Solid and papillary epithelial neoplasm of the pancreas is a rare, low grade malignant tumor of adolescence. The tumor we described was diagnosed by following preoperative percutaneous fine needle aspiration biopsy and confirmed by tissue examination. Characteristic cytologic findings were monotonous cells arranged in papillary fronds, acinus, and cords in necrotic and hemorrhagic backgrounds. Occasional foamy histiocytes and hyaline globules were present. The cytoplasm of the tumor cells were moderate in amount, pale eosinophilic or vacuolated with distinct borders. The nuclei were centrally located and round. There were one or two small nucleoli and finely granular chromatin throughout the nucleus.
Adolescent ; Male ; Female ; Humans ; Diagnosis, Differential ; Biopsy

This is a case of recurrent malignant fibrous histicytoma, histologic features of which are reminiscent of a clear cell carcinoma of soft tissue or myxoid liposarcoma. The tumor recurred 2 years and 10 months after the initial removal of the primary tumors in the lateral aspect of the left tigh. In view of histogenesis of malignant fibrous histiocytoma, possibility of recurrent tumor with a wide range of histologic features including clear cell type is discussed. Pertinent clinical history with review of the initial tumor is mandatory for a definite assessment of histologic feature of recurrent malignant fibrous histiocytoma.

BACKGROUND: Emergency Medical Technicians can do emergency care only under the control of the physicians. Emergency medical services system(EMSS) in Korea is now extended from the level of basic life support(BLS) to advanced life support(ALS). Unfortunately we don't have any official medical control system yet. We and regional EMSS, 119 rescue team(BLS), have had monthly joint meeting to validate and improve the prehospital care since August, 1998. METHODS: From August, 1998 to February, 1999, 1,708 patients were transported to Ewha Mokdong Hospital by regional 119 rescue team. Eight hundred and six(47.2%) run record were collected and analyzed. The appropriateness of the prehospital care were evaluated based on the comparison of assessment data and treatment data in each run record. The run record were divided into 5 groups; 1) necessary-adequate, 2) necessary-inadequate, 3) necessary-undo, 4) unnecessary-done, and 5) unnecessary-undo. 1) and 5) were judged as acceptable, and 2), 3), and 4) as unacceptable. RESULTS: Among 806 transported patients, 60.8% required one or more emergency care. 21.0% of required care were not provided, and 20.7% of provided care were not adequate. 78.8% of unprovided and 75.9% of inadequate care were 'airway and oxygen supply'. Overall unacceptable rate was decreased from 31.7% to 17.0% during first 5 months, but it rose up again to 24.7% after 2 months. Cardiopulmonary resuscitation(CPR) was performed in 29 prehospital cardiac arrest victims and admitted to ICU in 5 cases. CPR was not provided in 8 necessary situations, and unnecessary CPR was done in 3 cases. CONCLUSION: EMSS in Korea also need a kind of medical control system, even for BLS level. Major portion of the quality assurance program could be 'airway and oxygen supply', but attention should be focused in cardiac arrest victims and CPR. Record keeping and reliance of run record data are now pending problems. Fire department should develop a formal medical control system and the referring hospital should have an organization for maintaining the quality of prehospital care.
Cardiopulmonary Resuscitation ; Emergency Medical Services* ; Emergency Medical Technicians ; Fires ; Heart Arrest ; Humans ; Joints ; Korea ; Oxygen ; Retrospective Studies*

No abstract available.
Erythema Infectiosum*

No abstract available.
Humans* ; Keratinocytes* ; Protein-Serine-Threonine Kinases* ; Serine* ; Threonine*

Acrokeratosis verruciformis is a familial disease characterized by indolent papules resembIing flat warts on the backs of the hands and feet with lesser involvement of volar surfaces, wrists, and ankles. A cas of 42 years old female with acrokeratosis verruciformis is reported. The skin lesions of this patient showed numerous rice to pea sized, flat-topped, round or polygonal, warty papules on the dorsal aspects of the hands and feet and also, pitted keratolysis on both volar surface of the hands. The hitologic findings were those of features of acrokeratosis verruciformis, i.e. the epidermis shows marked hyperkeratosis with slight acanthosis and papillomatosis and circumscribed elevations of the epidermis resembling church spires characteristically.
Adult ; Ankle ; Darier Disease* ; Epidermis ; Female ; Foot ; Hand ; Humans ; Papilloma ; Peas ; Skin ; Warts ; Wrist

No abstract available.
Hepatitis, Chronic*

No abstract available.
alpha-Fetoproteins* ; Humans ; Infant* ; Infant, Newborn*

No abstract available.
Uterus*

BACKGROUND: Caudal anesthesia is considered a safe and reliable anesthetic technique for many pediatric surgical procedures. It is well known that extradural clonidine produces analgesia in adult. The purpose of this study is to assess its efficacy in children. METHODS: We randomized 45 pediatric patients aged under 10 years, weighted under 25 kg presented for lower abdominal surgery with duration of operation would be shorter than 2 hours, into three groups of 15 each. After sedation with the use of intravenous thiopental sodium, caudal anesthesia was performed with the use of 1 mL/kg of 0.25% bupivacaine. We allocated randomly the patients who received no additional medication in 0.25% bupivacaine (group I), with epinephrine 1/200,000 (group II), and with 1 mcg/kg of clonidine (group III). The degree of postoperative analgesia was evaluated using the Broadman ""Objective Pain/discomfort Scale"" (OPS) at hourly intervals for 24 hours. RESULTS: Duration of sleep in the recovery room was significantly longer in group III than in group I and group II, and statistical significant difference was found between the group I and group II. Duration of analgesia was significantly longer in group III than in group I and group II. Overall hourly OPS scores were lower in group III than in group I and group II. CONCLUSION: Duration of postoperative analgesia with caudal bupivacaine was increased by addition of 1 mcg/kg of clonidine.
Adult ; Analgesia ; Anesthesia, Caudal* ; Bupivacaine ; Child ; Clonidine* ; Epinephrine ; Humans ; Recovery Room ; Thiopental