We present a case of cerebral germinoma that occurred in the basal ganglia with progressive hemiparesis. A 10-year-old boy was referred to our hospital complaining of progressive right hemiparesis and decreased mental functions. Brain MRI showed left cerebral hemiatrophy and high signal intensity in left thalamus, basal ganglia, cerebral peduncle, and pons. However, no mass or enhancement was observed. 11C-Methionine positron emission tomography showed discernable hot uptake in the left basal ganglia and thalamus. Stereotactic biopsy, with a guide of 11C-Methionine positron emission tomography, was performed and the diagnosis of pure germ cell tumor was determined. 11C-Methionine positron emission tomography is useful for localization of a suspicious tumor in patients with cerebral hemiatrophy without overt mass or enhancing lesions in brain MRI.
Basal Ganglia* ; Biopsy ; Brain ; Child ; Diagnosis ; Electrons* ; Germinoma* ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasms, Germ Cell and Embryonal ; Paresis ; Pons ; Positron-Emission Tomography* ; Tegmentum Mesencephali ; Thalamus

IgA nephropathy was found in a 21-year-old woman with psoriasis vulgaris. She was first diagnosed as psoriasis vulgaris at 12 years age and had exhibited microscopic hematuria and proteinuria since 20 years of age. The histological findings of the renal biopsy showed mesangial proliferative glomerulonephritis and sclerosis. Mensangial deposits of IgA were observed by immunofluorescence. Therefore, we diagnosed this case as IgA nephropathy. Immune abnormalities have been reported in both diseases. The pathogenesis of psoriasis vulgaris and IgA nephropathy may be related through an immune mechanism. The overlapping or coexistence of these conditions has rarely been reported. Thus we described with IgA nephropathy associated with psoriasis vulgaris, psoriatic arthritis, and review the literatures.
Arthritis, Psoriatic* ; Biopsy ; Female ; Fluorescent Antibody Technique ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Proteinuria ; Psoriasis* ; Sclerosis ; Young Adult

PURPOSE: This study was performed to determine the outcome after treatment of osteosarcoma with intraarterial cisplatin as a preoperative chematherapy regimen. MATERIALS AND METHODS: Twenty five patients with extremity osteosarcoma were treated with intraarterial cisplatin at Seoul National University Children's Hospital from January 1987 to April 1996. The dose of cisplatin was 130 mg/m2 and three to six courses were repeated two- to three-week intervals, Systemic doxorubicin was added to six of these patients. This was followed by surgical resection(limb salvage or amputation) and postoperative adjuvant chemotherapy. RESULTS: Limb-salvage was possible in twenty of these twenty five patients. Pulmonary metastasis was present in five patients at diagnosis and developed later in three patients. In six patients treated with systemic doxorubicin, pulmonary metastasis was absent at diagnosis and during follow-up period. Local recurrence after limb salvage was occurred in one patient and treated with amputation and systemic chemotherapy. Seven patients died from pulmonary metastssis and one from unknown cause. The follow-up duration of these patients was three to eighty eight months(median twenty two months) and the overall five-year survival and event free survival rate were 62.1% and 57.5%, respectively. CONCLUSION: These data demonstrate that intraarterial cisplatin can be used as an effective regimen preoperatively for pediatric patients with extremity osteosarcoma. The combined use of systemic doxorubicin is expected to improve survival in patients with pulmonary metastasis.
Amputation ; Chemotherapy, Adjuvant ; Cisplatin* ; Diagnosis ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Extremities ; Follow-Up Studies ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Osteosarcoma* ; Recurrence ; Seoul ; Survival Rate

PURPOSE: Malignant lymphoma arising from mucosa-associated lymphoid tissue (MALT) accounts for a large proportion of a extranodal lymphomas. The stomach is the preferential site of MALT lymphoma, and the pathogenesis of a gastric MALT lymphoma is known to be closely related to Helicobacter pylori infection. Epigenetic silencing of tumor- related genes due to CpG island methylation, has recently been reported in B cell lymphomas, but its role in gastric lymphomas is unclear. METHODS: We analyzed the methylation status of cell cycle control (p16), apoptosis regulation (Death-associated protein kinase, DAPK) and DNA mismatch repair (MGMT, hMLH1, and hMSH3) genes using a methylation-specific polymerase chain reaction in 46 low- and high-grade gastric lymphomas, pathologically documented at Chonnam National University Hospital, between January 1999 and August 2004. RESULTS: Methylation of p16, DAPK, and MGMT was more frequent in the high- than in the low-grade lymphomas (80, 80 and 93 vs. 71, 74 and 84%, respectively). Methylation of hMLH1 and hMSH3 was rare or absent. There was no difference in frequencies of CIMP between the low- and high-grade gastric lymphomas. Of the 46 gastric lymphoma cases, compared with matched normal gastric mucosa, five had an MSI-low phenotype, with two and three in the low- and high-grade lymphomas, respectively. CONCLUSION: Methylation of p16, DAPK, and MGMT may represent a major pathogenetic event in gastric lymphomas, which may contribute to the early tumorigenesis and have clinical applications in the management and follow-up of low and high grade gastric lymphomas.
Apoptosis ; Carcinogenesis ; Cell Cycle Checkpoints ; CpG Islands ; DNA Mismatch Repair ; Epigenomics ; Gastric Mucosa ; Helicobacter pylori ; Jeollanam-do ; Lymphoid Tissue ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Methylation* ; Phenotype ; Polymerase Chain Reaction ; Protein Kinases ; Stomach