Since early 1980's high resolution ultrasound has been world-widely used for detection of cranial lesions ininfants but not widely used in korea. Authors prospectively analysed ultrasonographic findings of 107 cases whichwere confirmed by CT, autopsy or follow-up studies as supplement. the distribution of 107 cases was intracranialhematoma 40 cases, hydrocephalus 36 cases, hypoxic-ischemic encephalopathy 10 cases, porencephalic cyst 5 cases,cephalhematoma 5 cases, agenesis of corpus callosum 4 cases, medulloblastoma 2 cases and each one case of A-Vmalformation, intraventricular cyst, Dandy Walker cyst, lipoma and hydranecephaly. We could conclude thatneurosonography of infants was very useful and effective method in detection of cranial lesions such asintracranial hematoma, especially germinal matrix hemorrhage or intraventricular hemorrhage in preterm infant,hydrocephalus, hypoxic-ischemic encephalopathy and congenital anomalies.
Agenesis of Corpus Callosum ; Autopsy ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Hypoxia-Ischemia, Brain ; Infant ; Korea ; Lipoma ; Medulloblastoma ; Methods ; Prospective Studies ; Ultrasonography ; Walkers

OBJECTIVE: Angiogenesis, the formation of blood vessels by sprouting from pre-existing ones, is essential for the growth of solid tumors beyond 2-3mm in diameter and for tumor metastasis. Vascular endothelial growth factor (VEGF), is known as vascular permeability factor(VPF) and mediates vascularization and tumor-induced angiogenesis. This study examined the potential of growth, invasion, and metastasis of uterine cervical carcinomas associated with neovascularization. METHODS: From January 1996 to December 1999, at the Department of Obstetrics and Gynecology, Kyung-Hee University Hospital, 37 uterine cervical carcinomas and 7 normal cervical tissues were obtained and the samples were immediately frozen and stored at -70 degrees C. Immunohistochemical staining for VEGF was carried out to study VEGF localization, and the levels of VEGF subtype mRNAs were determined by quantitative RT-PCR in specimens. The relation between VEGF subtypes expression of cervical cancers was analysed. RESULTS: The positive staining for VEGF is seen dominantly in the cytoplasm of the cancer cells, and faintly in interstitial cells. The intensity of staining was stronger in squamous carcinomas than in adenocrcinomas, but there was no significant difference (p>0.05). Quantitative RT-PCR analysis demonstrated significantly increased VEGF121/VEGF165 mRNA expression levels (>0.56 / >0.72) in 21 (56.8%) and 15 (40.5%) of 37 cervical carcinomas comparing to control groups (mean: 0.28 / 0.36). There was no obvious relationship between VEGF121/VEGF165 mRNA expression levels and the clinical parameters examined including age, pathology, differentiation, tumor size, lymphovascular space invasion, LN involvement and invasion depth except clinical stage (p<0.05). CONCLUSIONS: The overexpression of VEGF mRNA may be an important contributing factor in cervical carcinomas. There is no significant differenece of VEGF mRNAs levels according to clinical parameters, so it seems that the expression of VEGF is involved in the promotion of angiogenesis on cervical cancer and plays an important role in early invasion.
Blood Vessels ; Capillary Permeability ; Carcinoma, Squamous Cell ; Cytoplasm ; Gynecology ; Neoplasm Metastasis ; Obstetrics ; Pathology ; RNA, Messenger* ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

Doxazosin is an adrenergic alpha-1 receptor antagonist used to treat lower urinary tract symptoms that are common in prostatic hyperplasia. To our knowledge, few cases of gynecomastia and mastodynia, as a complication of adrenergic alpha-1 receptor antagonist, have been reported to date; no cases have been reported in Korea. We describe a case involving a 78-year-old man treated for prostatic hyperplasia with 13 months of doxazosin. He complained about unilateral gynecomstia and mastodynia. Five months after the discontinuation of doxazosin, the gynecomastia was significantly improved. This is the first reported case of gynecomastia and mastodynia associated with doxazosin use in Korea.
Aged ; Doxazosin* ; Gynecomastia* ; Humans ; Korea ; Lower Urinary Tract Symptoms ; Male ; Mastodynia ; Prostatic Hyperplasia

Cardiovascular malformations, such as bicuspid aortic valve and coarctation of the aorta, are more prevalent in patients with Turner syndrome than in the general population. Here, we describe the case of a 35-year-old female with Turner syndrome who was admitted to our hospital with a fever caused by infective endocarditis. Aortic coarctation was diagnosed using computed tomography. The patient was treated with antibiotics and a stent was then implanted. Endovascular therapy using stents is a safe and effective treatment option for aortic coarctation in patients with Turner syndrome.
Adult ; Anti-Bacterial Agents ; Aortic Coarctation* ; Aortic Valve ; Bicuspid ; Endocarditis ; Female ; Fever ; Humans ; Stents* ; Turner Syndrome*

BACKGROUND AND OBJECTIVES: Antrochoanal polyp (ACP) is defined as a polyp that originates in the maxillary sinus and passes through the sinus ostia. Physical examination and radiologic findings are the two most important aspects in the diagnosis and treatment of ACPs. However, there have been little attempts to describe the OMU CT findings of ACPs. In this study, authors reviewed the preoperative OMU CT findings of ACPS. MATERIALS AND METHOD: A total of 21 patients without the history of any previous nasal operations were entered into the study. The following seven radiologic parameters were reviewed: presence of polyp, origin of ACP, identification of accessory ostium, destruction in the OMU area, bony changes of the medial maxillary sinus wall, shapes of ACP that extended into nasopharynx in relation with sinusitis. RESULTS: ACPs were classified into three stages according to the level of extension. Of those 21 patients, polyps were observed in 20 patients, destructive changes only in 2 patients and bony changes of the medial wall in 17 patients. Lobulated contour in shape was observed in 24% of the patients. CONCLUSION: ACP is originated in the maxillary sinus and it grows into the nasal cavity via the posterior fontanelle area. It may regress due to insufficient blood supply, but its shape is retained.
Cranial Fontanelles ; Diagnosis ; Humans ; Maxillary Sinus ; Nasal Cavity ; Nasal Polyps ; Nasopharynx ; Physical Examination ; Polyps* ; Sinusitis

We report a case of nephrotic syndrome with thymic neuroendocrine tumor. A 50-year-old woman was admitted with generalized edema. 24-hour urine collection revealed proteinuria of 20 gram daily and creatinine clearance of 28 mL/min. During examination, a thymic mass was found, which is unresectable due to metastasis to the lung. Biopsy of the thymus and the kidney revealed large cell neuroendocrine carcinoma of thymus origin and minimal change disease, respectively. Despite high dose steroid therapy, massive proteinuria continued for about 30 days. However, when the patient was given a chemotherapy (cyclophosphamide, adriamycin, vincristine), proteinuria began to decrease dramatically. The carcinoma showed the partial response after six cycles of chemotherapy. This is the first report on remission of malignancy-related nephrotic syndrome after chemotherapy, especially for thymic neuroendocrine tumor.
Biopsy ; Carcinoma, Neuroendocrine ; Creatinine ; Doxorubicin ; Edema ; Female ; Humans ; Kidney ; Lung ; Middle Aged ; Neoplasm Metastasis ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Neuroendocrine Tumors ; Proteinuria ; Thymus Gland ; Thymus Neoplasms ; Urine Specimen Collection

The nonrecurrent laryngeal nerve is a rare anomaly that may increase the risk of nerve injury during thyroid surgery. We experienced a case of nonrecurrent laryngeal nerve seen in a 35-year-old woman with adenomatous hyperplasia on her right thyroid. The nonrecurrent laryngeal nerve was incidentally found during the right thyroid lobectomy. It directly branched from the right vagus nerve and followed a transverse path parallel to the trunk of the inferior thyroid artery. The right lobectomy was performed with a careful preservation of the nerve. Postoperatively, the review of CT scan which was taken preoperatively revealed an aberrant right subclavian artery, which arose from the aortic arch and crossed behind the esophagus. To avoid an inadvertent injury to the nonrecurrent laryngeal nerve during thyroid surgery, it is important to be aware of the possibility of a nonrecurrent laryngeal nerve, particularly when an aberrant right subclavian artery is recognized preoperatively.
Adult ; Aorta, Thoracic ; Arteries ; Esophagus ; Female ; Humans ; Hyperplasia ; Laryngeal Nerves* ; Subclavian Artery ; Thyroid Gland ; Tomography, X-Ray Computed ; Vagus Nerve

PURPOSE: This study investigated the clinicopathological characteristics and prognostic factors in young patients with differentiated thyroid carcinoma. METHOD: Among the 3, 837 patients with DTC who were treated in the Department of Surgery at Yonsei University College of Medicine from March 1986 to March 2005, 71 patients were less than 20 years of age when diagnosed. The mean age was 14.9 years (range, 4~20 years). There were 59 females and 12 males with a mean follow-up period of 91.8 months (range, 14~205 months). RESULTS: The cause specific and the progression-free survivals at 10 years were 100% and 80.3%, respectively. Eleven patients (15%) experienced a recurrence and 1 patient showed a progression of a pulmonary metastasis at diagnosis. Compared with 39 patients older than 15, 32 patients younger than 15 years of age tended to have a higher incidence of a N1b and M1 stage, and a lower progression-free survival rate. Univariate analysis revealed that an age < or =15 years, multicentricity, N1b stage, M1 stage, and bilateral radical neck dissection had a negative impact on the progression-free survival. However, multivariate analysis showed that the age at diagnosis and the M1 stage were independent prognostic factors for progression- free survival. CONCLUSION: Being younger 15 years and the M1 stage are the most significant prognostic factors negatively influencing the progression-free survival. The high incidence of lateral neck and lung metastasis justifies a total thyroidectomy and modified radical neck dissection, followed by postoperative 131I therapy even in patients younger than 15 years of age.
Diagnosis* ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lung ; Male ; Multivariate Analysis ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

We report an unexplained anemia that persisted for 4 months in a renal transplant patient who was receiving immunosuppression therapy that included prednisolone, tacrolimus, and azathioprine. A bone marrow biopsy demonstrated pure erythroid hypoplasia and occasional giant pronormoblasts with intranuclear inclusions, characteristic of a parvovirus B19 infection. Both the serum and bone marrow cells were positive for a parvovirus B19 DNA polymerase chain reaction. The anemia resolved 6 weeks after the administration of IV immunoglobuln. But, 4 months later, refractory anemia developed and persisted despite treatment with IV immunoglobulin. However, the patient showed rapid improvement after tacrolimus was switched to cyclosporin A. A parvovirus B19 infection should be included in the differential diagnosis of renal transplant recipients who present with an anemia associated with low reticulocytes; and clinicians should be awared that tacrolimus may impair the clearance of a parvovirus B19 infection.
Anemia* ; Anemia, Refractory ; Azathioprine ; Biopsy ; Bone Marrow ; Bone Marrow Cells ; Cyclosporine ; Diagnosis, Differential ; DNA ; Erythroblasts ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Immunosuppression ; Intranuclear Inclusion Bodies ; Kidney Transplantation ; Parvovirus* ; Polymerase Chain Reaction ; Prednisolone ; Red-Cell Aplasia, Pure ; Reticulocytes ; Tacrolimus ; Transplantation

BACKGROUND AND PURPOSE: We studied the clinical significance of amplitude-reduction and disappearance alarm criteria for transcranial electric muscle motor-evoked potentials (MEPs) during cervical spinal surgery according to different lesion locations [intramedullary (IM) vs. nonintramedullary (NIM)] by evaluating the long-term postoperative motor status. METHODS: In total, 723 patients were retrospectively dichotomized into the IM and NIM groups. Each limb was analyzed respectively. One hundred and sixteen limbs from 30 patients with IM tumors and 2,761 limbs from 693 patients without IM tumors were enrolled. Postoperative motor deficits were assessed up to 6 months after surgery. RESULTS: At the end of surgery, 61 limbs (2.2%) in the NIM group and 14 limbs (12.1%) in the IM group showed MEP amplitudes that had decreased to below 50% of baseline, with 13 of the NIM limbs (21.3%) and 2 of the IM limbs (14.3%) showing MEP disappearance. Thirteen NIM limbs (0.5%) and 5 IM limbs (4.3%) showed postoperative motor deficits. The criterion for disappearance showed a lower sensitivity for the immediate motor deficit than did the criterion for amplitude decrement in both the IM and NIM groups. However, the disappearance criterion showed the same sensitivity as the 70%-decrement criterion in IM (100%) and NIM (83%) surgeries for the motor deficit at 6 months after surgery. Moreover, it has the highest specificity for the motor deficits among diverse alarm criteria, from 24 hours to 6 months after surgery, in both the IM and NIM groups. CONCLUSIONS: The MEP disappearance alarm criterion had a high specificity in predicting the long-term prognosis after cervical spinal surgery. However, because it can have a low sensitivity in predicting an immediate postoperative deficit, combining different MEP alarm criteria according to the aim of specific instances of cervical spinal surgery is likely to be useful in practical intraoperative monitoring.
Extremities ; Humans ; Monitoring, Intraoperative ; Prognosis* ; Retrospective Studies ; Sensitivity and Specificity