Glassy cell carcinoma is an unusual neoplasm of the uterine cervix with highly aggressive clinical behavior. On cervico-vaginal smear examination, the tumor has well confused of atypical repair cell of the endocervix. Recently, we have experienced two cases of glassy cell carcinoma of the uterine cervix, diagnosed on cervico-vaginal smears and confirmed on following histologic sections. The cervico-vaginal smears revealed abundant clusters with well defined boarders. The cell clusters were composed of large tumor cells. The tumor cells had distinct granular cytoplasm and eosinophilic macronucleoli. Characteristic cytologic features of this tumor were discussed in view of differential diagnosis.
Adenocarcinoma ; Breast ; Cervix Uteri ; Cytoplasm ; Diagnosis, Differential ; Eosinophils ; Female ; Hydronephrosis*

Locking of the metacarpophalangeal(MP) joint of thumb in mild hyperextension is relatively uncommon problem. The most frequently recognized cause appears that proximal palmar ligament or volar plate were ruptured tranversely with its distal part riding over the volar prominence of the radial condyle of the first metacarpal head. We experienced two cases of locking of the MP joint of the thumb due to volar plate injury. Closed reduction was failed in both cases and open reduction was done by cutting the constricted ligament hundle over the radial condyle of the first metacarpal head. Our description of this mechanism is supported by expeimental evidence that we obtained from the cadeveric specimens. The height of radial side condyle of first metacarpal head is higher than ulna side of that by 1.76mm in both hands of 16 cadeveric specimen. So we are going to report these cases with a review of the literature, and suggest that the preferable location of surgical incision in open reduction is radial side of metacarpal head.
Hand ; Head* ; Joints ; Ligaments ; Metacarpal Bones* ; Metacarpophalangeal Joint* ; Thumb* ; Ulna ; Palmar Plate

Although flexion and extension lateral views were known the most preferable diagnostic method of instability of lumbar spine, many authors had reported that there were some findings which suggested instability of lumbar spine in plain films. This study was undertaken to analyze clinical aspect and plain film findings of dynamic instability of lumbar spine and to suggest indication of dynamic X-ray to find out the causes of low back pain. A retrospective analsysis was perfomed on 30 patients who had dynamic instability of lumbar spine without spondylolithesis between January 1996 and March 1997. They were reviewed in sex, age, symptom duration and instability level, etiologic factor etc. And then their plain films and flexion and extension lateral views were reviewed. Following results were obtained. Dynamic instability was more frequent in women than in man and occured younger age in women. The mean symptom duration was 5 years and 10 months and simple degenerative change was the most common etiologic factor. In plain films, traction spur and dome shaped end plate were common findings and the L4-5 intervertebral disc space was most frequently involved(23/30 cases). Translation was occured more frequently in flexion position(23/30 cases). The mean dynamic translation distance was 4.7mm, the mean sagittal rotational angle was 16.2degreesand the mean angular displacement was 3.2degrees. Conclusively, among the diagnostic criteria af instability of lumbar spine, translational distance was the most common finding. Flexion and extension lateral views have diagnostic value in patients who complaint back pain from unknown origin, in old age, for prolonged symptom duration, or those who have findings associated with instability in plain films.
Back Pain ; Female ; Humans ; Intervertebral Disc ; Low Back Pain ; Retrospective Studies ; Spine* ; Spondylolisthesis* ; Traction

A clinical observation was made on the 236 patients who had undergone transurethral resection of bladder tumor(TUR) between Jan. 1990. and Feb. 1996. in the Department of Urology, Korea Cancer Center focusing on complications. The mean operating time was 59.0 minutes(n=400). The most common immediate complication was bleeding(1.8%), and the remainder was nonurologic fever(0.8%). The delayed complication was urethral stricture(1.0%) requiting visual urethrotomy. The immediate postoperative morbidity was 2.5% and risk factors for immediate morbidity after TUR were operating time longer than 60 minutes and tumor, invading the muscle or more deeply(p<0.05, by Chi-square test). The delayed morbidity was 1. 0% and the only risk factor for delayed morbidity after TUR was the number of ~IJR more than 2(p<0.05, by Chi-square test). Careful attention to surgical details and indications is needed to reduce the amount and significance of the postoperative morbidity.
Humans ; Korea ; Risk Factors ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology

A clinical observation was made on the 236 patients who had undergone transurethral resection of bladder tumor(TUR) between Jan. 1990. and Feb. 1996. in the Department of Urology, Korea Cancer Center focusing on complications. The mean operating time was 59.0 minutes(n=400). The most common immediate complication was bleeding(1.8%), and the remainder was nonurologic fever(0.8%). The delayed complication was urethral stricture(1.0%) requiting visual urethrotomy. The immediate postoperative morbidity was 2.5% and risk factors for immediate morbidity after TUR were operating time longer than 60 minutes and tumor, invading the muscle or more deeply(p<0.05, by Chi-square test). The delayed morbidity was 1. 0% and the only risk factor for delayed morbidity after TUR was the number of ~IJR more than 2(p<0.05, by Chi-square test). Careful attention to surgical details and indications is needed to reduce the amount and significance of the postoperative morbidity.
Humans ; Korea ; Risk Factors ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology

Pharmacologic therapy is still the primary management for epilpsy; however, surgical treatment is a reasonable therapeutic option for patients suffering from medically intractable seizures, especially temporal lobe epilepsy having a documented unilateral epileptogenic area. Thirty nine patients with pharmaco-resistant complex partial seizures underwent anterior temporal lobectomy and hippocampectomy in 38 cases and frontal cortisectomy in one case. On pathological examination, hippocampal sclerosis was a predominent pathologic finding and was identified in 18 cases. Other non-neoplastic lesions consisted of 5 cases of vascular lesions(2 cavernous angiomas, 2 arteriovenous malformations and 1 angiomatosis), 3 cases of fibrous nodule, 2 cases of cicatrical changes of cerebral cortex, and 1 case of parasitic infection. Neoplasms including two cases of oligodendroglioma and one case of anaplastic astrocytoma were also noted. In seven cases, there was no detectable lesion on gross and microscopic examination. On post-operative follow-up, seizures were completely terminated in most cases(31 cases, 79%). The rest of the patients also displayed marked alleviation of symptoms. The seizures tended to recur more aften among the patients with neoplasm or no pathologically detectable lesion. In order to detect any minute pathological lesion, thorough gross and microcsopic examinations are considered to be essential.

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry; to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome; and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity(NCV). The study group was divided into exposed group(39 cases)and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exist. 1. There are statistically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were confirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram; sensitivity 88.9%, specificity 84.2%. Tinel's sign; sensitivity 55.6%, specificity 72.8%. Phalen's sign; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.
Audiometry ; Carpal Tunnel Syndrome* ; Condoms* ; Diagnosis ; Hand ; Mass Screening ; Median Nerve ; Neural Conduction ; Occupations ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Ulnar Nerve ; Vibration ; Wrist

No abstract available.
Ascitic Fluid* ; Endometriosis* ; Female ; Humans ; Interleukins*

BACKGROUND: The focus of this paper was to determine the clinical characteristics of startle epilepsy characterized by reflex partial seizures of the sensorimotor cortex. METHODS: Eight patients with startle epilepsy were evaluated for their clinical seizure history, neurologic examination, MRI, routine EEG, video-EEG monitoring, and ictal SPECT. RESULTS: Etiologies were: perinatal injury (4 patients), kernicterus following hemorrhage during infancy (1), near-drowning at age 4 (1), and unknown (2). The age of seizure onset varied from several months to 16 years. All patients had spontaneous as well as reflex seizures. Effective triggers included several sensory modalities, typically proprioceptive and auditory. The stimuli should be sudden and unexpected. Seizures usually occurred daily and were medically intractable. Neurological examination was abnormal in 6 patients. Five had mental retardation, and 4 with motor deficit. MRI was abnormal in 6 patients, generally showing large encephalomalatic changes involving cortical and sub-cortical structures. Five had bilateral lesions. The semiology was characterized by unilateral or generalized tonic posture. Scalp interictal and ictal EEGs had limited value to lateralize the epileptogenic focus. Intracranial EEG in 1 patient who underwent surgery showed ictal onset on the lateral sensorimotor cortex. CONCLUSIONS: Startle epilepsy is a rare but distinctive epileptic syndrome characterized by reflex seizures triggered by unexpected sensory stimuli. Some clinical findings including etiologic events (kernicterus following hemorrhage, near-drowning), high incidence of bilat-eral lesions, ictal onset on lateral sensorimotor cortex without involvement of medial cortex, and ictal SPECT findings have not been reported or were different from previous studies.
Electroencephalography ; Epilepsy* ; Hemorrhage ; Humans ; Incidence ; Intellectual Disability ; Kernicterus ; Magnetic Resonance Imaging ; Near Drowning ; Neurologic Examination ; Posture ; Reflex ; Scalp ; Seizures ; Tomography, Emission-Computed, Single-Photon

We report a rare case of subepithelial hematoma of the renal pelvis (AntopoI-Goldman Lesion). A 55-year-old women visited our hospital because of gross hematuria. Ultrasonogram showed a 4cm well-defined solid mass of the left renal pelvis. Intravenous pyelography revealed compression of the left upper pelvicocalyceal system by the mass with contrast filling within the mass. CT scan revealed Iobulated well defined mass in the left renal pelvis extending into renal parenchyme. A transitional cell carcinoma or renal cell carcinoma was suspected radiologically, and the patient underwent left total nephrectomy. In pathology, the lesion turned out to be a subepithelial hemaroma. In the differential diagnosis of renal malignancy, a subepithelial hematoma of the renal pelvis may be included.
Carcinoma, Renal Cell ; Carcinoma, Transitional Cell ; Diagnosis, Differential ; Female ; Hematoma* ; Hematuria ; Humans ; Kidney Pelvis* ; Middle Aged ; Nephrectomy ; Pathology ; Tomography, X-Ray Computed ; Ultrasonography ; Urography