Malignant fibrous histiocytoma is the most common soft tissue sarcoma of late adult life, but it is rare in the pleura. We recently experienced a case of cytology of malignant fibrous histiocytoma in pleural fluid. The smear revealed histiocytic malignant cells, spindle malignant cells and inflammatory cells. The histiocytic cells showed abundant, pale cytoplasm and ovoid, irregular, eccentrically-placed nuclei. The spindle cells showed elongated nuclei. Intercellular collagen was also present.
Adult ; Child* ; Collagen ; Cytoplasm ; Diagnostic Errors ; Follow-Up Studies* ; Histiocytoma, Malignant Fibrous ; Humans ; Hypercalciuria* ; Pilomatrixoma ; Pleura ; Sarcoma

Among the precancerous lesions, dysplasia of the uterine cervix and adenoma of the colon have been widely studied in terms of genetic alterations. However, little has been performed regarding phenotypic alterations of the precancerous lesions. We investigated the relationship among cellular proliferation, clonality, immortality and histopathologic grading of the squamous epithelial lesions of the uterine cervix. Proliferation index (PI) was calculated based on the ratio of the epithelial cells positive for proliferating cell nuclear antigen to the total epithelial cells. Clonality was assayed by X-linked HUMARA polymorphism. For immortality assay, PCR-based TRAP (telomeric repeat amplification protocol) was done and telomerase processivity was calculated by comparison with the positive control. PI increased gradually as the lesions advanced from dysplasia to invasive carcinoma. Among informative case, all of the carcinoma in situ showed monoclonal pattern (7 of 7). Among invasive squamous cell carcinoma, 6 cases showed monoclonal pattern and 2 cases polyclonal pattern. TRAP reaction was positive in 92.6% (25 of 27) of dysplasia (high grade: 14 of 15; low grade: 11 of 12), 95.0% (19 of 20) of carcinoma in situ, 100% (9 of 9) of microinvasive carcinoma, and 92.9% (13 of 14) of invasive carcinoma. It was also positive in 12 of 12 samples of chronic cervicitis or squamous metaplasia near the lesions of dysplasia. There was no difference in TRAP positivity among the dysplasia, carcinoma in situ and invasive carcinoma, whereas telomerase processivity showed significant correlation. These results suggest that proliferative activity and telomerase processivity may be progressive events in oncogenesis, although telomerase activation may be an early event.
Adenoma ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cell Proliferation ; Cervix Uteri ; Colon ; Epithelial Cells ; Female ; Metaplasia ; Proliferating Cell Nuclear Antigen ; Telomerase ; Uterine Cervicitis

Squamous cell carcinoma (SCC) is a common head and neck cancer that is usually restricted to the mucosal surfaces and skin, so sometimes it is very difficult to diagnose a primary lesion. We report a case of a 73-year-old man who presented as a small skin ulcer and parotid mass. The pathologic diagnosis was a squamous cell carcinoma, although it was very difficult to distinguish between skin cancer invading the parotid gland and a primary SCC of the arotid gland extending to the skin. The patient was treated with surgical resection and radiation therapy.
Aged ; Carcinoma, Squamous Cell ; Head and Neck Neoplasms ; Humans ; Parotid Gland ; Skin ; Skin Neoplasms ; Skin Ulcer

We studied the intradural variations of spinal nerve rootlets in 100 cases of Korean adults. The results of the study are as follows ; 1. The incidence of intrasegmental variations (abberrant rootlets) is high in cervical segments and decreased toward lumbosacral segments. The incidence is higher in posterior rootlets than anterior, except cervical sesments. 2. The incidence of intersegmental variations is higher in posterior rootlets than anterior, and generally high in cervical and lumbar segments. 3. We divide the intersegmental variations into supernumerary rootlets, dividing rootlets, and anastomosing rootlets, and among them the incidence of anastomosing rootlets is higher. We divide the anastomosing rootlets into parallel anastomosing rootlets, uniting anastomosing rootlets, and rearrangement anastomosing rootlets. 4. The anterior to posterior anastomosing of spinal nerve rootlet is present in 4 of cases studied.
Adult ; Humans ; Incidence ; Spinal Nerves*

PURPOSE: This study was conducted to identify the predictive factors for prostate cancer in patients with prostate-specific antigen (PSA) levels equal to or less than 4 ng/ml. MATERIALS AND METHODS: A retrospective study of medical records was conducted on 292 patients with initial serum PSA < or =4 ng/ml among 2,305 patients who underwent prostate biopsy from January 2003 to December 2008. Prostate biopsy was performed on patients with PSA < or =4 ng/ml in the case of abnormal findings in the digital rectal examination (DRE) or transrectal ultrasonography (TRUS) or in those with a PSA level higher than the age-adjusted PSA levels. The patients were divided into the group diagnosed with prostate cancer and the non-prostate-cancer group. Subsequently, the variables of the two groups were compared. RESULTS: The patients' mean age was significantly higher in the prostate cancer group (n=28) than in the non-prostate-cancer group (n=264; p=0.033). In addition, for the patients with a PSA range of 2.0-2.9 ng/ml, their age (p=0.049) and PSA density (PSAD; p=0.042) were significantly higher and the prostate volume (p=0.028) was significantly smaller in the prostate cancer group than in the non-prostate-cancer group. CONCLUSIONS: Of the patients with PSA < or =4 ng/ml, the age of the patients who showed abnormal findings in the DRE or TRUS or who had a PSA level higher than the age-adjusted PSA level was a significant predictive factor for prostate cancer. In particular, for the PSA range of 2.0-2.9 ng/ml, a thorough screening test for prostate cancer was required if the patients had conditions such as higher age, smaller prostate, and higher PSAD.
Biopsy ; Digital Rectal Examination ; Humans ; Mass Screening ; Medical Records ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Retrospective Studies

Deep infection after total hip arthroplasty is one of the most serious post operative complications. Treatment of infection of the hip joint can be made very difficult by poor response to antibiotic therapy. Infection rates of total hip arthroplasty have decreased due to prophylactic antibiotics, sterilization of surgical instruments, cleaner operation environments, Improvement of surgical methods and proper patient selection. Recently, post operative infection rates of primary or revision arthroplasties were reported to still be as high as 1% to 2%. Therefore, the aim of this article is to review the recent literature and to evaluate the cause, environment diagnosis and treatment of infection after total hip arthroplasty.
Anti-Bacterial Agents ; Arthroplasty ; Hip ; Hip Joint ; Patient Selection ; Sterilization ; Surgical Instruments

Operating-room airway fires are serious and potentially fatal complications. To prevent airway fire in CO2 laser surgery of the larynx, many techniques and devices have been developed. Using laser safe tube is one of the common methods of preventing airway fire, but it is very expansive and hard to treat. In this study, we used a fire-resistant tape to protect the endotracheal tube and had very successful results in experiments with CO2 laser. In this article, we introduce the technique of using a fire-resistant tape to protect endotracheal tube.

Endoscopic sphincterotomy(EST) is now an established therapeutic procedure for various disorder of the pailla of Vater, the biliary tract, and the pancreas. From November 1992 to September l993, 123 cases of E.S.T were performed in our hospital. The success rate of EST was 97.8%, and choledocholithiasis was the indication for EST in 63. 4% of cases. Among 78 cases of choledocholithiasis, 47 cases were presence of gall bladder with stone (16 cases) or without stone (31 cases), especially 46 cases were assisted with needle type papillotome and 23 cases were assisted with guidewire. EST hae relatively low complications and is the therapy of choice for choledocholithiasis and various diisease of biliary tract. Guidewire assisted stanard papillotome probable reduce the use of needle type papillotome in the difficult cases that EST with pull type papillotome was impossible.
Biliary Tract ; Choledocholithiasis ; Needles ; Pancreas ; Sphincterotomy, Endoscopic* ; Urinary Bladder

PURPOSE: To evaluate clinical results of autologous osteochondral graft in osteochondral lesions of the talus. MATERIALS AND METHODS: Twenty feet in twenty patients underwent osteochondral autologous transfer in the osteochondral lesions of the talus. Sixteen were men and four were women. The mean age was 40.8 years old. The mean follow up was 2 years 9 months. Eighteen cases were medial, one case was lateral and one case was both, respectively. The average duration of symptom was 4 years 3 months. AOFAS ankle/hindfoot score (AOFAS score), visual analogue scale (VAS), Lysholm knee score were evaluated preoperatively and at the final follow up. RESULTS: Postoperative AOFAS score was 87.3 (range, 69-100), which was significantly improved from preoperative AOFAS score of 62.0 (p=0.000). Postoperative VAS was 2.9 (range, 0-7), which was significantly improved from preoperative VAS of 7.5 (p=0.000). Postoperative Lysholm knee score was 92.4 (range, 80-100). All osteotomy of medial malleolus was united by the 4th month after surgery. Postoperative VAS was conversely correlated with the follow up period (p=0.024). There was no complications associated with surgery. CONCLUSION: Autologous osteochondral grafts in osteochondral lesion of the talus demonstrated excellent results with a short-term follow up.
Female ; Follow-Up Studies ; Foot ; Humans ; Knee ; Male ; Osteotomy ; Talus* ; Transplants*

Upper gastrointestinal bleeding is one of the most common complications in patients with chronic renal failure. Common causes are peptic ulcer, gastritis, duodenitis, esophagitis, Mallory-Weiss tear, and angiodysplasia. However, gastric polyp is a rare cause of upper gastrointestinal bleeding. We diagnosed a bleeding hyperplastic polyp in chronic renal failure patient with melena. He had a bleeding polyp with a Y-shaped stalk. This polyp was treated effectively by endoscopic snare polypectomy.
Angiodysplasia ; Duodenitis ; Esophagitis ; Gastritis ; Hemorrhage* ; Humans ; Kidney Failure, Chronic* ; Mallory-Weiss Syndrome ; Melena ; Peptic Ulcer ; Polyps* ; SNARE Proteins