We present an autopsy case of signet ring cell carcinoma of urinary bladder which underwent widespread metastsis through nearly entire organ. The patient, 45-year old male, suffered from hematuria, dysuria and flank pain for 6 months. Under the diagnosis of the signet ring cell carcinoma by the cystoscopic biopsy, radical cystectomy and ileocutaneous ureteral division were performed. But he died after 11-months after the diagnosis. The autopsy confirmed the widespread metastasis at the lung, kidney, adrenal gland, parathyroid gland, heart, stomach, ileum, spine, rib and meninges. The preveously resected urinary bladder discolosed the well defined fungating mass at the dome and anterio-lateral portion without apparent evidence of the remnant of the urachus. Histologically, the signet ring cells were predominent and focally mucinous pool floating the signet ring cells was noted. We could find several foci of the well differentiated adenocarcinoma and poorly differentiated adenocarcinomas. The above findings may reflect that the origin of carcinoma may be from the multipotential transitional cell epithelium.
Adenocarcinoma ; Neoplasm Metastasis

This is a long term follow-up study to clarify whether arthroscopic synovectomy would be able to prevent further destruction of the articular cartilage in rheumatoid joints. Three hundred and eighteen rheumatoid joints of 94 patients who had surgery in the multiple joints(average 3.4 joints per person) and was followed for an average 39.9 months (range, 24-126 months) were selected. Diagnosis of rheumatoid arthritis was made according to the 1987 revised criteria of the American College of Rheumatology. The preoperative roentgenographic narrowing of cartilage space (modified classification of ARA) and the arthroscopic findings (grading of Outerbridge) were recorded. The points of investigation were 1) further destruction of articular cartilage on X-ray, postoperatively, and 2) reaccumulation of effusion. The results were as follows; 1) Knee Joint: Among 103 knee joints there were 92 (89.3%) Stage I, G-0 knees, 8 Stage II (G-2: 1, G-3: 3, G-4: 4 joints), and 3 Stage IIIB, G-4, preoperatively. The 3 Stage IIIB, G-4 knees showed progression of narrowing of joint space and were replaced by artificial joints two years after the synovectomy. 2) Wrist joint: Fifteen joints (28.3%) out of 53 joints were Stage II, G-4, and 2 joints joints (3.8%) were Stage I, G-3, preoperatively. They were progressed to Stage IIIB at final follow-up. 3) Other Joints: There was no further narrowing of the joint space following surgery in 22 fingers, 2 toes, 34 elbows, 34 shoulders and 70 ankles. 4) Prognosis seemed to depend upon postoperative medication. From these results it would be suggested that the rate and severity of recurrence of synovitis and further destruction of articular cartilage can be decreased with early synovectomy so long as proper anti-rheumatic medication is followed, although the surgery can not halt the disease process.
Ankle ; Arthritis, Rheumatoid ; Cartilage ; Cartilage, Articular ; Classification ; Diagnosis ; Elbow ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Prognosis ; Recurrence ; Rheumatology ; Shoulder ; Synovitis ; Toes ; Wrist Joint

PURPOSE: To develop an efficient journal searching program. MATERIALS AND METHODS: A graphic user interface oriented program was developed with Microsofts Access 2.0 and its Deveolper Tool Kit under the Windows system. The program needed four floppy diskettes {4.5 megabyte) for in stallment. With the author, title, journal name, volume and pages, index words, and abstracts from JKRS and JKSMU as the input data, the utility of the program was tested for its journal searching ability in 486 DX II with 8 megabyte main memory. RESULT: The author, titlie, index word, abstract, and variable queries were carried out from 3,200 articles within 13 seconds. The test of the program satisfied and useres, radiologists, and physicians. CONCLUSION: The program is recommended for seaching of journals as it is very eary to use and userfriendly.
Abstracting and Indexing as Topic* ; Humans ; Memory ; Microcomputers*

In the intestinal perforation during hydrostatic reduction for intussusception, the diluted isotonic Gastrografin may prevent body fluid shifting to peritoneal space, and granulomatous reaction resulting in intestinal obstruction, which can be induced by Barium on the peritoneal surface. We have experienced two perforations from 563 Gastrografin reductions during the last five years. One of the perforated cases had no complication on one year follow up after ileocecectomy, but the other, who was in the state of shock before the reduction, died at 133rd day after the operation. The cause of death was aspiration during the feeding. We report the above two cases of intestinal perforation by Gastrografin reduction without evidence of fatal complication.
Barium ; Body Fluids ; Cause of Death ; Child* ; Colon* ; Diatrizoate Meglumine* ; Follow-Up Studies ; Humans ; Intestinal Obstruction ; Intestinal Perforation ; Intussusception* ; Shock

Vanadate is a trace element in animal tissues and has been known to inhibit NA(+)-K(+) ATPase in various tissues including skeletal and cardiac muscles and smooth muscles. Vanadate shows contractile actions on various types of smooth muscles. Prolonged dietary administration of vanadate has been shown to cause arterial hypertension, increased peripheral resistance, and a marked reduction of coronary, visceral and renal blood flow.In isolated vascular smooth muscle of aorta, application of vanadate caused contraction. These studies have been conducted the preparation of vascular smooth muscles from which endothelial cell were removed. It has been reported that endothelial cell releases relaxing factor(s) (endothelium-derived relaxing factor, EDRF) in response to acetylcholine and a number of other stimuli and also produces vasoconstrictor substances (endothelium-derived contracting factor, EDCF). The aim of this present experiment is to elucidate whether vascular response of isolated rabbit aorta induced by vanadate are endothelium dependent or not. The result obtained were summarized as follows ; 1) When endothelium was intact, vanadate induced vascular relaxation of aorta precontracted with norepinephrine. But K+ induced contraction was augmented by vanadate in the aorta with or without endothelium. Whereas relaxation produced by vanadate precontracted with angiotensin II was endothelium-independent. 2) Hemoglobin, methylene blue, hydroquinone, and verapamil inhibited vanadate-induced vascular relaxation. But indomethacin and quinacrine had no effect on vanadate induced vascular relaxation. From the above results, it is speculated the vanadate act on endothelium, modifies the synthesis or release of endothelium-dependent relaxing factor and thus changes the contractile responses to norepinephrine in rabbit aorta.
Acetylcholine ; Adenosine Triphosphatases ; Angiotensin II ; Animals ; Aorta ; Endothelial Cells ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Hypertension ; Indomethacin ; Methylene Blue ; Muscle, Smooth ; Muscle, Smooth, Vascular* ; Myocardium ; Norepinephrine ; Quinacrine ; Relaxation ; Vanadates* ; Vascular Resistance ; Verapamil

We report a patient with an unusual manifestation of Trichophyton violaceum infection, who lives in Seoul. An 8-year-old male presented an erythematous nodule on the lower eyelid of the left eye which had persisted for 10 weeks. On physical examination, there was no abnormality except a skin lesion on the eyelid. The skin biopsy of the nodule showed epidermal hyperplasia and granulomatous change in the upper dermis. The biopsy specimen yielded Trichophyton uiolaceum on culture. The skin lesion disappeared 2 months after administration of ketoconazole.
Biopsy ; Child ; Dermis ; Eyelids ; Granuloma* ; Humans ; Hyperplasia ; Ketoconazole ; Male ; Physical Examination ; Seoul ; Skin ; Trichophyton*

Two-dimensional Doppler echocardiographic velocity profiles of four cardiac valves in a group of 85 infants and children with left to right shunt lesions(VSD, ASD and PDA) are presented. Velocities were obtained before operation and 10 days afterward. The results were as follows ; 1) VSD(type 2) Peak velocities of mitral valve were significantly decreased when compared preop. with postop. echocardiogram(n=37, preop 132+/-24, postop 98+/-16 cm/sec, p<0.0005). Peak velocities of tricuspid valve were also significantly decreased(n=30, perop 60+/-21, postop 50+/-17cm/sec, p<0.01). Peak velocities of aortic valve were decreased(n=18, perop 120+/-20, postop 108+/-26cm/sec, 0.010.05). Peak velocities of pulmonic valve were significantly decreased(n=17, perop 168+/-46, postop 104+/-51cm/sec, p<0.0005). 3) PDA Peak velocities of mitral valve were significantly decreased when compared perop. with postop. echocardiogram(n=29, perop 138+/-28, postop 111+/-19cm/sec, p<0.0005). Tricuspid valve velocities showed no significant changes between preop. and postop. echocardiogram (n=15, perop 47+/-12, postop 44+/-10cm/sec, p>0.05). Aortic valve velocities showed no significant changes (n=10, perop 134+/-23, postop 121+/-25cm/sec, p>0.05). Peak velocities of pulmonic valve were significantly decreased(n=28, perop 138+/-37, postop 107+/-27cm/sec, p<0.005). This study demonstrates that Doppler echocardiographic assessment of velovity changes are correlated with known hemodynamic data and also will be a good index in the evaluation of operation.
Aortic Valve ; Child ; Echocardiography* ; Echocardiography, Doppler ; Heart Valves* ; Hemodynamics ; Humans ; Infant ; Mitral Valve ; Tricuspid Valve

We report a case of primary cardiac angiosarcoma in a 35 year-old woman. She presented with dyspnea, facial edema and neck vein distension during 1 month. The oval round large mass(8x4 cm) filling the right atrium infiltrated into the entire thickness of the lateral wall and extended to the vena cava and ventricle. The interatrial septum and pericardium seemed to be intact. Despite the surgical excision and adjuvant chemo-and radiotherapy, the patient died 8 months later due to tumor recurrence. The histologic findings of tumor varied from benign looking capillary proliferation mimicking granulation tissue to sarcoma composed of spindle cells. But anastomosing vascular channels lined by anaplastic polygonal cells and intracytoplasmic lumen containing red blood cells were characteristic findings. These tumor cells showed positive reaction to endothelial cell antigen and factor VIII-related antigen. The intercellular junctional complex and vascular channels formed by cytoplasmic process of tumor cells were identified by the ultrastructural study.
Female ; Humans

BACKGROUND: Elecsys 2010 immunoassay system is based on the electrochemiluminescence immunoassay using a ruthenium (II) tris (bipyridyl) label. Since it was the first time to use the system in our laboratory, we would like to evaluate the analytical performances (precision, linearity and recovery rate) and correlation with radioimmunoassay (RIA) and microparticle enzyme immunoassay (MEIA) methods. METHODS: We used precicontrol tumor marker (TM1, TM2) for alpha-fetoprotein (AFP), prostatic specific antigen (PSA) and carcinoembryonic antigen (CEA), Precicontrol universal (Ul, U2) for triiodothyronine (T3) and thyroxine (T4), Precicontrol-TSH for thyrotropin (TSH) and pooled serum for the evaluation of precision and recovery rate. Patients' sera were used for the linearity and comparison study. RESULTS: The coefficients of variatron of Imprecision study were below; 4.0%, 8.7% and 10.2%, respectively in the within-run, within-day and between-day analysis. The recovery rates were 100.5%, 96.1% and 102.5%, respectively in T4, TSH, and AFP. The linearity were y=1.02x-0.182(r=0.99) for T4, y=1.01x+0.12 (r=0.99) for TSH and y=1.01x+0.54(r=1.00) for AFP. T3, T4, TSH, CEA and PSA results showed good correlation with RIA (r>0.90), but AFP showed r=0.88. Also, AFP, CEA and PSA results showed excellent correlation with AxSYM (r>0.99). CONCLUSION: Elecsys 2010 immunoassay system showed excellent precision, recovery rate, clinically acceptable linearity and good correlation with the results obtained by RIA and MEIA methods.
alpha-Fetoproteins ; Carcinoembryonic Antigen ; Immunoassay* ; Immunoenzyme Techniques ; Radioimmunoassay ; Ruthenium ; Thyrotropin ; Thyroxine ; Triiodothyronine

BACKGROUND: Tracheal intubation for general anesthesia often leads to trauma of the airway mucosa, resulting in postoperative sore throat and hoarseness. Numerous studies have investigated the factors as contributing causes, but the influence of method of anesthesia induction and time for extubation of the endotracheal tube has not been systematically examined. The aim of this study was to establish the effects of the methods of anesthesia induction and timing of extubation on postoperative sore throat and hoarseness. METHODS: Eighty patients with ASA physical status 1 or 2 were randomly divided into four groups. Group 1 patients (n=20) recieved succinylcholine 1.0 mg/kg for intubation and early extubated ; group 2 patients (n=20) recieved succinylcholine 1.0 mg/kg for intubation and lately extubated ; group 3 patients (n=20) recieved pancuronium 0.1 mg/kg for intubation and early extubated ; group 4 patients (n=20) recieved pancuronium 0.1 mg/kg for intubation and lately extubated. All patients were interviewed 6, 24, 48, and 72 hrs after operation by an anesthesiologist in a double-blind manner. RESULTS: The incidence of sore throat at postoperative 6 and 24 hrs were decreased in group 3 compaired with group 1, 2, and 4 (p<0.05), respectively. The severity of sore throat at postoperative 6 hrs were decreased in group 3 compared with group 1, 2 and 4 (p<0.05), and that of postoperative 24 hrs were decreased in group 3 compared with group 1 and 2 (p<0.05), respectively. The severity of hoarseness at postoperative 6 hrs were decreased in group 3 compared with group 2 (p<0.05). CONCLUSIONS: We suggest that postoperative sore throat and hoarseness may be developed more when extubation was perfomed lately than early. Therefore, early extubation provide advantage in terms of reducing sore throat and hoarseness in limited cases of anesthesia.
Anesthesia* ; Anesthesia, General ; Hoarseness* ; Humans ; Incidence ; Intubation ; Mucous Membrane ; Pancuronium ; Pharyngitis* ; Succinylcholine