Although embryonal rhabdomyosarcoma has been frequently reported in genitourinary tract, head and neck, embryonal rhabdomyosarcoma of the biliary tree is an extremely rarte. It must be considered in differential diagnosis of jaundice in childhood. About 35 cases have been reported in world literatures, since first description on 1875, by Moxon and Wilks. We present a case of embryonal rhabdomyosarcoma of the biliary tree in a 25 months old boy with brief review of literatures. Since chief complaints of this case were jaundice and loss of appetite, the first clinical diagnosis was infectious hepatitis. On ultrasound examination, there is a space occupying lesion in right lobe of liver and it was diagnosed as hepatoma. Choledochoduodenostomy with biopsy was done. The operation revealed dilated common bile dut and both hepatic ducts which were filled with light brown jelly like materials and diagnosed as embryonal rhabdomyosarcoma on frozen and permanent senions. In gross and histologic characteristics, this tumor resembles embryonal rhabdomyosarcoma(sarcoma botryoides) in other locations. In spite of chemo-and radiotherapy after operation, the boy was died.
Child ; Male ; Female ; Humans ; Diagnosis, Differential ; Biopsy

Breast carcinoma has been infrequently reported in children. About 25 cases have been reported in world literatures since first description in 1913, by Bryan. We present a case of juvenile breast carcinoma in a 17 months old girl with brief review of literatures. Grossly, the submitted specimen is grayish white and measured by 1.3x1.0x0.8 cm in size. It is not encapsulated and its cut surfaces are homogeneous. Microscopic examination showed a neoplastic proliferation of duct cells forming mainly glandular spaces with focal papillary pattern, solid sheets or cribriform pattern. The glandular spaces were filled with collections of PAS-positive eosinophilic secretory materials. The individual cell varied from columnar to polygonal and showed moderate hyperchromatism and variation of nuclear size. Mitoses and necrosis are not found. Tumor cell invasion into the stroma was found.
Child ; Male ; Female ; Humans

No abstract available.
Blood Donors* ; Humans

No abstract available.
Trichomonas*

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

BACKGROUND & PURPOSE: The aim of our study is to evaluate the stroke pattern, the correlation of collateralization with cerebral perfusion and stroke severity, and the utility of transcranial Doppler(TCD) to detect collateral pathways in patients with internal carotid artery(ICA) occlusion in the neck. METHODS: Thirty-six patients(28 men and 8 women, mean age of 59.6 ? 12.9 years) with ICA occlusion confirmed by transfemoral cerebral angiography(25 patients) or magnetic resonance angiography(MRA, 11 patients) were studied retrospectively. They had no potential cardiac source of stroke. We evaluated the pattern of cerebral infarcts by magnetic resonance imaging, and the number and the patency of collateral vessels, and the degree of perfusion through collaterals by cerebral angiography. The collateral vessels detected by TCD and MRA were compared with those by cerebral angiography. RESULTS: We found territorial infarcts in 23 patients(64%) and borderzone infarcts in 15(42%). Territorial infarcts(p<0.0001) and borderzone infarcts(p=0.02) occurred more in the ipsilateral hemisphere to the occluded ICA. The prevalence of small subcortical infarcts did not differ between hemispheres. Collateralizations through leptomeningeal anastomosis(p<0.01) and ophthalmic artery(OA, p<0.05) were associated with angiographically reduced cerebral perfusion. Collateralization through OA was also associated with severe symptomatic group(p<0.05); and collateralization through anterior or posterior communicating artery was associated with mild symptomatic group with marginal statistical significance(p=0.097). The number of collateral vessels was associated with neither the degree of perfusion nor the stroke severity. The sensitivity and specificity of TCD to detect collateralization through anterior communicating artery were 100% and 78%, through posterior communicating artery, 67% and 75%, and through OA, 67% and 63%, respectively. CONCLUSION: Cerebral infarcts related to a proximal ICA occlusion are more likely to be ipsilateral territorial or borderzone. The type of collateralization is more important factor for cerebral perfusion and stroke severity than the number of collateral vessels. TCD is a reliable tool for the evaluation of the collateral vessels in the patients with ICA occlusion.
Arteries ; Carotid Artery, Internal* ; Cerebral Angiography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Neck* ; Perfusion ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Stroke*

Multimodal stroke MRI including diffusion- and perfusion-weighted imaging has provided new insights into the diagnosis, mechanism and treatment of acute ischemic stroke. The concept of transient ischemic attack has been changed. New criteria of acute ischemic cerebrovascular syndrome based on MRI findings have been proposed. Various ischemic lesion patterns on diffusion-weighted imaging have a diagnostic value of stroke mechanism. Natural history studies have shown that acute ischemic stroke is a highly dynamic process. Silent recurrent ischemic lesions on MRI were frequent in the early post-stroke period and associated with subsequent clinical events. MRI markers of early blood-brain-barrier disruption predicted subsequent reperfusion, hemorrhagic transformation and poor clinical outcomes. Prospective studies showed that MRI can replace CT in the diagnosis of acute intracerebral hemorrhage, and MRI screening prior to thrombolytic therapy may be safe and feasible. Phase II clinical trials using MRI criteria showed that thrombolysis beyond 3 hours in patients with perfusion-diffusion mismatch may be safe and effective. MRI provides a tissue clock replacing the currently used time clock when deciding whether to initiate thrombolytic therapy. MRI is an established application in acute evaluation of stroke patients and will be a tool for selection criteria and surrogate endpoints in future clinical trials.
Biomarkers ; Cerebral Hemorrhage ; Diagnosis* ; Humans ; Ischemic Attack, Transient ; Magnetic Resonance Imaging* ; Mass Screening ; Natural History ; Patient Selection ; Reperfusion ; Stroke* ; Thrombolytic Therapy

No abstract available.
Cerebral Hemorrhage*

No abstract available.
Thyroid Function Tests* ; Thyroid Gland*

Ataxia telangiectasia is an autosomal recessive disorder characterized by progressive cerebellar degeneration, cancer predisposition, immune defects, radiosensitivity and genetic instability. Ataxia telangiectasia is rare and has not been reported in Korea. We present a 9-year-old girl with early onset progressive cerebellar ataxia. Neurologic examination showed gaze apraxia, bulbar dysfunction, retained tendon reflexes and conjunctival telangiectasia. Alpha-feto protein was elevated and serum IgA was decreased. Brain MRI showed prominent cerebellar atrophy. Literatures were reviewed.
Apraxias ; Ataxia Telangiectasia* ; Ataxia* ; Atrophy ; Brain ; Cerebellar Ataxia ; Child ; Female ; Humans ; Immunoglobulin A ; Korea ; Magnetic Resonance Imaging ; Neurologic Examination ; Radiation Tolerance ; Reflex, Stretch ; Telangiectasis