No abstract available.
Child* ; Humans ; Infant* ; Intussusception*

Graves disease occur in association with myasthenia gravis is rare. We report a case of Graves disease and myasthenia gravis treated by bilateral subtotal thyroidectomy and total thymectomy simultaneously. A 37 year old woman was admitted with anterior neck mass and ptosis. Various examinations were compatible with combined Graves disease and myasthenia gravis. The bilateral subtotal thyroidectomy and total thymectomy were done simultaneously. The pathologic diagnosis was Graves disease and thymic hyperplasia. The patients postoperative course was uneventful. The thyroid function of patient became euthyroid and the clinical symptoms related with myastenia gravis resolved during follow up period.
Adult ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease* ; Humans ; Myasthenia Gravis* ; Neck ; Thymectomy* ; Thymus Hyperplasia ; Thyroid Gland ; Thyroidectomy*

Cerebral aspergillosis is a rare condition that affects primarily the immunocompromised host. Most of cerebral aspergillosis is developed by hematogenous dissemination from extracranial foci, but aspergillosis of sino-nasal origin rarely affects the CNS. In case 1, wel symptom of tumor recurrence was unilateral numbness of the chin. A 65-year-old male was admitted because of paresthesia around the left chin and left lower lip. Neurologic examination revealed hypesthesia on the left side of chin, lower lip and buccal mucous mem-brane. Bone scan (Tc-99m MDP) showed focal hot uptakes on the left mandible and left first rib. Brain CT with bone window setting showed a focal osteolytic lesion in the bone marrow of the left mandibular canal without destruction of bone cortex. Both coronal T1 weighted image and axial T2 weighted image showed focal low signal intensities on the left ramus. The pathophysiologic mechanism could be understood by identification of the pathologic focus.
Aged ; Aspergillosis* ; Bone Marrow ; Brain ; Chin ; Humans ; Hypesthesia ; Immunocompromised Host ; Lip ; Male ; Mandible ; Neurologic Examination ; Paresthesia ; Recurrence ; Ribs

Computed tomographic findings of 24 cases of cervical tuberculous lymphadenitis were retrospectively analyzed. We classified the CT findings as 4 types: type 1(homogeneous soft tissue density mass), type 2(central low density with peripheral rim enhancement and with preservation of surrounding fat plane), type 3(central low density with peripheral rim enhancement and with obliteration of surrounding fat plane), type 4(large confluent low density mass, so called "cold abscess") As a result, there were 2 cases(8.3%) of type 1, 7 cases(29.2%) of type 2, 9 cases(37.5%) of type 3, 3 cases(12.5%) of type 4, 1 cases(4.2%) of type 1 combined with type 3, and 2 cases(8.3%) of type 2 combined with type 4. So 22 cases(91.7%) revealed central low density and peripheral rim enhancement, which suggest necrosis. The maximum thickness of enhancing rim was above 2mm in all of 64 definable necrotic lymph nodes and above 4mm in 42(65.5%) lymph nodes, suggesting that the wall of necrotic tuberculous lymphadenitis tends to be thick. We conclude that CT is useful not only for the diagnosis but also for the evaluation of the extent and the status of cervical tuberculous lymphadenitis.
Diagnosis ; Lymph Nodes ; Necrosis ; Retrospective Studies ; Tuberculosis, Lymph Node*

Periprosthetic fractures after total hip arthroplasty or hemiarthroplasty are an uncommon complication. These fractures have problems of fixation of fracture and stability of the femoral component. Ipsilateral femoral fractures after hip arthroplasty occurred in 14 cases (11 patients) out of 510 hip arthroplasties performed between January 1985 and May 1996. These fractures occurred at an average of 3 years and 6 months after primary hip arthroplasty. These fractures were classified by Johansson classification. Nine fractures were treated with plate and cerclage wires. Four fractures were treated with skeletal traction. Bone graft was applied to the fracture site in 9 fractures which were treated by open reduction and internal fixation with plate and cerclage wires. Average follow up period was 21 months. The results were as follows. 1. All but three of the fractures had been developed by low energy trauma. Seven patients had osteolytic lesion around femoral component. Of the seven patients who had osteolytic lesions, six patients had periprosthetic fractures which connected with osteolytic lesions. We think that osteolysis is one of the important factors of the periprosthetic fractures after hip arthroplasty. 2. Four cases were treated by skeletal traction. One case had malunion. Progressive subsidence of femoral component was noted after union of fracture in 3 cases. Therefore these periprosthetic fractures which had an osteolysis and subsidence preoperatively should be managed with operative methods. 3. Nine fractures which had treated with plates and autogenous bone graft showed good hip joint function with stable femoral component. We think that stabilization of periprosthetic fractures with plates and cerclage seemed to be a good method for femoral fractures after hip arthroplasty.
Arthroplasty* ; Arthroplasty, Replacement, Hip ; Classification ; Femoral Fractures* ; Follow-Up Studies ; Hemiarthroplasty ; Hip Joint ; Hip* ; Humans ; Osteolysis ; Periprosthetic Fractures ; Traction ; Transplants

No abstract available.
Anal Canal* ; Rectum*

OBJECTIVE: The aim of the present study was to evaluate the E-cadherin expression in normal cervical epithelium, carcinoma in situ of the cervix, and invasive carcinoma of the cervix, and to define the role of E-cadlherin expression in tumor invasion with respect to clinicopathologic parameters. METHODS: We conducted immunodetection of E-cadherin in 58 cases of cervical carcinoma using immunohistochemistry in formalin-fixed, paraffin-embbeded sections, RUSULTS: E-cadherin expression was different between normal cervical epithelium and carcinoma in situ of the cervix, and between normal cervical epithelium and invasive carcinoma of the cervix(p<0.05). However, there was no difference in E-cadherin expression between carcinoma in situ and invasive carcinoma of the cervix. In invasive cervical carcinomas, expression of E-cadherin and the intensity of cytoplasmic E-cadherin expression did not correlate with histologic type, lymphvascular space invasion, lymph node metastasis, and stage of disease. CONCLUSION: It is mncluded that expression of E-cadherin is related to tumor invasion in cervical tissues, but further studies with regard toE-cadherin/catenin/cytoskeleton complex are needed to clarify the prognostic role of E-cadherin with respect to clinicopathologic parameters in invasive cervical carcinoma,
Cadherins ; Carcinoma in Situ ; Cervix Uteri* ; Cytoplasm ; Epithelium ; Female ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Uterine Cervical Neoplasms

No abstract available.
Plasma* ; Prostate* ; Prostatic Neoplasms* ; Stomach Neoplasms*

PURPOSE: To understand the normal endosonographic anatomy of the perianal spaces, and to evaluate the diagnostic efficacy and limitation of endorectal sonography(EUS), correlative study with MRI, cadaveric sectional image and cadaveric MRI were performed. MATERIALS AND METHODS: EUS images of the normal 6 perianal spaces (pelvirectal, ischiorectal, intersphincteric, subcutaneous, central, submucous space) which were bounded by internal and external anal sphincters, rectal wall and levator ani muscle were correlated with MRI in 10 normal persons, cadaveric sectional images and cadaveric MRI in 2 cadavers. RESULTS: Pelvirectal space located superior to levator ani muscle could be demonstrable only on anterior wall scan but could not be visualized on lateral or posterior wall scan on EUS. Five perianal spaces located inferior to levator ani muscle were well seen on anterior, lateral, and posterior wall EUS. MRI was superior to EUS in the evaluation of pelvirectal and ischiorectal spaces but equal or inferior to EUS in the evaluation of intersphincteric, subcutaneous, central and submucous spaces. CONCLUSION: EUS was valuable in the evaluation of perianal spaces inferior to levator ani muscle but was limited in the evaluation of perianal spaces superior to levator ani muscle.
Anal Canal ; Cadaver* ; Humans ; Magnetic Resonance Imaging*

CD44 is a cell-surface glycoprotein postulated to play a role in tumor cell metastasis. Aberrant expression of the cell adhesion molecule CD44 has been detected in human tumors and the expression of specific isoforms(splice variants) has been shown to be associated with metastasis and poor prognosis in human malignancies. We used variant exon sequence-specific monoclonal antibody to epitope encoded by exon v6 of human variant CD44 to study the expression of CD44 splice variant by immunochemistry in fifty nine samples of human cervical cancer. twenty seven tissue samples of cervical intraepithelial neoplasia(CIN) and normal cervix were included in this study. CD44v6 was stained positive in the basal and parabasal layer of normal epithelial cells homogenously but was absent in the stromal cells. The intensity of CD44v6 staining was the strongest in invasive squamous cell carcinoma followed by normal cervical epithelium, CIN, adenocarcinoma. In the malignant samples, heterogeneity in staining intensity among different clusters of tumor cells was observed. Furthermore the intensity of staining was stronger in proportion to stage, depth of invasion, lymphovascular invasion(p<0.05), and lymph node metastasis(p=NS). This study suggest that the expression of CD44v6 adhesion molecule may be useful value in predict the high stage, depth of invasion, lymphovascular invasion and lymph node metastasis probably.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Adhesion ; Cervix Uteri ; Epithelial Cells ; Epithelium ; Exons ; Female ; Glycoproteins ; Humans ; Immunochemistry ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Population Characteristics ; Prognosis ; Stromal Cells ; Uterine Cervical Neoplasms*