Granulocytic sarcoma is a rare localized tumor composed of granulocytic precusor cells. Granu-locytic sarcoma occurs in a variety of clinical conditions and it is often misdiagnosed histologically. Differential diagnosis frorh lymphoma or nonhematopoietic malignancies such as undifferentiated carcinoma or sarcoma is difficult in the routing histologic examination. An evaluation of clinical and histopathologic features was done on 4 cases of granulocytic sarcoma which were diagnosed at Pusan Paik Hospital from 1988 to 1992. During the period, 282 cases of myelogenous leukemia were diagnosed. Immunohistochemical reaction for lysozyme, myelopero-xidase, leukocyte common antigen, epthelial membrane antigen and cytokeratin was assessed comparing to lymphoma and undifferentiated carcinoma. The histologic features of the granulocytic sarcoma revealed thin nuclear membrane, fine chromatin pattern and one or two small nucleoli. It also often involved the vascular wall and infiltrated the native structures without destruction. Immunohistochemical stain revealed that all(4 cases) of granulocytic sarcoma showed diffuse and strong positivity for myeloperoxidase, and partial but strong positivity for lysozyme. One case of granulocytic sarcoma was negative and 3 cases revealed focal positive reaction for LCA, and all 4 cases was negative for cytokeratin and EMA. In summary, careful observation under light microscopy with immunohistochemical stain for myeloperoxidase, lysozyme, and LCA is helpful in the differential diagnosis of granulocytic sarcoma from malignant lymphoma and cytokeratin and EMA is useful for differential diagnosis from undifferentiated carcinoma.
Diagnosis, Differential

A retrospective comparative study of MRI and CT in 24 patients with diffuse axonal injury (DIA) was undertaken. Three-quaters of the lesions were non-hemorrhagic, and the sites of involvement were lobar white matter (96%), corpus callosum (70%), and rostral brainstem (42%), in descending order. MRI was singnificantly more sensitive than CT in detecting DAI lesions. The average number of DAI lesions was higher with increasing clinical stage of the injury. MRI is more valuable than CT for staging the full magnitude of the injury and in predicting the neurologic prognosis of DAI lesions.
Axons* ; Brain Stem ; Brain* ; Corpus Callosum ; Diffuse Axonal Injury ; Humans ; Magnetic Resonance Imaging* ; Prognosis ; Retrospective Studies ; White Matter

Inflammatory pseudotumor of the liver is a relatively rare entity, and frequently misdiagnosed as a malignant tumor. We report a case of inflammatory pseudotumor involving the liver in a 53year-old man. The liver function test and serum alpha-fetoprotein level were within normal range. His preoperative diagnosis was as hepatocellular carcinoma by radiologic studies, and ultrasonography guided fine needle aspiration cytology and biopsy were done but confirmative diagnosis of malignancy or pseudotumor was not given. Grossly a relatively well marginated reddish brown soft mass with focal hemorrhage, measuring 5.0 cm in the largest diameter, was noted in the left lobe of liver. Surrounding hepatic parenchyma was yellowish brown in color without cirrhosis. Microscopically the mass showed typical findings of inflammatory pseudotumor and the ing liver tissue revealed diffuse fatty change and moderate chronic inflammatory cell on in the portal areas.
Biopsy ; Carcinoma, Hepatocellular

PURPOSE: Cerebral cortical dysplasias are one of the important causes for epileptic seizures and developmental disabilities in children, particularly in diffuse or bilateral cases. These developmental malformations are generally regarded as a group of neuronal migration disorders, however, the classification system and pathogenetic mechanisms of cortical dysplasias are not yet entirely clear. Even a novel entity, congenital bilateral perisylvian syndrome, characterized by speech delay, pseudobulbar Palsy, intractable seizures, and bilateral perisylvian abnormalities on imaging studies, have rather diverse figures on morphology and symptomatology than initially considered. We have studied the clinical features and correlations of clinical outcomes 3nd magnetic resonance imaging(MRI) findings of bilaterally involved cortical dysplasias. METHODS: 20 cases of bilateral cortical dyspalsias were grouped into three categories on the basis of MRI findings; centroparietal dysplasias(6 cases), diffuse dysplasias with (5) or without white matter lesions(4), and schizencephaly(5). EEGs, motor and language development, epilepsy, and outcomes were reviewed in each groups. RESULTS: Language delay(100%), motor developmental delay(94.7%), motor deficit(65%), epilepsy(40%) were the main reasons for their initial hospital visits. A meaningful word expression was possible at the mean age of 2 years and 2 months(1 to 4 years of age). Hypotonia and spastic motor paralysis were evident in all the cases of diffuse dysplasia with white matter lesions and the schizencephaly groups. All but one case of centroparietal dysplasia showed motor developmental delay. Epilepsies were developed in 8 cases at the mean age of 5 years and 5 months(2 months to 12 years of age) and the seizures were relatively well controlled with anticonvulsants. EEG findings were variable; normal, focal or diffuse abnormalities. High amplitude diffuse fast activities were only noted in the diffuse dysplasia group. CONCLUSION: The severity of neurological deficits and developmental delay had correlated to the size of cortical abnormalities. The epilepsies were relatively well controlled during childhood and the EEG finding of high amplitude diffuse fast activities was specific for the diffuse cortical dysplasias. Bilateral centroparietal dysplasias should be included on consideration of the causes for developmental aphasia.
Anticonvulsants ; Aphasia ; Child ; Classification ; Developmental Disabilities ; Electroencephalography ; Epilepsy ; Humans ; Language Development ; Language Development Disorders ; Magnetic Resonance Imaging* ; Malformations of Cortical Development* ; Muscle Hypotonia ; Muscle Spasticity ; Neuronal Migration Disorders ; Paralysis ; Pseudobulbar Palsy ; Seizures

The compartment syndrome was described by von Volkmann in 1872 and numerous reports have since been published. The anterior tibial syndrome is well known, but the peroneal compartment syndrome is very rare and have some differences in it's etiology, diagnosis and treatment. We experienced a case of the peroneal compartment syndrome developed after playing foot-ball, and treated by fasciotomy with some delay, but obtained a satisfactory functional result.
Anterior Compartment Syndrome ; Compartment Syndromes ; Diagnosis

It is generally accepted that integrity of the posterior cruciate ligament plays a major role in knee stability. The potential disability resulting from disruption of the posterior cruciate ligament is sufficient to warrant aggressive operative management when the lesion is discovered. From August 1980 to July 1982, the authors treated the 8 cases of the posterior cruciate ligament injury at the department of orthopedic surgery, Chung Ang university hospital; primary repair(2 cases), reconstruction using the medial head of the gastrocnemius muscle(6 cases). In the operative procedure of reconstruction using gastrocnemius, we experienced the following obstacle and resolved it effectively. l. In the surgical approach, we choosed the separate incision on the anteromedial and posteromedial aspect of knee and satisfactory results were obtained. 2. In adequate length of the gastrocnemius tendon was resolved by releasing of gastrocnemius as closer to it's femoral condyle origin as possible or together with attached periosteum and bone chips, by fixation of gastrocnemius with pull through wire suture method. 3. In advancement of the gastrocnemius into the knee joint, we used No. 32 chest tube and achieved the smooth enterance. 4. Adequate position of the femoral condyle drill hole was achieved by using hip screw reamer and K-wire.
Chest Tubes ; Head ; Hip ; Knee ; Knee Joint ; Methods ; Orthopedics ; Periosteum ; Posterior Cruciate Ligament ; Surgical Procedures, Operative ; Sutures ; Tendons

No abstract available in English.
Amputation

No abstract available.
Ankle Fractures* ; Ankle*

PURPOSE: A number of drugs are capable of changing body weight as a side effect. A number of neurotransmitter systems acting in several hypothalamic nuclei are pivotal to the storage regulation of body fat. Leptin is a protein encoded by the ob gene that is expressed in adipocyte. It regulates eating behavior by activating the action to the satiety center in the hypothalmus. The purpose of this study is to investigate the changes of serum leptin in children with epilepsy. METHODS: Serum leptin levels were measured in 43 epileptic patients (30 males, 13 females) receiving valproate or carbamazepine by radioimmunoassay. Thirty patients (19 males, 11 females, 10.0+/-5.0 years of age) were treated with valproate (VPA group) and 13 patients (11 males, 2 females, 9.1+/-4.0 years of age) were treated with carbamazepine (CBZ group). Obesity index and body mass index were calculated before and during anticonvulsant medications. RESULTS: 1) Body mass indices were significantly increased after VPA or CBZ medication; from 17.24+/-2.74 to 18.47+/-2.60 in VPA group, from 16.77+/-1.69 to 17.43+/-3.01 in CBZ group. 2) Obesity indices were increased without statistical significance after medication in both group. 3) Serum leptin levels were significantly higher in VPA group (4.54+/-4.77ng/ml) than CBZ group (2.47+/-2.26ng/ml). CONCLUSION: Body weight gain after VPA medication in susceptible individual might be related to a certain mechanism that elevates serum leptin level.
Adipocytes ; Adipose Tissue ; Body Mass Index ; Body Weight ; Carbamazepine ; Child* ; Epilepsy ; Feeding Behavior ; Female ; Humans ; Leptin* ; Male ; Neurotransmitter Agents ; Obesity ; Radioimmunoassay ; Valproic Acid ; Weight Gain

Econazole is one of the new imidazole derivatives displaying antifungal and antibacterial properties in vitro and in vivo. The present study was undertaken to evaluate the therapeutic efficacy of Econazole in patients with dermatomycoses anl to determine the minimal inhibitory concentration in vitro. A total of 48 patients with various forrns of dermatomycoses(25 patienta with T. cruris, 13 with T. pedis, l with T. corporis, 4 with T. versicolor and 5 with candidiasis) entered this study at the Departement of Dermatology, University Hospital, College of Medicine, Seoul National University during 3 months period. from July to September, 1976. Dia,gnosis was established clinically as well as microscopically by direct KOH mount. All patients were instructed to apply 1:o Econazole solution two to three times daily on the affected area for four to seven weeks and weekly examination of the clinical lesions and direct KOH mount were performed. In addition, minimal inhibitory concentration for Trichophyton mentagrophy tes was determined by the modified dilution technique in vitro. The results were as follows. 1. Thirty five patients (72. 9F) were cured clinically and microscopieally and thc remainders showed marked clinical improvement but positive KOH mount at 4 th week of treatment. At 7th week, nine (18.8io) of the remainders were cured clinically and microscopically and the overall cure rate at 7th week was 91. 7%. Five patients with tinea cruris experienced trar.sient irritation derrnatitis on their crural regions. 2. The minimal inhibitory coriceritration of Econazole for Trichophyton mentagrophytes was 25 pg per ml. of medium. The authors concluded that the 1 i Econazole was highly effective in the treatment of superficial rnycoses and the side effects were rninimal and only transient.
Dermatology ; Dermatomycoses* ; Dronabinol ; Econazole* ; Humans ; Indicator Dilution Techniques ; Seoul ; Tinea ; Trichophyton