Pleomorphic xanthoastrocytoma(PXA) is a benign brain tumor with favorable prognosis in spite of its marked pleomorphism. We report a case with review of the literature. An eight-year-old boy presented with headache and vomiting. Plain skull X-ray showed findings of increased intracranial pressure. The MR imaging demonstrated superficially located large cystic mass with a Iobulated mural nodule in the left frontal lobe. The mural nodule abutting leptomeninges showed intense enhancement on postcontrast Tl-weighted images, but the cyst wall was not enhanced. Preoperative diagnosis of PXA with the MRI findings could lead to avoidance of more aggressive brain resection and therefore more favorable neurological outcome
Brain ; Brain Neoplasms ; Child* ; Diagnosis ; Frontal Lobe ; Headache ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Male ; Prognosis ; Skull ; Vomiting

Intussusception is a condition of invagination of the proximal segment of bowel into the more distal receiving bowel. Intussusception is one of the common pediatric and surgical emergencies of infancy and childhood in Korea. Intussusception is the most common cause of acquired intestinal obstruction in infancy and childhood, and it needs emergency treatment. 1) On the age and sex distribution, the age under 15 month was the most common(70.6%), and the peak incidence was 3-12 months of age(60.1%). In sex distribution, male to female ratio was 1.25:1. 2) The seasonal distribution was summer(27.4%), spring, autumn and winter in order of frequency. 3) As to the etiology of Intussusception treated by surgery, idiopathic was the most common(75%). 4) The cardinal symptoms and signs were vomiting(72.5%), bloody or bloody mucoid stool(57.5%), abdominal pain(49.7%), abdominal distention(20.9%), abdominal mass(19.6%) and others in order of frequency. 5) On the hematologic finding, 60.8% revealed leukocytosis above 10,000/mm3. 6) As to the duration from the onset of the symptom to admission, 84.2% was within 24 hours, 9.8% was from 24 hours to 48 hours, and 5% was over 48 hours. 7) The common anatomical types were ileocolic(73.2%), and ileocecal(17.0%). 8) The success rate of air reduction was 84.3%. 9) In the method of operation, manual reduction was performed in 91.7% and intestinal resection in 8.3%. 10) The recurrence rate after air reduction was 12.4% and after operative manual reduction was 8.3%.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Female ; Humans ; Incidence ; Intestinal Obstruction ; Intussusception* ; Korea ; Leukocytosis ; Male ; Recurrence ; Seasons ; Sex Distribution

Prostatic cancer is a pervasive disease affecting a large percentage of men over the age of 50. In those cases where the malignancy is localized to the prostatic gland, digital rectal examination (DRE), the traditional diagnostic method for prostatic cancer, may not be diagnostic. It is also well recognized that although small nodular indurated areas in the prostate may be readily palpable the differentiation between benign and malignant area cannot be made reliably by digital rectal examination alone. Various techniques have been used to detect the prostatic cancer. But there are many problems for routine use. So in order to evaluate the diagnostic modalities for prostatic cancer such as DRE, serum PSA assay and transrectal ultrasonography (TRUS) according to histopathologic results, three diagnostic modalities (DRE, serum PSA assay and TRUS) were performed in 51 cases of 140 cases with prostatism in the Department of Urology, Chungnam National University Hospital from January. 1989 to November, 1990. The results were as follows: 1. In 140 patients with prostatism, 1O3 cases were benign prostatic hyperplasia, and 37 cases(23.6%) were prostatic cancer, which was increased with aging in its frequency. 2. In TRUS, serum PSA assay and DRE, diagnostic results for prostatic cancer were 93.3%, 73.3% and 60.0% in sensitivity, 91.7%, 88.9% and 86.1% in specificity, 82.4%, 73.3% and 64.3% in positive predictive value, 97.1%, 88.9% and 83.8% in negative predictive value, and 27.5%, 21 6% and 17.6% in detection rate, respectively. 3. The risk of malignancy is increased with high positive rate in TRUS, DRE and serum PSA. So, diagnostic error would be minimized, if more diagnostic modalities are used with combination than alone.
Aging ; Chungcheongnam-do ; Diagnostic Errors ; Digital Rectal Examination* ; Humans ; Male ; Prostate* ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; Prostatism ; Sensitivity and Specificity ; Ultrasonography* ; Urology

Nucleolar organizer regions(NORs) are argyrophilic and have a loops of DNA that tran scribes to ribosomal RNA by RNA Polymerase I and are involved in formation of nucleolus. They are used in measuring proliferative activity of cells. Mean AgNORs count is increased or large and NORs are irregular in shape in malignant tumors. To examine the relationship of AgNORs to the survival rate of the patients with invasive colorectal adenocarcinoma, we counted mean AgNORs in 200 tumor cells and mean AgNORs#(mean AgNORs in counting AgNORs of the upper 40 nuclei after sorting AgNORs counts of 200 cell nuclei in descending order) after AgNOR staining using 45 cases of formalin-fixed, paraffin-embedded tissue surgically excised at Kang-Dong Sacred heart hospital. The survival rates were not related to age, sex, locations, differentiation, mAgNORs and mAgNORs# except Dukes'stages. There were only statistical significances in AgNORs# between high and low age group(p=0.0001), and between colon and rectum(p=0.005). But it is known that there could be different results according to staining time, fixation and preservation of tissues, counting methods in measuring AgNORs. There might be clinical usefulness of AgNOR if more cases are examined together with better tissue processing and staining methods.
Adenocarcinoma ; Cell Nucleus ; Colon ; Colorectal Neoplasms ; DNA ; Heart ; Humans ; Nucleolus Organizer Region ; RNA Polymerase I ; RNA, Ribosomal ; Survival Rate*

Since Ender introduced the concepts of multiple flexible intramedullary nailing in 1970, Ender nailing has been mostly used in intertrochanteric fractures of the elderly patients, but it has been rarely used in younger patients because of serious complications such as shortening and external rotation deformity. Authors already contended that the incidence of such complications had intimate connection with the quality of bone, and accordingly with the age. To substantiate the contention, we analyzed thirty-four cases with more than one year follow-up among forty cases of intertrochanteric fractures treated with Ender nails during the period from 1982 to 1989. And the results are summarized as follows;1. The average age was 39 yrs., and the most common cause of fractures was fall from a height. 2. According to the Kyle et al. clsssification, stable fractures(type I & II ) were 13 cases(38%), and unstable fractures (type III & IV) were 21 cases(62%). 3. According to the Singh's index, the good in bone quality(Grade 4, 5, & 6) were 31 cases(91 %), and the poor(Grade 1, 2, & 3) were only 3 cases(9%). 4. Postoperative complications occurred in 6 cases(17%), which included ROM limitation of knee joint in three cases(9%), proximal migrations of nails in two(5%), and distal migrations of nails in one(3%). Among them, 4 cases required revisional operations. There was no case with apparent external rotation deformity over 20 and shortening over 2cm. 5. It is thought that, contradictory to common beliefs, Ender nailingis a safe method for intertrochanteric fractures of femur in younger patients with good bone quality, but requires some experiences and cautions to prevent such complications as external rotation deformity and shorterning.
Aged ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Incidence ; Knee Joint ; Methods ; Postoperative Complications

Complications from hysteroscopy are relatively rare events. They occur more frequently with operative hysteroscopy than with diagnostic hysteroscopy. Air embolism is a rare but devastating complication of hysteroscopy that rightly receives attention as a frightening, sudden, and potentially fatal hazard in otherwise healthy women. We experienced one case of air embolism during diagnostic hysteroscopy for abnormal uterine bleeding under general anesthesia. Early diagnosis and prompt treatment seem to be the keys to prevention of catastrophic outcomes and the hysteroscopists must understand the pathophysiology of air embolism to prevent, diagnose, and manage this potentially disastrous problem effectively.
Anesthesia, General ; Early Diagnosis ; Embolism, Air* ; Female ; Humans ; Hysteroscopy* ; Uterine Hemorrhage

PURPOSE: To compare breath-hold gadolinium enhanced MR angiography(MRA) with digital subtraction angiography. MATERIALS AND METHODS: Ten patients underwent angiography and breath-hold gadolinium enhanced MRA;the latterperformed at 1.5T with 3D FSPGR after a bolus injection of gadopentetate dimeglumine(0.4mmol/kg) RESULTS: Sevenof ten pathologic conditions(70%) evaluated by both techniques had a similar appearance. The conditions examinedwere as follows : the artery feeding renal cell carcinoma(n=2): renal artery stenosis(n=2); pulmonaryAVM(n=2);abdominal aortic aneurysm(n=1); atheromatous plaque in the lower abdominal aorta(n=1);an enlargedbronchial artery(n=1); and an aberrant renal artery(n=1). For evaluating an anatomic relationship, a reconstructed3D image obtained by MRA is more advantageous. CONCLUSION: Breath hold contrast enhanced MRA is a potentiallyuseful noninvasive screening method for detecting vascular abnormality of the aorta and its branches.
Angiography ; Angiography, Digital Subtraction ; Aorta ; Arteries ; Gadolinium ; Humans ; Mass Screening ; Renal Artery

Teratoma is one of germ cell tumor, common neoplasm in women of reproductive age, but it can arise at any age. Its malignant transformation is rare, less than 2%, frequently at older age. Nearly all the cases are squamous, sarcomatous and adenomatous transformation. Here we present a case of mixed transformation, adeno-squamous cell carcinoma with brief review of the concerned literature.
Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasms, Germ Cell and Embryonal ; Teratoma*

OBJECTIVES: To investigate whether endometrial proteins with molecular weight(MW) of 92 kilodalton(kDa) may be a specific antigen involved in autoimmunity in endometriosis and to evaluate the efficacy of enzyme-linked immunosorbent assay(ELISA) in determining antiendometrial antibodies, compared with Western blot. METHODS: Sera of forty-eight patients with endometriosis, 21 patients with normal control patients, 7 patients with Mayer-Rokitansky-Kustner-Hauser(MRKH) syndrome and cord sera of 22 male neonates(experimental controls) were tested for the presence of antibodies against endometrial proteins by Western blot and ELISA. All statistics were performed by Fishers exact teast and Student's t-test. RESULTS: Fourteen(29.1%), 18.8%, and 33.3% of sera from patients with endometriosis had immunoglobulin (IgG) antibodies that were reactive against endometrial proteins of MW of 71, 92, 103 kDa while any sera from experimental controls did not show any reactivity against these antigens. Overall, threr were specific IgG antiendometrial antibodies detectable by Western blot in 56.3% of patients with endometriosis and in a normal eontrol patient. The binding activities of serum IgG to endometrial proteins were higher in patients with endometriosis than other groups. Circulating IgG antiendometrial antibodies were detected by ELISA in 54.3% of 35 patients with endometriosis and in 2 normal control patients. The concordance rate between ELISA and Western blot in determining the presence of antiendometrial antibodies was 78.3%. CONCLUSIONS: Ninety-two kDa endometrial protein is a specific antigen eliciting IgG responses in endometriosis. ELISA may be an useful method in screening autoimmune endometriosis.
Antibodies* ; Autoimmunity ; Blotting, Western* ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin G ; Immunoglobulins ; Male ; Mass Screening

BACKGROUND: To assess the current level of development of emergency medicine (EM) systems in Asia. METHOD: Survey of EM professionals from 12 Asian countries during a 90-day period from August to November 1998. 12 EM professionals from 12 Asian countries completed the survey. All participants were physicians. 7 participants (58%) gave presentations at an international EM conference during the study period. Respondents completed a 103 question questionnaire about the status of EM specialty, academic, patient care, information and management systems and the factors influencing the future of EM in their countries. RESULTS: 92% of respondents stated that their countries have hospital-based emergency departments (ED). More than 80% of respondents reported that their countries have EMS systems and ED systems for trauma care and patient transfer. More than 70% stated that their countries have national EM organizations, EM research, national EMS activation phone numbers, ED systems for pediatric emergency care, emergency physician (EP) training in ACLS and ATLS and peer review. More than 60% reported official recognition of EM as an independent specialty status, ED triage systems and systems for customer service. More than 50% reported EM residency training programs, EM journals and EP ability to perform rapid sequence intubation (RSI). 50% reported EP ability to perform thrombolysis for acute MI and 33% reported EP ultrasonography. 92% felt that a lack of funding posed a moderate or great obstacle to the future development of EM in their countries. CONCLUSION: Many essential systems of EM now exist throughout Asia. In the systems of administration and emergency medical information in many countries, there are some parts to be developed further.
Asia ; Asian Continental Ancestry Group* ; Surveys and Questionnaires ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Emergency Service, Hospital ; Financial Management ; Humans ; Internship and Residency ; Intubation ; Patient Care ; Patient Transfer ; Peer Review ; Triage ; Ultrasonography