Agressive osteoblastoma is a very rare primary bone tumor having locally aggressive and destructive natures.But distant metastasis is not well occurred. Aggressive osteoblastoma may be similar to osteoblastomaradiologically, but has different pathological featurs. We experienced one case of aggressive osteoblastomaarising from left ilium and report this case with review of the literatures.
Ilium ; Neoplasm Metastasis ; Osteoblastoma

Tonsillar tuberculosis is uncommon and is almost secondary to pulmonary tuberculosis. Primary tonsillar tuberculosis is very rare, especially in children. The incidence of tuberculosis has been greatly reduced with chemotherapy, although it has not been eradicated. Recently, we experienced one case of pediatric primary tonsillar tuberculosis of left palatine tonsil. It was diagnosed pathologically after tonsillectomy and adenoidectomy. The purpose of this report is to point out that primary tonsillar tuberculosis still exists and to draw attention to the differential diagnosis in children.
Adenoidectomy ; Child* ; Diagnosis, Differential ; Drug Therapy ; Humans ; Incidence ; Palatine Tonsil* ; Tonsillectomy ; Tuberculosis* ; Tuberculosis, Pulmonary

The objective of this study is to measure eosinophil count and Eosinophil Cationic Protein (ECP) levels of tears and sera in patients with acute allergic conjunctivitis and normal subjects and to assess the correlation of this mediator with allergic conjuctivitis and the clinical usefulness. Seventeen subjects were selected on the basis of clinical manifestation, history, skin prick test, total IgE. Serum IgE and eosinophil count were increased in 10patients, and eosinophilia in conjunctival epithelium were present in 11subjects. ECP in tears were increased in patients significantly (12.0+/-8.0 vs 3.9+/-3.8ng/ml,p=0.01), but not in serum (52.5+/-43.1 vs 28.3+/-25.9ng/ml). There was significant relationship beween serum and tear eosinophil count(p=0.004,r=0.66). But there was no significant correlation between eosinophil count and ECP in serum (p>0.05m r=0.19), and no significant correlation between eosinophil count of conjectival epithelium and tears ECP (p=0.043, r=0.05). In conclusion, ECP in tears may be very important role in allergic conjunctivitis and is more reliable indicatior of diagnosis clinically rather than eosinophil count in tear and conjunctival epithelium.
Child* ; Conjunctivitis, Allergic* ; Diagnosis ; Eosinophil Cationic Protein* ; Eosinophilia ; Eosinophils* ; Epithelium ; Humans ; Immunoglobulin E ; Skin

Diffuse tremendous thickening of gastric wall caused by excessive proliferation of the mucosa of unknown causewas first decribed by Menetrier in 1888. The disease is highly uncommon, but the exact preoperative diagnosis iscrucial because of the more excellent prognosis than other malignant lesions including gastric lymphoma andinfiltrative gastric carcinoma. The authors recently experienced a case of Menetrier's disease which had beendiagnosed as gastric lymphoma preoperatively. Radiologic differentiation is not impossible between this extermelyrare disease and other mimicking malignant lesions, that is the reason why we introduce radiographic findings ofthe case by comparison with gastric lymphoma of giant rugal type and infiltrative gastric carcinoma. Typical upperG-I series findings of the case are: 1) Enlarged tortuous proximal gastric rugal folds only along the greatercurvature, 2) Perpendicular lines of barium spicules trapped by apposed folds with clubbed or forked appearance,3) Abrupt transition of transion to normal stomach, 4) No luminal narrowing and retained but sluggish peristalsis.Thus radiologists can diagnose Menetrier's disease scrupulously based on critical application of enlarged foldspattern and extent of the lesion in association with other radiologic features and clinial history of fairly longduration. Brief review of clinical and pathologic features about Menetrier's disease is included.
Barium ; Diagnosis ; Diagnosis, Differential ; Gastritis, Hypertrophic ; Hypertrophy ; Lymphoma ; Mucous Membrane ; Phenobarbital ; Prognosis ; Stomach

To evaluate MR findings of soft tissue masses in extremities and to find the helpful findings of distinguish benignity from malignancy, 28 soft tissue masses (22 benign and 6 malignant) in extremities were reviewed. T1-weighted, proton density, T2-weighted and Gd-DTPA enhanced images were obtained. MR images allowed a specific diagnosis in a large number of benign masses, such as hemangioma(8/9), lipoma(2/2), angiolipoma(1/1), epidermoid cyst(2/2), myositis ossificans(1/1), synovial chondromatosis(1/1) and pigmented villonodular synovitis (1/2). Specific diagnosis was difficult in the rest of the masses including malignancy. However, inhomogenous signal intensities with necrosis and inhomogenous enhancement may suggest malignant masses.
Diagnosis ; Extremities ; Gadolinium DTPA ; Myositis ; Necrosis ; Protons ; Synovitis, Pigmented Villonodular

In a series of 91 patients underwent stereotaxic evacuation of spontaneous intraparenchymal hematoma during last 2 years; 15 had simple aspiration and 76 had urokinase irrigation gradually through the indwelling silastic catheter. Dosage of used urokinase was average 26,000u and duration was average 2.8 days. The average removed volume percent of the hematoma was 80.1+/-15.2%, eight out of 76 cases were performed urokinase irrigation revealed rebleeding; causes were overpressure during aspiration in 4 cases, blood dyscrasia in 3 cases, and fibrinolytic effect of urokinase in one case. High incidence of rebleeding were; thalamus(4 out of 16 cases; 25%) in location, before 6 hours(4 out of 19 cases; 21.1%) in operation time interval from ictus, below 10ml(4 out of 13 cases; 30.8%) in volume of the hematoma, but not correlated with amount of used urokinase. Causes of unsatisfactory removed cases were small hematoma, brain stem and thalamic hemorrhage and malposition of the catheter. Even in cases of combined ventricular hemorrhage, we didn't experienced hydrocephalus with urokinase irrigation. In 20 cases sampled randomly, osmolality of serum and aspirated liquefied hematoma were compared; the serum osmolality was 297.6+/-12mEq and osmolality of liquefied hematoma induced by urokinase was 304.7+/-11.3mEq. These findings strongly suggest that the surrounding interstitial fluid of the hematoma was shifted into the liquefied hematoma because of 7mEq difference of osmotic pressure. Over all good result(daily living activity) on discharge was 64.5% and mortality rate was 7.9%.
Brain Stem ; Catheters ; Extracellular Fluid ; Hematoma* ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Mortality ; Osmolar Concentration ; Osmotic Pressure ; Urokinase-Type Plasminogen Activator

BACKGROUND: If epileptogenic foci are close to eloquent areas of the brain, awakening is needed for functional mapping during seizure surgery. In these cases adequate analgesia and sedation are needed. However sufficient dosage of intravenous anesthetics leads to many side effects. The authors used propofol and fentanyl infusion combined with scalp nerve block to reduce the severity of side effects from overdose of anesthetics. METHODS: The subjects were adult patients who would undergo awake craniotomy. After administering fentanyl 50~100 mcg intravenously, scalp nerve block was done to supraorbital, supratrochlear, auriculotemporal and lesser and greater occipital nerves of the surgical side with 0.25% bupivacaine containing 1 : 200,000 epinephrine. The anterior temporal region was infiltrated with the same local anesthetics. Oxygen was given by nasal cannula. During operation fentanyl was infused. Propofol was infused except during the awake period. Invasive arterial blood pressure, end-tidal CO2 and respiratory rate were monitored throughout the operation and arterial blood gas analysis was done intermittently. RESULTS: During total anesthesia time (410.3 39.9 min) propofol 16.2 6.3 mg/kg and fentanyl 11.9 3.7 mcg/kg were administered. The results of scalp nerve block were satisfactory. Brain swelling and transient decrease in respiratory rate were noticed in six patients and oxygen desaturation to 94% in one patient. All the patients were cooperative and the above problems were solved by reducing drug infusion rates. CONCLUSIONS: Propofol and fentanyl infusion with scalp nerve block may be an adequate method of anesthetic management for awake craniotomy.
Adult ; Analgesia ; Anesthesia ; Anesthetics ; Anesthetics, Intravenous ; Anesthetics, Local ; Arterial Pressure ; Blood Gas Analysis ; Brain ; Brain Edema ; Bupivacaine ; Catheters ; Craniotomy* ; Epinephrine ; Fentanyl ; Humans ; Nerve Block* ; Oxygen ; Propofol ; Respiratory Rate ; Scalp* ; Seizures

BACKGROUND: It is well known that growth hormone (GH) stimulates animal growth, but studies on metabolic effects of growth hormone have recently been increasing. The purpose of this study was to clarify the effects of growth hormone treatment on body composition and glucose metabolism in hypophysectomized growth hormone-deficient rats. METHODS: The 20-week-old rnale Sprague-Dawley rats were hypophysectomized and replaced with cortisol and thyroxine for 8 weeks, then administered with recombinant human growth hormone for 2 weeks. Group 1 consisted of intact controls (n 15), while group 2 consisted of hypophysectomized controls (n 12), and group three consisted of those with GH treatment (n 13). The body weights, body composition, blood glucose levels, plasma insulin-like growth factor-I (IGF-I) levels, euglycemic hyperinsulinemic clamp test, and glycogen synthase activities in gastrocnemius muscle were measured before and after growth hormone treatment. RESULTS: Plasma IGF-I levels in GH-treated group increased to intact control group levels after 2 weeks of GH treatment. There were significant changes in body composition after the treatment (fat mass significantly decreased and lean body mass significantly increased). There were no changes in glucose metabolism in peripheral tissue after 2 weeks of GH treatment. CONCLUSION: Human GH treatment (4 IU/kg/day) in adult hypophysectomized GH-deficient rats changed the body composition, but did not alter the glucose metabolism in peripheral tissue.
Adult* ; Animals ; Blood Glucose ; Body Composition* ; Body Weight ; Glucose* ; Glycogen Synthase ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hydrocortisone ; Insulin-Like Growth Factor I ; Metabolism* ; Muscle, Skeletal ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Thyroxine

Background: Following success of the phase III PROfound trial, the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib was approved by the US Food and Drug Administration in May 2020 for adult patients with deleterious homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer (mCRPC). As locally adopted multigene panel next-generation sequencing (NGS) assays for selecting PARP inhibitor candidates have not been thoroughly evaluated, we compared the analytical performance of the FoundationOne CDx (Foundation Medicine, Inc., Cambridge, MA, USA) (central laboratory) and other NGS assays (local laboratory) with samples from the PROfound trial in Korea. Methods: One hundred PROfound samples (60 HRR mutation [HRRm] cases and 40 non-HRRm cases) were analyzed. The results of HRR gene mutation analysis were compared between the FoundationOne CDx and two other NGS assays [SureSelect Custom Design assay (Agilent Technologies, Inc., Santa Clara, CA, USA) and Oncomine Comprehensive assay (Thermo Fisher Scientific, Inc., Waltham, MA, USA)]. Results: The positive percent agreement for single nucleotide variants (SNVs) and insertion/deletions (indels) between the central laboratory and local laboratory was 98.7%–100.0%. The negative percent agreement and overall percent agreement (OPA) for SNVs and indels between central and local laboratories were both 100%. Compared with that of the FoundationOne CDx assay, the OPA for copy number variations of the Oncomine Comprehensive and SureSelect Custom assays reached 99.8%–100%. Most mCRPC patients harboring a deleterious genetic variant were successfully identified with both local laboratory assays. Conclusions The NGS approach at a local laboratory showed comparable analytical performance for identifying HRRm status to the FoundationOne CDx assay used at the central laboratory.

Objective: A simultaneous detection of germline and somatic mutations in ovarian cancer (OC) using tumor materials is considered to be cost-effective for BRCA1/2 testing. However, there are limited studies of the analytical performances according to various sample types. The aim of this study is to propose a strategy for routine BRCA1/2 next-generation sequencing (NGS) screening based on analytical performance according to different sample types. Methods: We compared BRCA1/2 NGS screening assay using buffy coat, fresh-frozen (FF) and formalin-fixed paraffin-embedded (FFPE) from 130 samples. Results: The rate of repeated tests in a total of buffy coat, FF and FFPE was 0%, 8%, and 34%, respectively. The accuracy of BRCA1/2 NGS testing was 100.0%, 99.9% and 99.9% in buffy coat, FFPE and FF, respectively. However, due to the presence of variant allele frequency (VAF) shifted heterozygous variants, tumor materials (FFPE and FF) showed lower sensitivity (95.5%–99.0%) than buffy coat (100%). Furthermore, FFPE showed 51.4% of the positive predictive value (PPV) on account of sequence artifacts. When performed in the post-filtration process, PPV was increased by approximately 20% in FFPE. Buffy coat showed 100% of sensitivity, specificity and accuracy in BRCA1/2 NGS test. Conclusions On the comparison of the analytical performance according to different sample types, the buffy coat was not affected by sequencing artifacts and VAF shifted variants. Therefore, the blood test should be given priority in detecting germline BRCA1/2 mutation, and tumor materials could be suitable to detect somatic mutations in OC patients without identifying germline BRCA1/2 mutation.