The dysplasitc melanocytic nevus(DMN) of the skin is an atypical-appearing melanocytic tumor characterized by intraepidermal atypical melanocytic preliferation. Clinically, DMN has a diameter greater than 5mm, ill-defined irregular borders, irregularly distributed pigmentation surrounded by erythems,. Histopat- hologically, there are numerous discrete nests of atypical melanocytes situated at the dermoepidermal junction of elongated rete ridges. In the dermis, concentric lamellar fibroplasia, lymphocytic infiltrates and neovascularization are noted. We report herein a case of DMN developed on the trunk of 31-year-old Korean male.
Adult ; Dermis ; Humans ; Male ; Melanocytes ; Nevus, Pigmented* ; Pigmentation ; Skin

BACKGROUND: The relative importance of embolic mechanisms as opposed to hemodynamic factor in the pathogenesis of ischemic strokes associated with atherosclerotic middle cerebral artery (MCA) or internal carotid artery (ICA) disease remains unresolved. We conducted the present study to identify the differences of clinicoradiological patterns between MCA or ICA diseases. METHODS: We defined atherosclerotic disease of MCA or ICA as > 50% stenotic lesions or ulcerative plaques. We divided the patients into groups of MCA and ICA diseases, and analyzed clinical, laboratory, and neuroradiological data. RESULTS: Among the 620 consecutive patients with acute ischemic strokes, 84 (12.9%) patients met the criteria for atherosclerotic MCA or ICA disease: 54 patients with MCA disease and 30 patients with ICA disease. The mean age was younger in patients with MCA than ICA disease (p=0.003). MCA disease clinically more frequently presented with lacunar syndrome (p=0.001). ICA disease more frequently presented with total anterior circulation infarct and had higher initial NIHSS scores than MCA disease (p=0.004 and 0.003, respectively). While whole MCA territorial infarcts were common in ICA disease, deep perforator infarcts were more significantly caused by MCA disease (p< 0.05). MR topographic patterns showed difference between MCA and ICA diseases according to the degree of stenosis (p< 0.05). Cortical dots were significantly accompanied by superficial perforator infarcts than internal borderzone infarcts (p=0.017). CONCLUSIONS: Our present study suggests that clinical and neuroradiological representations might be different between MCA and ICA diseases, which might reflect difference of underlying pathogenesis.
Carotid Artery, Internal* ; Constriction, Pathologic ; Hemodynamics ; Humans ; Infarction ; Middle Cerebral Artery* ; Stroke ; Stroke, Lacunar ; Ulcer

BACKGROUND: The relative importance of embolic mechanisms as opposed to hemodynamic factor in the pathogenesis of ischemic strokes associated with atherosclerotic middle cerebral artery (MCA) or internal carotid artery (ICA) disease remains unresolved. We conducted the present study to identify the differences of clinicoradiological patterns between MCA or ICA diseases. METHODS: We defined atherosclerotic disease of MCA or ICA as > 50% stenotic lesions or ulcerative plaques. We divided the patients into groups of MCA and ICA diseases, and analyzed clinical, laboratory, and neuroradiological data. RESULTS: Among the 620 consecutive patients with acute ischemic strokes, 84 (12.9%) patients met the criteria for atherosclerotic MCA or ICA disease: 54 patients with MCA disease and 30 patients with ICA disease. The mean age was younger in patients with MCA than ICA disease (p=0.003). MCA disease clinically more frequently presented with lacunar syndrome (p=0.001). ICA disease more frequently presented with total anterior circulation infarct and had higher initial NIHSS scores than MCA disease (p=0.004 and 0.003, respectively). While whole MCA territorial infarcts were common in ICA disease, deep perforator infarcts were more significantly caused by MCA disease (p< 0.05). MR topographic patterns showed difference between MCA and ICA diseases according to the degree of stenosis (p< 0.05). Cortical dots were significantly accompanied by superficial perforator infarcts than internal borderzone infarcts (p=0.017). CONCLUSIONS: Our present study suggests that clinical and neuroradiological representations might be different between MCA and ICA diseases, which might reflect difference of underlying pathogenesis.
Carotid Artery, Internal* ; Constriction, Pathologic ; Hemodynamics ; Humans ; Infarction ; Middle Cerebral Artery* ; Stroke ; Stroke, Lacunar ; Ulcer

PURPOSE: The purpose of this study is to compare the sensitivity, specificity, positive predictive value, and negative predictive value of ultrasonography versus magnetic resonance imaging (MRI) in evaluation of pregnant patients with clinically suspicious acute appendicitis. METHODS: This study was a retrospective cohort study. A total of 60 pregnant patients who presented to the emergency department with suspected appendicitis and underwent ultrasonography or MRI were included. The official interpretation reports and pathologic reports were extracted and analyzed. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for ultrasonography and MRI for diagnosis of acute appendicitis. We also calculated and compared area under the curve (AUC) of both diagnostic tests with the receiver operating characteristic (ROC) curve analysis. RESULTS: Among 60 patients, 43 (71%) underwent ultrasonography, 37 (61%) underwent MRI, and 20 (33%) underwent both diagnostic tests. Twenty patients were confirmed as pathologically-proven acute appendicitis. The sensitivity, specificity, positive predictive value, and negative predictive value of ultrasonography for diagnosing acute appendicitis were 67%, 77%, 53%, and 86%, while those of MRI were 100% for all parameters. In ROC analysis, the AUC was 0.656, respectively, for ultrasonography, and 1.000 for MRI (p value<0.0001). CONCLUSION: This study suggests that MRI is more accurate than ultrasonography for the diagnosis of acute appendicitis in pregnant women, especially when the appendix is invisible with ultrasonography.
Appendicitis* ; Appendix ; Area Under Curve ; Cohort Studies ; Diagnosis ; Diagnostic Tests, Routine ; Emergency Service, Hospital ; Female ; Humans ; Magnetic Resonance Imaging* ; Pregnancy* ; Pregnant Women ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography*

A pulmonary thromboembolism usually results from deep vein thrombosis as a serious and fatal complication. It is well known that several risk factors are predisposed to these thrombotic events, causing sudden death. Recently, new variant forms of pulmonary thromboembolism, termed as "economy class syndrome or e-thrombosis" were reported in association with sitting for long time in aircraft seat or at computer. The authors experienced a case of death developed after prolonged gambling at casino in 46-year-old man and concluded that the cause of death was fatal pulmonary thromboembolism due to deep vein thrombosis, associated with prolonged sitting. Therefore, the author thought that this case may be contribute to another possible risk factor of life-threatening pulmonary thromboembolism and highlights the importance of predicting deep vein thrombosis after prolonged gambling in sitting position at casino in the similar mechanism of aforementioned reported cases.
Aircraft ; Autopsy* ; Cause of Death ; Death, Sudden ; Gambling* ; Humans ; Middle Aged ; Pulmonary Embolism* ; Risk Factors ; Venous Thrombosis

OBJECTIVE: The purpose of this study was to assess memory dysfunction in patients with mild and moderate traumatic brain injury (TBI) with and without frontal lobe injury (FLI). METHODS: The subjects were 110 TBI patients, who had recovered from the acute clinical phase, and comprised 20 (18.2%) mild TBI (MTBI) patients with FLI, 16 (14.5%) MTBI patients without FLI, 51 (46.4%) moderate TBI (MOTBI) patients with FLI and 23 (20.9%) MTBI patients without FLI. All patients were administrated the Korean version of the Memory Assessment Scale (K-MAS). RESULTS: Almost all the Summary Scale scores on the K-MAS failed to show any differences between TBI patients with and without FLI, but differences did emerge by types at severities. TBI patients with FLI showed higher Global Memory ability than TBI patients without FLI if their TBI was only mild, but when their TBI was more severe, this finding was reversed, and TBI patients with FLI showed lower Verbal and Global Memory abilities than TBI patients without FLI. CONCLUSION: Different kinds of assessment tools are needed for the measurement of memory abilities in TBI patients with FLI, and that the selection of the appropriate tool depends on the severity of the TBI.
Brain ; Brain Injuries ; Frontal Lobe ; Humans ; Memory

BACKGROUND: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled. METHODS: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups. RESULTS: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). CONCLUSIONS: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.
Arteries ; Embolism ; Humans ; Parents* ; Prognosis ; Recurrence ; Stroke ; Stroke, Lacunar*

Skeletal muscles are known to have tolerance to ischemia, but a prolonged ischemia can cause damage to muscular tissues. The ischemia-reperfusion injury results from the oxygen free radicals released by leucocytes and formed by the reaction of hypoxanthine and xanthine oxidase. Superoxide dismutase (SOD), one of major antioxidant enzymes ocurring in the various tissues of the body metabolizes or scarvanges the oxygen free radicals. Although many studies reported difference in tolerance to ischemia and reperfusion between white and red muscles, some other investigators failed in finding such difference. The present study was performed to examine effects of graded periods of ischemia and reperfusion on the cellular ultrastructure and activity of SOD in white and red muscles. The Sprague-Dawley rats (200~250 g) were used as experimental animals. Under pentobarbital (50 mg/kg IP) anesthesia, incision was made on lower abdomen and left common iliac artery was occluded by means of a vascular clamp for 2, 4 and 6 hour (hrs). Thereafter, the superficial portion of mid-belly of anterior tibial muscle and soleus muscles were excised at 0, 24 and 72 hrs after onset of reperfusion. The specimens were sectioned into slices, 2 mm in length, 1 mm in width and thickness. Some specimens were prepared for electron microscopic observation and others for determination of SOD activity by using antihuman Cu, Zn- and Mn-SOD antibodies. The results obtained were as follows. 1. In anterior tibial muscle, areas with loose electron-density and dilated cristae were observed in the mitochondria immediately after 2 hrs of ischemia, while widened intermyofibrillar spaces and dilated cisternae of sarcoplasmic reticulum were seen after 2 hrs and 24 hrs reperfusion. When subjected to 2 hrs ischemia and 72 hrs reperfusion, no significant change was found in the cellular ultrastructure. 2. In soleus muscle, electron density was loose in the matrix of mitochondria immediately after 2 hrs of ischemia, while cisternae of sarcoplasmic reticulum were dilalated after 2 hrs of ischemia and 24 hrs reperfusion. Following 2 hrs of ischemia and 72 hrs reperfusion, the electron microscopic findings were similar to those of normal rats. 3. The changes in cellular ultrastructure were more prominent in both the 4 hrs and 6 hrs ischemia groups, in which degree of ultrastructural changes were proportional to duration of reperfusion. 4. In anterior tibial muscle, trace or weak immunoreactivities of Cu, Zn- and Mn-SOD were seen, whereas trace immunoreactivity of Cu, Zn-SOD and trace or weak immunoreactivity of Mn-SOD were observed in soleus muscle. 5. The immunoreactivities of Cu, Zn- and Mn-SOD were not altered in 2 hrs ischemic and 72 hrs reperfused group, while they were increased slightly in 2 hrs ischemic and 24 hrs reperfused group. 6. In both muscles, the activity of SOD increased following 4 hrs or 6 hrs ischemia and 24 hrs or 72 hrs reperfusion. The changes in immunoreactivity of Mn-SOD were not different between two muscles, whereas immunoreactivity of Cu, Zn-SOD were higher in anterior tibial muscle. Consequently, it is suggested that significant ischemia reperfusion injuries are produced after 4~6 hrs ishemia followed by 24 hrs or 72 hrs reperfusion, that anterior tibial muscle is more susceptible to ischemic reperfusion injury and that the ischemic-reperfusion injury is closely related with activity of SOD.
Abdomen ; Anesthesia ; Animals ; Antibodies ; Free Radicals ; Humans ; Hypoxanthine ; Iliac Artery ; Ischemia* ; Mitochondria ; Muscle, Skeletal ; Muscles* ; Oxygen ; Pentobarbital ; Rats* ; Rats, Sprague-Dawley ; Reperfusion Injury ; Reperfusion* ; Research Personnel ; Sarcoplasmic Reticulum ; Superoxide Dismutase ; Xanthine Oxidase

PURPOSE: Radiofrequency ablation (RFA) of lung cancer in animals and humans has been described in previously published reports. The aim of this study was to present our preliminary experience of treatment of lung cancer involving this approach. MATERIALS AND METHODS: Eight patients with lung malignancies [stage IIIB or IV bronchogenic adenocarcinoma (n=6), metastatic squamous cell carcinoma (n=1), metastatic hepatocellular carcinoma (n=1)] underwent RFA treatment. In all cases LeVeen-type electrodes were employed and CT was used to monitor the procedure. One-day and one-month follow-up CT scans were obtained and analyzed. RESULTS: Prior to treatment, tumor diameter ranged from 2.5 to 5 cm; afterwards, low attenuation consistent with coagulative necrosis was observed. Complications included a small amount of pneumothorax (n=4), pleural effusion (n=8), and subcutaneous emphysema (n=1). Tumor size decreased in five patients, was unchanged in two, and increased in one. CONCLUSION: Radiofrequency ablation of lung cancer is safe and may result in a reduced tumor burden.
Adenocarcinoma ; Animals ; Carcinoma, Hepatocellular ; Carcinoma, Squamous Cell ; Catheter Ablation* ; Electrodes ; Follow-Up Studies ; Humans ; Lung Neoplasms* ; Lung* ; Necrosis ; Pleural Effusion ; Pneumothorax ; Subcutaneous Emphysema ; Tomography, X-Ray Computed ; Tumor Burden

Carcinoembryonic antigen (CEA) has been studied in the field of gynecologic malignancy to determine whether it can be used as a tumor marker for early detection of recurrence or evaluation of therapeutic results. From January 1985 through December 1989, a total of 239 cervical cancer patients were entered for an analysis of plasma CEA level in the group with cervical cancer compared to the control group consisting of 65 normal healthy women and 18 women with benign gynecologic disease. Plasma CEA levels appear to be directly related with the tumor extension and as stages advance, the incidence of patients with abnormal plasma CEA levels is increased. Also, there seems to be a little higher incidence of abnormal CEA levels in patients with adenocarcinomas or adenosquamous carcinoma but not statistically significant because of small number of patients. When the patients developed recurrence, plasma CEA levels are markedly elevated in the majority, particularly in patients with hepatic metastases. In conclusion, serial plasma CEA checks could be used to detect recurrence during follow-up after treatment of cervical cancer.
Adenocarcinoma ; Carcinoembryonic Antigen ; Carcinoma, Adenosquamous ; Female ; Follow-Up Studies* ; Genital Diseases, Female ; Humans ; Incidence ; Neoplasm Metastasis ; Plasma* ; Recurrence ; Uterine Cervical Neoplasms