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

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

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*

No abstract available.
Psoriasis

Objective: Menstruation is a great part as the procedure for physiological, psychological development and physical growth, and menstrual disorders are very common problems in adolescence period. these problems can be resolved by interview or appropriate education of normal pubertal development. However unlike other developed countries, systematic report or appropriate education for menstruation may not be performed in our country. Therefore. our pediatric department investigated for menstruation of normal pubertal age women as an information educating adolescence. Methods: In cross-sectional study (ex, questionnaire), 4112 junior high and high school girl students (12~18 years old) in Ansan, Kyungki-do were investigated for menarcheal age, menstrual cycle, duration, amount, premenstrual syndrome, dysmenorrhea and relation to family history. Resulta: 1) Mean Menarcheal age was 12.9+/-1.2 years. According to menarcheal age by present age, menarcheal age was younger when present age was young as menarcheal age 11.8+/-0.6 years at 12 years, 13.3+/-1.1 years at 16 years, and 13.7+/-1.1 years at 18 years, respectively (p<0.001). 2) The month during which menarche occurs most frequently was August (14.7%), followed by July, December and January. 3) Considering menstrual cycle, mixed type (regular and irregular cycle) was most common (39.0%), and menstrual cycle became regular after mean 8.8+/-8.4 months. 4) In women having regular menstrual cycle, most women (53.l0%) had menstrual cycles between 26 and 30 days, next was 21~25 days and 31~35 days according to frequency. 5) Menstrual duration was 5~6 days by 49.6% of the women. 6) Premenstrual syndrome was noted in 56.0% of the women, in that 42.5% experienced occasionally and 13.5% always, respectively. 7) Dysmenorrhea was showed in 85.0% of the women. A total of 63.7% of the respondents suffered from dysmenorrhea was unaffected on daily activity as grade l and was needed no medication to relieve pain. Grade 2 (20.5%) was defined that limited daily activity and was needed medication to relieve pain. Grade 3 (0.9%) was defined that inhibited daily activity seriously, and was unimproved by analgesics. 8) The prevalence of dysmenorrhea was 78.0% at 12 years, 85.9% at 15 years and 94.0% at 18 years, respectively. Getting older, frequency of dysmenorrhea was increasing. 9) Dysmenorrhea was experienced for the first time during the first year after the menarche by 65.3% of the women. The amount of menstrual bleeding was significantly correlated to the severity of dysmenorrhea (P<0.001), and dysmenorrhea reported by the women was singificantly correlated to maternal dysmenorrhea (p<0.01) and to sisters with dysmenorrhea (p<0.001). Conclusions: We found that Korean adolescent girls had earlier menarcheal age than past period, and they had many problems for menstruation. This study suggested that it may be needed adolescent education and appropriate treatment of menstrual disorders.
Adolescent ; Analgesics ; Cross-Sectional Studies ; Surveys and Questionnaires ; Developed Countries ; Dysmenorrhea ; Education ; Female ; Female* ; Gyeonggi-do* ; Hemorrhage ; Humans ; Menarche ; Menstrual Cycle ; Menstruation* ; Premenstrual Syndrome ; Prevalence ; Siblings

Background: Post-dural puncture headache (PDPH) is one of the well-known complication of spinal anesthesia. Epidural blood patch is the treatment of choice for PDPH but is rarely used for the prevention of PDPH after spinal anesthesia. The purpose of this study is to observe the effectiveness of epidural blood patch for prevention of PDPH and to evaluate the complications after epidural blood injection. Methods: Three hundred patients (ASA I or II) receiving spinal anesthesia were studied. They were randomly devided into two groups. Patients in Group I, the control group, were maintained in a supine position for 24 hour after spinal anesthesia. Patients in Group II, the study group, received 3 ml of autologous blood in the epidural space after spinal anesthesia. PDPH was evaluated for 5 days. The incidence, location, onset, and duration of headache in the patients presenting with PDPH were measured for 5 days, and the complications following epidural blood patch in Group II were observed for 2 weeks. Results: The incidence of PDPH in group I was 11%, but 0% in group II. There were no specific complications following epidural blood patch in Group II. Conclusions: This study suggest that the 3 ml epidural autologous blood patch is an useful method for the prevention of PDPH in patients with spinal anesthesia.
Anesthesia, Spinal* ; Blood Patch, Epidural ; Epidural Space ; Headache ; Humans ; Incidence ; Post-Dural Puncture Headache ; Punctures* ; Supine Position

Ritodrine hydrochloride (Yutopar (R)) is widely used for the treatment of premature uterine contraction with betasympathomimetic effect on the uterus but adverse effects associated with cardiopulmonary system are frequently reported. We experienced a case of pulmonary edema that occurred suddenly during cesarean section under epidural anesthesia. She had been treated with ritodrine for 3 days to arrest preterm labor of twin pregnancy. Intensive care including mechanical ventilation with PEEP via endotracheal intubation and diuretic therapy was attempted. At the 3rd day after operation patient was transferred to general ward without any sequale.
Anesthesia, Epidural* ; Cesarean Section* ; Female ; Humans ; Critical Care ; Intubation, Intratracheal ; Obstetric Labor, Premature ; Patients' Rooms ; Pregnancy ; Pregnancy, Twin ; Pulmonary Edema* ; Respiration, Artificial ; Ritodrine* ; Uterine Contraction ; Uterus