Retrospective clinicopathologic analysis of 15 patients with the phyllodes tumors(PT) of the breast, diagnosed at SNUH over 6 years period, was done. By light microscopy, 8 cases were diagnosed as benign, and 7 cases were diagnosed as malignant. Mean ages o the patients were 37 and 34 years in malignant and benign, respectively. Most of those cases were presented with a palpable mass of the breast. None of the patients with malignant PT had distant metastasis, Local recurrences were experienced in 3 patients among the malignant PT, and one patient among the benign PT. One of 7 malignant PT was coexisted with simultaneous ipsilateral infiltrating duct carcinoma. The clinical course was not well correlated with pathologic features. The prognostic significances of several histopathologic parameters were assessed for possible correlation with local recurrence, metastasis and death; stromal cellularity, stromal cellular atypism, mitotic activity, tumor contour, necrosis, tumor size and heterologous stromal elements. Immunohistochemistry using antibody to vimentin, proliferating cell nuclear antigen(PCNA) and epidermal growth factor receptor(EGF-R) were analysed. In the 5 cases of benign PT, the stromal cells stained diffusely positive for vimentin and 3 cases of malignant tumors show similar staining for vimentin. The percentage of PCNA-positive cells were higher in the malignant PT than in the benign ones; they were 3.5% to 60% in malignancy, while they were less than 60% in all benign PT. The results of EGF-R staining were correlated with the histologic classification; only 2 cases out of 8 benign PT show diffusely positive staining of EGF-R in the cytoplasm, but 6 cases out of 7 malignant PT show positive findings.
Neoplasm Metastasis

Familial hemiplegic migraine(FHM) is an autosomal dominant subtype of migraine with aura, characterized by the occurrence of hemiplegia during the aura. Two subforms of FHM families exist; pure FHM in 80% and FHM families with cerebellar symptoms in 20%. Half of the known FHM families show genetic linkage to chromosome 19p13, and in these families FHM is caused by missense mutations in a neuronal P/Q type calcium channel alpha-1 subunit gene(CACNA1A gene). Linkages to 1q31 and 1q21-23 have also been established. Other families are linked neither to chromosome 19 nor 1. Clinical variabilities are partially associated with the various types of CACNA1A gene mutations. FHM is distinguished from more frequent migraine types by a clear, dominant inheritance pattern and the relative absense of other headache types. Further investigation of FHM will help to clarify the genetics of more common migraine. We describe a male patient with FHM with a brief review of the literature.
Calcium Channels ; Chromosomes, Human, Pair 19 ; Epilepsy ; Genetic Linkage ; Genetics ; Headache ; Hemiplegia ; Humans ; Inheritance Patterns ; Male ; Migraine Disorders ; Migraine with Aura* ; Migraine without Aura ; Mutation, Missense ; Neurons

PURPOSE: This study was performed to find out the role of routine lumbar puncture in children presented with their first seizure with Fever. METHODS: This study included 220 children, over a 5 year period, from April 1999 to March 2003, who visited or were admitted at Dae Dong Hospital with their first febrile convulsion. Lumbar puncture was performed in all children. We analyzed their age, family history, type of seizure, duration of seizure, cause of fever, and the results of lumbar puncture. RESULTS: In the sex distribution, males(58.6%) outnumbered females(41.4%) and the ratio was 1.2:1. 81.7% of the patients had febrile convulsion from 6 months- to 3 years of age(P<0.05). 30.5% also had family history of febrile convulsion. The types of seizure were generalized tonic-clonic(72.7%), generalized tonic(17.7%), and generalized clonic(6.4 %). For the duration of seizure, 90.4% of the patients were estimated less than 15 minutes(P<0.05). The causes of fever were pharyngotonsilitis(40.5%), gastroenteritis(19.1 %), pneumonia or bronchitis(13.2%), meningitis(11%), otitis media, urinary tract infection, and exanthem subitum. However, 9.1% of the patients were diagnosed meningitis, with 18 of 20 patients under 3 years of age. CONCLUSION: In the first seizure with fever, lumbar puncture is a useful method for meningitis, especially under 3 years of age.
Child* ; Exanthema ; Fever* ; Humans ; Meningitis ; Otitis Media ; Pneumonia ; Seizures* ; Seizures, Febrile ; Sex Distribution ; Spinal Puncture* ; Urinary Tract Infections

No Abstract Available.
Rupture* ; Tendons*

No abstract available.
Child* ; Humans ; Purpura, Thrombocytopenic, Idiopathic*

No abstract available.
Abscess* ; Magnetic Resonance Imaging*

For the evaluation of children with urinary tract infection, the effective diagnostic approach with appropriate imaging studies may be one of the most important process. But there is no definitely standardized method to evaluate these children. The author analysed the radiologic findings on 88 consecutive children with recurrent urinary tract infection to investigate the diagnostic efficacy of abdominal ultrasonography compared to conventional excretory urography and determine logical sequence of uroradiologic study in children with urinary tract infection. The results were as follows: 1 Of all the children studied, there were 37 cases of vesicoureteral reflux (VUR) with or without another urologic abnormalities such as posterior urethral valve and double collecting system, 32 cases of ureteropelvic junction obstruction (UPJ obstruction) and 1 case of multicystic kidney. 2. All cases with UPJ obstruction and multicystic kidney were diagnosed with abdominal ultrasonography. But excretory urography did not detect 2 cases of mild UPJ obstruction due to intermittent hydronephrosis 3. Of 37 cases with VUR, 3 cases were not detected with abdominal ultrasonography and 5 cases were not detected with excretory urography 4. Of all the cases studied, 18 cases did not have any anatomical abnormalities. In these cases, abnormal findings on excretory urography and ultrasonography were detected in 2 and 3 cases, respectively 5. In the evaluation of anatomical abnormalities in the patient of recurrent UTI, combined radiologic study of ultrasonography and voiding cystourethrography has the same efficacy as excretory urography and voiding cystourethrography. These results suggest that abdominal ultrasonography may be more effective than excretory urography in the evaluation of children with urinary tract infection. And both ultrasonography and excretory urography are relatively insensitive for detecting reflux and its sequel. So in the evaluation of children with urinary tract infection, voiding cystourethrography and ultrasonography should be performed initially. And excretory urography could be performed for selected cases.
Child* ; Humans ; Hydronephrosis ; Logic ; Multicystic Dysplastic Kidney ; Ultrasonography* ; Urinary Tract Infections* ; Urinary Tract* ; Urography ; Vesico-Ureteral Reflux

Twenty-two cases of non-tuberculous spinale pidural abscess treated at the Dept. of Neurosurgery, Kyungpuk University Hospital during the past 7 years from 1962 to 1969 were observed clinically. The results were summarized as follows: 1. The ratio between male and female was 2; 1. The peak age incidence of these cases was between 40 and 50 years old with 36% of patients and between 10 and 20 years old with 27% of patients falling into this range. 2. The most important source of infection was the furuncle or abscesses of the skin, which was responsible for 50% of total known cases. The most frequent site of infection was thoracolumber area, which was responsible for 50% of total cases. Among others, thoracic (32%) and lumbar (18%) areas were included. Bacterial culture was performed in 14 cases and staphylococcus was isolated in 11 cases. 3. As for clinical symptoms 12 cases revealed back pain, there showed fever, root pain and headache in some cases. Paraplegia or paraparesis observed in 19 cases, sphincter disturbance in 18 cases, sensory deficits in 17 cases, back tenderness and stiff neck were included in these groups. Pyogenic pus was aspirated in 3 cases through lumbar puncture from the epidural space. Manometric studies during the lumber puncture revealed a partial or complete blockage in 13 cases. The CSF analysis showed an increase of protein in 15 cases and an increase of cell count in 12 cases. 4. The operative findings were classified in three types. The type I, which was composed of pus only, was 4%, The type Ii of pus and granulation tissue was 50% and the type II of granulation tissue and adhesion was 36%. The postoperative prognosis has revealed to be excellent in 5 cases, good recovery in 8 cases and unimprovement of neurological deficits in 6 cases. Three cases succumbed to uncontrollable sepsis and pneumonia.
Abscess ; Back Pain ; Cell Count ; Epidural Abscess* ; Epidural Space ; Female ; Fever ; Furunculosis ; Granulation Tissue ; Headache ; Humans ; Incidence ; Male ; Middle Aged ; Neck ; Neurosurgery ; Paraparesis ; Paraplegia ; Pneumonia ; Prognosis ; Punctures ; Sepsis ; Skin ; Spinal Puncture ; Staphylococcus ; Suppuration ; Young Adult

Clear cell sarcoma of tendon and aponeuroses is slow growing and painless. It occur chiefIy in young adults, predominates in women and is most common in the region of the foot and knee. It is intimately bound to tendons or aponeuroses and is composed of srnall nest or aggregates of round or fusiform, pale staining cells showing prominent nucleoli. And it is tend to recur and to resuIt in eventual development of metastatic growth after a protracted clinical ccurs. Herein, we report a case of clear cell sarcorna of tendon anu aponeuross of metatarsophalangeal joint area between 2nd and 3rd light of left foot. The patient, 50-year-old female had a slow groving, asymptomatic, slightly eevated, emooth surfaced and normal skin colored mass for 2 years. Histopatholcigic tindings in dermis revealed nests of atypical polygonal or monotonous cells. Each cell had vesicular or hyperchrornatic nucleus with prominent nucleoli, occcasionally mitotic figure and abundant eosinophilic cytoplasm. For. treatment, transmetatarsal amputation was done.
Amputation ; Cytoplasm ; Dermis ; Eosinophils ; Female ; Foot* ; Humans ; Knee ; Metatarsophalangeal Joint ; Middle Aged ; Sarcoma, Clear Cell* ; Skin ; Tendons ; Young Adult

Immunohistochemical study for c-erbB-2 oncoprotein was performed on paraffin sections of 76 primary breast carcinomas to determine the relationship between expression of c-erbB-2 and various clinicopathological prognostic indicators, including the expression of epidermal growth factor receptor (EGFR). Positive reaction for c-erbB-2 oncoprotein revealed an intense red granular staining predominantly located at the tumor cell membrane, with some cells exhibiting a weak cytoplasmic staining as well. The epithelial cells of the normal lobule and duct showed a negative reaction. Positive reaction for EGFR revealed a granular staining in the cytoplasm and the cell membrane of the tumor cells. Some tumors showed a positive EGFR staining in the epithelial cells of normal duct and lobule. Twenty six of 76 cases (34.2%) of primary breast carcinomas revealed a positive reaction for c-erbB-2 oncoprotein, and 28 cases (36.8%) were positive for EGFR. Expression of c-erbB-2 oncoprotein and EGFR was evident in 37.7% and 40.6% of 69 classic invasive ductal carcinomas, respectively. None of the other histological types showed a positive reaction. Expression of c-erbB-2 oncoprotein was strongly associated with tumor size(p=0.0015), histologic grade(.p=0.0175), vascular invasion(p=0.0043), and lymph node metastasis(p=0.0024), but not with age at diagnosis(p=0.1836). No significant association was found between expression of c-erbB-2 oncoprotein and EGFR. Co-expression of c-erbB-2 oncoprotein and EGFR was also strongly associated with tumor size (p=0.0029). These results suggest that c-erbB-2 oncoprotein is biologically distinct from EGFR, and may be used as a prognostic indicator of breast carcinoma due to its strong association with various clinicopathological prognostic factors.