Carcinsarcoma is an uncommon pulmonary malignancy characterized by carcinmatous parenchyma and sarcomatous stroma. The cytologic, immunohistochemical and ultrastructural features of a case of pulmonary carcinosarcoma suspected by fine needle aspiration cytology is presented. Only bizarre spindle cells arranged in loose groups, in microtissue fragments and in a dissociate fashion were present in the aspiration smears. They were markedly positive for vimentin. The epithelial component was not found, which was probably due to marked paucity of carcinomatous component that was proved by histologic examination of the resected tumor. The diagnosis of pulmonary carcinosarcoma should be conidered whenever poorly differentiated epithelial cell groups with a malignant mesenchymal component set in a myxoid background are seen in a pulmonary cytology specimen.
Biopsy, Fine-Needle ; Carcinosarcoma ; Child* ; Diagnosis ; Epithelial Cells ; Humans ; Interleukin-6* ; Nephritis* ; Purpura, Schoenlein-Henoch* ; Vimentin

We observed clinical features of 18 bronchopulmonary dysplasia (BPD) patients who were admitted to the neonatal intensive care unit in the Severance Hospital of Yonsel University College of Medicine from January 1. 1987 to June 30. 1991. Eight patients in whom ventilator settings were unchanged for more than 5 days because of lack of improvement in pulmonary function. The effects of dexamethasone in ventilator-dependent were included in the short-term dexamethasone therapy. 1) Eighteen BPD patients consisted of 15 premature infants (83%), 1 full-term infant, and 2 post-term infants, The mean gestational age of the patients were 30 weeks and the mean birth weight was 1,420gm. And there were 13 male and 5 female infants. 2) The underlying conditions which necessitated ventilatory support support were hyaline membrane disease in 13 patients (72%), apnea in 2 (11%), and meconium aspiration syndrome in 3. There patients with meconium aspiration syndrome were either full-term or post-term infants, of whom 2 had neonatal persistent pulmonary hypertension. 3) The mean age at the start of ventilator care was 8 hours and the mean PIP was 32 cm H2O. The mean duration of ventilator care of oxygen therapy and of high O2 requirement (FiO2>0.8) were 39 days, 75 days and 20 days, respectively. 4) Patent ductus arteriosus developed in 8 patients during mechanical ventilation, but they were all closed with the use of mefenamic acid, There were also 4 cases of pneumothorax, 2 cases of pulmonary parenchymal emphysema, and 1 case each of pneumomediastinum and pneumoperitoneum. 5) The mean gestational age of the dexamethasone-treated group was 30 weeks and the mean birth weight was 1,320gm, The mean age at which dexamethasone therapy was started was 39 days after birth, and in only 3.3 days 6 patients were successfully weaned from ventilator, In 5 cases the first trial of dexamethasone therapy was enough but the rest needed the 2nd trial for ventilator weaning. 6) In 6 BPD patient who were weaned from the ventilator after dexamethasone therapy, there were significant decreases in MAP (11.1 vs 8.0 cmH2O), and FiO2 (0.73 vs 0.61), but a significant increase in the urine output (2.56 vs 3.7ml/kg/hr) for the pretreatment (5 days prior to therapy) versus posttreatment period (first day of therapy). 7) The complications of dexamethasone treatment were transient hypertension and hyperglycemia in 3 patients, and systemic candidiasis and gastrointestinal bleeding in 2 patients who failed to be weaned after dexamethasone therapy. Our results suggest that the short-term dexamethasone therapy in bronchopulmonary dysplasia patients who are dependent on mechanical ventilation enables weaning in a short period of time. The inspiratory oxygen concentration and the mean airway pressure may be decreased and the urine output may be increased from the first day of medication, improves pulmonary function and decreases pulmonary interstitial edema.
Apnea ; Birth Weight ; Bronchopulmonary Dysplasia* ; Candidiasis ; Dexamethasone* ; Ductus Arteriosus, Patent ; Edema ; Emphysema ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyaline Membrane Disease ; Hyperglycemia ; Hypertension ; Hypertension, Pulmonary ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Male ; Meconium Aspiration Syndrome ; Mediastinal Emphysema ; Mefenamic Acid ; Oxygen ; Parturition ; Pneumoperitoneum ; Pneumothorax ; Respiration, Artificial ; Ventilator Weaning ; Ventilators, Mechanical ; Weaning

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*

Hyperglycemia is a well-recognized side effect of L-asparaginase in remission induction therapy of acute lymphocytic leukemia. Since hyperglycemia has preceded fatal diabetic ketoacidosis or hyperosmotic nonketotic coma in some patients, early detection and treatment of this complication are important. We determined retrospectively the risk of hyperglycemia in 117 patients with leukemia who had received L-asparaginase (& prednisolone). The results were as follows: 1) Twenty (17%) of the 117 patients developed hyperglycemia. 2) Of 47 female patients, 13 developed hyperglycemia, contrast with only 7 of 70 male patients(P<0.05). 3) All 2 obese patients developed hyperglycemia, contrast with 18 of 115 non obese patients (P<0.05). 4) Of 16 patients with a history of previous administration of L-asparaginase 6 (42%) developed hyperglycemia, contrast with only 14 (11%) of the remaining 101 patients (P<0.05). 5) Of the remaining factors analyzed-age, leukocyte counts, family history, dose of L-asparaginase-non had a statistically important influence on the development of hyperglycemia. 6) The mean glucose concentration at onset was 355+/-197.5mg/dl in patient who developed hyperglycemia with peak concentration of 404+/-253.6mg/dl. Hyperglycemia developed between 3 to 20 days after administration of L-asparaginase, and the duration of hyperglycemia was 6.90+/-5.54 days. Since hyperglycemia developed inevitably in a certain proportion of patients given L-asparaginase, we recommend blood glucose monitoring in patients with the risk factors.
Blood Glucose ; Child* ; Coma ; Diabetic Ketoacidosis ; Female ; Glucose ; Humans ; Hyperglycemia* ; Leukemia* ; Leukocyte Count ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Remission Induction ; Retrospective Studies ; Risk Factors*

Acute suppurative thyroiditis is uncommon in children. The relative rarity of thyroid infection is thought to reflect its complete fibrous encapsulation, generous vascular and lymphatic supply and high local iodine level. The bacterial involvement include the normal oropharyngeal microflora, and broad spectrum antibiotic therapy including anaerobic coverage should be utilized initially. We have experienced three cases of acute suppurative throiditis. All of them had painfull swelling on anterior cervical area and diagnosed by clinical and radiological features. Since two of them occured repeatedly, we report with brief review of literatures.
Child* ; Humans ; Iodine ; Thyroid Gland ; Thyroiditis, Suppurative*

Moving on the femoral srticular surface, the patella is doing a significant role in the patellofemoral mechanism as one of the most important components of the knee. The knowledge of patellar movement would be very helpful to understand the functional mechanism of the knee We studied the distance of patellar movement during the knee motion on the lateral X-ray view of 100 normal adult knees. The results were as follows :1. The average distance of patellar movement from full extension to full flexion of the knee was 8.4cm. 2. Patella moves average 1.7cm(20.2%) form 0° to 30° flexion, 2.6cm(31.0%) from 30° to 60° flexion, 1.7cm(20.2%) from 60° to 90° flexion, 1.3cm(15.5%) from 90° to 120° flexion and l.lcm(13.1%) from 120° to full flexion.
Adult ; Humans ; Knee ; Patella

Ulnar lengthening, one of the operative treatment methods for Kienbock's disease, is based on the theory that ulnar minus variance is a significant causative factor of Kienbock's disease. It is considered that this method can promote the revascularization of the devascularizied lunate by reducing the forces concentrated at the wrist joint and that over-all carpal collapse is halted or reversed when the ulnar part of the carpus is supported better. 4 patients with Kienbock's disease treated by ulnar lengthening with iliac bone graft were reviewed after follow-up ranging from12 months to 30months. In all of 4 patients, relief of pain was satisfactory and there was no remarkable complication.
Follow-Up Studies ; Humans ; Methods ; Osteonecrosis ; Transplants ; Wrist Joint

Through the review of 137 cases of ankle fracture treated and followed up in Department of Orthopedic Surgery, National Police Hospital, we got the following results. 1. Slipping was the most frequent cause of the fractures(45.3%). 2. Supination-external rotation type of Lauge-Hansen classification was more common than any other types(67.9%). 3. 94 cases out of 137 cases were treated by open reduction and internal fixation, and remaining 43 cases were treated conservatively. 4. The average duration of cast immobilization was 7.3 weeks for the operatively treated cases and 9.1 weeks for the conservatively treated cases. 5. The result of treatment was good or excellent in 87 cases(92.6%) of operatively treated 94 cases and in 36 cases(83.7%) of conservatively treated 43 cases. 6. We think that the anatomical reduction of the lateral malleolar or distal fibular fracture is necessary for better end results.
Ankle Fractures ; Ankle ; Classification ; Clinical Study ; Humans ; Immobilization ; Orthopedics ; Police

No Abstract Available.
Humans ; Kidney Failure, Chronic* ; Rupture* ; Tendons*

No abstract available.
Adenocarcinoma* ; Scrotum* ; Stomach Neoplasms*