A 25-year-old woman with focal seizure, intermittent morning headache and vomiting for 2 years showed microcytic hypochromic anemia on peripheral blood smear and a 6x7.5cm sized intracranial mass with cystic and solid portions at the right temporoparietal convexity on brain CT and MRI which was hypervascular on cerebral angiography. Histopathologic findings on light microscopy suggested chordoma, but it was confirmed as a chordold meningioma by immunohistochemical study. The present case suggests that the diagnosis of chordold meningioma shoud be considered in a juvenile or young adult who is presented with an extra-axial mass with typical location of meningiomas, findings of chordomas on light microscopy, and clinical findings of Castleman syndrome.
Adult ; Anemia, Hypochromic ; Brain ; Cerebral Angiography ; Chordoma ; Diagnosis ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Microscopy ; Seizures ; Vomiting ; Young Adult

This study was carried out to obtain the basic data for artificial culture of veiled lady mushroom (Dictyophora spp). The optimal conditions for the mycelial growth were 25degrees C and pH 5.0 for all isolates except the optimal temperature of 30degrees C for D. echinovolvata ASI 32002 and Phallus rugulosus . The optimal medium for Dictyophora spp. was PBA (potato bamboo sawdust extract agar) medium. The strain ASI 32002, D. echinovolvata , grew faster than. D. indusiata ASI 32003 and Phallus rugulosus ASI 25007 on the medium. Carbon sources such as glucose, maltose and inuline were favorable for stimulating a mycelial growth of the two strains of ASI 32002 and ASI 32003. Asparagine and glutamine appeared to be favorable to the strain ASI 32002 and ASI 32003, where as alanine, one of nitrogen source also favorable to the strain ASI 32002. The optimum C/N ratio of the two isolates of ASI 32002 and ASI 32003 was about 25 : 1 when 2% glucose as carbon source was mixed with the basal medium. While, in the case of 4% as carbon source, the optimum C/N ratio was about 30 : 1.
Agaricales* ; Alanine ; Asparagine ; Carbon ; Cultural Characteristics* ; Glucose ; Glutamine ; Hydrogen-Ion Concentration ; Inulin ; Maltose ; Nitrogen

PURPOSE: To analyse the causes of coagulopathy and determine the effect of embolotherapy on acute gastrointestinal(GI) bleeding coexisting with coagulopathy. MATERIALS AND METHODS: Between June 1991 and December 1998, 29 patients with acute GI bleeding (M:F =21:8, mean age, 57.8 years) underwent percutaneous embolotherapy and immediate cessation of bleeding was confirmed. The patients were divided into two groups: control (n =16) and those with coagulopathy (n =13), group membership being determined according to the criteria of >+/-2SD of normal prothrombin time (PT) and activated partial thromboplastin time (aPTT) ( PT >23 seconds, aPTT >40 seconds) at the time at which embolization was requested. Embolotherapy was, defined as clinically successful, if the patient was stable for at least three days, without bleeding, after technically successful embolization. The clinical success rate of embolization and the mortality rate were compared between the two groups, and the causes of coagulopathy statistically analysed. RESULTS: The clinical success rate of embolization was 75% (n =12) in the control group, compared with 38.5% (n =5) in the coagulopathic group (p < 0.05), while the mortality rate for the two groups was 6.3% (n =1) and 53.8% (n =7), respectively (p < 0.005). Statistically, massive transfusion and sustained shock before embolization were the causes of coagulopathy (p < 0.05). CONCLUSION: In coagulopathic patients with acute GI bleeding, embolotherapy induces transient bleeding control, but is unlikely to save lives.
Embolization, Therapeutic* ; Hemorrhage* ; Humans ; Mortality ; Partial Thromboplastin Time ; Prothrombin Time ; Shock

Intrascrotal extratesticular malignancies are rare, and the radiologic findings of extraskeletal chondrosarcoma have not been reported. We describe the radiologic findings of a case of mesenchymal chondrosarcoma arising from intrascrotal extratesticular soft tissue and represented by a complex, cystic, solid mass containing calcifications and hematoma.
Chondrosarcoma ; Chondrosarcoma, Mesenchymal* ; Hematoma ; Sarcoma

Primary Pigmented Nodular Adrenal Dysplasia (PPNAD) is a rare cause of Cushing's syndrome in infants and young adults. The familial occurrence, it may be variably associated with a complex of other pathologic characteristics that manifests extraadrenal disorders (includes cardiac myxomas, lentigines, mammary myxoid lesions, testicular tumors, pituitary adenomas, and neuroectodermal tumors) was considered indicative of Carneys complex. This was based on the failure of cortisol suppression by high-dose dexamethasone, either normal or suppressed basal adrenocorticotropic hormone (ACTH) levels, and normal radiographic studies of the sellar turcica, and adrenals glands is almost normal or slightlg eulaged.. Bilateral adrenalectomy has thus the only effective means of cure. The disease may be a component of a rare, but potentially dangerous complex of abnormalities that follow an autosomal-dominant mode of inheritance. Recently we experienced a case of Carney's complex composed by Cushings syndrome due to PPNAD with familial purple colored lentigines on their lips and report it with reviews of the literatures.
Adrenalectomy ; Adrenocorticotropic Hormone ; Cushing Syndrome* ; Dexamethasone ; Humans ; Hydrocortisone ; Infant ; Lentigo ; Lip ; Myxoma ; Neural Plate ; Pituitary Neoplasms ; Testicular Neoplasms ; Wills ; Young Adult

This study was undertaken to investigate the immunological mechanism of Behqet s syndrome, considered to be important in the pathogenesis of the disease. Seventy- three patients with complete, incomplete and suspected types of Behget's syndrotne were tested for leukocyte migration ingibition factor(LIF), one of the lymphokines. The results were as follows : 1. There was no difference between the average LIF activity of all the patients and that of eontrol. 2. LIF activity of complete type, according to Shirnizus classification, was significaritly lower than the control value. 3. LIF activity of ocular type, according to Lehners classification, was signficantly lower than the control value. 4. LIF activity for patients with 4 clinical symptoms was well below the value for patients with less symptomes 5. For patients with single clinical symptom, LIF activity of complete type was well below the values of incomplete and suspected types. 6. In suspected and mucocutaneous types, LIF activity was low when the patients showed two clinical symptoms than one. Thus, LIF activity was low for patients with complete, ocular and neurological types and with multiple symptorns.
Behcet Syndrome* ; Classification ; Humans ; Leukocytes* ; Lymphokines

BACKGROUND: Although lidocaine seems to be one of the most suitable spinal anesthetics for ambulatory surgery, the safety of lidocaine for spinal anesthesia has been called into question by report of transient neurologic toxicity. So diluted bupivacaine with opioids or adrenergic receptor agonist can replace spinal lidocaine, but delayed awakening, pruritis, intraoperative weak motor block are unsolved problems. This study explored the possibility of solving the unmerited problem to mix bupivacaine and plain lidocaine in spinal anesthesia for transurethral surgery. METHODS: Fifty patients presented for transurethral resection of bladder or prostate. The duration was expected to less one hour. All patients were randomized to two groups receiving the following spinal anesthetics: Group I (7.5 mg bupivacaine), 1.5 ml of 0.5% spinal bupivacaine in 8% dextrose + 0.6 ml saline; Group II (7.5 mg bupivacaine + 6 mg lidocaine), 1.5 ml of 0.5% spinal bupivacaine in 8% dextrose + 0.6 ml 1% plain lidocaine. The sensory and motor block level were checked via pinprick test and modified Bromage score. RESULTS: The highest level of sensory block was not different in group I and group II [median (range): T8 (T5-T9) vs. T8 (T5-T10)]. Onset time to peak block was similar in both groups (11+/-2 vs. 11+/-4 min). Time to two-segment regression (49+/-10 vs. 42+/-10 min; P < 0.05), L1 regression (139+/-27 vs. 113+/-24 min; P < 0.01), S2 regression (200+/-41 vs. 158+/-38 min; P < 0.01) were significantly reduced in group II. No clinical evidence of transient neurologic toxicity was found. Modified Bromage score to evaluate for motor block was not different at the same sensory block level. CONCLUSIONS: Bupivacaine and lidocaine mixture as spinal anesthetics provided the combination of adequate depth of anesthesia and rapid recovery.
Adrenergic Agonists ; Ambulatory Surgical Procedures ; Analgesics, Opioid ; Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Bupivacaine* ; Glucose ; Humans ; Lidocaine* ; Prostate ; Pruritus ; Urinary Bladder

BACKGROUND AND PURPOSE: This study aimed to estimate the changes in gray matter volume (GMV) and their hemispheric difference in patients with mesial temporal lobe epilepsy (MTLE) using a voxel-based morphometry (VBM) methodology, and to determine whether GMV changes are correlated with clinical features. METHODS: VBM analysis of brain MRI using statistical parametric mapping 8 (SPM8) was performed for 30 left MTLE (LMTLE) and 30 right MTLE (RMTLE) patients and 30 age- and sex-matched healthy controls. We also analyzed the correlations between GMV changes and clinical features of MTLE patients. RESULTS: In SPM8-based analyses, MTLE patients showed significant GMV reductions in the hippocampus ipsilateral to the epileptic focus, bilateral thalamus, and contralateral putamen in LMTLE patients. The GMV reductions were more extensive in the ipsilateral hippocampus, thalamus, caudate, putamen, uncus, insula, inferior temporal gyrus, middle occipital gyrus, cerebellum, and paracentral lobule in RMTLE patients. These patients also exhibited notable reductions of GMV in the contralateral hippocampus, thalamus, caudate, putamen, and inferior frontal gyrus. We observed that GMV reduction was positively correlated with several clinical features (epilepsy duration and seizure frequency in RMTLE, and history of febrile seizure in LMTLE) and negatively correlated with seizure onset age in both the RMTLE and LMTLE groups. CONCLUSIONS: Our study revealed GMV decreases in the hippocampus and extrahippocampal regions. Furthermore, the GMV reduction was more extensive in the RMTLE group than in the LMTLE group, since it included the contralateral hemisphere in the former. This difference in the GMV reduction patterns between LMTLE and RMTLE may be related to a longer epilepsy duration and higher seizure frequency in the latter.
Age of Onset ; Brain ; Cerebellum ; Epilepsy* ; Epilepsy, Temporal Lobe ; Gray Matter* ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe ; Prefrontal Cortex ; Putamen ; Seizures* ; Seizures, Febrile ; Temporal Lobe ; Thalamus

PURPOSE: To assess the spiral CT findings of inflammatory pseudotumor of the liver (IPTL), in order todistinguish this tumor from hepatocellular carcinoma, hepatic abscess or other space liver occupying lesions. MATERIALS AND METHODS: The spiral CT findings of IPTL were retrospectively evaluated in six patients. All caseswere confirmed by ultrasonography-guided gun biopsy. Four patients were men and two were women, and they were agedbetween 37 and 74 (mean, 49) years. The site, size, and number of IPTL were assessed, and their enhancementpatterns were evaluated during the arterial, portal and delayed phases of spiral CT. RESULTS: Five casesinvolveda solitary mass and in one there were multiple masses with surrounding small nodules. Four cases occurredin the right lobe and two in the left lobe. Four of five surrounding nodules were in the left lobe. During thearterial phase of spiral CT scanning, three layers were separated from four of five cases of solitary mass ; theywere composed of central and peripheral portions of low attenuation, and an intermediate portion ofisoattenuation. Delayed enhancement of the peripheral portion was prominent during the delayed phase. In the caseinvolving multiple masses three layers were not seen during the arterial phase, but during the delayed phaseenhancement was noted. CONCLUSION: The features of three layers, as seen on spiral CT, is considered to be veryspecific for distinguishing IPTL from other hepatic focal lesions.
Biopsy ; Carcinoma, Hepatocellular ; Female ; Granuloma, Plasma Cell* ; Humans ; Liver Abscess ; Liver* ; Male ; Retrospective Studies ; Tomography, Spiral Computed*

BACKGROUND: The aim of this study was to investigate the demographic and clinical characteristics of patients with primary frozen shoulder in a Korean population. METHODS: A total of 1,373 patients whose shoulders were diagnosed with primary frozen shoulder across 11 resident-training hospitals were reviewed retrospectively. Various demographic characteristics and clinical characteristics according to gender and presence of diabetes were evaluated. RESULTS: The average age of patients was 55.4 years. Gender proportion was 58.3% females and 41.7% males. The frozen shoulder involved the non-dominant arm in 60.7% of patients and the bilateral arms in 17.6% of patients. The average duration of symptoms was 8.9 months, and 51.3% of patients had experienced nocturnal pain. Comorbidities associated with frozen shoulder in our sample of patients included diabetes (18.7%), cardiovascular diseases (17.7%), thyroid diseases (5.4%), and cerebrovascular diseases (3.6%). The diabetic group was correlated with the following demographic and clinical characteristics: old age, involvement of the dominant arm, nocturnal pain, long duration of symptoms, and no history of trauma. Further, we found that, in males, having a frozen shoulder was significantly correlated with a history of trauma; in females, having a frozen shoulder was significantly correlated with having thyroid diseases. CONCLUSIONS: These demographic data of primary frozen shoulder in the Korean population were consistent with those of previously reported epidemiologic studies. Primary frozen shoulder with diabetes was correlated with old age, bilateral involvement, long duration of symptoms, and nocturnal pain.
Arm ; Bursitis* ; Cardiovascular Diseases ; Comorbidity ; Diabetes Mellitus ; Epidemiologic Studies ; Female ; Humans ; Male ; Retrospective Studies* ; Risk Factors ; Shoulder ; Thyroid Diseases