A pathological study was performed on four cases of infantile hemangioendothelioma of the liver. All the patients were between the age of 1 -5 months and the tumors were typical hemangio-endotheliomas, type 1. The tumors were composed basically of two components; the endothelial cell proliferation and the myxoid matrix. The endothelial cells were cytologically innocuous and formed vascular channels of varying sizes and shapes from capillary to sinusoidal and cavernous vessels. Fibrosis of the matrix, albeit not a major component of the tumor, was found particularly near the center. Immunohistochemically, CD31 was expressed strongly in almost all endothelial cells, in contrast to the stain for von Willebrand factor which was only focally and weakly positive. Alpha-fetoprotein was expressed in hepatocytes within the tumor or in hepatocytes around the tumor. Intratumoral bile duct structures were located mainly at peripheral portion. The results indicated that the type I infantile hemangioendothelioma is a tumor of endothelial cells and myxoid stroma, and that the endothelial cells undergo gradual maturation to form sinusoidal and cavernous vessels in accordance with gradual fibrosis of the myxoid stroma.
Infant ; Male ; Female ; Humans

E-cadherin is a calcium-dependent epithelial adhesion molecule which plays a role in the initial step of invasion of cancer cells. The step that follows the migration of separated tumor cells is a proteolytic lysis of basement membrane and extracellular matrix by protease of epithelial and endothelial cells such as matrix metalloproteinase (MMP). Vascular endothelial growth factor (VEGF) is known to be an endothelial cell-specific powerful mitogen as well as a vascular permeability factor. This study is aimed to evaluate the correlation between expression of these factors and pathologic or clinical variables and the roles and prognostic significance of those factors in squmous cell carcinoma and adenocarcinoma of the lung. Immunohistochemical stains were performed for E-cadherin, MMP-2, and VEGF in surgically resected specimens from 90 patients with squmous cell carcinoma and adenocarcinoma of the lung. Mean age of the patients was 59.7 years. Histologic type was categorized into 56 cases of squamous cell carcinoma and 34 cases of adenocarcinoma. Mean survival period of the 35 patients was 54 months. The immunohistochemical stains for E-cadherin, MMP-2, and VEGF revealed positive reaction in 67 cases (74.4%), 43 cases (47.8%), and 34 cases (37.8%), respectively. The expression of E-cadherin was higher in adenocarcinoma (82.4%) than in squamous cell carcinoma (69.6%). MMP-2 was expressed in the tumor cells, especially those invading into the surrounding stroma. The expression of MMP-2 was significantly correlated with the survival rate (p<0.05). The expression of VEGF in the tumor cells was significantly higher in cases with lymph node metastasis (p<0.05). In conclusion, these findings suggest that the expression of MMP-2 and VEGF predict poor prognosis of patients with squmous cell carcinoma and adenocarcinoma of the lung and that VEGF may play a role in tumor metastasis.
Adenocarcinoma* ; Basement Membrane ; Cadherins* ; Carcinoma, Squamous Cell* ; Coloring Agents ; Endothelial Cells ; Extracellular Matrix ; Humans ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Survival Rate ; Vascular Endothelial Growth Factor A*

To evaluate the correlation between the histologic grade and DNA ploidy or proliferation index/S phase fraction (SPF) of gastrointestinal stromal tumors, we performed the DNA analysis using the flow cytometry. Paraffin embedded tissue samples of 57 gastrointestinal stromal tumors were used. The sites of the tumors were: stomach (28), small intestine (23), and large intestine(6). DNA index, proliferative index, and SPF by the flow cytomery were compared with histologic grade. The histologic grade of the gastric tumors were benign (12), borderline (10), and malignant (6). Those of the small intestinal timors were benign (2), borderline (13), and malignant(8). The large intestine were borderline (2), and malignant (4). In stomach, aneuploidy was found in 25.0% of benign, 40.0% of borderline, and 100% of malignant. And there was statistically significant correlation between the histologic grade and ploidy (p < 0.05). By contrast, small and large intestinal tumors showed more frequent aneuploidy in benign than in malignant. The proliferative index was correlated with the histologic grade in gastric tumors (p<0.05), but the SPF was not. In conclusion, the ploidy and proliferative index of gastric tumors are closely correlated to the histologic grade. However, aneuploidy in tumors of the small and large intestine were difficult to predict the malignancy.
Aneuploidy ; DNA* ; Flow Cytometry ; Gastrointestinal Stromal Tumors ; Indonesia ; Intestine, Large ; Intestine, Small ; Paraffin ; Ploidies ; Stomach

No abstract available.
Cervix Uteri* ; Female ; Pregnancy*

Recently, we experienced the conservative management of ovarian cyst torsion using transvaginal ultrasonography-guided aspiration in 39 years old woman at 9 weeks of gestational age. The patient had a 7.3 cm-sized ovarian cyst suspected torsion. The symptom was acute lower abdominal pain. Transvaginal cyst aspiration was performed twice. The symptom was resolved after the procedures. The full term delivery was done by vaginal route and the ovarian cyst disappeared.
Abdominal Pain ; Adult ; Female ; Gestational Age ; Humans ; Ovarian Cysts* ; Pregnancy*

Primary testicular carcinoid tumor, occupying 0.23% of testicular neoplasm, is a rare and indolent neoplasm with the potential for distant metastasis. We present two cases of primary pure carcinoid tumor of the testis. Both patients were 36 years old. Physical examination revealed testicular mass with and without tenderness. The preoperative serum levels of beta-human chorionic gonadotropin and alpha-fetoprotein were normal and neither patient had carcinoid syndrome. The tumors measured 7.5x6x4 cm and 5.5x5x4 cm in size. Histologically, immunohistochemically and ultrastructurally, the tumors showed typical features of the carcinoid tumor. Case 1 showed extensive tumor necrosis and vascular invasion. DNA flow cytometric analysis showed aneuploidy with DNA index of 1.47 and S+G2M of 14.0% in case 1 and tetraploidy with DNA index of 1.96 and S+G2M of 22.1% in case 2. Both patients have been well without any signs of metastasis after operation for 24 months in case 1 and for 16 months in case 2.
Adult ; Carcinoid Tumor/pathology ; Carcinoid Tumor/metabolism ; Carcinoid Tumor/genetics* ; Case Report ; DNA, Neoplasm/analysis* ; Flow Cytometry/methods* ; Human ; Immunohistochemistry ; Male ; Testicular Neoplasms/pathology ; Testicular Neoplasms/metabolism ; Testicular Neoplasms/genetics*

PURPOSE: Feeding problems are common for typically developing children and have negative effects on physical, behavioral, and cognitive development. The purpose of the current study was to examine factors related to childhood feeding problems for typically developing children via parental reports. METHODS: The feeding questionnaire developed by the authors and the Childhood Eating Behavior Inventory (CEBI) were administered to 796 parents of children who recruited from 2 pediatric outpatient clinics (n=379) and community (n=417). Problem eaters (PE) were identified by parental report and frequency analysis was conducted for types of feeding problems and its severity, problem behaviors during mealtime, the feeding methods of the parents, and the need for treatment. RESULTS: The CEBI scores were significantly different between the PE and non-problem eaters (NPE), which suggests that the parental reports were reliable. The younger children had more feeding problems than the older children. The most frequent and severe feeding problems were selective eating and longer mealtimes across all age groups. One-half of the children had more than one problem behaviors during mealtime. Most parents of PE used ineffective methods to deal with children's behaviors during meal time, such as cajoling, which was related to their increased level of stress. Many parents reported their children need professional help for the feeding problems. CONCLUSION: Feeding problems are prevalent among children, especially younger children. Children with feeding problems showed a number of problem behaviors during mealtime and parental coping methods appeared to be ineffective. The need for treatment was considerable, thus the characteristics of this population must be acknowledged for providing proper treatment and advice.
Ambulatory Care Facilities ; Child ; Eating ; Feeding Behavior ; Feeding Methods ; Humans ; Meals ; Parents ; Surveys and Questionnaires

PURPOSE: The main purpose of this study was to compare the clinical competency in different instructio nal methods for funda- mentals of nursing practicum, standardized patients methods story as text method ,and traditional lecture/model method. METHOD: The study was designed as a quasi-experimental, nonequivalent control group post-test design with three separate classes of sophomore students attending fundamentals of nursing classes at one baccaleureate nursing school located in metropoli tan Seoul area. Control group was taught by traditiona lecture/ model method and two experimental groups were taught by standardized patients method and story as text method. Data were collected from September, 1999 to June 2001. There were 36 students in the standardized patient method group, 38 students in story as text group, and 40 students in the control group. Data analysis was done using SPSS WINDOW 9.0. RESULT: The results showed that the standardized patients method and story as text method groups were significantly better in clinical judgement and communication skills than the traditional lecture/model method group. The standardized patients method group was significantly better in clinical nursing skills performance than two other groups. However, there was no significant difference among the three groups in student satisfaction. CONCLUSION: The standardized patients method is an effective in teaching clinical cometency for student nurses. It is necessary to explore more efficient way to develop standardized patients cases for wider areas of nursing education. Also, it is recommended to develop more research projects with many nursing programs.
Education, Nursing ; Humans ; Nursing* ; Schools, Nursing ; Seoul ; Statistics as Topic ; Triacetoneamine-N-Oxyl

Thyrold storm, when related to surgery, usually develops within 6~18 hours postoperatively, with symptoms and signs of pyrexia, marked tachycardia, susceptability to severe hypotension, and restlessness. There are a few case reports of thyroid storm related to thyroid surgery or the surgery related to non thyroid surgery with the patient of the hyperthyroidism. We have experienced anesthetic management and postoperative thyroid storm management. The patient have had brain tumor and Grave's disease which was treated with antlthyroid agents and beta-blocking agents to mate the patient euthyroid state for two weeks by the internist. The patient tolerated the two hours of general anesthesia well, but on the first postoperative day, thyroid storm was developed with symptoms and signs of dyspnea, restlessness, nausea, vomiting, diarrhea and tachycardia. After thirty minutes to start the treatment with antithyroid agents, betablocking agents, sedatives and electrolyte balance, the thyroid storm was treated and the patient was discharged on the twenty first postoperative days with healthy state.
Anesthesia, General ; Antithyroid Agents ; Brain Neoplasms ; Diarrhea ; Dyspnea ; Fever ; Humans ; Hyperthyroidism ; Hypnotics and Sedatives ; Hypotension ; Nausea ; Psychomotor Agitation ; Tachycardia ; Thyroid Crisis* ; Thyroid Gland* ; Vomiting ; Water-Electrolyte Balance

Mucin-hypersecreting biliary neoplasm excretes excessive mucin that fills the biliary tree and results in marked dilatation of the bile ducts and obstructive jaundice. In these neoplasm, the mucin produced by the tumor rather than the tumor itself plays an important role in clinical course and radiologic patterns. The purpose of this paper is to report characteristic radiologic patterns of mucin-hypersecreting biliary neoplasms in two cases. These neoplasms were characterized by not only multilocular cystic hepatic mass or extra-hepatic bile duct mass resulting in marked biliary dilatation distal to the mass on US or CT, but also change of shape and extent of amorphous filling defects in the markedly dilated bile duct on serial cholangiograms.
Bile Ducts ; Biliary Tract ; Dilatation ; Jaundice, Obstructive ; Mucins