Verrucous carcinoma of the larynx is a distinct and uncommon variant of well-differentiated squamous cell-carcinoma. The authors hybridized in situ a case of laryngeal verrucous carcinoma with DNA prebes to humman papillomavirus (HPV) 6, 11, 16, 18, 31, 33 and 35. The DNAs from the verrucous carcinoma of larynx hybridized with mixed DNA probes HPV-16/18 and 31/33/35. In addition, there was an evidence of HPV infection based on hybridization with mixed DNA probe HPV-6/11 in the adjacent papilloma tissue. By in situ DNA hybridization techniques, we clearly demonstrated human papillomavirus (HPV-16/18, and 31/33/35) related sequences in this neoplasm. These findings suggest the role of HPV-6/11 in the development of laryngeal papilloma ad HPV-16/18 and 31/33/35 probably on the progression to verrucous carcinoma.
Humans

The authors examined 9 condylomas, 26 cervical intraepithelial neoplasms(CIN) and 22 invasive squamous cell carcinomas for the presence of human papillomavirus(HPV) DNA sequences by DNA-DNA in situ hybridization. In situ hybridization revealed target HPV DNA sequences mostly in the nuclei of the superficial cells from epithelium which contained either maturation or koilocytotic atypias. With the use of biotinylated HPV DNA probes 6/11, 16/18 and 31/33/35, 42 of the 57(73.7%) were positive with HPV-6/11, 23 with HPV-16/18, 32 with HPV-31/33/35 and 18 with two or more mixed probes. HPV-31/33/35 was wht most prevalent in CIN and invasive squamous cell carcinomas, follwed by HPV-16/18. The incidence of HPV DNA increased from 66.7% to 86.4% with increasing severity of the lesions from condylomas to invasive squamous cell carcinomas. Flat condyloma was most freuently accompanied by CIN.
Humans ; Incidence

We report a rare case of cervical intradural extramedullary neurilemmoma associated with extradural cavernous angioma in adolescent male patient. This 19-year-old man complained of increasing weakness of left extremities with pain and numbness, starting upwards from the region of left leg since 2 months before, which has aggravated gradually and developed to right side. Neither the patient nor any family member displayed the stigmata of spinal tumor. Neurological examination showed spastic qudriparesis, more severe on left side, disclosed absent vibratory sense and diminution of pain and touch below level of cervico-thoracic junction. Myelogram demonstrated a large filling defect at the C4-6 vertebral level, which was interpreted as an intradural extramedullary or extradural mass. Laminectomy was performed 4 days after admission. At surgery, reddish, diffuse and well demarcated friable mass was found extradural space at the level of C4-6. But post-operative course was not improved for 2 weeks, so we are performed second operation after identified another intradural extramedullary mass by spinal CT. A total removal of tumor mass was accomplished at second procedure. Hostological examination confirmed the diagnosis of cavernous angioma at the extradural mass, neurilemmoma at the intradural extramedullary mass. The post-operative course was satisfactory.
Adolescent ; Christianity ; Diagnosis ; Extremities ; Hemangioma, Cavernous* ; Humans ; Hypesthesia ; Laminectomy ; Leg ; Male ; Muscle Spasticity ; Myelography ; Neurilemmoma* ; Neurologic Examination ; Young Adult

One Hundred and eight patients received operation for acute subdural hematoma were evaluated in prognostic factors. They were admitted to the Neurosurgical Department in S.R.C.H during the 3 years from January, 1986 to December, 1988. The results were as follows ; 1) The patients were consist of 85 male patients and 23 female patients with the sex ratio 3.7 : 1. 2) Evaluated prognostic factors were age and sex, preoperative Glasgow coma scale(GCS), preoperative pathological physical findings, time interval from injury to operation, type of injury, midline shift, location of hematoma, thickness of hematoma, and operative procedure. 3) On the statistical analysis, factors of GCS and midline shift were considerable significant factors. 4) In the overall results of 108 patients, 47 patients(43.5%) had good recovery, 9 patients(8.3%) had moderate disabled state, 2 patients(1.9%) were severe disabled state, 4 patients(3.7%) were vegetative state, and 46 patients(42.6%) died.
Coma ; Female ; Hematoma ; Hematoma, Subdural, Acute* ; Humans ; Male ; Persistent Vegetative State ; Sex Ratio ; Surgical Procedures, Operative

We experienced a rare case of sacral meningeal cyst so called sacral perineurial cyst(Tarlov cyst). A 15 years old girl was admitted to the hospital because of sudden severe low back pain and Lt. sciatica for about one week. We performed delayed myelography and spinal computeized tomographic myelography(C.T.M) for differential diagnosis. Delayed filling of contrast media in the cyst was significant in diagnosis of sacral meningeal cyst type II. Laminectomy of sacrum(S1) was performed for partial excision of cystic wall and plastic suture. Operative finding was typical sacral perineurial cyst(Tarlov cyst) which was recently clssified as sacral meningeal cyst type II. The classification of spinal meningeal cysts in the literature was indistinct and confused. We also agree with Nabors et. al, in current classificcation of spinal meningeal cysts, in which the spinal meningeal cysts, in which the spinal meningeal cysts were divided into 3 groups as extradural spinal Mcs Type I(Diverticulum), Type II(perineurial cyst), intradural spinal Mcs(arachnoid cyst).
Adolescent ; Classification ; Contrast Media ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Laminectomy ; Low Back Pain ; Myelography ; Plastics ; Sciatica ; Sutures

We studied the incidence of spontaneous infarct related artery recanalization and it's effect on LV function in 120 patients with acute myocardial infarction by angiography within 1 month after onset of acute MI between Nov. 1983 to Sep. 1988. The total occlusion rate of the infarct related artery in 34 cases catheterized from 1st day to 7th day was 55.8%, that of 33 cases from 8th day to 14th day 51.5%, that of 32 cases from 15th day to 21th day 40.7% and that of 21 cases from 21th day to 30th day was 47.7%. These results suggest that spontaneous recanalization of infarct related artery has mainly occurred within 24 hours after acute MI. LV ejection fraction among those patients who showed spontaneous recanalization(n=59) was not significantly superior to those with persistent occlusion of the infarct related artery. Both anterior and inferior MI patients showed no difference in LV function as regard to whether they showed recanalization or persistent occlusion. Although early spontaneous reperfusion of the infarct related artery is not uncommon in acute MI, LV function was not influnced by the spontaneous recanalization at least until 1 month after MI.
Angiography ; Arteries ; Catheters ; Humans ; Incidence ; Myocardial Infarction* ; Reperfusion ; Ventricular Function, Left*

To evaluate the change in valvular morphology and occurence and severity of mitral regurgitation produced by PMV, 45 patients(33 women and 12 men,mean age 38+/-10 years) were studied using two-dimensional(2-D) and Doppler echocaediography before and 1-2 days after this procedure. Mitral valve area after PMV increased in all patients, from 0.9+/-0.2 to 1.8+/-0.4cm2(P<0.0001). In valve area estimation, the correlation between Gorlin`s method and 2-Dechocardiography was better(r=0.61, p<0.0001) than that between Gorlin`s method and Doppler pressure halftime(r=0.38, P<0.01) before valvuloplasty, but after the procedure Gorlin`s and 2-D image valve area correlated less well(r=0.33, P<0.05) than Gorlin`s-Doppler pressure halftime correlation(r=0.46, P<0.002). Before PMV, 37 patients had no mitral regurgutation, 7 had grade 1 and 1 had grade 2 mitral regurgutation. After PMV, new mitral regurgutation occurred in 14 patients, increased in severity in 5 patients and so mitral regurgutation newly developed or increased in severity in 19(42%) patients. There were no differences between the patients with and those without an increase in mitral regurgutation after PMV, in age, sex, caediac rhythm, initial mitral valve area, increase in mitral valve area and fluoroscopic calcification. However, morphologic characteristics especially mobility(P<0.01) and thickening(P<0.05) of mitral leaflets were better pressured, and EBDA/BSA(effective balloon dilating area/body surface area) was significantly smaller(P<0.02) in patients without an increase in mitral regurgutation. Thus, an increase in mitral regurgutation after PMV might be related to the features of valve morphology especially and thickand EBDA/BSA.
Female ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis

The authors have analyzed the factors influencing the outcome of the 168 patients with acute epidural hematoma who had been managed in our hospital for 3 years from July 1986 to June 1989. 1) Sex incidence showed that male patients were 4.8 times more commonly affected than females, and the most commonly affected age group was the 3rd decade. 2) The most common cause of injury was motor vehicle accidents. The patients with unknown cause of injury which probably suggested significant delay in starting the clinical managements had a higher mortality rate. 3) The most common site of hematoma was the FTP convexity(63.6%). The patients with diffuse hematoma in the fronto-temporo-parietal region had a high mortality and deteriorated level of consciousness. 4) Skull fractures were not seen only in 9.5% of the patients with acute epidural hematoma. 5) The main factors associated with the higher mortality rate were rapid development of hematoma, pupillary dilatation, low score in Glasgow Coma Scale on arrival, and more midline shifting on brain CT. 6) The patients with concomitant intracranial lesions had a high mortality rate(25.8%), and the patients with acute epidural hematoma alone had a low rate(2%), and the overall mortality rate of the patients with acute epidural hematoma was 11.3%.
Brain ; Consciousness ; Dilatation ; Female ; Glasgow Coma Scale ; Hematoma* ; Humans ; Incidence ; Male ; Mortality ; Motor Vehicles ; Skull Fractures

Recently, the authors have experienced a case of intracranial meningeal mesenchymal chondrosarcoma. Mesenchymal chondrosarcoma is a rare tumor of the bone and soft tissue. It has been reported that the most common site of their extra-osseous origin is the central nervous system. Precise differential diagnosis should be done because of 1) its similarity to angioblastic meningioma or hemangiopericytoma in pathological aspect, 2) much more malignant tendency. We present one case of intracranial meningeal mesechymal chondrosarcoma with a brief review of the relevant literature.
Central Nervous System ; Chondrosarcoma ; Chondrosarcoma, Mesenchymal* ; Diagnosis, Differential ; Hemangiopericytoma ; Meningioma

A case of left temporal gliosarcoma is reported. The patient was a 40-year old man who had headache, behavior change, dysphasia, and mental confusion for about 2 months duration. On brain CT, a large partially cystic mass with homogeneous enhancement was located at left temporal lobe and associated with remarkable peritumoral edema and mass effect. Angiographic tumor vascularity was faintly visualized. Surgical subtotal resection of the tumor and post-operative radiotherapy offered transient symptomatic improvement, being followed within several months by clinical deterioration and regrowth of the tumor on brain CT. Light microscopic studies of the H & E and special stained specimens showed two different components within the tumor in a mixed fashion, i.e. intermingled glioblastoma multiforme and fibrosarcoma. Electron microscopic study of the sarcomatous cells disclosed intracytoplasmic Weibel-Palade-like bodies, a specific marker of endothelial cells. The fibrosarcomatous component of gliosarcoma is believed to be originated from malignant transformation of the hyperplastic endothelial cells within the anaplastic glioma. Literature concerned with gliosarcoma is reviewed.
Adult ; Aphasia ; Brain ; Edema ; Endothelial Cells ; Fibrosarcoma ; Glioblastoma ; Glioma ; Gliosarcoma* ; Headache ; Humans ; Radiotherapy ; Temporal Lobe