PURPOSE: It has been generally known that prostatic volume is increased related to aging process and changing in hormonal environment, so lower urinary tract symptoms develops. But, our experience has revealed the decrease of prostatic volume in many cases with lower urinary tract symptoms despite aging. MATERIALS AND METHODS: The numbers of patient underwent TRUS were 301 cases. Among the patients who had visited urologic outpatient clinic from march, 1993 to march, 1996, transrectal ultrasonography of prostate was applied to patient with following conditions. 1) over 8 in IPSS with or without enlarged evidence from digital rectal examination 2) enlarged evidence from digital rectal examination 3) no symptomatic relief after 2weeks therapy with alpha blocker 4) when the patient wants more evaluation. RESULTS: Decrease of prostatic volume were shown in 66cases(22%) despite lower urinary tract symptoms. CONCLUSIONS: In our experience, many patients with lower urinary tract symptoms showed decrease of prostatic volume. So, we expect that many more cases of decrease of prostatic volume can be seen among asymptomatic cases with age. Because we can guess that prostatic volume can be influenced by racial differences and dietary habit, we also believe that further evaluation and investigation of this nature is needed.
Aging ; Ambulatory Care Facilities ; Digital Rectal Examination ; Food Habits ; Humans ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Ultrasonography

Discoid meniscus has been defined as a morphological anomaly, and several clinical classification has been proposed. Commonly used classification is Watanabes classification; complete, incomplete and Wrisberg ligament type discoid meniscus. It is a relatively more common disease of the knee in Korea and Japan than western countries. Eighty-one discoid meniscal tears which were operated arthroscopically between the period of June, 1991 and August, 1996 were reviewed retrospectively. The purpose of this study is to analyze the pattern of the tear and the extent of arthroscopic resection according to the arthroscopic classification of the discoid meniscus. Thirty-three cases were classified as complete and forty-five cases as incomplete and three cases were Wrisberg ligament type. The major pattern of the tear in the complete type lesions was horizon- tal(in twenty-three) and complex(in seven) tear. Of the knees that had an incomplete type lesion, longitudinal(in ten including six bucket-handle tear) and degenerative tear(in eight) were observed more frequently, and horizontal tear(in ten) less frequently than that of the complete type. The extent of arthroscopic resection of the discoid meniscus was related to the pattern of tear and type of the discoid meniscus. For the majority of the horizontal tear, arthroscopic partial meniscectomy (twentyeight of thirty-four) was performed, but arthroscopic subtotal and total meniscectomy was performed more frequently for longitudinal tear, complex tear, and Wrisberg ligament type.
Classification* ; Japan ; Knee ; Korea ; Ligaments ; Retrospective Studies

BACKGROUND: Although diagnostic peritoneal lavage (DPL) is a well-established, reliably objective method of diagnosis of intraperitoneal injury, it is too sensitive to be used as a absolute indicator for emergency laparotomy. Recently, Otomo et al, have devised a new DPL criteria specifically designed and modified the classics criteria to aid in diagnosis of intestinal injury. So the author studied the difference of diagnostic sensitivity, specificity, and accuracy between the new and classic criteria for intestinal injury. METHODS: The author reviewed retrospectively one hundred fifteen patients underwent DPL from January 1993 to August 1999. The author adopted the classic criteria positive for intestinal injury when the lavage fluid was white blood cell(WBC) > or = 500/mm3 and newly developed supplementary criteria positive when RBC > or = 100,000/mm3, the positive-negative borderline was adjusted to WBC > or = RBC/150, and when RBC <100,000/mm3, to WBC > or = 500/mm3. And analyzed the difference of sensitivity, specificity, and accuracy each other. RESULTS: Among 115 patients, the sensitivity, specificity, and accuracy for intestinal injury were 96.4%, 87.4%, and 89.6% for the new criteria, and 100%, 42.5%, and 56.5% for the classic criteria. After exclusion of 10 patients in whom-DPL was performed within 3 hours or after 18 hours from the time of injury, the sensitivity, specificity and accuracy for intestinal injury were 96.4%, 97.4%, and 97.1% for the new criteria, and 100%, 46.8%, and 61% for the classic criteria. When analyzed the time interval from injury to DPL in the new criteria, 105 patients that DPL was performed between 3 to 18 hours had 2 false-positive, while 115 patients regardless of DPL time 11 false-positive. CONCLUSIONS : The author concluded that the new criteria of DPL effluent performed between 3 to 18 hours from abdominal blunt trauma would be more specific and accurate indicator of intestinal perforation than the classic criteria. And this new criteria will be used as a reliable indicator for emergency laparotomy for that patients.
Diagnosis ; Emergencies ; Humans ; Intestinal Perforation ; Laparotomy ; Peritoneal Lavage* ; Retrospective Studies ; Sensitivity and Specificity ; Therapeutic Irrigation

No abstract available.
Adult* ; Humans ; Humerus*

The authors developed a computer program for use in report printing as well as data storage and retrieval system at the surgical pathology and its efficacy was evaluated at the Department of Pathology, Seoul National University Hospital. This program used IBM PC XT and was written in DBASE III plus language. The main features of the program included an automatic coding and decoding of the diagnosis, automatic searching of the previous biopsy during gross dictation, powerful word processing function and flexibility of the program. The data storage was carried out during the typewriting of the report, so that the typist's workload became markedly reduced. Two kinds of data files wer stored in the hard disk ; the temporary file contained full informations and the permanent file contained the core data only. Searching of a specific case was performed by pathology accession number, chart number, patient's name or by SNOMED code within a second. All the cases were arranged by copied to the diskette during the daily service automatically, with which data were easily restored in case of hard disk failure. The advantages of this program using a persosnal computer were discussed with comparison to those of larger computer system. Based on the experience of 8 months usage in Seoul National University, we assume that this program gives a sufficient solution to the surgical pathology service of many institutes where a large computer system with well designed software is not available yet.
Biopsy

The pathologic features of acute corrosive esophago-gastritis by ingestion of "Trapunc", a common commercial drain cleansing liquid, is presented. A 37-year-old woman ingested abut 30 ml of Trapunc (3 gm NaOH/100 ml) to commit suicide and received piecemeal esophagectomy and total gastrectomy 9 days after the episode. The esophagus and stomach were extremely friable and necrotic. The most part of the stomach showed acute toxic necrotizing gastritis which was manifested by extensive greenish brown discoloration due to liquefaction necrosis of the mucosa except for a few rugae along the greater curvature. The antrum and distal body revealed severe mucosal detachment and even transmural necrosis. The tissue reaction was basically the same as those of NaOH-induced corrosive esophago-gastritis of acute stage, although it appeared to be severer probably due to sodium hypochlorite, and additive constituent of the ingested cleanser. A unique distribution pattenr of mucosal involvement is discussed.
Female ; Humans

This report describes the pathologic features of 17 cases of Castleman's disease, examined at the Department of Pathology, Seoul National University Hospital during a period from 1973 to 1989. The lesions in 12 cases were hyaline-vascular type and the remainders plasma cell type. The pathologic features favoring the plasma cell type over the hyaline vascular type included a sufficient number to large-sized follicles. However, a histologic overlapping between two types was present. In the hyaline vascular type the age of the patients ranged from 7 to 76 years and they appeared to be no particular sex predominence. The majority of the lesions occurred in the neck and within the chest. Almost all cases presented with a solitary mass except three cases. Neither conventional symptoms nor systemic manifestations were associated. The plasma cell type was characterized by presentation of constitutional symptoms, involvement of intra abdominal and inguinal lymphnodes, in association with unusual clinicopathologic features including IgA nephropathy, diabetes mellitus, systemic progressive sclerosis, peripheral neuropathy, and anemia. Immunohistochemical study was performed in three cases of the plasma cell type. Two cases revealed poly-clonal plasma cell infiltration. In a patient with IgA nephropathy, however, serum IgA was increase and a strong immunoreactivity to IgA heavy chain was found. Another case, associated with systemic progressive sclerosis and neuropathy, revealed monoclonal plasma cell infiltration (IgG and lambda light chain). The above results support a possibility that in some of the plasma cell type an altered immune mechanism is involved in its pathogenesis.

Decubitus ulcer is often seen in the skin and underlying tissue of debilitated or immobilized patients as the result of prolonged pressure and impaired circulation. It manifests chiefly as an ulcer over bony prominences, but tumefaction is an extremely unusual presentation. A 53-year old male, a paralytic of the lower extremity for 18 years, developed a recurrent decubital ulcer despite repeated surgical repair, from which a rapidly growing, large fungating mass grew within a month. The last resected mass was bosselated and measured 15x9x3 cm with a major area of cicatrix-like induration, interdigitated with skeletal muscle bundles at the central area. Microscopically, the mass was composed of an upper half of active granulation tissue layer and a deeper half of dense, poorly cellular, fibrocollagenous bundles admixed with florid proliferation of atypical fibroblasts, but the absence of mitosis and the multifocal admixture of active inflammatory process-granulation tissue formation seemed to help exclude genuine fibromatosis, nodular fasciitis or proliferative myositis. We assume that this rapidly growing pseudofibromatosis is an additional manifestation of a prolonged decubitus ulcer, possibly related to the modified reparative process of decubitus ulcer following repeated excisions, for which we propose a term of decubitoma.

The study was the clinical analysis of 509 patients with pure ocular injuries who visited to Chonnam University Hospital Emergency center from July 1, 1996 to June 30, 1997 retrospectively. Clinical data survey including sex and age distribution, causes of trauma, injury site, ocular disease, and surgical intervention was done. Most of ocular injury patients were male. 3rd and 4th decade who were socially active were nearly 50%. Direct and indirect injury from foreign body was the most common cause of ocular injuries followed by fist blow, traffic accident, falling down, and sport injury. Cornea was the most common ocular injury site (209 patients, 41.1%). The incidence of the traumatic ocular disease showed corneal erosion (117 patients, 22.9%) and then eyeball perforation, traumatic hyphema etc. by frequency of order. Eyeball perforation was the most common ocular injury which needed a emergency surgical intervention. As a results, emergency physicians have to pay attention to the cornea in case of any type of ocular injuries and eyeball perforation which caused by direct and indirect injury from foreign body.
Accidents, Traffic ; Age Distribution ; Cornea ; Emergencies ; Foreign Bodies ; Humans ; Hyphema ; Incidence ; Jeollanam-do ; Male ; Retrospective Studies ; Sports

A computer program using automatic coding of the diagnosis has been used for report printing as well as data storage and retrieval system at the Department of Pathology, Seoul National University Hospital. Previous surgical pathology files were also computerized by the automatic coding system using personal computer, and 100,000 cases of surgical pathology data during 7 years were computerized at present. The cpmputerized surgical files were counted and listed according to topograph and morphologic diagnosis. It is available to print out the list of a specific diagnosis or to copy the records to a floppy diskette. Collection of cases in surgical pathology files using cpmputerized automatic coding system becomes much convenient and accurate than using stored file cards or log books. In addition, previous biopsy records of the patient are automatically searched during the routine work so that understanding of a patient as a whole is possible through the informations about previous pathologic diagnosis. We confirm that automatic coding methods is the most practical and economic method for computerization of the surgical pathology records.
Biopsy