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

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

No abstract available.
Cell Line* ; Cytokines* ; Humans* ; Neuroblastoma*

Primary non-Hodgkin's lymphoma of the brain is a rare malignancy and there are known to occur almost exclusively in brain parenchyme. Recent immunological advances and immunohistochemical techniques have provided new insights into the pathogenesis and diagnosis of the malignant lymphoma even in the small biopsied tissue and the majority of these CNS tumors is thought to be derived from B lymphocytes. A 22-year old man was admitted due to headack, dizziness and walking difficulty for 2 months. On the initial CT scan, there were two enhancing lesion in the suprasellar area and pineal gland which were completely disappeared with steroid therapy and three new lesions appeared on the follow-up CT and MRI studies in corpus callosum, third ventricle and left cerebral peduncle. The serial cytologic smears of cerebrospinal fluid and a stereotaxic biopsy tissue from the corpus callosum mass showed diffusely homogenous infiltration of neoplastic large noncleaved lymphocytes with focal perivascular arrangement. On the immunocytochemical stains, the reaction was negative for GFAP, positive for LCA and MB2, and negative for MT1. After radiation therapy, the masses completely disappeared on the follow-up CT scan and the patient was discharged free of all the clinical symptoms.
Male ; Humans ; Biopsy

BACKGROUND: Pantothenate-kinase-associated neurodegeneration (PKAN) is an autosomal recessive neurodegenerative disorder that is characterized by progressive extrapyramidal signs, visual loss, and cognitive impairment. PKAN is caused by mutations in the pantothenate kinase gene (PANK2), which is located on chromosome 20p13 and encodes pantothenate kinase, the key regulatory enzyme in coenzyme-A biosynthesis. CASE REPORT: In this report we describe a case of atypical PKAN with a novel PANK2 mutation, presenting with a 10-year history of postural tremor involving both hands. Upon neurological examination, the patient's face was masked and he spoke in a monotonous voice. The patient presented with mild bradykinesia and rigidity that involved all of the extremities. Horizontal saccadic eye movements were slow and fragmented. Brain MRI revealed a typical "eye-of-the-tiger" sign. A mutation analysis revealed three PANK2 mutations: two in exon 3 (Asp 378Gly and Leu385CysfsX13) and one in exon 4 (Arg440Pro). CONCLUSIONS: Parkinsonism is not an unusual presenting symptom in patients with atypical PKAN, and so it is important for physicians to consider PKAN in the differential diagnosis of patients presenting with young-onset parkinsonism.
Brain ; Diagnosis, Differential ; Exons ; Extremities ; Hand ; Humans ; Hypokinesia ; Masks ; Neurodegenerative Diseases ; Neurologic Examination ; Parkinsonian Disorders ; Phosphotransferases ; Phosphotransferases (Alcohol Group Acceptor) ; Saccades ; Tremor ; Voice

OBJECTIVES: The purpose of the present study was to evaluate the whitening effect, morphological and structural changes, and remineralization of the enamel induced by 3 combined agents: amorphous calcium phosphate (ACP), hydroxyapatite (HA), and tetrasodium pyrophosphate (TSP). METHODS: The study was performed on 90 bovine enamel slabs, which were divided into the 6 groups: negative control-distilled water (Group 1); positive control-opalescence F (Group 2); 10% mixed agent (Group 3); 25% mixed agent (Group 4); 50% mixed agent (Group 5); and 100% mixed agent (Group 6). Changes in the shade of the enamel slabs were evaluated using Shade Eye-NCC. Morphological changes were assessed by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) was used to determine the remineralizing effect of the three agents on enamel slabs. RESULTS: The change in shade of the enamel (ad*) was noted to increase significantly with increase in whitening frequency in all groups. The value of Δn* was significantly greater in all groups except for the negative control group (P<0.001). SEM revealed that the control group, Group 5, and Group 6 had similar morphologies. The fluorescence lesion areas in the 4 mixture-treated group were significantly smaller than those in the positive control group (P<0.001). CONCLUSIONS: These results showed that the mixture of ACP, HA, and TSP was highly effective for bovine enamel whitening and acted by inducing the remineralization of enamel. CLINICAL SIGNIFICANCE: We evaluated the applicability of a new mixture containing ACP, HA, and TSP. This mixture would be highly useful in aesthetic dentistry because of its whitening efficiency, which does not compromise the enamel's integrity.
Calcium* ; Dental Enamel* ; Dentistry ; Durapatite* ; Fluorescence ; Microscopy, Confocal ; Microscopy, Electron, Scanning ; Water

No abstract available.
Beclomethasone* ; Budesonide* ; Hydrocortisone*

Sleep disorders are commonly observed in multiple systemic atrophy (MSA). The rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by loss of normal voluntary muscle atonia during REM sleep. It usually presents during early course, and disappears over the course of disease progression. Sleep-disordered breathing (SDB) is also common sleep disorder in MSA which can be life-threatening, and continuous positive airway pressure (CPAP) treatment is useful in these patients. A 74-year-old woman with MSA presented for nocturnal respiratory disturbance. She had a five-year history of dream enacting behaviors, which had disappeared four months prior. Polysomnography revealed frequent stridor and sleep hypopnea. During the following full nigh CPAP titration for SDB, dream enacting behavior was observed during REM sleep stage. In MSA patients with SDB, CPAP administration may lead to increase REM sleep stage. An increase in REM sleep stage, which previously had been deprived, may have trigger RBD symptoms to reappear. The CPAP treatment should be considered with great caution in these patients.
Aged ; Atrophy ; Continuous Positive Airway Pressure ; Disease Progression ; Dreams ; Female ; Humans ; Multiple System Atrophy ; Muscle, Skeletal ; Polysomnography ; REM Sleep Behavior Disorder ; Respiratory Sounds ; Sleep Apnea Syndromes ; Sleep Wake Disorders ; Sleep, REM

Objectives: Periodontitis-causing microorganisms and their virulence factors can provoke periodontal destruction in the host. This study was aimed at evaluating the distribution of periodontal disease and its relationship with 11 periodontal disease-causing bacteria in the elderly. Methods: Individuals aged 60 years or above were recruited after obtaining informed consent. The clinical attachment loss was measured at studied sites to determine the severity of periodontitis. Further, the stimulated salivary samples were collected and analyzed with real-time polymerase chain reaction to detect 11 strains of periodontitis-causing bacteria. Results: The severity of periodontal disease was proportional to the amount of periodontal diseasecausing bacteria. Porphyromonas gingivalis in the red complex increased from 6.60±5.50 in stage 1 to 5.36±5.39 in stage 2 and 7.19±5.56 in stage 3 (P=0.003). Tannerella forsythia increased from 6.54±4.60 in stage 1 to 7.44±4.56 in stage 2 and 8.49±4.70 in stage 3 (P=0.007). Conclusions The presence of complex bacterial groups and their number of strains were high in participants with severe periodontitis. Controlling periodontitis-related bacteria is important for periodontal health in the elderly.