Eosinophilic granuloma, Hand-Schuller-Christian and Abt-Letterer-Siewe syndrome are known to be the same disease entity involving the reticulohistiocytic system of the body, although their clinical manifestations are different. So they were included under the term of Histiocytosis X and this concept has been generally accepted. The authors have experienced one case of Hand-Schuller-Christian disease and that of eosinophilic granuloma. The former was a 23 years old man with complaints of exophthalmos, polyuria and a tender palpable mass on the right parietal area and in the latter a soft pulastile mase located on the left parietal area in a 3 year old boy. There was no neurological deficits on their admission. We managed them with radiation and steroid therapy following surgical curettage.
Child, Preschool ; Curettage ; Eosinophilic Granuloma ; Exophthalmos ; Histiocytosis* ; Histiocytosis, Langerhans-Cell* ; Humans ; Male ; Polyuria ; Rabeprazole ; Young Adult

Spontaneous spinal epidural hematoma are rare disease and the cause of bleeding in epidural hematoma remains unknown in most of the cause. The most frequently identified risk factor is coagulopathy or treatment with anticoagulants. Recently, authors experienced I case of spontaneous spinal epidural hematoma at thoracic location. Laboratory examination showed no evidence of coagulopathy and hepatic disease. The patient had good surgical outcome after emergent decompressive laminectomy.
Anticoagulants ; Hematoma ; Hematoma, Epidural, Spinal* ; Hemorrhage ; Humans ; Laminectomy ; Rare Diseases ; Risk Factors

Diastematomyelia is an uncommon dysraphic condition in which the spinal cord is split, with or without a fibrous, cartilaginous, or bone septum. The septum usually occurs in the lower thoracic or lumbar regions. Most of the patients with this condition are children of less than the years old. The condition is much less common in adults. Congenital tumor associated with diastematomyelia is more uncommon finding. Now, authors report one case of diastematomyelia combined with intradural cystic teratoma who is eighteen years old female patient.
Adult ; Child ; Female ; Humans ; Lumbosacral Region ; Neural Tube Defects* ; Spinal Cord ; Teratoma*

The usual form of neurofibromatosis is characterized by cafe-au-Iait skin pigmentation and pedunculated fibrous skin tumors but in the severe form, malformations and tumors of the central nervous system may be associated with von Recklinghausen's disease. Schwannoma of the spinal sensory roots, of the vestibular part of 8th cranial nerve, and of the sensory root of the 5th cranial nerve are particularly common. Outside the central nervous system, other neuroectodermal tumors may develop including renal, pancreas, and suprarenal tumors. Recently, neurofibromatosis is subdivided into type 1 and 2, according to the site of involvement. Type 1 is classic von Recklinghausen's disease, and type 2 represents bilateral acoustic neurinomas. The authors experienced 2 cases neurofibromatosis type 1 and 1 case of neurofibromatosis type 2 in which neurofibromas involve both cerebello-pontine angles, multiple levels of spinal cord and cauda equina.
Cauda Equina ; Central Nervous System ; Cranial Nerves ; Neurilemmoma ; Neuroectodermal Tumors ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Neurofibromatosis 2 ; Pancreas ; Skin ; Skin Pigmentation ; Spinal Cord

Among all of the spontaneous TCH(intracerebral hemorrhage), the presence of IVH(intraventricular hemorrhage) is showing higher mortality and morbidity. Since the introduction of EVD(extraventricular drainage) and direct intraventricular infusion of Urokinase as a effective therapeutic methods of IVH, it's mortality and morbidity has been decreased. But, in cases of hemorrhage extended into all ventricular chambers showes poor prognosis even the EVD and infusion of Urokinase. Authors analyzed 40 cases of IVH treated with simple EVD or direct intraven-tricular infusion of Urokinase. The results were as follows: 1) The most common age groups of IVH patients were 5th and 6th decades and 22 patients were male, 18 patients were female. 2) All 15 cases of Urokinase treated group revealted over the 7 point of Graeb score. 3) On admission, Glasgow coma scale scores were under the 8 at the 11 cases(73%) of Urokinase treated group and 18 cases(72%) of simple EVD group. 4) Time of cleared ventricles showed fast at the Urokinase treated group than simple EVD group. 5) Incidence of complications were similar on both groups. 6) Prognosis revealed lower morbidity and mortality at the Urokinase treated group than simple EVD group. 7) In cases of high Graeb score and low Glasgow coma scale on admission showed poor prognosis in both groups.
Female ; Glasgow Coma Scale ; Hemorrhage* ; Humans ; Incidence ; Infusions, Intraventricular ; Male ; Mortality ; Prognosis ; Urokinase-Type Plasminogen Activator*

Hemorrhagic fever with renal syndrom is an acute febrile disease which is caused by Hantanvirus and several other viruses that belong to the genus Hantavirus. Gl and G2 glycoproteins of Hantanvirus have been thought to be involved in protective immunity against Hantanvirus infection. In this study, the antigenicity of G1 and G2 glycoproteins in cell mediated immune response was investigated. When peripheral blood mononuclear cell fraction from recovered hemorrhagic fever with renal syndrome patient was cultivated with a recombinant protein containing amino-terminal 78 amino acids of G2 glycoprotein, these cells were activated to proliferate and secreted significant amount of interleukin-2 and interferon-r. These results suggest that T cell epitope exists in the amino-terminal region of G2 glycoprotein.
Amino Acids ; Epitopes, T-Lymphocyte ; Fever ; Glycoproteins* ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Interleukin-2

BACKGROUND: Thyroid cancer is the most common tumor with a endocrine gland origin, and it has a gradually increasing incidence rate. An operative procedure is useful to obtain good results for this disease. Howevers, the selection of operation method remains controversial. Thus, we reviewed the variable prognostic factors which influence thyroid cancer recurrence in order to determine the treatment methods which reduce the recurrence rate. METHODS: We retrospectively reviewed the cases of 383 thyroid cancer patients who had received operations from January 1988 to December 1993. The review looked at age, sex, operation methods, lymph-node metastasis, histologic types, mass size and capsular invasions, and the correlations between these factors and recurrence were analyzed by using Chi-square and SAS trend tests. Complications which developed after various operation methods were also reviewed. RESULTS: Thyroid cancer recurred in 33 (8.6%) patients. Age, sex, lymph-node metastasis, histologic types and capsular invasions did not influence the cancer recurrence rate significantly. However, mass size and operation method were potential factors for recurrence. CONCLUSIONS: If thyroid cancer is diagnosed, a total thyroidectomy with lymph-node dissection is the best method for reducing the cancer recurrence rate. By careful management, complications can be prevented after a total thyroidectomy.
Endocrine Glands ; Humans ; Incidence ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: The value of serum lipid in children after recovery of Kawasaki disease may be important because of the predilection of this disease for the coronary artery. METHODS: We measured serum high density lipoprotein (HDL)-cholesterol, total cholesterol, triglycerides in 22 patients (mean age 38months, range 6 to 93 months) with Kawasaki disease during 10 days or less after onset and 2 months later after recovery. RESULTS: The level of serum HDL-cholesterol was depressed in the acute stage compaired with the level after recovery (33.6+/-15.2mg/dl vs. 54.8+/-8.3mg/dl, mean+/-S.D., p<0.05). Total cholesterol, triglycerides were normal during the acute stage (125.3+/-46.1mg/dl, 142.1+/-32.2mg/dl, respectively) and after recovery (147.4+/-35.5mg/dl, 130.6+/-74.9mg/dl, respectively). Echocardiography confirmed coronary aneurysm in 7 patients (31.8%) and otherwise, normal coronary figures (n=15). In the patients with coronary aneurysm, the level of serum total cholesterol, HDL-cholesterol were 134.0+/-34.1mg/dl, 34.5+/-14.9mg/dl, respectively and in the patients without coronary aneurysm 147.7+/-36.7mg/dl, 29.5+/-12.8mg/dl, respectively. They showed no significant differences between two groups (p=0.5, p=0.43, respectively). CONCLUSIONS: Significantly reduced HDL-cholesterol level, which is considered a risk factor for coronary atherosclerosis, is transient finding in the acute stage of Kawasaki disease and not associated with the incidence of coronary aneurysm. Further basic research is needed to elucidate the pathophysiology by which this abnormality is produced.
Child ; Cholesterol ; Cholesterol, HDL ; Coronary Aneurysm* ; Coronary Artery Disease ; Coronary Vessels ; Echocardiography ; Humans ; Incidence ; Lipoproteins ; Mucocutaneous Lymph Node Syndrome* ; Risk Factors ; Triglycerides

The authors experienced 32 cases of reoperation due to persistent or recurred symptoms who had once low back operation due to herniated lumbar disc. The results were summarized as follows: 1) The reoperated cases were most common in 5th decade(31.3% ) and 2nd most common in 4th decade(28.1%) of age, and the male to female ratio was 2:1. 2) The lesion sites of reoperated cases were L4-5 space(68.8%), L5-S1 space(18.8%), multiple space(9.4%) and L3-4 space(3.1%) in orders. 3) The symptom-free interval between 1st and 2nd operation were 1-5 years(34.4%), 6-10 years(15.6%) and 2-6 months(12.5%) in orders. The longest interval were above the 11 years (21.9%) and the shortest interval were below the 1 month(15.6%). 4) The main pathologic findings of reoperated 32 cases were epidural fibrosis(31.2%), incomplete disc removal+epidural fibrosis(31.2%), new disc herniation(21.8%), foraminal stenosis(9.4%) and opposite site herniation(6.3%) in orders. 5) The results of 32 reoperated cases were good(43.7%), excellent(21.8%), fair(18.7%) and poor(15.6%) in orders.
Female ; Humans ; Intervertebral Disc* ; Male ; Reoperation

Of the case of malignant astrocytoma, spontaneous transdural extension is very rare. Only several cases of transdural extension of primary intracranial tumor are reported. However, these cases are through the foramina of the skull base. We have experienced a case of malignant astrocytoma which directly extended out through the dura and calvarium near the pterion of the left side.
Astrocytoma* ; Skull ; Skull Base