No abstract available.
Drug Interactions*

Dedifferentiated chordoma is a rare pathologic entity presenting an additional sarcomatous component in otherwise classical chordoma. It has been also emphasized that this neoplasm is classified as a distinct entity because of its different clinical settings and aggressive behavior. Dedifferentiation is a peculiar phenomenon but its histogenesis has remained controversial. A 50-yera-old man developed a huge tumor mass in the retrorectal, presacral area, featured with two histological components. The one was a typical chordoma accounted for approximately 60% of the mass and the other was made up of highly cellular, plemorphic, undifferentiated tumor cells, reminiscent partly to the cells of plemorphic malignant fibrous histiocytoma. Ultrastructural features and immunoreactivity against cytokeratin, S-100 protein and alpha-1-antichymotrypsin in both portions support that histologically different components of this neoplasm derive from the same origin. To our knowledge, this is the first case of dedifferentiated chordoma in Korea.
Male ; Humans

Among the skeletal tuberculous spondylitis is high incidence and curable disease, if early diagnosis and treatment are possible. We reviewed clinical manifestations and radiologic analysis of 30 cases tuberculous spondylitis from May 1983 to Sept. 1986, at Yeungnam medical center, Yeungnam University. The results were follows: 1. The frequent involve sites were thoracolumbar vertebra. 2. The continuous lesion is 86.7% of the all cases. 3. The most common type was intervertebral type, and lytic and sclerotic lesion were same incidence. 4. Paravertebral abscess, kyphosis and disc space narrowing were demonstrated more than 80.0% of the cases. 5. Computed tomography was more accurate diagnostic method rather than conventional plain study to evaluation of extent of lesion, involvement of spinal canal and cord, and size and location of paravertebral abscess. And CT guided abscess drainage procedure was helpful to diagnosis and treatment. 6. Ultrasonography was helpful to differential diagnosis between paravertebral abscess and other solid mass, and useful to follow up study of paravertebral abscess after treatment.
Abscess ; Diagnosis ; Diagnosis, Differential ; Drainage ; Early Diagnosis ; Follow-Up Studies ; Incidence ; Kyphosis ; Methods ; Spinal Canal ; Spine ; Spondylitis* ; Ultrasonography

Epithelioid hemangioendothelioma is a recently described vascular neoplasm characterized by epitheloiod endothelial linings and its borderline biologic behavior. We report a case of epithelioid hemangioendothelioma in a 6-year-old male. The tumor was presented as a non-tender dermal nodule on the left middle finger. The microscopic sections revealed irregular proliferation of vascular channels lined by epithelioid cells with histiocytoid features and frequent intracytoplasmic vacuoles, mimicking so called signet ring cells. Immunohistochemical stainings for factor VIII and vimentin were positive both in epithelioid and vacuolated endothelial cell. Electron microscopic finding reveals abundant intermediate filaments.

The author studied on the 197 cases of the pleomorphic adenoma which had been diagnosed with biopsy during the period of 1985 to 1996 at the Kyungpook National University Hospital. This study contains the statistical analysis of the clinico-pathological findings such as sex, age, location, chief complaint, duration, treatment method, size, recurrence, and treatment department in relation to anatomical location. The result were as follows : 1. The treatment department in oxter were ENT(16.2%), GS(22.8%), OMFS(18.8%), PS(12.2%). 2. The incidence of pleomorphic adenoma were parotid gland(57.8%), palatal salivary gland(20.3%), submandibular gland(17.2%), other minor salivary glands(4.5%). 3. The tumors were more common in females than males, with a male to female ratio of 1 : 1.85. 4. The peak age of ocurrence was in the forth decade. 5. The duration of the most cases were less than 5 years. 6. Although the size of the tumors was variable, the incidence was highest between 3cm and 4cm(25.4%). 7. The most prevalent chief complaint was swelling(94.9%). 8. Conservative treatment was performed 30.0%, and radical treatment was employed 70.0%. 9. The recurrence rate is 8.1%, and recurrence used to be relatively common with conservative treatment. 10. The rate of malignant transformation is 1%. 11. The anatomical location has no relationship with the factors of sex, duration, and malignant transformation. 12. There was statistical significance on the anatomical location to the treatment department, age, chief complaint, size, treatment method, recurrence (P<0.05).
Adenoma, Pleomorphic* ; Biopsy ; Female ; Gyeongsangbuk-do ; Humans ; Incidence ; Male ; Recurrence

Primary biliary cirrhosis, a chronic, progressive, and often fatal cholestatic liver disease, is characterized by destruction of intrahepatic bile ducts, portal inflammation and scarring, and the eventual development of cirrhosis and liver failure. We reviewed four cases of primary biliary cirrhosis primarily suspected with peritoneoscopic liver biopsy specimens. All patients were female and their age ranged from 29 to 50 years(median age: 43.8 years). Presenting symptoms were typically pruritus and/or upper abdominal discomfort. On physical examination, interus was presented in 3; hepatomegaly in 3; chronic liver disease stigmata in one. Co-existing autoimmune diseases such as Hashimoto' thyroiditis and Sjoegren' syndrome were found in 2 cases. Biochemical tests of liver function revealed a cholestatic pattern. An antimitochondrial-antibody test was positive in 2 out of 3 patients(75%). Increase levels of serum immunoglobulins, especially of IgM, were evident in 3 cases. Histologic staging(Ludwig et al.) disclosed stage I lesion in one, stage III in two, and stage IV in the remaining one.
Female ; Humans ; Biopsy

Colonic sarcomatoid carcinomas are known to be extremely rare tumors, with only 22 cases reported either as sarcomatoid carcinomas or carcinosarcomas in the literature. The known characteristics are rapid growth, a high recurrence rate, and an extremely poor prognosis. Herein we report a case of a patient who had a sarcomatoid carcinoma of the sigmoid colon and died only 22 days after surgery due to rapid tumor growth.
Carcinosarcoma ; Colon ; Colon, Sigmoid ; Humans ; Prognosis ; Recurrence

Magnetic resonance (MR) is rapidly emerging technique that provides high quality images and potentially provides much more diagnostic information than do conventional imaging modalities. MRI is conceptually quite different from currently used imaging methods. The complex nature of MRI allows a great deal of flexibility in image production and available information, and key points are as follows. 1. MR offers a non-invasive technique with which to generate in vivo human images without ionizing radiation and with no known adverse biological effects. 2. Imaging mechanism of MRI is quite different from conventional imaging modality and for more accurate diagnostic application, It is necessary for physician to understand imaging mechanism of MRI 3. M.R. makes available basic chemical parameters that may provide to be useful for diagnostic medical imaging and more specific pathophysiologic information which are not available by alternate techniques. 4. M.R. can be produced by number of different methods. This flexibility allows the imaging technique to be applicated for particular clinical purpose. Multiplanar and three dimensional imaging may extend the imaging process beyond the single section available with current CT. 5. Future directions include efforts to; a. Further development of hard ware b. More fastening scan time c. Respiratory and cardiac gated imaging d. Imaging of additional nuclei except hydrogen. e. Further development of contrast media f. MR in vivo spectroscopy g. Real time MR imaging
Comprehension* ; Contrast Media ; Diagnostic Imaging ; Humans ; Hydrogen ; Magnetic Resonance Imaging ; Pliability ; Radiation, Ionizing ; Spectrum Analysis

Complicated hepatic microabscess secondary to ascending cholangitis following ERCP (Endoscopic retrograde cholangiopancreatogram) is rare, and needs to be differentiated from other microabscesses, metastasis or Caroli's disease. We experienced a case of hepatic microabscess associated with septic cholangitis following ERCP. Cholangiogram showed multiple sac-like abscess pockets with characteristic biliary communication, and CT scan revealed multiple low attenuated lesions. At the resolving stage of chotangitic microabscess, CT scan showed partial rim enhancement of the abscesses and disproportional dilatation of intrahepatic ducts. The residual parenchymal enhancement surrounding the resolved microabscess pockets and dilatated biliary ducts, however, remained even after clinical recovery.
Abscess ; Caroli Disease ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis* ; Dilatation ; Neoplasm Metastasis ; Tomography, X-Ray Computed

Background: Positive end-expiratory pressure(PEEP) ventilation causes reduction in cardiac output and increase of intra-thoracic pressure, hence reduction of hepatic blood flow. The purpose of this study is to evaluate the changes of hepatic venous oxygen saturation, tension and content during increase and removal of PEEP and to evaluate hemodynamic variable which has the greatest effect on hepatic oxygenation. Method: Eight dogs were anethetised with 1.0 vol% isoflurane and 100% oxygen. After 30 minutes of stabilization of vital signs, PEEP were increased from 0 cmH2O to 5 cmH2O and 10 cmH2O and lowered to 0 cmH2O again, and hemodynamic data (heart rate, arterial blood pressure, central venous pressure(CVP), pulmonary arterial pressure, pulmonary arterial occlusion pressure and cardiac output(CO)) and hepatic venous oxygenation data (hepatic venous oxygen saturation(ShvO2), tension(PhvO2) and content(ChvO2)) were measured at each step. Results: CO, ShvO2, PhvO2 and ChvO2 decreased significantly at 10 cmH2O PEEP compared to the baseline and 5 cmH2O PEEP and CO, ShvO2 and ChvO2 increased signicantly with removal of PEEP. CVP increased significantly at 10 cmH2O PEEP and decreased significantly with PEEP removal. PEEP showed close correlationship with CO and CVP considering all steps of PEEP and PEEP removal. ShvO2 and PhvO2 showed most close correlationship with CO considering all steps of PEEP and PEEP removal. Conclusion: ShvO2 with PEEP therapy is dependent upon CO. Therefore cardiac output maintenance is essential during PEEP therapy. For exact evaluation of hepatic oxygenation, it is valuable to monitor ShvO2.
Animals ; Arterial Pressure ; Cardiac Output ; Dogs* ; Hemodynamics ; Isoflurane ; Oxygen* ; Positive-Pressure Respiration* ; Ventilation ; Vital Signs