We report a rare case of carcinosarcoma arising in the stomach. The tumor is presented in the posterior wall of the gastric lower body and antrum of a 56-year-old man. Grossly the tumor has polypoid appearance with diffuse surface ulceration and measures 5.5 cm in diameter. The tumor is accompanied with three separate well differentiated early gastric adenocarcinomas (two EGC type IIc & IIa). Microscopically, the tumor consists of moderately well differentiated adenocarcinoma in the periphery, and lobulated sarcomatous areas in the center, which shows chondroid differentiation. Transitional areas between adenocarcinoma and chondrosarcoma are evident. Immunohistochemical studies show positivity for cytokeratin and carcinoembryonic antigen in the epithelial component, and for vimentin and S-100 in the sarcomatous component. The transitional areas are positive in carcinoembryonic antigen, vimentin, S-100, and cytokeratin. The tumor extended to the subserosa and showed metastasis of only adenocarcinomatous component in six out of 47 dissected perigastric lymph nodes.
Adenocarcinoma ; Carcinoembryonic Antigen ; Carcinosarcoma* ; Chondrosarcoma ; Humans ; Keratins ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Stomach* ; Ulcer ; Vimentin

BACKGROUND: Antiphospholipid antibodies(APA) including anticardiolipin antibodies(ACA) are significantly associated with ulcerations of the leg. Moreover, resistance to activated protein C(aPC) may be an important risk factor in leg ulcerations. Until now, there has been no clinical investigation about the positivity of APA or resistance to aPC in patients with leg ulcers in Korea. OBJECTIVE: We investigated the positivity to APA and the presence of resistance to aPC in patients with leg ulcers in Korea. METHODS: Venous or arterial ultrasonic Doppler, semiquantitative assay for serum APA and functional analysis for aPC resistance were conducted in 32 patients with leg ulcers. RESULTS: 1. Of the 32 patients with leg ulcers, 34,3% had a positive APA. APA were more frequently associated with venous ulcerations of the leg than in subjects with leg ulcers of arterial or mixed origin. 2. aPC resistance based upon the functional analysis, occurred in 43.7% to 46.8% of leg ulcer patients. 3. Livedo reticularis (38.1%) and superficial thrombophlebitis (19.0%) were the most common cutaneous manifestations accompanied by leg ulcers in 21 APA-positive and/or aPC resistant patients. Deep vein thrombosis of extremities was the most common complication (47.6%) among the systemic thrombotic sequelaes in APA-positive and/or aPC resistant patients. CONCLUSION: APA positivity and aPC resistance may be relatively common anticoagulant defects among patients with leg ulcerations in Korea. APA positivity and aPC resistance should be considered important risk factors for the development of not only leg ulcers but also systemic thrornbotic complications.
Activated Protein C Resistance* ; Antibodies, Antiphospholipid* ; Extremities ; Humans ; Korea ; Leg Ulcer* ; Leg* ; Livedo Reticularis ; Risk Factors ; Thrombophlebitis ; Ulcer ; Ultrasonics ; Varicose Ulcer ; Venous Thrombosis

The number of post-irradiated surgical specimen appears to have risen in recent years due to the increasing utiliz ation of radiotherapy for cancer patients. Radiation therapy damages cells by its effects on the deoxyribonucleic acid and the spectrum of injury ranges from acute self-limited lesion to irreversible chronic lesion. We reviewed 24 cases of post-irradiated specimen and thought that time interval is the main factor influencing the morphologic change. Within six weeks, the individual cytologic changes such as biz arre nuclei, altered nucleus/cytoplasm ratio, amphophilic and vacuolated cytoplasm are noted. Chronic injury resulting from progressive changes in the fibrovascular tissue of the radiated area occur in six months after the initial course of radiation and the vascular changes of intimal thickening and fibrosis, foamy histiocytes within media, periadventital fibrosis and chronic inflammatory cells infiltration are present. Althouhg above mentioned finding are not pathognomonic, we thought them quite constant nd reproducible characteristics of radiation injury.

PURPOSE: To investigate the changes in postural balance before and after total hip arthroplasty (THA) using computerized dynamic posturography MATERIALS AND METHODS: This was a prospective study of 18 patients undergoing total hip arthroplasty. We evaluated each patient's postural balance prior to, and at least 12 months after, total hip arthroplasty by using computerized dynamic posturography. We compared the preoperative equilibrium scores with the postoperative equilibrium scores. Clinical results were assessed for all patients preoperatively and postoperatively using the Harris hip scoring system. We investigated whether postural balance improves, and what factors were related to this parameter. RESULTS: Patients showed significant improvement in postural balance by means of proprioception after total hip arthroplasty (p<0.05). We found, during intercepting visual compensation, that an increase in the Harris hip score was correlated with an improvement in balance (p<0.01, r = 0.649). CONCLUSION: Patients with Total hip arthroplasty showed improvement in dynamic postural balance through proprioceptive recovery, and balance improved as the Harris hip score increased. This resulted in decreased pain, recovery of articular function, enhancement of physical activity, and ultimately improvement in postural balance by means of total hip arthroplasty.
Arthroplasty ; Compensation and Redress ; Hip ; Humans ; Motor Activity ; Postural Balance ; Proprioception ; Prospective Studies

This study investigated the stress of community residents in Kwang-Ju and Chonnam areas by using the General Health Questionnaire(GHQ-60) as a instrument of stress measurement. The number of subject were 445 residents who lived in three areas (large city, middle city, and rural area) and they were individually interviewed in March, 1994. The result of study showed that the degrees of stress measured by GHQ-60 were statistically significant in the residents' area, age. sex variables: (a) the residents in middle city among three area had the highest level of stress: (b) the resident who were more than 60 in age had the highest level of stress: (c) the female resident had more stress than male residents: (d) particularly, the residents who were more than 60 years old in the middle city had the highest level of stress. Further, the results of factor analysis showed that there were three factors of social dysfunction, depression and anxiety, and psychosomatic symptom. The social dysfunction factor was statistically significant in both age and resident area variables. The depression and anxiety factor was statistically significant in the residents' area, age. sex variables. The psychosomatic symptom factor was statistically significant in both age and sex variables. The study suggested that they should give a special attention to solve the old people's stress because stress was closely related to residents age.
Anxiety ; Depression ; Factor Analysis, Statistical ; Female ; Gwangju ; Humans ; Jeollanam-do ; Male ; Mass Screening* ; Middle Aged ; Surveys and Questionnaires*

As the use of free tissue reconstruction becomes more routine, attention is being focused not only on flap survival, but also on functional refinements in these flaps. One of the more important aspects of improving the outcome of these reconstruction may relate to the return of sensation. The anterolateral thigh free flap is based on the descending branch of the lateral circumflex femoral artery. This fasciocutaneous flap is indicated whenever a relatively thin flap is required in reconstruction. A neurosensory flap can be employed based on the anterior branched of the lateral femoral cutaneous nerve of the thigh. Since 1996, 15 patients with soft tissue defect on various regious were treated by using the anterolateral thigh sensate free falp. All flaps survived without total loss. Anastomosis of the sensible nerve on the recipient site with the anterior branch of the lateral femoral cutaneous nerve of the thigh was performed. All patients showed recovery of sensation in the anterolateral thigh sensate free falp beginning between the 4th and 6th month postoperatively. Follow-up periods ranged from 8 to 34 months and the results of sensory recovery were satisfactory. Therefore, resensitization of an anterolateral thigh free flap should be attempted by a nerve anastomosis in this transplant. The longterm success in this study suggests the benefits of microsurgical neurotization in free tissue transplantation.
Femoral Artery ; Follow-Up Studies ; Free Tissue Flaps* ; Humans ; Nerve Transfer ; Sensation ; Thigh* ; Tissue Transplantation ; Transplants

No abstract available.
Glomerulonephritis*

A 65-year-old female patient visited our clinic complaining of multiple skin lesions since one year ago. There were yellowish to brownish colored, bean to walnut-sized nodules on both lower extremities. Dylon stain with polarizing microscopy, immunohistochemical stain to amyloid P and immunoglobuhn-kappa chain showed positive reactivities but keratin stain was negative. According to histopathologic and immunohistochemical findings, she was diagnosed as nodular amyloidosis.
Aged ; Amyloid ; Amyloidosis* ; Female ; Humans ; Lower Extremity ; Microscopy ; Skin

This study was aimed at investigation of the stimulatory innervations on the rat urinary bladder. Detrusor muscle strips of 15 mm long were suspended in isolated muscle chambers containing 1 ml of PSS maintained at 37℃ and aerated with 95% O²/5% Co². Isometric myography was performed, and the results were as followings: Muscle strips showed “on-contraction” by electric field stimulation (EFS) frequency-dependently. The EFS-induced contraction was not affected by hexamethonium, a ganglion blocker, but abolished by tetrodotoxin, a nerve conduction blocker. Physostigmine, a cholinesterase inhibitor enhanced the EFS-induced contraction which was inhibited by hemicholinium, an inhibitor of choline uptake at the cholinergic nerve ending. Such an EFS-induced contraction was antagonized by atropine only partially, and the atropine-resistant portion was completely abolished by the desensitization of purinergic receptors by prolonged incubating of the strips in the presence of high concentration of ATP. Bethanechol, a cholinergic agonist, elicited concentration-dependent contraction. Adenosine triphosphate (ATP), a purinergic agonist, induced a weak but concentration-dependent contraction of short duration. Bethanechol-induced contraction was not affected by ATP-desensitization, and ATP-induced contraction was not affected by tetrodotoxin. These results suggest that there are at least two main stimulatory components of innervations in the detrusor muscle, cholinergic muscarinic and purinergic; and those receptors are independent each other.
Adenosine Triphosphate ; Animals ; Atropine ; Bethanechol ; Choline ; Cholinergic Agonists ; Cholinesterases ; Ganglion Cysts ; Hemicholinium 3 ; Hexamethonium ; Myography ; Nerve Endings ; Neural Conduction ; Physostigmine ; Rats* ; Receptors, Purinergic ; Tetrodotoxin ; Urinary Bladder*

Parencymal pulmonary endometriosis is a rare gynecologic problem, characterized by cyclic hemoptysis. Lung is the origin of hemoptysis. The diagnosis is based upon the clinical history and exclusion of other causes of recurrent hemoptysis, changes in the radiologic findings of chest lesion associated with menstrual cycle. We describe three women with recurrent hemoptysis during menstruation and localized lesion on computerized tomography (CT) scanning. The patients were treated with gonadotropin releasing hormone (GnRH) agonist or surgery. We represent three cases with a brief review of literature.
Diagnosis ; Endometriosis* ; Female ; Gonadotropin-Releasing Hormone ; Hemoptysis ; Humans ; Lung ; Menstrual Cycle ; Menstruation ; Thorax