A case of unicameral bone cyst developed in proximal portion of left femur complicated with femoral neck fracture is reported. The case was 18 years old girl who complained of the swelling and pain over the left hip region and limited range of the motion of the hip for an year. Roentgenological study revealed a large lobulated cystic destruction involving the proximal portion of the left femur with thin cortical expansion and a pathological femoral neck fracture. Curettage of the cyst and cancellous bone graft paeked into the cyst were performed. The cyst measured 9cmX6cm in size and was composed of multiloculated cavities separated by fibroosseous septa. The cyst was filled with bloody gelatineous fluid. The diagnosis of unicameral bone cyst was confirmed by microscopic examination.
Bone Cysts ; Curettage ; Diagnosis ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Gelatin ; Hip ; Humans ; Transplants

The author carried out an experimentation to clarify a possible pathogenesis of renal papillary necrosis induced by an univisceral Shwartzman reaction. The experimental animals were healthy white rabbits in weighing between 1.7 kg and 3.0 kg. Under the condition of ureterostomy, animals were pretreated with 0.5 cc of 50% ethyl alcohol and followed by administration of 0.2 ~ 1.5 mg endotoxin (E. coli 026 : B6, bacto lipopolysaccharide B. Difco, U.S.A.) as preparation in the renal pelvis. And then sacrificed at 10 minutes, 30 minutes, 1 hour, 2 hours, 6 hours and 24 hours after intravenous injection of 0.2 mg or 0.6 mg endotoxin through the ear veins, subjection to examine light and electron microscopically. The obtained results were summarized as follows: Papillary necrosis was developed in 88% among 18 cases excluding 6 cases died before sacrification. There were two types of necrosis, namely papillary and medullary type, but the former and combined forms of both types were the most common findings. Initial main target site of injury in renal papilla induced by endotoxiin was the endothelium of vasa recta and then followed by the Henle's loop, interstitial cell and collecting tubule respectively. Vascular injuries such as swelling and detachment of endothelium were observed since 10 minutes after endotoxin injection. Henle's loop showed stratification of basement membrane without consistent features with time lapses and initially observed fatty vaculoes at 1 hour after endotoxin injection were more eminent in 24 hours group. Main changes of interstitial cells were decrease of lipid droplets while increase of fatty vacuoles; the latter were initially observed in 1 hour group and more eminent in 24 hours group. Collecting tubule showed many fatty vacuoles especially in 24 hours group. It is thought that emergence of fatty vacuoles seems to be a kind of immature lipid droplets to compensate the increased demand of PC release due to continuous ischemic condition. In conclusion, it is thought that ischemic injury due to the vascular changes is pathogenic mechanism producing renal papillary necrosis. Endotoxin induced univisceral Shwartzman reaction in the kidney may be a good experimental model in studying renal papillary necrosis.
Rabbits ; Animals

The purpose of this study was to identify the re lationship of hopelessness and spiritual-need of cancer patients. Subjects for this study were 272 cancer patients sampled from a madical center in Pusan. The data were collected from Feb. 1 to Mar. 10, 1998 using questionnaire method. Hopelessness measured hopelessness scale was the One(1986) modification of Beck(1974) and spiritual -need measured spiritual-need scale by Kim (1986) according to classification of Fish and Shelly. The questionnaire consisted of question regarding hopelessness scale(20 items 5 point) and spiritual-need scale (30 items 5 point scale). The reliability of this instrument was that the hopelessness scale was Cronbach's alpha=0.89 and the spiritual-need was Cronbach's alpha=0.93. The data were analyzed with the SFSS program using mean, standard deviation, frequency and percentage, t-test, ANOVA, Post hok test and Pearson's Correlation Coefficient. The results of this study were as follow : 1. The mean score of the total hopelessness was 2.79 in 1(lowest) -to-5(highest) scoring system. The analysis of the hopelessness according to general characteristics of the cancer patients showed duration of treatment(F=3.77), cognition prognosis(F=2.92) age(F=2.66), religional effect of life(2.48). 2. The mean score of the total spiritual-need was 3.47 in 1(lowest)-to-5 (highest) scoring system. age(F=5.517), sex(F= .919), religion(F=25.89), religional effect of life(F=18.54), diagnosis(F= 7.67), main care giver(F=4.09), cognition of disease(F=2,92), cognition of prognosis (F=331), inspiring source(F= 12.72), acceptioal attitude of present situation(F= 13.52). according to the categoiised paiL were showed to the need for meaning and purpose(9.40), to the need for love and relatedness(7.08), and to the need for being forgiven(6,93). 3. There was significant correlation between the degree of hopelessness and spiritual-need(gamma=.146, P<0.05).
Busan ; Classification ; Cognition ; Humans ; Love ; Prognosis ; Surveys and Questionnaires

The author studied 11-cases of adenocarcinoma of the stomach confirmed by gastrofiberscopic biopsy before in order to differentiate between differentiated and undifferentiated adenocarcinoma by scanning electron microscope. Light and transmission electron microscopie examination were done, too. Seven of them are differentiated accompanied by severe intestinal metaplasia and four of them are undifferentiated with rearly focal intestinal metaplasia. Two of the undifferentiated cases shows focal tubular differentiation on the superficial region of the mucosa. Microvilli on the free border are long, regular on the differentiated type but in state of variable loss of microvilli under the transmission electron microscope. Number and density of the mucous granules are variable. Scanning electron microscopic examination shows prominent disorganization of the folds, cellular pleomorphism and pleomorphic microvilli are suggestive of early marker of neoplastic transformation. The size of them are 0.6 micrometer and 1.2 micrometer on the differentiated type respectively. Disorganization of the folds is an important differential point between differentiated and undifferentiated type on the lower power examination. Development of folds, furrow, and hemispheric colliculi are more porminent on the differentiated adenocarcinoma. Presence of striated border, partial or complete loss of microvilli and intestinal metaplasia on the undifferentiated and differentiated adenocarcinomas are consisent with origin from common precursor cells.
Adenocarcinoma ; Biopsy

The authors studied the ultrastructural changes of liver cell mitochondria in autolysis. The male Sprague-Dawley rats, weighting 140~160 gm were sacrificed for extract liver tissue. The slices of the liver tissue were incubated in 37 degrees C aseptic normal saline, and those were examined by following intervals; 10, 20 and 30 minutes and 1, 2, 6, 12 and 24 hours with light and electron microscope. The results obtained by light microscopy were summerized as follow. Several fine intracytoplasmic vacuoles were observed 1 hour after incubation. After 3 hours, focal destruction of cytoplasmic membrane with pyknosis of nuclei were observed. More delicate intracytoplasmic architectural changes could not be detected at light microscopic studies. The cord arrangement and cellular boundaries were relatively well preserved until 24 hours after incubation. Electronmicroscopically, mild intramitochondrial swelling with diminution of intramatrical granules were observed at 20 minutes. These were the earliest findings. Both high amplitude swelling and destruction of mitochondrial membrane were observed concurrently at 1 hour after incubation. The earlier membrane changes were observed at inner membrane with cristae and followed by degeneration of the outer membrane. The intramatrical amorphous dense deposits were observed at 30 minutes when the membranes were not destroyed. These deposits were noted in the other experimental groups which were incubated longer than 30 minutes. More electron dense deposits were observed after 1 hour at that time the membrane changes appeared. Vhe results suggest in this experiment that the earliest autolytic changes of liver cell mitochondria is loss of intramitochondrial granules and the membraneous changes led to the irreversible mitochondiral injury. The appearance of two types of intramitochondrial dense deposits would be an interesting finding needed to require further investigation for the chemical stucture and mechanism of dense deposit formation.
Male ; Humans

Herpes zoster is a acute viral infection of nerve structures manifesting cutaneous lesions in the form of groups of vesicles distributed along one or more peripheral sensory nerves. Sometimes involve motor nerves. The skin lesions usually appear on unilateral, but some on bilateral. And caused by variella-zoster virus, which is the same virus, with varicella. The most important etiologic mechanism is the reactivation of the latent virus; a latent virus infection is set up in spinal and cranial sensory ganglion as a result of hematogenous dissemination during the initial varicella infection and is activated in later life so that the virus spread down to the peripheral nerve into the skin. Durig last 5 years (1968-1972) 94 cases of Herpes zoster, of Dermatology Dept. in N.M.C. were investigated by statistics of sex, age, predilection site of skin eruptions, seasonal variation, and of its complications or associated diseases. The reults were following; In sex, age distribution, female is rather common than male and more commonly affected after 40's. In predilection site, more than half cases, involved thoracic cutaneous nerves, and the least were sacral and lateral cutaneous nerves. Right and left side proportion was about same (40: 49), bilateral or mid-zone involvement were 5 cases. In seasonal distribution, there was no relation between epidemic of varicella and Herpes zoster, The most were at Summer, and the least at Autumn. In complications and associated diseases, complication noted in 4 cases, 3 were Herpes zoster ophthalmicus and 1 case was Ramsey-Hunt syndrome. The most frequent associating disease was pulmonary tuberculosis, otherwise were diabetes, asthma etc.
Age Distribution ; Asthma ; Chickenpox ; Dermatology ; Female ; Ganglia, Sensory ; Herpes Zoster Ophthalmicus ; Herpes Zoster* ; Humans ; Male ; Peripheral Nerves ; Seasons ; Skin ; Tuberculosis, Pulmonary

A case of 23 years old male with Reiters syndrome was reported. The skin lesions were characterized by thick, britle and heavy keratotic crust formation on whole body with weakness, severe arthritis, ankylosis, on the feet, wrists, knees, ankle and finger joints. Histopathological examination showed a spongiform vesicopustules, acanthosis and parakeratosis, interpapillary process elongated in the epidermis hyperkeratosis, dilated. vessels with perivascular infiltrate in the dermis. He was treated with Arning's tincture, Nystatin ointment, coaltar ointment painting and oral administration of prednisolone, methotrcxate for 1 month, resulting favorable improvement.
Administration, Oral ; Ankle ; Ankylosis ; Arthritis ; Candidiasis* ; Dermis ; Epidermis ; Finger Joint ; Foot ; Humans ; Knee ; Male ; Nystatin ; Paint ; Paintings ; Parakeratosis ; Prednisolone ; Skin ; Wrist ; Young Adult

Synovectomy of the knee in rheumatoid arthritis has been recommended as an effective procedure which improved symptoms such as pain, swelling, and limitation of motion. But some problems, such as limitation of range of motion, infection, long hospital days, occured in open synovectomy. Arthroscopic synovectomy yields reliable result compatible to open synovectomy with less invasiveness and postoperative morbidity. The authors analyzed 20 knees of 14 patients who has done synovectomy of knee in Kyung Hee University Hospital from September 1989 to October 1992. Of the 14 patients, thirteen were females and only one was male, ten knees were affected on the right and ten on the left respectively. Five knees were operated as open synovectomy and fifteen knees as arthroscopic synovectomy. In six patients, both knees were operated either open or arthroscopic synovectomies. The preoperative diagnosis of 20 knees were rheumatoid arthritis as clinically, serologically and radiologically, 13 knees are confirmed as pathologically. Average hospital days after operation were 19 days in open synevectomy and 11 days in arthroscopic synovectomy. Average operation time were 72 minutes in open synovectomy and 84 minutes in arthroscopic synovectomy. No complication occured as a result of these synovectomies. After average follow up of 19 monthes, 1 knee from 5 knees in open synovectomy and 3 knees from 15 knees in arthroscopic synovectomy had pain and intermittent swelling as postoperatively. And only 1 knee in open synovectomy had loss of range of motion. No other patients lost motion in their knees. Preoperatively 17 knees showed radiographic change of rheumatoid arthritis and 16 knees showed no progressive radiographic deterioration at final follow up. And patients overall showed a significiantly increased functional status postoperatively. In conclusion, the result obtained after arthroscopic synovectomy are comparable with those obtained after open synovectomy. In addition arthroscopic procedure had lessened postoperative morbidity as loss of range of motion, postoperative infection, long hospital days and useful as palliative surgery in advanced rheumatoid arthritis.
Arthritis, Rheumatoid ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Palliative Care ; Range of Motion, Articular

Amiodarone, an antiarrhythmic drug, may exert pulmonary toxicity in some patients but the pathogenesis is not clear. This study was carried out to investigate the pathogenetic mechanism of pulmonary injury induced by amiodarone at dose of 100 mg/kg/day given to rats by intraperitoneal injection for 3 weeks. And the preventive effects of concomitantly injected steroid (10 mg/kg/day) on amiodarone induced pulmonary injury was also studied using bronchoalveolar lavage, light microscopy and transmission electron microscopy. The results obtained were summarized as follows: Mild lymphocytosis of bronchoalveolar lavage fluid was found in all experimental groups. Intracytoplasmic lamellar body formation was found in all types of pulmonary cells and type II pneumocytes revealed the earliest abnormal lamellar body formation. The capillary endothelial cells showed cellular swelling and detachment from underlying basement membrane at early phase of experiment and the edema of alveolar wall and interstitium were noted. Interstitial fibrosis and proliferation of type II pneumocytes were noted at late phase. The lungs of steroid injected groups revealed accumulation of lamellar bodies in all types of pulmonary cells but interstitial fibrosis was not occurred. These findings support the concept that amiodarone is responsible for a drug-induced phospholipidosis and directly toxic to pulmonary endothelial and epithelial cells. And steroid may regress the progression of amiodarone induced pulmonary injury.
Rats ; Animals

The authors studied the formation of giant mitochondria in liver cell. The Sprague Dawley rats were sacrificed following intervals; 5, 10, 20, 30, and 60 minutes after intraperitoneal injection of hydrazine in the amount of 200 microliter/kg. And the extracted liver tissues were examined with light and electron microscopes. The results obtained were summarized as follow; Light microscopically, there is little difference between control and experimental groups. Electron microscopically, elongated, bizzare shaped mitochondria are appears 5 minutes after hydrazine injection. Those show attenuated portion, Y, U, or C shaped feature suggesting fusion or budding mitochondria. The number of giant mitochondria is decreased after 10 minutes group and rarely present in 60 minutes group. The results suggest in this experiment that the formation of giant mitochondria is kind of reversible change and it is different from the mitochondrial swelling of cellular injury. Intermitochondrial fusion and mitochondrial budding may be related with the formation of giant mitochondria.
Rats ; Animals