Cellular schwaninoma is a variant of schwannoma, which is characterized by predominance of cellular Antoni A area, presence of mitotic activity, nuclear hyperchromasia, pleomorphism, and absence of Verocay body. These pathologic features often prompted a misdiagnosis of malignancy. However, the clinical outcome has indicated the benignity of the tumor. We have experienced a case of cellular schwannoma arising from right facial nerve with right hemifacial weakness and erosion of mastoid process. Grossly, it was a 3.5 x 3 cm sized and relatively well encapsulated mass with yellowish, friable cut surface. Microscopically, cellular growth with moderate cellular pleomorphism and some mitotic activity (5/40 HPFS, up to 2/HPF) were noted. Immunostaining for S-100 protein showed diffuse strong positive reaction.
Diagnostic Errors ; Facial Nerve* ; Mastoid ; Neurilemmoma* ; S100 Proteins

OBJECTIVE: To determine the changes of nitric oxide production in preeclampsia, the concentration of nitric oxide metabolite, nitrite, was measured in umbilical vein after perfusing plasma from normal pregnant women and preeclamptic pregnant women. MATERIAL AND METHOD: 15 normal and 15 preeclamptic umbilical cords were obtained at the time of cesarean section. Two pieces of umbilical cord in equal length(20 cm in length) were prepared from each umbilical cord. Two pieces of umbilical cord were connected in parallel in a perfusion chamber. One piece of umbilical cord was perfused sequentially for 20-minutes' interval with the perfusates in the order of cord buffer, cord buffer including 15% normal pregnant serum, 15% normal pregnant serum with histamine(10-5mol/L), 15% normal pregnant serum with calcium ionophore A23187(5 mol/L) and the other one was perfused exactly same way using 15% preeclamptic serum instead of 15% normal pregnant serum. All the perfusates used were gassed with 95% O2 and 5% CO2 and warmed to 37degree C. Perfusates were collected in eppendorf tube and freezed at -70degree C until assayed. NO was measured by means of Greiss reaction. one way ANOVA and paired t-test were used where appropriate and p-value < 0.05 was considered significant. RESULTS: NO production in normal umbilical cords was not different regardless of perfusate. Although adding histamine and calcium ionophore, the NO production was slightly increased but statistically not significant in both groups. NO production in preeclamtic umbilical cords was significantly increased with 15% preclamptic serum(15% normal serum vs. 15% preeclamptic serum; 0.060+/-0.016microgram/ml/min vs 0.075+/-0.014microgram/ml/min, p<0.05). CONCLUSION: The preeclamptic sera may not affect the production of NO in the human umbilical vein endothelial cells. The biologic significance of increased NO production in preeclamptic umbilical cord with perfusing preeclamptic serum is unknown, but it might be compensation for the vasoconstriction of preeclampsia.
Calcium ; Cesarean Section ; Compensation and Redress ; Female ; Histamine ; Human Umbilical Vein Endothelial Cells ; Humans ; Nitric Oxide* ; Perfusion ; Plasma ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Umbilical Cord ; Umbilical Veins ; Vasoconstriction

BACKGROUND: Seborrheic dermatitis is a very common chronic inflammatory disease. Previous studies suggested that, Pityrosporum, lipophilic fungi, may play an important role in the pathogenesis of the disease. OBJECTIVE: The purpose of this study was to investigate the disease clinically and mycologically for better understanding of the pathogenesis. METHODS: Two hundred and one new patient.s with seborrheic dermatitis of the scalp and 67 norrnal subjects were obs!,rved clinically by the dermatologist and studied stat,istically by questionnaires. A mycologic study of Pityrosporum was also performed by direct smear. RESULTS: Among a total of 201 patients wit,h seborrheic dermatitis, 72.6% had pityriasis sicca, 10.5% had pityr iasis steartoides and 16.9% had inflammatory seborrheic dermatitis. On clinical grading by the Kligman.. scale, grade III(slightly scaling) was the most common in the patients and 52.6% of the norma. subjects were below grade II (no scaling). Spores of Pityrosporum were observed in 76.7% of the patients and 91.5% of the normal subjects. The incidence of Pityrosporum was lower particularly in t,he patients with inflammatory seborrheic dermatitis t,han in other pa~tients groups. CONCLUSION: According to the results of the study, it, is difficult to conclude that Pityrosporum is a main causative ager t of seborrheic dermatitis. In addition, it is thought t.hat further studies of the role of Pityrosporum in seborrheic dermatitis are needed.
Dermatitis, Seborrheic* ; Fungi ; Humans ; Incidence ; Malassezia* ; Pityriasis ; Scalp* ; Spores ; Surveys and Questionnaires

BACKGROUND: Seborrheic dermatitis is a very common chronic inflammatory disease. Previous studies suggested that, Pityrosporum, lipophilic fungi, may play an important role in the pathogenesis of the disease. OBJECTIVE: The purpose of this study was to investigate the disease clinically and mycologically for better understanding of the pathogenesis. METHODS: Two hundred and one new patient.s with seborrheic dermatitis of the scalp and 67 norrnal subjects were obs!,rved clinically by the dermatologist and studied stat,istically by questionnaires. A mycologic study of Pityrosporum was also performed by direct smear. RESULTS: Among a total of 201 patients wit,h seborrheic dermatitis, 72.6% had pityriasis sicca, 10.5% had pityr iasis steartoides and 16.9% had inflammatory seborrheic dermatitis. On clinical grading by the Kligman.. scale, grade III(slightly scaling) was the most common in the patients and 52.6% of the norma. subjects were below grade II (no scaling). Spores of Pityrosporum were observed in 76.7% of the patients and 91.5% of the normal subjects. The incidence of Pityrosporum was lower particularly in t,he patients with inflammatory seborrheic dermatitis t,han in other pa~tients groups. CONCLUSION: According to the results of the study, it, is difficult to conclude that Pityrosporum is a main causative ager t of seborrheic dermatitis. In addition, it is thought t.hat further studies of the role of Pityrosporum in seborrheic dermatitis are needed.
Dermatitis, Seborrheic* ; Fungi ; Humans ; Incidence ; Malassezia* ; Pityriasis ; Scalp* ; Spores ; Surveys and Questionnaires

No abstract available.
Female ; Humans ; Prevalence*

OBJECTIVE: The changes of the production of nitric oxide in preeclampsia are still controversial. To determine the changes of nitric oxide production in preeclamptic pregnancies, NOS activity and eNOS and iNOS expression in preeclamptic placentae were compared with those in normal placentae, and to determine the changes of nitirc oxide production according to the sites of placenta, NOS activity and eNOS expression in preeclamptic placentae were also compared with those in normal placentae. METHODS: Human placentae were obtained from 15 normal and 15 preeclamptic pregnant women at the time of cesarean section. NOS activity was assessed by measuring the conversion of [3H]-arginine into [3H]-citrulline. The eNOS and iNOS expression were assessed by using western blot analysis. Data were analyzed by Student t-test and paired t-test where appropriate. RESULTS: The NOS activity(judged by measurement of [3H]-citrulline production) was significantly increased in preeclamptic placentae compared to normal(P<0.05). In normal and preeclamptic pregnant placentae, the NOS activity in main stem villi was increased compared to that in terminal villi. However, the difference of NOS activity between main stem villi and terminal villi was not significant(P>0.05). Quantification of the autoradiographic images demonstrated that the integrated optical density of the immunoreactive bands of eNOS were significantly lower in preeclamptic placentae compared to normal(p<0.05). Conversely, the integrated optical densities of the bands of iNOS were significantly higher in preeclamptic placentae compared to normal(p<0.05). CONCLUSIONS: Although the eNOS expression in preeclamptic placentae was lower than that in normal placentae, the NOS activity was significantly higher in preeclamptic placentae than that in normal in this study. These are result from increased production of iNOS in the compensatory mechanisms for the decreased nitric oxide production in pre-eclamptic placentae.
Blotting, Western ; Cesarean Section ; Female ; Humans* ; Nitric Oxide Synthase* ; Nitric Oxide* ; Placenta* ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women

We describe a case of fine needle aspiration cytology of metastatic nasopharyngeal carcinoma in the lymph node of the neck presenting a predominantly spindle cell pattern. A 36 year-old male patient complained of dysesthesia on the right face and a palpable neck mass. Fine needle aspiration was done on the neck mass. Tumor cells were present in syncytial groups or singly with mainly spindle shaped nuclei, vesicular chromatin, thin and regular nuclear membrane, occasional prominent nucleoli and a few foci of cellular cohesiveness. The cytoplasm was scant and pale with ill-defined borders. Mature lymphocytes were present in the background of aspirates and within the tumor cell clusters. Histologically, the tumor of nasopharynx showed several areas of spindle cell pattern. Because the tumor cells showed a predominantly spindle shape with vesicular nuclear chromatin, the differential diagnosis of spindle cell sarcoma or granuloma of epithelioid cells were considered, but the characteristic morphology of the nuclei with vesicular chromatin and prominent nucleoli, and cellular cohesiveness were important in making the diagnosis of nasopharyngeal carcinoma. The possibility of metastatic carcinoma should always be considered in fine needle aspiration cytology of the lymph node in the neck because the incidence of metastatic carcinoma, particularly of the nasopharyngeal carcinoma in the lymph nodes of the neck is relatively high.
Child ; Male ; Female ; Humans ; Diagnosis, Differential ; Incidence ; Neoplasm Metastasis

OBJECTIVES: The critical pathways provide high quality of medical services in a cost-effective manner. To investigate the decrease in length of hospital stay and increase of cost effectiveness by using critical pathways, we compared hospital stay, cost of treatment, and the patient's satisfaction before and after critical pathway use. METHODS: We made a critical pathway team, which consisted of obstetric staff members, a resident, two nurses, a pharmacist, two clerical staff members. We made critical pathways for the medical team and patients. A prospective evaluation of a critical pathway for cesarean section was used as a comparison for control patients. RESULTS: The data for 305 patients with a critical pathway were compared to those of 136 control patients. The mean hospital stay is shorter in critical pathway patients than control patients. The cost of treatment decreased and differences between DRG (Diagnosed Related Groups) and cost of treatment increased in critical pathway patients. CONCLUSIONS: Using critical pathways in cesarean section decreased the duration of hospital stay and increased cost effectivesess. The critical pathways were useful as a means to minimize cost while increasing patient satisfaction.
Cesarean Section* ; Cost-Benefit Analysis ; Critical Pathways* ; Diagnosis-Related Groups ; Female ; Humans ; Length of Stay ; Patient Satisfaction ; Pharmacists ; Pregnancy ; Prospective Studies

OBJECTIVE: To evaluate whether twin discordancy is a risk factor for adverse perinatal and neonatal outcomes. METHODS: Three hundred and seventy-five twin gestations over 28 weeks of gestation were included in this retrospective study. Medical records of mothers and infants were reviewed. Pregnancies were divided into 2 groups according to the birth weight discordancy(%) between twin neonates(group I;less than 25%, group II;25% or more). Birth weight discordancy was calculated from following formula; (birth weight of larger twin-birth weight of smaller twin)/birth weight of larger twin x 100. Perinatal and neonatal outcomes in group I and II were compared with each other. Also, difference in the outcomes between the smaller and larger twins of group II was evaluated. To evaluate whether birth weight discordancy is an independent variable in predicting poor perinatal and neonatal outcomes, multiple logistic regression analysis was used. RESULTS: Thirty-seven gestations(9.9%) were documented to belong to group II. Group II showed significantly higher incidence of preeclampsia, placenta previa, and small for gestational age infants(p<0.01, p<0.05 and p<0.001, respectively). The group also showed higher incidence of adverse neonatal outcomes(admission to neonatal intensive care unit, respiratory distress syndrome, pneumonia, bronchopulmonary dysplasia, patent ductus arteriosus, intraventricular hemorrhage, retinopathy of prematurity, necrotizing enterocolitis, sepsis, congenital anomaly, neonatal death, p<0.01). Outcomes of the larger and smaller twins of group II were not significantly different with each other except small for gestational age infants(p<0.005). However, birth weight discordancy was not an independent variable in predicting adverse perinatal and neonatal outcomes. CONCLUSION: Fetal growth discordancy of 25% or more should be regarded as a risk factor for adverse perinatal and neonatal outcomes in twin gestations. However it is not an independent factor in predicting adverse perinatal and neonatal outcomes.
Birth Weight ; Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Fetal Development* ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Logistic Models ; Medical Records ; Mothers ; Placenta Previa ; Pneumonia ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Twin ; Retinopathy of Prematurity ; Retrospective Studies ; Risk Factors* ; Sepsis

This is a nonequivalent control group pretest- posttest design in quasi experimental basis to assess how the thermal head and feet support influences on early stage weight gain in premature neonates. The clients were selected among the premature infants with the weight under 2000gms and with the gestational period under 37 weeks, admitted over 15 days in K university hospital, Seoul. The control group of 29 were selected from January 1998 to August 1998, who were without head and feet thermal support, and the experimental group of 30 were selected from September 1998 to May 1999, who were with the two thermal interventions. The results of the study follow, 1.The experimental group with thermal interventions showed more weight gain than the control group without thermal interventions, which was statistically significant between the two groups. 2.The physiological weight loss after birth showed less in the experimental group than in the control group. 3.The recovery of the birth weight after the physiologic weight loss showed no statistical difference between the experimental group and the control group. Consequently, the thermal head and feet supportive nursing intervention could be applied as a nursing intervention program to help the premature neonates' development. With the results above we should like to suggest the following: 1) A continuous application in the practice of our thermal supportive intervention for the premature neonates, a development of the content through evaluation, and a comparision of the results through a long time study. 2) A neccessity of deveopment of various study and cross comparision. 3) A neccessity of multi-angular study on the premature infants' characteristics influencing the thermal therapy and the study of the individual differences of the clients.
Birth Weight ; Body Weight ; Foot* ; Head* ; Humans ; Individuality ; Infant, Newborn* ; Infant, Premature ; Nursing ; Parturition ; Seoul ; Time and Motion Studies ; Weight Gain* ; Weight Loss ; Child Health