Lipoma involving brain and spinal cord is a rare tumor that most commonly located in the midsagittal region. This lesion is usually asymptomatic and has been reported incidentally at postmortem examination. Recently, the CT scan establishes the diagnosis of intracranial lipoma on the basis of typical X-ray absorption and location. The authors experienced a case of intracranial lipoma of occipital lobes. The patient was 7 months-old male who had protruding mass on the occipital region after birth. The mass revealed an uncapsulated lipoma with foca cartilage formation. We report this case with brief review of literatures.
Male ; Humans

We present the cytologic features of a case of solid and papillary neoplasm of the pancreas. Cytologically, the tumor was composed of a monotonous population of polygonal cells containing eccentrically located round nuclei with one or two distinct small nucleoli and a finely stippled chromatin pattern. The tumor cells were similar to those of the islet cell tumor and showed isolated loosely aggregated and solid sheets or large cell clumps. The large cell clumps revealed a branching papillary structure containing fibrovascular central core, which is characteristic histologic feature of solid and papillary neoplasm of the pancreas. This case was confirmed by tissue examination including histochemical, immunohistochemical and electron microscopical studies. Ultrastructurally, the tumor cells contained a few membrane-bound electron dense granules.
Adenoma, Islet Cell ; Chromatin ; Pancreas ; Urinary Tract*

The technique of radial artery cannulation and its complications are well documented, but serious complications are rare. This is a report of one case of amputation of wrist due to finger necrosis developed from the radial artery cannulation in patient who had craniectomy surgery. This 52-year-old 79 kg male underwent subdural hematoma removal surgery. Right radial artery cannulation was carried out percutaneously using 22 gauge Teflon extracath needle after modified Allen's test appeared to be positive. It was intermittently flushed by heparinized solution. His arterial blood pressure was maintained 100/70-110/80 mmHg and 5 units of banked whole blood and 1 unit of fresh frozen plasma were transfused during 8-hours operation. Cannula was removed on the 9th hour after operation because that was obstructed. On the 12th hour after removal of cannula, his right hand noted to be cool and cyanotic. So, warm towel and hot bag applied continuously on the right hand and the right stellate ganglion block was carried out every day for 4 times. However, on the 10th day after removal of cannula, necrotic change of all fingers of the right hand became worse and skin of fingers were shrunken. Therefore, disarticulation of the right wrist carried out on the 71th day of his hospitalization.
Amputation* ; Arterial Pressure ; Catheterization* ; Catheters ; Disarticulation ; Extremities* ; Fingers ; Hand ; Hematoma, Subdural ; Heparin ; Hospitalization ; Humans ; Male ; Middle Aged ; Necrosis ; Needles ; Plasma ; Polytetrafluoroethylene ; Radial Artery* ; Skin ; Stellate Ganglion ; Wrist

Before beginning the extracorporeal circulation, perfusionists should supply oxygen into the oxygenator and establish blood flow through the blood line of the heart-lung machine. But these manipulation can induce severe hypocarbic state of priming solutions due to wash out of CO2 gas in the solution. This study was carried out to examine the relationship of blood gas changes between hypocarbic priming solutions and body circulation in 15 patients undergoing open heart surgery with extracorporeal circulation. PaCO₂, pH, buffer base and PaO2 were measured from priming solutions before and 15 minutes after the extracorporeal circulation. The results were as follows; 1) Before the extracorporeal circulation, mean PaCO₂ level was 12.1±7.8 mmHg in the priming solution. However, 15 minutes after extracorporeal circulation, the PaCO₂ level was maintained at 35.7±5.7 mmHg. 2) pH in the priming solution was variable from 6.93 to 7.99 (mean 7.45±0.29), but after 15 minutes it was ranged from 7.28 to 7.42 (mean 7.35±0.05). 3) Mean buffer base level in the priming solution was 7.9±3.5 mmol/l. but after 15 minutes, it was 19.6±1.2 mmol/l. 4) Mean PaO₂ level in the priming solution was 667.1±45.6 mmHg, but after 15 minutes, it was 280.7±131.7 mmHg.
Extracorporeal Circulation* ; Heart* ; Heart-Lung Machine ; Humans ; Hydrogen-Ion Concentration ; Oxygen ; Oxygenators ; Thoracic Surgery*

Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
Male ; Humans

BACKGROUND: In pregnancy, paternal human leukocyte antigen (HLA) that the fetus possesses can induce the development of cytotoxic HLA antibodies in the pregnant women. We investigated the frequency and the characteristics of HLA antibodies during the pregnancy in Koreans. METHODS: Sera from 192 pregnant women (46 in the 1st trimester, 120 in the 2nd and 26 in the 3rd trimester) were tested for the presence of HLA antibody. Home made lymphocyte panel from 36 volunteers whose HLA-A, B and C antigens had been already identified 3nd formerly frozen in a liquid nitrogen tank were dispensed in duplicate into 72-well microplates and used as testing trays Test sera of one pregnant women with one negative control serum were dispensed in each plate and the plates were tested by microlymphocytotoxic method using anti-human immunoglobulin. The results were observed under fluorescence microscope and PRA (panel reactive antibody) values were determined by the percentage of wells showing positive reactions. HLA antibody specificities were identified by analysis of reaction characteristics. RESULTS: Among the 192 sera, 22 (11.5%) showed positive PRA value (PRA > 0%) in HLA antibody screening tests, in which 20 were less than 50% and 2 were more than 50% of PRA value. Two of the 46 subjects (4.3%) in the 1st trimester, 15 of the 120 (12.5%) in the 2nd and 5 of the 26 (19 2%) in the 3rd trimester were positive for HLA antibody. Among the 22 positive sera , specificities of HLA antibodies were identified in 14 (64%) sera: 8 sera had HLA antibody against single private HLA antigen. 5 had HLA antibodies against two or more antigens. and 1 sera showed anti-Bw4 antibody. CONCLUSION: In 192 pregnant women, 22 (11.5%) had HLA-A, B antibodies and they showed higher frequencies with the progress of pregnancy. Most of the pregnant women who were positive for HLA antibodies showed PRA value less than 50%. HLA antibody specificities were identified in 14 out of 22 positive sera (64%).
Antibodies* ; Antibody Specificity ; Female ; Fetus ; Fluorescence ; HLA-A Antigens* ; Humans ; Immunoglobulins ; Leukocytes ; Lymphocytes ; Mass Screening ; Nitrogen ; Pregnancy ; Pregnant Women* ; Volunteers

BACKGROUND: CD34 positive cell enumeration by flow cytometry is currently used to determine the optimal timing of peripheral blood stem cell collections (PBSC) and to predict engraftment of stem cell transplantation. However, the technical problems and lack of a standardized method are sources of significant variability in the quantitation of the CD34 positive cells. ProCOUNT(TM) (Beckon Dickinson Immuno- cytometry System, USA) kit for three color flow cytometric analysis was introduced to enumerate CD34 positive cells using a standardized method. This study was conducted to evaluate the usefulness of the three color method, ProCOUNT(TM), in comparison with two color method. METHODS: CD34 positive cells from 25 cord blood samples were enumerated by two methods, two color (CD34-PE/CD45-FITC) and three color (ProCOUNT(TM) , nucleic acid dye/CD34-PE/ CD45-PerCP) flow cytometric analysis, in which CD34 positive cells were counted directly in comparison with counting beads introduced in the sample. RESULTS: The count of CD34 positive cells in the cord blood was 28.3(+/-20.0)/uL and 20.9 (+/-16.0) /uL by three color and two color methods, respectively, The number of CD34 positive cells enumerated by ProCOUNTTM kit was well correlated with that by two color method, but the count was significantly higher in the former method (p<0.01). CONCLUSIONS: In the three color method, loss of stem cells was significantly lower than that in the two color method, and it was possible to obtain a direct count of CD34 positive cells by using a standardized procedure.
Fetal Blood* ; Flow Cytometry ; Hematopoietic Stem Cells* ; Stem Cell Transplantation ; Stem Cells

BACKGROUND: CD34 positive cell enumeration by flow cytometry is currently used to determine the optimal timing of peripheral blood stem cell collections (PBSC) and to predict engraftment of stem cell transplantation. However, the technical problems and lack of a standardized method are sources of significant variability in the quantitation of the CD34 positive cells. ProCOUNT(TM) (Beckon Dickinson Immuno- cytometry System, USA) kit for three color flow cytometric analysis was introduced to enumerate CD34 positive cells using a standardized method. This study was conducted to evaluate the usefulness of the three color method, ProCOUNT(TM), in comparison with two color method. METHODS: CD34 positive cells from 25 cord blood samples were enumerated by two methods, two color (CD34-PE/CD45-FITC) and three color (ProCOUNT(TM) , nucleic acid dye/CD34-PE/ CD45-PerCP) flow cytometric analysis, in which CD34 positive cells were counted directly in comparison with counting beads introduced in the sample. RESULTS: The count of CD34 positive cells in the cord blood was 28.3(+/-20.0)/uL and 20.9 (+/-16.0) /uL by three color and two color methods, respectively, The number of CD34 positive cells enumerated by ProCOUNTTM kit was well correlated with that by two color method, but the count was significantly higher in the former method (p<0.01). CONCLUSIONS: In the three color method, loss of stem cells was significantly lower than that in the two color method, and it was possible to obtain a direct count of CD34 positive cells by using a standardized procedure.
Fetal Blood* ; Flow Cytometry ; Hematopoietic Stem Cells* ; Stem Cell Transplantation ; Stem Cells

BACKGROUND: As a result of exposure to human leukocyte antigen(HLA) by pregnancy, blood transfusion and previous organ transplantation, many patients awaiting renal transplantation can develop HLA antibodies. The level of HLA sensitization is determined by PRA(panel reactive antibody) test using a lymphocyte panel from HLA phenotyped selected donors. In Korea, PRA tests have not been performed routinely for organ transplantations. and there is no available data about HLA sensitization in renal transplantation. METHODS: PRA test was done in 136 sera of chronic renal failure(CRF) patients receiving dialysis (hemodialysis 108, peritoneal dialysis 28) by NIH standard microlymphocytotoxicity method with a frozen lymphocytes panel from 36 HLA-typed donors. PRA positive sera were re-tested after dithiothreitol(DTT) treatment and analyzed for HLA antibody specificities. RESULTS: Thirty five out of 136 sera(25.7%) showed positive PRA values in HLA antibody screening test. The PRA(%) values of the 35 positive sera were distributed into 1-10%(n=8), 10-20%(n=7), 20-50%(n=12) and 50%-100%(n=8). respectively. After DTT treatment, the change of PRA reactivity was divided into three groups. The PRA values of Group A(22 sera: 63%) showed no change, Group B(7 sera: 20%) declined, and Group C(6 sera. 17%) completely disappeared after DTT treatment. The specificities of HLA antibodies were identified in 19 out of 35 sera(54%). The success rate in defining antibody specificities was 0 at PRA values of 1-10% and 70-100%, and high at PRA values of 20-70%. CONCLUSION: We observed that about a quarter of CRF patients have developed HLA antibodies of immunoglobulin class-IgG, mixed IgG and IgM, and IgM HLA antibody in decreasing order of frequency.
Antibodies ; Antibody Specificity ; Blood Transfusion ; Dialysis ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Isoantibodies* ; Kidney Failure, Chronic* ; Kidney Transplantation ; Korea ; Leukocytes ; Lymphocytes ; Mass Screening ; Organ Transplantation ; Peritoneal Dialysis ; Pregnancy ; Tissue Donors ; Transplants