A clinical analysis was carried out with 108 cases of head injuries under 15 years of age, admitted at the Department of Neurosurgery, In Ha University Hospital in 11/2 years between Jan., 1987 and June., 1988. The material was classified into three groups according to main lesions, i.e. 1) simple cerebral contusion without skull fractures. 2) various types of skull fractures. 3) intracranial hemorrhagic lesions, representing such lesions as follows:a) epidural hematoma b) subdural hematoma. c) intracerebral hematoma, intraventricular and subarachnoid hemorrhage. The results were as follows: 1) The age incidence was greatest in 7 years of age, and 51 cases(47.2% of total) were included in the age group between seven and ten. 2) The accident occurred mostly between March and May. 3) Males outnumbered females by almost 2:1. 4) The head injuries were caused by traffic accident(52 cases:48%), fall down(47 cases:43%), hit(9 cases:9%). 5) In clinical picture, vomiting(57 cases:53.7%) and convulsion(8 cases:7.4%) and neck sprain(55 cases:50.9%) were developed and at accident, forty seven cases(43.5%) had the history of loss of consciousness. 6) Of the patients between GCS 5 and 14, 57 cases(92%) were included in the simple cerebral contusion. Of the patients below GCS 13, 45 cases(98%) were included in the skull fracture or intracranial hemorrhagic lesions but eighteen cases of the patients below GCS 13 were taken operation. 7) In skull fracture patients, the location in the order of frequency was parietal, occipital, temporal and frontal bone. The vault skull fracture was about twelfth fold as frequent as basal skull fracture and the incidence of linear skull fracture was higher than that of depressed skull fracture, the ratio being about 7:1. 8) Among the intracranial hemorrhagic lesions, the epidural hematoma was most common lesion. Twenty one cases(81%) of the patients with intracranial hemorrhagic lesions were accompanied by skull fracture but of the patients with skull fracture, 21 cases(47%) were accompanied by intracranial hemorrhagic lesions. Seventeen cases(46%) with the linear skull fracture involved in the intracranial hemorrhagic lesions. 9) Contre coup injury was developed in 6 cases(12%) and Lucid interval was observed in 4 cases(5%) of the cases with intracranial hemorrhagic lesions. 10) Associated injuries were found in about 27% of the total patients. The frequent ones were clavicle fracture, femur fracture, tibia/fibular fracture, pelvic fracture and so on order. 11) Sequelae were noticed in about 20% of the total patients. The most frequent one was post traumatic syndrome. 12) The period of hospitalization was about 2 weeks on an average in non-surgical cases(83%) and 4-6 weeks on an average in surgical cases(70%).
Child* ; Clavicle ; Contrecoup Injury ; Contusions ; Craniocerebral Trauma* ; Female ; Femur ; Frontal Bone ; Head* ; Hematoma ; Hematoma, Subdural ; Hospitalization ; Humans ; Incidence ; Infant* ; Male ; Neck ; Neurosurgery ; Rabeprazole ; Skull Fracture, Depressed ; Skull Fractures ; Subarachnoid Hemorrhage ; Unconsciousness

The cystic teratoma is the most common germ cell tumors in reproductive age women. The malignant change of cystic teratoma is rare, about 1~2%, and mostly change to squ-amous cell carcinoma. We experienced 4 cases of squamous cell carcinoma arising in cystic teratoma and re- port our cases with a brief review of the literature.
Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasms, Germ Cell and Embryonal ; Ovary* ; Teratoma*

Although intrathoracic liver in association with a congenital diaphragmatic hernia has been well documented, the finding of intrathoracic ectopic liver tissue in the presence of an intact diaphragm is an extremely rare congenital anomaly. We have experienced a case of intrathoracic ectopic liver without any diaphragmatic hernia. A 37-year-old woman was admitted for the treatment of an incidentally detected right lung mass. A chest computed tomography scan revealed a right lower lobe lung mass close to the diaphragm, and this was suspicious for bronchial carcinoid tumor. Upon surgery, 2 round solid masses 3.5x3.5 cm and a 2.0x2.0 cm in size were noted, with their bottoms attached to the diaphragm dome. The masses were completely resected. Histologically, they were confirmed to be intrathoracic ectopic livers. The patient had an uncomplicated postoperative course.
Adult ; Carcinoid Tumor ; Choristoma ; Diaphragm ; Female ; Hernia, Diaphragmatic ; Humans ; Liver ; Lung ; Thorax

Although intrathoracic liver in association with a congenital diaphragmatic hernia has been well documented, the finding of intrathoracic ectopic liver tissue in the presence of an intact diaphragm is an extremely rare congenital anomaly. We have experienced a case of intrathoracic ectopic liver without any diaphragmatic hernia. A 37-year-old woman was admitted for the treatment of an incidentally detected right lung mass. A chest computed tomography scan revealed a right lower lobe lung mass close to the diaphragm, and this was suspicious for bronchial carcinoid tumor. Upon surgery, 2 round solid masses 3.5x3.5 cm and a 2.0x2.0 cm in size were noted, with their bottoms attached to the diaphragm dome. The masses were completely resected. Histologically, they were confirmed to be intrathoracic ectopic livers. The patient had an uncomplicated postoperative course.
Adult ; Carcinoid Tumor ; Choristoma ; Diaphragm ; Female ; Hernia, Diaphragmatic ; Humans ; Liver ; Lung ; Thorax

Multiple primary malignant neoplasm means that more than 2 cancers are independently developed in one individual. In general, the neoplasms are diagnosed simultaneously or within 6 month interval. Simultaneous presentation of carcinomas involving ovary and uterus is not a common event and presents a diagnostic dilemma when they are of the same histology. We experienced a rare case of multiple primary malignant neoplasm involving the uterine endometrium and the ovary synchronously. Thus we report this case with a review of literatures.
Endometrium* ; Female ; Ovary* ; Uterus

No abstract available.
Bleomycin* ; Lymphangioma, Cystic*

Plasma cell myelomas generally manifest as bone or soft-tissue tumors with variable mass effects, pain, and infiltrative behavior. Extramedullary involvement occurs most commonly in the spleen, liver, lymph nodes, and kidneys, but intracranial involvement in plasma cell myeloma is a rare extramedullary manifestation. These authors recently encountered a case of intracranial involvement of plasma cell myeloma. A 69-year-old man was hospitalized for headache and mental changes. Brain CT showed subdural hemorrhage caused by plasma cell myeloma. Plasma cell myeloma with intracranial involvement has poor prognosis, and the patient in this case died from acute complications, such as subdural hemorrhage. Based on this case report, it is suggested that more effective treatment regimens of plasma cell myeloma with intracranial involvement be developed. Moreover, a screening method and decision on the appropriate time for intracranial involvement are needed for plasma cell myeloma patients.
Aged ; Brain ; Brain Neoplasms ; Headache ; Hematoma, Subdural ; Humans ; Kidney ; Liver ; Lymph Nodes ; Mass Screening ; Multiple Myeloma ; Plasma ; Plasma Cells ; Prognosis ; Spleen

BACKGROUND/AIMS: Limited data exist on the outcome of gastroesophageal reflux disease (GERD) treatment and its impact on the health-related quality of life (HRQoL) in the Asian population. This study aims to evaluate the treatment outcomes, to investigate the factors associated with recurrence, and to evaluate the impact of the treatment outcome on the HRQoL in a Korean GERD population. METHODS: This was a prospective, multicenter study involving a total of 824 GERD patients. The response to treatment was assessed at week 4 (or week 8 for the patients who did not achieve complete resolution [CR] at week 4). The EQ-5D questionnaire was used at baseline, end of treatment, and first recurrence to assess the HRQoL. To assess GERD symptoms, contact of patients by phone at 1, 6, and 12 months following treatment was carried out. RESULTS: CR was achieved in 65.6% and recurrence was observed in 47.8% following treatment. CR and recurrence rates did not differ by the presence of esophagitis. Multivariate analysis revealed that acid regurgitation (odds ratio 2.249; 95% confidence interval 1.293-3.912; P = 0.004) and both acid regurgitation and heartburn (odds ratio 2.330; 95% confidence interval 1.392-3.901; P = 0.001) were independent risk factors for GERD recurrence. EQ-5D scores were more improved in patients with CR than in those without CR, and worsened more during follow-up in patients with recurrence than in those without recurrence. CONCLUSIONS: We should achieve complete symptom relief and attempt to prevent recurrence in GERD patients to improve their HRQoL.
Asian Continental Ancestry Group ; Esophagitis ; Follow-Up Studies* ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Multivariate Analysis ; Prospective Studies* ; Quality of Life* ; Recurrence* ; Risk Factors ; Treatment Outcome

PURPOSE: Micro-computed tomography (micro-CT) has been widely used in the evaluation of regenerated bone tissue but the reliability of micro-CT has not yet been established. This study evaluated the correlation between histomorphometric analysis and micro-CT analysis in performing new bone formation measurement. METHODS: Critical-size calvarial defects were created using a 8 mm trephine bur in a total of 24 Sprague-Dawley rats, and collagen gel mixed with autogenous rat bone marrow stromal cells (BMSCs) or autogenous rat BMSCs transduced by adenovirus containing bone morphogenic protein-2 (BMP-2) genes was loaded into the defect site. In the control group, collagen gel alone was loaded into the defect. After 2 and 4 weeks, the animals were euthanized and calvaria containing defects were harvested. Micro-CT analysis and histomorphometric analysis of each sample were accomplished and the statistical evaluation about the correlation between both analyses was performed. RESULTS: New bone formation of the BMP-2 group was greater than that of the other groups at 2 and 4 weeks in both histomorphometric analysis and micro-CT analysis (P=0.026, P=0.034). Histomorphometric analysis of representative sections showed similar results to histomorphometric analysis with a mean value of 3 sections. Measurement of new bone formation was highly correlated between histomorphometric analysis and micro-CT analysis, especially at the low lower threshold level at 2 weeks (adjusted r2=0.907, P<0.001). New bone formation of the BMP-2 group analyzed by micro-CT tended to decline sharply with an increasing lower threshold level, and it was statistically significant (P<0.001). CONCLUSIONS: Both histomorphometric analysis and micro-CT analysis were valid methods for measurement of the new bone in rat calvarial defects and the ability to detect the new bone in micro-CT analysis was highly influenced by the threshold level in the BMP-2 group at early stage.
Adenoviridae ; Animals ; Bone and Bones ; Bone Regeneration ; Collagen ; Genetic Therapy ; Mesenchymal Stromal Cells ; Osteogenesis ; Rats ; Rats, Sprague-Dawley ; Skull ; X-Ray Microtomography

BACKGROUND/AIMS: The red-blood-cell distribution width (RDW) is a newly recognized risk marker in patients with cardiovascular disease, but its role in nonalcoholic fatty liver disease (NAFLD) has not been well defined. The aim of the present study was to determine the association between RDW values and the level of fibrosis in NAFLD according to BARD and FIB-4 scores. METHODS: This study included 24,547 subjects who had been diagnosed with NAFLD based on abdominal ultrasonography and questionnaires about alcohol consumption. The degree of liver fibrosis was determined according to BARD and FIB-4 scores. The association between RDW values and the degree of fibrosis in NAFLD was analyzed retrospectively. RESULTS: After adjusting for age, hemoglobin level, mean corpuscular volume, history of hypertension, history of diabetes, and high-sensitivity C-reactive protein, the RDW values were 12.61+/-0.41% (mean+/-SD), 12.70+/-0.70%, 12.77+/-0.62%, 12.87+/-0.82%, and 13.25+/-0.90% for those with BARD scores of 0, 1, 2, 3, and 4, respectively, and 12.71+/-0.72%, 12.79+/-0.66%, and 13.23+/-1.52% for those with FIB-4 scores of <1.30, 1.31-2.66, and > or =2.67, respectively (P<0.05). The prevalence of advanced fibrosis (BARD score of 24 and FIB-4 score of > or =1.3) increased with the RDW [BARD score: 51.1% in quartile 1 (Q1) vs. 63.6% in Q4; FIB-4 score: 6.9% in Q1 vs. 10.5% in Q4; P<0.001]. After adjustments, the odds ratio of having advanced fibrosis for those in Q4 compared to Q1 were 1.76 (95%CI=1.55-2.00, P<0.001) relative to BARD score and 1.69 (95%CI=1.52-1.98, P<0.001) relative to FIB-4 score. CONCLUSIONS: Elevated RDW is independently associated with advanced fibrosis in NAFLD.
Adult ; Alcohol Drinking ; C-Reactive Protein/analysis ; Diabetes Mellitus/pathology ; Erythrocyte Indices ; Fatty Liver/complications/*diagnosis/ultrasonography ; Female ; Humans ; Hypertension/pathology ; Liver Cirrhosis/*diagnosis/epidemiology/etiology ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; Questionnaires ; Severity of Illness Index