Mucoepidermoid carcinoma occurs commonly in salivary gland, but rarely in lacrimal gland. In literature about ten or more cases of mucoepidermoid carcinoma of the lacrimal gland have been described. A 73-year-old woman had noted upper lid swelling and lacrimation of the left eye for 2 months. Computed tomographic scan demonstrated a large homogenous mass on superotemporal portion of the left orbit. The mass extended into the left temporal fossa, middle cranial fossa, and ethmoidal sinus with bone destruction. Histopathologically, the mass was proved to be a intermediate grade mucoepidermoid carcinoma of the lacrimal gland.
Aged ; Carcinoma, Mucoepidermoid* ; Cranial Fossa, Middle ; Female ; Humans ; Lacrimal Apparatus* ; Orbit ; Salivary Glands

PURPOSE: It is important to diagnose paragonimiasis in early active stage because it can be dured by chemotherapy. However, it is difficult to make a correct diagnosis of cerebral paragonimiasis in the early active stage, and the radiographic findings of cerebral paragonimiasis have been rarely reported. Thus, this experimental study was designed to produce early active cerebral paragonimiasis and to demonstrate radiologic-pathologic correlations. MATERIALS AND METHODS: In 8 cats, 7-8 metacercariae of Paragonimus westerrnani were directly introduced into the brain parenchyma of each cat's after trephination of the skull. In anogher 16 cats, the juvenile worms and the adult worms that had developed for varying periods (2 weeks, 4 weeks, 6 weeks, 8 weeks and 12 weeks) in the lunges of another cats were introduced into the brain parenchyma of each cat's with the same procedures described above. Follw-up MR images and chest radiographs were obtained at 2 days, 1 weeks, 2 weeks, 4 weeks and 8 weeks after innoculation. The autopsies and histopathological examinations of the cat's brain were undertaken in 22 cats. In 9 cats that were suspected with pulmonary lesions on chest radiograph, the soft tissue radiographs of inflated-fixed lungs were obtained. RESULTS: In one cat with innoculation of adult worm, acute suppurative inflammation of the brain parenchyma was demonstrated. But the other cats with innoculction of adult worm or juvenile worm and the cats with innoulation of metacercaris did not reveal any evidence of acute cerebral paragonimiasis. More than half of the introduced metacercariae(5 out of 8 cats) were found in the lung parenchyma, while only 25%(4 out of 16 cats) of the adult worm innoculated cats were. CONCLUSION: Acute suppurative inflammation suggesting acute stage cerebral paragonimiasis was obtained in one case of adult worm innoculated cat. Most of the innoculated metacercariae and some of the juvenile worms or adult worms were migrated to the lungs.
Adult ; Animals ; Autopsy ; Brain ; Cats* ; Diagnosis ; Drug Therapy ; Humans ; Inflammation ; Lung ; Metacercariae ; Paragonimiasis* ; Paragonimus ; Radiography, Thoracic ; Skull ; Trephining

PURPOSE: We tried to evaluate the effect of oxalate on the growth of distal renal tubular epithelial cells MATERIALS AND METHODS: Madin-Darby canine kidney(MDCK) cell line, derived from canine distal renal tubular epithelial cell, supplied from American Type Culture Collection was used in this study. RPMI 1640 containing 10mM HEPES-buffer, 100IU/ microliterpenicillin, 100 microgram/ microliterstreptomycin, 300 microgram/ microliterglutamine, and with or without 10% fetal bovine serum(FBS) was used as the culture media. And the cell survivals under various concentrations of ammonium oxalate were assessed by MTT assay. RESULTS: Exposure of MDCK cells to oxalate resulted in a concentration dependent suppression of the cell growth in both 10% FBS supplied media and FBS deprived media. CONCLUSIONS: From these observations we could conclude that oxalate is not a mere constituent of calcium oxalate stone, but oxalate might offer a good environment for calcium oxalate stone formation in the urinary tract via MDCK cellular damage.
Calcium Oxalate ; Cell Line ; Culture Media ; Epithelial Cells* ; Madin Darby Canine Kidney Cells ; Oxalic Acid ; Urinary Tract

BACKGROUNDS: As the elderly population in-creases the health problem, especially dementia, becomes the clinically important problem. So in the part of primary care medicine it becomes so important that family physician make a focus on the detection, evaluation, and management of demented patient. Until nowadays there is few cohort study about the dementia and few nursing home in Korea. So author performed the MMSE-K in the elderly who are over 65 to get the cognitive function for early diagnosis, management and rehabilitation of psychosocial problem. METHODS: One hundred three persons who included in community society in Seoul and nursing home of Kyunggido were tested. The survey was done twice on september 1997 and September 1998. Author used the MMSE-K to the elderly by same doctors. The analysis was done by SAS 6.12 and t-test, one-way ANOVA and two-way ANOVA with linear trend test. RESULTS: The mean of first MMSE-K score in the community is 26.1 and in the nursing home is 24.4. And the mean of second MMSE-K score in the community is 25.5 and in the nursing home is 22.0. The MMSE-K score is elevated with male and longer duration of education and is decreased with the advanced age in two groups. According to the classification by MMSE-K score the number of people who have normal cognitive function is 45(43.7%), mild impaired cognitive function is 45(43.7%), moderately impaired cognitive function is 13(12.6%) and none has severely impaired cognitive function in both groups. The follow up MMSE-K score shows that the difference of two MMSE-K scores increases as the age increases. CONCLUSION: Until todays there is few study that designed in the form of cohort study about the elderly cognitive function in Korea. So family physicians must perform the prospective cohort study with the consistent concern and effort to get the research data about the dementia for earthy detection, management and rehabilitation for elderly.
Aged* ; Classification ; Cohort Studies ; Dementia ; Early Diagnosis ; Education ; Follow-Up Studies* ; Gyeonggi-do ; Humans ; Korea ; Male ; Nursing Homes ; Physicians, Family ; Primary Health Care ; Rehabilitation ; Seoul

We experienced a case of aeute cerebral infaretion after operation. A 74 year old female patient slipped down and received left femoral neck fracture. Preoperatively, orthopedist, internist and anesthesiologist visited and evaluated her but could not find any suspicious symptoms related to cerebral infarction. She have suffered from hypertension and diabetes mellitus for 1Q yrs. She underwent bipolar endoprosthesis under general anesthesia. Postoperatively, she became deep drowsy and revealed respiratory depression, abnormal neurological sign and was diagnosed as acute cerebral infartion on cranial computed tomography and ultimately expired.
Aged ; Anesthesia, General* ; Cerebral Infarction* ; Diabetes Mellitus ; Female ; Femoral Neck Fractures ; Humans ; Hypertension ; Respiratory Insufficiency

No abstract available.
Population Characteristics* ; Thyroid Gland* ; Thyroiditis*

Dedifferentiated chordoma (DC) is defined as a chordoma containing sarcoma components. DC is distinguished from conventional chordoma by the rapidity of tumor growth and the potential for distant metastasis. We report two cases of DC, which are developed in the sacrum. We reviewed the medical records and imaging studies of 2 patients diagnosed with DC and the literature published. In the first case, percutaneous biopsy revealed that it was conventional chordoma in the sacrum. Patient underwent radiation therapy (RT). Six years after the RT, the tumor recurred. Surgical removal was performed and the recurrent tumor was diagnosed as DC in histopathologic examination. In the second case, a patient underwent gross total resection of sacral tumor, which was diagnosed with conventional chordoma. Aggravated tumor was detected after 4 months, and patient underwent reoperation. The second operation revealed the transformation of the tumor into DC. The survival time of the patients after the diagnosis was 10 and 31 months. Dedifferentiated chordoma is a rare and highly aggressive tumor. De novo type exists, but it usually transformed from recurrent chordoma after surgical resection or radiation.
Biopsy ; Chordoma* ; Diagnosis ; Humans ; Medical Records ; Neoplasm Metastasis ; Reoperation ; Sacrum* ; Sarcoma

PURPOSE: Phyllodes tumor is a rare fibroepithelial tumor of the breast, first described by Johannes Muller in 1838. Much has been written about phyllodes tumor, but very few widely accepted conclusions about its clinical behavior, treatment modality, and prognosis have been reached. This study aims to analyze the clinical, radiological, and pathological characteristics of phyllodes tumor of the breast. METHODS: The medical records of 41 patients with phyllodes tumor who had been treated between February 1982 and August 1998 at the Department of Surgery, Seoul National University Hospital, were retrospectively reviewed for clinical, radiological and pathological findings, treatment modalities, and follow-up results. RESULTS: Of these 41 cases, there were 28 cases (68.3%) of benign tumors and 13 cases (31.7%) of malignanat tumors. All patients were females, and the mean ages of onset were 33.2 years for benign tumors and 40.8 years for malignant tumors. Most patients, 100% of benign and 92.3% of malignant, presented with a papable mass in the breast. The median duration of illness was 2 months for malignant tumors and 8 months for benign tumors. The tumor size was greater than 10 cm in diameter in 5 cases (38.5%) of malignant tumors and in 3 cases (10.7%) of benign tumors. Only 4 cases were preoperatively diagnosed as having a phyllodes tumor by using radiological and fine needle aspiration cytology. Out of the 10 malignant cases reviewed, 5 cases were confirmed as malignant, and 5 cases were confirmed as borderline phyllodes tumors. Cellularity was moderate or above in all 5 malignant and 5 borderline cases. Atypism above moderate degree was found in 4 of 5 (80%) malignant tumors, in 3 of 5 (60%) borderline tumors, and in 4 of 24 (16.7%) benign tumors. Mitotic counts in all 5 malignant cases were 5 or more per 10 high power field while those in the 5 borderline tumors were 2-5 mitoses per 10 high power field. The most commonly performed operative procedures were a simple mastectomy (50%) for malignant tumors and a simple excision (64.3%) for benign tumors. Post-operative adjuvant therapy was done for 4 cases; out of these, 1 case had been initially diagnosed as a malignant phyllodes tumor, but the diagnosis was changed to a benign phyllodes tumor upon review. Of the 27 follow-up cases, recurrences developed in 3 cases (16.7%) of benign tumors. CONCLUSION: From the above results, there were no specific clinical features for differentiating benign from malignant phyllodes tumor preoperatively; therefore, we cannot help depending on the pathologic findings. Pathologic reviews showed that among several criteria, atypism, cellularity, and mitotic count were the most definite pathologic characteristics in differentiating benign from malignant phyllodes tumor. But much more experience and long-term follow-up may be needed to define optimal treatments and to analyze the prognosis for phyllodes tumors of the breast.
Biopsy, Fine-Needle ; Breast* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Simple ; Medical Records ; Mitosis ; Phyllodes Tumor* ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Surgical Procedures, Operative

OBJECTIVES: To evaluate the incidence rate and associated factors of dementia in the elderly of rural community. METHODS: This study was three and half year follow-up of Yonchon cohort, participated in a prevalence study of dementia and depression in 1996 (N=1,037). A two-phase study was conducted using the Korean version of Psychogeriatric Assessment Scale in phase I and the diagnostic interview according to DSM-IV criteria by two psychiatrists in stage II. RESULTS: Of the 968 elderly residents who had not dementia in 1996 prevalence study, 596 residents completed the incidence study. The annual incidence rate for total dementia, dementia of Alzheimer's type and vascular dementia were 1.88% (1.86% in men, 1.98% in women), 1.58% (1.39% in men, 1.80% in women) and 0.34% (0.45% in men, 0.25% in women), respectively. Increasing age was significantly associated with total dementia and dementia of Alzheimer's type (p<0.01, p<0.05, respectively). There was statistically significant difference of the three and half year mortality rate between the dementia patients who were diagnosed in prevalence study and the non-dementic elderly (chi2=28.89, df=1, p<0.001). Only the 2.8% of newly onset dementia patients sought psychiatric service in the previously year. CONCLUSIONS: The incidence of dementia among the Korean elderly in a rural community was relatively consistent with the epidemiological studies of other countries. Age was the only risk factor for total dementia and dementia of Alzheimer's type. Very few dementia patients were treated by psychiatrist.
Aged* ; Cohort Studies* ; Cross-Sectional Studies ; Dementia* ; Dementia, Vascular ; Depression ; Depressive Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiologic Studies ; Follow-Up Studies* ; Humans ; Incidence* ; Male ; Mortality ; Prevalence* ; Psychiatry ; Risk Factors ; Rural Population

Transcatheter arterial chemoembolization (TACE) is the mainstay of treatment for unresectable hepatocellular carcinoma (HCC). Although various complications of TACE have been reported, cerebral lipiodol embolism after TACE is rare. We report a 67-year-old man, who had patent foramen ovale and developed cerebral lipiodol embolism after TACE via the inferior phrenic artery. At 20 months after third TACE of 3 cm sized HCC in the left hepatic lobe, computed tomography (CT) revealed about 1.6 cm newly developed HCC in the anterior superior segment of right hepatic lobe. The angiogram revealed the HCC was supplied from the right inferior phrenic artery. Toward the end of TACE, there were accumulations of the iodized oil in the pulmonary vasculature. Immediately after TACE, he complained of weakness in right upper and lower limbs and sensory decrease in right limbs and right hemitrunk. Magnetic resonance imaging revealed a cerebral lipiodol embolism. Transesophageal echocardiography revealed no visible thrombi but contrast-echocardiography using hand agitated saline revealed an intracardiac right to left shunt consistent with patent foramen ovale. Motor weakness and sensory decrease were gradually improved, and all neurological symptoms disappeared over 4 weeks.
Aged ; Carcinoma, Hepatocellular/complications/diagnosis/*therapy ; *Chemoembolization, Therapeutic ; Contrast Media/*adverse effects/diagnostic use ; Humans ; Intracranial Embolism/*diagnosis/*etiology/ultrasonography ; Iodized Oil/*adverse effects/diagnostic use ; Liver Neoplasms/complications/diagnosis/*therapy ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed