Many articles concerning the accuracy of diagnosis of malignant tumor cells in body fluids have appeared in the literature, but few authors have attempted to describe the characteristics of these cells to determine the site of the primary tumor as they relate to tumors of specific primary sites. This paper presents the results of a retrospective study on malignant body cavity effusions of which the primary site was established on the basis of either biopsy or surgical resection of the primary neoplasm during the period of 6 years beginning from January 1983 to December 1988. The results obtained are summarized as follows: 1) The 143 fluid specimens from 129 patients were composed of 51 cases of pleural, 69 of peritoneal, and 9 of pericardial origin. 2) Adenocarcinoma was the most frequent type of malignant effusions (78.3%). The most common primary site was the lung (50%) in pleural fluid and stomach (55.2%) in ascites. 3) The results of this study show that the primary site of tumor cells can be identified in the body fluid of accurate cytomorphologic criteria are used. Identification of the primary site of an effusion would be improved by the consideration of clinical information
Adenocarcinoma ; Biopsy

Leiomyomas are benign tumors of smooth muscle origin and are very rare in the female genital tract. To date, approximately 35 cases of urethral leiomyoma have been reported in the literature. A 34-year-old woman presented with a 3-year history of a mass at the urethral meatus. Physical examination showed 2 x 1.5 cm lump at the urethral meatus, posterior lip. Histologically the tumor was mainly composed of benign cigar shaped smooth muscle izells which were arranged in interlacing fascicles without cellular atypia or mitosis. Immunohistochemistry confirmed leiomyoma with positive staining for vimentin, desmin and muscle specific actin.
Female ; Humans

During tumor progression, a subset of cells acquires metastatic properties, presumably through a series of genetic alterations. CD44 variant glycoproteins containing sequences encoded by exon v6 are related to tumor progression of human colorectal cancer. But their expression in normal colonic epithelium is controversial and studies of CD44 on each step of colorectal carcinogenesis are scanty. We studied CD44v6 expression in the normal colonic mucosa, adenoma, carcinoma in situ, and invasive colorectal carcinomas of different Astler-Coller stages. Endoscopically or surgically resected 36 normal colonic mucosa, 19 adenomas, 8 cases of carcinoma in situ, and 25 cases of carcinoma were selected. After immunohistochemical stain with CD44v6 antibody, positivity was graded as 0 to 4 based on the estimated percentage of positively stained tumor cells. The intensity of positive staining cells was also graded as 0 to 3. In all but one cases (97.2%), normal colorectal mucosa was negative for CD44v6. Positive rates in adenoma, carcinoma in situ, Astler-Coller stage A/B and C/D carcinoma were 73.6%, 88.9% and 87.5%, respectively. There was no statistically significant difference in the positivity between these groups. The staining intensity was significantly higher in the cases of stage C/D carcinoma group than those of adenomas (p<0.05). The percentage of positivity for CD44v6 was higher in stage C/D carcinoma group than adenoma, carcinoma in situ, and stage A/B carcinoma group (p<0.05). Expression of CD44v6 in the normal colonic mucosa was extremely rare and the positivity was increased according to the progression of colorectal tumors. Furthermore, it is more important to interpret the CD44v6 positivity according to the estimated percentage of positively stained tumor cells.
Adenoma ; Carcinogenesis ; Carcinoma in Situ ; Colon ; Colorectal Neoplasms* ; Epithelium ; Exons ; Glycoproteins ; Humans ; Mucous Membrane ; Neoplasm Metastasis

No Abstract Available.
HIV-1* ; Transcription Factors*

BACKGROUND: Cosmetics are one of the common causes of contact dermatitis and many new cosmetic products are being introduced rapidly into our market. OBJECTIVE: Our purpose was to investigate the as is patch test result by several factors including age, cosmetic product and atopic diseases, and to compare as is patch result with those of standard and cosmetic patch tests. METHODS: The records of 240 patients were reviewed who had been patch tested with their own cosmetics and toiletries with a clinical impression of cosmetic contact dermatitis at the patch clinic of Kangnam St. Mary's Hospital in the period of 1991-1995. RESULTS: Of the 95 patients who were tested with European standard series 54 (56.8%) showed a positive reaction and nickel sulfate was the most common allergen. Eighteen (38.3%) of the 47 patients tested with a cosmetic series revealed a positive reaction and imidazolidinyl urea and dodecyl gallate were the most common allergens. In as is patch test, 99 (41.3%) of the 240 patients showed a positive reaction to 248 (7.3%) of the 3403 cosmetics. Common cosmetic products showing positive reactions were skin care products (26.2%), face make-ups (19.8%), and hair preparations (16.9%). There was no statistically significant difference in the positive reaction rate between atopy and non-atopy patients. The positive correlation rate of as is test with standard and cosmetic series was relatively low. CONCLUSION: Commercial standard patch test series including cosmetic series are not enough to detect causative allergen in cosmetic contact dermatitis. As is patch test should be encouraged to detect new allergens, because many cosmetic ingredients are developed and introduced in market.
Allergens ; Dermatitis, Contact* ; Hair Preparations ; Humans ; Nickel ; Patch Tests* ; Skin Care ; Urea

BACKGROUND: Recently-developed equipment based on bioelectrical impedance analysis (BIA) not only measures total body fat but also displays several estimated indicators that reflect intra-abdominal fat, such as waist circumference (WC) and waist-to-hip ratio (WHR). This study examined the usefulness of these indicators in the diagnosis of metabolic syndrome (MS). METHODS: A total of 632 people over 20 years of age (355 men and 277 women, mean age 48.61+/-11.08 years, mean BMI 23.62+/-3.00 kg/m2, 117 MS patients) were enrolled in the study. Measurements of WC and hip circumference were measured by one individual, and WHR was calculated. BIA was performed to estimate waist circumference (BIAWC) and waist-to-hip ratio (BIAWHR). Receiver operating characteristic (ROC) curve analysis was used to examine the usefulness of BIAWC and BIAWHR in diagnosing MS. RESULTS: The areas under the curve (AUCs) were 0.836 (95% CI 0.805-0.864) for WC, 0.814 (95% CI 0.782-0.844) for BIAWC, 0.815 (95% CI 0.782-0.844) for WHR, and 0.805 (95% CI 0.772-0.835) for BIAWHR. The difference between the AUCs of WC and BIAWC (0.022, 95% CI -0.004 to 0.048) and the difference between the AUCs of WHR and BIAWHR (0.010, 95% CI -0.015 to 0.034) were not significant. CONCLUSIONS: The indices for central obesity estimated by BIA had high agreement with the direct method, and they were not inferior to direct measured indices for predicting metabolic syndrome.
Adipose Tissue ; Area Under Curve ; Electric Impedance ; Female ; Hip ; Humans ; Intra-Abdominal Fat ; Male ; Obesity, Abdominal ; ROC Curve ; Waist Circumference ; Waist-Hip Ratio

No abstract available.
Ultrasonography*

A clinical and histologic survey was done on 71 cases of basal cel carcinoma(BCC) filed at Department of Clinical Fathology, Kang Nam, Han Kang, and Kang Dong Sacred Heart Hospital during past 13 year s from 1979 to 1991. The results were summerized as follows: 1. Of all malignant skin tumors BCC accounted for 31.6%. The frequency of BCC in the total number of outpatients visiting the Department of Dermatology was 0.06%. 2. The ratio of men to women with HCC was 1:1.03. 83.8% of the pat.ients with BCC were older than the age of l0 years with the mean age of 56.9 years. 3. 83.8% of the BCC appared in the face, especially on the nose(25.4%), eyelid(20.3%). 4. On the basis of classification of Lever et al, the solid type(66.7% ) was the most com mon histologic pattern, followed by the adenoid(8.8%), pigmented(8.8%), and etc. By the classification of Farmer et al, the nodulocystic type(35.1% ) was the most common histologic pattern followed by infiltrative(31.6%), adenoid(8.8%), pigmented(8.8%), and etc. By the classification on Sexton et al, in the order of decreasing frequency, liistologic subtypes were the nodular(43.9%), mixed (22.8%), infiltrative(19.3%), supeficial(3.5%), morpheic(3.5%), and micronodular(3.5%).
Carcinoma, Basal Cell* ; Classification ; Dermatology ; Female ; Heart ; Humans ; Male ; Outpatients ; Skin

BACKGROUND : The proportion and absolute number of older patients admitted through the emergency department (ED) are increasing yearly. As people getting older, they are more likely to suffer from emergency situation of disease, disability, and trauma. Combining with the decrease in physiologic reserve, these added burdens make the elderly more vulnerable to any of the additional situations. Understanding the implications of these facts is crucial to one who is providing optimal triage and emergency care to elderly (aged 65 years or older) and adults (between 15year of age and 64 years of age). METHODS : We conducted an observational survey of emergency patients age 15 or older who admitted to emergency department of Asan Medical Center. A convenience sample of 3,481 were divided into 2 groups by 65 years of age, and final results (admission vs. discharge) after emergency care was compared. The admission rate according to between two groups. We calculated odds ratios of important outcomes by pooling data from individual trials using logistic regression analysis. RESULTS : Admission rate of elderly was higher than adults as 59.2% versus 36.4% (odds ratio=2.32) 95% CI=1.21~3.24). Although vital signs were within normal ranges, admission rate of elderly was significantly higher than adults as follows; normal range of systolic blood pressure (56.0% vs. 35.5%), normal range of respiration rate per minute (55.4% vs. 36.4%), alert status of mentality (34.2% vs. 54.7%). CONCLUSION : We could not define the severity of emergency patients only by using vital signs and/or clinical symptoms, especially to the elderly patients. Even though the vital signs of elderly patients. emergency physician should manage them carefully because of the high severity of clinical condition in elderly then we expected. Emergency Geriatric Assessment tools must be developed differently from general triage tools.
Adult ; Aged* ; Blood Pressure ; Chungcheongnam-do ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Geriatric Assessment ; Humans ; Logistic Models ; Odds Ratio ; Reference Values ; Respiratory Rate ; Triage ; Vital Signs

PURPOSE: This study was done to evaluate validity and reliability of the Korean version of the expanded nursing stress scale (ENSS). METHODS: Forward-backward translation of ENSS from English to Korean was conducted. The translated instrument was pilot-tested and administrated to 285 nurses who worked in five general hospitals in Korea. Internal consistency reliability was assessed using Cronbach's alpha and composite reliability. Validity was evaluated through construct validity with confirmatory factor analysis, convergent and discriminant validity. RESULTS: The Korean version of ENSS showed a reliable internal consistency with Cronbach's alpha .95 and composite reliability .99. Model fit indexes for 46 items were validated by confirmatory factor analysis(goodness of fit index .82, Tucker-Lewis index .92, root mean square error of approximation .04), indicating suitable construct validity. Factor loading of the 48 items (.47~.88) and average variance extracted out of nine factors (.52~.71.) indicated satisfactory convergent validity. Some values of square of the correlation coefficient between factors (.12~.89) were higher than average variance extracted values of each factor (.52~.71) so that it partly satisfied discriminant validity. CONCLUSION: Findings show that the Korean version ENSS has good reliability and suitable validity; therefore, can be used to assess and identify Korean nurses' job stress.
Factor Analysis, Statistical ; Hospitals, General ; Korea ; Nursing* ; Reproducibility of Results* ; Stress, Psychological ; Translations