No abstract available.
Carcinoma, Hepatocellular* ; Diagnosis*

The clinicopathology of nine cases of eccrine spiradenoma was examined. The ages of the patients ranged from 32 to 65 years, with an average age of 46 years. There were four males and five females. Eight tumors out of the nine presented on the ventral surface of the upper body. The tumors were solitary in seven cases and multiple in two cases(cases 8 and 9). Six tumors were either painful or tender to palpation. Histologically, two cases(cases 1 and 2) were adenomas with well developed tubular structures, while the remaining seven cases were epitheliomas with poor organization and prominent reticular pattern. All tumors were composed of two distinct cell types. Since four cases showed considerable edema with a lot of cystic change, it was difficult in some areas to differentiate these from other adnexal tumors or vascular tumors. Immunohistochemical staining was performed on paraffin-embedded sections of 5 eccrine spiradenomas. CEA and EMA were expressed in the cytoplasm of tumor cells in all cases. Cytokeratin was expressed in 4 out of 5 cases, and S-100 in 3 out of 5 cases. There has been no evidence of recurrence in 8 cases. In one case(case 9) the tumor recurred locally with carcinomatous transformation- characterized by the presence of solid areas of tumor which was composed of large cells with irregularly shaped nuclei and mitotic figures. There were foci of ductal differentiation, extensive areas of tumor necrosis and invasion into surrounding connective tissue. The carcinomatous portion revealed positive reaction for CEA, EMA, S-100 protein and cytokeratin.
Female ; Male ; Humans ; Adenoma

Neurofibromatosis, or von Recklinghausen's disease, is a hereditary, harmartomatous disorder that primarilyinvolves neuroectoderm and mesoderm. The estimated incidence is 1 in 2,500 to 3,000 births. The clinical featuresare skin manifestations such as cafe-au-lait spots, skeletal manifestations primarily in volving vertebrae,central and peripheral nervous manifestations, and other associated abnormalities with increased risk ofmalignancy. The authors analysed the radiologic findings of 18 cases of patients with neurofibromatosis whovisited Pusan Kosin Medical Center and Taegu Dongsan Medical Center during the last five years. All were proven bysurgery, biopsy and other diagnostic criteria. The results obtained were as follows: 1. The male ot female ratiowas 11:7 and the age ranged from 11 months to 51 years. 2. All the cases fulfilled the diagnotic criteria of Croweand associates. 3. Bone manifestations were present in 44% of the cases. The other radiologic findings wereintrathoracic meningocele, bilateral acoustic neurinomas, mediastinal or chest wall mass shadows, and peripheralsoft tissue masses. 4. One of the soft tissue masses was proved to be malignant.
Biopsy ; Busan ; Cafe-au-Lait Spots ; Daegu ; Female ; Humans ; Incidence ; Male ; Meningocele ; Mesoderm ; Neural Plate ; Neurofibromatoses ; Neurofibromatosis 1 ; Neurofibromatosis 2 ; Parturition ; Skin Manifestations ; Thoracic Wall

PURPOSE: The incidence of congenital hypothyroidism (CH) has increased in several countries. Lower cut-off in screening programs have led to an increase in the proportion of transient hypothyroidism (TH) cases diagnosed, leading to debate on the associated clinical and economic impact. This study aimed to identify factors that would allow discrimination between TH and permanent CH (PH) in patients with a eutopic thyroid gland. METHODS: Sixty-six patients with CH from 3 different hospitals were studied: 26 cases of TH, and 40 cases of PH. Laboratory findings and clinical parameters were analysed in 56 patients with eutopic thyroid gland. RESULTS: Initial serum thyroid stimulating hormone levels and L-thyroxine dose at 12 and 24 months of age were significantly higher in PH than TH patients with a eutopic thyroid gland. The area under the curve for the 12-month and 24-month dose for the prediction of TH in eutopic CH was 0.799 (95% confidence interval [CI], 0.678-0.919; P<0.001) and 0.925 (95% CI, 0.837-1.000; P<0.001), respectively. The optimum 12-month and 24-month dose in predicting TH is 3.25 microg/kg (12-month: sensitivity, 87.1%; specificity, 68.0%; 24-month: sensitivity 93.5%, specificity 88%). CONCLUSION: Infants with CH requiring lower L-thyroxine doses (<3.25 microg/kg) are likely to have TH, and thus might be re-evaluated at 12 months or 24 months rather than 3 years of age.
Congenital Hypothyroidism* ; Discrimination (Psychology) ; Humans ; Hydrogen-Ion Concentration ; Hypothyroidism ; Incidence ; Infant ; Mass Screening ; Thyroid Gland ; Thyrotropin ; Thyroxine*

Type II membranoproliferative glomerulonephritis (MPGN) is characterized by thickening of the glomerular basement membrane owing to electron-dense deposits on electron microscopy. We experienced a case of type II MPGN in a child presenting with proteinuria, hematuria on school urinary screening tests. He had been treated with losartan and enalapril. This is the first case report of type II MPGN detected by school urinary screening tests in Korea. Thus we report a case of 10-years-old male with type II MPGN with a review of brief literature.
Child ; Enalapril ; Glomerular Basement Membrane ; Glomerulonephritis, Membranoproliferative ; Hematuria ; Humans ; Korea ; Losartan ; Male ; Mass Screening ; Microscopy, Electron ; Proteinuria

PURPOSE: A graft patency is influenced by various factors; the degree of preoperative ischemia, type of procedure, kinds of the conduit and the stati of inflow and outflow vessels. The aim of this study was to evaluate the patency rate according to the distal anastomosis level, kinds of conduit and the impact of runoff score. METHODS: Between August 1998 and August 2003, 141 lower extremity arterial bypass operations were performed. The runoff scores of the outflow arteries were graded according to the system proposed by the Ad Hoc Committee on Reporting Standards, SVS/ISCVS. The graft patency was determined by clinical examination, and ABI measurements, and with a Duplex scan if required, and assessed by a regular follow-up schedule. RESULTS: The primary patency rates according to the level of distal anastomosis at 1, 3 and 5 years were as follows; femoral artery (FA) 94.8, 87.1 and 87.1%, above-knee popliteal artery (AKPA) 83.7, 79.3 and 68.0%, below-knee popliteal artery (BKPA) 85.9, 64.4 and 42.9%, respectively, and the secondary patency rates; FA 95, 87.6 and 87.6%, AKPA 91.6, 68.3 and 38.6%, BKPA 83.8, 69.9 and 46.6%, respectively. The patency rates of below-knee popliteal bypass showed no statistical difference between each conduit, but showed a tendency to increase in the order: PTFE, vein patch and vein graft. No significant difference in the patency rate was shown except between a runoff score of 1 and above 1 at each level. CONCLUSION: The patency rates for the relatively proximal site of the distal anastomosis were superior to those of the distal site. The choice of conduit influenced the patency of infrapopliteal bypass grafts. The patent outflow vessels and the autogenous vein graft at infrapopliteal artery were more favorable for good graft patency. The recommended runoff score system seems to be revision in order to improve the predictability of a graft patency.
Appointments and Schedules ; Arteries ; Femoral Artery ; Follow-Up Studies ; Ischemia ; Lower Extremity* ; Polytetrafluoroethylene ; Popliteal Artery ; Transplants* ; Veins

Reactive oxygen species (ROS) have been implicated in the pathogenesis of various diseases. And vitamin C has shown a protective effect for the tissues. The aim of this study was to evaluate the effects of H2O2 and ascorbic acid on matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinase (TIMP: TIMP-1, TIMP-2), Type 1 collagen, fibronectin, and PDLs22 level in human periodontal ligament fibroblasts (hPDLF) via reverse transcription-polymerase chain reaction (RT-PCR). hPDLF was obtained from a healthy periodontium and cultured in Dulbecco's modified Eagles's medium plus 10% fetal bone serum. The concentration of ascorbic acid in hPDLF was 50 microgram/ml, and that of H2O2 in hPDLF was 0.03% and 0.00003%. Ascorbic acid only, H2O2 only and mixture of ascorbic acid and H2O2 were applied with hPDLF for 1-, 3-, and 30-min., respectively. The gene expression of MMP-1-, TIMP-1-, TIMP-2-, Type 1 collagen-, fibronectin-, and PDLs22-mRNA in hPDLF was analysed via RT-PCR. The results were as follows; 1. hPDLF in response to 30-min. incubation with 0.03% H2O2 did not show any gene expression. 2. In all the experimental groups, the gene expression of fibronectin mRNA showed the decreased tendency compared to control. 3. In all the experimental groups, the gene expression of TIMP-1 mRNA showed the tendency similar to control. 4. hPDLF in response to 30-min. incubation with 0.03% H2O2 and ascorbic acid increased mRNA induction for MMP-1. 5. In all the experimental groups, hPDLF increased mRNA induction for PDLs22, collagen type I, and TIMP-2 compared to control. Within the limited experiments, H2O2 and ascorbic acid increased mRNA induction for PDLs22, collagen type I, and TIMP-2 in hPDLF. More research will be needed in order to confirm the relative importance of the different roles of ROS and antioxidants in hPDLF from a periodontal regeneration or repair standpoint.
Antioxidants ; Ascorbic Acid* ; Collagen Type I* ; Fibroblasts* ; Fibronectins ; Gene Expression ; Humans* ; Matrix Metalloproteinase 1 ; Periodontal Ligament* ; Periodontium ; Reactive Oxygen Species ; Regeneration ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2*

Trigeminal neurinoma is a rare condition arising from the gasserian or trigeminal nerve root. It comprises 0.2% of all brain tumors, and usually affects middle life, but about 10% of it appears in adolescents. Middle fossa syndrome, symptoms and signs of cerebellopontine angle tumor and mixture of these may be developed through the extension of the tumor. Symptoms and signs of cerebellar and midbrain compression may also be elicited in some stage of the tumor. Erosion of the Anteromedial portion of the petrous apex and defect of the flow of the middle fossa contribute to the diagnosis. Air studies and cerebral antiography have been used, and recently pantopaque basal cisternography has been introduced. The route of operation depends upon the main localization of the tumor, but transtemporal approach with tentorial section is widely used for dumbbell-shaped tumor. A case of cerebellopontine angle tumor which had been postoperatively proved to be a trigeminal neurinoma is reported.
Adolescent ; Brain Neoplasms ; Diagnosis ; Humans ; Iophendylate ; Mesencephalon ; Neurilemmoma* ; Neuroma, Acoustic ; Puberty* ; Trigeminal Nerve

Trigeminal neurinoma is a rare condition arising from the gasserian or trigeminal nerve root. It comprises 0.2% of all brain tumors, and usually affects middle life, but about 10% of it appears in adolescents. Middle fossa syndrome, symptoms and signs of cerebellopontine angle tumor and mixture of these may be developed through the extension of the tumor. Symptoms and signs of cerebellar and midbrain compression may also be elicited in some stage of the tumor. Erosion of the Anteromedial portion of the petrous apex and defect of the flow of the middle fossa contribute to the diagnosis. Air studies and cerebral antiography have been used, and recently pantopaque basal cisternography has been introduced. The route of operation depends upon the main localization of the tumor, but transtemporal approach with tentorial section is widely used for dumbbell-shaped tumor. A case of cerebellopontine angle tumor which had been postoperatively proved to be a trigeminal neurinoma is reported.
Adolescent ; Brain Neoplasms ; Diagnosis ; Humans ; Iophendylate ; Mesencephalon ; Neurilemmoma* ; Neuroma, Acoustic ; Puberty* ; Trigeminal Nerve

BACKGROUND: Laryngoscopy and tracheal intubation are associated with hemodynamic pressor responses, which lead to adverse effect. Opioids have been used to reduce the hemodynamic change. The purpose of this study was to investigate an optimal dosage of remifentanil for attenuating hemodynamic change. METHODS: 120 ASA class 1-2 patients, scheduled for elective surgery, were divided randomly into 4 groups. Anesthesia was induced with vecuronium priming dose (0.01 mg/kg) and TCI of propofol target concentration 8 microgram/ml. This was reduced to 4 microgram/ml when the effect-site concentration had been 3 microgram/ml. After the effect-site concentration had reached 4 microgram/ml, vecuronium (0.09 mg/kg) was given. At the same time, control group received normal saline, group R0.25 received remifentanil 0.25 microgram/kg, group R0.5 received remifentanil 0.5 microgram/kg, group R1 received remifentanil 1 microgram/kg over 60s and an infusion 0.2 microgram/kg/min. Intubation was performed after maximum depression of the single twitch was shown by single twitch stimulation test. Sytolic blood pressure, mean arterial pressure, diastolic blood pressure, heart rate and BIS value were measured preinduction, after propofol induction, immediately before and after intubation and 1, 2, 3, 4 minutes after intubation, respectively. RESULTS: Post-intubation mean arterial pressure decreased significantly from pre-intubation value in group R0.5 and R1 (P < 0.05). In group R0.5 and R1, hypotension and bradycardia occurred but there were no significant differences in their incidence between two groups. CONCLUSIONS: We suggest that remifentanil 0.5 microgram/kg bolus and an infusion of 0.2 microgram/kg/min attenuate the pressor response to tracheal intubation in patients anesthetized with propofol TCI.
Analgesics, Opioid ; Anesthesia ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Depression ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Incidence ; Intubation* ; Laryngoscopy ; Propofol* ; Vecuronium Bromide