Sarcomatoid carcinomas are malignant epithelial neoplasms in which the tumor cells assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification of some true carcinomas as sarcomas. These spindle cells are malignant and manifest various amount of both vimentin and cytokeratin. Positive reaction of some of the spindle cells for cytokeratin antibodies is confirmatory. Clinical features do not differ significantly from those of patients with high-grade transitional cell carcinoma. So far, 13 cases of sarcomatoid transitional cell carcinoma of the renal pelvis have been reported in English and Korean literature. In this report, we describe clinicopathologic features of recently observed two cases of sarcomatoid transitional cell carcinoma of the renal pelvis and summarize the pathologic findings of previously reported cases with review of the literature.
Antibodies ; Carcinoma ; Carcinoma, Transitional Cell* ; Carcinosarcoma ; Classification ; Humans ; Keratins ; Kidney Pelvis* ; Sarcoma ; Vimentin

Arteriovenous malformation of the uterus is rarely encountered. It is potentially lethal because of profuse, uncontrollable bleeding at the time of diagnostic dilatation and curettage. To our knowledge, only 38 cases of localized uterine arteriovenous malformation have been reported in English and Korean literature. Recently we experienced a case of uterine arteriovenous malformation in a 28-year-old multiparous woman. Under the clinical impression of uterine tumors or arteriovenous malformation, a total hysterectomy was done. Gross examination demonstrated a vascular nature of the mass in the posterior wall of the fundus. Microscopically, there was an ill-defined mass composed of numerous irregular, anastomosing large vessels with various diameters.
Female ; Humans

BACKGROUND: It has been reported that hypercholesterolemia is associated with coronary heart disease and that alcohol intake has influence on the lipid metabolism. This study was conducted to evaluate the relations between alcohol intake and serum lipid level. METHODS: We reviewed 906 subjects who had visited for routine checkup at family practice of Hanil hospital and then excluded 130 subjects with DM, renal disease, thyroid disease, hepatic disease or drug administration which might have influence on serum lipids. From the remaining 776 subjects, we obtained the amount and the frequency of alcohol drinking during the previous 2 weeks and the duration of alcohol intake, using a formed questionnaire. The alcohol dependence score was recorded by the National Alcoholism Screening Test. The serum lipids such as total cholesterol, triglyceride, and HDL-cholesterol were tested by enzyme method and the obesity index was obtained by Broca's method. These data were analyzed by SAS/PC program RESULTS: The total number of subjects was 776. Of those, 67.7%(n=525) were male and 32.3%(n= 251) females. The mean age of subjects was 50.5 years(range 15 to 77 years). The distribution according to the obesity index was as follows ; underweight group 7.1%, normal-weight group 38.1%, overweight group 31.6%, obesity group 23.2%. The number of the drinkers was 382(49.2%) in males and 7 (0.9%) in females. The mean serum lipid level were compared and analyzed among the groups. The results were as follows ; the total cholesterol and triglyceride levels were higher in males and the HDL-cholesterol levels was higher in female. The total cholesterol and triglyceride levels increased with age and obesity index, the HDL-cholesterol level decreased with obesity index. In the relationship between alcohol intake and serum lipid levels in males, the geometric mean of triglyceride level was higher among all the variables of alcohol intake, and that of HDL-cholesterol level increased with the amount and the frequency of alcohol intake. The results of multiple regression analysis associated with age, obesity index, the amount and the frequency of alcohol intake in males were as follows ; the triglyceride level was positively associated with the amount of alcohol intake, and the HDL-cholesterol level was positively associated with the frequency of akohol intake. CONCLUSIONS: The effects of age, sex and the obesity index on the serum lipid level are remarkable, and in males, alcohol intake increases triglycaride and HDL-cholesterol levels. Further study is needed to find out about whether alcohol intake have influences on coronary heart disease according to serum lipid levels.
Alcohol Drinking ; Alcoholism ; Cholesterol ; Coronary Disease ; Family Practice ; Female ; Humans ; Hypercholesterolemia ; Lipid Metabolism ; Male ; Mass Screening ; Obesity ; Overweight ; Thinness ; Thyroid Diseases ; Triglycerides ; Surveys and Questionnaires

On a standpoint of commonly available ESWL for the treatment of urinary stone, percutaneous stone extraction had the role of cooperation to it, and sometimes it could be the first procedure of choice. We have performed percutaneous extraction of the renal and upper ureteral stones in 35 renal unite. The overall success rate was 78.4%, average operation time was 81 minutes, mean fluoroscopic exposure time was 11 minutes, average postoperative hospital stay was 7 days. Causes of failure were as followings ; five inadequate calyceal puncture, one ureteral perforation, one impacted stone, and one downward stone migration. The complications were inappropriate position of the nephrostomy tube, prolonged hematuria through nephrostomy tube, and partial ureteral avulsion. They were not serious but resolved by conservative management.
Hematuria ; Length of Stay ; Punctures ; Ureter ; Urinary Calculi

In Korea, the proportion of B-cell and T-cell lymphomas has not yet been clearly estimated. In the present study, we analysed clinicopathologic and immunophenotypic findings in 60 cases of non-Hodgkin's lymphomas(NHL) and in 17 cases of polymorphic reticulosis. Immunohistochemical studies for monoclonal antibodies, such as MB2, UCHL-1, Kappa/Lambda light chains, and IgG/IgM/IgD heavy chains were performed on formaldehyde-fixed paraffin embedded tissue sections. Among 60 cases of NHL, 28 cases(46.7%) expressed B-cell markers, 29 cases(48.3%) T-cell markers, and 3 cases(5.0%) lacked detectable markers, whereas 16 of 17 cases(94.2%) of polymorphic reticulosis reacted with T-cell markers. The mean survival of the 16 cases of T-cell lymphoma group was shorter than that of the lymphoma group positive for B-cell markers.

From December 1986 to August 1988, three patients with early prostatic cancer diagnosed primarily by fine needle aspriation cytology and/or Tru-cut needle biopsy underwent potency preserving radical retropubic prostatectomy. Herin we report the results and associated problems. Most difficulty was the diagnosis of the early prostatic cancer. We used fine needle aspiration cytology to diagnose the prostatic cancer primarily. One case of class V on the preoperative cytologic examination has proved to be BPH with chronic prostatitis postoperatively. Another problem was possibility of major bleeding intraoperatively, and complications were uncommon and not serious.
Biopsy, Fine-Needle ; Biopsy, Needle ; Diagnosis ; Hemorrhage ; Humans ; Needles ; Prostatectomy* ; Prostatic Neoplasms ; Prostatitis

From December 1986 to August 1988, three patients with early prostatic cancer diagnosed primarily by fine needle aspriation cytology and/or Tru-cut needle biopsy underwent potency preserving radical retropubic prostatectomy. Herin we report the results and associated problems. Most difficulty was the diagnosis of the early prostatic cancer. We used fine needle aspiration cytology to diagnose the prostatic cancer primarily. One case of class V on the preoperative cytologic examination has proved to be BPH with chronic prostatitis postoperatively. Another problem was possibility of major bleeding intraoperatively, and complications were uncommon and not serious.
Biopsy, Fine-Needle ; Biopsy, Needle ; Diagnosis ; Hemorrhage ; Humans ; Needles ; Prostatectomy* ; Prostatic Neoplasms ; Prostatitis

A wide range of denomination has been used for inflammatory myofibroblastic tumor (IMT). IMT is not entirely homogeneous, even though it shows some overlapping histologic features such as haphazard proliferation of spindle cell and polymorphic chronic inflammatory cell infiltraion. The spindle cell is considered to be of myofibroblastic origin but follicular dendritic cell origin was reported recently. IMT is known as nonneoplastic, aberrant inflammatory response. However, IMT could show local invasion, recurrence, vascular invasion, and malignant transformation, and clonal characteristics and aneuploidy of IMT support the hypothesis that IMT may be a neoplastic process. In order to define the nature of spindle cell of IMT, immunohistochemical stains for smooth muscle actin (SMA), vimentin (VMT), lysozyme, S-100 protein, cytokeratin, CD21 were done. Additional immunohistochemical stains for MIB-1 for proliferating activity and LMP (latent membrane protein) for Epstein-Barr virus (EBV) were done. IMTs were composed of each 2 cases from lung, liver and lymph node and one case from common bile duct, maxillary sinus, bladder and thigh, and were histologically subclassified according to Coffin et al. Nine cases (90%) were positive for SMA and VMT, but no correlation between SMA and VMT immunoreactivity and histologic types was identified. Five cases (50%) were positive for lysozyme and S-100 protein, and histologic type III was negative for lysozyme and S-100 protein, and immunoreactivity for S-100 protein was different according to the histologic subtypes. All 11 cases were negative for CD21 and EBV LMP. MIB-1 labelling index was less than 1% in all cases. In summary, the spindle cell is regarded as myofibroblastic origin rather than follicular dendritic cell origin. Relationship with EBV is not clear, and negligible MIB-1 reaction suggests that IMT might have a good prognosis.
Actins ; Aneuploidy ; Coloring Agents ; Common Bile Duct ; Dendritic Cells, Follicular ; Herpesvirus 4, Human ; Immunohistochemistry ; Keratins ; Liver ; Lung ; Lymph Nodes ; Maxillary Sinus ; Membranes ; Muramidase ; Muscle, Smooth ; Myofibroblasts* ; Prognosis ; Recurrence ; S100 Proteins ; Thigh ; Urinary Bladder ; Vimentin

Ultrasonography is a very useul diagnostic modality for the evaluation of clinically suspicious abdominalmasses in infants and children, especially in assessing their existence, size,location, origin and internalconsistency. Authors analyzed and present ultrasonographic findings of 92 pathologically and/or clinically provenpediatric abdominal masses that were studied and treated in Chonnam University Hospital during recent 4 years. Theresults were as follows: 1. The most common originating site was kidney(26 cases: 28.3%), followed bygastrointestinal tract (21 cases: 22.8%), genital organ(17 cases: 18.5%), non-renal retroperitoneum (13cases:18.5%), hepatobilary tract (12 cases:13.0%), and anterior abdominal wall (3 cases: 3.3%) in ordre offrequency. 2. The most common mass was hydonephrosis(18 cases: 19.6%). Neuroblastoma(7 cases:7.6%),hepatoblastoma, ovarian teratoma, periappendiceal abscess and abdominal tuberculosis(6 cases: 6.5%, respectively),Wilms tumor(5 cases: 5.4%) were next in order of frequency. 3. The sex distribution is rather similar, that is ,male 42(45.7%) and female 50(54.3%), but characteristically choledochal cyst(2 cases) and genital mass(17 cases)were found only in females. Considering age distribution, 78 cases(84.8%) were found within the range of one to 15years of age. The rest, 14 cases(15.2%), were under the age of one year. 4. With ultrasonography, the diagnosis ofhydronephrosis could be made easily in every case and we could evaluate its severity and level of obstruction withhigh accuracy. 5. All Wilms tumor were large, round or oval, sharply marginated and relatively homogenous solidmasses. 6. All neuroblastomas were irregular shaped, poorly defined, heterogeneous solid masses. Tumorcalcification and extension across the midline were noted in 6 cases(85.7%) and 5 cases(71.4%), respectively. 7.All periappendiceal abscesses had irregular thickened wall and posterior acoustic enhancement: 4 cases (66.7%)among them were mixed echo pattern and 2 cases(33.3%) ehco free. 8. Among the 6 abdominal tuberculoses, 2 wereseen as irregularly defined solid masses, 1 as conglomeration of multiple hypoechoic nodulles and 3 as mixedpatterns. 9. All hepatoblastomas were seen to be poorly marginated solid masses with more echogenicity thanadjacent normal hepatic echo in 5 cases except one. 10. Among the 6 ovarian teraomas, 4 cases were cystic and 2cases solid. Acoutic shadowing was seen in 3 cases. 11. Choledochal cyst (2 cases), hydrops of gallbladder(1cases) and cyst of pancreas head(1 cases) had similar ultrasonic appearance as a large elliptical systic mass,but, it was important in differential diagnosis to ascertain the existence of gallblader and the connectionbetween the cyst and bile duct.
Abdominal Wall ; Abscess ; Acoustics ; Age Distribution ; Bile Ducts ; Child ; Choledochal Cyst ; Diagnosis ; Diagnosis, Differential ; Edema ; Female ; Hepatoblastoma ; Humans ; Infant ; Jeollanam-do ; Male ; Neuroblastoma ; Pancreas ; Sex Distribution ; Shadowing (Histology) ; Teratoma ; Tuberculosis ; Ultrasonics ; Ultrasonography ; Wilms Tumor

PURPOSE: The aim of this study was to identify the factors influencing nursing performance in caring for patients with delirium.METHODS: This study included 166 nurses who worked for more than 6 months at 4 general hospitals in Jeju Province, South Korea. Patients were administered a self-reported questionnaire. The study was carried out from May 20, 2014, to June 19, 2014. Data analyses were conducted using stepwise multiple regression, Pearson's correlation coefficients, t-test, and analysis of variance using the SAS WIN 9.2 program (SAS Institute, Cary, NC, USA).RESULTS: The factors associated with nurses' performance in delirium care were work position (β=.22, t=2.58, p < .001) and having received education on delirium care (β=.16, t=2.24, p=.026).CONCLUSION: The results showed that the nurses' work position and having received education on delirium care affected nursing performance in delirium care. In order to improve nurses' performance in delirium care, hospitals should provide a delirium education program for nurses and establish standard guidelines on delirium care.
Delirium ; Education ; Hospitals, General ; Humans ; Korea ; Nursing ; Statistics as Topic