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*

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

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

PURPOSE: Starvation causes impairment in the urinary concentration ability. However, the molecular basis for the impaired urinary concentration and polyuria remains undefined. We examined the effects of food deprivation on the water handling by the kidney and it's regulatory mechanism. METHODS: Sprague-Dawley rats were used. They were placed in metabolic cages and deprived of food but had free access to water for 24 hours. Control rats had free access to both water and food. Protein expression of aquaporin-2 (AQP2) and Na+-K+-2Cl- cotransporter (NKCC2) was determined in the kidney by Western blot analysis. Protein expression of type VI adenylyl cyclase and prostaglandin E2 synthase (PGES) was determined. Urinary PGE2 excretion was also determined by radioimmunoassay. RESULTS: Food deprivation (FD) resulted in impaired urinary concentration associated with decreased tubular water reabsorption and increased urine output. The expression of AQP2 proteins was significantly decreased in the inner stripe of the outer medulla (ISOM). The expression of NKCC2 was not affected in ISOM. The adenylyl cyclase VI expression was increased in ISOM in FD rats. The protein expression of PGES was decreased in the cortex/OSOM and ISOM. The 24 hr urinary excretion of PGE2 was significantly decreased in FD rats compared with controls. CONCLUSION: These findings indicate that FD-induced urinary concentration defect may related to a reduced abundance of AQP2 in the kidney. It is also suggested that the primary impairment in the pathway to the activation of AQP2 in food deprivation is independent of vasopressin/cAMP or prostaglandin activity.
Adenylyl Cyclases ; Animals ; Aquaporin 2 ; Aquaporins* ; Attention ; Blotting, Western ; Dinoprostone ; Food Deprivation ; Kidney* ; Polyuria* ; Prostaglandins E ; Radioimmunoassay ; Rats* ; Rats, Sprague-Dawley ; Sodium* ; Starvation ; Water*

Ileal Dieulafoy lesion is an unusual vascular abnormality that can cause gastrointestinal bleeding. It can be associated with massive, life-threatening hemorrhage and requires urgent angiographic intervention or surgery. Ileal Dieulafoy lesion is hard to recognize due to inaccessibility and normal-appearing mucosa. With advances in endoscopy, aggressive diagnostic and therapeutic approaches including enteroscopy have recently been performed for small bowel bleeding. We report two cases of massive ileal Dieulafoy lesion bleeding diagnosed and treated successfully by single balloon enteroscopy with a review of the literature.
Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Ileum ; Mucous Membrane

BACKGROUND: In order to improve MRI volumetry of hippocampus, we obtained the Longitudinal Regional Volume Curve (LRVC) of hippocampi and compared the sensitivity of LRVC with those of conventional hippocampal volume-tries (total and regional) in temporal lobe epilepsy (TLE). METHODS: Thirty-eight normal subjects and 24 TLE patients were included in this study. The pathology of all patients showed hippocampal sclerosis. The volume of the hippocampus was measured by a manual tracing in 3 mm-thickness coronal MRI slices perpendicular to the long axis of the hippocampus and a three-dimensional reconstruction. Total volume and regional volumes (anterior, middle, and posterior 1/3) of the right and left hippocampi were measured. Then, the focal hippocampal volume of each of the coronal slices (3 mm) was plotted in a X-Y graph to obtain LRVC. The presence and pattern of HA were determined in LRVC. RESULTS: The mean volume of right hippocampus (2512+/-629 mm3) was bigger than that of the left one (2262.6+/-563.2 mm3) in normal subjects. The normal range of right-left total volume difference was 3.6~495.2 mm3. The sensitivities of conventional volumetry, regional volumetry, and LRVC were 66.7%, 75%, and 83.3%, respectively. Eleven patients showed diffuse HA (11/20, 55.0%) and nine had focal HA (9/20, 45.0%). In focal HA, the middle and posterior HA were more frequent (6/9, 66.7%) than anterior HA. CONCLUSIONS: LRVC improved the sensitivity of MRI volumetry in detecting hippocampal sclerosis and could reveal the pattern (diffuse or focal) of HA. (J Korean Neurol Assoc 19(2):125~131, 2001)
Axis, Cervical Vertebra ; Epilepsy, Temporal Lobe* ; Hippocampus ; Humans ; Magnetic Resonance Imaging* ; Pathology ; Reference Values ; Sclerosis* ; Temporal Lobe*

BACKGROUND: In order to improve MRI volumetry of hippocampus, we obtained the Longitudinal Regional Volume Curve (LRVC) of hippocampi and compared the sensitivity of LRVC with those of conventional hippocampal volume-tries (total and regional) in temporal lobe epilepsy (TLE). METHODS: Thirty-eight normal subjects and 24 TLE patients were included in this study. The pathology of all patients showed hippocampal sclerosis. The volume of the hippocampus was measured by a manual tracing in 3 mm-thickness coronal MRI slices perpendicular to the long axis of the hippocampus and a three-dimensional reconstruction. Total volume and regional volumes (anterior, middle, and posterior 1/3) of the right and left hippocampi were measured. Then, the focal hippocampal volume of each of the coronal slices (3 mm) was plotted in a X-Y graph to obtain LRVC. The presence and pattern of HA were determined in LRVC. RESULTS: The mean volume of right hippocampus (2512+/-629 mm3) was bigger than that of the left one (2262.6+/-563.2 mm3) in normal subjects. The normal range of right-left total volume difference was 3.6~495.2 mm3. The sensitivities of conventional volumetry, regional volumetry, and LRVC were 66.7%, 75%, and 83.3%, respectively. Eleven patients showed diffuse HA (11/20, 55.0%) and nine had focal HA (9/20, 45.0%). In focal HA, the middle and posterior HA were more frequent (6/9, 66.7%) than anterior HA. CONCLUSIONS: LRVC improved the sensitivity of MRI volumetry in detecting hippocampal sclerosis and could reveal the pattern (diffuse or focal) of HA. (J Korean Neurol Assoc 19(2):125~131, 2001)
Axis, Cervical Vertebra ; Epilepsy, Temporal Lobe* ; Hippocampus ; Humans ; Magnetic Resonance Imaging* ; Pathology ; Reference Values ; Sclerosis* ; Temporal Lobe*