A case of a pleomorphic giant cell tumor of the pnacreas in a 54 year old man is presented. It produced hugecystic mass in the pancreatic area ultrasonographically. Also multiple loculated pancreatic pseudocyst andmultiple low densities in liver were presented in CT. Pathologically this case was a form of giant cell carcinomawhich was called as epulis-osteoid type, but the osteiod component in this case was not conspicuous.
Carcinoma, Giant Cell ; Giant Cell Tumors ; Giant Cells ; Liver ; Pancreas ; Pancreatic Pseudocyst

Transcatheter embolization was done in 15 patients wtih various diseases at departement of radiology, SeoulNational University Hospital from Sept. 1978 to July 1983 using absolute ethanol, autologous blood clots andgelfoam particles as embolic agents. The results were as follows; 1. Successful embolizations were done in 14 of15 cses. (Success rate:93%). 2. Most of complication was post-embolization syndrome such as fever, nausea, painbut minimal. Serious complicaiton was very little. 3. Transcatheter embolization appears to be highly valuableadjuvant therapy in debulking of preoperative and inoperable hypervascular mass or treatment of bleeding fromvarious etiology.
Ethanol ; Fever ; Hemorrhage ; Humans ; Nausea

35 neurogenic tumors of the thorax were analyzed with plain film and CT scan. Radiological analysis emphasizedshape, location calcification, bone change, pleural change in plain film and calcification, cystic change, bonechange, pleural change, presence of contrast enhancement in CT scan. The results were as follows; 1. Age may bethe most important clinical factor for differential diagnosis. 2. Plain film findings(35 cases); 1) The mostcommon shape in the ganglion series tumor (ganglioneuroma, ganglioneuroblastoma, neuroblastoma), was elongation(80%) and these tumors generally had tapered borders(50%). In contrast with those of the genglion series, nervesheath tumors(schwannoma, neurofibroma, malignant Schwannoma) showed a definite tendency to be roudn (95%) and thesulcus effect was more frequetnly seen(67.5%). Most of the masses were smooth. The lobulated masses were commonlymalignant ganglion series tumors. 2) Though overall incidence of calcification was low(8.6%), it was observed morefrequently in ganglion series tumors(20%). 3) Associated bony abnormality were generally observed in large tumorsabove 5cm in long axis, especially in neuroblastoma and ganglioneuroblastoma. 4) Tumors showed pleural effusionwere all malignant. 3. CT findings (17 cases); 1) The overall incidence of cystic change of the mass was 23.6%. Itwas most common in Schwannoma(60%). 2) The contrast enhancement was noted in 64.7%. It's degree was variable andshowed no predilection to any specific tumors. 3) The incidence of calcification, associated bony abnormality andpleural effusion were similiar to plain film. Confident specific diagnosis can be made in most of the neurogenictumors of the thorax by shape of the mass in plain film and internal architecture in CT combined with patient'sage as clinical information.
Diagnosis ; Diagnosis, Differential ; Ganglion Cysts ; Ganglioneuroblastoma ; Incidence ; Neuroblastoma ; Neurofibroma ; Thorax ; Tomography, X-Ray Computed

Transcatheter arterial embolization was applied in 7 cases of hepatic disease including hemobilia of various causes and malignant tumors at Department of Radiology, Seoul National University Hospital during recent several years. The embolic materials were autologous blood clot and Gelfoam particle. Successful control of bleeding or devascularization of tumor vessel was made in 6 of the 7 patients. There was no serious complications; however, post embolization syndrome was found including pain, fever, nausea and vomiting in all cases and subsided after a few days. Transcatheter hepatic arterial embolization is suggested to be a safe and effective treatment in control of hemobilia and devascularization of malignant hepatic tumors.
Fever ; Gelatin Sponge, Absorbable ; Hemobilia ; Hemorrhage ; Humans ; Nausea ; Seoul ; Vomiting

Though intravenous digital subtraction angiography (IV DSA) has several advantages over conventionalangiography in diagnosis and follow up of various vascular disease, it also has several undesirable problems suchas large volume of the contrast medium and inferior image quality compared to conventional angiography. Sorecently intraarterial digital subtraction angiography (IA DSA) was introduced for better image quality usingsmall amount of contrast medium. The authours had good clinical results IA DSA which were made in 20 patients withour own system, SRM-II, developed by cooperation of Departements of Radiology and Medical engineering, Seoul.National University Hospital. Intraarterial digital substraction angiography was found to have several advantagesover conventional angiography: (a) small amount of contrast medium, (b) reduced need for selective arterialcatheterization,(c) lower film cost, (d) shortened examination time, (e) ability to obtain a “road map”, and (f)easier detection of contrast medium. Also IA DSA has several advantages over IV DSA : (a) less dependency oncardiac output, (b) far less vessel overlapping, (c) reduction in patient motion through less painful procedure byreduced volume of contrast media and shorter imaging time.
Angiography ; Angiography, Digital Subtraction ; Contrast Media ; Diagnosis ; Follow-Up Studies ; Humans ; Vascular Diseases

Idiopathic intracranial hypertension, a syndrome of obscure origin, occurs particularly in fat adolescent girls and young women. The usual symptoms are headache, blurred vision, a vague dizziness, horizontal diplopia and transient visual obscurations etc., and ophthalmoscopic examination reveals papillederma, due to increased ICP. Visual field testing usually shows slight peripheral constrictions with enlargement of the blind sports. CSF pressure is elevated in the range of 250 to 450 mm of water. Radiological or the other laboratory tests show no specific abnormalities. Treatment for idiopathic intracranial hypertension is focused on early detection and prevention of vision loss, the only permanent morbidity. Many different modes of medical treatment, including weight reduction, repeated lumber puncture, corticosteroids, diuretics, glycerol or carbonic anhydrase inhibitors, have successfully been tried up to 90% of the patients. In the remaining patients, particularly in those with measurable impairment of vision that does not respond to conventinal medical therapies, surgical procedure should be considered. We report a case of idiopathic intracranial hypertension successfully treated with optic nerve sheath fenestration.
Adolescent ; Adrenal Cortex Hormones ; Carbonic Anhydrase Inhibitors ; Constriction ; Diplopia ; Diuretics ; Dizziness ; Female ; Glycerol ; Headache ; Humans ; Optic Nerve* ; Pseudotumor Cerebri* ; Punctures ; Sports ; Visual Field Tests ; Water ; Weight Loss

Protein C exerts anticoagulatory effects by inactivating factor V and VII and stimulating fibrinolysis. Hereditary protein C-deficient individuals have an increased risk of venous thrombosis and thromboembolism at young age. To our knowledge, the deep cerebral venous thrombosis associated with protein C deficiency has not been reported in Korea. A 34-year-old man was admitted to our hospital because of sudden onset of headache with nausea, vomiting and ocular pain. He had suffered from recurrent deep vein thrombosis of the right lower extremity for one year. Brain MRI showed thrombosis of the straight and confluent sinuses and venous infarction of the right thalamus. The result of cerebral angiography corresponded to MRI findings. Protein C antigen concentration was decreased to 65% and its functional activity was 37%. Other coagulation test and routine blood examination was normal. The protein C level of his mother was low in both antigen and activity, but protein C levels of three siblings were normal in functional activity. We speculate that the etiology of the deep cerebral venous thrombosis in this patient is associated with protein C deficiency and suggest it is valuable to measure protein C level in patients with cerebral venous thrombosis.
Adult ; Brain ; Cerebral Angiography ; Factor V ; Fibrinolysis ; Headache ; Humans ; Infarction ; Korea ; Lower Extremity ; Magnetic Resonance Imaging ; Mothers ; Nausea ; Protein C Deficiency* ; Protein C* ; Siblings ; Thalamus ; Thromboembolism ; Thrombosis* ; Venous Thrombosis ; Vomiting

We analyzed 77 patients with lumbosacral radiculopathy on the basis of electromyography and radiologic study including CT scan and myelography. The results were as followings: 1. In the 62 male and 15 female subjects with a mean age of 39.3 years. The peak incidence was between ages 20 and 40 years (64%). 2. The causes of lumbosacral radiculopathy were herniated lumbosacral intervertebral disc (78%), lumbar strain (9%), fracture of lumbar vertebra (6%), spinal cord tumor (4%), spinal stenosis(3%) in order. 3. Most common involving site was L5 root on EMG and L4-5 intervertabral disc space on radiological study. 4. The prognosis of the patients with normal EMG finding was better than that of the patients with abnormal EMG finding(p<0.05). 5. There was no significant difference between the prognosis of the patients with abnormal radiologic finding and that of the patients with normal radiologic finding.
Electromyography ; Female ; Humans ; Incidence ; Intervertebral Disc ; Male ; Myelography ; Prognosis* ; Radiculopathy* ; Spinal Cord Neoplasms ; Spine ; Tomography, X-Ray Computed

Mitochondnal encephalomyopathies are multisysternic diseases affecting predominantly the CNS and skeletal muscLes by mitochondrial dysfunction. Mitochondrial diseases include three distinct syndromes: mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS): myoclonus epilepsy associated with ragged-red fibers (MERRF):and chronic progressive external ophthalmoplegia(CPEO). A characteristic abnormality called "ragged-red fibers" is usually seen on histochemical evaluation of muscle biopsy specimens in these diseases. The characteristic clinical presentations of MELAS are short stature, recurrent stroke like episodes, migraine-like headache, sensorineural hearmg loss, glucose intolerance and neuropathy. We now report a case of MELAS syndrome confirmed by demonstrating "ragged-red fibers" and abnormal mitochondria in muscle biopsy.
Biopsy ; Epilepsies, Myoclonic ; Glucose Intolerance ; Headache ; MELAS Syndrome* ; Mitochondria ; Mitochondrial Diseases ; Muscle, Skeletal ; Stroke

Hemobilia is a hemorrhage into the biliary tract that may follow trauma (including surgical and percutaneous techniques in hepatobiliary system), aneurysms of the hepatic artery (and its branch), tumors of the biliary tract, hepatoma, inflammation, liver abscess, and gallstone disease. But, a case has not been reported involving of hemobilia associated with gallbladder hemorrhage without obvious predisposing factors or causes. A 62-year-old woman was admitted to Kyunghee Medical Center due to intermittent nausea, and right upper quadrant pain for 2 days before admission. She had no history of abdominal trauma. On the second and third day of her stay, she experienced melena of which the amount was about 300 ml. Abdominal ultrasonography revealed a gallbladder with a 8 mm sized cystic lesion attached to the fundus. Computed tomographic (CT) evaluation of the abdomen demonstrated a highly enhanced 7~8 mm sized nodular mass in the lumen of the gallbladder. The gallbladder, cystic duct, and CBD were dilated due to the filling of blood clots or sludge material. An ERCP was performed and bleeding from the papilla of Vater was confirmed. Subsequently, emergent laparoscopic cholecystectomy was conducted. Pathologic evaluation revealed a grayish-red gallbladder that had a ruptured vessel. The ruptured vessel showed a severe hypertrophic state but there was no evidence of vasculitis, aneurysm, arterio-venous malformation, or malignancy. The case is here in reported of hemobilia associated with spontaneous gallbladder hemorrhage.
Abdomen ; Aneurysm ; Biliary Tract ; Carcinoma, Hepatocellular ; Causality ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Cystic Duct ; Female ; Gallbladder* ; Gallstones ; Hemobilia* ; Hemorrhage* ; Hepatic Artery ; Humans ; Inflammation ; Liver Abscess ; Melena ; Middle Aged ; Nausea ; Sewage ; Ultrasonography ; Vasculitis