We report a case of cutaneous sarcoidosis which occurred in a 32-year-old female who had, in addition to some cutaneous nodules, recently developed an acute spontaneous erythematous area of induration in old scars on her forehead and lower lip. Histopathologic findings revealed well-demarcated islands of epitheloid cells with a few giant, cells. In addition, slight admixture of lyrnphoid cells with present. at the margins of the epitheloid cell granulomas. Complete regression of the skin lesions was obtained with systemic steroid therapy without recurrence for some 8 months.
Adult ; Cicatrix ; Female ; Forehead ; Granuloma ; Humans ; Islands ; Lip ; Recurrence ; Sarcoidosis* ; Skin

No abstract available.
Granular Cell Tumor*

BACKGROUND: It was recognized that the intake of the whole cow's milk(WCM) early (before 1 year old of age) and large amount in early childhood is related to the iron deficiency, sometimes the iron deficiency anemia in advanced state. To verify the relationship between the variables in the WCM intake and the iron status, we carried out this study. METHODS: Thirty subjects(1 year to 3 years old of age) were classified as a WCM large intake group and a WCM small intake group. The relationship between the WCM commencing age and the iron status(serum ferritin, transferrin saturation and hemoglobin) in the WCM large intake group was evaluated and analyzed by the linear regression. Futhermore, the relationship between the value of WCM intake amountxduration/10 and the iron status(serum ferritin, transferrin saturation and hemoglobin) in the WCM large and small intake groups was evaluated and analyzed by the linear regression. RESULTS: As the WCM commencing age was earlier, the values of serum ferritin, transferrin saturation and hemoglobin decreased significantly(P<0.05). The values of serum ferritin and transferrin saturation decreased significantly as the value of WCM intake amountxduration/10 increased(P<0.05). But the value of hemoglobin decreased insignificantly as the value of WCM intake amountxduration/10 increased(P>0.1). CONCLUSION: The variables in the intake of WCM influence upon the iron status in early childhood. The early commencing of the WCM(before 1 year old of age) is the worst variable that influences adversely upon the iron status in early childhood. The amount of WCM intake and the duration influence upon the storage iron(serum ferritin and transferrin saturation), but not hemoglobin. In this regard, it is necessary to inform the parents of the correct WCM intake ways to avoid the irreversible recognition impairment and behavioral change.
Anemia, Iron-Deficiency ; Child, Preschool ; Ferritins ; Humans ; Iron* ; Linear Models ; Milk* ; Parents ; Transferrin

The diagnosis of acute inflammation of the placenta, represented as acute chorioamnionitis, is important in that it is associated with a poor clinical outcome for both the mother and the fetus, including major perinatal morbidities such as sepsis, respiratory distress syndrome, and CNS damage. However, current medical trends in Korea seem to overlook the significance of a histopathological diagnosis of acute placental inflammation, mainly due to the indifferences of clinicians and pathologists. Since late 1993, histopathological examinations have been performed on preterm placentas at Seoul National University. These examinations have demonstrated acute placental inflammation in a significant number of cases. In the present study the incidence of acute placental inflammation was analyzed in 521 placentas which were submitted for pathological examinations in 1995. Examinations were performed to provide basic information on the incidence and profile of acute placental inflammation in this hospital and, thereby, to emphasize the significance of histopathological examinations of the placenta in the routine surgical pathology service. Among the 521 placentas, acute inflammation was found in 194 cases (37.2%). In preterm placentas acute inflammation was found in 39.6% of the cases (67/169), while 36.1% (127/352) of term placentas showed acute inflammation. Taking the delivery mode into account, 26.3% (49/186) of the placentas delivered by cesarean section showed acute inflammation, while 43.3% (145/335) of the transvaginally delivered placentas showed inflammation. The present analysis demonstrates the existence of acute inflammation in a significant proportion of placentas with different clinical settings. The importance of a histopathological examination in routine hospital practice should be emphasized.
Incidence

Posterior reversible encephalopathy syndrome (PRES) is characterized by headache, vomiting, confusion, and seizure. In addition, PRES is associated with reversible bilateral cortical and subcortical edema on occipital lobe or parieto-occipital lobe. Eclampsia is a rare condition to pregnant and puerperal women and one of common causes of the PRES. The clinical and radiologic manifestations can be resolved without irreversible complication by early diagnosis and appropriate treatment. The authors report a case of eclamptic encephalopathy associated with PRES, in which an 18-year-old woman had clinical manifestations of visual disturbance, headache, and tonic-clonic seizure at 34 hours after vaginal delivery. High signal intensities are seen in both parieto-occipital lobes and left basal ganglia on fluid attenuated inversion recovery (FLAIR) images and T2 weighted images performed at emergency room. But no significant signal change in both parieto-occipital lobes on diffusion weighted images (DWI). Because seizure was repeated, then anticonvulsant was administered at intensive care unit. On the second day, the clinical manifestations were resolved as blood pressure was normalized. The FLAIR imaging and DWI sequences can play an important role in the diagnosis of PRES.
Adolescent ; Basal Ganglia ; Blood Pressure ; Diagnosis ; Diffusion ; Early Diagnosis ; Eclampsia ; Edema ; Emergency Service, Hospital ; Female ; Headache ; Humans ; Intensive Care Units ; Occipital Lobe ; Posterior Leukoencephalopathy Syndrome* ; Pregnancy ; Seizures ; Vomiting

Microsurgical tumor removal is the treatment of choice to relieve the mass effect for the treatment of acoustic neurinoma patients. Gamma knife radiosurgery is another treatment option for patients with tumor size of less than approximately 4cm. Between May, 1990 and March, 1994, 55 tumor lesions from 50 patients were treated with gamma knife radiosurgery at Asan Medical Center. Following microsurgery, 20 patients underwent gamma knife radiosurgery for tumors not removed surgically. The remaining 30 patients underwent gamma knife radiosurgery alone. For an average follow-up period of 26 months(ranging from 6 to 45 months), 37 lesions out of 39 lesions responded, giving a tumor growth control rate of 94.9%. Facial neuropathy and trigeminal neuropathy were noted in 8% and 6%, respectively. According to these results, it is suggested that gamma knife radiosurgery in an effective altrnative therapeutic modality for the management of small to moderate sized acoustic neurinomas.
Acoustics* ; Chungcheongnam-do ; Facial Nerve Diseases ; Follow-Up Studies ; Humans ; Microsurgery ; Neuroma, Acoustic* ; Radiosurgery ; Trigeminal Nerve Diseases

BACKGROUNDS: Moyamoya disease is a progressive occlusive cerebrovascular disease which has characteristics of distal ICA stenosis and basal collateral vessels. Various methods of surgical treatment are recommended in the literatures but surgical strategies and outcome are not well established yet. AIMS AND METHODS: The aims of study is to evaluate surgical outcomes of moyamoya disease and to establish surgical indications. Total 155 patients diagnosed with moyamoya disease since 1990, were analyzed retrospectively. Female was more predominant by 1.5 : 1. There were two peaks of age of onset at the 1st decade (39.0%) and 4th (15.9%). Familial occurrence was 6.8% (n=17). The mean duration of follow-up was 41.1 months (12-156 months). Moyamoya syndrome was excluded in this study. Surgical outcomes were measured by grading activity of daily living (ADL) and prognostic factors were analyzed statistically with SAS. RESULT: The most common clinical presentations were transient ischemic attacks (69.1%), followed by cerebral infarction (26.0%) and hemorrhage (4.9%) in pediatric patients, but in adult hemorrhage (49.2%) was the most prevalent. Recurrence of symptoms developed in 8 patients (11.4%) among 70 of cerebral infarction with mean intervals of 30.8 months and 7 patients (21.9%) among 32 of hemorrhage with mean interval of 42.3 months. Forty five (29.0%) of 155 patients showed stenosis of posterior cerebral arteries on cerebral angiography at the age of diagnosis. The surgical treatment were performed at 183 hemispheres of 115 patients, direct bypass surgery was done in 10 hemispheres, indirect bypass surgery in 169 hemispheres (106 EDAMS, 14 EDAS, 40 frontal EDS or burr hole, 6 EDAMS and EDAS, 3 others), combined direct and indirect bypass surgery in 4 hemispheres. The improvement of ADL was not so different between 68 (59.1%) of 115 patients treated with surgery and 23 (57.5%) in 40 patients with conservative care. The initial and final grade of ADL of pediatric patients were better than those of adult (p<0.01). The grades of ADL of patients with transient ischemic attack were better than those with infarction or hemorrhage (p<0.01). Those patients with recurrent hemorrhage were poorer in the outcome than recurrent infarction (p<0.05). The incidence of recurrent infarction in the surgical cares was lower than that in conservative care (5.9% vs 26.3%, p<0.05), but there was no statistical difference between two groups with regard to rebleeding (8.3% vs 30.0%, p>0.1). Significant prognostic factors affecting outcomes of moyamoya disease age at onset, clinical features, and initial grade of ADL. CONCLUSION: Children with transient ischemic attack were the best, but adults with recurrent hemorrhage were the worst in outcomes. Surgical treatment for moyamoya disease should be carefully tailored according to age of onset and clinical features regardless of surgical methods. Further prospective study is indicated to determine optimal treatment guideline for moyamoya disease.
Activities of Daily Living ; Adult ; Age of Onset ; Cerebral Angiography ; Cerebral Infarction ; Child ; Constriction, Pathologic ; Diagnosis ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Infarction ; Ischemic Attack, Transient ; Moyamoya Disease* ; Posterior Cerebral Artery ; Recurrence ; Retrospective Studies

No abstract available.

PURPOSE: Ganglioglioma is a rare primary brain tumor usually found in the temporal lobe. The purpose of thisstudy is to describe the characteristic MR findings of temporal lobe ganglioglioma. MATERILA AND METHODS: Over aseven-year period, ten patients with cerebral ganglioglioma were evaluated at our institution. Seven cases oftemporal lobe ganglioma were found ; six of these involved men, and one, a woman ; their mean age was 29.6 years.In three patients, Gd-DTPA-enhanced T1 weighted images were also obtained. We retrospectively analysed the MRIfindings with respect to location, size, cortical involvement, margin, cystic change, degree of enhancement, MRsignal intensity, calcification and peritumoral change. RESULTS: In five cases, tumors were located within thetemporal lobe. In one, a tumor extended from the temporal lobe to the thalamus, and in one from the temporal lobeto the thalamus and cerebral peduncle. All temporal gangliogliomas measured 1.6-3.8cm in their greatestdiameter(mean diameter, 2.7cm). In all cases, the cortices were involved with the maintenance of gyriform. Thetumor margin was ill defined in five cases and well defined in two. Tumors showed multiple small cystic changes infour cases, a large cyst in two, and a solid nodule in one. In three cases in which contrast media wasadministered, no lesions were enhanced. On T1-weighted images, iso-signal intensities were seen in five cases andhigh signal intensities in two. On T2-weighted images, the corresponding figures were five and two. On MRI, tumorcalcification and calvarial erosion were each detected in two cases. CONCLUSION: In patients with temporal lobeepilepsy in whom cortical solid or cystic and poorly enhanced lesions were seen on brain MRI, and in whomaccociated findings such as calcification and or adjacent bony erosion were noted, ganglioglioma must beconsidered.
Brain ; Brain Neoplasms ; Contrast Media ; Female ; Ganglioglioma* ; Humans ; Magnetic Resonance Imaging* ; Male ; Retrospective Studies ; Tegmentum Mesencephali ; Temporal Lobe* ; Thalamus

OBJECTIVES: Though gastric cancer is one of the most common cancer in Korea, there have been few studies to explore psychological distress in gastric cancer. The purpose of this study was to investigate the prevalence and associated risk factors of psychological distress among patients with gastric cancer. METHODS: With consecutive sampling, a total of 274 patients with gastric cancer who admitted to a cancer center in a general hospital were recruited and assessed on psychological distress using the Hospital Anxiety and Depression Scale(HADS). Sociodemographic and cancer-related clinical variables were also evaluated. RESULTS: One hundred fifty-three(55.8%) patients with gastric cancer showed psychological distress. Logistic regression models revealed that having alcohol drinking experience[odds ratio(OR)=2.10, p=0,034] and low performance status(OR=2.40 p=0.002) were significantly associated with psychological distress in patients with gastric cancer. CONCLUSIONS: These findings indicate that approximately half of patients with gastric cancer suffered from psychological distress and having alcohol drinking experience and low performance status would be associated risk factors, suggesting the need for distress screening and psychosocial supportive care in patients with gastric cancer.
Alcohol Drinking ; Anxiety ; Depression ; Hospitals, General ; Humans ; Korea ; Logistic Models ; Mass Screening ; Prevalence ; Risk Factors ; Stomach Neoplasms