Quality assurance analysis of frozen section diagnosis is very important for the pathologists to improve the diagnostic ability and the quality of medical service. We analysed 5,273 consecutive cases of frozen section diagnosis which were done in Samsung Medical Center during 10 months from June 1, 1998 to March 31. 1999 with special reference to the discordance between frozen section diagnosis and final diagnosis. The concordance rate was 97.65%, discordance rate 1.34%, and deferred diagnosis (type 1) rate 1.01%. Category A (discordant diagnosis without any effect on the patients) was 53 cases (1.01%), category B (discordant diagnosis with minimal but no serious effect on the patients) was 10 cases (0.19%), and category C (discordant diagnosis with serious effect on the patients) was 8 cases (0.15%). Type 2 (discordant diagnosis by extra-pathologist problem) was 22 cases (0.42%) and type 3 (discordant diagnosis by pathologist problem) was 49 cases (0.93%). The most frequent causes of type 2 and 3 discordant diagnosis were presence of new lesions on deeper sections and the misinterpretation of lesions. Discordant diagnosis was noted in lymphoreticular system, central nervous system, thyroid, gastric resection margin, breast, female genital organs, intestine, hepatobiliary system, upper aerodigestive tract, urinary tract, lung, and soft tissue in descending order of frequency. Frozen section diagnosis was deferred in central nervous system, lymphoreticular system, gastric resection margin, female genital organs, thyroid, intestine, upper aerodigestive tract, lung, and soft tissue in descending order of frequency. The most important cause of discordant diagnosis was a misinterpretation of the lesions. Based on our results, a continuous and careful follow-up of quality assurance analysis of frozen section diagnosis and a share of experience of problematic cases are mandatory for the pathologists to improve the quality of medical services.
Breast ; Central Nervous System ; Diagnosis* ; Female ; Frozen Sections* ; Genitalia, Female ; Intestines ; Lung ; Thyroid Gland ; Urinary Tract

No abstract available.

No abstract available.
Transurethral Resection of Prostate*

BACKGROUND: We have previously demonstrated the isoflurane and halothane may be detrimental to in vitro fertilization of mouse oocytes in high concentrations. The aim of this study is to compare the toxic effects of volatile anesthetics on mouse embryos using in vitro growth model of two cell mouse embryos. METHODS: Mouse two-cell embryos exposed to three volatile anesthetics, enflurane(0.5 mM; 1.5 mM), isoflurane(0.26 mM; 0.78 mM) and halothane(0.24 mM; 0.72 mM). Mouse two-cell embryos unexposed to any drugs were included as controls. RESULTS: The percentages of two-cell mouse embryos developed over morula stages on the third day after exposure of high concentrations of isoflurane and halothane decreased significantly compared with controls. The rates of embryos arrested at 2-8 cell stage in these groups were significantly higher than that of controls. There were no significant differences in these rates between enflurane group, isofiurane and halothane group of lower concentrations and controls. The hatching and/or hatched blastocysts development were significantly lower in isoflurane and halothane group than in controls. No significant differences in the hatching rate of blastocyst developed were observed among groups. CONCLUSIONS: Our data show that isoflurane and halothane in high concentrations have harm effects of the in vitro growth of two cell mouse embryos.
Anesthesia* ; Anesthetics ; Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures ; Enflurane ; Female ; Fertilization in Vitro ; Halothane ; Isoflurane ; Mice ; Morula ; Oocytes ; Pregnancy

BACKGROUND: We have previously demonstrated the isoflurane and halothane may be detrimental to in vitro fertilization of mouse oocytes in high concentrations. The aim of this study is to compare the toxic effects of volatile anesthetics on mouse embryos using in vitro growth model of two cell mouse embryos. METHODS: Mouse two-cell embryos exposed to three volatile anesthetics, enflurane(0.5 mM; 1.5 mM), isoflurane(0.26 mM; 0.78 mM) and halothane(0.24 mM; 0.72 mM). Mouse two-cell embryos unexposed to any drugs were included as controls. RESULTS: The percentages of two-cell mouse embryos developed over morula stages on the third day after exposure of high concentrations of isoflurane and halothane decreased significantly compared with controls. The rates of embryos arrested at 2-8 cell stage in these groups were significantly higher than that of controls. There were no significant differences in these rates between enflurane group, isofiurane and halothane group of lower concentrations and controls. The hatching and/or hatched blastocysts development were significantly lower in isoflurane and halothane group than in controls. No significant differences in the hatching rate of blastocyst developed were observed among groups. CONCLUSIONS: Our data show that isoflurane and halothane in high concentrations have harm effects of the in vitro growth of two cell mouse embryos.
Anesthesia* ; Anesthetics ; Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures ; Enflurane ; Female ; Fertilization in Vitro ; Halothane ; Isoflurane ; Mice ; Morula ; Oocytes ; Pregnancy

The accidental swallowing of foreign bodies by infants and children is a common problem. The proper methods of therapy must be carefully selected according to the age of the patient, the type of forei gn body, the location of impaction, the duration of ingestion, and the available medical resources and skills. This report reviews 41 cases of ingested foreign bodies in the upper GI tract at the Department of Pediatrics, Yonsei University College of Medicine between January 1981 and June 1991. The results were as follows: 1) The ages ranged from 3 months to 13 years with 34 cases less than 5 years of age, 5 cases between 5 to 10 years of age, and 2 cases greater than 10 years of age. 2) The male to female ratio was 1.9:1 with 27 male and 14 female patients. 3) The types of ingested foreign bodies were coins in 15 cases(36.6%), pins in 9 cases(22.0%), rings in 3 cases, food in 3 cases, nails in 2 cases, and others. 4) presenting symptoms were varable with vomiting in 8 cases(19.5%), coughing in 4 cascs(9.8%), dysphagia in 4 cases(9.8%), poor oral intake in 2 cases(4.9%), diarrhea in 2 cases(4.9%), and others. 5) Ingested foreign bodies were located in the esophagus in 14 cases(34.2%), stomach in 24 cases(58.5%), duodenum in 1 cases(2.4%)and uncertain locations in 2 cases. 6) Methods for the removal of ingested foreign bodies included 15 cases of endoscopic removal(53.6%), 1 surgical removal (3.6%), and 12 spontancous removals(42.8%). 10cndoscopic removals were carried out in 12 esophageal cases(83.3%), but 10 out of 16 stomach cases were removed spontaneously (62.5%). 7) Duration from ingestion to removal of foreign bodies renged from 19 hours to 2 years. All 12 spontaneous removal cases were within 2 weeks, and 1 surgical case was performed 2 years after ingestion. 8) Endoscopic findings of patients with esophageal foreign bodies included 3 normal cases(30.0%)and 7 moderate to severe abnormal cases(70.0%), and those patients with gastric foreign bodies included 3 normal cases(60.0%)and 2 mild superficial mucosal lesion cases.
Child* ; Cough ; Deglutition ; Deglutition Disorders ; Diarrhea ; Duodenum ; Eating ; Endoscopy ; Esophagus ; Female ; Foreign Bodies* ; Gastrointestinal Tract ; Humans ; Infant* ; Male ; Numismatics ; Pediatrics ; Stomach ; Upper Gastrointestinal Tract* ; Vomiting

No abstract available.
Keratosis, Seborrheic ; Skin Diseases ; Skin Diseases, Papulosquamous

This study was performed to investigate the prevalence of theileriosis and to compare the prevalence of this disease in Korean native cattle reared under different environmental conditions, namely, in a grazing area and a non-grazing area by polymerase chain reaction. Three hundred and one Korean native cattle (276 cows and 25 bulls) that had not received prior treatment or been vaccinated to prevent theileriosis were examined by PCR for Theileria sergenti infection from 2001 to 2002. In our study, the parasitemia range in T. sergenti-positive cattle by microscopy were from 0.1 to 3% (mean 0.8%). In terms of mean prevalence, 204 of the 301 Korean native cattle (67.8%) were positive reaction by PCR. Our results also revealed that the infection rate among cows (70.3%) was significantly higher than that among bulls (40.0%) (p < 0.01). T. sergenti infection among the over 3 year-old-group (75%) had a significant higher prevalence than that among the less than 3 year-old-group (61.8%) (p < 0.05). Our data also showed that grazing areas (76.1%) had the significant higher prevalence than non-grazing areas (51%) (p < 0.001). In conclusion, this study demonstrates that the prevalence of T. sergenti infection is high and that its prevalence in grazing cattle is higher than that in non-grazing cattle. Therefore, life-long treatment and the development of an optimal vaccine are needed to reduce the numbers of bovine theileriosis in both grazing and non-grazing areas.
Animals ; Cattle ; Cattle Diseases/diagnosis/*epidemiology/parasitology ; DNA, Protozoan/*analysis ; Female ; Korea/epidemiology ; Male ; Poaceae ; Polymerase Chain Reaction/methods/veterinary ; Prevalence ; Sex Factors ; Theileria/genetics/*isolation & purification ; Theileriasis/diagnosis/*epidemiology/parasitology

Liver cell dysplasia of Anthony(LCD) is a common association in hepatocellular carcinoma(HCC)-bearing liver and has been regarded as a premalignant condition with strong linkage to hepatitis B virus infection and cirrhosis. A total of 189 surgically resected livers [HCC(168 cases), cholangiocarcinoma(3 cases), metastatic carcinoma(3 cases), and non-neoplastic lesions(15 cases)] were reviewed to elucidate the nature of LCD by means of light microscopic examination, in situ hybridization method for HBV DNA and expression of proliferatin cell nuclear antigen(PCNA) using immunohistochemical technique. LCD was present in 141 cases(74.6%), and its prevalence rate was independently significant in HCCs with or without cirrhosis than other groups. There was no difference in mean age, although LCD-positive group was younger than its negative counterpart. Association rate of LCD in HCC-cirrhosis group was statistically significant than the non-cirrhotic group, and higher histological grading of LCD was correlated well with wider distribution pattern and clustering. Seropositivity of HBsAg was not correlated with presence of LCD or with histological grading. In situ hybridization techique using HBV DNA probe demonstrated fine granular stainable particles even in LCD cells. Immunohistochemical study for PCNA revealed that the proliferative activity of LCD was lower than that of the cirrhotic cell. With the above results it is concluded that LCD reflects neither a regenerating condition nor a premalignant lesion but suggest a reactive change.
Carcinoma, Hepatocellular ; Neoplasm Metastasis

Plasma renin activity (PRA) and aldosterone were measured to evaluate various status of clinical conditions in normal controls and patients with essential hypertension. Fourteen controls and 45 essential hypertensive patients for PRA, and 10 controls and 28 patients with essential hypertension for plasma aldosterone were studied. The results obtained are summarizing as follows. 1. Mean value of PRA of normal subjects was 2.9+/-1.4ng/ml/hr at rest, and 5.9+/-2.3ng/ml/hr by double stimulation, respectively, the latter elevated up to twice the former. 2. Mean value of PRA in the patients with essential hypertension was 3.37+/-3.0ng/ml/hr at rest, and 5.99+/-4.9ng/ml/hr by double stimulation. The latter have increased to 1.8 times the former. 3. The patients with low PRA observed in 33.3%, the normal in 42.2%, and the high in 22.5%, at rest. After double stimulation, the low group was observed in 22.2%, the normal in 60.0%, and the high in 17.8%. 4. Mean age of the patietns with low PRA was 57.2+/-2.6 years. Though it was higher than those of normal and high PRA groups(52.0+/-10.1 years), statistical significances were observed (0.05 Aldosterone* ; Blood Pressure ; Cholesterol ; Electrocardiography ; Furosemide ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular ; Motor Activity ; Plasma* ; Potassium ; Proteinuria ; Renin* ; Sodium ; Triglycerides