No abstract available.
Mandibulofacial Dysostosis*

Bizarre parosteal osteochondromatous proliferation was first described in 1983, when Nora and his collegues reported 35 examples of a proliferative lesion involving bones of the hands and the feet. In 1993, Meneses reported 65 cases of this condition. A fourth of all the reported cases involved the long bones. It is important to identify the clinical, roentgenographic, and histologic characteristic to seperate it from other entities because it is a benign lesion with atypical microscopic features with a tendency to recur. Roentgenograms show a calcific mass attached to the underlying cortex having a broad base. Histologically, the lesion exhibites proliferative activity, irregular bony cartilaginous interfaces, and enlarged, bizarre, and binucleated chondrocytes. We reviewed the bone tumors, diagnosed in the KyungHee University Hospital, dated from 1984 to 1994. Five cases were revised to Nora's lesion, all of which were previously diagnosed as osteochondroma. The ages of the patients ranged from 12 to 57 years (median, 19 years), and all of them were males. Two cases involved the bones of hands and feet (metacarpal and talus), and 3 cases involved the long bones (humerus, fibula, and ulna). One lesion involving the humerus has a recurrence. No metastasis had been reported.
Neoplasm Metastasis

No abstract available.
Humans ; Infant, Newborn*

Twenty nine cases of wrist tuberculosis were reviewed(19 joint involvement cases and 4 tendon involvement cases) and twenty three cases were followed up more than one and half years. The mean follow up period was 26.7 months. Synovectomies were not satisfactory in cases of joint involvement and they were useful only in cases of tendon involvement. Arthrodesises were used for 16 cases of joint involvement and were satisfactory in 87,5 percent by Robin's criteria. Finger stiffness was most serious complication(initially, 8.7 percent and finally, 34.8 percent) and it is suggested that early motion of fingers after arthrodesis can prevent this complication.
Arthrodesis ; Fingers ; Follow-Up Studies ; Joints ; Tendons ; Tuberculosis ; Wrist

PURPOSE: The purpose of this study was to identify the levels of relocation stress syndrome (RSS) and influencing the stress experienced by Intensive Care Unit (ICU) patients just after transfer to general wards. METHODS: A cross-sectional study was conducted with 257 patients who transferred from the intensive care unit. Data were collected through self-report questionnaires from May to October, 2009. Data were analyzed using the Pearson correlation coefficient, t-test, one-way ANOVA, and stepwise multiple linear regression with SPSS/WIN 12.0. RESULTS: The mean score for RSS was 17.80+/-9.16. The factors predicting relocation stress syndrome were symptom experience, differences in scope and quality of care provided by ICU and ward nursing staffs, satisfaction with transfer process, length of stay in ICU and economic status, and these factors explained 40% of relocation stress syndrome (F=31.61, p<.001). CONCLUSION: By understanding the stress experienced by ICU patients, nurses are better able to provide psychological support and thus more holistic care to critically ill patients. Further research is needed to consider the impact of relocation stress syndrome on patients' health outcomes in the recovery trajectory.
Adaptation, Psychological ; Adult ; Aged ; Critical Illness/*psychology ; Cross-Sectional Studies ; Female ; Humans ; *Intensive Care Units ; Male ; Middle Aged ; Patient Transfer ; Questionnaires ; Stress, Psychological/*etiology ; Syndrome

BACKGROUND: Basal cell carcinoma(BCC) is the commonest type of skin malignacy, and its incidence is increasing. As a result, the number of cases requiring treatment by dermatologists may also be increasing. OBJECTIVE: The aim of this study was to clarify the presentation pattern of BCC and to assessce the surgical treatment used in the dermatological surgery clinics in Seoul National University Hospital and Seoul City Boramae Hosptial between 1994 to 1998. METHOD: We reviewed the medical records and checked clinical aspects and surgical treatment methods. RESULTS: The Total number of patients was 33. There were 21 Females and 12 males. The Mean age was 63.1. The most common anatomical site was the face and scalp(30 cases, 91%). The mean size of the tumor was 12.2 by 9.6 mm. BCCs were removed by complete surgical excision with a normal skin margin of 2 to 4 mm. The local flap was most commonly used to repair surgical wounds (55%) and primary closure was used in 39% of patients. A Pedicle flap and full thickness skin graft were also used in surgical defect reconstruction. CONCLUSION: With increasing public awareness and earlier presentation there may be a reduction in tumor size at the time of diagnosis. As most BCCs are found on the head and neck and are usually more or less than 1cm in diameter, it is thought that appropriate education of surgical skills should be needed and offered.
Carcinoma, Basal Cell* ; Diagnosis ; Education ; Female ; Head ; Humans ; Incidence ; Male ; Medical Records ; Neck ; Seoul ; Skin ; Transplants ; Wounds and Injuries*

Lymphocytic hypophysitis is a rare but important cause of pituitary hypofunction which predominantly affects young women in the peripartum period. It is believed to be an autoimmune disorder with an association with other autoimmune disorders. Clinically, it presents most frequently with symptoms and signs attributable to pituitary hypofunction, headache, visual disturbance and amenorrhea. It is difficult to distinguish lymphocytic hypophysitis from a pituitary adenoma on preoperative imaging. So the diagnosis must be confirmed pathologically. The frozen section must be done for saving the risk of permanent hypopituitarism that would have attended a more radical debulking procedure. If lymphocytic hypophysitis is confirmed by frozen section, extensive surgical debulking may not be necessary. A 31-year-old woman presented during the third trimester of pregnancy in July of 2003 with headache, vomiting and gradually progressive bilateral visual loss. There was a large 8 shaped homogeneous sellar mass on MR images before delivery. The subtotal excision of tumor was done via transsphenoidal surgery three weeks after cesarean delivery. Visual field testing revealed marked resolution of her visual field defects in both eyes. We report a case of lymphocytic hypophysitis occurred in the third trimester of pregnancy with a brief review of literatures.
Adult ; Amenorrhea ; Diagnosis ; Female ; Frozen Sections ; Headache ; Humans ; Hypopituitarism ; Peripartum Period ; Pituitary Neoplasms ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnancy* ; Visual Field Tests ; Visual Fields ; Vomiting

BACKGROUND: Carcinoma of the uterine cervix is a theoretically preventable disease because its precursor lesions can be detected by cervical Papanicolau smears and appropriately treated, Although cervical cytology screening programmes have resulted in the redution of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. The focus of criticism has been the false-negative Pap smear, and the false-negative Pap smear is the major quality issue currently facing the physicians. To reduce the false-negative rate of Pap smear, it is essential to improve the accuracy of Pap smear. But false-negative rate of Pap smear has been reported variously. OBJECTIVE: This study was undertaken to evaluate accuracy of Pap smear by study false-negative and false-positive rate of Pap smear and to determine whether false-negative and false-positive rate had any correlations with clinical factors. STUDY DESIGN: The study population was comprised of 346 women, who were undertaken gynecologic operation at the Department of Obstetrics & Gynecology at Hanyang University hospital between March, 1997 and April, 1998. All patients were taken Pap smear before operation. In 93 women of these, preoperative diagnosis were cervical intraepithelial neoplasia and carcinoma in situ of uterine cervix, and in 253 women of these, preoperative diagnosis were benign disease as uterine myoma or adenomyosis, etc. All of their surgical specimen were examined. Pap smear, pathology, medical charts of all patients were reviewed retrospectively, and false-negative rate and false-positive rate were calculated. Clinical factors that associated with false-negative and false-positive rate were evaluated. Fishers exact test and Pearson chi-square test were used of statistical analysis, RESULTS: False-negative rate of Pap smear was 7.2%, false-positive rate was 4.6%, corresponding rate with histology was 88.2%. Sensitivity and specificity of PAP smear were 87.0% and 97.0% respctively. According to gross finding of uterine cervix, erosion was 46.6% in cervical intraepithelial neoplasia, 67.8% in carcinoma in situ, 66.6% in microinvasive carcinoma of uterine cervix and 55.3% of 103 erosion findings was cervical intraepithelial neoplasia, carcinoma in situ or microinvasive carcinoma. 23.1% of cervical lesion were normal gross finding. Menopause was associated with false-negative rate and previous vaginal infection history, previous cervical minor operation, delivery mode, contraception method, pelvic inflammatory disease history, vaginal bleeding at Pap smear and gross finding of cerbix were not associated. There were no clinical factors that were associated with false-positive rate. CONCLUSION: Compared with other reports, false-negative rate(7.2%) and false-positive rate(4.6%) of Pap smear was lower and corresponding rate(88.2%) was higher in Hanyand university hospital. Because of higher false-negative rate in menopausal women, it need more careful to take and interpretate Pap smear in these group.
Adenomyosis ; Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Contraception ; Diagnosis ; Female ; Gynecology ; Humans ; Incidence ; Leiomyoma ; Mass Screening ; Menopause ; Mortality ; Obstetrics ; Pathology ; Pelvic Inflammatory Disease ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; Uterine Hemorrhage

Meningioangiomatosis is a rare benign hamartomatous lesion. We describe a case of meningioangiomatosis in an 18-year-old boy with a 15 year history of seizures. Computed tomography reveals an irregular calcification density along the right temporal gyrus. Microscopically, irregularly branched blood vessels, surrounded by a concentric arrangement of proliferating spindle cells, are extending into the gray matter from the meningeal surface. Ultrastructural and immunohistochemical examination failed to demonstrate features of meningothelial cell origin in this case. This is the first case of meningioangiomatosis published in Korea along with immunohistochemical and electron microscopic studies. The pathogenesis and previous reports of this lesion will be discussed.
Adolescent ; Brain Neoplasms/*pathology/radiography/ultrastructure ; Hemangioma/*pathology/radiography/ultrastructure ; Humans ; Immunohistochemistry ; Male ; Microscopy, Electron

OBJECTIVE: To verify the pattern of p53 and TGF-beta protein expression in benign and malignant epithelial ovarian tumors. METHODS: An immunohistochemical technique was applied to formalin-fixed paraffin-embedded samples of 22 benign and 9 malignant epithelial ovarian tumors using p53 monoclonal antibody and TGF-beta polyclonal antibody. Expressions of p53 and TGF-beta protein in two histological types were compared, and correlated with clinico-pathologic findings of the respective cases. RESULTS: p53 immunoreactivity of high or intermediate degree was detected in 2 out of 22 benign (9%) and 5 out of 9 malignant (55%) cases. On the other hand, intermediate to high TGF-beta expression was found in 17 out of 22 benign (77%), and 3 out of 9 malignant (33%) cases. The prevalence differences of p53 and TGF-beta expression between benign and malignant groups were statistically significant (p<0.05). In addition, the prevalence of immunoreactivities of p53 and TGF-beta in malignant tumor didn't show any association with age, tumor size, histologic types and stage. CONCLUSION: Our results suggest that p53 expression and loss of TGF-beta expression may play an important role in the malignant transformation of ovarian epithelial cells. However further studies seem to be necessary to know the exact relationship between their roles.
Epithelial Cells ; Hand ; Prevalence ; Transforming Growth Factor beta*