PURPOSE: This study was undertaken to investigate the traumatic brain injury(TBI) in childhood and to identify factors related with its prognosis. METHODS: The medical records of 256 children with traumatic brain injury were analyzed retrospectively, who were treated in Chungnam National University Hospital for more than 6 years from January, 1998 to December, 2003. Outcomes were classified by age, sex, cause, Glasgow Coma Scale(GCS), Glasgow Outcome Scale(GOS), sequelae and so forth. RESULTS: A total of 256 patients were identified. The male to female ratio was 1.9:1. The main cause of TBI was traffic accidents(67.1%), followed by falls(25.8%). The outcomes of TBI were determined by GOS, in which death occurred in 16 cases(6.2%), severe disabilities in 11 cases(4.3%), moderate disabilities in 24 cases(9.4%), and good recoveries in 205 cases(80.1%). Poor prognostic factors were low GCS, post-traumatic early seizure, high blood glucose levels and abnormal pupil reflexes(P<0.05). The sequelae of TBI were quadriparesis(3.5%), learning disability(3%), mental retardation(2.3%), hemiparesis(1.6%) and others. CONCLUSION: This study suggest that it is possible to predict poor outcomes of TBI children by assessing the clinical manifestations. A long term follow-up of seizures and other sequelae is essential to TBI children who have poor prognosis.
Blood Glucose ; Brain ; Brain Injuries* ; Child ; Chungcheongnam-do ; Coma ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Humans ; Learning ; Male ; Medical Records ; Prognosis ; Pupil ; Retrospective Studies ; Seizures

PURPOSE: The most common complication of Kawasaki disease(KD) is the development of coronary artery aneurysm. Other cardiac complication include myocarditis, pericarditis, mitral or aortic insufficiency, congestive failure, and arrhythmia. These non- coronary cardiac problems have important role on clinical course in acute phase of KD. Extensive researches have been performed about the pathogenesis, natural course and treatment of coronary artery lesion. But the studies about non-coronary cardiac complication have been limited, so we aimed to study the manifestation, incidence, and clinical predictor of carditis. METHODS: The retrospective studies was performed to the 48 KD patients diagnosed in Chungnam National University Hospital from May 1998 to September 2004. The patients were divided into two groups. Patients with carditis(11 patients) and without carditis(37 patients) before receiving the IVGG infusion were analyzed. RESULTS: There were no differences in age and sex between two groups. Patients with long duration of fever and high Harada score had the significant increase in the incidence of carditis before the initial IVGG infusion. No significant differences were not shown between the two groups in terms of WBC count, hemoglobin, hematocrit, platelet count, total protein, AST/ALT, LDH, CPK, troponin I, total cholesterol, and triglyceride before the initiL IVGG infusion. The incidence of carditis was high in patient with high CRP, low albumin, and high cholesterol and triglyceride. CONCLUSION: The possibility of significant carditis should be considered before the infusion of high dose IVIG, which may worse the caridac dysfunction. Some predictors of significant carditis such as long duration of fever, high Harada score, high levels of CRP, and low levels of albumin can be suggested.
Aneurysm ; Arrhythmias, Cardiac ; Child* ; Cholesterol ; Chungcheongnam-do ; Coronary Vessels ; Estrogens, Conjugated (USP) ; Fever ; Hematocrit ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis* ; Pericarditis ; Platelet Count ; Retrospective Studies ; Risk Factors* ; Triglycerides ; Troponin I

Intracranial calcification is relatively common, but calcification of chronic subdural hematoma is rare condition. Nevertheless, already in 1884 Von Rokitansky had described a calcified chronic subdural hematoma found at autopsy. Subsequently Lewis(1889), Elsner(1896), and O'sullivan(1925) mentioned calcification of intracranial hematoma. In 1930, Goldham reported the first case treated by operation. A 15-year-old Korean male was admitted to this hospital because of a episode of generalized epileptic seizure, one day before admission. Past history was unknown about head injury and his past birth condition. Patient has complained weakness of right upper and lower extremely since his infant. Neurological examination revealed the left hemiparesis, but others were normal. Skull X-ray films showed dense conglomerated calcific density with surrounding rim like lucency in left fronto-parietal region. Left carotid angiogram revealed no abnormalities except hypoplasia of left hemisphere. Brain computed tomogram demonstrated hyperdense subdural mass surrounding decreased parenchymal density in left fronto-parietal region. A craniectomy was performed for removal of the calcified mass. A oval concaved bony hard mass was found in subdural space. The calcified bony hard mass was adherent with the surface of cortex by loose sonnective tissue. We removed the bony hard mass completely. The postoperative course was very satisfactory and seizure has not been appeared after discharge. Microscopic findings demonstrated ossification and fibrosis, consisting with old hematoma which showed up a calcification of chronic subdural hematoma.
Adolescent ; Autopsy ; Brain ; Child* ; Craniocerebral Trauma ; Epilepsy ; Fibrosis ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Infant ; Male ; Neurologic Examination ; Paresis ; Parturition ; Seizures ; Skull ; Subdural Space ; X-Ray Film

The meningioma constitutes 12 to 16 percent of all intracranial tumors. Generally, meningiomas arise from intracranial arachnoid villi and located intracranially. Extension of an intracranial meningioma onto the frontal and ethmoidal sinus occurs occassionally, but primary meningiomas of the frontal and ethmoidal sinus are extremely rare. The authors experienced a case of cystic, meningotheliomatous meningioma containing lamellated calcification involving of the lest frontal and ethmoidal sinus, which presented with protrusion of frontal bone and exophthalmos. In addition to our case, other types of extracranial meningioma are discussed with review of literature.
Arachnoid ; Exophthalmos ; Frontal Bone ; Meningioma*

Objective: We investigated the proportions of and reclassified BRCA1/2 variants of unknown significance (VUS) in Korean patients with epithelial ovarian, tubal, and primary peritoneal cancers. Methods: Data from 805 patients who underwent genetic testing for BRCA1/2 from January 1, 2006 to August 31, 2018 were included. The VUS in BRCA1/2 were reclassified using the 2015 American College of Medical Genetics and Genomics and the Association for Molecular Pathology standards and guidelines. Results: A BRCA1 pathogenic variant was found in 17.0% (137/805) of the patients, and BRCA1 VUS were found in 15.9% (128/805) of the patients. Further, 8.7% (69/805) of the patients possessed a BRCA2 pathogenic variant and 18.4% (148/805) of the patients possessed BRCA2 VUS. Fifty-three specific BRCA1 VUS were found and 20 were further reclassified as benign (n=11), likely benign (n=5), likely pathogenic (n=3), and pathogenic (n=1). The remaining 33 remained classified as VUS. For BRCA2, 55 specific VUS were detected; among these, 14 were reclassified as benign or likely benign, and 2 were reclassified as likely pathogenic. Among the 805 patients, 195 were found to have only VUS and no pathogenic variants (PV), and 41.5% (81/195) were reclassified as benign or likely benign, and 10.3% (20/195) as pathogenic or likely pathogenic variants. Conclusions Approximately 33.3% (36/108) of the specific BRCA1/2 variants analyzed in this study that were initially classified as VUS over a 13-year period were reclassified. Among these, 5.6% (6/108) were reclassified as pathogenic or likely pathogenic variants.

We experienced a rare case of sacral meningeal cyst so called sacral perineurial cyst(Tarlov cyst). A 15 years old girl was admitted to the hospital because of sudden severe low back pain and Lt. sciatica for about one week. We performed delayed myelography and spinal computeized tomographic myelography(C.T.M) for differential diagnosis. Delayed filling of contrast media in the cyst was significant in diagnosis of sacral meningeal cyst type II. Laminectomy of sacrum(S1) was performed for partial excision of cystic wall and plastic suture. Operative finding was typical sacral perineurial cyst(Tarlov cyst) which was recently clssified as sacral meningeal cyst type II. The classification of spinal meningeal cysts in the literature was indistinct and confused. We also agree with Nabors et. al, in current classificcation of spinal meningeal cysts, in which the spinal meningeal cysts, in which the spinal meningeal cysts were divided into 3 groups as extradural spinal Mcs Type I(Diverticulum), Type II(perineurial cyst), intradural spinal Mcs(arachnoid cyst).
Adolescent ; Classification ; Contrast Media ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Laminectomy ; Low Back Pain ; Myelography ; Plastics ; Sciatica ; Sutures

The peripheral neuroblastomas are malignant neoplasms that originate from the adrenal gland and sympathetic nervous tissues. They usually occur in childhood. They exhibit such malignant features that they metastasize early to lung, liver, bone, rarely skull and other structures. The patients with peripheral neuroblastoma have short duration of symptom and short survival period. They reveal the characteristic light microscopic features that resemble other small cell carcinomas. The establishment of final diagnosis of peripheral neuroblastoma needs various special stainings for small cell carcinomas, and the electron microscopic findings are the most reliable. The authors recently experienced a case of peripheral neuroblastoma in a 26-year-old man which involved right frontoparietal skull vault. The only chief complaint was a local non-tender mass at right frontoparietal scalp. Neither headache nor any neurological deficits was detected. Simple skull X-ray revealed a punched out radiolucency at right frontoparietal bone and brain CT showed a superficial elliptical high density mass that enhanced strongly. The mass was totally removed by wide craniectomy. The tumor invaded and penetrated the dura but the arachnoid membrane. At the tumor bed was not invaded by the tumor. The tumor was confirmed as peripheral neuroblastoma by various special stainings for small cell carcinomas. Following surgical resection of the mass, post-operative radiotherapy was offered(4800 rads for about 5 weeks). The patient aggrevated progressively and showed numerous metastases to such bones as lumbar vertebrae, pelvis and humerus to became paraplegic. 8 months after the operation, the patient died.
Adrenal Glands ; Adult ; Arachnoid ; Brain ; Carcinoma, Small Cell ; Diagnosis ; Headache ; Humans ; Humerus ; Liver ; Lumbar Vertebrae ; Lung ; Membranes ; Neoplasm Metastasis ; Neuroblastoma* ; Pelvis ; Radiotherapy ; Scalp ; Skull

We report two cases of lipoma of the parotid gland which present as a non-tender, freely movable and intraparotid mass. Lipomas are common soft tissue neoplasms but found very rarely in the parotid gland, and so are often not considered in the initial differential diagnosis of parotid gland tumor. We believe that these tumors are cured by simple excision, and thus superficial parotidectomy is enough for treatment.
Adult ; Aged ; Case Report ; Female ; Human ; Lipoma/*pathology/radiography/ultrasonography ; Male ; Parotid Gland/*pathology/radiography/ultrasonography ; Parotid Neoplasms/*pathology/radiography/ultrasonography ; Tomography, X-Ray Computed

We report two cases of lipoma of the parotid gland which present as a non-tender, freely movable and intraparotid mass. Lipomas are common soft tissue neoplasms but found very rarely in the parotid gland, and so are often not considered in the initial differential diagnosis of parotid gland tumor. We believe that these tumors are cured by simple excision, and thus superficial parotidectomy is enough for treatment.
Adult ; Aged ; Case Report ; Female ; Human ; Lipoma/*pathology/radiography/ultrasonography ; Male ; Parotid Gland/*pathology/radiography/ultrasonography ; Parotid Neoplasms/*pathology/radiography/ultrasonography ; Tomography, X-Ray Computed

PURPOSE: Simple and noninvasive methods for the diagnosis of transitional cell carcinoma of the bladder are needed for the prevention of invasive tumor. A proteomic technology has recently been developed to facilitate protein profiling of biological mixtures. We investigated the role of this proteomic approach as a possible tool to detect the marker protein during the initiation stages on BBN-induced bladder carcinogenesis in rats. MATERIALS AND METHODS: Ten rats group A were given 0.05% BBN in drinking water for 12 weeks. Ten rats in group B were designated as a control group and were not given BBN. Whole urinary bladders of all rats were excised at 12 weeks from the beginning of the experiment. Conventional proteomics was performed with high resolution 2-D gel electrophoresis followed by computational image analysis and protein identification using mass spectrometry. RESULTS: A comparison of urinary bladder hyperplasia tissue with control tissue showed that five proteins; actin gamma2 propeptide, cytokeratin-20, proapolipoprotein, alpha2 actin(alpha-cardiac actin) and heat shock 27kDa protein 1 were over-expressed in hyperplastic tissues. Three protein; transcription factors, seminal vesicle secretory protein VI precursor and hypothetical protein RMT-7 were under-expressed in hyperplastic tissues. CONCLUSIONS: In an animal model system, BBN-induced, urinary bladder mucosal hyperplasia resulted in an increase in five proteins and a decrease in three proteins. Of these altered proteins, CK-20 and SVS-VI seem to be important. The proteomic approach may be a simple and noninvasive method for monitoring and follow-up of bladder cancer patients. However more information is needed regarding CK-20 expression in nonmalignant urological disease and in human tumor tissue, and regarding SVS-VI expression in other organs, for clinical usage.
Actins ; Animals ; Carcinogenesis ; Carcinoma, Transitional Cell ; Diagnosis ; Drinking Water ; Electrophoresis, Gel, Two-Dimensional ; Follow-Up Studies ; Hot Temperature ; Humans ; Hyperplasia ; Keratin-20 ; Mass Spectrometry ; Models, Animal ; Precancerous Conditions* ; Proteomics ; Rats ; Seminal Vesicles ; Shock ; Transcription Factors ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urologic Diseases