We present an autopsy case of signet ring cell carcinoma of urinary bladder which underwent widespread metastsis through nearly entire organ. The patient, 45-year old male, suffered from hematuria, dysuria and flank pain for 6 months. Under the diagnosis of the signet ring cell carcinoma by the cystoscopic biopsy, radical cystectomy and ileocutaneous ureteral division were performed. But he died after 11-months after the diagnosis. The autopsy confirmed the widespread metastasis at the lung, kidney, adrenal gland, parathyroid gland, heart, stomach, ileum, spine, rib and meninges. The preveously resected urinary bladder discolosed the well defined fungating mass at the dome and anterio-lateral portion without apparent evidence of the remnant of the urachus. Histologically, the signet ring cells were predominent and focally mucinous pool floating the signet ring cells was noted. We could find several foci of the well differentiated adenocarcinoma and poorly differentiated adenocarcinomas. The above findings may reflect that the origin of carcinoma may be from the multipotential transitional cell epithelium.
Adenocarcinoma ; Neoplasm Metastasis

No abstract available.
Congenital Hypothyroidism*

Teratoma is very rarely developed in the third ventricle. We report a case of third ventricular mature teraroma in 12 year old boy with headache and precocious puberty. In TlWl and Gd-DTPA enhanced TlWl, the mass in the third ventricle showed mixed signal intensities with signal void and partial contrast enhancement. The tumor was confirmed as a mature teratoma including teeth and fatty tissue.
Adipose Tissue ; Child ; Gadolinium DTPA ; Headache ; Humans ; Magnetic Resonance Imaging* ; Male ; Puberty, Precocious ; Teratoma* ; Third Ventricle* ; Tooth

No abstract available.
Antigens, CD4*

A study was carried out to evaluate the house rats in southern Korea as reservoir host of intestinal trematodes, in 13 different areas: 7 in inland and 6 in brackish-water zones, during the period from August 1980 to August 1981. A total of 170 house rats was captured; 101 rats from inland and 69 from brackish-water zones. They consisted of 129 Rattus norvegicus, 22 R. rattus rufescens, and 19 unidentified. The infection status of the rats were as follows: Total 29 rats (17.1%) were infected by one or more kinds of intestinal trematodes; 27 from inland and 2 from brackish-water zones by areas. Rats in inland were more heavily infected. The intestinal trematodes collected from rats were identified as Echinostoma hortense, E. cinetorchis, Plagiorchis muris, Fibricola seoulensis, Clonorchis sinensis and Metagonimus yokogawai. As a reservoir host, the rats were very important in Echinostoma hortense and E. cinetorchis infection. Rats infected with these trematodes were found widely in southern Korea, and its infection rates were the highest among the discriminated flukes. In this study, no rats were found to be infected with Heterophyes and Pygidiopsis even in endemic areas. The negligible importance of rats as reservoir host of these heterophyid should be reevaluated in the future.
parasitology-helminth-trematoda ; rat- Rattus norvegicus-Rattus rattus rufescens ; zoonosis ; epidemiology ; Echinostoma hortense ; Echinostoma cinetorchis ; Plagiorchis muris ; Fibricola seoulensis ; Clonorchis sinensis ; intestine ; Metagonimus yokogawai

The most common etiologic agents of neonatal osteomyelitis in the last decades were Staphylococcus aureus, Group B streptococcus, and E. coli, but Klebsiella pneumoniae as a cause of neonatal osteomyelitis appears to be rare. Klebsiella pneumoniae is one of the most important organisms associated with hospital acquired infections in the neonate and outbreaks with multiresistant strains have been reported from neonatal intensive care units around the world. These multiresistant Klebsiella pneumoniae have been shown to produce tranferable plasmid mediated beta-lactamases that are able to hydrolyze oxyimmino- beta-lactamas and these confer resistance to the third generation cephalosporin and named extended spectrum beta-lactamase producing Klebsiella pneumoniae. We experienced two cases of neonatal osteomyelitis due to extended spectrum lactamase producing Klebsiella pneumoniae in our neonatal intensive care unit during the same period. To our knowledge this represents the first documented neonatal osteomyelitise to extended spectrum beta-lactamase producing Klebsiellae pneumoniae in Korea.
beta-Lactamases* ; Disease Outbreaks ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Osteomyelitis* ; Plasmids ; Pneumonia ; Staphylococcus aureus ; Streptococcus

Total anomalous pulmonary venous return(connection) is a congenital heart disease. Especially, the reports of the patients with double connections of all pulmonary veins were rare. An infant who underwent operation for total anomalous pulmonary venous return had double drainge of all pulmonary veins to both left vertical vein and anomalous descending vein. This second lesion was not diagnosed preoperatively, but in operative field. Operative treatments were performed by ligation of left vertical vein and central pulmonary vein-to-left atrium anastomosis without ligation of the descending anomalous vein. For these less common variants fo total anomalous pulmonary venous return,a more detailed and precise understanding of morphology can facilitate accurate surgical repair. And also, early detection of the disease is an another issue for a good prognosis.
Heart Defects, Congenital ; Humans ; Infant ; Ligation ; Prognosis ; Pulmonary Veins ; Scimitar Syndrome* ; Veins

Cerbral embolism in the patient with rheumatic heart disease is a serious complication and has poor prognosis. In view of the abundance of rheumatic heart disease in Korea, a retrospective clinical study was done on 49 cases of cerebral embolism with rheumatic heart disease admitted to Severance Hospital from 1970 through 1977. The resultls were as follows; 1. The age distribution of the 49 patients ranged from 20 to 70 years and the mean age was 48.7 years. Twenty-five patients, more than half of the total number, were in their 5th and 6th decades, and the peak of the incidence was in the 6th decade. Male to female ratio was 1:1.3. 2. Mitral stenosis was by far the most predominant valvular lesion representing 33 of the 49 cases, and 25 of the 33 patients had "pure" mitral stenosis. Mitral valve involvement represented 43 of the 49 cases. 3. Seventeen of the total 49 cases were in regular sinus rhythm whereas 32 of the 49 were in atrial fibrillation at the time of admission. 4. Twenty-two of the 49 patients expired during the hospitalization whereas only six made complete recovery and the other 21 made variable degrees of recovery. The anticoagulant treatment did not appear to make any significant difference in the mortality probably due to inadequacy of timing, completeness and followup.
Age Distribution ; Atrial Fibrillation ; Embolism ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Intracranial Embolism* ; Korea ; Male ; Mitral Valve ; Mitral Valve Stenosis ; Mortality ; Prognosis ; Retrospective Studies ; Rheumatic Heart Disease*

An echogenic lobulated round mass in the head of pancreas was found during abdominal ultrasonography for routine checkup on a 34 year-old man. CT and MRI showed characteristic findings of lipoma. Clinical followup confirmed intrapnacreatic lipoma, which had been reported only once proviously. This lesion should be added to the list of benign connective tissue tumor of the pancreas.
Connective Tissue ; Follow-Up Studies ; Head ; Lipoma* ; Magnetic Resonance Imaging ; Pancreas ; Ultrasonography

Tuberous Sclrosis is a rare hereditary disease first described by Bourneville in 1880, and usually transmitted as autosomal dominant trait, and is characterized by mental retardation, seizares, and adenoma sebaceum. This 21 year old male patient visited for multiple pin head to pea siaed yelhwish red waxy papules on the face and gingival papillema af 10 years dunatio. Attacks of grandmal seisure eccr oacurred times in the past 8 yeara. Past hiatory and family history were noncountributory. There was a shagreen patch on left lower lumbo-sacral area. Hiatopathology disclosed an adenoma sebaceum showing dilatation of the capillaries, proliferation of collagen, mild cellular infiltration of papillary dermis and perivascular areas. EEG revealed asymmetrieal slow waves on right side of the brain, predommantly in anterior part, and intermittent sharp waves on right anterior frontotemporal area of the brain.
Brain ; Capillaries ; Collagen ; Dermis ; Dilatation ; Electroencephalography* ; Genetic Diseases, Inborn ; Head ; Humans ; Intellectual Disability ; Male ; Peas ; Tuberous Sclerosis* ; Young Adult