Teratoma is one of germ cell tumor, common neoplasm in women of reproductive age, but it can arise at any age. Its malignant transformation is rare, less than 2%, frequently at older age. Nearly all the cases are squamous, sarcomatous and adenomatous transformation. Here we present a case of mixed transformation, adeno-squamous cell carcinoma with brief review of the concerned literature.
Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasms, Germ Cell and Embryonal ; Teratoma*

Intramural hematoma(IMH) and penetrating aortic ulcer have been increasingly recognized as causes of acute aortic pathology in addition to aortic dissection. The presence of the intimal tear and a flap traversing the aortic lumen is considered to be a most reliable differential point of aortic dissection and IMH. Transesophageal echocardiography(TEE) has become a valuable modality for the diagnosis, prognosis and management of acute aortic syndrome with the unique advantages of portability and the ability to obtain high-resolution real time images. Endovascular Stent-graft placement over the primary entry tear may be an alternative to open surgery because it can close the intimal tear, which leads to thrombosis of the false lumen, excluding flow through the intimal tear and redirecting aortic flow exclusively into the true lumen. We report 88 year-old male with aortic dissection in descending thoracic aorta, successfully treated with endovascular Stent-graft implantation, which was mimicking intramural hematoma by its appearance and subclinical intimal tear diagnosed exclusively by TEE against other imaging studies.
Aged, 80 and over ; Aorta, Thoracic* ; Diagnosis ; Hematoma* ; Humans ; Male ; Pathology ; Prognosis ; Thrombosis ; Ulcer

PURPOSE: A sensitive assay to detect minimal residual disease in neuroblastoma is necessary for accurate assessment of disease status and optimal treatment. In this study, we compared the usefulness of sensitive methods, flow cytometry and RT-PCR for the detection of minimal residual disease in neuroblastoma. METHODS: Eighteen patients who were newly diagnosed and treated at Severance Hospital since 1999 were included in this study. Samples from bone marrow, peripheral blood, and peripheral blood stem cell product were examined for tumor cell contamination by RT-PCR (TH RT-PCR) to detect tyrosine hydroxylase mRNA and by flow cytometry identifying CD9+/CD56+/CD45- cells. RESULTS: We analyzed 20 cases from 18 patients, which were assayed by both methods at the same time. Among 20 cases, 16 cases showed same results, which were compatible with histologic results and clinical course, and 4 cases showed different results. One case of them showed positive result in histology and flow cytometry, but negative result in TH RT-PCR. The other 3 cases showed negative results in flow cytometry, but positive results in TH RT-PCR, and 1 patient of them relapsed. Among 16 patients, 2 patients, showing positive results in only TH RT-PCR, relapsed. CONCLUSION: Detection of minimal residual disease using TH RT-PCR and flow cytometry was effective and useful in evaluating disease status and deciding for proper treatment.
Bone Marrow ; Flow Cytometry* ; Humans ; Neoplasm, Residual* ; Neuroblastoma* ; RNA, Messenger ; Stem Cells ; Tyrosine 3-Monooxygenase

Cord blood is a useful source of allogeneic hematopoietic stem cells for bone marrow reconstitution. The number of umbilical cord blood transplants is increasing worldwide. In this a case 15- month-old boy with acute myeloid leukemia was treated with umbilical cord blood transplant from an HLA-3 loci mismatched unrelated donor. Granulocyte recovery greater than 500/mm3 occurred at day 49, and the platelet recovered greater than 20,000/mm3 independent of transfusion at day 81 after stem cell infusion.
Blood Platelets ; Bone Marrow ; Fetal Blood* ; Granulocytes ; Hematopoietic Stem Cells ; Humans ; Leukemia, Myeloid, Acute* ; Male ; Stem Cells ; Umbilical Cord* ; Unrelated Donors*

PURPOSE: In 1970, the Berlin-Frankfurt-Munster(BFM) group introduced an intensification therapy after remission induction to reduce relapse of acute lymphoblastic leukemia(ALL) in childhood. Delayed intensification(DI) phase has been included for treatment of ALL in our hospital since the mid-1990s. The purpose of this study is to evaluate the outcome with vs. without DI phase and the outcome with two vs. one DI phase for intermediate risk patients. METHODS: One hundred and thirty nine children with ALL who were treated at the Department of Pediatrics of Wonju Christian Hospital and Yonsei University Medical Center between March, 1990 and July, 2002 were analysed retrospectively. RESULTS: Thirty-eight patients were treated with a DI phase, and 101 patients were treated without a DI phase. Among the DI patients, seven patients were treated with a double DI phase. Five-year overall survival(OS) in the low, intermediate, and high risk groups were 68%, 66% and 58%, respectively. 5-year OS in DDI, DI, and control were 95%, 86% and 40%, espectively. In the low risk group, 5-year event free survival(EFS) in DI, and control were 94% and 58%, respectively. CONCLUSIONS: Delayed intensification improved EFS on childhood ALL in all risk groups.
Academic Medical Centers ; Child ; Gangwon-do ; Humans ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Remission Induction ; Retrospective Studies

No abstract available.
Hematoma* ; Liver* ; Snake Bites* ; Snakes*

BACKGROUND: Amorolfine is a new topical antifungal drug of the morpholine class has broad spectrum fungicidal activity. Amorolfine nail lacquer 5% is a transungual delivery system which can penetrate well through the nail plate to the infected keratin and remain there for a prolonged period. OBJECTIVE: The aim of this study is to assess the efficacy and tolerability of 5% amorolfine nail lacquer given once weekly to the patients with onychomycosis. METHODS: 29 patients with onychomycosis affecting not more than 80% of the surface of nail were treated once weekly for up to 9 months with amorolfine nail lacquer 5%. Clinical and mycological examination were performed before treatment and 3, 6, 9 months after start of treatment. Final evaluation was done 3 months after the end of treatment. RESULTS: Average affected area(%) and average score of clinical signs-thickening, splitting, discoloration-were significantly decreased 3 months after start of treatment. Mycological cure rate was continuously increased according to the treatment duration reaching 75.9% at 3 months after treatment. Overall efficacy assessed by the investgators were cure in 31.0% and improvement in 41.4%. Tolerability, mode and frequency of treatment, and formulation were evaluated as good or excellent by most of the patients.No systemic or local side effect was observed. CONCLUSION: Amorolfine nail lacquer 5% used once weekly up to 9 months was relatively effective and safe for the treatment of onychomycosis.
Fingers* ; Humans ; Lacquer* ; Onychomycosis* ; Toes*

BACKGROUND: It has been suggested that CDT is a potential biological marker in the Western countries to reflect the degree of past alcohol consumption. This study was performed to compare CDT, AST (aspartate transaminase), ALT (alanine transaminase), and GGT (gamma- glutamyl transferase) as a biological marker reflecting drinking amounts in Korean patients. METHODS: The 25 males with moderate drinking(<14 drinks/week) and 26 males with heavy drinking (>21 drinks/week) were studied for the relationships between their weekly drinking amount and the blood levels of CDT, AST, ALT, and GGT. RESULTS: Only CDT was significantly correlated (P=0.001) with weekly drinking amount among heavy drinkers, while both CDT (P=0.029) and GGT (P=0.000) were significantly correlated in moderate drinkers. Stepwise multiple regression revealed that GGT had R2 of 49.1% in moderate drinkers and CDT had R2 of 38.9% in heavy drinkers for the weekly drinking amount. CONCLUSION: The results described above suggested that CDT can be a potential biological marker for the purpose of quantitative monitoring the drinking behavior of heavy drinkers in Korea.
Alcohol Drinking* ; Biomarkers ; Drinking ; Drinking Behavior ; Humans ; Korea ; Male* ; Transferrin*

Renovascular hypertension is the most common cause of curable hypertension. The exact prevalence of renovascular hypertension is not known, and the diagnosis is probably missed in many patients. It is important to recognize this condition in clinical practice, first, because it is a correctable form of secondary hypertension, and second, it is a reversible cause of renal failure in some patients. The Basic lesion of renovascular hypertension is stenosis of the renal artery caused usually by either one of the two most common etiologies, atherosclerosis or fibromuscular dysplasia. Other known causes of renovascular hypertension include aneurysm, embolism, arterio venous fistula, neurofibromatosis, tumor, hematoma, foreign body induced compression, and trauma. Its treatment can be divided into surgical intervention, percutaneous transluminal balloon angioplasty, and medical therapy. Recently, selective embolization has been introduced as a useful alter native therapeutic modality in the management of arterio venous fistula and aneurysm. We report a case of delayed renovascular hyper-tension in stab injury induced renal artery-IVC fistula and its renal artery aneurysm in a 20 year-old man. Embolization of the renal arterio venous fistula was achieved by inserting a detachable balloon, and embolization of the renal aneurysm and lumbar artery pseudoaneurysm was performed using micro-eo-ils. Arteriogram immediately after embolization con- firmed complete occlusion of the ancurysm and closure of the arterio venous fistula. After the procedure, improvement of blood pressure was noted in the patient who is currently being followed-up on an out-patient basis.
Aneurysm* ; Aneurysm, False ; Angioplasty, Balloon ; Arteries ; Atherosclerosis ; Blood Pressure ; Constriction, Pathologic ; Diagnosis ; Embolism ; Fibromuscular Dysplasia ; Fistula* ; Foreign Bodies ; Hematoma ; Humans ; Hypertension* ; Hypertension, Renovascular ; Neurofibromatoses ; Outpatients ; Prevalence ; Renal Artery* ; Renal Insufficiency ; Young Adult

Hemo-Q (R) and Albumax (R) solution are widely used antianemics. Hemo-Q (R) contains cow's milk protein (casein) and Albumax (R) contains egg white protein (ovalbumin). Cow's milk protein and egg protein can cause common allergic diseases in infants and young children. We reported two cases of young children with milk and egg allergy who presented skin symptoms after ingestion or cutaneous contact with Hemo-Q (R) or Albumax (R) solution. When Hemo-Q (R) or Albumax (R) solution was taken or rubbed on, erythematous papules and wheals were developed in 10-20 minutes, but other antianemics which don't contain milk or egg protein contents didn't show skin manifestations.
Caseins ; Child ; Eating ; Egg Hypersensitivity ; Egg White* ; Food Hypersensitivity ; Humans ; Infant ; Milk Proteins* ; Milk* ; Ovalbumin ; Ovum* ; Skin ; Skin Manifestations ; Urticaria*