No abstract available.
Autografts*

No abstract available.
Skull Base* ; Skull*

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

There have been many reports on cerebrovascular disease in Korea, almost all of which were done at the Department of Neurosurgery, Neurology, and Internal Medicine. It is established that hemorrhagic stroke(HS) occurs at a higher rate than ischemic stroke(IS) compared to Western societies. However, many patients with IS visit to Oriental Medicine in Korea. Because of the paucity of published information including stroke data of Oriental Medicine, it was our purpose to analyse characteristic pattern of stroke occurrence, clinical data, and outcome for 762 patients visited to emergency room or admitted to the University Hospital and Oriental Medicine for a twelve month period. The incidence of IS was at least 1.5 times that of HS(IS: 309, HS: 453). Among age groups, those in sixties and seventies were the most predominant. The distribution of patients according to each Departments and Oriental Medicine was 118(HS: 2, IS: 116) in Department of Internal Medicine, 286(HS: 251, IS: 35) in Neurosurgery, and 358(HS: 56, IS: 302) in Oriental Medicine. The overall outcome for HS are much poorer than those for IS: in HS, 69.6% good, 10.7% morbidity, and 19.7% mortality, and in IS, 83.2%, 13.0% and 3.8%, respectively. Considering the fact that many IS patients with mild symptoms and signs tend to visit private clinics, these results suggest the actual incidence of Is is much higher than HS in Korea, compared with previous reports. We expect that a multicentered cooperative study including Oriental Medicine will be motivated by this study for establishing more accurate characteristics of stroke in Korea in the future.
Emergency Service, Hospital ; Hemorrhage ; Humans ; Incidence ; Internal Medicine ; Ischemia ; Korea ; Medicine, East Asian Traditional ; Mortality ; Neurology ; Neurosurgery ; Stroke

No abstract available.
Abortion, Spontaneous* ; Female ; Humans ; Incidence* ; Pregnancy

Hemangiopericytoma is a rare vascular tumor arising from pericytes. The tumor usually develops in the skin or subcutaneous tissue, particularly in the extremities.4 pulmonary origin of hemangiopericytoma is known to be quite rare. It has the potential to become a highly malignant lesion, so wide excision is the treatment of choice. We present a case of primary malignant hemangiopericytoma of the lung and discuss the clinical symptoms, diagnosis, therapy and prognosis within the context of a brief review.
Diagnosis ; Hemangiopericytoma* ; Lung* ; Pericytes ; Prognosis ; Skin ; Subcutaneous Tissue

We report a case of dedifferentiated liposarcoma of retroperitoneum as a recurrent form in a 41 year old male. The patient received a extirpation for retroperitoneal mass and diagnosed as myxoid liosarcoma 4 years ago. The patient experienced 3 recurrences over a period of 4 years and diagnosed as myxoid liposarcoma in the second, third recurrence also. Histologically, the mass was composed of several clearly distinct elements : well differentiated liposarcoma, myxoid liposarcoma, myxoid malignant fibrous histiocytoma, poorly differntiated sarcoma, and fibrosarcoma. Immunohistochemically, S-100 protein was expressed in the area of spindle cell sarcoma, well differentiated liposarcoma, and malignant fibrous histiocytoma but alpha-1-antichymotrypsin was only expressed in the area of myxoid malignant fibrous histiocytoma.

The Her-2/neu protooncogene encodes a transmembrane tyrosine kinase that is structurally homologous to the receptor for epidermal growth factor. Its amplification and overexpression are associated with poor prognosis in breast cancer patients. Neu differentiation factor is a ligand for Her-2/neu protooncogene and was detected in ras-transformed rat fibroblasts. Heregulin (human homologue of neu differentiation factor) is a 44-kilodalton glycoprotein that stimulates tyrosine phosphorylation and induces growth arrest or stimulation and differentiation in human breast cancer cell lines. In this study we examined the expression of heregulin mRNA by nested reverse transcription (RT) PCR with fresh tissue, Her-2/neu protein, ICAM-1 and steroid receptors by immunohistochemistry, and DNA ploidy pattern by flow cytometry with paraffin-embedded tissue in invasive breast carcinoma. We compared the data with nodal status, lymphovascular invasion, steroid receptor status and DNA ploidy pattern. For RT-PCR to heregulin mRNA, 38 cases of fresh breast cancer tissue were obtained. Total 68 cases of invasive breast carcinoma tissue were fixed in formalin, which were used for routine histology, immunohistochemistry and flow cytometry. The results are as follows; 1) Heregulin mRNA was expressed in 86.1% of patients with invasive breast carcinoma and 100% of patients with benign breast lesion using nested RT-PCR analysis. 2) Her-2/neu protein was overexpressed in 50.0% of tumors using immunohistochemistry. The expression of Her-2/neu protein was significantly correlated with high counts of lymph nodes with metastasis (p<0.05), and high nuclear grade (p<0.05). 3) Her-2/neu protein overexpression was significantly correlated with a high DNA index(p<0.05). All of the tumors showing Her-2/neu protein overexpression and no heregulin mRNA expression revealed near tetraploid DNA content. However, both Her-2/neu overexpression and heregulin mRNA expressing tumors revealed near tetraploidy in 38.9% and diploidy in 50.0%. Based on these results, heregulin mRNA expression rate was 86.1% in human invasive breast carcinoma. Her-2/neu protein overexpression is associated with high positive lymph node number and DNA index. Statistically significant reverse correlation with lymph node metastasis is not present.
Animals ; Breast Neoplasms* ; Breast* ; Cell Line ; Diploidy ; DNA* ; Epidermal Growth Factor ; Fibroblasts ; Flow Cytometry ; Formaldehyde ; Glycoproteins ; Humans* ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Lymph Nodes ; Neoplasm Metastasis* ; Neuregulin-1* ; Phosphorylation ; Ploidies* ; Polymerase Chain Reaction ; Prognosis ; Protein-Tyrosine Kinases ; Rats ; Receptors, Steroid ; Reverse Transcription ; RNA, Messenger* ; Tetraploidy ; Tyrosine

Inflammatory pseudotumor, originally described in the lung, is a relatively rare tumor-like lesion that occurs in various organs and tissues. It is usually well demarcated from the surrounding tissue, however it can be unfortunately resected as a malignant tumor. A few inflammtory pseudotumor in the kidney have been reported in English literature, but there have been no reports in Korea. We report a case with inflammatory pseudotumor of the kidney. A 48 year old woman had an intermittent flank pain on the right side. An ultrasonographic study suggested a renal cell carcinoma and a nephrectomy was done. Grossly, there were two separate masses with a well demarcated yellowish appearance, measuring 2.3 cm and 1.3 cm in diameter, respectively. Histologically, they were composed of smooth muscle actin positive spindle cells and a large number of foamy histiocytes, lymphocytes, and plasma cells in the fibrotic backgound.
Actins ; Carcinoma, Renal Cell ; Female ; Flank Pain ; Granuloma, Plasma Cell* ; Histiocytes ; Humans ; Kidney* ; Korea ; Lung ; Lymphocytes ; Middle Aged ; Muscle, Smooth ; Nephrectomy ; Plasma Cells

BACKGROUND: N-acetylcysteine(ACE) is used both orally and intravenously in a variety of experimental pathologies resembling human disease states which exhibit endothelial toxicity as a result of oxidative stress, including acute pulmonary oxygen toxicity, septicemia and endotoxin shock. Despite these observations in vivo, it is not certain how this thiol drug produces its protective effects. ACE is a cysteine derivative which is able to directly react with oxygen radicals and may also act as a cysteine and glutathione(GSH) precursor following deacetylation. In this paper, we tried to know whether the therapeutic doses of ACE can modify the inflammatory function of the neutrophils and can increase the glutathione level of plasma in chronic obstructive pulmonary disease(COPD) patients. In addition, the effect of ACE to the purified neutrophil in terms of superoxide release and glutathione synthesis were observed. METHOD: Firstly, we gave 600mg of ACE for seven days and compare the release of superoxide, luminol-enhanced chemiluminescence from the neutrophils, neutrophil chemotaxis, and plasma GSH levels before and after ACE treatment in COPD patients. Secondly, we observed the dose dependent effect of ACE to the purified neutrophil's superoxide release and GSH levels in vitro. RESULTS: 1) Usual oral therapeutic doses(600mg per day) of ACE for seven days did affect neither on the neutrophils superoxide release, chemiluminescence, chemotaxis, nor on the plasma GSH concentration in the COPD patients. 2) ACE decreases the purified neutrophil's superoxide release and increase the GSH production in dose dependent fashion in vitro. CONCLUSION: Despite the fact that oral ACE treatment did not affect on the neutrophil's inflammatory function and plasma GSH concentration in COPD patients in usual therapeutic doses, it decreases the superoxide release and increases the GSH production from the isolated neutrophils in high molar concentrations. These findings suggest that to obtain an antioxidative effects of ACE, it might be needed to increase the daily dosage of ACE or therapeutic duration or change the route of adminisration in COPD patients.
Acetylcysteine* ; Chemotaxis* ; Cysteine ; Glutathione* ; Humans ; Luminescence ; Molar ; Neutrophils* ; Oxidative Stress ; Oxygen ; Pathology ; Plasma* ; Pulmonary Disease, Chronic Obstructive ; Reactive Oxygen Species ; Sepsis ; Shock ; Superoxides*