Teratocarcinoma is a form of mixed germ cell tumor composed of a mixture of teratoma and embryonal carcinoma. It is rarely found in the brain, but when present it is most commonly found in the pineal region. We investigated a case of primary teratocarcinoma in the pineal region. The patient was a 10 year old boy who had suffered from a bitemporal headache for one month. Brain CT and MRI revealed a rather well defined ovoid heterogenous mass in the pineal gland region, measuring 4.3 x 3.8 x 3.0 cm in size. Microscopically the tumor contained areas of immature teratoma and embryonal carcinoma. Immunohistochemical staining revealed positive reactions for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen, and alpha-fetoprotein in the embryonal carcinoma component.

The clincopathologic features of microcystic adnexal carcinoma are presented. Microcystic adnexal carcinoma is a recently described, very rare neoplasm characterized by a locally aggressive growth pattern, and as far as we know, only two reports on the microcystic adnexal carcinoma have been published in the Korean literature. Recently we experienced two cases of microcystic adnexal carcimoma occurred in a 32-year-old male and 27-year-old female patient. They had 2.5 x 2.0 x 2.0 cm and 1.2 x 0.9 x 0.9 cm sized, slowly growing mass in the glabella and below the lower lip, respectively. The immunohistochemical staining for CEA antigen stains the glandular structures but not pilar structures. So we thinked that this tumor would be originated from primitive adnexal cells differentiating into both pilar and eccrine structures.
Female ; Male ; Humans

PURPOSE: Right middle lobe symdrome is characterized by a spectrum of disease from recurrent atelectasis and pneunomitis to brobchiectasis of the Right middle lobe symdrom. It was first reported gy Grahm describing 12 patients with middle loge atelectasis and bronchiectasis due to enlarged lymph nodes. The incidence of Right middle lobe syndome seems tobe increasing in children, byt there have been only a few studies of right middlelobe syndrome in Korea. METHODS: Twenty-five children with RMLS who had been admitted during the last 10 years were evaluated with particular attention to clinical features, laboratory results, bronchographic findings, and treatment RESULTS: All patients were symptomatic and complained of chronic cough(25), sputum(20), fever(16), dyspnea(3), vomiting(2), and foreign body in the bronchus(2). Most of the patients had recurrent pneumonia: 6 patients had Mycoplasma pneumonia, and 6 patients had ashma and allergic disorders. Only 5 out of the 25 patients showed sufficient obstruction on bronchography and 6 patients took computed tomography scans. Chest radiography, bronchography and computed tomography scans were evaluated for review in 25 patients showing consolidation(17), patchy infiltration(14), atelectasis(12), hyperinflation(5), bronchiectasis(2), and air bronchogram(2). Most patients were improved by conservative medical management and only 2 patients had closed thoracostomy. CONCLUSION: These 25 patients who had been diagnosed as Right middle lobe syndrome were improved after 2 week treatment of antibiotics and conservative management and their prognosis were good during the follow-up period.
Anti-Bacterial Agents ; Bronchiectasis ; Bronchography ; Child ; Follow-Up Studies ; Foreign Bodies ; Humans ; Incidence ; Korea ; Lymph Nodes ; Middle Lobe Syndrome* ; Pneumonia ; Pneumonia, Mycoplasma ; Prognosis ; Pulmonary Atelectasis ; Radiography ; Thoracostomy ; Thorax

Three hundred ninety potentially curative resections for an adenocarcinoma of the stomach were performed in the Surgical Department of Chonbuk National University Hospital between 1991 and 1995. Eighty-nine patients were over 65 years of age, and three hundred-one patients were under 65 years of age. Pre-operative risk factors were statistically common in the over 65-years-old group(p<0.0044). Among the risk factors, pulmonary dysfunction was the most common pre-operative risk factor in both age groups, but diabetes mellitus was statistically significant factor in the under 65-years-old group. The incidence of post-operative complications revealed no statistical difference between two groups, and diarrhea was the most common complication in both groups. The incidence of complications increased when the disease was in an advanced stage and we did an extended operation, including a gastrectomy and a lymphadenectomy, but there was no statistical difference between the two age groups. The 3-year survival rate was higher when we did a curative resection with a subtotal or a total gastrectomy with a D2 lymphadenectomy than when we did non-curative resection, but there was no statistical difference between the two age groups. Hence, a curative resection including a radical gastrectomy with a D2 lymphadenectomy, if it is indicated, is reasonable approach for improving the survival rate in patients with an adenocarcinoma of the stomach, even elderly patients over 65 years of age.
Adenocarcinoma ; Aged* ; Diabetes Mellitus ; Diarrhea ; Gastrectomy ; Humans ; Incidence ; Jeollabuk-do ; Lymph Node Excision ; Risk Factors ; Stomach ; Stomach Neoplasms* ; Survival Rate*

BACKGROUND: Exofocal neuronal death in the substantia nigra (SN) is a well-known form of anterograde transsynaptic cell death. Exofocal neuronal death could theoretically also occur in the globus pallidus (GP) after striatal injury. CASE REPORT: Case 1. A 70-year-old woman visited the emergency room because of decreased mentality. On admission, blood-gas analysis indicated that her oxygen tension was 69.1 mm Hg. The caudate nucleus, putamen, and temporooccipital cortex on both sides of the brain exhibited high-intensity diffusion-weighted magnetic resonance imaging (MRI) signals. At 10 days after admission, new high-intensity signals had developed in the SN and GP on both sides. Case 2. A 48-year-old man visited the emergency room because of right-sided weakness. Lesions were noted in the left caudate nucleus and putamen. At 4 days after admission, newly developed high-intensity MRI signals were observed in the left SN and GP. CONCLUSIONS: Exofocal neuronal death can occur in the GP as well as in the SN; these findings need to be clearly distinguished from those of recurrent ischemic injuries, such as recurrent stroke.
Brain ; Caudate Nucleus ; Cell Death ; Emergencies ; Female ; Globus Pallidus ; Humans ; Magnetic Resonance Imaging ; Neurons ; Oxygen ; Putamen ; Stroke ; Substantia Nigra

The Flow cytometric analysis of DNA in tumors have been reported to reflect the cellular activities and proliferative rates. Currently, it has been used to predict the prognosis and responsiveness of tumors to various modality of therapy. The author analyzed thirty seven meningiomas(7 syncytial, 9 transitional, 6 fibroblastic, 9 angioblastic, 6 atypical) using paraffinembeddede tissues. The ploidy pattern and relative value(%) in the GO/GI, S, and G2/M phases were calculated for each specimen. In our series, All were diploid types except 6 meningiomas(2 syncytial, 2 angioblastic, 2 atypical). Diploidy with weak tetraploidy(upto 10%) was found in 8 cases(40% of atypical, 33% of fibrobiastic and transitional) but not in syncytial meningioma. Diploidy with strong teraploigy(10-25%) was found in 1 transitional, 1 angioblastic meningioma. There was wide variation in 4C values even in the same subgroups of meningiomas. The distribution of P. I values is even and lower especially in fibroblastic meningiomas. On the contrary, the distribution of P. I values is relatively uneven and highly variable in other types of meningiomas & even in the same subgroups of meningiomas except fibroblastic meningioma. The prediction of recurrences in operated cases remained further investigation due to lack of long-term follow-up.
Diploidy ; DNA* ; Fibroblasts ; Flow Cytometry ; Meningioma* ; Ploidies ; Prognosis ; Recurrence

We studied the status of estrogen(ER) and progesterone(PR) receptors in meningiomas removed from 32 patients, using immunoperoxidase(IP) assays. PR were detected in 72% of the cases & ER were detected in 31%. The possible correlation between age, sex, histological type, ploidy pattern and proliferation index values with steroid receptor activity were discussed. The date suggest that the majority of meningiomas contain high affinity receptors for progesterone, that estrogen receptors are present in only a few meningiomas.
Estrogens* ; Humans ; Meningioma* ; Ploidies ; Progesterone* ; Receptors, Estrogen ; Receptors, Progesterone* ; Receptors, Steroid

The posterior fossa tumors were reviewed from January 1980 through September 1988. During that time, 72 tumors were diagnosed, with a male: female ratio of 1 : 1.8. The distribution of histopathologic types was; 17 acoustic neuromas(23%), 14 astrocytomas(19%), 8 hemangioblastomas(11%), 8 meningiomas(11%), 7 medulloblastomas(10%), 6 stem gliomas(8%), 4 metastatic tumors(5%), 3 granulomas(4%). The most common presenting symptoms were headache, nausea and vomiting, dizziness, diplopia and hearing diffrculty. Twenty-five patients(37%) showed hydrocephalus on CT scan. For the entire series of 60 patients operated on, results were: 31% excellent, 37% good, 8% fair, 13% poor and 10% Dead. Individuals with meningioma, acoustic neuroma or hemangioma were more favorable prognostically. With survival time should be further investigated for postoperative irradiation and chemotherapy.
Acoustics ; Diplopia ; Dizziness ; Drug Therapy ; Female ; Headache ; Hearing ; Hemangioma ; Humans ; Hydrocephalus ; Infratentorial Neoplasms ; Male ; Meningioma ; Nausea ; Neuroma, Acoustic ; Tomography, X-Ray Computed ; Vomiting

Immunohistochemical study of gliomas was maed using the indirect Avidin-Biotin Complex(ABC) method in order to investigate the presence and patterns of distribution of GFAP, neurofilament, and S-100 protein in 37 cases of human gliomas. Generally, two immunostaining patterns were observed; perikaryal and diffuse fibrillary background staining. All of the glial tumor cases were stained positively for GFAP except for the 3 oligodendrogliomas. The S-100 protein was sensitive for all the glial tumors and for neurofilament, in about half of the cases. These observations support previous reports that GFAP is specific for astrocytes, and that S-100 protein is sensitive, but not specific for glial tumors. Furthermore, our data suggest that immunostaining patterns of G.M. is different from that of astrocytoma grad II and III.
Astrocytes ; Astrocytoma ; Glioma* ; Humans ; Immunohistochemistry ; Oligodendroglioma ; S100 Proteins*

The author has investigated the protective effects of systemic Heparin and intrathecal Urokinase in the multi-hemorrhage canine model of severe chronic cerebral vasospasm. Each of 20 adult mongrel dogs was assigned to one of three experimental groups. All animals received a total of 12ml of fresh unheparinized autologous blood via three cisternal injections. Selective vertebral angiograms were obtained before and 8 days after the initial subarachnoid blood injection. Seven animals were treated by systemic Heparin for 7 days, the other seven were treated by intracisternal Urokinase for 3 days, and the remaining were not treated. Comparisons were based on the percentage of reduction in basilar artery diameter(% RBAD). The ultrastructural changes were studied by transmission electron microscopy(TEM). There was a mean reduction(+/-standard deviation) of 65+/-7% in control dogs, 53+/-5% in dogs with systemic Heparin(difference significant t-test, p<0.01), 37+/-6% in dogs with intrathecal Urokinase(difference signignificant, t-test, p<0.01). The preventive effects of intrathecal Urokinase was superior to systemic Heparin. There was a stroung trend toward reduction of medial necrosis in the basilar artery in dogs with intrathecal Urokinase(p<0.01), and with systemic Heparin(0.05 Adult ; Angiography ; Animals ; Arteries ; Basilar Artery ; Dogs ; Heparin* ; Humans ; Muscle, Smooth ; Necrosis ; Urokinase-Type Plasminogen Activator* ; Vasospasm, Intracranial*