We report a case of angiosarcoma of the jejunum in a 65-year-old female. This angiosarcoma developed 20 years after postoperative irradiation for cervical carcinoma of the uterus. Grossly, the resected jejunum showed a 8 cm long segmental hemorrhagic lesion with multiple, small hemorrhagic nodules or cysts on its serosa and mesentery. Microscopically, the wall of jejunum was infiltrated by epithelioid or polygonal tumor cells arranged in solid nests or lining irregular vascular spaces. The case is of interest that the tumor occurred in the very unusal site for angiosarcoma and the patient had a past history of irradiation for uterine cervical carcinoma 20 years ago. In addition, the resected intestine showed histologic changes of chronic irradiation effect. Therefore, this case supports the view that there is cause and effect relationship between irradiation adn angiosarcoma.
Female ; Humans ; Cysts

Brenner tumors constitute about l.5~2.5% of all primary ovarian neoplasms and are almost always benign. It appears to derive from the surface epithelium of the ovary which undergoes metap1asia to form the urothelial-like components. we experienced a case of malignant Brenner tumor with adenocarcinoma and squamous cell carcinoma patterns in a 57-year-old woman. It was partly cystic tumor and contained a 4cm-sized gray yellow, lobulated or papillary solid mass, projecting from the cystic wall. Ultrastructurally, the solid mass was composed of malignant urothelial-like cells with focal glandular differentiation.
Female ; Humans ; Adenocarcinoma

Well differentiated osteosarcomas are variants of osteosarcoma composed mainly of fibrous and osseous tissue with minimal cystologic atypia. This tumor may be misinterpretated as a benign lesion if the radiologic and clinical features are not taken into account. We report a typical case of intraosseous well differentiated osteosarcoma occuring in the left distal femur of a 58-year-old woman. Radiologically, it appered as an ill-defined lesion with a mixture of sclerotic and osteolytic ares. But there was a lack of highly destructive appearance of conventional osteosarcoma. Grossly, the mass occupied a metaphysis of the distal femur with extension into the diaphysis and epiphysis. Multifocal cortical destruction and sclerosis were also associated. Histologically, the mass showed typical features of intraosseous well differentiated osteosarcoma. There were various patterns of osteoid deposits and bone formation mimicking those of fibrous dysplasia, nonossifying fibroma or parosteal osteosarcoma.
Female ; Humans

BACKGROUND: The College of Medicine at Korea University has lunched the new curriculum which incorporated optional elective courses in 2000. Optional elective course is consisted of 10 subjects. 8 subjects are conducted in classroom lectures and 2 of them are active experiences in research or community service. The purpose of this study is to identify the level of achievement of its own educational goals and objectives. Also, we tried to explore the possibilities of improving this course for the maximum educational effectiveness.. MATERIAL AND METHOD: We conducted a survey and the subjects of this study were second, and third year medical students who finished this course. RESULTS: 84.8% of respondents were aware of the goals of the course. 91.1% of them agreed this course is needed to enhance the effectiveness in undergraduate medical education. Most students agreed the course provide an opportunity to broaden their perspectives of field of medicine(81.4% of respondents). Also, this course provided good informations for students' future career choice(78.6% of respondents). However, students wanted to have more in-depth learning experience. INTERPRETATION: The implementation of the optional elective course at the Korea University, Medical College was successful. Despite of its initial success, the course has to be revised to allow students to get more in - depth study according their own interests.
Curriculum ; Surveys and Questionnaires ; Education, Medical, Undergraduate ; Humans ; Korea ; Learning ; Lectures ; Lunch ; Social Welfare ; Students, Medical

For quality assurance purposes, the authors correlated aspiration cytology and subsequent tissue findings and examined the reasons for discrepancies. In three months from Jan. to Mar. 1996, 1,383 aspirations were performed, of which 285 (20.6%) had subsequent tissue diagnoses within two months. The aspiration sites were thyroid (483), lymph node (LN) (290), breast (250), soft tissue (154), liver (89), lung (49), salivary gland (26), pancreas (22), gallbladder (3), bone (3), joint (2), adrenal gland (2), scrotum (2), mediastinum (2), omentum (2), oral cavity (1), chest wall (1), and intraabdominal (1) and pelvic cavities (1). A total of 68 discrepancies were identified, and biopsies and smears from these cases were reviewed monthly. In 27 cases (40%), the discrepancy was attributed to sampling error. In five cases (9%), aspiration gave superior results with better sampling and preservation than biopsy. Thirty six cases (53% of discrepant cases) were errors in cytologic diagnosis. We categorized these discrepancies into "A", "B", and "C" ("A": minor disagreement with no affect on patient care, "B": minimal affect on patient care, "C": major affect on patient care), which were 9 (13%), 14 (21%) and 13 (19%) cases, respectively. In thirteen cases of category "C", there were eleven false negative and two false positive diagnoses. Eleven false negative cases included thyroid (3), lymph node (2), breast (2), bone (1), salivary gland (1), lung (1), and liver (1). Three cases of thyroid were papillary carcinomas diagnosed as nodular hyperplasia (1), occasional pleomorphic cells (1), and cystic change (1). Two breast cases of invasive ductal carcinomas were diagnosed as ductal hyperplasia. A malignant lymphoma was diagnosed as reactive hyperplasia and a metastatic carcinoma of LN was diagnosed as tuberculosis. Other cases were malignant tumors of bone, salivary gland, lung, and liver those were misinterpreted as benign lesion or normal. Of two false positive cases, one was nodular hyperplasia of thyroid diagnosed as papillary carcinoma and the other was normal islet cell of pancreas diagnosed as islet cell tumor. A continuous monitoring of laboratory performance is an essential component of the quality control and assurance, and the review of discrepant cases provides useful information for improvement of diagnosis.
Adenoma, Islet Cell ; Adrenal Glands ; Aspirations (Psychology) ; Biopsy ; Breast ; Carcinoma, Ductal ; Carcinoma, Papillary ; Diagnosis ; Gallbladder ; Humans ; Hyperplasia ; Islets of Langerhans ; Joints ; Liver ; Lung ; Lymph Nodes ; Lymphoma ; Mediastinum ; Mouth ; Omentum ; Pancreas ; Patient Care ; Quality Control ; Salivary Glands ; Scrotum ; Selection Bias ; Thoracic Wall ; Thyroid Gland ; Tuberculosis

Cytopathologic findings of two cases of adenoid cystic carcinoma of the trachea are reported. The carcinomas grew as a intratracheal mass. By bronchial washing, brushing and/ or post-bronchoscopic sputum cytology, large cohesive sheets, lobulated clusters, or three dimensional ball-like structures were obtained. They had numerous cyst-like spaces containing characteristic globular basophilic material. The tumor cells were uniform and had a small amount of cytoplasm. Nuclei were small and hyperchromatic. Nucleoli were occasionally observed. The cytological diagnosis was confirmed by bronchoscopic biopsies.
Adenoids* ; Basophils ; Biopsy ; Carcinoma, Adenoid Cystic ; Cytoplasm ; Diagnosis ; Sputum ; Trachea*

PURPOSE: The purpose of this study was to evaluate the CT findings of thyroglossal duct cysts MATERIALS AND METHODS: Sixteen patients with pathologically proved thyroglossal duct cysts were included in the study. CT scans were assessed'retrospectively for shape, size, location, density of the central portions, septations, rim enhancement, changes in the adjacent fascial planes and investment within the strap muscles in the infrahyoid cysts. RESULT: Thirteen cases of thyroglossal duct cysts were seen as round or oval cystic masses, two cases of them were seen as irregular-shaped Iobulated cystic masses, and one case was seen as ovoid soft tissue mass. The cysts were from 1.4 to 5.7cm in diameter(mean, 2.6cm). The cyst was infrahyoid in 15 cases and suprahyoid in one case. The cyst was located in midline in eight cases, off midline in four cases, and both midline and off midline in four cases. The density of the central portions ranged from 15 to 82HU(mean, 32HU). Septations were noted in four cases. Rim enhancement was seen in 14 cases(93%), and heterogenously enhancing soft tissue mass was seen in one case. In four cases, abnormal fascial planes were observed. All but one of the infrahyoid cysts(14/15) were embedded within the strap muscles, and one case of them was located anteriorly to strap muscles. CONCLUSION: CT permits one to make the diagnosis a thyroglossal duct cyst with a high degree of accuracy, as it can differentiate thyroglossal duct cysts from the other anterior neck masses by their typical location, characteristic morphology, and investment within the strap muscles.
Diagnosis ; Humans ; Investments ; Muscles ; Neck ; Thyroglossal Cyst* ; Tomography, X-Ray Computed

PURPOSE:Urine examination for microalbuminuria during the clinical silent years can help to identify those patients most likely to progress to overt nephropathy. The normalization of the AER(Albumin Excretion Rate) by alteration of glomerular hemodynamics may be the key to preventing or delaying overt nephropathy. The prognostic and therapeutic implications have led to attempts to identify patients with microalbuminuria as early as possible.Because diagnosis of microalbuminuria has required a 12 or 24 hour urine collection,there has been interested in developing tests that might serve as a first-stage screen for microalbuminuria. Most reports have dealt with the usefulness of either the albumin concentration or the albumin/creatinine ratio in a timed or randomly collected urine specimen. Exercise induced albumin excretion is increased compared to resting and could unmask latent glomerular damage. The purpose of this study is to evaluate diagostic significance of urinary albumin measurement after exercise in children with insulin dependent diabetes. METHODS:Fifty-seven patients with IDDM collected their overnight urine from 22:00 to 6:00 in following morning. Exercised method for urine examination was 100M running and collected 2 hour urine after exercise. The AER and Albumin/ creatinine ratio(ACR) were measured in the urine and compared with before and after exercise. RESULTS:Mean ages of diabetic children was 13.7 yrs old and duration of diabetes was 4.1+/-2.7yrs, HbA1c 8.6+/-1.9%,Systolic BP 107+/-10mmHg and Diastolic BP 67+/-8mmHg. The exercise induced AER was increased compared to before exercise(10.3+/-10.5 vs 18.1+/-16.0 mg/24hr). The exercise induced ACR also increased too(1.4+/-1.5 mg/g.Cr vs 4.1+/-3.6mg/g.Cr)(P<0.01). Two(3.5%) children with IDDM was positive for microalbuminuria in terms of AER before exercise and 8 children(14%) after exercise. No one positive for microalbuminuria in terms of Alb/cr before and after exercise. The charateristics of 8 children with microalbuminuria after exercise was no specific difference between positive and negative microalbuminuria. There was specific correlation between microalbuminuria and HbA1c(P<0.05) but sex, ages, duration of diabetes & blood pressure were not correlated with incidence of microalbuminuria. CONCLUSION: The mean timed urinary albumin excretion after exercise was significantly higher than before exercise. Measurement of timed urinary albumin excretion after exercise will be helpful for detecting microalbuminuria earlier.
Blood Pressure ; Child* ; Creatinine ; Diabetes Complications ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies ; Diagnosis ; Hemodynamics ; Humans ; Incidence ; Insulin ; Running

PURPOSE: The purpose of this study was to determine handwashing-related factors in nurses. Specific purposes of this study were to examine 1) the applicability of the hypothetical model constructed for this study, on the basis of Theory of Planned Behavior(TPB), and 2) relationships between handwashing practice and other variables such as age, career, level of education, and level of recognition about handwashing. METHOD: Data were collected from 187 nurses in one university hospital in Kyung-Ki province. RESULT: The hypothetical model based on TPB was revealed applicable, but the degree of the variance explaining handwashing practice was small(26%). Perceived behavioral control(PBC) was the most strong variable explaining handwashing practice, and intention didn't have a significant effect on handwashing practice. Norm and PBC had significant effects on intention, but attitude was not a significant factor of intention. Age, career, and the level of awareness of handwashing practice were significantly related to handwashing practice. CONCLUSION: The result of this study suggests that we should focus on perceived behavioral control, awareness of handwashing practice and subjective norm about handwashing practice to increase the level of nurses' handwashing practice.
Education ; Gyeonggi-do ; Hand Disinfection* ; Intention

PURPOSE: The purpose of this study was to determine handwashing-related factors in nurses. Specific purposes of this study were to examine 1) the applicability of the hypothetical model constructed for this study, on the basis of Theory of Planned Behavior(TPB), and 2) relationships between handwashing practice and other variables such as age, career, level of education, and level of recognition about handwashing. METHOD: Data were collected from 187 nurses in one university hospital in Kyung-Ki province. RESULT: The hypothetical model based on TPB was revealed applicable, but the degree of the variance explaining handwashing practice was small(26%). Perceived behavioral control(PBC) was the most strong variable explaining handwashing practice, and intention didn't have a significant effect on handwashing practice. Norm and PBC had significant effects on intention, but attitude was not a significant factor of intention. Age, career, and the level of awareness of handwashing practice were significantly related to handwashing practice. CONCLUSION: The result of this study suggests that we should focus on perceived behavioral control, awareness of handwashing practice and subjective norm about handwashing practice to increase the level of nurses' handwashing practice.
Education ; Gyeonggi-do ; Hand Disinfection* ; Intention