No abstract available.
Broad Ligament* ; Female ; Leiomyosarcoma*

No abstract available.

No abstract available.

No abstract available.
Bone Marrow* ; Histiocytes* ; Niemann-Pick Diseases*

Inflammatory myofibroblastic tumor (IMT) of the biliary tree is extremely rare and is generally a benign condition, though malignant change is possible. Making a differential diagnosis between this lesion and other malignant conditions is very difficult on preoperative imaging studies. Hence, the final diagnosis of IMT may be made during or after operation depending on the pathologic examination. We treated a 63-year-old woman who received right hepatectomy with caudate lobectomy under the suspicion of hilar cholangiocarcinoma. Frozen biopsy during the operation showed carcinoma in situ and there were stromal cells in the bile duct's resection margins. The postoperative hospital course was uneventful except for minor bile leakage. At postoperative month 4, she developed jaundice, ascites and pleural effusion. Computed tomography images showed a mass-like lesion in the porta hepatis with portal vein thrombosis and a right chest wall mass. Excisional biopsy was done and the pathology report was malignant spindle cell tumor suggestive of an aggressive form of IMT. Her condition rapidly deteriorated regardless of the best supportive care and she expired at postoperative month 5. Further investigation is necessary to clarify the reasons for recurrence and infiltration of this disease.
Ascites ; Bile ; Bile Ducts ; Biliary Tract ; Biopsy ; Carcinoma in Situ ; Cholangiocarcinoma ; Diagnosis, Differential ; Female ; Hepatectomy ; Humans ; Jaundice ; Middle Aged ; Myofibroblasts ; Pleural Effusion ; Portal Vein ; Recurrence ; Stromal Cells ; Thoracic Wall ; Thrombosis

No abstract available.
Female ; Humans ; Middle Aged* ; Myofibroblasts

Carbon monoxide (CO) is a kind of freq uent toxic gas around our living lives, for common use of briquet as fuel, and its pathologic effect has been known due to mainly hypoxia and direct cytotoxicity in some part to almost all organs, especially to the brain and heart. Some authors have reported pathologic and anatomic changes of the acute of posioning, although in a few cases, that bilaterally symmetrical lesions of the globus pallidus or cerebral white matter regarded as typical. After using computed tomography (CT), those findings have been discovered more easily and acurately. Authors analysed CT find ings of 32 cases, who had a history of acute CO posioning and performed CT at Hanyang University Hospital from May 1979 to June 1983. The results were as follows: 1. Of all 32 cases with CT scan, low density lesions were demonstrated in 28 cases (88%) and others were hemorrhagic and calcified in 2(6%), respectively. 2. AII lesions were seen as bilaterally symmetrical, exce pt 2 cases of hemorrhage and 1 of low density . 3. Of all 28 cases of the low densities, 15 cases(53.6%) were located in the globus pallidus, 10(35.7%) in the cerebral white matter and 3( 1 0.7%) in both of them. 4. Of all 13 cases of the low density lesions in the cerebral wh ite matter, common locations were in the frontal and parietal lobes (65.6%), and more in frontal (40.6%). 5. Of all 13 cases of low density lesions in the cerebral white matter, cases of involving all of the lobes were found in only 4. 6. All of 2 cases of the cal c ified lesions were seen at both sides of the globus pallidus, symmetrically. 7. All of 2 cases of the hemorrhage were seen at thalamus, ventricles and head of caudate nucleus, and these locations were different from those of the low densities or calcifications.
Anoxia ; Brain ; Carbon Monoxide Poisoning ; Carbon Monoxide ; Carbon ; Caudate Nucleus ; Globus Pallidus ; Head ; Heart ; Hemorrhage ; Parietal Lobe ; Thalamus ; Tomography, X-Ray Computed ; White Matter

The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients residing in hospice units. The convenient sample of this study consisted of 41 terminally ill cancer patients at three hospice units in university affiliated hospitals. Patients were interviewed with structured questionnaires three times at predetermined intervals: admission to the hospice unit (Time 1), one week later (Time 2), and two weeks later (Time 3). The data was collected from January 1998 to January 1999 and was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. The results of this study were as follows: 1. The mean age of the participants was approximately 55 years old. In terms of diagnosis, lung cancer showed the highest frequency (19.5%), followed by stomach cancer and rectal cancer (17.1%). The motive of seeking hospice unit admission was control (72. 2%), followed by spiritual care (50%), and symptom relief (38.9%). 2. Regarding the type of pain felt, the highest pain frequency the participants experienced was deep pain (55%), followed by multiple pain (25%), intestinal pain (10%), then superficial (5%) and neurogenic pain (5%). For the level of pain measured by VAS, there was no significant difference among the three time points; Time 1 (5.04 +/-2.21), Time 2 (4.82+/-2.58) and Time 3(4.73+/-2.51). 3. There was significant change seen in spirituality and physical care in each time interval. Namely, the longer the length of admission at the hospice unit, the higher the importance of spirituality (p=0.0001) and the more the physical care the participants received (p=0.01). The opioid use at the three time points showed the following frequencies : Time 1 (75.6%), Time 2 (85.4%) and Time 3 (75.6%). 4. Regarding factors influencing pain, the pain level was significantly affected by the depression level (p <0.01) and the opioid use (p <0.1). These results were the most significant at the two time points (Time 1 and Time 2). At Time 3 (two weeks later), the pain level was significantly affected by the depression level (p <0.05) and the amount of physical care the participants received (p <0.1). In conclusion, the terminally ill cancer patients had moderate pain, were generally depressed, and were treated with opioid analgesics. As approaching death, the patients received more physical care due to increased physical symptoms experienced and they had a higher perception of the importance of spirituality. Thus, health care professionals need to provide continuous care for each of them to die comfortably physically, psycho- logically, and spiritually.
Analgesics, Opioid ; Delivery of Health Care ; Depression ; Diagnosis ; Hospices* ; Humans ; Logic ; Lung Neoplasms ; Middle Aged ; Surveys and Questionnaires ; Rectal Neoplasms ; Spirituality ; Stomach Neoplasms ; Terminally Ill*

BACKGROUND: Left ventricular thrombus is a common complication after acute myocardial infarction. Methods and RESULTS: To Study the incidence of left ventricular thrombosis (LVT) after acute myocardial infarction, we performed serial two-dimensional echocardiography (2D-Echo) in 35 consecutive patients with acute myocardial infarction prospectively ; 10 patients had inferior wall myocardial infarction, 25 patients had anterior wall myocardial infarction. 2D-Echo was obtained within 3 days of acute myocardial infarction, at 4-10 days after symptom onset, and 2-4 weeks after symptom onset serially in each case. 19 out of 35 patients received thrombolytic therapy with urokinase. Left ventricular thrombi were identified in 9(25.7%) of the 35 study patients. The location of myocardial infarction was anterior and apical in all cases with left ventricular thrombi. The shape of thrombi was mural in 6 cases and protruding in 3 cases. The incidence of left ventricular thrombi in patients who received urokinase was not significantly different from that in patients who didn't(31.9% vs 18.8%,p=0.22). Wall motion score was significantly higher in patients who developed left ventricular thrombi than in patients who had no left ventricular thrombus(8.2+/-1.9 vs 5.8+/-2.6, p<0.005). All thrombi appeared within 10 days after myocardial infarction. CONCLUSIONS: Thus left ventricular thrombi develops within 10 days following myocardial infarction with large anterior and apical location. The thrombolysis therapy has no effect in the incidence of left ventricular thrombi in this study. But because of confounding effect of thrombolysis and location of myocardial infarction and extent of myocardial infarction, further investigation is needed.
Anterior Wall Myocardial Infarction ; Echocardiography ; Humans ; Incidence* ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Prospective Studies ; Thrombolytic Therapy ; Thrombosis* ; Urokinase-Type Plasminogen Activator

Twin pregnancies represent a high risk obstetric population with perinatal morbidity and mortality much greater than that of singleton pregnancies. A retrospective dinical evaluation was attempted to analyse 211 cases of twin pregnancies in Chunchon Sacred Heart Hospital of Hallym University from Jan. l. 1988 to Dec. 31. 1997. The results were as follows. 1) The incidence of twin pregnancy was 1 in 93.9 deliveries. 2) The age of mother ranged from 19 to 42 years and predominant age group was 26-30 which covers 43.1% of all. 3) Nullipara was 61.1% and multipara was 38.9%. 4) The predominant gestational age group at delivery was 36-37 weeks, 33.2%. 5) In presentation, both cephalic combination was 46.4%, cephalic-breech was 26.1%. 6) The birth weight was less than 2500gm in 64.9% of the 1st babies and 70.6% of the 2nd babies, respectively. 7) The rate of cesarean section was 89.0%. The indications of cesarean section were malpresention (48.9%), elective cesarean section(38.8%), and toxemia(9.0%). 8) In 23 cases of vaginal delivery, the average duration of labor was 7.0 hours and 43.5% of 2nd baby was delivered within 5 min after 1st baby delivery, 9) The most frequent maternal complications during pregnancy were anemia(36.0%), preterm labor(34.6%) and preeclamsia(17.5%). 10) The perinatal mortality rate of the first and second twins was 10.4% and 12.3%, respectively. The main causes of perinatal death were prematurity(52.1%) and stillborn(22.9%). 11) Both female was 43.6%, both male was 39.3%, and opposite sex was 17.1% in infant.
Birth Weight ; Cesarean Section ; Female ; Gangwon-do ; Gestational Age ; Heart ; Humans ; Incidence ; Infant ; Male ; Mortality ; Mothers ; Perinatal Mortality ; Pregnancy ; Pregnancy, Twin* ; Retrospective Studies