Localized or solitary fibrous tumor (SFT) of the pleura has been classified as a type of mesothelioma, arising from the submesothelial connective tissue cells. The preoperative diagnosis of the tumor at the cytologic or histologic level is very important for the proper handling of the lesion. This preoperative diagnosis is now possible by means of the advance in the transthoracic fine needle aspiration biopsy (FNA) techniques and in the very experience of the cytopathologists. We describe FNA cytologic feature of two cases of SFT arising from the pleura. Cytologic, histologic, immunohistochemical, and electron microscopic characteristics of pleural SFT are discussed. The tumor cells of SFT are spindle or oval in shape with a variable amount of cytoplasm. They are arranged in irregular trabeculae intimately ass- ociated with capillaries. A unique cytologic feature observed in this tumor is that thick, eosinophilic, amorphous collagen bundles are scattered between tumor cells
Biopsy ; Biopsy, Fine-Needle ; Capillaries ; Child* ; Collagen ; Connective Tissue Cells ; Cytoplasm ; Diagnosis ; Eosinophils ; Hematuria* ; Humans ; Mesothelioma ; Pleura ; Rhabdomyosarcoma ; Solitary Fibrous Tumors

Adenoid cystic carcinoma arising from the submucosal glands of the trachea and bronchial tree is rare. The histopathology and natural history of bronchial adenoid cystic carcinoma have been well documented, but detailed descriptions of its cytomorphology are few. We report a case of primary bronchial adenoid cystic carcinoma in a 20-year-old female, diagnosed by bronchial brushing cytology. The cytologic specimens showed large clusters of small cells arranged around cystlike spaces containing globular basophilic material.
Basophils ; Bronchi ; Carcinoma, Adenoid Cystic ; Ependymoma ; Female ; Humans ; Infant* ; Natural History ; Seizures* ; Spinal Cord ; Trachea ; Young Adult

Neuroaesthetics is an area of research on the essence of aesthetic experience according to the neurobiological perspective. The purpose of this article is to introduce both the important results from some studies based on neuroaesthetics and some neuroaesthetic reports in specific psychiatric disease. Aesthetic experience is thought to be a series of cognitive and affective processes for pursuing aesthetic judgment and aesthetic emotion. According to the present neuroaesthetic studies, the important domains are reward system, embodiment, aesthetic perspective in contrast with practical perspective, sublime, and so on. The neuroaesthetic approach to specific psychiatric disease is just beginning; however, case studies on the sudden appearance of artistic talents in neuropsychiatric patients have been frequently reported. We expect that neuroaesthetics is likely to continue to contribute new knowledge regarding the ultimate causes of various psychiatric diseases and the creativity of many psychiatric patients.
Aptitude ; Beauty ; Brain ; Creativity ; Humans ; Judgment ; Reward

BACKGROUND: The incidence and prevalence of gait disturbance increases as age increases. The importance of cognitive aspects of gait disturbances has been studied in various types of dementia and MCI. This study was performed to identify relationship between cognitive impairment and change in gait, and investigate specific domains of cognitive function that may have affects in gait disturbance. METHODS: Three hundred eighty three participants over 60 years old volunteered for the study. Three stages evaluation were performed, dementia screening and timed up and go test (TUG), work up for cognitive impairment and dementia, and classifying cognitive impairment and dementia into subcategories by evaluating cause of the disease. To evaluate cognitive impairment, MMSE-KC (MMSE in the Korean version of the CERAD assessment packet) and Korean version of Consortium to Establish a Registry of Alzheimer's Disease (CERAD-K) assessment were used. One hundred forty one people were excluded from study and 242 people were analyzed. Timed Up and Go test (TUG) was performed for evaluation of gait disturbance. Relationship in every subcategory of CERAD-K and TUG was studied by correlation and multiple logistic analysis. RESULTS: Of the 242 participants, 122 were without cognitive impairment, 51 had mild cognitive impairment, 56 had Alzheimer's disease and 13 had vascular dementia. These four groups showed different results in TUG. Normal group had the lowest values in TUG compare to other groups significantly. MMSE score also correlated with the value of TUG (r=-0.528, p<0.001). Every subcategory of CERAD-K score had significant correlation with the value of TUG. But there were no specific subcategory that had predominant effect in TUG. Only age was an independently significant factor influencing TUG (p<0.05). CONCLUSIONS: This study shows that increase in age and impairment in cognitive function has an association with gait disturbance. Therefore clinician should be concerned about cognitive factors for evaluation of a patient who has gait disturbance.
Alzheimer Disease ; Dementia ; Dementia, Vascular ; Gait* ; Humans ; Incidence ; Mass Screening ; Methods ; Mild Cognitive Impairment ; Prevalence

BACKGROUND: Established risk factors for coronary artery disease include smoking, hypertension, diabetes mellitus and hypercholesterolemia. However, these account for less than 50% of the actual incidence of coronary artery disease and the importance of other risk factors is being increasingly realized. It has been known that insulin resistance associated with hyperinsulinemia is a pivotal link to several risk factors of coronary artery disease, including hypertension, glucose intolerance, dyslipidemia and obesity. Recently both experimental and clinical studies have produced evidence suggesting that high plasma insulin level may promote the development of atherosclerotic vascular diseasa. Several prospective studies showed independently that high plasma insulin is associated with an increased risk of major coronary artery disease. In our study, plasma glucose, insulin and C-peptide level were determined with oral glucose tolerance test to assess the insulin resistance or hyperinsulinemia as a risk factory of coronary artery disease. METHOD: From September 1993 to April 1995, after excluding patients with hypertension, diabetes mellitus, hypercholesterolemia and obesity, 17 patients with significant coronary artery stenosis and 10 control subjects with normal coronary finding were selected among the 226 patients who undertook coronary angiography. In the 17 cases(M:F=15:2) of coronary artery disease group, the mean age was 54+/-10 years, and in the 10 cases(M:F=8:2) of control group, 51+/-9 years. All were matched for age, gender and body mass index. Blood pressure, lipid and lipoprotein were measured and smoking history was assessed. Glucose, insulin and C-peptide responses to oral glucose tolerance test were also determined. RESULT: 1) There was no significant difference in systolic and diastolic and diastolic blood pressure, total-cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, ApoA and smoking history except ApoB between the subjects with coronary artery disease and normal control subjects. 2) In oral glucose tolerance test, the plasma glucose levels were not significantly different in the two groups. plasma insulin and C-peptide levels at 60 and 120 minutes were higher in the patient group than control, but the results lack statistical significance. The area under the insulin curve and C-peptide curve were larger in patient group than control, but the result lack statistical significance also. CONCLUSION: Although our study dose not prove the hypothesis that insulin resistance or hyperinsulinemia is statistically an independent risk factor for coronary artery disease, this study showed the tendency of insulinresistance to be correlated with development of coronary artery disease. As this study has limitations due to small sample size, further study is required to confirm the role of hyperinsulinemia using a larger sample size.
Apolipoproteins A ; Apolipoproteins B ; Blood Glucose ; Blood Pressure ; Body Mass Index ; C-Peptide ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diabetes Mellitus ; Dyslipidemias ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Humans ; Hypercholesterolemia ; Hyperinsulinism ; Hypertension ; Incidence ; Insulin Resistance* ; Insulin* ; Lipoproteins ; Obesity ; Plasma ; Prospective Studies ; Risk Factors* ; Sample Size ; Smoke ; Smoking ; Triglycerides

BACKGROUND: Circadian rhythms have been described for acute myocardial infarction, sudden cardiac death, cerebrovascular disease, ischemic heart disease, and ventricular arrhythmia. Most of studies reported that the frequency of ventricular permature contractions(VPC's) shows a peak in day time. We tried to see that the circadian rhythm of VPC's in hypertension and ischemic heart disease(IHD) patients. And we will also studied the relationship between heart rate and frequencey of VPC's. METHOD: Twenty four hour holter monitoring was performed in hypertensive patients (N=23), ischemic heart disease patients(N=25), and normal control group(N=30). We tested the circadian pattern of VPC's and heart rates and the relationships of the frequency of VPC's and heart rates. RESULT: In hypertension group, a peak incidence of heart rate is between 5 and 8 P.M., in ischemic heart disease group, between 3 and 6 P.M.. In control group, the heart rate shows a peak beteen 1 and 3 P.M.. The frequency of VPC's in hypertension group shows the first peak between 4 and 10 P.M., and the second peak beteen 7 and 10 A.M.. In ischemic heart disease group, they show a peak between 2 and 8 P.M..In control group, there was no circadian variation for the frequency of VPC;s. Both in hypertension and IHD patients group, there was significant correlation between the frequency of VPC's and the heart rates. CONCLUSION: It seemed that VPC' were more frequently occurred in relation to the increase of heart rate in the afternoon, in hypertensive and ischemic heart disease patients.
Arrhythmias, Cardiac ; Circadian Rhythm ; Death, Sudden, Cardiac ; Electrocardiography, Ambulatory ; Heart ; Heart Rate ; Humans ; Hypertension* ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Ventricular Premature Complexes*

Morphometry of nuclei of the benign and malignant prostatic lesions was performed to study the relationship between nuclear size and shape and the prognosis of prostatic adenocarcinoma. Fifty one cases of prostatic adenocarcinoma and 13 cases of benign prostatic hyperplasia were included to evaluate area, perimeter, Dmax, Dmin, and 5 form factors of the nuclei by image analyzer (Zeiss Ibas 2000) using hematoxylin-eosin stained slides. All analytic factors of nuclear size and shape were significantly different between benign lesions and adenocarcinomas. Increased nuclear size was associated with nu- clear irregularity, presence of metastasis, advanced clinical stage, and high Gleason's grade and score of prostatic adenocarcinoma. On Kaplan-Meier method, survival was decreased with older age, no hormonal treatment, stage D, high Gleason's grade and stage as well as with larger size and irregular shape of the nuclei. In conclusion, morphometry of nuclei of the prostate can be a helpful tool to differentiate between benign and malignant lesions. Nuclear morphology is thought to be associated with prognosis of prostatic adenocarcinoma.
Adenocarcinoma ; Breast ; Fibroadenoma ; Hepatitis B e Antigens* ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Neoplasm Metastasis ; Prognosis ; Prostate ; Prostatic Hyperplasia

We report 2 cases of midface defect reconstructed with latissimus dorsi myocutaneous free flap. In these cases, the main points to cover the defects were as follows: 1. For the contour of zygoma and maxilla, it was well preserved without bone graft which was not used for second stage reconstruction. In first case, for application of artificial eyes and in second case, for operation after full development. 2. For the drainage of paranasal sinuses, we made the nostril with skin graft, and it was well preserved without any complications during follow up. 3. It was sufficient to cover the defect with latissimus dorsi muscle well designed before surgery and thick enough to fill the defect. 4. In second case, the remained defect of palate and maxilla was not covered for the appropriate reconstructions after full development. In conclusions, we experienced two cases of midface defect reconstructed with latissimus dorsi myocutaneous free flap without any complication and with good results.
Drainage ; Eye, Artificial ; Follow-Up Studies ; Free Tissue Flaps* ; Maxilla ; Palate ; Paranasal Sinuses ; Skin ; Superficial Back Muscles* ; Transplants ; Zygoma

Imipramine(Tofranil(R)) is one of the tricyclic antidepressants commonly used in depressive symptoms or enuresis. An accidental or nonaccidental poisoning of imipramine is common today. A 16 years old girl was admitted to Seoul National university Hospital because of unocnsciousness and frequent attacks of seizure after the impulsive ingestion of 1.4gm of imipramine. She showed variable arrhythmias such as complete RBBB, secod degree AV block and ventricular tachycardia and recovered from poisoning without residual myocardial damage. We present a case of imipramine poisoning with cardiac arrhythmias with review of literatures.
Adolescent ; Antidepressive Agents, Tricyclic ; Arrhythmias, Cardiac* ; Atrioventricular Block ; Depression ; Eating ; Enuresis ; Female ; Humans ; Imipramine ; Poisoning* ; Seizures ; Seoul ; Tachycardia, Ventricular

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