Malignant fibrous histiocytoma is a pleomorphic sarcoma in adults, which occurs principally as a mass on an extremity or in the abdominal cavity or retroperitoneum. It typically involved deep fascia or skeletal muscle and only rarely was confined to the subcutis without fascial involvement. Malignant fibrous histiocytomas developed in the intraabdominal organs are very rare and only few cases have been reported until now. Here, we report a case of malignant fibrous histiocytomar developed in the stomach of a 46-year old male who showed clinical and histologic features of malignant fibrous histiocytoma without any identified etiologic factors. The patient was treated successfully with surgery, and has had no recurrence since, during the ensuring one and a half yars.
Abdominal Cavity ; Adult ; Extremities ; Fascia ; Histiocytoma, Malignant Fibrous* ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; Recurrence ; Sarcoma ; Stomach*

We have studied 286 cases of intracranial aneurysm patients, who were admitted, surgically treated and registered at Korea University Medical Center between January, 1980 and February, 1989. This report resents an analysis of 286 cases of surgically treated intracranial aneurysms. The following results were obtained; 1) Intracranial aneurysm was the most common in the 6th decade(100 cases, 35.0%) and the next order was in the 5th decade(82 cases, 28.7%). 2) The male to female ratio was 1 : 1.53, but male predominant below 4th decade. 3) Aneurysmal size was the most common between 3mm and 10mm(264 cases, 85.2%). 4) The most frequent site was anterior communicating artery(102 cases, 32.9%) and the next order was posterior communicating artery(90 cases, 29.0%). 5) The incidence of multiple aneurysm was 6.6%(19 cases). 6) The incidence of single unruptured aneurysm was 7.6%(19 cases), its most common initial symptom was 3rd cranial nerve palsy. 7) The initial clinical status of patients seems to parallel the postoperative prognosis. 8) The degree of cerebral vasospasm on angiography seems to parallel the postoperative prognosis. 9) Postoperative mortality was 10.8%, but it was 3.8% in operation cases after January, 1986. 10) The most common cause of postoperative mortality was cerebral vasospasm(38.7%), and the next order was rebleeding(19.4%).
Academic Medical Centers ; Aneurysm ; Angiography ; Cranial Nerve Diseases ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Korea ; Male ; Mortality ; Prognosis ; Vasospasm, Intracranial

OBJECTIVE: We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. METHODS: In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. RESULTS: Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. CONCLUSION: Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.
Abducens Nerve Diseases ; Carotid Artery, Internal ; Cavernous Sinus ; Cranial Fossa, Anterior ; Cranial Fossa, Middle ; Cranial Fossa, Posterior ; Craniopharyngioma ; Facial Paralysis ; Follow-Up Studies ; Hearing Loss ; Humans ; Hypesthesia ; Meningioma ; Neurilemmoma ; Oculomotor Nerve Diseases ; Paresis ; Pituitary Neoplasms ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Skull Base*

Although a pathogenic mechanism of hemolytic anemia complicated with viral hepatitis is unknown, it is suggested that there are four mechanisms; 1) In the individual who has predisposition to hemolytic anemia, viral infection accelerates the red cell destruction & hemolysis become obvious. 2) Directly, virus itself injures to the red cell membrane. 3) The serious liver failure & hypersplenism induce the hemolysis. 4) Autoimmune hemolytic anemia because of immunological abnormality caused by viral infection. We experienced a case of autoimmune hemolytic anemia in 33-year-old male patient who was diagnosed as chronic lobular hepatitis B with biopsy. Diagnosis was estabilished by clinical features, blood cell count, routine urinalysis, direct & indirect Coombs test, liver function test, immunoglobulin quantitations, hepatitis B marker, bone marrow aspiration, and liver biopsy. This case was treated with corticosteroid and transfusion. During follow-up, he has been well tolerated.
Adult ; Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune* ; Biopsy ; Blood Cell Count ; Bone Marrow ; Cell Membrane ; Coombs Test ; Diagnosis ; Follow-Up Studies ; Hemolysis ; Hepatitis B* ; Hepatitis* ; Humans ; Hypersplenism ; Immunoglobulins ; Liver ; Liver Failure ; Liver Function Tests ; Male ; Urinalysis

17 -Hydroxylase deficiency is a rare form of congenital adrenal hyperplasia that is characterized by primary amenorrhea, absence of secondary sex characteristics, hypertension, and a hypokalemic alkalosis that has resulted resulting from increased production of deoxycorticosterone and corticosterone by the adrenal. The diagnosis of this enzyme deficiency can be recognized by the increasing serum concentrations of steroid precursors, DOC and corticosterone and the decreasing concentrations of cortisol, and adrenal androgens. We diagnosed this in a 19 year old female who presented with primary amenorrhea. We report this case with a review of the literatures.
Adrenal Hyperplasia, Congenital ; Alkalosis ; Amenorrhea* ; Androgens ; Corticosterone ; Desoxycorticosterone ; Diagnosis ; Female ; Humans ; Hydrocortisone ; Hypertension ; Sex Characteristics ; Young Adult