Malignant fibrous histiocytoma, which is interesting because of its pleomorphic nature, is a rare soft tissue sarcoma possibly arising from histiocyte. The tumors are usually situated in the skin or subcutaneous tissues, especially of the extremities, but they may also involve deeper structures, such as the retroperitoneum or genital organs. Herin we report a case of malignant fibrous histiocytoma in the retroperitoneal space and discuss the pathologic and clinical features.
Extremities ; Genitalia ; Histiocytes ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous* ; Retroperitoneal Space ; Sarcoma ; Skin ; Subcutaneous Tissue

The accepted treatment for significant obstruction of the ureteropelvic junction has in general been open operative surgery. However, attention has recently been drawn to the efficacy of percutaneous pyeloplasty. We experienced the twenty-eight patients of the UPJ obstruction during a 10-year period. Of these patients 20 have underwent open pyeloureteroplasty and 8 were performed percutaneous pyeloplasty. Among these 8 patients, 5 were undergone endopyelotomy only and 3 were dilated successfully by balloon dilation after endopyelotomy. The results led us to evaluate these modalities for treatment of UPJ obstruction and the initial results of percutaneous pyeloplasty were encouraging.
Humans

BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

BACKGROUND: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. METHODS: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. RESULTS: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was 127.5°. CONCLUSIONS: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.

Eleven patients with uric acid nephrolithiasis(Five with uric acid stones alone and six with both uric acid and calcium stone) underwent long-term treatment(0.5 to 3.75 years, mean of 2.33 years) with potassium citrate(30 to 80 mEq/day. usually 60mEq/day). Urinary pH increased from low(5.0-6.0) to normal(6.5-7.0) during treatment. Urinary content of uric acid which was 584+/-150 mg, day. slightly increased to 595+/-163 mg/day following treatment. Serum content of uric acid which was 6.45+/-0.9 mg%, slightly decreased to 6.1+/-0.8 mg%. The protein matrix was round in all 11 cases. And 4 types of nucleus were found. which were ca. oxalate, ca. phosphate, dried blood and suture material During the period' (Jan. 1987-Mar. 1990) of preventive management(enough fluid intake. restiction of animal protein and Polycitra-K), no new stones were found.
Animals ; Calcium ; Humans ; Hydrogen-Ion Concentration ; Nephrolithiasis* ; Potassium Citrate* ; Potassium* ; Sutures ; Uric Acid*

BACKGROUND: This study was conducted to analyze the current problems in completing death certificates and to identify the correct method for completing death certificates. METHODS: We reviewed 262 death certificates in three hospitals from March 1 to April 30, 2000, and 119 death certificates in one hospital from March 1 to 31, 2000. We identified major and minor errors and analyzed and compared them retrospectively. RESULTS: A total of 381 death certificates were reviewed: 59 in Seoul National University Hospital, 101 in Ewha Woman's University Hospital, and 102 in Gachon Medical College Hospital, which has no education program for completing death certificates in postgraduate training, and 119 in Samsung Medical Center which has an education program for completing death certificates. 358 certificates(94.0%) had at least one error. There were only 23 death certificates(6.0%) without an error. In 182 cases(47.8%), there was one major error. In 321 death certificates(84.3%), there were more than two errors. A comparison of Samsung Medical Center with the other hospitals showed that the number of total errors was statistically different(p=0.001). CONCLUSION: There were few death certificates without an error in this study. In a hospital which has postgraduate training in completing death certificates, there are fewer errors than in other hospitals which have no training course. Emergency physicians actually certify many deaths, so they must know the correct method of completing death certificates for statistics on morbidity and mortality.
Death Certificates* ; Education ; Emergencies ; Mortality ; Retrospective Studies ; Seoul

The development of balloon catheters and advances in percutaneous endourology have made transluminal dilatation a safe and effective procedure for the treatment of benign ureteral strictures. Herein we introduce a case of our successful experience of percutaneous antegrade balloon dilatation of the allograft ureteral stenosis.
Allografts ; Catheters ; Constriction, Pathologic* ; Dilatation* ; Humans ; Ureter*

In the 1980s ultrasound and CT gradually replaced angiography as the primary diagnostic modalities for renal masses. From 1983 to 1988, a comparative diagnostic study was carried out on 24 patients with pathologically proven renal cell carcinoma which were staged by various methods. Staging was correct with computerized tomography in 75 per cent of the lesions (15 of 20), with ultrasound in 68.2 per cent (15 of 22) and angiography in 53.8 per cent (7 of 13). We conclude that at the present time CT is the optimal technique to stage renal cell carcinoma. Angiography should be used selected cases not adequately evaluated by CT or ultrasound.
Angiography* ; Carcinoma, Renal Cell* ; Humans ; Ultrasonography*

We report herein the case of a 38-year-old woman with Cushings syndrome caused by bilateral adrenocortical adenomas. The adrenal tumor on the left side hypersecreted cortisol and no findings of cortisol hypersecretion from the adrenal tumor on the right side were observed on bilateral adrenal vein samplings. Both adrenal tumors were resected and histologically without any findings of nodular hyperplasia. The left adrenal tumor was histologically diagnosed as a so-called black adenoma. These data imply that the adrenal adenomas developed primarily from the adrenal gland itself, and that one of the tumors was well differentiated and secreted excess hormones, while the other remained in cell proliferation without hypersecretion.
Adenoma* ; Adrenal Glands ; Adrenocortical Adenoma* ; Adult ; Cell Proliferation ; Cushing Syndrome* ; Female ; Humans ; Hydrocortisone ; Hyperplasia ; Veins

We reviewed 723 breast cancer patients treated between Jan. 1981 and Dec. 1991 at the Department of Surgery, Seoul National University Hospital. Survival curves were constructed using the life table method. The significance of the differences in the survival patterns was determined by the log-rank test in univariate analysis, by the Cox proportional hazards regression test in multivariate analysis. Distribution of the patients and the survival rate between this patients and 802 breast cancer patients from Jan. 1970 to Dec. 1988 were compared using paired sample t-test. The mean age of the patients was 46.9 years, and the most prevalent age group was the 5th decade. The distribution of patients according to the tumor stage showed no meaningful change from our previous study. The overall 5-year and 10-year survival rate were 80.1%, 68.4% respectively. On univariate analysis, tumor size, lymph node status, number of lymph node metastasis and stage were found to influence survival significantly. On multivariate analysis, tumor size(p=0.0004), lymph node status (p=0.0231) were found to be significant prognostic factors. In conclusion, the increased proportion of early stage breast cancer patients, although not statistically significant, seems to account for the slight improvement of the overall survival compared to that of our previous study. The tumor size and the lymph node status were potential prognostic factors on survival, a result which is as that of our previous study.
Breast Neoplasms* ; Breast* ; Humans ; Life Tables ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Seoul ; Survival Rate