Small cell neuroendocrine carcinoma of the uterine cervix is a distinct subtype of cervical cancer that appears analogous to oat cell carcinoma and carcinoid tumors of the lung. It has been assumed to be derived from the neural crest via argyrophilic cells in the normal endocervix. We have recently encountered a case of small cell neuroendocrine carcinoma of the uterine cervix coexisting with adenocarcinoma which was argyrophil negative. A 66-year-old multiparous woman was admitted because of vaginal bleeding for 2 months. Cervicovaginal smear revealed several scattered clusters and sheets of monotonous small cells with some peripheral palisading in the background of hemorrhage and necrosis. Radical hysterectomy specimen revealed an ulcerofungating tumor on endocervical canal which was composed of two components. Major component of the tumor was made up of monomorphic population of small oval-shaped tumor cells arranged in sheets and partly in acinar structures or trabecular fashion. Other component was adenocarcinoma, endocervical well-differentiated type. Argyrophilia was present on the Grimelius stain and immunohistochemical studies revealed diffuse positivity to neuron-specific enolase and carcinoembryonic antigen. Electron microscopic examination showed clusters of small round to oval cells, which had a few well-formed desmosomes and several membrane-bound, dense-core neuro- sectetory granules.
Adenocarcinoma ; Aged ; Carcinoembryonic Antigen ; Carcinoid Tumor ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Cervix Uteri ; Desmosomes ; Epididymitis* ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Lung ; Male ; Necrosis ; Neural Crest ; Phosphopyruvate Hydratase ; Purpura, Schoenlein-Henoch* ; Uterine Cervical Neoplasms ; Uterine Hemorrhage

No abstract available.

No abstract available.
Biology*

Quality assurance analysis of frozen section diagnosis is very important for the pathologists to improve the diagnostic ability and the quality of medical service. We analysed 5,273 consecutive cases of frozen section diagnosis which were done in Samsung Medical Center during 10 months from June 1, 1998 to March 31. 1999 with special reference to the discordance between frozen section diagnosis and final diagnosis. The concordance rate was 97.65%, discordance rate 1.34%, and deferred diagnosis (type 1) rate 1.01%. Category A (discordant diagnosis without any effect on the patients) was 53 cases (1.01%), category B (discordant diagnosis with minimal but no serious effect on the patients) was 10 cases (0.19%), and category C (discordant diagnosis with serious effect on the patients) was 8 cases (0.15%). Type 2 (discordant diagnosis by extra-pathologist problem) was 22 cases (0.42%) and type 3 (discordant diagnosis by pathologist problem) was 49 cases (0.93%). The most frequent causes of type 2 and 3 discordant diagnosis were presence of new lesions on deeper sections and the misinterpretation of lesions. Discordant diagnosis was noted in lymphoreticular system, central nervous system, thyroid, gastric resection margin, breast, female genital organs, intestine, hepatobiliary system, upper aerodigestive tract, urinary tract, lung, and soft tissue in descending order of frequency. Frozen section diagnosis was deferred in central nervous system, lymphoreticular system, gastric resection margin, female genital organs, thyroid, intestine, upper aerodigestive tract, lung, and soft tissue in descending order of frequency. The most important cause of discordant diagnosis was a misinterpretation of the lesions. Based on our results, a continuous and careful follow-up of quality assurance analysis of frozen section diagnosis and a share of experience of problematic cases are mandatory for the pathologists to improve the quality of medical services.
Breast ; Central Nervous System ; Diagnosis* ; Female ; Frozen Sections* ; Genitalia, Female ; Intestines ; Lung ; Thyroid Gland ; Urinary Tract

78 cases of ankle fracture are experienced and especially 25 cases of supination-outward rotation injuries treated during the period from January 1959 to October 1970 were analyed. 1) 17 cases of male and 8 cases of female, and 11 caces in right side and remaider in left side. 2) According to the Lauge-Hansens classification, 5 cases in type II, and 20 cases in type IV. 3) Conservative treatment was given in 8 cases and open reduction in 17 cases. 4) A comparison has been made between functional results treated by conservative treatment and open reduction; satisfactory results were obtained in 3 cases of type II and I case of type IV by conservative treatment. I case of type II and 14 cases of type IV by open reduction. 5) Time of complete healing by bony union were 7. 8 weeks in conservative treatment and 9. 3 weeks in open reduction. 6) Wound infection, necrosis of wound edge and pseudoarthrosis were noted as post-operative complications.
Ankle Fractures ; Ankle ; Classification ; Female ; Humans ; Male ; Necrosis ; Pseudarthrosis ; Wound Infection ; Wounds and Injuries

6 cases of idopathic asceptic necrosis of femoral head were experienced at the Department of Orthopedic Surgery. Age distribution ranged from 19 to 58 years and the ratio of sex was 3:3. Two of them had bilateral involvement of necrosis of femoral head. Two of them were primarily treated by means of arthrotomy, joint debridement and drilling of the necrotic area. Symptoms only temporarily relieved and required further surgical procedure. As a whole, arthrodesis in 2, cup arthroplasty in 1, Austin-Moor hip prosthesis in 2 and total hip prosthesis, McKee-Farrar type, in 1 case were performed. Four of the mobile operation of the hip restored satisfactory range of hip motions despite the types of surgery.
Age Distribution ; Arthrodesis ; Arthroplasty ; Debridement ; Head ; Hip ; Hip Prosthesis ; Joints ; Necrosis ; Orthopedics

At Orthopedic Department of Kyung Hee University Hospital, we performed 20 total knee replacements in 12 patients who had rheumatoid arthritis and 18 total knee replacements in 13 patients who had osteoarthritis during the period from August 1982 to May 1986. All patients were female. Comparative analysis was done between the two groups with a follow-up period ranging from 1 year to 4 years 8 months, average being 2 years and 3 months. The average age of rheumatoid arthritis patients was 10 years younger than osteoarthritis patients. The improvement of range of knee motion after total knee replacement was greater in rheumatoid arthritis comparing to osteoarthritis. Preoperative flexion contracture was more severe in rheumatoid arthritis than osteoarthritis, but after total knee replacement the average degree of flexion conrcacture was no significant difference between two groups. The average of preoperative Hospital Surgery Knee Rating Scale was low in rheumatoid arthritis group than in osteoarthritis group, but postoperative Knee Rating Scale was similar in both groups. It seems that the problem of wound was more frequent in rheumatoid arthritis than in osteoarthritis.
Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee ; Orthopedics ; Osteoarthritis ; Wounds and Injuries

The anterior cruciate ligament injury is one of the most common ligament injury of the knee joint, and anterior cruciate ligament is as important structure for stabilization as a primary restraint. Noyes reported that the diagnosis of a tek of the anterior cruciate ligament was made by the original treating physician in only 6.8%. And there are many controversies in its treatment. It is certain thatearly diagnosis and treatment are th most important clue. Authors studied 48 patients of isolated anterior cruciate ligament injury who were diagnosed by same physician from Jan. 1983 to Dec. 1985 after follow ups ranging from six mnths to 4 years, average beimng one year and two months. The results were as followings: 1. The most common cause was sports injury. 2. The most common sign and symptom were hemarthrosis in acute injury and giving way in chronic injury. 3. Anterior drawer test without anesthesia had 25% of diagnostic accuracy but pivot shift test under anesthesia 95.8%. 4. 31 cases in 48 cases (64.8) had associated meniscal injury. 5. In acute torn ACL, the primajy repair was preparable but conservative treatment with arthroscopic partial menisectomy was eful in chronic case.
Anesthesia ; Anterior Cruciate Ligament ; Athletic Injuries ; Clinical Study ; Diagnosis ; Follow-Up Studies ; Hemarthrosis ; Humans ; Knee ; Knee Joint ; Ligaments

No abstract available.
Fourth Ventricle* ; Meningioma*

No abstract available.
17-alpha-Hydroxyprogesterone*