To evaluate the incidence and clinico-pathologic correlation of benign epithelial changes of endometrium, we tried to classify the changes into squamous cell change, ciliary change, eosinophilic cell change, papillary surface epithelial change, and mucinous cell change by the criteria of Hendrickson. Based on the 450 hysterectomy specimens obtained from Jan. 1994 to Dec. 1994 in PMC, the incidence of the cell changes was as follows: squamous cell change: 1.1%, eosinophilic cell change: 6.8%, mucinous cell change: 6.6%, ciliary change: 10.4%, papillary surface epithelial change: 16.4%. Squamous cell change was noted in severe endometritis or endometrial hyperplasia and papillary surface epithelial proliferation was mainly associated with plasma cell infiltration in adenomyosis or leiomyoma. Eosinophilic change and ciliary change were sometimes concomitantly found in dilated glands of the basal layer or in the invaded glands of adenomyosis. The results of this study suggested a correlation of benign epithelial changes with endometritis, adenomyosis, leiomyoma and dysfunctional uterine bleeding.
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The incidence of primary cardiac tumor is rare, furthermore the cardiac tumor which cause arrhythmia is very rare. We presesent a case of cardiac lipoma combined with paroxysmal atrial tachycardia.
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PURPOSE: Three-dimensional conformal radiation therapy (3DCRT) and intensity-modulated radiation therapy (IMRT) were found to reduce the incidence of acute and late rectal toxicity compared with conventional radiation therapy (RT), although acute and late urinary toxicities were not reduced significantly. Acute urinary toxicity, even at a low-grade, not only has an impact on a patient's quality of life, but also can be used as a predictor for chronic urinary toxicity. With bladder filling, part of the bladder moves away from the radiation field, resulting in a small irradiated bladder volume; hence, urinary toxicity can be decreased. The purpose of this study is to evaluate the impact of bladder volume on acute urinary toxicity during RT in patients with prostate cancer. MATERIALS AND METHODS: Forty two patients diagnosed with prostate cancer were treated by 3DCRT and of these, 21 patients made up a control group treated without any instruction to control the bladder volume. The remaining 21 patients in the experimental group were treated with a full bladder after drinking 450 mL of water an hour before treatment. We measured the bladder volume by CT and ultrasound at simulation to validate the accuracy of ultrasound. During the treatment period, we measured bladder volume weekly by ultrasound, for the experimental group, to evaluate the variation of the bladder volume. RESULTS: A significant correlation between the bladder volume measured by CT and ultrasound was observed. The bladder volume in the experimental group varied with each patient despite drinking the same amount of water. Although weekly variations of the bladder volume were very high, larger initial CT volumes were associated with larger mean weekly bladder volumes. The mean bladder volume was 299+/-155 mL in the experimental group, as opposed to 187+/-155 mL in the control group. Patients in experimental group experienced less acute urinary toxicities than in control group, but the difference was not statistically significant. A trend of reduced toxicity was observed with the increase of CT bladder volume. In patients with bladder volumes greater than 150 mL at simulation, toxicity rates of all grades were significantly lower than in patients with bladder volume less than 150 mL. Also, patients with a mean bladder volume larger than 100 mL during treatment showed a slightly reduced Grade 1 urinary toxicity rate compared to patients with a mean bladder volume smaller than 100 mL. CONCLUSION: Despite the large variability in bladder volume during the treatment period, treating patients with a full bladder reduced acute urinary toxicities in patients with prostate cancer. We recommend that patients with prostate cancer undergo treatment with a full bladder.
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The diagnosis of acute inflammation of the placenta, represented as acute chorioamnionitis, is important in that it is associated with a poor clinical outcome for both the mother and the fetus, including major perinatal morbidities such as sepsis, respiratory distress syndrome, and CNS damage. However, current medical trends in Korea seem to overlook the significance of a histopathological diagnosis of acute placental inflammation, mainly due to the indifferences of clinicians and pathologists. Since late 1993, histopathological examinations have been performed on preterm placentas at Seoul National University. These examinations have demonstrated acute placental inflammation in a significant number of cases. In the present study the incidence of acute placental inflammation was analyzed in 521 placentas which were submitted for pathological examinations in 1995. Examinations were performed to provide basic information on the incidence and profile of acute placental inflammation in this hospital and, thereby, to emphasize the significance of histopathological examinations of the placenta in the routine surgical pathology service. Among the 521 placentas, acute inflammation was found in 194 cases (37.2%). In preterm placentas acute inflammation was found in 39.6% of the cases (67/169), while 36.1% (127/352) of term placentas showed acute inflammation. Taking the delivery mode into account, 26.3% (49/186) of the placentas delivered by cesarean section showed acute inflammation, while 43.3% (145/335) of the transvaginally delivered placentas showed inflammation. The present analysis demonstrates the existence of acute inflammation in a significant proportion of placentas with different clinical settings. The importance of a histopathological examination in routine hospital practice should be emphasized.
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Optic nerve gliomas manifest either as a solitary form or a component of von Recklinghausen's neurofibromatosis. The reported incidence of coexistence with neurofibromatosis varies from 12% to 70%. Usually there are no significant cytological differences between the gliomas that accomapny the disease and those that are deemed to be solitary manifestations. The only possible difference between them is the apparently more common association, with the former, of extensive arachnoid hyperplasia and of a more florid local gliomatous infiltration into the leptomeninges, altogether resulting in perineural thickening. Our cases were 8 and 6 years old girls, respectively, presented with slowly progressive proptosis for 4 years and visual disturbance for 2.5 months. There were multiple cafe au lait spots on their trunks, and case 2 showed Lisch nodules in the iris. MRI of brain revealed unilateral optic nerve thickening with involvement of chiasm or multiple intracranial lesions. Resection of optic nerve tumor was performed. Microscopically, variable degree of tumorous change was seen. Most typically enlarged area was composed of intraneural and perineural portions surrounded by a layer of intact dura. Intraneural tumor revealed proliferation of elongated, spindle-shaped pilocytic astrocytes in intertrabecular spaces and distention of the pial septa with fibrovascular thickening. Another segment had areas with reactive gliosis. Perineural tissue was considerably thickened and, associated with proliferation of meningothelial cells and fibroblasts intermingled with astrocytes and Rosenthal fibers. There were increase of the optic nerve diameter and distention of the overlying dura. Foci of arachnoid cell hyperplasia were noted in both cases, although differed in degree. Immunohistochemically, the tumor cells expressed glial fibrillary acidic protein in intraneural and perineural portions particularly in case 2.
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Multiple symmetric lipomatosis is a rare disease and affects almost exclusively middle aged man, usually with a background of excessive a alcohol intake. The disease is characterized by progressive growth of subcutaneous fat masses which are located symmetrically at neck, shoulders, chest, abdomen and groin, and which subsequently penetrate deeply into the surrounding spaces and structures with symptomatic compression of deep organs, such as trachea. A recent survey revealed a high incidence of sometic and autonomic neuropathy. The exact cause of the disease is not known, but a hyperplastic mechanism has been postulated, with in vitro studies demonstrating a defect in adrenergic-stimulated lipolysis of lipomatous tissue. We have experienced two cases of multiple symmetric lipomatosis. Case 1 was a 59-year-old male, complaining of slowly enlarging doughunt ring-shaped mass at his neck. He had a habit of excessive alcohol intake for many years. The subcutaneous mass at the neck was excised. The pathology report described the specimen as "normal adipose tissue". Case 2 was a 49-year-old male, complanining of slowly enlarging multiple symmetric masses at the neck, shoulders, chest, abdomen, flank and groin over a period of 6 years. He also complained of mild muscular weakness. He had a habit of excessive alcohol intake for many years. The subcutaneous mass in the neck was excised. The specimen had a tendency to form globular masses and microscopically indistinguishable from mature adipose tissue.
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STATEMENT OF PROBLEM: Higher incidence of prosthetic complications such as screw loosening, screw fracture has been reported for posterior single tooth implant. So, there is ongoing research regarding stability of implant-abutment interface. One of those research is increasing the implant diameter and prosthetic table width to improve joint stability. In another part of this research, internal conical type implant-abutment interface was developed and reported joint strength is higher than traditional external hex interface. Purpose. The purpose of this study is to compare stress distribution in single molar implant between external hex butt joint implant and internal conical joint implant when increasing the implant diameter and prosthetic table width : 4mm diameter, 5mm diameter, 5mm diameter/6mm prosthetic table width. MATERIAL AND METHOD: Non-linear finite element models were created and the 3-dimensional finite element analysis was performed to see the distribution of stress when 300N static loading was applied to model at 0., 15., 30.off-axis angle. RESULTS: The following results were obtained: 1. Internal conical joint showed lower tensile stress value than that of external hex butt joint. 2. When off-axis loading was applied, internal conical joint showed more effective stress distribution than external hex butt joint. 3. External hex butt joint showed lower tensile stress value when the implant diameter was increased. 4. Internal conical joint showed lower tensile stress value than external hex butt joint when the implant diameter was increased. 5. Both of these joint mechanism showed lower tensile stress value when the prosthetic table width was increased. CONCLUSION: Internal conical joint showed more effective stress distribution than external hex joint. Increasing implant diameter showed more effective stress distribution than increasing prosthetic table width.
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History, incidence and associated anormalies of the anorectal malformations were reviewed.
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Malignant hyperthermia is a dramatic syndrome that rarely arises during anesthesia and which is still fatal in the majority of cases. It is a hypermetabolic muscle condition characterized by hyperpyrexia and skeletal muscle rigidity. Any potent inhalation anesthetic agent or any skeletal muscle relaxant can trigger this acute catast rophic reaction. A case is presented of a 28 year old femal with a family history of malignant hyperthermia in herrelatives. She sunderwent repair of a retinal detachment under N2O-O2-halothane withcinduction by thiopenthal and succinylcholine. One and half hours after induction, arrhythmia developed and was followed by unstable blood pressure, hyperpyrexia, muscular rigidity. Anesthesia was ended and vigorous emergency treatment was attempted. But she died postoperatively on the 4th day after anesthesia. The etiologic factors, incidence, clinical feature, prevention, treatment and prognosis of malignant hyperthermia are discussed.
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Cervical plexus block has been evaluated clinically for surgery of the anterior neck in 13 patients during the 10 months(from July 1981 to April 1982) at the Department of Anesthesiology in Capital Armed Forces General Hospital. We have assessed CPB for technique, onset, anesthetized area, duration, complication and supplimentary agents, and reviewed the anatomical aspects of cervical plexus. The distribution of injected local anesthetics was demonstrated under radiography using Urographin. We experienced incomplete block in 9 cases which needed substitution with Thalamonal. The incidence of complications was few and most significant complication seen in this study was respiratory difficulty. However, There was no evidence for phrenic nerve paralysis. Cervical plexus block was performed safely and effectively for surgery of the anterior neck.
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