Lipid cell tumors of the ovary are among the rarest of the functional ovarian neoplasms. Recently, authors experienced a case of lipid cell tumor of the left ovary in a 19 year old female, who presented with amenorrhea and hirsutism for 4 years. Grossly, the ovary was well encapsulated, and measured 6.5x6x4.5 cm. Cut surface show homogenous yellowish bulging neoplastic tissue and peritheral displaced normal ovarian tissue. Microscopically, neoplastic cells were composed of rounded and polyhedral cells, arranged in nests seperated by rich vascular networks. On the basis of the author's findings and the evidence available in the literature, we determined this case as ovarian lipid cell tumor.
Female ; Humans

A 55 year old male complain right shoulder pain and right upper quadrant pain about three months. He was a heavy alcoholism. Highly selective angiography, CT scan and operation findings suggest primary malignant neoplasm of the liver. Right hepatic lobectomy and partial diaphragmectomy was done under impression of heaptocellular carcinoma. The specimen measured 15x11x9 cm and disclose relatively hard and nodular mass devoid of cirrhotic changes. Cut surface show unilobar large mass measuring 11x8x6 cm and bearing brightly yellow discoloration and multifocal hemorrhagic necrosis. Histological characteristics were diffuse proliferation of large neoplastic cells with ample cytoplasm, containing granular materials, erythrophagocytosis, neutrophagocytosis and hemosiderin pigments. Atypical and bizarre mitosis and multinucleated giant cells bearing abundant erythro and neutrophagocytosis were frequently seen. The large or vesicular nuclei were irregular, with occasional deep indentations and revealed sharply defined nuclear membrane, coarse chromatin and conspicious nucleoli. Ultrastructurally the cytoplasm of neoplasltic cells had lysosomal granule, phagolysosome, phagocytized material and residual bodies. Immunohistochemical stains for alpha 1-antitrypsin, alpha 1-antichymotrypsin, vimentin and lysozyme showed positive reactions, but, alpha fetoprotein, cytokeratin, S-100 protein, factor VIII, complement 3 receptor and carcinoembryonic antigen were negative. Alpha-naphtyl acetate esterase activity in paraffin embedded tissue ribbon showed negative reaction. These findings show compatible with primary malignant lymphoma, true histiocytic type, (histiocytic sarcoma, Kupffer cell carcinoma) of the liver.
Male ; Humans

To know the pattern of visual field (VF) defect of low tension glaucoma (LTG), its diffuse and localized VF defects were compared using the significance values (p-value) of mean deviation (MD) and corrected pattern standard deviation (CPSD), which are calculated with STATPAC in Humphrey Visual Field Analyser. Sixteen eyes of LTG were enrolled and 34 eyes of primary open angle glaucoma (POAG) were used as controls. The degree of VF defects in LTG and POAG was relatively mild with the p-value of MD equal to or greater than 1%. Neither mean MD nor mean CPSD of LTG was significantly different from each of POAG (p > 0.8 and p > 0.2, respectively). Comparing the p-values of MD and CPSD, many patients showed more significant p-value of MD in LTG and POAG (62.5% and 61.8%, respectively). However, relatively more severe defect of CPSD tended to occur more frequently in LTG than in POAG (25% and 5.9%, respectively, chi-square = 4.964, p < 0.09). The relation between p-values of MD and CPSD was not significantly influenced by the intraocular pressure, MD or vertical cup to disc ratio in either LTG or POAG.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Glaucoma, Open-Angle/*pathology/physiopathology ; Humans ; *Intraocular Pressure ; Male ; Middle Aged ; Optic Disk/*pathology ; Probability ; Vision Disorders/*pathology ; *Visual Fields

Anterior mediastinal teratoma was removed from the right hemithorax of a 15-year-old male patient presenting initially with right chest discomfort and hemoptysis. He was died following precipitous clinical deterioration, 2 months after open thoracotomy. The true malignant nature of this tumor, that there are endodermal sinus tumor and squamous cell carcinoma, was apparent on resection specimen. The former had metastasized to right supraclavicular lymph node. A similar case has not been reported previously on the review of the pertinent literature on malignant mediastinal teratoma.
Male ; Humans

PURPOSE: Since a few cases of keratectasia after LASIK were reported, the importance of residual corneal thickness has been emphasized. This study was to analyze adverse effects which may occur in reducing corneal flap thickness to increase residual corneal thickness. METHODS: A total of 237 eyes of 149 patients who had been followed up for 6 months or more after LASIK were evaluated retrospectively. Intended corneal flap thickness was 130 micrometer in 116 eyes(group A), and 160 micrometer in 121 eyes(group B) using an Automated Corneal Shaper(Chiron, USA). Clinical outcomes were compared between two groups. RESULTS: Except for some cases with retinal complication after surgery, 3 eyes lost best-corrected visual acuity by 2 lines or more in group A and 1 eye in group B, which was not statistically significant.(p>0.05) Fourteen eyes lost 1 line or more best-corrected visual acuity by postoperative irregular astigmatism in group A and 10 eyes in group B, which showed no significant difference, either. The incidence of flap-related complications such as wrinkling and free cap did not differ significantly between two groups(p>0.05). CONCLUSIONS: To leave residual cornea of greater thickness using a 130 micrometer thick flap rather than 160 micrometer may be a useful method to avoid postoperative keratectasia, one of the most severe complications.
Astigmatism ; Cornea ; Humans ; Incidence ; Keratomileusis, Laser In Situ* ; Retinaldehyde ; Retrospective Studies ; Visual Acuity

In a study of primary brain tumors 104 cases having satisfactory clinical, operative and histological proofswere analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to April, 1985. The resultswere as follows: 1. The male to female ratio of primary brain tumor was 54:46. 2.The 2nd decade group (26%) wasthe most prevalent age group, followed by the 5th decade(16.3%), 1st decade(14.4%), 3rd decade(12.5%), 4thdecade(11.5%), 6th decade(10.6%), 7th decade(8.7%) in that order. 3. The incidence of primary brain tumors was found to be: glioma 64 cases(61.6%) (among the GM, the most frequent 17 cases(16.3%), followed by meningioma 12cases (11.5%), pituitary adenoma 10 cases (9.6%), craniopharyngioma 6 cases(5.8%), pinealoma and germinoma 3cases(2.9%) respectively, and dermoid cyst 2 cases(1.9%) in that order. 4. The locations of the primary braintumors were as follows: cb. hemisphere(49%) of these 24.5% in parietal region, 11.9% in temporal region, 9.7% infrontal region, 3.0% in occipital region: Juxtasella area(16.3%), cerebellar hemisphere(8.7%), Parapineal andintraventricle(7.7%) respectively, cerebello-pontine angle area(5.8%), vermis and 4th ventricular region(4.8%). 5.There were no remarkable differences in the findings of pre-and post-contast CT scanning of primary brain tumorscompared with others.
Brain ; Brain Neoplasms ; Craniopharyngioma ; Dermoid Cyst ; Female ; Germinoma ; Glioma ; Humans ; Incidence ; Male ; Meningioma ; Occipital Lobe ; Parietal Lobe ; Pinealoma ; Pituitary Neoplasms ; Protestantism ; Temporal Lobe ; Tomography, X-Ray Computed

Leriche syndrome is a chronic disorder mostly in male and is a specific symptom complex due to thrombotic obliteration of the aortic bifurcation as result of an atherosclerotic change. The symptoms include 1) extreme liability to fatigue of both lower limbs; 2) symmetric atrophy of both lower limbs; 3) pallor of the legs and feets; 4) inability to maintain stable erection. There are several methods for surgical management of this disorder; 1) thromboendarterectomy with or without sympathectomy; 2) aortoiliac bypass graft; 3) aortofemoral bypass graft. Here we report a case of Leriche syndrome which was successfully managed with aortobifemoral bypass graft with Dacron and reviewed literatures on it briefly.
Atrophy ; Endarterectomy ; Fatigue ; Foot ; Humans ; Leg ; Leriche Syndrome* ; Lower Extremity ; Male ; Pallor ; Polyethylene Terephthalates ; Sympathectomy ; Transplants

No abstract available.
Infectious bursal disease virus*

Neurilemmomas of the trachea are extremely rare. The most common site of them is the distal third of the trachea and the age of the patients at presentation varied from 6 to 78 years old. They usually have a freqeuntly very long natural history, causing symptoms only after they have attained a considerable size. We experienced a case of near-total obstruction of the trachea by an intraluminal sessile neurilemmoma. The patient was a 66-year-old man with 2-year history of progressive exertional dyspnea and had several episodes of pneumonitis associated with productive cough. Grossly, the tumor was a well-circumscribed mass. Microscopically, typical cellular Antoni A and myxoid Antoni B areas were revealed.
Aged ; Cough ; Dyspnea ; Humans ; Natural History ; Neurilemmoma* ; Pneumonia ; Trachea

BACKGROUND: The increasing implementation of organ transplantation requires an unequivocal diagnosis of brain death for moral and legal reasons. Among instrumental investigations, angiographic demonstration of absent intracranial blood flow is considered to be the most reliable test in diagnosing brain death. This test should be easily accessible since most brain dead patients are vitally unstable and have various life-supporting equipments besides their beds. To investigate the usefulness of an intracranial CT angiography (CTA) for the diagnosis of brain death, we performed CTA in comatose patients who were either clinically brain dead or not. METHODS: Fourteen comatose patients (11 male and 3 female, aged from 17 to 63 years) with various brain insults were included in this study. Eleven patients were clinically brain dead. Among the remaining three patients, one showed subtle withdrawal movements in one extremity to noxious stimuli with absent brainstem reflexes, and the other two showed multifocal myoclonic seizures. CT scanning was performed with a table speed of 2 mm/sec, twenty seconds after beginning an injection of contrast media. The data were reformatted by maximum intensity projection (MIP) and shaded surface display (SSD) after the reconstruction of a 1 mm interval. A portable electroencephalography (EEG) was also taken serially in clinically brain dead patients except one. RESULTS: Intracranial arterial blood flow was preserved in those who showed either a seizure, abnormal posture or intact brainstem reflexes. On the other hand, intracranial arteries were not visualized in all brain dead patients with electrocerebral silence (ECS) on their EEG with the exception of one patient whose EEG was difficult to determine a ECS due to excessive mechanical artifacts. However, in the clinically brain dead patients, the intracranial arterial flow was preserved in those who suffered from widespread brainstem and cerebellar infarction or whose EEG demonstrated periodic lateralizing epileptiform discharges or a burst suppression pattern. CONCLUSIONS: Intracranial CTA seems to be a safe and noninvasive procedure for the determination of brain death that produces fast, reliable, and easy-to-interpret results. It can be used as an alternative method to the EEG when the EEG is not possible or difficult to interpret due to artifacts.
Angiography* ; Arteries ; Artifacts ; Brain Death* ; Brain Stem ; Brain* ; Coma ; Contrast Media ; Diagnosis ; Electroencephalography ; Extremities ; Female ; Hand ; Humans ; Infarction ; Male ; Organ Transplantation ; Posture ; Reflex ; Seizures ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Transplants