No abstract available.
Echocardiography* ; Endocarditis*

Squamous cell carcinoma arising in mature cystic teratoma of the ovary is an uncommon carcinoma that is histologically defined by the presence of squamous cell carcinoma within the mature cystic teratoma of the ovary. Although all three germ layers in benign cystic teratoma are thought to undergo malignant transformation, squamous cell carcinoma derived from ectoderm is by far the most common tumor. Clinical differentiation of malignant from benign mature teratomas, as well as from other ovarian tumors, is rarely possible preoperatively. The prognosis is generally poor but there is no consensus on optimal therapy and prognostic factor. We experienced one case of squamous cell carcinoma arising in benign cystic teratoma of the ovary in a 27 year old woman and report this case with a brief review of the concerned literature.
Adult* ; Carcinoma, Squamous Cell* ; Consensus ; Ectoderm ; Female ; Germ Layers ; Humans ; Ovary* ; Prognosis ; Teratoma*

PURPOSE: The mechanisms, which alter urinary bladder muscle function during infectious cystitis, are poorly understood. The objective of this study was to identify potential resident targets for endotoxin lipopolysaccharide(LPS) within normal bladder smooth muscle and test the hypothesis that LPS induces an inflammatory response within the bladder muscle and that this is associated with a decrease in muscle contractility. MATERIALS AND METHODS: Male rats were studied 24 hours after a single bolus i.p. injection of LPS(15mg/kg). Whole-mount preparations of the bladder muscle were immunohistochemically stained for neutrophils(myeloperoxidase), macrophages(ED2), activated leukocytes(LFA-1) and mast cells(FITC-Avidin). Contractile activity was assessed from muscle strips of the bladder in response to bethanechol(0.3-300microM). Voiding frequency and urine volume for 24 hours were measured using metabolic cage. Cystometry was performed to measure the intravesical bladder pressure. RESULTS: Using the resident macrophage marker ED2, dense network of macrophages were observed within the bladder muscle of control and LPS treated rats. Few neutrophils(myeloperoxidase-positive cells, 2.3 +/- 0.38 cells, x200) were detected in whole-mounts of bladder muscle of control rats, while LPS pretreatment resulted in a significant increase in the number of neutrophils which demonstrate inflammatory response(10.8 +/- 1.70 cells, x200, p<0.001). LFA-1 immunohistochemistry demonstrated an increased presence of LFA-1 positive cells in bladder muscle of LPS treated rats, which had a morphology similar to both neutrophils and resident macrophages. The expression of LFA-1 is known as a marker of cells that are in an activated state. LPS pretreatment resulted in a significant reduction in bladder muscle contractions in response to bethanechol(i.e. control = 0.049 +/- 0.010 vs. LPS= 0.029 +/- 0.003 gr/mm2/sec, 100microM, p<0.05). Voiding frequency of LPS treated rats was significantly increased compared to that of control rats. In LPS treated rats, voiding phase representing bladder contractility in cystometry was observed. CONCLUSIONS: These data demonstrate that a single intraperitoneal injection of LPS initiates an inflammatory response within the bladder muscle that is associated with a decrease in the functional activity of the bladder. We hypothesize that secretions from the resident macrophages and extravasated leukocytes within the muscle cause the observed suppression in bladder muscle activity in vitro.
Animals ; Cystitis ; Humans ; Immunohistochemistry ; Inflammation* ; Injections, Intraperitoneal ; Leukocytes ; Lymphocyte Function-Associated Antigen-1 ; Macrophages ; Male ; Muscle Contraction ; Muscle, Smooth ; Neutrophils ; Rats* ; Urinary Bladder*

Spontaneous spinal epidural hematoma is a rare cause of spinal cord compression. Recently, at our hospital, the author et al had the opportunity of observing case with spontaneous cervical epidural hematoma in a 28 years old woman who had suddenly felt a strong pain in interscapular area. Rapidly after she noticed weakness in her legs and one day later she was completely paraplegia. The MRI of spine was done. There show tubular like low signal intensity at posterior epidural space of C7 level and ghigh signal intensity of cord at C7 level due to cord compression effect. In this article, we are adding one more rare case of spontaneous cervical spinal epidural hematoma confirmed by MRI.
Adult ; Epidural Space ; Female ; Hematoma ; Hematoma, Epidural, Spinal* ; Humans ; Laminectomy ; Leg ; Magnetic Resonance Imaging ; Paraplegia ; Spinal Cord Compression ; Spine

Gastric submucosal tumors are occasionally symptomatic (bleeding) but usually found incidentally at endoscopy. To evaluate comparisons of gastric endoscopy and upper gastrointestinal series in the submucosal tumor, we studied 50 patients which were diagnosed as submucosal tumor at SNUH from 1985 to 1988. The results were as follow: 1) Gastric submucosal tumors occupied 2.2% of the stomach cancer. (continue...)
Endoscopy* ; Humans ; Stomach Neoplasms

BACKGROUND/AIMS: Microsatellite instability (MSI) reflects the defect in DNA mismatch repair (MMR) pathways and plays an important role in certain malignancies. However, the role of MSI in the development of gastric B-cell lymphomas remains unsettled. We aimed to investigate the clinical significance of MSI in patients with gastric B-cell lymphoma. METHODS: Seven micosatellite loci (BAT25, BAT26, D2S123, D5S346, D17S250, D14S50, IGF-IIR) were used for MSI analyses. Microsatellite genotypes were categorized as microsatellite stable (MSS, no positive marker), low frequency MSI (MSI-L, <40% positive marker) and high frequency MSI (MSI-H, >40% positive marker). Among the gastric B-cell lymphoma patients who underwent MSI analysis between September 2002 and May 2003, twenty-two patients were enrolled. Median follow-up duration was 23 months (6-32 months). RESULTS: Median age was 46 years (26-73 years). Male to female ratio was 1:1.4. Twelve patients (54.5%) underwent Helicobacter pylori (H. pylori) eradication and ten patients (45.5%) underwent chemoradiation therapy. No case presented MSI-H. MSI-L was observed in 40.9% (9/22). Between MSS group and MSI-L group, there was no significant difference in age, tumor stage, location, grade of large cell component, H. pylori infection, bulk of tumor and proportion of regression or recurrence. All positive markers belonged to the dinucleotide markers. CONCLUSIONS: The current study suggests that the role of MSI is questionable in the development of gastric B-cell lymphoma due to their low incidence.
Adult ; Aged ; Female ; Helicobacter Infections/genetics ; Helicobacter pylori ; Humans ; Lymphoma, B-Cell/*genetics ; Male ; Microsatellite Repeats/*genetics ; Middle Aged ; Stomach Neoplasms/*genetics

Neuroendocrine carcinoma of the colon is a very rare entity. However, this type of tumor is known to have aggressive progression and poor prognosis. A case of a 72-year-old male is presented in this report. A 3 cm sized tumor was found on the rectum with multiple liver metastases. The pathological findings including a positive immunohistochemical staining for synaptophysin and cytokeratin done with colonoscopic biopsy and liver biopsy confirmed the tumor as a neuroendocrine carcinoma. The nomenclature and definition of this disease still remains somewhat unclear, and not a small population of this disease may thus have been misdiagnosed and treated as other less aggressive entities, such as carcinoid tumor. The necessity to make an accurate differential diagnosis in such cases is thus emphasized because of different treatments and clinical courses. For its rarity and clinical significance, we report this case with a review of the literatures.
Aged ; Biopsy ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Colon ; Diagnosis, Differential ; Humans ; Keratins ; Liver ; Male ; Neoplasm Metastasis ; Prognosis ; Rectum* ; Synaptophysin

Neuroendocrine carcinoma of the colon is a very rare entity. However, this type of tumor is known to have aggressive progression and poor prognosis. A case of a 72-year-old male is presented in this report. A 3 cm sized tumor was found on the rectum with multiple liver metastases. The pathological findings including a positive immunohistochemical staining for synaptophysin and cytokeratin done with colonoscopic biopsy and liver biopsy confirmed the tumor as a neuroendocrine carcinoma. The nomenclature and definition of this disease still remains somewhat unclear, and not a small population of this disease may thus have been misdiagnosed and treated as other less aggressive entities, such as carcinoid tumor. The necessity to make an accurate differential diagnosis in such cases is thus emphasized because of different treatments and clinical courses. For its rarity and clinical significance, we report this case with a review of the literatures.
Aged ; Biopsy ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Colon ; Diagnosis, Differential ; Humans ; Keratins ; Liver ; Male ; Neoplasm Metastasis ; Prognosis ; Rectum* ; Synaptophysin

Four cases of intracerebral hemorrhage remote from the site of initial supratentorial craniotomy are presented. Traumatic cases are excluded in this report and all cases developed after uneventful elective craniotomy. Two patients had ruptured aneurysm and the other two had giant supratentorial tumors, one craniophayrngioma and one ependymoma. All patients were operated on supine position and no patient had preoperative hypertension. Two had hematoma in the sucortical white matter, one in the cerebellar hemisphere and the other one showed hematoma both in the cerebellar hemisphere and the supratentorial subcortical area. The size of hematoma ranged from 8-20cc in volume. No definite cause could be found except one in which the blood pressure was transiently elevated during induction of anesthesia. A possible cause might be the sudden changes of blood pressure during induction and recovery from anesthesia, overdrainage of CSF, continuous CSF drainage and sudden changes in intracranial dynamics by removal of a huge intracranial mass. One patient with intracerebellar hemorrhage needed emergency suboccipital craniectomy for removal of the hematoma. One patient shows no improvement due to aspiration pneumonia and subsequent lung abscess. Although rare, these conditions may occur after any craniotomy and surgeons should always be alert to the possibilities of such comlication, especially when intracranial pressure(ICP) was elevated.
Anesthesia ; Aneurysm, Ruptured ; Blood Pressure ; Cerebral Hemorrhage ; Craniotomy ; Drainage ; Emergencies ; Ependymoma ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Lung Abscess ; Pneumonia, Aspiration ; Supine Position ; Supratentorial Neoplasms

Two cases of redundant nerve root syndrome of cauda equina in patient was described. The general clinical features were the intermittent neurologic claudication with improvement at rest, low back pain of long duration and radicular pain in one or both legs, sensory & motor change in one or both legs. Myelography revealed a partial to complete block with characteristic serpentine filling defects above or below the block simulating a vascular malformation. One case was associated with lumbar H.N.P and the other cases were associated with L-H.N.P and pseudospondylolithesis. In addition to, we reviewed the literature of redundant nerve root syndrome of the cauda equina.
Cauda Equina* ; Humans ; Leg ; Low Back Pain ; Myelography ; Vascular Malformations