Germ cell tumors(GCT) are not infrequently encounted tumor in pediartic age group. In order to study the clinical behaviors of the disease, we reviewed 29 cases of GCT diagnosed and treated at Kosin Medical Center in the period of 7 years form Jan. 1984 to Dec. 1991 and the results are summarized as follows: 1) The age distribution is the highest between 10 and 15 years(45%) and girls have 1.9 times higher frequency than that of boys. 2) The most frequent primary site of GCT was ovary(15). The next common primary site was testis(5), pineal body(4), sacrococcygeal region(2), retroperitoneum(1), soft palate(1), anterior mediastinum(1) in descending order of frequency. 3) In the pathological analysis of tumors, the most frequent type was mature teratoma(12). The next common type was endodermal sinus tumor(6), immature teratoma(5), dysgerminoma(3), mixed type(2), and choriocarcinoma(1)in descending order of frequency. 4) All the 5 cases of EST have elevated serum levels of alpha-fetoprotein. Two of the three dysgerminoma, one of the two mixed type tumors both of which have germinoma components, and one choriocarcinoma have elevated serum levels of beta-HCG above the age related physiological levels. 5) Among 17 cases of malignant GCT, 9 cases have metastatic areas such as regional lymph nodes, scrotum, pleura, retroperitoneum, omentum and lumbar spine. 6) All except on case of immature teratoma in the anterior mediastinum underwent surgery. Chemotherapy was given to 12 of 17 malignant GCT and radiotherapy was given to 4 of 17 malignant GCT. 7) Among the 4 expired cases within 12 months of follow up, three were originated from pineal body, which had been underwent simple V-P shunt or incomplete resection, and one case was metastatic immature teratoma of anterior mediastinum to the pleura which had not been undergone surgery. Finally, in review of literature and or cases, the survival of properly managed GCT except some of those difficult surgical access is relatively good. To continue the survival of children of GCT to be impoved, we should use all the treatment modalit properly with more positive outlook about the disease.
Age Distribution ; alpha-Fetoproteins ; Child* ; Choriocarcinoma ; Drug Therapy ; Dysgerminoma ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Germinoma ; Humans ; Lymph Nodes ; Mediastinum ; Neoplasms, Germ Cell and Embryonal* ; Omentum ; Pineal Gland ; Pleura ; Pregnancy ; Radiotherapy ; Scrotum ; Spine ; Teratoma

Lymphomatous involvement of the heart, occurring at initial diagnosis and presentation, is extremely rare. We report here a case of 58 year old man who presented with generalized edema, pericardial effusion, and a large right atrial mass detected by transesophageal echocardiography. There is no other evidence of disseminated lymphoma in this patient. Tumor removal and pulmonary embolectomy was done. Pathologically, the mass was malignant lymphoma, diffuse large cell type. Unfortunately, we have no chance to perform the intensive chemotherapy. The patient discharged in moribund state.
Diagnosis ; Drug Therapy ; Echocardiography, Transesophageal ; Edema ; Embolectomy ; Heart ; Humans ; Lymphoma* ; Middle Aged ; Pericardial Effusion

End-to-side neurorrhaphy had been firstly reported at the beginning of this century, but no further clinical reports have been released. In some cases of end-to-end neurorrhaphy, donor nerve incision or even sacrification is inevitably necessary. In doing end-to-side neurorrhaphy, has not been widely accepted because previous results were not satisfactory. The purpose of this study is to evaluate the applicability of end-to-side neurorrhaphy in rats. Twenty female Sprague-Dawley rats, weighing approximately 200-250 g(232.50+/-12.6g) were used. In 10 rats, their right and left peroneal nerves were cut and the distal end of peroneal nerves were end-to-side neurorrhaphied to the tibial nerve. On the right side, the epineurium was left intact and on the left side, it was removed. The proximal end of peroneal nerves were imbedded in the thigh muscle. After 6 months, eletrophysiologic tests, including nerve conduction velocity, the amplitude and the areas of action potential of the tibial cranial muscle were done and then all rats were sacrificed for histologic analysis. The other 10 offspring rats were raised and used for control group. The mean weight of the tibial cranial muscle was 1.74(+/-0.30)g on the right side, 1.54(+/-0.31)g on the left side and 1.97(+/-0.28)g in the control group, which was statistically not significant. The number of muscle fibers in x 100 magnification was 106.10(+/-4.28) on the right side, 109.67(+/-4.69) on the left side and 107.80(+/-4.64) in the control group, which was also not significant. The amplitude and width of muscle action potential were not statistically different among the right side, the left side and in the control group. However, the nerve conduction velocity was bilaterally delayed if compared to control group. In histologic analysis, the presence of epineurium did not impact the results and end-to-side neurorrhaphy were successfully regenerated in all rats. End-to-side neurorrhaphy seem to be a functionally and histologically tolerable alternative when end-to-end neurorrhaphy is not available.
Action Potentials ; Animals ; Female ; Humans ; Nerve Regeneration* ; Neural Conduction ; Peripheral Nerves* ; Peroneal Nerve ; Rats* ; Rats, Sprague-Dawley ; Thigh ; Tibial Nerve ; Tissue Donors

Chronic idiopathic intestinal pseudo-obstruction syndrome is a clinical condition induced by an impaired function of intestinal motility. Although its clinical symptoms are those of intestinal obstruction, mechanical obstruction of the intestine cannot be found by vigorous studies, even by operative exploration. We have experienced nine cases of chronic idiopathic intestinal pseudo-obstruction syndrome. It will help in diagnosis and treatment of the pseudo-obstruction to present the patients with these syndromes. In all cases severely delayed intestinal transit times were noted in radiological gastrointestinal studies without evidence of mechanical obstruction. The most frequent tentative diagnoses were congenital megacolons. But all of the patients showed the presence of ganglion cells in the intestinal wall. Histological abnormalities of the muscle layer were found in three patients. We could not resolve the symptoms by the surgical decompression of the intestine (such as colostomy, ileostomy etc.). But the symptoms were improved after total colectomy in a patient whose main affected site was confined to the colon. The megacystis was the most frequent combined anomaly. All patients had been improved with NPO and total parenteral nutrition therapies were inevitable. The drugs which facilitate the intestinal activities such as cisapride could not resolve the symptoms of obstruction. Three patients were died with the complications of total parenteral nutrition, and four patients improved clinically. Early diagnosis and proper management will reduce the mortality and morbidity.
Child ; Cisapride ; Colectomy ; Colon ; Colostomy ; Decompression, Surgical ; Diagnosis ; Early Diagnosis ; Ganglion Cysts ; Gastrointestinal Motility ; Hirschsprung Disease ; Humans ; Ileostomy ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Intestines ; Mortality ; Parenteral Nutrition, Total

No abstract available.
Appendicitis* ; Child* ; Humans

Pseudoaneurysm due to chronic pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality associated with the pseudoaneurysm, early detection and treatment is essential. Surgical ligation or resection of the aneurysm has a high mortality and therefore, transcatheter embolization is preferably carried out. We report a case in which gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis was successfully treated by transcatheter embolization using Gelfoam and Gianturco spring coils.
Aneurysm ; Aneurysm, False* ; Arteries* ; Gelatin Sponge, Absorbable ; Hemorrhage ; Ligation ; Mortality ; Pancreatitis, Chronic*

No abstract available.
Broad Ligament* ; Female ; Hemorrhage* ; Pregnancy*

Plexiform schwannoma is a rare benign tumor arising from the peripheral nerve sheath and characterized by a multinodular and plexiform growth pattern. This tumor usually arises sporadically. In rare cases, plexiform schwannomas have been associated with neurofibromatosis type 2. Plexiform schwannoma should be differentiated from plexiform neurofibroma, because the latter is pathognomonic tumor of neurofibromatosis type 1 and has a potential of malignant transformation. We report a case of multiple plexiform schwannomas associated with bilateral acoustic neuromas and meningioma.
Meningioma ; Neurilemmoma* ; Neurofibroma, Plexiform ; Neurofibromatoses* ; Neurofibromatosis 1 ; Neurofibromatosis 2* ; Neuroma, Acoustic ; Peripheral Nerves

In North East Asians, they have many anatomical characteristics different from Caucasians: thick skin, heavy subcutaneous tissue, relatively weak SMAS and platysma muscle, prominent zygoma and mandible. In addition, Caucasians have lean and narrow face, so facial flap can easily be lifted superiorly and posteriorly, but North East Asians have short and wide face, so facial flap cannot be lifted easily in a three dimensional direction especially superiorly and posteriorly. Recent facial rejuvenation has been improved to solve these problems through various combined adjuvant surgery. We performed facial rejuvenation with following surgical emphases:1. Shaving and infracture of zygomatic prominence and multistaged curved osteotomy of the prominent mandibular angle, body and symphysis 2. Earlier Skin resection before flap dissection protects the skin incision margin 3. Sufficient fat removal by facial liposuction4. Plane of dissection; suborbicularis and submalar fat pad in midface: preplatysmal layer in lower face and neck 5. Excision of lateral part of orbicularis oculi muscle for correction of crow's feet. 6. SMAS plication and platysmal sling. Based on our experiences, we offer these personal techniques for facial rejuvenation of North East Asians.
Adipose Tissue ; Asian Continental Ancestry Group* ; Foot ; Humans ; Mandible ; Neck ; Osteotomy ; Rejuvenation ; Skin ; Subcutaneous Tissue ; Zygoma

BACKGROUND/AIMS: This study was aimed to examine if FB1 induced-hepatotoxicity involves apoptosis, and cholesteryl hemisuccinate (CS) pre-treatment would selectively interfere with FB1 induced-apoptosis of hepatocytes. METHODS: Sprague-Dawley rats were intravenousely injected with FB1 (1.25 mg/kg/day) for two days, and were sacrificed at 3, 6, 12, 24 and 48 hours after injection. Another experiment group was composed of rats with pretreatment of CS (100 mg/kg/day, i.p.) before FB1 injection. RESULTS: This study demonstrated that administration of hepatotoxic dose of FB1 to Sprague-Dawley rats resulted in liver injury leading to cell death by apoptosis. FB1-induced apoptosis was preceded by early elevation in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol, and appearance of injured pre-apoptotic cells at 12 hours was followed by massive fragmentation and margination of heterochromatin at 24 hours. CS pre-treatment prior to FB1 injection ameliorated serum biochemistry and hepatic injury with apoptosis, demonstrated by histological, ultrastructural and TUNEL (terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end labeling) methods. In addition, there was remarkable decrease in number of PCNA (proliferative cell nuclear antigen)-positive proliferating hepatocytes compared to that of FB1 treated group. CONCLUSION: This study suggests that apoptosis significantly contributes to FB1-induced hepatotoxicity in vivo, and pre-exposure of rat to CS prevents FB1-induced hepatic apoptosis and proliferation.
Alanine Transaminase ; Animals ; Apoptosis* ; Aspartate Aminotransferases ; Biochemistry ; Cell Death ; Cholesterol ; Hepatocytes* ; Heterochromatin ; In Situ Nick-End Labeling ; Liver* ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley