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

We herein present a case of simultaneous occurrence of apocrine adenocarcinoma, syringocystadenoma papilliferum, syringoma, and eccrine hydrocystoma arising in an organoid nevus (nevus sebaceus of Jadassohn) which had been present on the right occipitoparietal scalp of a 60-year-old man since birth.
Adenocarcinoma* ; Humans ; Middle Aged ; Nevus* ; Organoids* ; Parturition ; Scalp ; Skin* ; Syringoma

No abstract available.
Animals ; Imipramine* ; Lymphocytes* ; Plasma* ; Rats*

No abstract available.
Memory*

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

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

BACKGROUND: Whether the changes of risk factors (hypertension, diabetes mellitus, smoking, alcohol) can precipitate stroke remains unknown, and antecedent infection and psychologic stress are described insufficiently as predisposing risk factors for cerebral infarction. Therefore, we attempted to examine the roles of recent infection, psychologic stress, and the changes of risk factors as potential precipitants in each stroke subtypes. We also tested the temporal relationship between preceding exposure to coldness and stroke onset. METHODS: In this case-control study, 113 consecutive patients with acute cerebrovascular disease (38 small vessel disease, 43 large vessel disease, 11 cardiogenic infarction, 4 infarction of undetermined cause, and 17 intracerebral hemorrhage) and 23 control subjects were evaluated. Changes of the risk factors (and their management) were interviewed. A sign/symptom based questionnaire was used to characterize the prevalence of recent prior infection and exposure to coldness. Psychologic stress was measured with the use of Social Readjustment Rating Scale. RESULTS: The negative change of alcohol drinking was significantly higher in the stroke group. However, there was no significant difference between stroke and control groups in the changes of the other risk factors. The prevalence of previous (within 1 month) infection was significantly higher in the stroke group compared with control subjects (p=0.03). However, there were no significant differences among the stroke subtypes in the prevalence of infection(p=0.08). Upper respiratory tract infections constituted the most common type of infection. The exposure to coldness was significantly higher in the stroke group compared with control subjects (p=0.002). The level of stress within the prior 1 month/1 year was significantly higher in the stroke group than control group (p=0.01). CONCLUSION: Our data suggest that preceding infection, exposure to coldness, psychologic stress, and the negative change of alcohol drinking may be com.
Alcohol Drinking ; Case-Control Studies ; Cerebral Infarction ; Diabetes Mellitus ; Humans ; Infarction ; Prevalence ; Surveys and Questionnaires ; Respiratory Tract Infections ; Risk Factors* ; Smoke ; Smoking ; Stress, Psychological* ; Stroke*