The clinical and pathological features of solitary fibrofolliculoma are presented. Solitary fibrofolliculoma is very rarely encountered and to our knowledge, only 7 cases have been reported in the Western literature and no cases have been published in Korea. We experienced a case of solitary fibrofolliculoma occurring in a 56-year-old female, who had a 1.0 cm-sized and slowly growing nodule on her chin. A brief review of the literature, was made especially in relation to the pathological findings and histogenesis of solitary fibrofolliculoma.
Female ; Humans

Vibrio damsela is a halophilic bacterium that has been reported to cause skin ulcers and death in damselfish (Chromis punctipinnis) as well as wound and soft-tissue infections in human. Most of the previously reported cases in humans haute involved wound infections associated with exposure to seawater or handling fish. We experienced a case of primary septicemia due to V. damsela after eating raw fists in a healthy 66-year-old woman who had neither wounds nor history of exposure to sea- water. She presented fever and diarrhea followed by rapidly pregressive bullae and painful edema on left band and forearm. The patient was Improved by intensive surgical debrldement of necrotic tissue and antibiotic therapy.
Aged ; Diarrhea ; Eating ; Edema ; Female ; Fever ; Forearm ; Humans ; Seawater ; Sepsis* ; Skin Ulcer ; Vibrio* ; Wound Infection ; Wounds and Injuries

The selective targeting of an integrin alphavbeta3 receptor using radioligands may enable the assessment of angiogenesis and integrin alphavbeta3 receptor status in tumors. The aim of this research was to label a peptidomimetic integrin alphavbeta3 antagonist (PIA) with 99mTc(CO)3 and to test its receptor targeting properties in nude mice bearing receptor-positive tumors. PIA was reacted with tris-succinimidyl aminotriacetate (TSAT) (20 mM) as a PIA per TSAT. The product, PIA-aminodiacetic acid (ADA), was radiolabeled with [99mTc(CO)3(H2O)3](+1), and purified sequentially on a Sep-Pak C-18 cartridge followed by a Sep-Pak QMA anion exchange cartridge. Using gradient C-18 reverse-phase HPLC, the radiochemical purity of 99mTc(CO)3-ADA-PIA (retention time, 10.5 min) was confirmed to be > 95%. Biodistribution analysis was performed in nude mice (n = 5 per time point) bearing receptor-positive M21 human melanoma xenografts. The mice were administered 99mTc(CO)3-ADA-PIA intravenously. The animals were euthanized at 0.33, 1, and 2 hr after injection for the biodistribution study. A separate group of mice were also co-injected with 200 microg of PIA and euthanized at 1 hr to quantify tumor uptake. 99mTc(CO)3-ADA-PIA was stable in phosphate buffer for 21 hr, but at 3 and 6 hr, 7.9 and 11.5% of the radioactivity was lost as histidine, respectively. In tumor bearing mice, 99mTc(CO)3-ADA-PIA accumulated rapidly in a receptor-positive tumor with a peak uptake at 20 min, and rapid clearance from blood occurring primarily through the hepatobiliary system. At 20 min, the tumor-to-blood ratio was 1.8. At 1 hr, the tumor uptake was 0.47% injected dose (ID)/g, but decreased to 0.12% ID/g when co-injected with an excess amount of PIA, indicating that accumulation was receptor mediated. These results demonstrate successful 99mTc labeling of a peptidomimetic integrin antagonist that accumulated in a tumor via receptor-specific binding. However, tumor uptake was very low because of low blood concentrations that likely resulted from rapid uptake of the agent into the hepatobiliary system. This study suggests that for 99mTc(CO)3-ADA-PIA to be useful as a tumor detection agent, it will be necessary to improve receptor binding affinity and increase the hydrophilicity of the product to minimize rapid hepatobiliary uptake.
Animals ; Chromatography, High Pressure Liquid ; Histidine ; Humans ; Hydrophobic and Hydrophilic Interactions ; Integrin alphaVbeta3 ; Melanoma ; Mice ; Mice, Nude ; Radioactivity ; Succinimides ; Transplantation, Heterologous ; Ursidae

The purpose of this report is to evaluate the validity of the differential diagnosis of epidural and subdural hematomas on the basis of the varied angiographic findings and also to determine the correlation between hematoma shape and the injury-angiogram time interval in subdural hematomas. Conventional cerebral angiograms in 27 cases of epidural and 53 cases of subdural hematoma among surgically proven 155 intracranial hematoma patients, observed at the Department of (Neurosurgery) Seoul National University Hospital, during the past 5 years from August, 1968 to July 1973, were reviewed. 53 subdural hematomas were subdivided into three groups upon the injury-angiogram time interval as follows: acute; within 48 hours ---------- 28 cases, subacute; 3 days to 2 weeks ---------- 14 cases, chronic; over 2 weeks ---------- 11 cases. The results were as follows: 1. In epidural hematoma, the A-P view of angiogram showed typical lentiform (biconvex) avascular zone in 11 cases and crescent-shaped avascular zone in 3 cases among total 27 cases, whereas in acute to subacute subdural hematoma it showed crescent-shaped avascular zone in 15 cases but only 2 cases showed the lentiform appearance. 2. Lentiform avascular zone was also typically seen in 5 cases of chronic subdural hematoma, but it might be differentiated from that of epidural hematoma with more clear inner margin in the former. 3. In epidural hematoma, the following characteristic findings providing excellent diagnostic aids were also noted. 1) medial or inward displacement of middle meningeal artery ---------- 3 cases, 2) extravasation from middle meningeal artery into arterio-venous sheath-4 cases into hematoma ---------- 2 cases, 3) amputation of middle meningeal artery ---------- 2 cases, 4) extravasation from dural sinus ---------- 4 cases, 5) displacement of dural sinus from the inner table of skull ---------- 4 cases, 6) lentiform avascular zone only ---------- 4 cases. In 20 cases of epidural hematoma, one or more of the above findings could be found. Among them, extravasation from middle meningeal artery and dural sinus, amputation of middle meningeal artery and displacement of dural sinus were thought as pathognomonic. In subdural hematoma, none of the above findings was seen. 4. In subdural hematoma, hematoma shape (avascular zone) showed some tendency to change its from according to the injury-angiogram time interval: in the group ranging from 1 to 7 days and over a month, the crescent-shaped hematoma was predominant and in the group between these periods, lentiform hematoma and hematoma with flat inner margin were somewhat predominant. But there was no valid basis for predicting the age of subdural hematoma from its configuration at angiography. 5. There was no direct correlation between the shape of the hematoma and the patients' age. 6. Simple skull roentgenogram provided some aids in the differential diagnosis between epidural and chronic subdural hematoma. 20 cases out of 27 epidural hematomas showed linear or depressed skull fracture, whereas only 1 out of 11 cases of chronic subdural hematoma showed linear skull fracture.
Amputation ; Angiography ; Diagnosis, Differential ; Hematoma ; Hematoma, Subdural* ; Hematoma, Subdural, Chronic ; Humans ; Meningeal Arteries ; Seoul ; Skull ; Skull Fracture, Depressed ; Skull Fractures

In the past many authors have contributed most of the fundamental observations of alteration in the sella turcica resulting from raised intracranial pressure and hydrocephalus, and some authors have attempted to distinguish different types of sella change specific to particular pathology. The author has observed upon the change of sella with proved hydrocephalus in 57 patients(45 cases of obstructive hydrocephalus and 12 cases of communicating hydrocephalus) during the period from Jan. 1967 to July 1973 at the Department of Neurosurgery, Seoul National University Hospital. Results are as follows: 1. Among 57 cases in total; no evident abnormalities were seen in 18 cases(32%); erosion and circular expansion at the posterior portion of sella turcica in 36 cases(63%); erosion of the posterior clinoid processes in 31 cases(53%). These changes were more often observed in the cases over 15 years of age than under 15 years of age as well as in the cases of obstructive hydrocephalus than communicating one. 2. The changes of sella related to the site of lesion in obstructive hydrocephalus were as follows; radiologically normal sella were more often observed in the 3rd ventricular lesion than posterior fossa lesion, erosion and circular expansion of the posterior portion of sella in the posterior fossa lesion, and thinning and pointing of dorsum sella in the 3rd ventricular lesion. These changes of sella were not relevant to the age. 3. The changes of sella related to the duration of symptoms of raised intracranial pressure in the obstructive pattern were that the severity of changes was relatively proportionate to the duration; most of the changes were observed around the 6 months of duration regardless of the age. 4. The evident sellar enlargement was observed in 19 out of 36 cases with erosion and circular expansion of the posterior portion of sella, and sellar elongation in 4 cases. 5. Among 27 cases of the obstructive pattern being studied by ventriculogram, cases with anterior end of 3rd ventricle apart from the dorsum showed sellar changes in 40%, those touching the dorsum in 58%, and those extending into sella in 100%. The main findings in the latter two groups were the erosion and circular expansion of the posterior portion of the sella turcica. 6. The raised intracranial pressure did not produce the sellar changes without the change of vault in those cases below 15 years of age.
Hydrocephalus* ; Intracranial Pressure ; Neurosurgery ; Pathology ; Sella Turcica* ; Seoul

OBJECTIVES: This study was to investigate the prevalence of cognitive impairment and depressive symptoms among the elderly in an urban community. METHODS: Korean version of Mini-Mental State Examination(MMSE-K), Short version of Geriatric Depression Scale(SGDS), and the Center for Epidemiologic Studies Depression(CES-D) were administered to 447 elderly persons(37.7% of all residents aged 65 and older) who resided in "Sanggye 10 Dong" by lay interviewers. Then a Psychiatrist and two Psychiatric residents interviewed the elderly scoring 23 or less on MMSE-K and diagnosed with dementia according to the criteria of DSM-III-R. RESULTS: The prevalence of cognitive impairment was estimated as 37.1%(male 18.8%, female 47.0%) by MMSE-Kor=25 and 15.8% by SGDS>or=10. Prevalences(CES-D>or=25) for the age groups 65 to 69, 70 to 74, 75 to 79, 80 to 84, and over 85 were, respectively 15.7%, 18.1%, 23.4%, 13.3%, and 23.5%. Caseness of depressive symptoms(CES-D >or= 25) was not related to sex, age, years of education, marital status, physical illness, occupation, living condition, and financial status. Of 166 persons who had cognitive impairment(MMSE-K Aged* ; Dementia ; Depression* ; Education ; Epidemiologic Studies ; Female ; Humans ; Marital Status ; Occupations ; Prevalence* ; Psychiatry ; Social Conditions

PURPOSE: There is a distinct probability of severe complications with stroke unless patients are administered proper treatment at the optimal time. S-100B protein has been reported to be elevated in brain injuries. The current study investigates the efficacy of serum S-100B protein administration during the diagnostic process for patients who have had an acute stroke. METHODS: We prospectively recruited the patients with nonspecific neurological symptoms. Non-specific neurological symptoms were defined as no focal neurological deficits or stroke suspected symptoms with NIHSS score zero. We grouped the patients according to the presence of a brain lesion (positive vs negative group) by computed tomography or magnetic resonance imaging. Using serum S-100B protein together with CT/MRI imaging at the time of diagnosis, the cutoff value, sensitivities, and specificities were calculated in making a diagnosis of acute stroke. RESULTS: Thirty one patients were enrolled. The level of serum S-100B protein was higher in positive group (median 0.201, interquartile range 0.134-0.469) than in negative group (0.085, 0.060-0.106, p=0.001). In diagnosing acute stroke, the sensitivity was 90.9% at a cutoff value for serum S-100B protein of 0.10 microgram/L . At the cutoff level of serum S-100B protein and the specificity was 75.0%. CONCLUSION: The current results suggest that serum S-100B protein may be a useful serologic marker for detecting acute stroke that is suspected with non-specific neurological abnormalities. Further studies are necessary to use the marker as a screening method for acute strokes.
Brain ; Brain Injuries ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Nerve Growth Factors ; Neurologic Manifestations ; Prospective Studies ; S100 Proteins ; Sensitivity and Specificity ; Serologic Tests ; Staphylococcal Protein A ; Stroke

A 34-year-old male patient was first admitted to our Department on October 16, 1965. He complained of frontal headaches especially in the morning and ild right hemiparesis over the previous 6 months, which were progressively more severe as time went by. On examination, he was mentally clear ut slightly dysphasic: there were mild right hemisparesis and marked bilateral papilledema. Angiogram showed a left posterior frontal vascular tumor. At operation on November 3, 1965, total excision of a posterior frontal parasagittal tumor was performed. To the naked eye, this seemed to be a meningioma; the tumor was egg-sized, round but somewhat lobulated, graysish white in color, firm and fibrotic appearance, and it attached to the superior longitudinal sinus, involving without occluding it. Histologically. It was considered a meningioma of firbrolastic type, containing small amount of capillaries and some areas of collegen deposition around the fibroblasitc cell masses with foci of meningoendothelial cluster; though some doubt was expressed over its innocence. He tolerated the resection of frontal tumor well, and remained in relatively good health for 7 years, as to do his usual farmer work with minimal right hemiparesis. There were some episodes of generalized seizure during there periods. The patients was readmitted on December 25, 1972, however, because of frontal headaches and vomiting over recent 6 months and dysphasia, mental confusion developing rapidly over the previous 3 months. Urinary incontinence was also complained of. On examination he was drowsy, apathetic and mentally confused, more so than when first admitted. There was a goose-egg sized tense bulging in the left frontotemporal region, previously operated. Central-typed right facial palsy, right hypoglossal palsy and bilateral marked papilledema were noted. There were spastic hemiparesis, greater in the upper extremity, and long tract signs on the right side. Angiogram revealed a posterior frontal parasagittal vascular tumor, much as before. At operation on January 5, 1973, subtotal resection of tumor was performed, remaining the deep-seated parasagittal posterior frontal mass. The gross appearance of tumor was necrotic partially on the surfaces, potato-shaped with nodularith and pinkish white in color. On sectioning cut surface was slightly myxoid with cystic degeneration in the center. There was also patchy degeneration, showing yellow tinge in the cut surface. Microscopically, there were prominent hypercellularity with many mitoses, atypism, pleomorphism and degenerative process. Vascutar reaction with amyloid-like infiltration in perivascular area was also demonstrated as with focal pseudocartilagenous degeneration and partial hemorrhage; overall findings were highly suggestive of recurrent memingioma with malignant change (sarcomatous change) in left posterior frontal parasagittal region.
Adult ; Aphasia ; Capillaries ; Facial Paralysis ; Headache ; Hemorrhage ; Humans ; Male ; Meningioma* ; Mitosis ; Muscle Spasticity ; Papilledema ; Paralysis ; Paresis ; Seizures ; Superior Sagittal Sinus ; Tolnaftate ; Transcutaneous Electric Nerve Stimulation ; Upper Extremity ; Urinary Incontinence ; Vomiting

The authors studied clinical features, thymus histology, acetylcholine receptor antibody titers and the responses to multiple modalities of treatment in a consecutive series of 151 patients to know the characteristics of myasthenia gravis in Korea and to clarify the selection of theraputic regimens. The MG subjects were enrolled in Seoul National University Hospital Myasthenia Gravis Registry and followed for at least over 12 months from 1986 to 1991. The overall clinical features were nearly the same as other previous reports in other country except that pure ocular MG group showed younger age of onset and no significant sexual difference. When we classified 151 MG subjects by several criteria. The most valid grouping variables were whether the thymoma was present or not and whether the symptoms were generalized or not. However there was no difference of clinical features when they were divided by age of onset. Therefore we thought that it may be reasonable to classify the MG subjects by a few variables listed above for it will be helpful for comparing therapeutic modalities, estimating the prognosis, and understanding the basic pathomechanisms underlying each subgroups.
Acetylcholine ; Age of Onset ; Follow-Up Studies* ; Humans ; Korea ; Myasthenia Gravis* ; Prognosis ; Seoul ; Thymoma ; Thymus Gland

No abstract available.
Brain* ; Carotid Artery, Internal* ; Carotid Stenosis* ; Humans ; Tomography, Emission-Computed, Single-Photon*