The authors report a case of malignant teratoma in a 3-year-old girl who suffered from occipital headache and vomiting for about 2 months. The tumor occupied left cerebellopontine angle resulting in a moderate degree of hydorcephalus. Histologically, the tumor consisted mainly of neuroepithelial tissues showing varying degrees of differentiation, with areas of epidermis, mature fat tissue, connective tissue, gastrointestinal glands and smooth muscle bundles containing ganglions. Also noted are groups pf polygonal or spindle cells representing immature mesodermal tissue. In contrast to two malignant intracranial teratomas previously reported in Korean literatures, this case is characterized by the presence of predominent neuroepithelial components and by uncommon tumor location, the posterior fossa far from middle line of the body.

The Pleomorphic xanthoastrocytoma(PXA) is considered as a special subgroup of gliomas because of its distinctive characteristics: onset in young subject; predilection for the temopral or parietal lobe and a superficial location; frequent appearance as a yellow encapsulated mass with a grossly visible tumor-associated cyst; marked histological pleomorphism; little or no mitosis and no necrosis; presence of a rich reticulin network; and demonstrable GFAP in many of the fusiform and giant cells; most importantly, the relatively favorable prognosis despite plemorphism and bizzare giant cells in the microscopic picture. The objective of this report is to add one more case of pleomorphic xanthoastrocytoma to the medical literature.

No abstract available.
Craniocerebral Trauma* ; Head* ; Perfusion* ; Tomography, Emission-Computed, Single-Photon*

A case of pineoblastoma in a 28-year-old male is reported. A computerized tomography showed hydrocephalus and a mass in the pineal region. Histologically, the tumor is composed of regular, patternless aggregates of small round undifferentiated cells, resembling medulloblastoma-retinoblastoma group. Immunohistochemical reactivity of the neoplastic cells for neuron specific enolase and synaptophysin demonstrates neuronal differentiation. The patient underwent partial resection of the mass followed by radiotherapy. The patient had no cerebrospinal dissemination at 8 month follow-up. The pineoblastoma is a highly malignant neoplasm, one of the class of primitive neuroectodermnal tumors. The tumor is a very rare pineal parenchymal meoplasms, representing an incidence of less than 0.1% of intracranial tumors. This is the first case of pineoblastoma reported in Korea. In this report the divergent differentiation of the tumor is discussed, along with review of literatures.
Male ; Humans ; Incidence

A case of pineoblastoma in a 28-year-old male is reported. A computerized tomography showed hydrocephalus and a mass in the pineal region. Histologically, the tumor is composed of regular, patternless aggregates of small round undifferentiated cells, resembling medulloblastoma-retinoblastoma group. Immunohistochemical reactivity of the neoplastic cells for neuron specific enolase and synaptophysin demonstrates neuronal differentiation. The patient underwent partial resection of the mass followed by radiotherapy. The patient had no cerebrospinal dissemination at 8 month follow-up. The pineoblastoma is a highly malignant neoplasm, one of the class of primitive neuroectodermnal tumors. The tumor is a very rare pineal parenchymal meoplasms, representing an incidence of less than 0.1% of intracranial tumors. This is the first case of pineoblastoma reported in Korea. In this report the divergent differentiation of the tumor is discussed, along with review of literatures.
Male ; Humans ; Incidence

In 56 breast cancer tissues (infiltrating ductal carcinoma) with a clinical follow-up period of more than 5 years, positivity of estrogen receptor(ER) by enzyme immunoassay and expressions of bcl-2 and p53 oncoproteins by immunohistochemistry were evaluated. The purposes of this study were to determine prevalence of bcl-2 and p53 in breast cancer, the interrelationship between expression of the proteins and estrogen receptor, correlation between histologic grade and the expression of the tumor-related oncogenes, and to explore the biologic bahavior of breast cancer (lymph node metastasis, recurrence rate, and survival) via expression of bcl-2 and p53. Twelve of 56 (21.4%) carcinomas were bcl-2 positive, and seventeen (30.4%) were p53- positive. Eleven of 12 bcl-2 positive tumors (91.7%) were ER-positive, and bcl-2 expression was significantly associated with ER-positivity(P=0.043). Seven of 36 ER-positive tumors (12.5%) were p53 positive, and p53 expression was inversely associated with ER-positivity(P=0.006) significantly. The bcl-2 protein expression showed a significant relationship to low histologic grade of tumor (P=0.0002), and an almost significant relationship to lower recurrence rate (P=0.09). The p53 protein expression showed a significant relationship to high histologic grade of tumor (P=0.002) and an almost significant relationship to lymph node metastasis (P=0.09). Also an almost inverse relationship between bcl-2 and p53 was demonstrated (P=0.057). The bcl-2 expression had a tendency to be associated with longer patient survival(P= 0.09), but p53 immunoreaction was found not to be associated with shorter patient survival(P=0.16). These results provide further evidence that higher incidence of bcl-2 expression is correlated with higher incidence of ER and lower grade of tumor, while p53 expression is correlated with lower incidence of ER and higher grade of tumor. In conclusion, although the biologic function of bcl-2 protein is not yet well understood in breast cancer, our results suggest that bcl-2 and p53 oncoproteins might play significant roles in estrogen receptor and development of breast cancer. But their prognostic significance could not be determined; our results are 'not significant' but 'almost significant'. Thus, contribution of bcl-2 and p53 immunohistochemical phenotyping of breast cancer with ER to the clinical management need verification in larger series.
Humans ; Neoplasm Metastasis ; Breast Neoplasms

No abstract available.
Child* ; Epidemiologic Studies* ; Gastroenteritis* ; Humans ; Rotavirus*

PURPOSE: The purpose of this study was to classify the elderly in long-term care facilities using the Resource Utilization Group(RUG-III) and to examine the feasibility of a payment method based on the RUG-III classification system in Korea. METHOD: This study measured resident characteristics using a Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. Data was collected from 530 elderly residents over sixty, residing in long-term care facilities. Resource use for individual patients was measured by a wage-weighted sum of staff time and the total time spent with the patient by nurses, aides, and physiotherapists. RESULT: The subjects were classified into 4 groups out of 7 major groups. The group of Clinically Complex was the largest (46.3%), and then Reduced Physical Function(27.2%), Behavior Problems (17.0%), and Impaired Cognition (9.4%) followed. Homogeneity of the RUG-III groups was examined by total coefficient of variation of resource use. The results showed homogeneity of resource use within RUG-III groups. Also, the difference in resource use among RUG major groups was statistically significant (p<0.001), and it also showed a hierarchy pattern as resource use increases in the same RUG group with an increase of severity levels(ADL). CONCLUSION: The results of this study showed that the RUG-III classification system differentiates resources provided to elderly in long-term care facilities in Korea.
Aged ; Female ; Health Resources/*utilization ; Homes for the Aged/*economics ; Humans ; Korea ; Long-Term Care/*economics ; Male ; Nursing Homes/*economics ; Patients/*classification ; *Prospective Payment System

PURPOSE: This study was attempted to investigate the prevalence of the expression of c-fos protein, TGF-alpha and -beta, PCNA , DNA ploidy pattern and histopathological parameters of giant cell tumor (GCT) of bone and to correlate with prognosis and to extend our understanding on tumorigenesis of GCT. MATERIALS AND METHODS: Twenty eight cases of paraffin-embedded tissue were studied, classified as recurrent (5 cases) and non-recurrent group (12cases) within the limits of the cases which afforded surgical material on first operation. RESULTS: No significant difference was observed in cellularity of stromal cells, atypia of stromal and giant cells, presence of hemorrhage and necrosis between recurrent and non-recurrent group. However, presence of more than 10 mitotic figures in 10 high power fields in recurrent group was significantly higher than non-recurrent group (p<0.05). The immunoreactivity for PCNA was seen only in nuclei of stromal cells, whereas nuclei of giant cells showed negative staining. The positivity of PCNA revealed no significant difference between non-recurrent (mean; 40.9%) and recurrent group (34.4%). The expression of c-fos oncogene was seen in 5 cases (100%) in recurrent group, and 8 cases (66.7%) in non-recurrent group, and no significant difference was seen. No significant difference of expression of TGF-alpha was seen in 5 cases (100%) in recurrent group and in 11 cases (91.7%) in non-recurrent group. The expression of TGF-beta in stromal cells was significantly higher in non-recurrent group (80%) compared to recurrent group (100%) (p<0.05). In DNA analysis out of 18 cases, 4 cases (22.2%) were aneuploidy and 14 cases (77.8%) were diploidy. Among 4 aneuploidy cases, 3 cases (75%) had no recurrence, and 1 case (25%) had metastasis to lung and expired. No significant difference of DNA ploidy pattern was seen between the recurrent and non-recurrent group. CONCLUSION: Presence of more than 10 mitotic figures in 10 high power fields and less expression of TGF-beta are related to higher possibility of recurrence and it is suggested that the number of mitotic figure (more than 10/10HPF) and expression of TGF-beta could be helpful parameters in predicting recurrence of GCT.
Aneuploidy ; Carcinogenesis ; Diploidy ; DNA* ; Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells* ; Hemorrhage ; Lung ; Necrosis ; Negative Staining ; Neoplasm Metastasis ; Oncogenes ; Ploidies ; Prevalence ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Recurrence ; Stromal Cells ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Transforming Growth Factors*

Nucleolar organizer regions are DNA loops encoding rihbosomal RNA production and detectable by the argyrophilia of their associated proteins(AgNORs). AgNOR numbers correlate with cellular proliferating activity. Many studies have shown a significnt difference in AgNOR counts between benign and malignant tumors. AgNOR counts were also helpful in differential diagnosis. For the evaluation of its diagnostic utility in gastric lesions, a silver staining technique was carried out in paraffin sections of 5 control cases, 5 benign peptic ulcers, 7 hyperplastic polyps, 10 tubular adenomas, 16 early gastric adenocarcinomas and 15 advanced gastric adenocarcinomas. The results were as follows. The mean numbers of AgNORs in early and advanced gastric adenocarcinomas(1.94 and 2.16) were significantly higher than those of normal foveolar epithelium(1.43) and epithelia of benign gastric ulcers(1.54), hyperplastic polyps(1.64) and tubular adenomas(1.79). In malignancy, there was increased variability in size and shape of AgNORs. There was little differences in mean AgNOR numbers between early and advanced gastric adenocarcinomas. Differentiation of the tumor made no difference in AgNOR numbers. From the above results, the AgNORs count, if its morphologic change are taken into consideration, is helpful in differentiation between malignant and non-malignant lesions.
Diagnosis, Differential ; Adenocarcinoma