The term "pineal anlage tumor" has been recently proposed and few cases have been reported. We report the first Korean case of pineal anlage tumor in a 6-year-old girl who complained of headache and vomiting for 2 months. Brain MRI revealed a well defined, lobulated, calcifying mass in the pineal region. Tumor was totally removed. Pathological examination revealed a primitive pineal parenchymal tumor with melanotic epithelial component that was similar to histologic findings of melanotic neuroectodermal tumor of infancy, so-called retinal anlage tumor and of the developing pineal gland. The tumor was composed mostly of small, undifferentiated cells, Flexner-Wintersteiner rosettes, and ganglionic differentiation. The tumor also contained the cartilage and skeletal muscle cells.
Brain ; Cartilage ; Child ; Female ; Ganglion Cysts ; Headache ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Neuroectodermal Tumor, Melanotic ; Pineal Gland ; Pinealoma ; Vomiting

PURPOSE: The purpose of this study is to illustrate MR patterns of bone marrow of calvarium and vertebral body in normal subjects according the age distribution and to understand the course of the fatty replacement from red marrow. METHODS AND MATERIAL: We retrospectively evaluated MR examinations of the calvaria(n=71), cervical spine(n=71), thoracic spine(n=65), Imbar spine(n =68) in subjects without bone marrow abnormality whose age ranged 3 weeks to 74 years. Three distinctive patterns were categorized on Tl-weighted images of the skull. In pattern 1, uniformly low signal intensity with or without very small areas of high intensity in frontal and occipital bones is noted. In pattern 2, frontal and occipital bones have uniformly high signal intensity, and patchy area of high intensity appears in parietal bone. In pattern 3, the entire skull has uniformly high signal intensity. In the spine, four patterns were categorized on Tl-weighted MR images. In pattern 1, the vertebral body has uniformly low signal intensity except for linear areas of high intensity superior and inferior to basivertebral vein. In pattern 2, bandlike and triangular areas of high signal intensity are found in the periphery. Pattern 3 and 4 have diffusely distributed areas of high signal intensity; pattern 3 consist of numerous indistinct dots measuring a few millimeter or less, and pattern 4 consist of fairly well marginated areas ranging in size from 5 to 1.5cm. RESULT:In the calvaria, 73% of pattern 1 were younger than 20 years, pattern 2 were evenly distributed, and 86% of pattern 3 were older than 40 years. In the spine, 87% of pattern 1 were younger than 40 years, 72% of pattern 3 were in 40 to 50 years, and 87% of pattern 4 were older than 50 years. Pattern 2 were evenly distributed in the cervical and thoracic spine, but in the thoracic spine 62% were younger than 30 years. CONCLUSION:It is concluded that younger age group shows mainly pattern 1, whereas elderly group has pattern 3 or 4 in the calvarial and vertebral body marrow. This suggests that conversion to fatty marrow begin locally and progress diffusely with age.
Age Distribution* ; Aged ; Bone Marrow* ; Humans ; Occipital Bone ; Parietal Bone ; Retrospective Studies ; Skull* ; Spine ; Veins

Purpura fulminans is one of rare consumptive coagulopathy in children. The most common predisposing conditions of purpura fulminans are infectious disease like streptococcal infection and chickenpox. This disease is characterized by ecchymotic lesions that are usually distributed symmetrically on the lower extremities and buttocks. These ecchymotic lesions undergo necrosis, unless there is effective treatment. We experienced 3 cases of purpura fulminans which improved almost completely after early heparin administration. In the case 1, a 12 month old girl, purpura fulminans developed during sepsis and gastroenteritis. In the case 2, a 4 month old boy, purpura fulminans developed during acute sepsis. We reported 3 cases with a brief review of related literature.
Buttocks ; Chickenpox ; Child ; Communicable Diseases ; Dacarbazine ; Female ; Gastroenteritis ; Heparin ; Humans ; Infant ; Lower Extremity ; Male ; Necrosis ; Purpura Fulminans* ; Purpura* ; Sepsis ; Streptococcal Infections

In order to evaluate the the effectiveness of low-dose longterm Vibramycin (Doxycycline) treatment on Acne Vulgaris, a double-blind study was performed on fifty two patients with Acne Vulgaris. The patients were classified as to the severi.ty of their disease before treatment according to Wand. et al. The degree of the effcctiveness of the treatment was evaluated every other week for 12 weeks on the grounds of clinical improvement. The therapeutic results obtaincd were as follovs: araong the 19 patients who received 50 mg per day for 12 weeks, 13 cases (72.2%) showed excellent improverrent after 6 weeks; whereas in thc placebo group only 4 out of 15 patients (26. 7%) showed good response, Statistical analysis of the data revealed that there was a significant difference (p<0.05) in effectiveness between the Vibrarzycin 50mg per day group and the placebo group. Among the 19 patient who received a 100mg capsile orally per day for 4 weeks (subsequently this group received 50mg per day for 8 weeks) 13 cases.(68.4%) showed excellent improvement in 4 weeks; whereas in the placebo group only 4 cases(26, 7%) showed good respnnse Statistical analysis of this data revealed that there was a significant difference (p<0. 05) in efectivencess the Vibramycin 100mg per day group and the placebo group, It was noted that 44 out of 52 patients (83%) had a distinct family history of the disease, suggesting that there might be a predisposing hereditary factor involvcd in the manifestation of Acne Vulgaris It is concluded f rom this study that Vibramycin, when administrated in a dose of 50mg per day for more than 6 weeks is effective in the treatment of Acne Vulgaris.
Acne Vulgaris* ; Double-Blind Method* ; Doxycycline* ; Dronabinol ; Humans

PURPOSE: The purpose of this study was to identify the effects of a weight control program and compliancy in overweight women. METHOD: This program was composed of strategies to modify diet and exercise and to change compliance and self determination over an 8 week period. The subjects were 19 overweight women who participated in our project voluntarily. Data was collected from May 4 to Jun 30 of 2007. The program consisted of regular rapid walking exercise, diet, mobile phone messages and e-mail. The data was analyzed by Repeated Measures ANOVA using the SPSS WIN program. RESULT: According to 3 assessment periods, there were significant differences in body weight, body mass index, and compliance. There were no significant differences in self determination. CONCLUSION: These findings suggest that more intensive interventions may be needed to demonstrate a change in self determination.
Adult ; Body Mass Index ; Diet ; Exercise ; Female ; Humans ; Mental Competency ; Obesity/diet therapy ; Overweight/*therapy ; Patient Compliance ; Personal Autonomy ; Walking

Creutzfeldt-Jakob disease(CJD) is characterized clinically by rapidly progressive dementia with pyramidal, extrapyramidal, and cerebellar symptoms and signs, and histologically by spongiform change, neuronal loss and reactive gliosis. We have experienced 2 cases of CJD. Case 1 was a 36-year-old male who had suffered from myoclonus and cerebellar symptoms including sluggish speech, gait and balance disturbance. Case 2 was a 70-year-old female who had showed cognitive dysfunction, ataxic gait and disturbance of extraocular movement. Both patients, underwent brain biopsy. Case 1 revealed marked cortical atrophy, 2mm in thickness, with neuronal loss and astrocytic proliferation extending into white matter. The spongiform change, made up of many small, usually rounded or oval, vacuoles was noted mainly in the neuropil. Case 2 revealed remarkable spongiform change throughout the cortex and cytoplasmic vacuoles compressing the nuclei of neuronal cells were numerous. Neuronal loss and gliosis were also found without considerable change in the white matter. On double immunostaining against GFAP and PrP(Prion Protein), there was a weak positive reaction for PrP in the perinuclear cytoplasm in case 1, and a strongly positive reaction in case 2. The electron microscopic examination showed numerous membrane-bound vacuoles in neuropil and perikarya of neurons. The majority of the vacuoles were multiseptated by thin membranous structures. They demonstrated curled, or disrupted membrane, that had foldings and protrusions into the vacuolar clear spaces. There were neither identifiable virus-like particles nor amyloid deposition.
Female ; Male ; Humans

PURPOSE: The purpose of this study was to determine the effects of surgery information service on one-day surgery patients' anxiety and satisfaction with nursing care. METHODS: The study used the nonequivalent control group time difference design. Sampling and measurement of the control group participants (n=30) was completed first. Later, participants in the experimental group (n=30) were sampled, intervened, and measured. The experimental group participants received the surgery information services twice: before and after the surgery, 20~30 minutes for each of the sessions. The anxiety was measured with the State-Trait Anxiety Inventory developed by Spielberger (1975), and modified by Kim & Shin (1978). The patient satisfaction with nursing care was measured with the Patient Satisfaction with Nursing Care Scale developed by La Monica and colleagues (1986), and modified by Shin (1999). The data was collected between February 1 and May 30, 2006. RESULTS: The results were as follows: 1) The level of anxiety in the experimental group was not significantly different from that in the control group. 2) The level of patient satisfaction with nursing care in the experimental group was significantly higher than in the control group (t=-4.53, p=.00). CONCLUSION: These findings suggested that the one-day vocal cord surgery information service could be a useful nursing intervention to improve patient satisfaction with nursing care, but not for controlling the anxiety of one-day surgery patients.
Anxiety ; Humans ; Information Services ; Nursing Care ; Patient Satisfaction ; Vocal Cords

The advent of computerized cranial tomography made a greater advance in the diagnosis of very wide variety of intracranial lesions. Authors analyzed 58 pathologically proven sellar and parasellar tumors examined at Kyung Hee Un-iversity Hospital from Oct. 1977 to Jun. 1981 and the results were as follows; 1. The distribution of the tumors is 28 pituitary adenomas, 18 craniopharyngiomas, 5 meningiomas, 4 germinomas, 2 astrocytomas, and 1 sphenoid mucocele. 2. In pituitary adenoma, the precontrast CT scan of tumors appeared as isodensity in 11 cases, mixed density in 8 cases, high density in 6 cases, and low density in 3 cases, and associated with destruction of sellar turcica in 15 cases, calcification in 3 cases, and hydrocephalus in 2 cases. The postcontrast CT scan study revealed 24 cases of contrast enhancement, including 17 cases of homogenous and 7 cases of ring or rim enhancement. 3. In craniopharyngioma, the precontrast CT scan of tumors appeared as low density in 12 cases, isodensity in 4 cases and high density in 2 cases and associated with calcification in 16 cases, hydrocephalus in 15 cases and destruction of sellar turcica in 2 cases. The postcontrast CT scan study revealed no enhancement in 10 cases and contrast enhancement in 8 cases including 6 of ring enhancement and 2 heterogenous enhancement.
Astrocytoma ; Craniopharyngioma ; Diagnosis ; Germinoma ; Hydrocephalus ; Meningioma ; Mucocele ; Pituitary Neoplasms ; Tomography, X-Ray Computed

OBJECTIVE: To evaluate the clinical and electrodiagnostic findings of ulnar neuropathy at the elbow. METHOD: Sixty-two patients with ulnar neuropathy at the elbow were reviewed retrospectively to establish causes, severity and type of neuropathy, symptom, sign, operation name and operative findings. RESULTS: 1) Of total 62 cases, 41 were male and 21 were female and the most often were in their forties and fifties. 2) The main cause of the neuropathy is bone deformity caused by previous fracture or dislocation (43.6%). 3) The symptoms observed were motor weakness (66.1%), sensory change (79%) and muscle atrophy (35.5%). 4) Forty-nine cases showed abnormality in nerve conduction study and needle electromyography study, and 9 cases showed abnormality only in the needle electromyography study. 5) On needle electromyography, sparing of flexor carpi ulnaris was shown in 50 cases (80.6%). 6) Operative treatment was performed in 15 cases. Among them, electrodiagnostic and operative diagnosis coincided in only 12 cases (80%). CONCLUSION: We conclude that above clinical and electrodiagnostic findings are useful for the diagonosis ulnar neuropathy at the elbow with consideration of etiology, localization and for the selection of operative treatment.
Congenital Abnormalities ; Diagnosis ; Dislocations ; Elbow* ; Electrodiagnosis ; Electromyography ; Female ; Humans ; Male ; Muscular Atrophy ; Needles ; Neural Conduction ; Retrospective Studies ; Ulnar Neuropathies*

BACKGROUND: Left ventricular thrombus is a common complication after acute myocardial infarction. Methods and RESULTS: To Study the incidence of left ventricular thrombosis (LVT) after acute myocardial infarction, we performed serial two-dimensional echocardiography (2D-Echo) in 35 consecutive patients with acute myocardial infarction prospectively ; 10 patients had inferior wall myocardial infarction, 25 patients had anterior wall myocardial infarction. 2D-Echo was obtained within 3 days of acute myocardial infarction, at 4-10 days after symptom onset, and 2-4 weeks after symptom onset serially in each case. 19 out of 35 patients received thrombolytic therapy with urokinase. Left ventricular thrombi were identified in 9(25.7%) of the 35 study patients. The location of myocardial infarction was anterior and apical in all cases with left ventricular thrombi. The shape of thrombi was mural in 6 cases and protruding in 3 cases. The incidence of left ventricular thrombi in patients who received urokinase was not significantly different from that in patients who didn't(31.9% vs 18.8%,p=0.22). Wall motion score was significantly higher in patients who developed left ventricular thrombi than in patients who had no left ventricular thrombus(8.2+/-1.9 vs 5.8+/-2.6, p<0.005). All thrombi appeared within 10 days after myocardial infarction. CONCLUSIONS: Thus left ventricular thrombi develops within 10 days following myocardial infarction with large anterior and apical location. The thrombolysis therapy has no effect in the incidence of left ventricular thrombi in this study. But because of confounding effect of thrombolysis and location of myocardial infarction and extent of myocardial infarction, further investigation is needed.
Anterior Wall Myocardial Infarction ; Echocardiography ; Humans ; Incidence* ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Prospective Studies ; Thrombolytic Therapy ; Thrombosis* ; Urokinase-Type Plasminogen Activator