Ancient (degenerated) schwannomas are benign tumors that display pronounced degenerative changes including cyst formation, calcification, hemorrhage, and hyaliniz ation. The tumors are usually infiltrated by large numbers of inflammatory cells such as neutrophils, lymphocytes, siderophages, and histiocytes. They are located in deep locations such as the retroperitoneum and must be differentiated from malignant soft tissue tumors because spindle cells with nuclear atypia may be present in the fine needle aspiration biopsy. The cytologic findings of two cases of ancient schwannoma occurring in posterior mediastinum and retroperitoneum, respectively, are described. Computerized tomographic findings of both cases showed changes of cystic degeneration or necrosis. A case occurred in retroperitoneum revealed features of destruction of vertebral body to suggest a malignant soft tussue tumor radiologically. The cytologic findings of aspiration biopsy of both tumors revealed that the tumor cells were spindle in shape with elongated nuclei. Some of tumor cells were arranged in a palisading fashion. Cell structures that resemble the Verocay bodies were observed. Some of the tumor cells showed pleomorphic bizarre nuclei, but no mitotic activity or chromatin clumping was seen. Inflammatory cells, siderophages and histiocytes were scattered in fibrillar material. These cytologic findings are important in the diagnosis of ancient schwannoma and in the differentiation of this tumor from the malignant spindle cell tumor.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Needle ; Child* ; Chromatin ; Diagnosis ; Hemorrhage ; Histiocytes ; Humans ; Lymphocytes ; Mediastinum ; Methylprednisolone* ; Necrosis ; Nephrotic Syndrome* ; Neurilemmoma ; Neutrophils

The Taylor's approach is a special paramedian approach to enter the L5-S1 interspace. The L5-S1 interspace is the largest in vertebral column. This approach is particularly useful when the interspace has been narrowed by pathologic bone destruction such as rheumatoid arthritis or osteoarthritis. Surgery in geriatric patients is associated with a markedly higher incidence of perioperative complication or mortality rate. Optimal anesthetic management of geriatric patients depends on understanding of the normal anatomy and physiologic changes in response to drug in aging. We studied of 3-geriatric patients with Taylor's approach. These patients had problems with respiratory dysfunction and anatomic constraints, which make other approaches unfeasible.
Aging ; Arthritis, Rheumatoid ; Humans ; Incidence ; Mortality ; Osteoarthritis ; Spine

The author investigated the allergic contact dermatitis patients which visited our out-patient skin dispensary during 1969 and 1970. The patients were evaluated arcording to age, sex and cause of the disease. Furthermore, the patients were analysed as to the causative allergic contact factors by clinical inspection and history. The causes were confirmed by the patch test which was done on 88 of the allergic contact dermatitis patients. It is believed that patch test is clinically a most reliable procedure for the determination of responsible antigenic substance in allergic contact dermatitis and the positive reactions may be labelled as latent or potential hypersensitivity(Hjorth et al, 1968; Maibach, 1965). There is a group of chemicals used on the so-called routine screening patch test tray, which have proved to be frcquent causes of allergic contact dermatitis. Many diagnostic groups of chemicals and therapeutic trays, shoe trays, metal trays, etc., in addition to the standard routine screening patch test tray are used. Certain allergens seem to cause dermatitis in all countries hut many sensitizers vary from one country to anothcr (Calnan, 1955), The author has tried to establish a standard routine screening patch test tray fitted to our country according to the basic consideration used with standard routine patch test trays of the Skin and Cancer Unit, New York University Hospital. Paraphenylene diamine, ammoniated mercury, mercury bichloride, formalin, crude coal tar, potassium dichromate and mercaptobenzothiazole were the most potent sensitizers. These chemicals must be included in our standard screening routine patch test tray. However, the patch test results and the present clinical dermatitis (i.e. cosmetic dermatitis and rubber or leather dermatitis) did not coincide. Further investigation for the establishment of a proper stanard patch test tray for Korea should be carried out.
Allergens ; Coal Tar ; Dermatitis ; Dermatitis, Allergic Contact ; Formaldehyde ; Humans ; Korea* ; Mass Screening ; Mercuric Chloride ; Outpatients ; Patch Tests ; Potassium Dichromate ; Rubber ; Shoes ; Skin

OBJECTIVE: To analyze the factors affecting the participation rate in the health screening program of medical insurance. METHOD: We investigated the factors associated with the participation rate in the health screening program in Korea. Data were collected at the aggregate level from 145 employee health insurance societies and 227 self-employed health insurance societies from 1995 to 1997. Data were also collected at the individual level from four health insurance societies. This study hypothesized that the participation rate of the health screening program was related to 1) the characteristics of its members and the size of the health insurance society; 2) the specifications of the health screening program; 3) the venue of the health screening institution and the interests of individuals in the health screening program; and 4) the activities of the health insurance society. We used bivariate and multiple regression models to examine the factors on the participation rate of the health screening program. RESULTS: First, in the case of dependents of on employee health insurance society, the ratio of dependents 40 years old and over, the average monthly contribution per household, the interest and satisfaction level of individuals in health screening, and the level of refunds for over-payment were all associated with the participation rate in the health screening program, accounting for 54.4% of the participation rate. Second, in case of those insured by the self-employed health insurance society, the interest and satisfaction level of individuals in health screening, the level of refunds for over-payment, and the performance level of on-the-spot health screening were statistically significant, accounting for 40.1% of the participation rate. CONCLUSION: The factors concerning the participation rate in the health screening program of medical insurance, in both a health insurance society and for individuals, were closely related to the age and gender of individuals and household contributions.
Adult ; Family Characteristics ; Humans ; Insurance* ; Insurance, Health ; Korea ; Mass Screening* ; Occupational Health

Thromboembolic complications (TECs) are clinically important sequelae of nephrotic syndrome (NS). The incidence of TECs in children is approximately 2%-5%. The veins are the most commonly affected sites, particularly the deep veins in the legs, the inferior vena cava, the superior vena cava, and the renal veins. Arterial thrombosis, which is less common, typically occurs in the cerebral, pulmonary, and femoral arteries, and is associated with the use of steroids and diuretics. Popliteal artery thrombosis in children has been described in cases of traumatic dissection, osteochondroma, Mycoplasma pneumoniae infection, and fibromuscular dysplasia. We report of a 33-month-old girl with bilateral iliac and popliteal arterial thrombosis associated with steroid-resistant NS due to focal segmental glomerulosclerosis. Her treatment involved thrombectomy and intravenous heparinization, followed by oral warfarin for 8 months. Herein, we report a rare case of spontaneous iliac and popliteal arterial thrombosis in a young child with NS.
Child* ; Child, Preschool ; Diuretics ; Female ; Femoral Artery ; Fibromuscular Dysplasia ; Glomerulosclerosis, Focal Segmental* ; Heparin ; Humans ; Iliac Artery ; Incidence ; Leg ; Mycoplasma pneumoniae ; Nephrotic Syndrome ; Osteochondroma ; Pneumonia, Mycoplasma ; Popliteal Artery ; Renal Veins ; Steroids ; Thrombectomy ; Thrombosis* ; Veins ; Vena Cava, Inferior ; Vena Cava, Superior ; Warfarin

No abstract available.
Acidosis, Renal Tubular* ; Arthritis, Rheumatoid* ; Sjogren's Syndrome*

Brain metastasis from primary uterine cervical carcinoma have been described but are extremely rare and usually occur in the presence of widely disseminated diseases. The authors report a case of solitary cerebellar metastasis from uterine cervical carcinoma, which was confirmed by histopathological examination. The patient has shown no evidence of metastatic lesions elsewhere, thus far, but had undergone a radical hysterectomy under the diagnosis of uterine cervical carcinoma 52 months prior to the surgical excision of the cerebellar metastasis.
Brain ; Diagnosis ; Humans ; Hysterectomy ; Neoplasm Metastasis*

In the present study, we show that the expression of type 2 glucose transporter isoform (GLUT2) could be regulated by PPAR-gamma in the liver. Rosiglitazone, PPAR-gamma agonist, activated the GLUT2 mRNA level in the primary cultured hepatocytes and Alexander cells, when these cells were transfected with PPAR-gamma/RXR-alpha. We have localized the peroxisome proliferator response element in the mouse GLUT2 promoter by serial deletion studies and site-directed mutagenesis. Chromatin immunoprecipitation assay using ob/ob mice also showed that PPAR-gamma rather than PPAR-alpha binds to the -197/-184 region of GLUT2 promoter. Taken together, liver GLUT2 may be a direct target of PPAR-gamma ligand contributing to glucose transport into liver in a condition when PAPR-gamma expression is increased as in type 2 diabetes or in severe obesity.
Animals ; Cells, Cultured ; Chromatin Immunoprecipitation ; Gene Expression Regulation ; Genes, Reporter ; Hepatocytes/*metabolism ; Liver/metabolism ; Male ; Mice ; Mice, Inbred ICR ; Mice, Transgenic ; Monosaccharide Transport Proteins/*biosynthesis/genetics ; Mutagenesis, Site-Directed ; PPAR alpha/genetics/metabolism ; PPAR gamma/agonists/genetics/*metabolism ; *Promoter Regions (Genetics) ; Protein Isoforms/biosynthesis ; Research Support, Non-U.S. Gov't ; *Response Elements ; Thiazolidinediones/pharmacology

PURPOSE: Hydronephrosis constitutes a great portion of fetal anomalies screened by prenatal sonogram. The present authors made an attempt to access its natural courses through follow up neonatal hydronephrosis diagnosed by prenatal sonogram. METHODS: The study was composed of 23 neonates(36 renal units) who were diagnosed with hydronephrosis through prenatal sonogram screening and confirmed 3-7 days after birth with sonographic evaluation at Kyung Hee University Hospital. The neonates were closely monitored for 12-24 months with renal sonogram, diuretic renogram, intravenous pyelography(IVP) and voiding cystoureterography(VCUG). RESULTS: The underlying diseases were composed of 16 cases(44%) of functional abnormalities, 14 cases(39%) of ureteropelvic junction(UPJ) obstruction, three cases(8%) of vesicoureteral reflux (VUR) and on case each of multicystic dysplastic kidney, UPJ obstruction with ureteral stenosis and ureterovesical junction(UVJ) obstruction with VUR. The degree of hydronephrosis was divided into three classes according to its severity. In 30 renal units with UPJ obstruction and functional abnormalities, 26(87%) showed mild hydronephrosis, while four(13%) were moderate. During the follow up period, six cases(20%) showed natural resolution of hydronephrosis, 15 cases(50%) showed improvement while two cases(7%) were aggravated with improvement only after surgery of the underlying disease. The cases which showed natural resolution were all mild hydronephrosis at diagnosis and the cases which underwent surgery due to continuous aggravation were mild one case and moderate one case. CONCLUSION: Those with cases of mild hydronephrosis show rapid natural improvement. On the other hand, in some cases, follow up monitoring reveal aggravation of the situation, emphasizing the necessity for thorough follow up for a long period of time.
Constriction, Pathologic ; Diagnosis ; Follow-Up Studies ; Hand ; Humans ; Hydronephrosis* ; Infant, Newborn ; Mass Screening ; Multicystic Dysplastic Kidney ; Parturition ; Ultrasonography ; Ultrasonography, Prenatal* ; Ureter ; Vesico-Ureteral Reflux

Pancreatic lipomas are commonly diagnosed based on radiologic images, although the prevalence of lipomas has not been established. Histologic confirmation of pancreatic lipomas is extremely rare because surgical treatment is unnecessary in most cases. Endoscopic ultrasound-guided fine-needle aspiration cytology has been suggested to avoid unnecessary surgery to distinguish between a lipoma and a well-differentiated liposarcoma; however, surgery would be needed when the tumor is associated with symptoms or difficult to distinguish from a liposarcoma. We present a case of a pancreatic lipoma in a 54-year-old male patient that was histologically-confirmed by subtotal pancreatectomy.
Biopsy, Fine-Needle ; Humans ; Lipoma ; Liposarcoma ; Male ; Middle Aged ; Pancreas ; Pancreatectomy ; Prevalence ; Unnecessary Procedures