PURPOSE: The purpose of this study was to evaluate the spectrum of MR characteristics of cystic acoustic neurinomas and to correlate with pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the MR findings of 12 patients with cystic acoustic neurinomas. The signal intensity and enhancement pattern of the cystic components as well as the location relative to the tumors were analyzed. RESULTS: A total of 30 cysts were found in 15 acoustic neurinomas;28 were intratumoral cysts and the remaining two were extratumoral cysts. The signal intensity of all 28 intratumoral cysts was higher than that of CSF on Tl-weighted images, and isointense to CSF on T2-weighted images, while the signal intensity of the two extratumoral cysts was same as CSF on both Tl-weighted and T2-weighted images. Rim enhancement was seen in 27 of 28 intratumoral cysts but in none of the two extratumoral cysts. CONCLUSION: We concluded that intratumoral cyst was due to tumoral necrosis, hemorrhage or degenerative change and extratumoral cyst due to secondary arachnoid cyst formation.
Acoustics* ; Arachnoid ; Hemorrhage ; Humans ; Necrosis ; Neuroma, Acoustic* ; Retrospective Studies

OBJECTIVE: To describe normal postoperative MR findings and MR findings of postoperative discitis in patients who underwent operation due to herniated intervertebral disc. MATERIALS AND METHODS: We retrospectively reviewed normal postoperative MR findings and MR findings of discitis in 30 patients(21-61yrs.) (13 cases dignosed as discitis and 17 cases as normal) who previonsly underwent laminectomy and discectomy, or bony fusion. We analyzed signal intensity of end plate and disc, end plate destruction, and enhancement of end plate and disc on T1- and T2-weighted images(WI) of 1.5T MRI. RESULTS: Among 14 out of 17 patients with no evidence of discitis, 7 patients showed high signal of the posterior portion of disc on T1- and T2-WI and 11 patients revealed enhancement at the same sites. In all 13 patients suspected of having discitis, end plate and disc showed low signal on T1-WI, high signal on T2-WI, heterogeneous enhancement, and irregular destruction of end plate. Meanwhile, 3 cases with no evidence of postoperative discitis clinically who underwent bony fusion showed similiar findings to those of the above 13 patients, except for homogeneous enhancement of end plate and vertebral body. CONCLUSION: The MR findings of postoperative discitis were low signal on T1-WI, high signal on T2-WI, and heterogeneous enhancement of and plate and disc, and destruction of end plate.
Discitis* ; Diskectomy ; Humans ; Intervertebral Disc* ; Laminectomy ; Magnetic Resonance Imaging ; Retrospective Studies

Fifteen patients with 38 compression fractures of the spine underwent magnetic resonance(MR) imaging. We retrospectively evaluated MR images in these benign compression fractures. MR images showed four patterns in T1-weighted images. MR imaging patterns were normal signal(21), band like low signal(8), low signal with preservation of peripheral portion of the body(8), and diffuse low signal through the vertebral body(1). The low signal portions were changed to high signal intensities in T2-weighted images. In 7 of 15 patients(11 compression fractures). There was a history of trauma, and the remaining 8 patients(27 compression fractures) had no history of trauma. Benign compression fractures of trauma, remained 8 patients(27 compression fractures) were non-traumatic. Benign compression fractures of the spine reveal variable signal intensities in MR imagings. These patterns of benign compression fractures may be useful in interpretation of MR imagings of the spine.
Fractures, Compression* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Spine*

Primary intimal sarcoma of the pulmonary artery is a rare disease and there has been no report of any case originating from the pulmonary valve. Recently we experienced a 62 year-old female patient who had a primary intimal sarcoma of the pulmonary valve with distal metastasis. She was brought to medical attention due to exertional dyspnea facial edema productive coughing and general weakness for 1 month. Chest CT and echocardi-ography suggest an acute pulmonary thromboembolism or tumor. Exploration showed a large polypoid mass arising from the pulmonary leaflets and multiple masses on distal pulmonary arteries. We replaced the pulmonary valve and reconstructed the pulmonary artery. She received radiotherapy 1 month postoperatively and now 4 months after surgery she has begun receiving chemotherapy.
Cough ; Drug Therapy ; Dyspnea ; Edema ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Valve* ; Radiotherapy ; Rare Diseases ; Sarcoma* ; Tomography, X-Ray Computed

Apoptosis is an intrinsic and fundamental biological process that plays a critical role in the normal development of multicellular organisms and in maintaining tissue homeostasis. Some of the well known regulators of apoptosis are cytokines of the tumor necrosis factor(TNF) ligand family, such as Fas ligand(Fas L) and TNF, which induce apoptosis by activation of their corresponding receptors, Fas and TNFR-1. Recently, a new member of the TNF family known as TRAIL (TNF-related apoptosis-inducing ligand) was identified and shown to induce p53-independent apoptosis in a variety of tumor cell lines but not in normal cells, Four human receptors for TRAIL were also recently identified and designated TRAIL-R1, -R2, -R3, and -R4. The aim of this study is to examine whether TRAIL and TRAIL receptots(-R1, -R2, -R3) are expressed in uterine cervical cancer and whether it is correlated with apoptosis, TRAIL and TRAIL receptors. The subjects were 20 patients who were diagnosed with cervical cancer. Western blotting was performed in 9 cases, immunohistochemical staining for TRAIL and TRAIL receptors(-R1, -R2, -R3) and TUNEL method for detection of apoptosis in 11 cases. There were proteins for TRAIL, TRAIL-R1, -R2, and -R3 in tissues from cervical cancer. All TRAIL receptors were expressed in both normal cervical epithelium and tumor cells, and TRAIL-Rl and -R2 were more strongly expressed in tumor cells than normal epithelium(p<0.05). Apoptosis correlated with expression of TRAIL-Rl and -R2(p<0.05). This study suggests that TRAIL induces apoptosis in cervical cancer through its receptors.
Antigens, CD95 ; Apoptosis ; Biological Processes ; Blotting, Western ; Cell Line, Tumor ; Cytokines ; Epithelium ; Homeostasis ; Humans ; In Situ Nick-End Labeling ; Necrosis ; Receptors, TNF-Related Apoptosis-Inducing Ligand* ; Uterine Cervical Neoplasms*

Choriocarcinoma is a relatively rare malignancy of which characteristic is rapid metastasis to the other organs. It is related to the previous gestation or originated from the teratoma. Choriocarcinoma is mostly originated from the intrauterine chorionic villi, but it is rarely originated from the utreine cervix, fallopian tube, ovary, vagina and pelvic cavity. Primary choriocarcinoma of the fallopian tube is exceedingly rare and it is originated from ectopic tubal pregnancy, tubal migration from the intrauterine pregnancy or intratubal teratoma. 9 Symptoms and signs of the choriocarcinoma originated from the ectopic pregnancy are abdominal pain, vaginal bleeding, palpable adnexal mass, positive pregnancy test and amenorrhea. Thus it is difficult to distinguish choriocarcinoma from ectopic pregnancy on the basis of symptoms before the microscopic diagnosis presented.20 Effective treatment of choriocarcinoma is chemotherapy. Additional operation is possible. B-HCG is a useful measure for the follow up. We experienced a 36-year-old multigravida Korean woman who was diagnosed as the rupture of ectopic pregnancy after left salpingectomy in our hospital and then confirmed primary choriocarcinoma of the fallopian tube without metastasis on microscopic finding. Postoperative chemotherapy was performed with methotrexate. The follow up of disease is still on going at two month intervals and she has remained healthy, We report this case with review of literatures.
Abdominal Pain ; Adult ; Amenorrhea ; Cervix Uteri ; Choriocarcinoma* ; Chorionic Villi ; Diagnosis ; Drug Therapy ; Fallopian Tubes* ; Female ; Follow-Up Studies ; Humans ; Methotrexate ; Neoplasm Metastasis ; Ovary ; Pregnancy ; Pregnancy Tests ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Rupture ; Salpingectomy ; Teratoma ; Uterine Hemorrhage ; Vagina

Polycystic ovary syndrome is characterized by symptoms of oligomenorrhea, amenorrhea, infertility, hirsutism and obesity. It is known that the women with such diseases would have higher risks to coronary heart diseases, hypertension, DM and endometrial cancer later on, Known risk factors of endometrial cancer are nullipara, late menopause, obesity, DM, unopposed estrogen, tamoxifen treatment, and atypical endometrial hyperplasia ect. 75% of endometrial cancer occurs in age over 50 and 4% of endometrial cancer occurs in age under 40. Particulary endometrial cancer concurrent polycystic ovary syndrome occurs usually in people under age 40 and is commonly well differentiated cell type and is related to good prognosis. We experienced a case of endometrial cancer with polycystic ovary syndrome, who was early dignosed, presented with infertility and got an operation in our hospital, and report this case with a brief review of literature.
Amenorrhea ; Coronary Disease ; Endometrial Hyperplasia ; Endometrial Neoplasms* ; Estrogens ; Female ; Hirsutism ; Humans ; Hypertension ; Infertility ; Menopause ; Obesity ; Oligomenorrhea ; Polycystic Ovary Syndrome* ; Prognosis ; Risk Factors ; Tamoxifen

PURPOSE: It is well known that the incidence of cholelithiasis and cholecystitis increases after a gastrectomy and vagotomy for peptic ulcer disease, but operations for ulcers have decreased due to improved medical therapy. However, there are not so many studies about cholelithiasis and cholecystitis after a gastric resection due to gastric cancer. Therefore, we investigated its incidence, the factors affecting it, and its natural course. METHODS: Six hundred eighty-four gastric patients who had received a gastric resection at the Korea University Guro Hospital from January 1992 to October 1999 and who had been followed regularly with abdominal ultrasonography or computed tomography were enrolled in this study. The incidence of gallstones and sludge was investigated according to age group (< OR =60 vs >60), sex, extent of gastric resection (subtotal vs total), anastomotic methods (duodenal bypass vs duodenal passage of food), and degree of lymph node dissection (< OR =D2 vs > or =D2+alpha). The clinical course of cholelithiasis was also followed up. RESULTS: Gallstones were discovered in 38 patients (5.6%) with a mean duration of 26.4+/-20.7 months, and sludge was found in 17 patients (2.5%) with a mean duration of 25.1+/-20.5 months. There were no significant differences of incidence of gallstones and sludge according to sex, age group, and other surgical options (p>0.05). Twenty- eight cases of gallstones (73.7%) were detected within 36 months, and 11 cases of sludge (64.7%) within 24 months. Among the 38 gallstones patient, only 7 patients (18.4%) developed acute cholecystitis; they received cholecystectomy during the follow-up period, and all removed stones were pigment stones. CONCLUSION: The incidences of cholelithiasis and chole-cystitis do not increased very much after a gastric resection with lymph-node dissection due to gastric cancer, and there are no specific factors affecting those incidences. A prophylactic cholecystectomy during the gastric cancer operation should be performed with caution.
Cholecystectomy ; Cholecystitis ; Cholecystitis, Acute ; Cholelithiasis* ; Follow-Up Studies ; Gallstones ; Gastrectomy ; Humans ; Incidence ; Korea ; Lymph Node Excision ; Peptic Ulcer ; Sewage ; Stomach Neoplasms* ; Ulcer ; Ultrasonography ; Vagotomy

CD44 is a cell-surface glycoprotein postulated to play a role in tumor cell metastasis. Aberrant expression of the cell adhesion molecule CD44 has been detected in human tumors and the expression of specific isoforms(splice variants) has been shown to be associated with metastasis and poor prognosis in human malignancies. We used variant exon sequence-specific monoclonal antibody to epitope encoded by exon v6 of human variant CD44 to study the expression of CD44 splice variant by immunochemistry in fifty nine samples of human cervical cancer. twenty seven tissue samples of cervical intraepithelial neoplasia(CIN) and normal cervix were included in this study. CD44v6 was stained positive in the basal and parabasal layer of normal epithelial cells homogenously but was absent in the stromal cells. The intensity of CD44v6 staining was the strongest in invasive squamous cell carcinoma followed by normal cervical epithelium, CIN, adenocarcinoma. In the malignant samples, heterogeneity in staining intensity among different clusters of tumor cells was observed. Furthermore the intensity of staining was stronger in proportion to stage, depth of invasion, lymphovascular invasion(p<0.05), and lymph node metastasis(p=NS). This study suggest that the expression of CD44v6 adhesion molecule may be useful value in predict the high stage, depth of invasion, lymphovascular invasion and lymph node metastasis probably.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Adhesion ; Cervix Uteri ; Epithelial Cells ; Epithelium ; Exons ; Female ; Glycoproteins ; Humans ; Immunochemistry ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Population Characteristics ; Prognosis ; Stromal Cells ; Uterine Cervical Neoplasms*

OBJECTIVE: The aim of the present study was to evaluate the E-cadherin expression in normal cervical epithelium, carcinoma in situ of the cervix, and invasive carcinoma of the cervix, and to define the role of E-cadlherin expression in tumor invasion with respect to clinicopathologic parameters. METHODS: We conducted immunodetection of E-cadherin in 58 cases of cervical carcinoma using immunohistochemistry in formalin-fixed, paraffin-embbeded sections, RUSULTS: E-cadherin expression was different between normal cervical epithelium and carcinoma in situ of the cervix, and between normal cervical epithelium and invasive carcinoma of the cervix(p<0.05). However, there was no difference in E-cadherin expression between carcinoma in situ and invasive carcinoma of the cervix. In invasive cervical carcinomas, expression of E-cadherin and the intensity of cytoplasmic E-cadherin expression did not correlate with histologic type, lymphvascular space invasion, lymph node metastasis, and stage of disease. CONCLUSION: It is mncluded that expression of E-cadherin is related to tumor invasion in cervical tissues, but further studies with regard toE-cadherin/catenin/cytoskeleton complex are needed to clarify the prognostic role of E-cadherin with respect to clinicopathologic parameters in invasive cervical carcinoma,
Cadherins ; Carcinoma in Situ ; Cervix Uteri* ; Cytoplasm ; Epithelium ; Female ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Uterine Cervical Neoplasms