Histiocytosis X is characterized by aggregates of Langerhans cells with other inflammatory cells. These Langerhans cells are antigen-presenting cells to T lymphocytes and identified by characteristic morphology, ultrastructural demonstration of Birbeck granules and immunologic reactivity with OKT-6 and HLA-DR antibodies. In this report, the tumor arising in a 2-years-old baby was examined byimmunostaining with several macrophage/dendritic cell markers. The main tumor cells showed cytoplasmic and nuclear staining with S-100 protein and ring-like surface and paranuclear staining with PNA. However, they were negative for follicular dendritic cell marker CD21, macrophage markers lysozyme, Mac 387, alpha-1 antitrypsin and CD68, and interdigitating reticulum cell marker ID4 and ID5. These observations demonstrate the usefulness of S-100 protein and PNA for the identification of Langerhans cells in paraffin-embedded tissue.

BACKGROUND: To know the effect of droperidol and ondansetron on nausea and sedation in postoperative patients, we studied 120 gynecological patients receiving patient-controlled analgesia (PCA) with morphine and droperidol or ondansetron. METHODS: Subjects were randomly allocated to one of four groups according to PCA regimen, morphine 0.5 mg/cc alone (group M); morphine plus droperidol 0.034 mg/morphine 1 mg (group D); morphine plus ondansetron 0.132 mg/morphine 1 mg (group O1); morphine plus ondansetron 0.066 mg/morphine 1 mg (group O2). The PCA device, WalkMed was set at basal rate 2 ml/hr (1 mg/hr), bolus dose 1 ml (0.5 mg), lockout time 10min, 1 hour maximum dose 4 mg. The severity of nausea, sedation and pain were assessed at 1h, 4h, 8h, 12h, 24h, and 48h postoperatively. RESULTS: The occurrence of nausea was not different among groups. But there were statistical differences in the nausea severity (p<0.05). The group D and group O1 had lower nausea scores, and between them there was no difference. The scores for sedation were significantly lower in the group O1 compared with group M and group D (p<0.05). Overall pain scores were not different among groups. CONCLUSIONS: Ondansetron and droperidol are effective in reducing nausea. Ondansetron is superior to droperidol in avoiding excessive sedation.
Analgesia, Patient-Controlled* ; Droperidol* ; Humans ; Morphine ; Nausea ; Ondansetron* ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting*

Elastofibroma is a rare benign tumorous growth presenting as a slowly growing ill-defined mass of fibroblastic tissue occurring in elderly persons and arising mainly form the connective tissue between the lower portion of the scapula and the chest wall. Its pathogenesis is not well established but it may be the result of nonneoplastic reactive hyperplasia taking place with constitutional predisposition in the background. A case of elastofibroma occurring in the subscapular area of a 65-year-old female cook is presented. The mass, 6x5x3 cm in maximum dimensions, was poorly circumscribed, solid, hard, pale fleshy and pray-white fibrous tumor. Microscopically, it was composed of numerous small globular and linear elastic fibers embedded in collagenous matrix. To our knowledge, it is the first case of elastofibroma in Korea.
Female ; Humans

Alzheimer's disease (AD) is an age-related disorder. Both the prevalence and the incidence of AD double approximately every 5 years after the age of 60. This is a particularly serious problem considering that the Korean elderly population is rapidly growing. We present three illustrative cases of AD in mild, moderate, and advanced stages, respectively. Their initial symptoms were memory impairment which was followed by language disturbance and visuospatial dysfunction. Abnormal behaviors such as delusion and aggression occurred in moderate and severe cases. The presence and severity of dementia in these cases were established by history taking, neurological examination, standardized mental status assessment, and neuropsychological test. Laboratory investigations showed no abnormalities that could account for the cognitive deficits. Brain CT or MRI findings of the patients wee not remarkable except for a diffuse atrophy demonstrated by increased ventricular volume, narrowed gyri, and widened sulci, As an addendum, risk factors, clinical symptoms, clinical diagnosis, and natural history of AD were reviewed.
Aged ; Aggression ; Alzheimer Disease* ; Atrophy ; Brain ; Cognition Disorders ; Delusions ; Dementia ; Diagnosis ; Humans ; Incidence ; Magnetic Resonance Imaging ; Memory ; Natural History ; Neurologic Examination ; Neuropsychological Tests ; Prevalence ; Risk Factors

BACKGROUND AND OBJECTIVES: Although pain resulting from thalamic stroke was described by D jerine & Roussy in 1906, its pathomechanism & anatomical substrate have not been defined yet. Several clinical & experimental studies suggest that laterality of lesion for generation of central pain is as important as location of lesion. We performed this study to evaluate clinical features of thalamic pain syndrome, including incidence, onset interval from stroke, nature, distribution, accompaniments, and to assess the relationships between laterality & location of lesion and occurrence of pain. METHODS: We reviewed the medical records and brain imaging of all patients with thalamic stroke from 1990 to 1997. Patients with thalamic pain syndrome due to a single well-demarcated thalamic stroke were included, and excluded tumoral, non-vascular etilogy, and patients with sensory deficit without pain and excluded patients who had multiple cerebral lesions even they have thalamic pain syndrome. RESULTS: One-hundred one cases were selected under the inclusion criteria, and twenty-four patients(24%) with thalamic pain syndrome were identified from 101 thalamic stroke. Pain onset within the first week poststroke was 17(71%). The patients with allodynia were 8(33%), increased by movement, stress, and thermal contact. The painful area distributed mainly limbs(50%), especially arm(35%), face plus hemibody(34%), and hemibody below face(8%). Thalamic pain syndrome accompanied with the pain and temperature loss was 17(71%). Thirteen patients had a right-sided lesion, 11 left-sided lesion. The lesion causing thalamic pain syndrome mainly located in the posterolateral areas(75%). CONCLUSIONS: We conclude that the thalamic pain syndrome resulting from mainly posterolateral thalamic lesion cause the spontaneous pain on the contralateral body, especially upper extrimity, and accompanied with pain & tempterature loss. The laterality of lesion is not represent for generation of thalamic pain syndrome. Key word : thalamic stroke, central pain.
Humans ; Hyperalgesia ; Incidence ; Medical Records ; Neuroimaging ; Stroke*

The authors experienced a case of pulmonary alveolar proteinosis. A 58-year-old woman presented with 6 months duration of cough sputum and multiple patch mottled densities in both lung fields. Major histologic finding was filling of the alveoli by Periodic-Acid-Schiff-positive proteinaceous material with maintenance of normal alveolar architecture. Osseous metaplasia was seen in the alveolar space, focally. Ultrastructural study revealed numerous lamellar bodies in alveolar spaces. The immunohistochemical study using antibody to surfactant apoprotein revealed positive reaction in proteinaceous material.
Female ; Humans

No abstract available.
Psoriasis

No abstract available.

Hemangioblastomas comprise 1 to 2% of all intracranial neoplasm, and 8 to 12% of tumors within the posterior fossa. They are composed of admixtures of three different cell types; endothelial cells, pericytes and stromal cells. Although most hemangioblastomas arise sporadically, they are associated with von Hippel-Lindau disease in about 20% cases. We have experienced a case of multiple hemangioblastomas occuiing in the cerebellum, medulla oblongata and cervical spinal cord simultaneously in a 55-year-old male. He had complained of headache, dizziness, generalized weakness and gait disturbance for 2 weeks. The patient had neither specific family history nor increased hematocrit. MRI showed a nonenhancing cystic lesion with an enhancing mural nodule in the right cerebellar hemisphere and two separate enhancing nodules in the medulla oblongata and dorsal cervical spinal cord at the 5-6th. Grossly, the excised mass of the cerebellum, 2.5 x 2 x 1.8cm, was solid to partly cystic, and that of spinal cord, lcm in diameter, was mostly solid. Microscopically, the tumor was composed of thin-walled blood vessels in variable size and interspersed stromal cells. The stromal cells revealed dimorphic cytoplasm that were either homogeneous and eosinophilic, or clear and vacuolated. Immunohistochemically, the endothelial cells reacted positively for glial fibrfllaty acidic protein(GFAP) and vimentin. The stromal cells reacted diffusely positively for vimentin, focally positively for GFAP and S-100 protein near the periphery of the tumor, focally positivel for neuro specipic enolase(NSE), and negatively for lysozyme, desmin and chromogranin. Ultrastructurally, the stromal cells contained numerous microfilaments and lipid droplets.

Hemangioblastomas comprise 1 to 2% of all intracranial neoplasm, and 8 to 12% of tumors within the posterior fossa. They are composed of admixtures of three different cell types; endothelial cells, pericytes and stromal cells. Although most hemangioblastomas arise sporadically, they are associated with von Hippel-Lindau disease in about 20% cases. We have experienced a case of multiple hemangioblastomas occuiing in the cerebellum, medulla oblongata and cervical spinal cord simultaneously in a 55-year-old male. He had complained of headache, dizziness, generalized weakness and gait disturbance for 2 weeks. The patient had neither specific family history nor increased hematocrit. MRI showed a nonenhancing cystic lesion with an enhancing mural nodule in the right cerebellar hemisphere and two separate enhancing nodules in the medulla oblongata and dorsal cervical spinal cord at the 5-6th. Grossly, the excised mass of the cerebellum, 2.5 x 2 x 1.8cm, was solid to partly cystic, and that of spinal cord, lcm in diameter, was mostly solid. Microscopically, the tumor was composed of thin-walled blood vessels in variable size and interspersed stromal cells. The stromal cells revealed dimorphic cytoplasm that were either homogeneous and eosinophilic, or clear and vacuolated. Immunohistochemically, the endothelial cells reacted positively for glial fibrfllaty acidic protein(GFAP) and vimentin. The stromal cells reacted diffusely positively for vimentin, focally positively for GFAP and S-100 protein near the periphery of the tumor, focally positivel for neuro specipic enolase(NSE), and negatively for lysozyme, desmin and chromogranin. Ultrastructurally, the stromal cells contained numerous microfilaments and lipid droplets.