Germ cell tumors(GCT) are not infrequently encounted tumor in pediartic age group. In order to study the clinical behaviors of the disease, we reviewed 29 cases of GCT diagnosed and treated at Kosin Medical Center in the period of 7 years form Jan. 1984 to Dec. 1991 and the results are summarized as follows: 1) The age distribution is the highest between 10 and 15 years(45%) and girls have 1.9 times higher frequency than that of boys. 2) The most frequent primary site of GCT was ovary(15). The next common primary site was testis(5), pineal body(4), sacrococcygeal region(2), retroperitoneum(1), soft palate(1), anterior mediastinum(1) in descending order of frequency. 3) In the pathological analysis of tumors, the most frequent type was mature teratoma(12). The next common type was endodermal sinus tumor(6), immature teratoma(5), dysgerminoma(3), mixed type(2), and choriocarcinoma(1)in descending order of frequency. 4) All the 5 cases of EST have elevated serum levels of alpha-fetoprotein. Two of the three dysgerminoma, one of the two mixed type tumors both of which have germinoma components, and one choriocarcinoma have elevated serum levels of beta-HCG above the age related physiological levels. 5) Among 17 cases of malignant GCT, 9 cases have metastatic areas such as regional lymph nodes, scrotum, pleura, retroperitoneum, omentum and lumbar spine. 6) All except on case of immature teratoma in the anterior mediastinum underwent surgery. Chemotherapy was given to 12 of 17 malignant GCT and radiotherapy was given to 4 of 17 malignant GCT. 7) Among the 4 expired cases within 12 months of follow up, three were originated from pineal body, which had been underwent simple V-P shunt or incomplete resection, and one case was metastatic immature teratoma of anterior mediastinum to the pleura which had not been undergone surgery. Finally, in review of literature and or cases, the survival of properly managed GCT except some of those difficult surgical access is relatively good. To continue the survival of children of GCT to be impoved, we should use all the treatment modalit properly with more positive outlook about the disease.
Age Distribution ; alpha-Fetoproteins ; Child* ; Choriocarcinoma ; Drug Therapy ; Dysgerminoma ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Germinoma ; Humans ; Lymph Nodes ; Mediastinum ; Neoplasms, Germ Cell and Embryonal* ; Omentum ; Pineal Gland ; Pleura ; Pregnancy ; Radiotherapy ; Scrotum ; Spine ; Teratoma

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

A case of hepatocellular carcinoma (HCC) complicating with secondary biliary cirrhosis due to intrahepatic bile duct growth of the tumor is presented. The patient was 34 years-old male who had been suffered from right upper quadrant pain with intermittent fluctuating jaundice for 4 months. Left lobectomy specimen contained a single, 4 cm sized, relatively well circumscribed and partly protruding nodular HCC in the medial seqment of left lobe. It compressed the left hepatic duct, and the intra and extra-hepatic ducts were completely plugged with tumor casts (extending to the common bile duct at the operating table). Remaining hepatic parenclyma was the seat of advanced secondary biliary cirrhosis in which were abundance of HBsAg-containing hepatocytes possibily representing a HBsAg carrier status. Biliary cirrhosis in HCC is an extremely rare manifestation, reflecting the delayed adequate clinical procedure by unusual pattern of obstructive jaundice. In such a case presenting as persisting and fluctuating obstructive jaundice in HCC, an intrabile duct tumor growth should be suspected.
Male ; Humans ; Carcinoma, Hepatocellular

No abstract available.
Appendicitis* ; Child* ; Humans

The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T on seizure duration. The results were follows ' 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine 0.0093mg kg(-1), pentothal 2.76mg kg(-1) or propofol 1.42mg kg(-1). 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal(35.7 sec)(p<0.001). This suggest the possibility that additional treatment may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.
Atropine ; Bipolar Disorder ; Delusions ; Depressive Disorder, Major ; Dihydroergotamine ; Electroconvulsive Therapy ; Humans ; Inpatients ; Propofol* ; Schizophrenia ; Seizures* ; Thiopental*

Posterior lumbar fusion is a safe and effective surgical method for diseases, such as lumbar stenosis, spondylolisthesis, lumbar instability, spinal deformity, and tumor. Pedicle screw (PS) fixation was first introduced by Bouche and has been adopted as the gold standard for posterior lumbar fusion. Santoni and colleagues introduced a new methodological screw insertion technique that uses a cortical bone trajectory (CBT), described as that from a medial to lateral path in the transverse axial plane and caudal to the cephalad path in the sagittal plane through the pedicle for maximum contact of the screw with the cortical bone. Owing to the lower invasiveness, superior cortical bone contact, and reduced neurovascular injury incidence, the CBT technique has been widely used in posterior lumbar fusion; however, these advantages have not been proven in clinical/radiological and biomechanical studies. We designed the present study to review the existing evidence and evaluate the merit of CBT screw fixation. Six electronic databases were searched for relevant articles published in August 2020 using the search terms “cortical bone trajectory,” “CBT spine,” “CBT fixation,” “cortical pedicle screws,” and “cortical screws.” Studies were analyzed and divided into the following groups: “biomechanics investigation,” “surgical technique,” and “clinical/radiological studies.” Most studies compared CBT and PS fixation, and the CBT screw fixation method showed better or similar outcomes.

PURPOSE: To report a case of a patient with posterior ischemic optic neuropathy and abducens nerve palsy who responded to steroid therapy. CASE SUMMARY: A 47-year-old man visited our clinic with decreasing visual acuity and abduction limitation in his right eye, which suddenly started 4 days earlier. The best corrected visual acuity (BCVA) was 20/250 in the right eye and 20/20 in the left eye. Fundus examination showed normal in both eyes, and relative afferent pupillary defect was positive in the right eye. The visual field test showed a right central scotoma with inferior altitudinal field defect. In addition, the brain magnetic resonance imaging (MRI) was done. Orbit MRI, fluorescein angiography (FAG), and carotid ultrasonography results were normal. Therefore, the patient was diagnosed with non-arteritic posterior ischemic optic neuropathy. The systemic steroid therapy was started and tapered over a period of 5 weeks. At one month after treatment, the BCVA was 20/20 and abduction limitation in the right eye improved.
Abducens Nerve ; Abducens Nerve Diseases ; Brain ; Eye ; Fluorescein Angiography ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Optic Neuropathy, Ischemic ; Orbit ; Pupil Disorders ; Scotoma ; Visual Acuity ; Visual Field Tests

No abstract availble.
Adenoma/diagnosis/epidemiology/*etiology ; Anticipation, Genetic ; Colonic Neoplasms/diagnosis/epidemiology/*etiology ; Humans ; *Insulin Resistance ; Obesity/*complications/epidemiology ; Risk Factors

Secondary amyloidosis occurs in patients with chronic inflammatory diseases, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The major therapeutic approach to secondary amyloidosis involves controlling the underlying inflammatory disease. Tumor necrosis factor-alpha (TNF-alpha) inhibitors have revolutionized the treatment of rheumatic diseases; in many cases dramatic clinical improvement of secondary amyloidosis due to AS has been observed in response to treatment with these agents. However, the development of secondary amyloidosis associated with AS refractory to treatment with TNF-alpha inhibitors has been infrequently reported. Here, we described a case of a 37-year-old male patient with longstanding AS who was diagnosed with secondary amyloidosis due to high disease activity despite treatment with etanercept, adalimumab and infliximab.
Adult ; Amyloidosis* ; Arthritis, Rheumatoid ; Humans ; Male ; Rheumatic Diseases ; Spondylitis, Ankylosing* ; Tumor Necrosis Factor-alpha* ; Adalimumab ; Infliximab ; Etanercept

PURPOSE: To review the clinical and laboratory features of patients with Wilson disease at diagnosis. METHODS: In this retrospective study, records of all 20 patients, who were diagnosed as having Wilson disease at the Paik hospital in Busan from 1990 to 2000, were reviewed. RESULTS: Out of 20 patients, 12 pateints (60%) have hepatic presentation alone, 2 patients (10%) have neurologic presentation, 4 patients (20%) have hepatic and neuropsychiatric presentation, and one patient (5%) has hematologic presentation at diagnosis. One patient (5%) has neither symptom nor laboratory finding of Wilson disease except very low serum ceruloplasmin level and positive family history. Family screening test revealed 3 cases of Wilson disease. 12 patients were revealed to be combined with liver cirrhosis at diagnosis. CONCLUSION: Early diagnosis and treatment is very important in patients with Wilson disease. Children or adolescents who manifest symptoms of hepatitis, who has prolonged elevation of liver enzymes, and has family history of hapatitis of unknown origin, with mild hematologic or urinary abnormalities must be suspected to have Wilson disease. Also, in adolescents with extrapyramidal symptoms or other neuropsychiatric symptoms, liver function test should be done.
Adolescent ; Busan ; Ceruloplasmin ; Child ; Diagnosis ; Early Diagnosis ; Hepatitis ; Hepatolenticular Degeneration* ; Humans ; Liver ; Liver Cirrhosis ; Liver Function Tests ; Mass Screening ; Retrospective Studies