Gastrointestinal angiodysplasia is a distinct disease entity which causes frequent gastrointestinal bleeding. It predominantly arises at the stomach and duodenum in the upper gastrointestinal tract and cecum and ascending colon in the lower gastrointestinal tract. The general histological finding of the angiodysplasia is a submucosal vascular ectasia and tortuosity. We have experienced two cases of the intestinal angiodysplasia. The first case occurred on a jejunum in a 22-year-old woman who had anemia. The second case occurred on a sigmoid colon in a 59-year-old man who had constipation. In addition to the general histologic finding of the angiodysplasia, the microscopic findings of the first case revealed some capillary hemangioma-like areas; and in the second case, there was a marked ischemic change and the thickening of the wall.
Anemia ; Angiodysplasia* ; Capillaries ; Cecum ; Colon, Ascending ; Colon, Sigmoid ; Constipation ; Dilatation, Pathologic ; Duodenum ; Female ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Jejunum ; Lower Gastrointestinal Tract ; Middle Aged ; Stomach ; Upper Gastrointestinal Tract ; Young Adult

Achondrogenesis type 2 is a lethal form of congenital skeletal dysplasia characterized by severe short-limbed dwarfism, decreased vertebral ossification and normal ossification of the skull. We report an autopsy case of achondrogenesis type 2 in a female fetus terminated at 29 weeks of gestation. External morphology revealed a relatively large head, short upper and lower extremities, short neck, and distended abdomen. The x-ray finding showed normal calvarial ossification, hypoplastic ilium and unossified ischium, and metaphyseal flares of the femur and tibia. Histologically, chondrocytes were large and irregular with increased vascularity.
Abdomen ; Autopsy* ; Chondrocytes ; Dwarfism ; Female ; Femur ; Fetus ; Head ; Humans ; Ilium ; Ischium ; Lower Extremity ; Neck ; Pregnancy ; Skull ; Tibia

Clear cell meningioma is a recently recognized morphologically unique entity. It shows no sex predilection, affects primarily the lumbar region, and the cerebellopontine angle. Despite its benign appearance, it may be aggressive, particularly in intracranial cases. All lesions are moderately cellular, with the exception of stromal hyalinization. The tumor consists largely of a sheet- like or somewhat lobular pattern of polygonal cells, the cytoplasm of which is clear. No close association is noted between the recurrence or the clinical outcome and factors such as mitotic activity, the PCNA index, and the DNA ploidy status. But the MIB-1 proliferation index is appreciably higher in recurrent tumors. We experienced a case of clear-cell meningioma showing a characteristic histologic finding. A 39-year-old man was admitted due to the recent onset of right-sided, facial-nerve palsy, left hemiparesis and general weakness. A CT scan of the head showed a well defined mass in the petroclival area. After surgical resection, the patient was in good condition, but 1 year later symptoms recurred. A CT scan of the head showed a huge, recurrent petroclival tumor with adhesion to the surrounding brain parenchyme.
Adult ; Brain ; Cerebellopontine Angle ; Cytoplasm ; DNA ; Head ; Humans ; Hyalin ; Lumbosacral Region ; Meningioma* ; Paralysis ; Paresis ; Ploidies ; Proliferating Cell Nuclear Antigen ; Recurrence ; Tomography, X-Ray Computed

Almost all cases of acute methanol intoxication result from ingestion. Absorption of methanol following oral administration is rapid and peak concentration occurs within 30-60 min. Foromic acid converted metabolites of methanol are responsible for its toxic effect. Methanol poisoning typically induces nausea, vomiting, abdominal pain, and mild central nervous system depression. Then there is a latent period lasting, followed by an uncompensated metabolic acidosis and visual dysfunction, depending on the dose of methanol ingested. Here we report on three patients who were victims of methanol intoxication due to ingestion of windshield washer fluid, which was misidentified as an alcoholic beverage. One patient had a mild form, which included abdominal discomfort, another patient had a moderate case, which included nausea, vomiting, and acidosis, and the other patient had severe acidosis and altered mentality and visual dysfunction. Except one case of visual dysfunction, all three patients recovered successfully following medical treatment and hemodialysis.
Abdominal Pain ; Absorption ; Acidosis ; Administration, Oral ; Alcoholic Beverages ; Alcoholics ; Central Nervous System ; Depression ; Eating ; Humans ; Methanol ; Nausea ; Renal Dialysis ; Vomiting

The retrograde microorganismal colonization in the pharynx from stomach may cause the nosocomial pneumonia and that may be more likely when the gastric pH is relatively high. We tried to find out the relationships between the gastric pH and the incidence of nosocomial pneumonia with twenty patients intubated for longer than 48 hours at ICU. We achieved following results: 1) The incidence of the nosocomial pneumonia was twenty percent. 2) All the patients developed nosocomial pneumonia showed the gastric pH above 4.0. 3) In the patients intubated for longer than 5 days, the incidence of nosocomial pneumonia was 33.3% in contrast to 9.0% for less than 5 days. 4) With the sputum culture, the incidence of colonization was higher in the patients with gastric pH above 4.0 than that in the patients with gastric pH below 4.0(84.6% vs 58.1%). 5) With regard to the duration of intubation, the incidence of colonization was higher in the patients intubated for longer than 4 days than that in the patients intubated for less than 4 days(90% vs 50%). 6) The most common pathognomic organisms were astreptoccus and Pseudomonas aeroginosa. It is conculded that the nosocmial pneumonia might develop more frequently in the patients with gastric pH above 4.0 than in the patients with gastric pH below establishment of the relationship between the treatment of the stress ulcer and the nosocomial pneumonia.
Colon ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Intubation ; Pharynx ; Pneumonia* ; Pseudomonas ; Sputum ; Stomach ; Ulcer

Patients with rheumatoid arthritis of any degree of severity or duration may develop necrotizing granulomatous pleuritis, a morphologic replica of the inflammatory reaction characteristic of rheumatoid synovitis and rheumatoid nodules. The principal feature is the background composed of granular, amorphous, particulate material or debris of various hues. The material is sometimes eosinophilic, sometimes more cyanophilic, or even green in the Papanicolaou stain. Within this background are elongated, fibroblast-like epithelioid cells, numerous multinucleated giant cells and degenerating leukocytes. The combination of the debris, spindle epithelioid cells, and multinucleated giant cells in fluid is pathognomonic for rheumatoid pleuritis. We experienced a hcase of rheumatoid pleuritis showing these characteristic cytologic findings. The patient was a 63 year-old man with positive rheumatoid factor. The pleual fluid specimen revealed elongated epithelioid cells and multinucleated giant cells in a background of amorphous granular material.
Arthritis, Rheumatoid ; Eosinophils ; Epithelioid Cells ; Giant Cells ; Humans ; Leukocytes ; Middle Aged ; Pleural Effusion* ; Pleurisy* ; Rheumatoid Factor ; Rheumatoid Nodule ; Synovitis

Metaplastic carcinoma of the breast is a morphologically heterogenous group of neoplasms characterized by ductal adenocarcinoma with extensive squamous differentiation, a spindle-cell pattern of growth, and/or heterologous mesenchymal elements. We experienced a case of metaplastic carcinoma diagnosed by fine needle aspiration(FNA) and confirmed by radical mastectomy in a 46 year-old woman. The FNA cytologic findings included atypical squamous cells with kertinization lying singly and in clusters in a necrotic background. In addition, scattered spindle cells with pleomorphic large nuclei and prominent nucleoli were present in a hemorrhagic and necrotic background. The histopathologic findings showed moderately differentiated squamous cell carcinoma and highly pleomorphic sarcoma with chondroid component. The immunohistochemical stain revealed focal positive reaction for cytokeratin as well as diffuse reactivity for vimentin in the sarcomatous area.
Adenocarcinoma ; Biopsy, Fine-Needle* ; Breast* ; Carcinoma, Squamous Cell ; Carcinosarcoma ; Deception ; Female ; Humans ; Keratins ; Mastectomy, Radical ; Middle Aged ; Needles ; Sarcoma ; Vimentin

No abstract available.
Humans ; Needles* ; Peritonsillar Abscess*

Purpose: This study aimed to describe clinical nurses’ lived experiences of workplace verbal violence through qualitative research using descriptive phenomenology. Methods: Six female Korean nurses who had less than 5 years of clinical experience and had experienced verbal violence in the workplace within the past year participated in the study. Data were collected through one-on-one in-depth interviews with the participants and analyzed using Colaizzi’s phenomenological method. Results: A total of 27 codes, eight themes, and four theme clusters were derived from the participants’ statements. The four theme clusters of the clinical nurses’ experiences of verbal violence in the workplace were as follows: “tip of the iceberg,” “beyond me and my control,” “fear and resignation,” and “personal burden.” The participants recognized that nurses experienced verbal violence daily, and that the causes of and responses to verbal violence were determined by external situational factors rather than nurses’ individual problems. This suggests that nurses felt that they had no choice but to personally cope with verbal violence and bear the consequences due to systematic indifference and silence about verbal violence experienced by clinical nurses. Conclusion The findings show that verbal violence was pervasive and unmerited, yet often endured at the cost of a personal burden to nurses. A clear definition of verbal violence and education for employees are needed, and a reporting system should be established to report all forms of violence regardless of the severity of the incident.

Agenesis of the right lobe of the liver is a rare anomaly which may be associated with stone diseases, portal hypertension, and other congenital anomalies. The radiological differential diagnosis includes lobar atrophy due to cirrhosis or hilar cholangiocarcinoma. We present a case of agenesis of the right lobe of the liver with characteristic clinical and radiological findings.
Atrophy ; Diagnosis, Differential ; Fibrosis ; Hypertension, Portal ; Klatskin Tumor ; Liver*