No abstract available.
Nasal Bone*

BACKGROUND: Squamous cell carcinoma(SCC) is one of the most conimon forms of skin cancer that arises from the surface epidermis. Although many authors have reported on the incidence and clinical features of SCC, we could not find any reports concerning the widerange of histopathologic features of a number of cases of SCC in Korean dermatologic literature. OBJECTIVE: We examined the histopathologic features of SCC. METHOD: Twenty six biopsy specimens from 26 patients with SCC were examined microscopically including the tumors themselves and surrounding epidermis and dermis on routine histologic staining. RESULTS: Grade 1 tumor was found in 15 cases, grade 2 in 8 casese, and grade 3 in 3 cases. Eighteen cases showed keratin pearls, and 11 cases showed squamous eddies. P cantholysis of tumor cells was found in all 26 cases, but glandular structure was found only in 5 cases. The epidermis overlying the tumor showed hyperkeratosis and parakeratosis in all 26 cases, follicular plug in 13 cases, and ulceration in 18 cases. The dermis beneath the tumor showed vessel dilataticn, hemorrhage, and infiltration of inflammatory cells in all 26 cases, and basophilic degeneration in 1.3 cases, fibrosis in 20 cases, lichenoid reaction in 6 cases, and necrosis in 6 cases. Rare dermal findings were abscess, foreign body reaction calcification and Russell body. CONCLUSION: The histopathologic findings of SCC were variable not inly those of the tumors themselves, but also those of the surrounding epidermis and dermis.
Abscess ; Basophils ; Biopsy ; Carcinoma, Squamous Cell* ; Dermis ; Epidermis ; Fibrosis ; Foreign-Body Reaction ; Hemorrhage ; Humans ; Incidence ; Necrosis ; Parakeratosis ; Skin Neoplasms ; Ulcer

Poor R-Wave Progression(PRWP) of precordial leads is frequently encountered electrocardiographic findings of uncertain significance and has simply been deemed as suggestion of anterior myocardial infarction without concrete ground. 217 cases with poor R-Wave Progression have been analyzed on clinical records and results are as follows. 1) PRWP was most frequently found in fifties and sixities, comprising 63.9% of the subjects. 2) Co-existent disease entities with PRWP were classified into three categories, cardiovascular diseases, chronic lung diseases and normal variants. 3) The cardiovascular diseases related with PRWP were mainly hypertensive diseases, comprising 59.8% of cardiovascular diseases, followed by ischemic heart disease, valvular heart disease and cardiomyopathies. 4) PRWP may be an early sign of acute myocardial infarction in a certain part of cases, which was endorsed by typical clinical symptoms and enzyme studies. 5) As the criterion of PRWP, V3R equal to or less than 3 mm was thought more adequate for higher specificity rather than 4 mm.
Cardiomyopathies ; Cardiovascular Diseases ; Electrocardiography ; Heart Valve Diseases ; Lung Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Sensitivity and Specificity

The branches of the axillary artery have been studied in 38 Korean female cadavers. 1. The superior thoracic artery arose from the first part and the second part of the axillary artery in 84% of sides. 2. The thoracoacromial artery arose from the axillary artery near the superomedial border of the axillaly artery more often (91%) than from any other source. 3. The lateral thoracic artery was found on 64% of the sides as a main axillary artery, usually arising from the second part of the axillary artery(61%). It arose from the subscapular artery in 28%. 4. The subscapular artery was seen as the lagrgest of the axillary artery. It arose from the second part (42%) and the third (58%) of the axillary artery. 5. The posterior circumflex humeral artery was a direct branch of the third part of axillary artery in 37% of sides. In 21% fo sides the posterior circumflex humeral artery arose by a common stem from the third part of the axillary artery. In 33% of sides the posterior circumflex humeral artery arose from the subscapular artery. 6. The anterior circumflex humeral artery was found more constantly at the third part of the axillary artery than the posterior circumflex humeral artery was. It arose from a direct branch of the third part of the axillary artery in 70% of sides.
Arteries ; Axillary Artery* ; Cadaver ; Female* ; Humans ; Thoracic Arteries

PURPOSE: In gastric cancer, metastasis to the paraaortic lymph nodes had been regarded as an incurable factor, but many cases of long term survival have been reported with dissection of metastatic paraaortic nodes. And several reports suggested survival benefit with paraaortic lymph node dissection (D4) in advanced gastric cancer. In patients with advanced gastric cancer who underwent paraaortic lymph node dissection we tried to evaluate the factors predisposing metastasis in these nodes and survival data. MATERIALS AND METHODS: The authors analyzed retrospectively pathological features of 95 patients who underwent paraacntic lymph node dissection for advanced gastric cancer at Kangnam General Hospital Public Corporation Bom May 1991 to Feb. 1998. And we also analysed survival results of 72 cases among them. We excluded 18 cases of distant metastasis (3 liver metastasis, 15 peritoneal seeding), 2 operative mortalities, 1 other disease mortality, and 2 unlmown causes of death in survival analysis. RESULTS: The frequencies of paraaortic lymph node metastasis were 0.0% (0 of 32 cases) in T2, 19.2% (10 of 52 cases) in T3, 18.2% (2 of 11 cases) in T4. And those of paraaortic lymph node metastasis were 5.8% (3 of 52 cases) in antrum, 14.3% (3 fo 21 cases) in body, 20.0% (3 of 15 cases) in cardia, and 42.9% (3 of 7 cases) in whole area. The five-year survival rates (5 YSRs) in relation to the paraaortic lymph node (No16) status was 0.096 in No16+, and 57.8Po in Nol6 with D4 of advanced gastric cancer. The 5 YSRs were 78.1%, 40.8% and 0% in T2, T3 and T4, respectively and 93.8%, 64.2%, 24.2% and 0.0% in n0, nl, n2 and n.3, respectively and 88.9%, 80.5%, 57.9% and 0.0% (47.6%) and 0.0% in stage IB, II, IIIA, IIIB and IV, respectively. CONCLUSION: The depth of gastric wall invasion and the location of primary tumor were significant predisposing factors to para-aortic lymph node metastasis in multivariate analysis (p<0.05). Survival of No16 metastasis was very poor. And three factors of T stage, n stage, and Bonmann type were also prognostically significant in terms of five year survival in cases of D4 of advanced gastric cancer in multivariate analysis (p < 0.05).
Cardia ; Causality ; Cause of Death ; Drug Therapy* ; Granisetron* ; Hospitals, General ; Humans ; Liver ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Nausea* ; Neoplasm Metastasis ; Platinum* ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate ; Vomiting*

PURPOSE: Kawasaki Disease(KD) is a febrile disease with acute multisystemic vasculitis associated with early development of acute myocarditis and coronary artery abnormalities. The cause and etiologic agents are still unknown. Clinical studies suggest that KD is one of the autoimmune disorders caused by infectious agent, but this is not proved yet. The study was performed to investigate the levels of vascular endothelial growth factor(VEGF) in the acute stage of KD before treatment of intravenous-gammaglobulin(IVGG) to confirm and find an early diagnostic method of vasculitis by serologic test. METHODS: The patient group consisted of 61 cases in acute stages of KD before treatment of IVGG who were hospitalized from Jan. 1998 to Feb. 2001. The control group consisted of 24 cases among the admitted cases who suffered from non KD. The levels of VEGF in the obtained sera were measured by using chemoluminoimmunoassay, and those of both groups were compared to each other. RESULTS: The sex ratio of male to female was 1.6:1, males were more prone to infection, and mean age was 2.6+/-1.6 years old. The levels of VEGF in patients group(143.64+/-115.38 pg/mL) were significantly increased as compared with control group(26.55+/-13.75 pg/mL)(P<0.05). One case of acute myocarditis and two cases of left coronary artery dilations occurred in the patient group, but they all recovered after treatment two months later. Acute phage reactants such as CRP, ESR were positive and WBC was increased in acute stages of both groups. CONCLUSION: The significant increasing level of serum VEGF in acute febrile stages of KD suggests that acute vasculitis began in the early stage in all of the patients group, and the measurement of VEGF can be one of useful method for early diagnosis of vasculitis in KD. This may be helpful in early IVGG treatment of the condition.
Bacteriophages ; Coronary Vessels ; Early Diagnosis ; Female ; Humans ; Male ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis ; Serologic Tests ; Sex Ratio ; Vascular Endothelial Growth Factor A* ; Vasculitis

Patients with human immunodeficiency virus (HIV) infection have a higher burden of seizures, but few studies have examined seizures in HIV-infected individuals in Korea. A retrospective study was conducted to determine the epidemiology and clinical characteristics of seizures in patients with HIV infection. Among a total of 1,141 patients, 34 (3%) had seizures or epilepsy; 4 of these individuals had epilepsy before HIV infection, and the others showed new-onset seizures. Most patients exhibited moderate (200 to 500, n = 13) or low (below 200, n = 16) CD4 counts. The most common seizure etiology was progressive multifocal leukoencephalopathy (n = 14), followed by other HIV-associated central nervous system (CNS) complications (n = 6). Imaging studies revealed brain lesions in 21 patients. A total of 9 patients experienced only one seizure during the follow-up period, and 25 patients experienced multiple seizures or status epilepticus (n = 2). Multiple seizures were more common in patients with brain etiologies (P = 0.019) or epileptiform discharges on EEG (P = 0.032). Most seizures were controlled without anticonvulsants (n = 12) or with a single anticonvulsant (n = 12). Among patients with HIV infection, seizures are significantly more prevalent than in the general population. Most seizures, with the exception of status epilepticus, have a benign clinical course and few complications.
Adult ; Aged ; Anticonvulsants/therapeutic use ; Causality ; Comorbidity ; Electroencephalography/*statistics & numerical data ; Female ; HIV Infections/diagnosis/*epidemiology ; Humans ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk Factors ; Seizures/*diagnosis/*epidemiology/prevention & control ; Treatment Outcome

PURPOSE: It has been believed that o-blocker affects the stromal component of BPH, while 5 alpha -reductase inhibitor affects the glandular component. Information on the tissue composition of BPH might be helpful to choose an appropriate medical therapeutic agent. We evaluated whether transrectal ultrasonographic findings could reflect the histologic composition of BPH and the correlation of the composition of BPH and the clinical parameters such as patient's age, peak flow rate, IPSS symptom score, and prostate volume. MATERIALS AND METHODS: Fifty five patients with BPH treated by transurethral resection were studied. The proportions of stromal and glandular area in the resected prostate were determined by image analyzer. "Stromal hyperplasia"was defined when more than 75% of the resected prostate was composed of stromal tissue and microscopically, abundant stromal tissue with normal or atrophic glands were dominant. "Glandular hyperplasia" was defined when more than 25% of the prostate was composed of glandular tissue and microscopically, hyperplastic glandular cells and dilated lumen with occasional cystic changes were dominant. Ultrasonographically, it is classified as stromal hyperplasia when the echo of central gland is fine and lower echogenic than that of peripheral gland, and classlfied as glandular hyperplasia when the echo of central gland Is coarse and isoechogenic or hyperechogenic with focal echopenic areas. Statistical significance was judged by Student t-test and linear regression analysis. Concordance of ultrasonographic findings and histopathologic findings of BPH was determined by Kappa index. RESULTS: Sixty nine percent of resected prostate tissue were composed of stromal tissue. The proportion of stromal tissue in stromal hyperplasia and glandular hyperplasia was 85.8+/- 1.6% and 64.8+/- 1.0%, respectively(p<0.001). Ultrasonography accurately reflect histopathologlc type in 50 of 55 BPH. Two of 12 stromal hyperplasia and 3 of 43 glandular hyperplasia were falsely interpreted on ultrasonography. Three of 5 falsely interpreted cases showed marginal stromal tissue composition(60.9%, 72.9%, 73.3%, 76.4%, and 84.2%). Kappa index of ultrasonogrhaphic finding and histopathologic classification was 0.74(fair to good). In the meantime, clinical parameters including patient's age, peak flow rate, IPSS symptom scores did not correlate with tissue composition. Only prostate volume and resected prostate weight showed negative correlation with proportion of stromal tissue(p=0.0953 and p=0.0794, respectively). CONCLUSIONS: Using our sonographic criteria, transrectal ultrasonography could reflect histologic type of BPH so that choice of medical therapeutic agent may be possible. Larger prostates had less stromal tissue, however, the histologic composition of the prostate was not related to the severity of symptoms or peak flow rate.
Classification ; Humans ; Hyperplasia ; Linear Models ; Prostate ; Prostatic Hyperplasia ; Ultrasonography

This is a ease report of intraluminal partial obatructian of an endotracheal tube after cuff ballooing, a complication of a malfunctioned endotracheal tube, This 18 year old female patient with herniated intervertebral disc of L4-5 was anesthetized for archotomy and removal of disc. Aneethesia was maintained with N2O-O2-halothanepancuronium after endotracheal intubation with a Murphy tube. (Porges-Latex-tube No. 7), manufactured in France. A few minutes later, airway obstruction signs such as sudden hypertension, tachycardia, resistance of the researvoir bag in inspiration, and delayed filling time of the reservoir bag in expiration appeared. We suspected kinking of the tube, tubal obstruction from secretions, bronchospasm etc, but we could not find the exact cause of airway obstruction in spite of detailed checking. After recovery of the patient from anesthesia we checked the extubated tube. There was intraluminal partial obstruction of the endotracheal tube according to increase of intracuff volume and pressure because of the thin walled, flexible tube and diffusion of N2O into the cuff. After extubation the patient returned to normal. We surmmerized this case and also reviewed with the literature.
Airway Obstruction ; Anesthesia ; Bronchial Spasm ; Diffusion ; Fallopian Tube Diseases ; Female ; France ; Humans ; Hypertension ; Intervertebral Disc ; Intubation, Intratracheal ; Tachycardia

BACKGROUND: Although the pathophysiology of pulmonary vascular injury has been reported, exact its mechanism has not yet been elucidated. Recent studies have reported that reactive oxygen species, including hydrogen peroxide(H2O2) and superoxide, formed in association with a variety of oxidative stress-related diseases, may play an important role in cell injury and apoptosis. In this study, we investigated whether H2O2 induces apoptosis, a possible mechanism of pulmonary vascular injury. MATERIAL AND METHOD: The calf pulmonary artery endothelial cell line(CPAE) was used in the experiment. For the measurement of cytotoxicity of H2O2, 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium bromide(MTT) assay was performed. To find out whether H2O2 affects cell morphology, cells were examined by phase-contrast microscopy. To confirm the induction of apoptosis, H2O2-treated cells were analyzed by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL) assay, 4',6-diamidino-2-phenylindole(DAPI) staining and flow cytometric analysis. RESULT: Compared to the untreated control(100%), viabilities of cells treated with H2O2 of concentrations of 10 microM, 50 microM, 100 microM and 500 microM for 3 hours were about 70%, 33%, 26% and 28%, respectively. Morphologically, H2O2-treated cells(50 microM) showed retraction of processes, cell shrinkage, cytoplasm condensation and irregularity of shape. Both TUNEL assay and DAPI staining also showed typical apoptotic features of nuclear condensation and nuclear fragmentation in some nuclei of H2O2-treated cells. Through flow cytometric analysis, it was determined that there was an increased number of cells in the sub-G1 phase and a decreased number of cells in the G1 phase among the H2O2-treated cells, compared to those of the control. CONCLUSION: Through morphological and biochemical analyses, it was first demonstrated that cell death induced by H2O2 in CPAE showed classic apoptotic features. These results suggest the possibility that H2O2-induced apoptosis may, in part, be involved in the molecular mechanism of pulmonary vascular injury.
Apoptosis* ; Cell Death ; Cytoplasm ; Endothelial Cells* ; G1 Phase ; Hydrogen ; In Situ Nick-End Labeling ; Microscopy, Phase-Contrast ; Oxygen ; Pulmonary Artery* ; Reactive Oxygen Species ; Superoxides ; Vascular System Injuries