The authors developed a computer program for use in report printing as well as data storage and retrieval system at the surgical pathology and its efficacy was evaluated at the Department of Pathology, Seoul National University Hospital. This program used IBM PC XT and was written in DBASE III plus language. The main features of the program included an automatic coding and decoding of the diagnosis, automatic searching of the previous biopsy during gross dictation, powerful word processing function and flexibility of the program. The data storage was carried out during the typewriting of the report, so that the typist's workload became markedly reduced. Two kinds of data files wer stored in the hard disk ; the temporary file contained full informations and the permanent file contained the core data only. Searching of a specific case was performed by pathology accession number, chart number, patient's name or by SNOMED code within a second. All the cases were arranged by copied to the diskette during the daily service automatically, with which data were easily restored in case of hard disk failure. The advantages of this program using a persosnal computer were discussed with comparison to those of larger computer system. Based on the experience of 8 months usage in Seoul National University, we assume that this program gives a sufficient solution to the surgical pathology service of many institutes where a large computer system with well designed software is not available yet.
Biopsy

No abstract available.
Aged* ; Femur* ; Humans

Herpes simplex esophagitis can occur in those with normal immune function, but is more often seen in those who are immunocompromised. In one series, 5 percent of post-kidney transplant recipients had herpes esophagitis. We experienced a case of herpes simplex esophagitis, following renal transplantation in a 9 year old male. He complained of epigastric pain, nausea and blood-tinged vomiting. Endoscopic examination showed volcano ulcer, mucosal friability and multiple confluent ulcers covered by whitish exudates on elevated margin in the middle and lower esophagus. Microscopic findings revealed multinucleated giant cells, margination of chromatin, intense nonspecific inflammation and strong positive for herpes simplex virus immunohistochemical staining. Esophageal lesions and symptoms improved after acyclovir therapy.
Acyclovir ; Child* ; Chromatin ; Esophagitis ; Esophagus ; Exudates and Transudates ; Giant Cells ; Herpes Simplex* ; Humans ; Inflammation ; Kidney Transplantation ; Male ; Nausea ; Simplexvirus* ; Transplantation ; Ulcer ; Vomiting

No abstract available.
Intestinal Atresia*

The author reports an anesthetic experience of right adrenalectomy. The patient was 38 years old male, having suffered from pheochromocytoma. Thiopental sodium, 300mg of 2.5% was used for induction, followed by N2O, O2, and halothane for maintenance and 0.1% S.C.C. solution in 500 ml of 5% D/W solution, dripped intravenously for muscle relaxation. AS the time of surgical manipulation of the gland, blood pressure was suddenly raised to 250/160mmHg, and a few minutes later massive bleeding, about 1800ml in amount, was detected in the operating and then the heart was arrested. Resuscitation was performed with adequate oxygenation and medications. The patient recovered well without any sequelae. The importance of preoperative preparation, sufficient sedation, smooth anesthetic induction, complete analgesia, good muscle relaxation, adequate ventilation and proper cardiovascular control are discussed together with the choice of anesthetic agents and practices.
Adrenalectomy ; Adult ; Analgesia ; Anesthetics ; Blood Pressure ; Halothane ; Heart ; Hemorrhage ; Humans ; Male ; Muscle Relaxation ; Oxygen ; Pheochromocytoma* ; Resuscitation ; Thiopental ; Ventilation

Anesthesia was induced with intravenous thiopental, followed by succinylcholine, N2O-O2-halothane and pancuronium. An endotracheal semiclosed circle absorption technic with controled ventilation was performed. Under continuous monitoring of blood pressure, pulse, EKG, CVP and urine output, the patient tolerated during the anesthetic period well. And high blood pressure was adequately controlled by increasing the percentage of halothane concentration only.
Absorption ; Adrenalectomy* ; Anesthesia ; Blood Pressure ; Electrocardiography ; Halothane ; Humans ; Hypertension ; Pancuronium ; Succinylcholine ; Thiopental ; Ventilation

BACKGROUND: Soluble IL-2R, soluble CD8 and TNF-alpha are elevated in sera of some patients with hematological malignancies, and a marked elevation of these cytokines could be used to assess disease activity and prognosis in this malignancy group. METHODS: The serum levels of sIL-2R, sCD8 and TNF-alpha were assessed in 28 patients with myelodysplastic syndrome (MDS) and 32 patients with acute myeloid leukemia (AML), and 39 cases of healthy control subjects to define clinical usefulness as prognostic markers by sandwich enzyme immunoassay. RESULTS: In MDS patients, serum sIL-2R levels were significantly higher as compared with controls, and a more pronounced increase of serum sIL-2R levels was found in patients with RAEB RAEB-t and CMML as compared with RA and RARS. Serum sCD8 levels were higher as compared with controls, but not related with FAB classification. In patients with leukemic conversion. sCD8 levels tended to be higher as compared with patients with non-conversion. The sIL-2R levels of AML patients were significantly higher than controls, and a significant correlation was detected between the levels of sIL-2R and WBC counts. Higher sIL-2R levels( >2000 U/ml) tended to affect both complete remission rate and survival. Serum sCD8 levels were higher than controls, but not related to FAB classification. No differences of serum TNF-alpha levels were detected as compared with healthy controls. CONCLUSIONS: From these results, this study indicates that serum sIL-2R and sCD8 are significantly increased in some patients with MDS and AML, and increased levels of serum sIL-2R and sCD8 may be useful for predicting prognosis of these patients.
Anemia, Refractory, with Excess of Blasts ; Classification ; Cytokines ; Hematologic Neoplasms ; Humans ; Immunoenzyme Techniques ; Leukemia, Myeloid, Acute* ; Myelodysplastic Syndromes* ; Prognosis ; Tumor Necrosis Factor-alpha*

Astrovirus is frequently associated with diarrhea in children. It can not be readily isolated by cell culture, and an electronmicroscope is usually used for detection of this agent. Recently in 1995 a combined method of reverse transcription-polymerase chain reaction (RT-PCR) was designed for easier detection of astrovirus, which is based on the conserved sequence in 3'-end of genomes of the 7 known serotypes of human astrovirus. As of yet there has not been any report of astrovirus data in Korea using the RT-PCR methods. The purpose of this study was to detect astrovirus incidence, severity of symptoms, seasonal variation and coinfection rate with rotavirus in Korean children inpatients with diarrhea. Fecal specimens from 61 young children hospitalized with gasteroenteritis Korea from Jan. 1996 through Mar. 1997. They were examined for astroviurs infection by RT-PCR method. Results are as follows: 1. Astrovirus was detected at 9.8% (6/61) from fecal specimens of children with severe diarrhea by EIA using monoclonal antibody coated plates. 2. Astorvirus was detected at 29.5% (18/61) from fecal specimens of children with severe diarrhea by RT-PCR. 3. The age of the 18 children affected by astrovirus ranged from 2 monthes to 7 years with mean of 3.0 years. 4. Mean hospital stay of the 1S children was 6.1 days. 5. Five (27.8%) astrovirus RT-PCR positive strains were confirmed in November and in December, respectively out of 18 specimens in total. 6. Astrovirus coinfection with rotavirus type G1 was confirmed in 15/16 specimens (93.8%), and with type G2 was in 1/16 specimens (6.3%).
Cell Culture Techniques ; Child* ; Coinfection ; Conserved Sequence ; Diarrhea ; Feces* ; Genome ; Humans ; Incidence ; Inpatients ; Korea ; Length of Stay ; Mamastrovirus ; Polymerase Chain Reaction* ; Reverse Transcription* ; Rotavirus ; Seasons

This study is based on 155 patients of congenital me colon. For the diagnosis, 93 cases were histologically proven and the remaining 63 cases were diagnosed on clinical basis including barium enema or surgical gross findings. On histologic examination, 80 cases(86%) showed typical features of absence of ganglion cell in the myenteric plexus and the 13 cases(14%) had atypical features which were segmental absence Of ganglion cell in one case. There we 127 males(82%) and 28 females(18%). The age at diagnosis was younger than 30 days in 87 cases(56%), I month to 1 year in 39 cases(25%) and older than I year in 29 cases(18%). The levels of aganglionosis were variable: short segment (rectosigmoid) in 134 cases(86%), intermediate segment (more proximal colon) in 14 cases(100%). and 6 cases(4%) had total aganglionosis. Common clinical presentations were abdominal distention, delayed meconium passage or bilious vomiting in neonate, and chronic constipation in infancy or childhood. Following initial colostomy or ileostomy, a definitive procedure was performed in 151 cases(Duhamel type in 150 cases; Soave type in 2 cases; Swenson type in 3 cases). Frequently associated problems after definitive procedure were persistent constipation(ll%) due to septum formation, fecaloma, remnant aganglionic segment and rectal stenosis. Overall mortality rate was 4%, and increased mortality was associated with enterocolitis(14%) which was the most frequent cause of death. The follow-up study longer than 3 months was available in 138 patients who underwent a definitive procedure(mean 2 year 11 months). Seventy-three cases(53%) had normal bowel function, 38cases(27.5%) had occasionally used enema or stool softners, and 27 cases(19.5%) had severe constipation or soiling. The bowel habit improved with time, and were considered normal in 60% of patients after follow-up more than 3 years. The results of definitive procedures for congenital megacolon including Duhamel operation was satisfactory, and long-term follow-up appeared an important and critical component of patients'care.
Child ; Male ; Female ; Infant, Newborn ; Humans ; Mortality ; Follow-Up Studies

No abstract available.
Caroli Disease*