1.Fetal Rhabdomyomatous Nephroblastoma: A case report.
Nam Hoon KIM ; Chan Pil PARK ; Eun Kyung HONG ; Poong Man JUNG ; Moon Hyang PARK
Korean Journal of Pathology 1995;29(1):96-102
A fetal rhabdomyomatous nephroblastoma is considered to be a predominantly monophasic mesenchymal variant of Wilms' tumor, which acts less aggressively than a conventional Wilms' tumor despite its much larger size. Bilaterality of this tumor in a nine month-old girl, however, may negatively affect the overall prognosis. A radical nephrectomy for bulky masses in the left kidney and a partial nephrectomy for right kidney with five small tumor masses was performed at the same time. Two small tumor masses in the upper part of right kidney were left behind because of preserving minimal renal functional capacity. Pathological study revealed a mixed type of nephroblastoma which was composed predominantly of mesenchymal components with fetal rhabdomyomatous differentiation. After post-operative chemotherapy with vincristine, actinomycin D and adriamycin, and radiotherapy(2,130 rad), residual tumor masses became a single tumor 5 cm in diameter and well demarcated, which was resected at 15 months after first operation when the size and renal function of remained right kidney was appropriate to resect out the residual tumor. The tumor resected out at second operation was entirely composed of scattered differentiated fetal skeletal muscle cells in the fibrovascular tissue. Only a few entrapped epithelial components were seen but no blastemal cornponents were present. Follow up abdominal CT and ultrasonographic examinations revealed no evidence of tumor recurrence. The girl has developed normally without disease.
2.Prognostic Value of Somatosensory Evoked Potentials in Comatose Patients after Cardiopulmonary Resuscitation.
Se Min CHOI ; Dong Rul OH ; Seung Pil CHOI ; Kyu Nam PARK ; Se Kyung KIM
Journal of the Korean Society of Emergency Medicine 2000;11(4):450-456
BACKGROUND: The improved technique for cardiopulmonary resuscitation(CPR) has resulted in the survival of many patient who experienced cardiac arrest. However, mortality in resuscitated patients is high, and the survival rate without brain damage is very low. Various neurological examination models, neuro-imaging techniques, electrophysiological procedures, and biochemical tests have been studied with respect to the detection of cerebral damage and outcome, but an early, reliable prediction of individual outcomes is still uncertain. METHODS: We studied twenty patient who had been in a coma for more than 24 hours after CPR, Somatosensory evoked potentials(SEP) were measured within the first three days after CPR. RESULTS: Of the twenty patients, seven patients(35%) had a good outcome, and thirteen patients(65%) had a bad outcome. Of the eleven patients with loss of the cortical evoked potential's N20 peak, all had a bad outcome. CONCLUSION: SEPs are of great benefit in prognostic evaluation after CPR.
Brain
;
Cardiopulmonary Resuscitation*
;
Coma*
;
Evoked Potentials, Somatosensory*
;
Heart Arrest
;
Humans
;
Mortality
;
Neurologic Examination
;
Survival Rate
3.A Classification of Asphyxia Autopsy Cases of the Korea in 2012 according to New Classification of Asphyxia.
Joo Young NA ; Jong Pil PARK ; Kyung Moo YANG ; Nak Eun CHUNG ; Han Young LEE
Korean Journal of Legal Medicine 2014;38(1):8-12
No accepted standard currently exists to classify asphyxia and define its subtypes. Sauvageau and Boghossian proposed an asphyxia classification system in 2010 that divided asphyxia into suffocation, strangulation, mechanical asphyxia, and drowning. Here, we present a modification of this classification system. We propose to classify asphyxia into four main categories: suffocation, strangulation, mechanical asphyxia, and complicated asphyxia. Suffocation includes smothering and choking as well as confined spaces, entrapment, and vitiated atmosphere. Strangulation is subdivided into hanging, ligature strangulation, manual strangulation, and other unspecified strangulation. Mechanical asphyxia includes positional and traumatic asphyxia. Finally, complicated asphyxia is defined as cases with two or more identifiable mechanisms of asphyxia. In this study, we review autopsy cases from 2012 diagnosed as asphyxia and classify them according to our proposed asphyxia classification system. In 24.7% of cases, the age range was 40-49 years, and 51.9% were men. The most common method of asphyxia was hanging (245 cases, 55.1%), followed by ligature or manual strangulation (53 cases, 11.9%). Most hangings were suicides; smothering, ligature, and manual strangulation were usually homicides. Eighteen cases were complicated asphyxia. This classification provides a simplified, unified, and useful tool to classify and understand deaths due to asphyxia.
Airway Obstruction
;
Asphyxia*
;
Atmosphere
;
Autopsy*
;
Classification*
;
Confined Spaces
;
Drowning
;
Homicide
;
Humans
;
Korea*
;
Ligation
;
Male
;
Suicide
4.A retrospective study on related factors affecting the survival rate of dental implants.
Hee Won JANG ; Jeong Kyung KANG ; Ki LEE ; Yong Sang LEE ; Pil Kyoo PARK
The Journal of Advanced Prosthodontics 2011;3(4):204-215
PURPOSE: The aim of this retrospective study is to analyze the relationship between local factors and survival rate of dental implant which had been installed and restored in Seoul Veterans Hospital dental center for past 10 years. And when the relationship is found out, it could be helpful to predict the prognosis of dental implants. MATERIALS AND METHODS: A retrospective study of patients receiving root-shaped screw-type dental implants placed from January 2000 to December 2009 was conducted. 6385 implants were placed in 3755 patients. The following data were collected from the dental records and radiographs: patient's age, gender, implant type and surface, length, diameter, location of implant placement, bone quality, prosthesis type. The correlations between these data and survival rate were analyzed. Statistical analysis was performed with the use of Kaplan-Meier analysis, Chi-square test and odds ratio. RESULTS: In all, 6385 implants were placed in 3755 patients (3120 male, 635 female; mean age 65 +/- 10.58 years). 108 implants failed and the cumulative survival rate was 96.33%. There were significant differences in age, implant type and surface, length, location and prosthesis type (P<.05). No significant differences were found in relation to the following factors: gender, diameter and bone quality (P>.05). CONCLUSION: Related factors such as age, implant type, length, location and prosthesis type had a significant effect on the implant survival.
Dental Implants
;
Dental Records
;
Hospitals, Veterans
;
Humans
;
Kaplan-Meier Estimate
;
Male
;
Prognosis
;
Prostheses and Implants
;
Retrospective Studies
;
Survival Rate
5.Intermediate Myasthenia Syndrome Following Organophosphate Intoxication.
Jai Woog KO ; Jun Seok PARK ; Kyung Ryung LEE ; Sung Pil CHUNG ; Hahn Shick LEE
Journal of the Korean Society of Emergency Medicine 2000;11(4):579-585
BACKGROUND: Intermediate myasthenia syndrome(IMS) is thought to have clinical importance because it may cause sudden respiratory failure during the recovery phase of a cholinergic crisis of organophosphate poisoning. We designed this study to identify the prevalence, the inducing agent, clinical predictor, and the proposed treatment of IMS. METHODS: Patients who had admitted with the diagnosis of acute organophosphate poisoning from 1992 to 1998 at two teaching hospitals were enrolled in this study. We selected the cases of IMS based on a review of medical records using modified He's criteria. RESULTS: Twelve(12) out of 110 patients with acute organophosphate poisoning were diagnosed for a prevalence at 10.9%. The drug inducing IMS were identified as dichlorvos, fenthion, EPN, methidathion, and phosphamidon. The occurrence of IMS was not related to either the initial treatment with atropine and pralidoxime, or the level of serum cholinesterase. Complications were pneumonia, sepsis, pancreatitis, and pseudomembranous colitis, etc. Eleven(11) patients were discharged without sequelae, and one patient was discharged as a hopeless care. CONCLUSION: This study suggests that IMS is not rare, so close observation is required to detect IMS in organophosphate-poisoning patients. Also, more studies are required to find predictors and treatments.
Atropine
;
Cholinesterases
;
Diagnosis
;
Dichlorvos
;
Enterocolitis, Pseudomembranous
;
Fenthion
;
Hospitals, Teaching
;
Humans
;
Medical Records
;
Organophosphate Poisoning
;
Pancreatitis
;
Phosphamidon
;
Pneumonia
;
Prevalence
;
Respiratory Insufficiency
;
Sepsis
6.Percutaneous Transhepatic Venous Embolization of Pulmonary Artery Aneurysm in Hughes - Stovin Syndrome.
Kyung Ah KIM ; Man Deuk KIM ; Do Yun OH ; Pil Won PARK
Journal of the Korean Radiological Society 2007;57(2):141-144
Hughes-Stovin syndrome is an extremely rare entity. We present a case of a 42-year-old man, who developed deep vein and inferior vena cava (IVC) thrombosis, repeated internal bleeding and pulmonary artery aneurysms (PAAs). The patient presented with massive hemoptysis and with PAAs of a 2.5 cm maximum diameter. We describe the successful percutaneous transhepatic venous embolization of the PAAs due to occluded common vascular pathways to the pulmonary artery.
Adult
;
Aneurysm*
;
Hemoptysis
;
Hemorrhage
;
Humans
;
Pulmonary Artery*
;
Thrombosis
;
Veins
;
Vena Cava, Inferior
7.Correlation between Brain Ischemia-Reperfusion Injury and Tumor Necrosis Factor-alpha Following Cardiac Arrest in Rats.
Seung Pil CHOI ; Kyu Nam PARK ; Seung Hyun PARK ; Sang Hyun PARK ; Si Kyoung JEONG ; Se Kyung KIM
Journal of the Korean Society of Emergency Medicine 1999;10(4):531-540
BACKGROUND: Tumor necrosis factor-alpha(TNF-alpha) has been thought to play a major role in neurological injury during global brain ischemia and subsequent reperfusion following resuscitation in cardiac arrest. So, we hypothesized that the elevation in TNF-alpha was dependent upon the duration of the global brain ischemia, and related to delayed neuronal damage. METHODS: Fourteen rats were divided two groups ; 1 minute-cardiac arrest group(n=7) and 3 minute-cardiac arrest group(n=7). we induced cardiac arrest by chest compression and damping of tracheal tube for 1 minute and 3 minutes respectively. And then, resuscitation was initiated. To measure the plasma activity of TNF-alpha, blood samples were drawn before and at the end of cardiac arrest, and 30, 60, 90, and 120 minutes after initiation reperfusion. At 72 hours after resuscitation, the ND(neurologic deficit) score was determined and the histopathologic outcome of hippocampal CA1 neuron was observed by the percent dead hippocampal CA1 neurons. RESULTS: 1. TNF-alpha level during the early reperfusion period(<2h) was significantly increased in 3 min-cardiac arrest group compared with 1 min-cardiac arrest group(p=0.0001). 2. There was a no significant difference of neurologic deficit score between 1 min- and 3 min-cardiac arrest. 3. Percent dead hippocampal neurons were significantly increased in 3 min-cardiac arrest group compared with 1 min-cardiac arrest group(9.1+/-1.2% vs 1.2+/-0.9%, p<0.05). CONCLUSION: The results suggest that longer duration of global brain ischemia causes a more profound increase in plasma TNF-alpha level during the early reperfusion period(<2h) and more delayed neuronal damage than lessor duration of global brain ischemia, and that increase in TNF-alpha level during the early reperfusion period(<2h) is related to delayed neuronal damage.
Animals
;
Brain Ischemia
;
Brain*
;
Heart Arrest*
;
Heart Arrest, Induced
;
Necrosis
;
Neurologic Manifestations
;
Neurons
;
Plasma
;
Rats*
;
Reperfusion
;
Reperfusion Injury*
;
Resuscitation
;
Thorax
;
Tumor Necrosis Factor-alpha*
8.A Case of Hypernatremic Dehydration in an Exclusively Breast-Fed Newborn Infant.
Kyung Pil PARK ; Jin Kyung KIM ; Heng Mi KIM
Journal of the Korean Pediatric Society 2002;45(6):790-795
Sporadic reports of hypernatremic dehydration in breastfed newborn infants have appeared in medical literature for at least 3 decades. We report the first case of hypernatremic dehydration resulting from inadequate breast-feeding in Korea. A 14-day old baby, born to a mentally retarded mother, was transferred to our hospital with a body weight loss of 460 g since birth(17%) and a serum sodium(Na) level of 179 mEq/L, after initial hydration at another hospital. On admission, a cardiac murmur was heard and an enlarged liver was palpated. Cardiac ultrasonogram revealed ventricular septal defect and ostium secundum atrial septal defect. During hydration, a seizure-like attack developed. Serum Na decreased to 135 mEq/L on the 5th day of admission. Brain ultrasonography and brain magnetic resonance image revealed no remarkable abnormalities. Electroencephalography was normal. She suffered from prerenal azotemia, hyperglycemia and disseminated intravascular coagulation at admission but was treated successfully. Heart failure was also controlled with dobutamine, diuretics and digoxin.
Azotemia
;
Body Weight
;
Brain
;
Breast Feeding
;
Dehydration*
;
Digoxin
;
Disseminated Intravascular Coagulation
;
Diuretics
;
Dobutamine
;
Electroencephalography
;
Heart Failure
;
Heart Murmurs
;
Heart Septal Defects, Atrial
;
Heart Septal Defects, Ventricular
;
Hepatomegaly
;
Humans
;
Hyperglycemia
;
Hypernatremia
;
Infant, Newborn*
;
Korea
;
Mentally Disabled Persons
;
Mothers
;
Ultrasonography
9.Solitary fibrous tumor of the nasal cavity: A report of 1 case.
Seung Hwan LEE ; Sung Geun KIM ; Hyung Seok LEE ; Kyung Sung AHN ; Chan Pil PARK ; Eun Kyung HONG
Korean Journal of Otolaryngology - Head and Neck Surgery 1993;36(6):1338-1344
No abstract available.
Nasal Cavity*
;
Solitary Fibrous Tumors*
10.Non-Hodgkin's Lymphoma of the Uterine Cervix: 3 cases report.
Chan Pil PARK ; Young Hyeh KO ; Jung Dal LEE ; Moon Il PARK ; Kyung Tai KIM ; Sam Hyun CHO
Korean Journal of Pathology 1995;29(3):368-373
Three patients with primary non-Hodgkin's lymphoma of the uterine cervix are reported and the literature is reviewed. All the three patients in the current study presented with vaginal bleeding. They were found to have diffuse large cleaved cell lymphoma, one of which was multilobated variant with marked sclerosis. Histologically, differential diagnsis from undifferentiated small cell carcinoma, endometrial stromal sarcoma & other sarcomas was difficult and requires special stains including immunobistochemical study. Vaginal pap smears were diagnosed as 'class V; malignant lymphoma' in only one patient. Immunologically, two cases were beta-cell lineage and one case was T-cell lineage. All the patients were treated with chemotherapy only and showed good responses.