were mainly injured by punching and objects throwing. The Prevalence of domestic violence victims almost presented at Emergency department between 6:00/P.M. and 8:00 A.M.. CONCLUSION: Emergency physicians suspect domestic violence victims who injured at face and head by punching or hitted would. In these patients, we need more detail history and physical exam. And in case of repeated domestic violence, refer to neuropychatry dept and social workers with perpetratrs, and need mere concerte social programs for domestic violence.
Academic Medical Centers ; Domestic Violence* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Head ; Humans ; Injury Severity Score ; Korea ; Prevalence ; Retrospective Studies ; Social Workers

PURPOSE: Early diagnosis of neonatal sepsis is very difficult because of no specific clinical and laboratory findings. It also takes at least 48 hours of incubation period to isolate the organism by culture study. So several laboratory tests have been evaluated for their usefulness in rapid detection of the neonatal sepsis. Those are evaluated either singly or in combination with a defined scoring system include leukocyte count with differential count, platelet count, C-reactive protein level, erythrocyte sedimentation rate, haptoglobin level, fibronectin level, leukocyte alkaline phosphatase and so on. But no single test or combination with others has proved superior to the leukocyte count and differential count as a reliable indirect indicator of neonatal bacterial infection. We performed this study to determine the appropriate screening test for early detection of neonatal sepsis. METHODS: During the period of May 1991 through April 1997, we selected 200 neonates who were admitted to the neonatal intensive care unit of Kon-Kuk University Medical Center Seoul Hospital. All of the cases were retrospectively evaluated and divided two groups; sepsis group-88 neonates who were confirmed by blood cultures, and control group-112 neonates who had no evidence of neonatal bacterial infection. RESULTS: The results were as follows; 1) The sex ratio of male to female was 1.5:1 in the sepsis group and showed significant difference between two groups (P<0.05). The incidence of neonatal sepsis in prernature infant was higher in sepsis group than control group (P<0.05), and mean body weight was lower in sepsis group (2351.4148.3g) than control group (Z821.8 142.6g) significantly (P<0.05). 2) Predisposing perinatal factors associated with neonatal sepsis were premature rupture of membrane (> or = 24hrs) (14.5%) meconiurn staining (6.8%), asphyxia (Apgar score < or = 6 at 5mins) (5.7%), eclampsia and preeclampsia (4.5%), maternal infection (3.4%) and bleeding (including placenta previa, abruptio placenta) (1.1%) in order of frequency. Among th, only premature rupture of membrane was significant difference between two groups (P<0.05). Others risk factors including umbilical catheterization, endotracheal intubation, ventilatory care, total parenteral nutrition were also signi- ficant difference between two groups (P<0.05). 3) The common presenting symptoms of neonatal sepsis were jaundice (48.9%), poor feeding (45.5%), ternperature instability (43.2%), lethargy (30.7%), irritability, dyspnea, diarrhea, vomiting, tachypnea, and cyanosis in order of frequency. Among the above symptoms, poor feeding, dyspnea and cyanosis were significant difference between two groups (P<0.05). 4) The peripheral blood findings (leukocyte count, platelet count, ESR) showed no significant differences between two groups (P>0.05). The acute phase reactants (APR) score above two (37/88) and positive C-reactive protein (51/88) in the sepsis group were regarded as significantly high compared to the control group. 5) In the cases with APR score above two including positive C-reactive protein and abnormal total leukocyte count, sensitivity was 17.0%, specificity 97.3% positive predictive predictive value 83.3%, and negative predictive value 60.0%. CONCLUSIONS: The higher frequency of neonatal sepsis was proved in the cases of APR score above two including positive C-reactive protein. In the cases with abnormal total leukocyte count and APR score above two including positive C-resctive protein, the specificity was 97.3% and the positive predictive value was 83.8%. So APR score above two including positive C-reactive protein and abnormal total leukocyte count could be regarded as an useful test method for early detection of neonatal sepsis.
Academic Medical Centers ; Acute-Phase Proteins ; Alkaline Phosphatase ; Asphyxia ; Bacterial Infections ; Blood Sedimentation ; Body Weight ; C-Reactive Protein ; Catheterization ; Catheters ; Cyanosis ; Diarrhea ; Dyspnea ; Early Diagnosis* ; Eclampsia ; Female ; Fibronectins ; Haptoglobins ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Intubation, Intratracheal ; Jaundice ; Lethargy ; Leukocyte Count ; Leukocytes ; Male ; Mass Screening ; Membranes ; Parenteral Nutrition, Total ; Placenta Previa ; Platelet Count ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Risk Factors ; Rupture ; Sensitivity and Specificity ; Seoul ; Sepsis* ; Sex Ratio ; Tachypnea ; Vomiting