Solid hemangioblastomas of the medulla oblongata are benign vascular neoplasms located in a critical area. We experienced a case of solid hemangioblastoma originated in the medulla oblongata with the syrinx in the cervical spinal cord. Preoperative magnetic resonance imaging provided precise anatomical location and radiologic features of the tumor, which facilitated its total removal. Cardiovascular and pulmonary disorders often complicate this type of surgery, and postoperative dysphagia is a frequent sequelae.
Deglutition Disorders ; Hemangioblastoma* ; Magnetic Resonance Imaging ; Medulla Oblongata* ; Spinal Cord ; Vascular Neoplasms

No abstract available.
Colitis, Ulcerative* ; Ulcer*

Intracranial chondromas are extremely rare tumors, but when present, are generally related to the synchondrosis of the base, and they have several distinct features. They are slow growing benign tumors, and plain roentgenogram frequently reveals lytic lesion and stippled calcification at base of the skull. They are radioresistant, and surgical removal is treatment of choice. We report the rare case of chondroma arisen from base of the skull which diagnosed by brain CT and confirmed by operation.
Brain ; Chondroma* ; Cranial Fossa, Middle* ; Skull

Despite of their frequent occurrence among the brain tumor, meningiomas are rarely seen as a multiple growth. Most authors report an incidence ranging from 1 to 3% of all meningioma prior to the introduction of computed tomography. After the CT has introduced, diagnostic problems involved with multiple meningiomas were resolved, and its reported incidence was arisen to 8~8.9% of all meningiomas. It may be difficult to differenciate multiple meningioma from the special varient(forme fruste) of von Recklinghausen's disease. Although the pathogenetic factors related to the multiple meningiomas are unknown, various theories of the etiology have been studied and reported. We report a patient with multiple meningioma without evidence of von Recklinghausen's diseases.
Brain Neoplasms ; Humans ; Incidence ; Meningioma* ; Neurofibromatosis 1

The management of pineal region tumors remains controversial. Advocates of a conservative approach emphasize the excellent results of radiotherapy, particularly with germinoma, while a number of recent reports have demonstrated the safety of direct surgery. We analyzed 8 cases of pineal region tumors which had been treated at our institution over the past 7 years. Tissue diagnosis was obtained in 3 patients before irradiation and 5 patients underwent irradiation without histological diagnosis. Among 5 irradiated patients initially, four patients had been achieved complete remission by radiotherapy thus they were presumptively germinoma, but other one patient had no response, so she had been underwent surgery. Among 3 biopsy proven cases, 2 were teratoma and other one was embryonal carcinoma. Complete gross microsurgical excision of well encapsulated tumor was possible in two teratoma cases. MRI and other neuroradiological studies have ben found to be useful in indicating the biological nature and histological type of pineal tumor. So, consideration of MRI scans together with tumor markers and response to small dose irradiation will generally allow a specific diagnosis with a high degree of probability. In this way, germinomas may be selected for radiotherapy and the tumor less likely to response may be subject to primary surgery to obtain complete tumor extirpation or tissue diagnosis.
Biopsy ; Carcinoma, Embryonal ; Diagnosis ; Germinoma ; Humans ; Magnetic Resonance Imaging ; Pinealoma ; Radiotherapy ; Teratoma ; Biomarkers, Tumor

Pregnancy related stroke is rare and poorly understood. A 28-year-old pregnant woman at 20 weeks of gestation presented with sudden headache and left homonymous hemianopsia. MRI revealed acute right posterior cerebral artery territory infarction. Laboratory data revealed combined protein C and S deficiencies. Coagulation profiles returned to normal 6 months after the delivery. Although stroke can occur either with protein C or S deficiency, acute cerebral infarction associated with combined protein C and S deficiencies during gestation is very rare.
Adult ; Cerebral Infarction ; Female ; Headache ; Hemianopsia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Posterior Cerebral Artery ; Pregnancy* ; Pregnant Women ; Protein C* ; Protein S ; Stroke*

Extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is usually indolent. Although it was reported recently that about 20-30% cases of MALT lymphoma presented with a disseminated disease at diagnosis, it was described as a disease localized at diagnosis and remaining stable for a prolonged period. However, only a few cases of MALT lymphoma involved the lung and gastrointestinal tract all at once. We report a case of a 73-year-old man with disseminated MALT lymphoma. He presented with non-productive cough, initial chest radiograph showed a nodule in the right lower lobe. The diagnosis of stage IV MALT lymphoma was made by CT scan, video-assisted thoracoscopic excisional biopy, gastrofiberscopic biopsy and bone marrow biopsy. The lymphoma involved the lung, stomach and bone marrow at the time of diagnosis. Because he refused chemotherapy, he discharged after Helicobacter pylori eradication without chemotherapy. Regular follow-up examination did not show any evidence of disease progression over 22 months.
Aged ; Biopsy ; Bone Marrow ; Cough ; Diagnosis ; Disease Progression ; Drug Therapy ; Follow-Up Studies ; Gastrointestinal Tract ; Helicobacter pylori ; Humans ; Lung ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Radiography, Thoracic ; Solitary Pulmonary Nodule* ; Stomach ; Tomography, X-Ray Computed

Objective: The objective of the study was to compare the effects of long-term and short-term embryo culture to assess whether there is a correlation between culture duration and clinical outcomes. Methods: Embryos were divided into two study groups depending on whether their post-warming culture period was long-term (20–24 hours) or short-term (2–4 hours). Embryo morphology was analyzed with a time-lapse monitoring device to estimate the appropriate timing and parameters for evaluating embryos with high implantation potency in both groups. Propensity score matching was performed to adjust the confounding factors across groups. The grades of embryos and blastoceles, morphokinetic parameters, implantation rate, and ongoing pregnancy rate were compared. Results: No significant differences were observed in the implantation rate or ongoing pregnancy rate between the two groups (56.3% vs. 67.9%, p=0.182; 47.3% vs. 53.6%, p=0.513). After warming, there were more expanded and hatching/hatched blastocysts in the long-term culture group than in the short-term culture group, but there was no significant between-group difference in embryo grade. Regarding pregnancy outcomes, the completion of re-expansion was faster in women who became pregnant than in those who did not for both culture durations (long-term: 2.19±0.63 vs. 4.11±0.81 hours, p=0.003; short-term: 1.17±0.29 vs. 1.94±0.76 hours, p=0.018, respectively). Conclusion The outcomes of short-term culture and long-term culture were not significantly different in vitrified-warmed blastocyst transfer. Regardless of the post-warming culture time, the degree of blastocyst re-expansion 3–4 hours after warming is an important marker for embryo selection.

OBJECTIVE: Assisted reproductive technology has been associated with an increase in multiple pregnancies. The most effective strategy for reducing multiple pregnancies is single embryo transfer. Beginning in October 2015, the National Supporting Program for Infertility in South Korea has limited the number of embryos that can be transferred per in vitro fertilization (IVF) cycle depending on the patient's age. However, little is known regarding the effect of age and number of transferred embryos on the clinical outcomes of Korean patients. Thus, this study was performed to evaluate the effect of the number of transferred blastocysts on clinical outcomes. METHODS: This study was carried out in the Fertility Center of CHA Gangnam Medical Center from January 2013 to December 2014. The clinical outcomes of 514 women who underwent the transfer of one or two blastocysts on day 5 after IVF and of 721 women who underwent the transfer of one or two vitrified-warmed blastocysts were analyzed retrospectively. RESULTS: For both fresh and vitrified-warmed cycles, the clinical pregnancy rate and live birth or ongoing pregnancy rate were not significantly different between patients who underwent elective single blastocyst transfer (eSBT) and patients who underwent double blastocyst transfer (DBT), regardless of age. However, the multiple pregnancy rate was significantly lower in the eSBT group than in the DBT group. CONCLUSION: The clinical outcomes of eSBT and DBT were equivalent, but eSBT had a lower risk of multiple pregnancy and is, therefore, the best option.
Blastocyst* ; Embryo Transfer* ; Embryonic Structures ; Female ; Fertility ; Fertilization in Vitro ; Humans ; Infertility ; Korea ; Live Birth ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Reproductive Techniques, Assisted ; Retrospective Studies ; Single Embryo Transfer

PURPOSE: To evaluate the diagnostic utility and predictors for determinate results of an enzyme-linked immunospot assay using induced sputum cells (IS ELISPOT) for a rapid diagnosis of pulmonary tuberculosis (TB). MATERIALS AND METHODS: Subjects suspected of pulmonary TB who had either sputum acid fast bacilli smear-negative or not producing sputum spontaneously were prospectively enrolled. ELISPOT assay was performed using cells from induced sputum. RESULTS: A total of 43 subjects, including 25 with TB (TB group) and 18 with non-TB disease (non-TB group) were enrolled. Results of IS ELISPOT were determinate in only 17/43 (39%) subjects, but all of determinate results were consistent with the final diagnosis. Of the 43 sputum samples, 11 (26%) were inadequate to perform IS ELISPOT. Of 32 adequate sputum samples, the proportion of determinate results was significantly higher in the TB group (75%, 15/20) than in the non-TB group (17%, 2/12) (p=0.002). The status of active TB was a unique predictor but smear positivity was not a significant predictor for determinate results. In addition, sensitivity of IS ELISPOT (75%, 9/12) in smear negative TB was higher than that of TB-polymerase chain reaction (25%, 3/12). CONCLUSION: IS ELISPOT showed relatively high diagnostic value and accuracy in the TB group, independent of smear positivity. IS ELISPOT may provide additional diagnostic yield for microbiological tools in the rapid diagnosis of smear-negative TB.
Adult ; Aged ; *Enzyme-Linked Immunospot Assay ; Female ; Humans ; Immunologic Tests/*methods ; Male ; Middle Aged ; Mycobacterium tuberculosis/*isolation & purification ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Sputum/*microbiology ; Tuberculosis, Pulmonary/*diagnosis/microbiology