PURPOSE: To evaluate whether there are any differences in MR findings between the childhood and the adult moyamoya disease. MATERIALS AND METHODS: We compared the brain MR findings in 22 children (13 boys and 9 girls, 2-18 years of age) who had moyamoya disease with 15 adult patients (7 men and 8 women, 19-55 years of age). The MR findings were classified as parenchymal-(infarctions and intracranial hemorrhages) and vascular abnormalities (intracranial vascular patency and moyamoya vessels). The difference in each of these MR findings was analyzed using Chi-squaretest and Fisher's exact test (two-tailed). Out of 22 children, two children with normal MR finding were excluded from the statistical analysis. Moyamoya diseases were diagnosed angiographically in all adult patients. In children, they were diagnosed by MR imaging, MR angiography(6), and/or conventional cerebral angiography(18). RESULTS: In children, cerebral infarctions were observed in 20 of 22 patients (91%) (cortex 86%, periventricular white matter/centrum semiovale 32%, basal ganglia 10%). In two patients, there was no parenchymal abnormality. Intra-cranial hemorrhages were not demonstrated in any patients. In adults, intra-cranial hemorrhages(intracerebral hematoma, intraventricular hemorrhage, alone or combined) were demonstrated in 10 of 15 patients(67%). Cerebral infarctions with or without intracranial hemorrhage were detected in 10 of 15 patients(67%)(cortex 40%, periventricular white matter/centrum semiovale 53%, basal ganglia 20%). The difference in parenchymal abnormalities between the childhood and the adult moyamoya disease was statistically significant (p=0. 000164). There was no significant difference between the two groups with regard to the occlusive changes of the internal carotid and middle cerebral arteries or to moyamoya vessels(p> 0.01 ). CONCLUSION: This study could prove the fact that the principal clinical symptoms in the childhood moyamoya disease were due to cerebral infarction and those in the adult cases were due to infarction and intracranial hemorrhage. In addition, cortical infarction was more prevalent in children and infarction in periventricular white matter/centrum semivoale and basal ganglia was more frequentin adults. There was no significant difference in vascular abnormalities between the two groups.
Adult* ; Basal Ganglia ; Brain ; Cerebral Infarction ; Child* ; Female ; Hematoma ; Hemorrhage ; Humans ; Infarction ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Male ; Middle Cerebral Artery ; Moyamoya Disease* ; Vascular Patency

PURPOSE: The purpose of this study was to analyze the results of treatment and prognosis of Marjolin's ulcer compared with primary squamous cell carcinoma. MATERIALS AND METHODS: Fourteen patients treated for Marjolin's ulcer were analyzed. Twenty patients with primary squamous cell carcinoma treated during the same time period was the control group. Mean age was 61.2 years. There were 24 males and 10 females. The locations, TNM stages, histological grades, recurrence, metastasis, and survival rate were analyzed and compared between two groups. RESULTS: The mean follow-up period was 54.8 months (range, 12-168 months). Local recurrences were found in 6 cases, 5 ones in Marjolin's ulcer patients, and one case in primary squamous cell carcinoma patients. The mean time interval between the initial presentation and occurrence of local recurrences was 9 months (range, 2-20 months). There were 6 metastases. 2 (14.3%) metastases were found in Marjolin's ulcer patients, and 4 (20.0%) metastases in primary squamous cell carcinoma patients. Total events (metastasis or local recurrence) were found in 10 pateients, 6 of them in Marjolin's ulcer group, and the remaining four in primary group. 5-year disease-free survival rate was 64.3% in Marjolin's ulcer group and 95.0% in primary squamous cell carcinoma group. CONCLUSION: Squamous cell carcinomas originating as Marjolin's ulcers revealed higher recurrence rate and lower survival rate despite of aggressive treatment. Therefore, new treatment modalities should be developed for improving outcomes.
Carcinoma, Squamous Cell ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Male ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Survival Rate ; Ulcer

Kaposi's sarcoma is a rare tumor comprising 0.1 per cent of all malignancies worldwide. There is, however, an increased ineidence following renal transplantation, immunosupression and in the acquried immunodeficency syndrome(AIDS) Kaposi's sarcoma has been shown to involve every organ of the body except the brain. Gastrointesinal involvement is the most common extracutaneous site of involvement. Gaatrointesinal Kaposis sarcoma is preaent in approximately half of patients with cutaneous Kaposis sarcoma and the acquired immune deficiency syndrome(AIDS). Although usually asymptomatic, gastrointestinal Kaposi's sarcoma may cause pain, bleeding, diarrhea, obstruction, intussusception, perforation. malabsorption, and protein-losing enteropathy. Three distinct gastroscopic appearances of Kaposi's sarcoma have been described: maculopapular, polypoid, and umbilicated nodular lesions. We report a case of Kaposis sarcoma of the stomach.
Brain ; Diarrhea ; Hemorrhage ; Humans ; Intussusception ; Kidney Transplantation ; Protein-Losing Enteropathies ; Sarcoma, Kaposi* ; Stomach*

The potential of malignant melanoma to metastasize to all parts of the body is well known. Metastatic melanoma of the stomach may present with vague gastrointestinal symptoms, abdominai pain, or gastrointestinal bleeding. When gastrointestinal symptoms occur in a patient with known melanoma, gastric metastases should be considered. Melanoma metastatic to the stomach develops multiple small ulcerating masses. These sharply delineated submucosal lesions have been described as having a "bull's eye" or "target" configuration. Barium X-ray study, endoscopy, cytology study, and biopsy may yield the diagnosis. The prognosis is poor. We report a case of metastatic melanoma of the stomach with the review of the literature.
Barium ; Biopsy ; Diagnosis ; Endoscopy ; Hemorrhage ; Humans ; Melanoma* ; Neoplasm Metastasis ; Prognosis ; Stomach* ; Ulcer

No abstract available.

A clinical study was made on the 28 cases underwent prostatectomy during the 5 year-period from 1964 to 1968. The results are summarized as follows: 1. The patient underwent prostatectomy revealed increasing tendency in incidence, residual urine in average and being usually in the age range between 60 and 70 years. 2. The degree of prostatic enlargement was mostly grade 11 on rectal palpation and the removed prostate was 49. 3gm. in average weight. 3. Blood loss attributable to the operative manipulation was 1143 cc. in average. The patients underwent prostatectomy were discharged on the average 21.3 days postoperatively in which postoperative indwelling catheter was left in place for 15.3 days in average. 4. Postoperatively the convalescence was uneventful and the residual urine was disappeared or decreased markedly. 5. In the patients underwent prostatectomy via retropubic approach operative blood loss was mild and postoperative duration of indwelling catheterization was short as compared to that via the suprapubic approach. 6. No serious complication other than epididymitis developed in a few patients was observed postoperatively. 7. Suprapubic prostatectomy was found to be suitable for the patient with marked prostatic enlargement while the retropubic one yielded less tissue damage and somewhat rapid postoperative convalescence as compared to the former.
Catheters, Indwelling ; Convalescence ; Digital Rectal Examination ; Epididymitis ; Humans ; Incidence ; Male ; Prostate ; Prostatectomy*

BACKGROUND: T cell mediated immune destruction is an important mechanism of liver injury in patients with chronic hepatitis C. Serum levels of soluble interleukin-2 receptor(sIL-2R) seem to serve as a marker for the T cell activation and progressive liver injury, This study examined serum levels of sIft-2R and hepatitis C virus (HCV) RNA in patients with chronic HCV infection to determine the correlation with the severity of chronic hepatocellular damage. METHODS: Serum levels of sIft-2R in 73 patients with HCV infection (chronic hepatitis 52, liver cirrhosis 9, hepatocellular carcinoma 12) and 40 healthy controls were measured by sandwich enzyme immunoassay (CELLFREE, T Cell Sciences, USA). HCV RNA was quantified by QUANTIPLEX(TM) HCV RNA 2.0 assay (Chiron, USA) with duplication. This assay is a sandwich nucleic acid hybridization procedure using branched DNA amplification for the quantitation of HCV RNA. RESULTS: The sIL-2R levels of 52 patients with chronic hepatitis (591.4+/-238.7U/mL), 9 with liver cirrhosis(949.4+/-721.9 U/mL), and 12 with hepatocellular carcinoma (1,167.4+/- 554.4 U/mL) were significantly higher than those of healthy controls(370.8+/-71.8 U/mL) (p<0.001). A progressive and significant increase occurred in sIL-2R levels with chronic hepatitis C, liver cirrhosis and hepatocellular carcinoma (HCC) in order (p(0.001). The HCV RNA was detected in all patients and the means of HCV viral load were 3.3 MEq/mL in chronic hepatitis, 2.8 MEq/mL in cirrhosis, and 3.7 MEq/mL in HCC. There was no significant correlation between HCV RNA and the severity of liver injury in chronic HCV infection. There were no correlations among sIL-2R, HCV RNA and serum ALT. CONCLUSIONS: These results suggest that chronic hepatocellular injury by HCV progress mainly by T cell mediated immune response, not by direct cytopathic injury. Also, sIL-2R can be useful as a marker in monitoring the patients with HCV infection at high risk of getting HCC.
Carcinoma, Hepatocellular ; DNA ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis C, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoenzyme Techniques ; Interleukin-2* ; Liver ; Liver Cirrhosis ; Nucleic Acid Hybridization ; RNA ; Viral Load

BACKGROUND: T cell mediated immune destruction is an important mechanism of liver injury in patients with chronic hepatitis C. Serum levels of soluble interleukin-2 receptor(sIL-2R) seem to serve as a marker for the T cell activation and progressive liver injury, This study examined serum levels of sIft-2R and hepatitis C virus (HCV) RNA in patients with chronic HCV infection to determine the correlation with the severity of chronic hepatocellular damage. METHODS: Serum levels of sIft-2R in 73 patients with HCV infection (chronic hepatitis 52, liver cirrhosis 9, hepatocellular carcinoma 12) and 40 healthy controls were measured by sandwich enzyme immunoassay (CELLFREE, T Cell Sciences, USA). HCV RNA was quantified by QUANTIPLEX(TM) HCV RNA 2.0 assay (Chiron, USA) with duplication. This assay is a sandwich nucleic acid hybridization procedure using branched DNA amplification for the quantitation of HCV RNA. RESULTS: The sIL-2R levels of 52 patients with chronic hepatitis (591.4+/-238.7U/mL), 9 with liver cirrhosis(949.4+/-721.9 U/mL), and 12 with hepatocellular carcinoma (1,167.4+/- 554.4 U/mL) were significantly higher than those of healthy controls(370.8+/-71.8 U/mL) (p<0.001). A progressive and significant increase occurred in sIL-2R levels with chronic hepatitis C, liver cirrhosis and hepatocellular carcinoma (HCC) in order (p(0.001). The HCV RNA was detected in all patients and the means of HCV viral load were 3.3 MEq/mL in chronic hepatitis, 2.8 MEq/mL in cirrhosis, and 3.7 MEq/mL in HCC. There was no significant correlation between HCV RNA and the severity of liver injury in chronic HCV infection. There were no correlations among sIL-2R, HCV RNA and serum ALT. CONCLUSIONS: These results suggest that chronic hepatocellular injury by HCV progress mainly by T cell mediated immune response, not by direct cytopathic injury. Also, sIL-2R can be useful as a marker in monitoring the patients with HCV infection at high risk of getting HCC.
Carcinoma, Hepatocellular ; DNA ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis C, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoenzyme Techniques ; Interleukin-2* ; Liver ; Liver Cirrhosis ; Nucleic Acid Hybridization ; RNA ; Viral Load

BACKGROUND: Several studies have demonstrated that quantitation of hepatitis B virus (HBV) DNA in sera of HBsAg-positive patients is more useful test for the assessment of infectivity and for the evaluation of disease status than previously utilized numerous serological markers and qualitative polymerase chain reaction for the detection of HBV DNA. We tried to measure serum HBV DNA using a branched DNA (bDNA) signal amplification assay, which is recently introduced and known to be a simple and nonradioisotopic method. METHODS: Total forty patients with HBsAg were randomly selected and serum HBV DNA was measured with duplication using bDNA signal amplification assay (QUANTIPLEXTM HBV DNA ASSAY, Chiron, USA). Quantitation was determined from a standard curve and expressed as HBV DNA equivalents/mL (Eq/mL; 1 Eq = 1 molecule of the primary HBV DNA standard). Serum HBeAg, aspartate aminotransferase (AST), alanine aminotransferase (ALT) , and soluble interleukin-2 receptor (sIL-2R) were compared with HBV DNA. RESULTS: Serum HBV DNA was quantitated in 13 patients (32.5%) (range 6.4x106-7.4x109 Eq/mL, mean 1.8x109 Eq/mL, CV 8.1%). All eleven patients (100%) with both HBsAg and HBeAg an4 2 of 29 patients (6.9%) with HBsAg but not with HBeAg showed measurable HBV DNA (p < 0.001). In addition, serum levels of AST, ALT, and sIL-2R were significantly higher in HBV DNA measured patients compared with those of unmeasured patients. CONCLUSIONS: Above results show that more than half the HBsAg-positive patients do not have enough HBV DNA which is measurable with boNA signal amplification assay but all of HBeAg-positive patients and some of HBeAg-negative patients do. In addition, HBV DNA quantitation might be correlated with the disease activity in HBsAg-positive patients because serum levels of AST, ALT, and sIL-2R are higher in patients measured with HBV DNA than unmeasured.
Alanine Transaminase ; Aspartate Aminotransferases ; Branched DNA Signal Amplification Assay* ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Interleukin-2 ; Polymerase Chain Reaction

PURPOSE:Insulin induced hypoglycemia and L-dopa are potent for growth hormone(GH) secretion in children. We evaluated the effects of GH secretion with insulin and L-dopa in 22 children with height percentile below 3 and 11 children with height percentile between 10 to 25. METHODS:Thirty four children were performed GH secretion study after classified by height percentile and bone age according to their age and sex. Twenty two children are height percentile below 3 and bone age is delayed more than one years compare to chronologic age(group A). As a control group, twelve children took part in this study and their height percentile were between 10 to 25 but, bone age was not concerned(group B). Serum GH concentration and blood glucose level was detected on 0, 30, 60, and 90 minutes after insulin 0.1U/kg was injected intravenously. And then serum GH concentration was measured on 0, 30, 60, and 90 minutes after L-dopa 10mg/kg was administered orally. Serum GH was measured by radioimmunoassay. RESULTS:GH level in group A was below 7ng/mL in 13 children(59%) after insulin and L-dopa administration respectively but in 11 children(50%) GH level were all below 7ng/mL after insulin and L-dopa adminstration. GH deficiency(7ng/mL) was detected only one children in group B. In Group A and B, peak GH concentration was noted on 30 minutes after insulin administration, but on 60 minutes after L-dopa, peak GH concentration appeared in group B. GH concentration in zero time to 90 minutes after L-dopa was steady increased in group A. CONCLUSION: Anthropometric data such as height percentile and bone age are good for prediction of GH deficiency and if we use these data and GH secretory effects of insulin induced hypoglycemia and L-dopa, we can predict GH deficiency more accurately.
Blood Glucose ; Child* ; Growth Hormone* ; Humans ; Hypoglycemia* ; Insulin* ; Levodopa* ; Radioimmunoassay