Trichoblastic fibroma is a benign trichogenic tumor that has both epithelial and mesenchymal components and exhibits partial follicular induction. We studied 4 cases of trichoblastic fibroma and reviewed their clinical and histologic features. Two tumors were present in the face. The remaining two were in the vulva and perianal area, respectively. The age of the patients ranged from 53 to 68 years, with an average age of 62. All were female. Histologically, the lesions showed a well circumscribed mass, located at dermo-subcutaneous junction in three patients and subcutaneous in one. They demonstrated mesenchymal induction evidenced by hair germ-like structure and perifollicular sheath. There was no connection between the tumor and epidermis. Differentiation toward hair structure led to the formation of the infundibulum through inner root sheath. Trichoblastic fibroma may be confused clinically and/or histologically with basal cell carcinoma. Identification of the mixed epithelial and mesenchymal components, and the absence of epidermal connection and cleft within the stroma are important in differentiating this benign neoplasm from basal cell carcinoma.
Carcinoma, Basal Cell ; Epidermis ; Female ; Fibroma* ; Hair ; Humans ; Vulva

Primary malignant parovarian epithelial tumors are extremely rare, with only 56 cases previously reported in the world literature. Most parovarian epithelial tumors are of paramesonephric (Mullerian) origin. In this article, we report the first case in the Korean literature of papillary serous cystadenoma of borderline malignancy from paramesonephric parovarian cyst. This case presented here is of particular interest since this neoplasm is rare. A 48-year-old female underwent a hysterectomy with bilateral adnexectomy and pelvic lymph node dissection for a cystic tumor of the right parovarian area. The tumor, measuring 13 cm in diameter, was apart from the ovaries, fallopian tubes and uterus. The cyst wall had well-developed smooth muscle layers. The cyst was lined with mildly atypical ciliated and non-ciliated low columnar cells compatible with those of paramesonephric origin. From the inner surface of the cyst several cauliflower-like structures projected into the lumen. They were of a predominantly papillary architecture covered by atypical epithelial cells with piling-up and occasional glandular growth. No destructive stromal invasion was identified.
Cystadenoma, Serous* ; Epithelial Cells ; Fallopian Tubes ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Middle Aged ; Muscle, Smooth ; Ovary ; Parovarian Cyst* ; Uterus

PURPOSE: To analyze contrast-enhancement pattern of stomach cancer on dynamic MRI and to verify the efficacy of intravenous contrast agent in the evaluation of stomach cancer. MATERIALS AND METHODS: Twelve patients with proven stomach cancer underwent dynamic MRI, By using 1.0T scanner, we obtained precontrast FLASH images, and 30, 60, 90 second delay FLASH images after intravenous contrast injection. All patients ingested on liter of water and had intramuscluar injection of Buscopan just before MR study. For quantitative analysis we measured signal to noise ratio (S/N) of stomach cancer on each image, and signal difference to noise ratio (SD/N) between cancer and intraluminal fluid, cancer and the pancreas. For qualitative analysis two radiologists evaluated lesion conspicuity on each image by grading system(grade 0, 1, 2, 3: poor, fair, good, excellent). RESULTS: S/N of stomach cancer increased gradually by time(precontrast, 30, 60, 90 second delay:38.7, 42.5, 57.4, 65.7). SD/N between cancer and intraluminal fluid significantly increased after contrast enhancement(1.24, 25.01, 39.30, 45.89). SD/Ns between cancer and the pancreas were 10.5, 9.33, 9.99, 10.66 respectively. In qualitative analysis, precontrast images were better than postcontrast images for delineation of stomach cancer, Postcontrast images showed clear endo-luminal side of stomach cancer, but outer margin of stomach cancer was more distinct on precontrast images. CONCLUSION: Precontrast MR images are better than postcontrast MR images in the depiction of stomach cancer. Intravenous contrast agent is not imperative in the evaluation of stomach cancer.
Butylscopolammonium Bromide ; Humans ; Magnetic Resonance Imaging* ; Noise ; Pancreas ; Signal-To-Noise Ratio ; Stomach Neoplasms* ; Water

No abstract available.
Neuroectodermal Tumors, Primitive*

Until recently, the gastrointestinal lymphomas were classified according to the criteria developed for the node-based lymphomas. In recent years, the REAL classification provided a new category of MALT lymphoma and Mantle cell lymphoma in B-cell lymphomas. Low-grade MALT lymphomas have been well characterized clinically, histologically, and immunophenotypically. We retrospectively recategorized 41 cases of the primary gastrointestinal B-cell lymphoma and investigated the expression of cyclin D1, bcl-2, bcl-6, p53 protein, and PCNA by immunohistochemical method. The cases were categorized in 5 groups, low grade MALToma, low/high grade MALToma, high grade MALToma, diffuse large cell lymphoma, and mantle cell lymphoma according to the morphological findings. The expression of cyclin D1 protein was restricted to the cases of mantle cell lymphoma. The bcl-2 protein expression was higher in the low grade MALT lymphoma than in the high grade lymphoma (P=0.006). The bcl-2 protein expression was higher in the low grade area than in the high grade area in the low/high grade MALT lymphoma (P=0.005). The bcl-6 and p53 protein expression was higher in the high grade MALT lymphoma than in the low grade lymphoma (P=0.022, P<0.018). However, the bcl-6 protein expression of the tumor cells was higher in high grade area than in low grade area in the low/high grade MALT lymphoma (P=0.004). The degree of the PCNA expression was positively correlated with the grade of the malignant lymphoma (P=0.003). The above results suggest that the cellular proliferation assessed by PCNA index correlates with the histologic grade. And the bcl-2, bcl-6, p53 protein may be effective in the transition from the low grade MALT lymphoma to the high grade lymphoma. Therefore, we can differentiate the low grade lymphoma from the high grade lymphoma by the immunohistochemical staining for cyclin D1, bcl-2, bcl-6, p53 protein and can predict the prognosis of the patients in accordance with the grade of the tumor.
B-Lymphocytes* ; Cell Proliferation ; Classification* ; Cyclin D1* ; Cyclins* ; Gastrointestinal Tract ; Humans ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Mantle-Cell ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Retrospective Studies

Acute pyogenic arthritis in renal transplant patient is one of the serious problem resulting in significant morbidity and mortality. The purpose of this paper is to analyze seven patients in whom acute pyogenic arthritis developed following renal transplantation. Pyogenic arthritis developed in seven (0.7%) out of 958 renal transplant patients whose transplanted kidney functioned well for more than two years. The age of the patients ranged from 37 to 65 years with a mean of 48 years. All patients were male. Pyogenic arthritis developed between the period of one and 12 years (mean: 4.5+/-4.2 years) following transplantation. Causative organisms were Staphylococcus aureus (three), E. coli (two), Salmonella (one) and Acinetobacter bananii (one). Involved joints were four knees, one hip, one elbow and one finger. Two patients improved on a conservative regimen of bed rest and antibiotics and five patients required open drainage. However, pyogenic arthritis recurred in three years, four years and seven years after renal transplant in one patient. Looking at the probable risk factors of age, sex, immunosuppresants, diabetics and acute graft rejection, diabetics and older age (over 40 years old) are highly associated with post renal transplant pyogenic arthritis.
Acinetobacter ; Anti-Bacterial Agents ; Arthritis* ; Bed Rest ; Drainage ; Elbow ; Fingers ; Graft Rejection ; Hip ; Humans ; Joints ; Kidney ; Kidney Transplantation ; Knee ; Male ; Mortality ; Risk Factors ; Salmonella ; Staphylococcus aureus ; Transplantation*

No abstract available.
Spondylolysis*

A pathological fracture occurs spontaneously or with minimal trauma. The underlying pathological changes may be subtle and the diagnosis not obvious. The two goals in the treatment of pathologic fracture in weight bearing long bones are to provide relief of pain by secure fixation of the fracture and to permit early smbulation and a prompt return to prefracture status. Thirteen cases of pathological fracture were treated during the period from June, 1986 to February, 1988 at Kangnam Sacred Heart Hospital. The results are as follows. 1. Most patients were over 45 of age. 2. Malignancy was the common cause. 3. Most frequent involved site was femur. 4. Occured by trivial trauma such as slip down injury. 5. Satisfactory result by curettage, open reduction and internal fixation, bone graft or bone cement augmentation.
Clinical Study ; Curettage ; Diagnosis ; Femur ; Fractures, Spontaneous ; Heart ; Humans ; Transplants ; Weight-Bearing

CT has becom increasingly important diagnostic method as the inital examination in the diagnosis of subarachnoid hemorrhage with direct detection of extravasated blood inbasal cistern and cortical sulci. Furthermore, CT provides better and exact visualization of the presence, localization, extent and degree of intracerebral, intraventricular and subdural hemorrhage, infarction, hydrocephalus and rebleeding which may be associated wtih subarachnoid hemorrhage, and also could detect the causative lesions with contrast enhancement inmany cases. The purpose of the paper is to describe the CT findings of subarachonid hemorrhage due to various causes and to evalute the diagnostic accuracy of CT in subarachonoid hemorrhage. Authors analysed a total of 153 cases with subarachnoid hemorrhage confirmed by lumbar puncture at Seoul National University Hospital from March 1979 to April 1981, with special emphasis on CT findings.All of the cases took CT scan and 125 cases of the mangiography. The results are as follows; 1. Most prevalent age group was 4th to 6th decades (78%). The ratio ofmale to female was 1.1:1. 2. Of all 125 with angiography, aneurysm was a major cause (68%). Others were arterio-venous malformation (9.6%), Moya-moya disease(4%) and unknown (18.4%). 3. Of all 153 cases with CT scan,hemorrhage was demonstrated in 98 cases (64.1%); SAH in 72 cases (47.1%), ICH in 65 cases (42.5%), IVH in 34 cases(22.2%) and SDH in 1 case(0.7%). SAH combined with ICH was a major group (34.7%) in SAH. Detecton rate of SAH was68.3% within the first 7 days and 5.8% after 7 days. 4. In aneurysms, SAH was detected in 60 of 85 cases (70.6%);88.1% within the first 7 days and 5.6% after 7 days. Anterior communicating artery was the most common site of theaneurysms(40%), in which detection rate of SAH was 100% within the first 7 days. SAH was combined with ICH in38.3%. 5. On CT, SAH of unilateral Sylvian fissure was pathognomonic for ruptured MCA aneurysm and ICH of corpuscallosum for ACA aneurysm. 6. The detection rate of aneurysm itself on CT was 20%(17/85) and its size was variablefrom 5 to 25mm. 7. Infarction was demonstrated in 9 cases (6%) and there was no significant correlation between infarction and angiospasm, 8. Hydrocephalus was detected in 65% cases(42.5%), and 21 cases (32.3%) were demonstrated within the first 3 days.
Aneurysm ; Angiography ; Arteries ; Diagnosis ; Female ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hydrocephalus ; Infarction ; Methods ; Seoul ; Spinal Puncture ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed

Renal infarction with ethanol was induced exprimentally in rabbits and selective renal angiography wasperformed to evaluate the effectiveness of ethanol as embolic material. The results were as follows; 1. Completeobstruction of renal artery was produced in all cases within 1 week after injection of absolute ethanol(0.5ml/kg). 2. Incomplete obstruction of renal artery was produced in majority after injection of absolute ethanol(0.2ml/kg) and changed to complete obstruction above half cases with time. 3. Incomplete obstruction of renalartery was produced in minority after injection of 60% ethanol (0.2ml/kg) and complete obstruction of renal arterywas not produced. It was considered that ethanol is an effective agent for complete renal infarction and 0.2 to0,5ml/kg of absolute ethanol is effective dose for complete renal infarction.
Angiography ; Ethanol ; Infarction ; Rabbits ; Renal Artery