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

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

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

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

PURPOSE:The incidence of glucose intolerance is increased in patients with Turner syndrome. Both noninsulin dependent diabetes mellitus and insulin dependent diabetes mellitus are increased. The purpose of this study was to investigate the impaired rate of carbohydrate metabolism in Turner syndrome after growth hormone treatment. METHODS:We investigated the incidence of carbohydrate intolerance and diabetes mellitus in 94 patients with Turner syndrome with NDDG and WHO criteria. The oral glucose tolerance test was performed in 78 patients. In 12 patients treated with growth hormone, the glucose tolerance test was performed before and after treatment. The insulin tolerance test was done in 20 patients. RESULTS:Only one patient had random plasma glucose level of more than 200 mg/dl. In results of the glucose tolerance test(n=78), 2 patients had glucose tolerance by NDDG criteria and 7 patients had it by WHO criteria. There was no change in glucose tolerance test results during growth hormone treatment. According to the results of the insulin tolerance test, we couldn't find any difference in insulin resistance between the growth hormone treatment group and the other treatments(oxandrolone, estrogen) group. CONCLUSION: The impaired rate of carbohydrate metabolism in Turner syndrome was much lower than in other reports. We observed that the impaired rate of carbohydrate metabolism did not increase after growth hormone treatment. However, the long-term effects in patients treated with growth hormone will be elucidated.
Blood Glucose ; Carbohydrate Metabolism* ; Diabetes Mellitus ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Growth Hormone* ; Humans ; Incidence ; Insulin ; Insulin Resistance ; Turner Syndrome*

Due to the limited supply of livers for transplantation and acute situations in which an orthotopic liver transplantation (OLT) is needed, nonidentical ABO blood group OLTs are performed. One of the risks of transplanting an O liver into an A/B/AB recipient is the development of hemolysis. We managed 2 cases of ABO-compatible but nonidentical OLTs. Both recipients suffered from Wilson's disease (blood group B+ ) and received a blood group O+ donor liver. One of them was a 39.5 kg, 12 year-old-girl and the other was an 81 kg, 21 year-old-woman. The average duration of anesthesia was about 12 hr 30 min and the anhepatic times were 51 min and 57 min, respectively. During and after the operation, we used the recipients' type packed red cells and fresh frozen plasma. Hemodynamic values, serum electrolytes and blood coagulation were relatively well maintained throughout the operation. A mild decrease in hematocrit was observed 10 and 7 days after operation, respectively. However, there was no evidence of hemolysis, clinically.
Anesthesia ; Blood Coagulation ; Electrolytes ; Hematocrit ; Hemodynamics ; Hemolysis ; Hepatolenticular Degeneration ; Humans ; Liver Transplantation* ; Liver* ; Plasma ; Tissue Donors

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

STUDY DESIGN: This is a retrospective study analyzing 73 patients treated by decompression, pedicular screw instrumentation and posterior lumbar interbody fusion (PLIF) for lumbosacral spondylolithesis and symptomatic spinal stenosis. we used laminected laminar and spinous process instead of iliac bone. OBJECTIVES: This is to evaluate fusion rate and clinical results of PLIF with laminected laminar and spinous process. MATERIALS AND METHODS: PLIF in 73 patients with lumbosacral disorders who carried out at Pohang St. Mary's Hospital from March 1994 to January 1996. Fusion rate was evaluated by simple X-ray and dynamic view. Clinical effect was evaluated by Kirkaldy-Willis criteria. RESULTS: The solid fusion was achieved at 67 cases(91.8%) and the average period of fusion was 6.4 months. Complications were 2 cases of superficial skin infection and 3 cases of root irritation. The functional results by Kirkaldy-Willis were as follows ; excellent 40 cases, good 23 cases, fair 9 cases and poor 1 case. CONCLUSIONS: This PLIF procedure combined with transpedicular instrumentation showed sufficient fusion rate and excellent clinical results and improvement in vertebral alignment.
Decompression ; Gyeongsangbuk-do ; Humans ; Retrospective Studies ; Skin ; Spinal Stenosis