No abstract available.
Drug Therapy* ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

Sertoli-Leydig cell tumors of the ovary are rare, accounting for no more than 0.5% of all ovarian neoplasms. These tumors occur predominantly in women 10 to 30 years of age. Heterologous elements are found in over 20% of the moderately and poorly differentiated Sertoli- Leydig cell tumors. The most common element is gastrointestinal mucin-secreting epithelium, found in approximately 20% of all cases. Approximately 4% of Sertoli-Leydig cell tumors contain immature skeletal muscle and/or cartilaginous elements. The origin of these neoplasms is regarded as neometaplasia of the mesodermal neoplastic element. While the degree of differentiation of Sertoli-Leydig cell tumors is probably of greater importance in determining prognosis than the presence of heterologous components, recent evidence does point to an unfavorable effect on clinical outcome when heterologous mesenchymal components such as cartilage and striated muscle are present. We experienced two cases of ovarian heterologous Sertoli-Leydig cell tumors with gastrointestinal type epithelium and striated skeletal muscle in 20 and 21 year-old females, respectively. One case involved a patient who had complained of amenorrhea for 3 years while the other case involved a patient who had complained of left lower abdominal tenderness and amenorrhea for one and one half years. It was determined by ultrasonography of the pelvis that the two patients suffered from right and left ovarian masses. Both patients underwent adnexectomy. These tumors were large with partly solid and partly cystic areas. Based on light microscopic examination one case was classified as an intermediate Sertoli-Leydig cell tumor with heterologous gastrointestinal type epithelium, while the other case was classified as a poorly differentiated Sertoli-Leydig cell tumor with heterologous striated skeletal muscle.
Female ; Humans

Congenital ocular motor apraxia is a rare syndrome characterized by rotational head thrusts that attempt to compensate for the lack of voluntary eye movements. We describe the clinical, oculographic and magnetic resonance imaging features of two children with congenital ocular motor apraxia.
Apraxias ; Child ; Cogan Syndrome ; Eye Movements ; Head ; Humans ; Magnetic Resonance Imaging

BACKGROUND: Methyl bromide is toxic to the central and peripheral nervous systems. Two patients with occupational exposure to this agent are described. CASE: Two cases of previously healthy young men were involved. They had worked in a fumigating plant spraying fruits using methyl bromide for several months before admission. They showed general weakness, severe ataxia, bilateral dysmetria and bilateral lateral gaze limitation. And gaze-evoked nystagmus was observed in one of them. Brain MRI showed symmetrically increased signal intensity lesions including the brainstem, cerebellum and splenium of corpus callosum. After conservative treatment, they gradually improved over the next few weeks. CONCLUSIONS: Symmetry and topography of our patients??clinical and radiographic abnormalities support the proposal that methyl bromide exposure can produce symptoms similar to Bickerstaff's brainstem encephalitis.
Ataxia ; Brain ; Brain Stem ; Cerebellar Ataxia ; Cerebellum ; Corpus Callosum ; Encephalitis ; Fruit ; Humans ; Hydrocarbons, Brominated ; Male ; Occupational Exposure ; Peripheral Nervous System ; Plants

Isaacs' syndrome is a rare and heterogeneous syndrome of continuous muscle fiber activity that originates from peripheral nerves. We report a 56-year-old male patient who showed symptoms of Isaacs' syndrome after the removal of a malignant thymoma. Needle electromyography revealed spontaneously occurring repetitive myokymic discharge in the affected muscles. Acetylcholine receptor (AChR) antibodies were significantly elevated, but clinical and electrophysiologic findings did not indicate the presence of myasthenia gravis. We deduce that in Isaacs' syndrome, raised AChR antibodies may facilitate rather than inhibit cholinergic action.
Acetylcholine ; Antibodies ; Electromyography ; Humans ; Isaacs Syndrome ; Male ; Middle Aged ; Muscles ; Myasthenia Gravis ; Needles ; Peripheral Nerves ; Thymoma

A twenty four-year-old female patient had suffered progressive dyspnea for 6 years until death. She denied any symptoms suggestive of connective tissue disease, or deep vein thrombosis. She suffered an episode of pontine infarct in 1995. Four years after diagnosis of primary pulmonary hypertension, she died of sudden death during hospitalization. Gross features of pulmonary arteries at autopsy were as follows: left main pulmonary artery showed dilation of the lumen and thickening of the wall, and right main pulmonary artery was markedly dilated and contained fresh thrombus. Hematoxylin and eosin-stained sections of lung tissue showed plexiform lesions of pulmonary arteries, complete luminal obliteration of pulmonary arterioles and dilated lesion of pulmonary arterioles, and capillaries. This patient represents a typical case with a primary pulmonary arteriopathy with plexiform lesions with thrombotic lesion, demonstrating the importance of thrombosis in situ in the pathogenesis of primary pulmonary hypertension. To our knowledge, this is the first autopsy report on the primary pulmonary hypertension in Korea.
Arterioles ; Autopsy ; Capillaries ; Connective Tissue Diseases ; Death, Sudden ; Diagnosis ; Dyspnea ; Female ; Hematoxylin ; Hospitalization ; Humans ; Hypertension, Pulmonary* ; Korea ; Lung ; Phenobarbital ; Pulmonary Artery ; Thrombosis ; Venous Thrombosis

Post-traumatic encephalopathy is characterized by the combination of upper motor neurons, basal ganglia, cerebellar, and psychiatric disturbances. A "striatal" variant, with predominant parkinsonism, is uncommon and may be difficult to distinguish from idiopathic Parkinson's disease. A 38-year-old man, who had history of head injuries associated with brief losses of consciousness, developed a resting tremor and rigidity of the left lower extremity. Upon admission, he showed masked face and bradykinesia without dementia or other neurologic abnormalities. Brain MRI and SPECT studies showed no abnormalities. A BAEP study revealed an abnormal prolongation of inter-peak latencies between wave III and V.
Adult ; Basal Ganglia ; Brain ; Brain Injuries ; Consciousness ; Craniocerebral Trauma* ; Dementia ; Head* ; Humans ; Hypokinesia ; Lower Extremity ; Magnetic Resonance Imaging ; Masks ; Motor Neurons ; Parkinson Disease ; Parkinsonian Disorders* ; Tomography, Emission-Computed, Single-Photon ; Tremor

Post-traumatic encephalopathy is characterized by the combination of upper motor neurons, basal ganglia, cerebellar, and psychiatric disturbances. A "striatal" variant, with predominant parkinsonism, is uncommon and may be difficult to distinguish from idiopathic Parkinson's disease. A 38-year-old man, who had history of head injuries associated with brief losses of consciousness, developed a resting tremor and rigidity of the left lower extremity. Upon admission, he showed masked face and bradykinesia without dementia or other neurologic abnormalities. Brain MRI and SPECT studies showed no abnormalities. A BAEP study revealed an abnormal prolongation of inter-peak latencies between wave III and V.
Adult ; Basal Ganglia ; Brain ; Brain Injuries ; Consciousness ; Craniocerebral Trauma* ; Dementia ; Head* ; Humans ; Hypokinesia ; Lower Extremity ; Magnetic Resonance Imaging ; Masks ; Motor Neurons ; Parkinson Disease ; Parkinsonian Disorders* ; Tomography, Emission-Computed, Single-Photon ; Tremor

BACKGROUND AND OBJECTIVE: Transient global amnesia(TGA) is a neurological syndrome affecting preferentially middle-aged or elderly people and characterized by sudden onset of transient impairment of antegrade amnesia with variably retrograde amnesia. TGA was defined over 30 years ago, but the etiology remain unclear. Several mechanisms have been proposed, including arterial thromboembolic ischemic attacks in both posterior cerebral artery territories, epilepsy, and migraine. Although many studies have reported TGA, only a few reported cerebral perfusion studies using SPECT because of the brief duration of the episode. Technetium-99m-ethyl cysteinate dimmer(ECD) is superior to sensitivity of lesion detection and lesion to normal contrast, probably due to lower back diffusion from the brain to the blood and its excellent radiochemical stability. So we evaluate pathophysiologic mechanism of TGA by using 99mTC-ECD SPECT with or without acetazolamide(ACZ) stress. METHODS: We evaluated six patients with transient global amnesia, four women and two men, age ranges 56 to 78 years, mean 62.2 years. Measurements of CBF and vascular reserve using 99mTC-ECD with or without ACD stress were performed during or after TGA episode. RESULTS: One patient, who was evaluated in TGA episode showed that regional cerebral blood flow was decreased in both anteroinferior frontal, both temporal, right thalamus, both inferior parietal and left parietal region with impaired vascular reserve in left inferior temporal and right thalamus. Others, who were evaluated more than 6days in TGA episode showed that regional cerebral blood flow was decreased in left temporal (4), both temporal region (1), left thalamus (2) and both basal ganglia (1) with preserved vascular reserve except one, showed impaired vascular reserve in left thalamus. CONCLUSION: This result show that severe hypoperfusion of bilateral temporal region and impaired vascular reserve in left temporal region in TGA episode. Other patients who were recovered from TGA showed hypoperfusion of left temporal region and preserved vascular reserve. 99mTc-ECD with acetazolamide SEPCT that sensitively detects localized impaired cerebraovascular reserve should help elucidate these processes. But further study with more cases is necessary for evaluation of pathophysiology of TGA.
Acetazolamide ; Aged ; Amnesia ; Amnesia, Retrograde ; Amnesia, Transient Global* ; Basal Ganglia ; Brain ; Diffusion ; Epilepsy ; Female ; Humans ; Male ; Migraine Disorders ; Perfusion ; Posterior Cerebral Artery ; Rabeprazole ; Technetium* ; Thalamus ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Abortion, Spontaneous* ; Chorion* ; Chorionic Villi* ; Female ; Humans ; Pregnancy