We described a 65-year-old woman with a papule on the left temple area of } year duration. The lesion showed typical findings of atypical fibroxanthoma and was located on the lesion of solar keratosis, So sunlight may be the most important one among the various insults to atypical fibroxanthoma of the skin.
Aged ; Female ; Humans ; Keratosis ; Skin ; Sunlight

Liver is generally known as an organ which is most commonly involved by the metastic tumors. According to the tendency of using fine needle aspiration in the diagnosis of hepatic tumors, the differentital diagnosis between hepatocellular carcinoma and metastatic carcinoma frequently has been a main issue in the poorly differentitated cases, especially to the pathologists of Korea, an endemic area of hepatocellular carcinoma. Until now the problem has been usually solved by the comparison of cytologic characteristics of their tumor cells but not by background cytologic features which rarely have been studied. We observed the background cytologic features helpful for the differential diagnosis through the analysis of 20 cases who had confirmed primary cancer and were diagnosed as metastatic carcinomas in the liver by fine needle aspiration cytology. Twenty cases included 9 adenocarcinomas, 7 spuamous cell carcinomas, 1 small cell carcinoma, 1 carcinoid, 1 adenoid cystic carcinoma, and 1 renal cell cacinoma. Analysis of background cytologic features revealed that 77% of adenocacinoma cases showed benign mesenchymal components and hepatocytes and spuamous cell carcinoma cases disclosed benign mesenchymal tissue (71%) and necrosis (57%). Remaining cases showed variable combinations of benign mesenchymal component, necrosis, hepatocytes, and bile duct epithelial cells. No case revealed atypical hepatocytic naked nuclei, a useful cytologic finding of hepatocellular carcinoma. In summary, the background cytologic features more commonly observed in metastatic carcinomas than in the hepatocellular carcinoma were benign mesenchymal components, hepatocytes, necrosis, and bile duct epithelium. The endothelial cells and hepatocytic naked nuclei, two relatively specific findings of hepatocellular carcinoma were not observed except for renal cell carcinoma. Above background cytologic features are thought to be helpful for the differential diagnosis between the hepatocellular carcinoma and various metastatic carcinomas in the poorly differentiated cases.
Adenocarcinoma ; Bile Ducts ; Biopsy, Fine-Needle ; Carcinoid Tumor ; Carcinoma, Adenoid Cystic ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Carcinoma, Small Cell ; Diagnosis ; Diagnosis, Differential ; Endothelial Cells ; Epithelial Cells ; Epithelium ; Hemolytic-Uremic Syndrome* ; Hepatocytes ; Korea ; Liver ; Necrosis ; Pneumococcal Infections* ; Ulnar Nerve

The authors report the result of cryo-extraction of the lens in 50 eyes (44 cases) which were operated in B.N.D. Hospital from January 1978 to April 1980. The results are as follows: 1. The incidences of complication during operation were hyphema(8%), vitreous loss and rupture of the lens capsule(2%). Hyphema was the most common complication during operation. 2. The incidences of early postoperative complication were striate keratitis(26%), hyphema (2%), shallow anterior chamber(2%) and uveitis. 3. The incidences of late postoperative complication were vitreous prolapse into anterior chamber (6%), updrawn pupil(6%), macular edema(4%) and posterior synechia (2%), corneal degeneration with abnormal tissue growth into anterior chamber (2%), iris atrophy (2%) and vitreous opacity (2%). 4. The postoperative final visual acuity more than 0.5 were 37 eyes(74%) and less than 0.1 were 2 eyes(4%).
Anterior Chamber ; Atrophy ; Cataract* ; Hyphema ; Incidence ; Iris ; Postoperative Complications ; Prolapse ; Rupture ; Uveitis ; Visual Acuity

PURPOSE: We compared the outcome of transurethral electro-vaporization of the prostate (TVP) with that of transurethral resection of the prostate (TURP) in patient with benign prostate hyperplasia (BPH). MATERIALS AND METHODS: Fifty-four patients with BPH were treated with TVP (Group I) and sixty-two with TURP (Group II). Patients were assessed at baseline for both safety and efficacy and in follow-up at 1 and 3 months. Efficacy parameters evaluated included American Urological Association (AUA) symptom score, peak urinary flow rate (Qmax) and post-void residual urine volume (ml). Safety parameters evaluated included incidence of side effects, operative time, postoperative catheterization time, change in hematocrit and serum sodium. RESULTS: The mean prostate size was 28.4+/-4.8gm in GroupI and 37.1+/-5.3gm in Group II. The mean operation time was shorter in Group I (48.2+/-10.5min) than in Group II (75.2+/-32.6min) (p<0.05). The change of hematocrit (%) was lower in Group I (from 40.2+/-4.1 to 38.7+/-4.1) than in Group II (from 40.3+/-3.8 to 34.9+/-5.5), (p<0.05). The mean catheterization time was 3.2+/-1.2 days and 4.9+/-1.9 days (p<0.05). The change of peak urinary flow rate, post-void residual urine volume, AUA symptom score, incidence of postoperative complications was not significantly different between each group. CONCLUSIONS: Although the TURP is the gold standard for the treatment of symptomatic BPH with high success rate, significant morbidities are associated with this procedure. Our early clinical experience highlights several advantages of electro-vaporization, particulary the low incidence of postoperative morbidity.
Catheterization ; Catheters ; Follow-Up Studies ; Hematocrit ; Humans ; Hyperplasia ; Incidence ; Operative Time ; Postoperative Complications ; Prostate* ; Prostatic Hyperplasia* ; Sodium ; Transurethral Resection of Prostate

BACKGROUND: More than 90% of acute stroke patients have measurable cardiovascular sequelae, but we have been often overlooked in formal discussions of treatment. If we estimate the incidence of myocardial injury in patient with spontaneous SAH, we may figure the possibility of cardiac dysfunction in such patients. This study was designed to investigate the incidence of myocardial injury in patients with spontaneous SAH using cardiac troponin I(cTnI). METHODS: A prospective single emergency center study was performed to determined preoperative incidence of unrecognized cardiac injury in patients suffering spontaneous SAH. We include the spontaneous SAH patients who underwent serum measurements of the cardic troponin I immediately upon admission last six month period. ECG, CK, CK-MB and myoglobin were also performed at admission. We excluded the spontaneous SAH patients who had past history of myocardial ischemia and ECG abnormality. RESULTS: Fifty-two patients(34 females, 18 males) with spontaneous SAH were studied prospectively. 18 patients(34.6% of the total study population) had cTnI level above 0.5ng/ml. ECG was performed in 52 patients and was abnormal in 15 of the 52 patients(28.8%). CONCLUSION: The measurement of cTnI has provided physicians with a myocardial marker that has a cardiac sensitivity for cardiac injury equal to that of CK-MB yet with greater specificity. So, cardiac troponin I is useful to estimate the incidence of myocardial injury in patients with spontaneous SAH. And we may estimate the possibility of cardiac dysfunction in such patients. This knowledge will hopefully aid in the care and improve the outcome.
Electrocardiography ; Emergencies ; Female ; Humans ; Incidence* ; Myocardial Ischemia ; Myoglobin ; Prospective Studies ; Sensitivity and Specificity ; Stroke ; Troponin I* ; Troponin*

To define the risk factors affecting the early major morbidity and mortality after multiple-valve operations, the preoperative, intraoperative and postoperative informations were retrospectively collected on 124 consecutive patients undergoing a multiple-valve operation between October 1985 and July 1996 at the department of Thoracic and Cardiovascular Surgery of Pusan Paik Hospital. The study population consists of 53 men and 71 women whose mean age was 37.9+/-11.5 (mean+/-SD) years. Using the New York Heart Association (NYHA) classification, 41 patients (33.1%) were in functional class II, 60 (48.4%) in class III, and 20 (16.1%) in class IV preoperatively. Seven patients (5.6%) had undergone previous cardiac operations. Atrial fibrillations were present in 76 patients (61.3%), a history of cerebral embolism in 5 (4.0%), and left atrial thrombus in 13 (10.5%). The overall early mortality rate and postoperative morbidity was 8.1% and 21.8% respectively. Among the 124 cases of multiple-valve operation, there were 57 (46.0%) of combined mitral valve replacement (MVR) and aortic valve replacement (AVR), 48 (38.7%) of combined MVR and tricuspid annuloplasty (TVA), 12 (9.7%) of combined MVR, AVR and TVA, 3 (2.4%) of combined MVR and aortic valvuloplasty, 2 (1.6%) of combined MVR and tricuspid valve replacement, and others. The patients were classified according to the postoperative outcomes; Group A (27 cases) included the patients who had early death or major morbidity such as low cardiac output syndrome, mediastinitis, cardiac rupture, ventricular arrhythmia, sepsis, and others; Group B (97 cases) included the patients who had the good postoperative outcomes. The patients were also classified into group of early death and survivor. In comparison of group A and group B, there were significant differences in aortic cross-clamping time (ACT, group A:153.4+/-42.4 minutes, group B:134.0+/-43.7 minutes, p=0.042), total bypass time (TBT, group A:187.4+/-65.5 minutes, group B:158.1+/-50.6 minutes, p=0.038), and NYHA functional class (I:33.3%, II:9.7%, III:20%, IV:50%, p=0.004). In comparison of early death (n=10) and survivor (n=114), there were significant differences in age (early death:45.2+/-8.7 years, survivor:37.2+/-11.6 years, p=0.036), sex (female:12.7%, male:1.9%, p=0.043), ACT (early death:167.1+/-38.4 minutes, survivor:135.7+/-43.7 minutes, p=0.030), and NYHA functional class (I:0%, II:4.9%, III:1.7%, IV:35%, p=0.001). In conclusion, the early major morbidity and mortality were influenced by the preoperative clinical status and therefore the earlier surgical intervention should be recommended whenever possible. Also, improved methods of myocardial protection and operative techniques may reduce the risk in patients with multiple-valve operation.
Aortic Valve ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Busan ; Cardiac Output, Low ; Classification ; Female ; Heart ; Heart Rupture ; Humans ; Intracranial Embolism ; Male ; Mediastinitis ; Mitral Valve ; Mortality* ; Retrospective Studies ; Risk Factors* ; Sepsis ; Survivors ; Thrombosis ; Tricuspid Valve

No abstract available.
Neurofibroma, Plexiform* ; Urinary Bladder*

The authors experienced a case of osteopetrosis with optic atrophies and nystagmoid movements, exceedingly rare disease, in 12 year-old girl for 5 years without fracture in long bone. On the X-ray studies: 1. The skull bone showed moderately increased osteosclerotic changes in base of the skull and narrowings in optic foramina. 2. The findings of the extremities showed flask shaped deformities and cortical thickness in both femurs. and transverse line and epiphyseal separations in mid-tibia.
Atrophy ; Child ; Congenital Abnormalities ; Extremities ; Female ; Femur ; Humans ; Optic Atrophy* ; Osteopetrosis* ; Rare Diseases ; Skull

The retraction syndrome in its classic form is characterized that severe limitation of abduction, slightly limitation of adduction, globe retraction and narrowing of the palpebral fissure on adduction, frequently associated elevation or depression in adduction, and convergency insufficiency. While many authors reported this type, there were few reports about inverse Duane's retraction syndrome, as exotropia in primary position, severe limitation of adduction. globe retraction and narrowing palpebral fissure on abduction. So the authors present a case of inversed Duane's retraction syndrome.
Depression ; Duane Retraction Syndrome* ; Exotropia

Multiple periodontal pathogens sequentially colonize the subgingival niche during the conversion from gingivitis to destructive periodontal disease. An animal model of sequential immunization with key periodontal pathogens has been developed to determine whether T and B lymppocyte effector functions are skewed and fail to protect the host from pathogenic challenge. The present study was performed to evaluate immunomodulatory effect of exposure to Fusobacterium nucleatum(F. nucleatum) prior to Porphyromonas gingivalis(P.gingivalis). Group 1(control) mice were immunized with phosphate-buffered saline, Group 2 were immunized with F. nucleatum prior to P. gingivalis, while Group 3 were immunized P. gingivalis alone. All the T cell clones derived from Group 2 demonstrated type 2 helper T cell clone(Th2 subsets), while those from Group 3 mice demonstrated Th1 subsets. Exposure of mice to F. nucleatum prior to P. gingivalis interfered with opsonophagocytosis function of sera against P. gingivalis. In adoptive T cell transfer experiments, in vivo protective capacity type 2 helper T cell clones(Th2) from Group 2 was significantly lower than type 1 helper T cell clones(Th1) from Group 3 against the lethal dose infection of P. gingivalis. Western blot analysis indicated the different pattern of recognition of P. gingivalis fimbrial proteins between sera from Group 2 and Group 3. In conclusion, these study suggest that colonization of the subgingival niche by F. nucleatum prior to the periodontal pathogen, P. gingivalis, modulates the host immune responses to P. gingivalis at humoral, cellular and molecular levels.
Animals ; Blotting, Western ; Clone Cells ; Colon ; Fusobacterium nucleatum* ; Fusobacterium* ; Gingivitis ; Immunization ; Mice* ; Models, Animal ; Periodontal Diseases ; Porphyromonas gingivalis* ; Porphyromonas*