Various anatomical defects have been described in the surviving twin who had a stillborn, macerated monozygotic co-twin with Disseminated Intravascular Coargulation. The etiology is thought to be placental transfer of emboli or thromboplastic material through placental vascular anastomoses. We experienced a case of monozygotic twin with deceased co-twin at 30 weeks of gestation and confirmed to have antenatal periventricular germinal matrix and intraventricular hemorrhage, multicystic periventricular leukomalacia and diffuse encephalomalacia by neurosonography on first day of life despite of no clinical evidence of brain damage. The pathologic findings of placenta revealed infarct with massive fibrin deposition. A brief review of related literature is presented.
Brain* ; Encephalomalacia ; Fibrin ; Hemorrhage ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Placenta ; Pregnancy ; Twins ; Twins, Monozygotic*

Erythromelanosis follicularis faciei et coli is a pigmentary disorder of unknown cause originally described by Kitamura et al in 1960. We describe two cases of erythromelanosis follicularis faciei et colli occured in adolescence. Clinical features of these patients were consistent with the clinical changes described in previous cases having clinical triad of erythema, hyperpigmentation and follicular papules. This pigmentary disorder may not be an uncommon disease, however it might be neglected from the concern of the dermatologists.
Adolescent ; Erythema ; Humans ; Hyperpigmentation

No abstract available.
Mandible*

Pancreatic pseudocyst occurs as a complication of pancreatitis or trauma, which results in the escape of pancreatic enzymes from the parenchyma or ductal system of pancreas. At that time, serum amylase may have returned to normal level, and the patient may be subjectively asymptomatic. In this phase, the radiologic findings are relatively greater significance than laboratory data. In the conventional radiologic study, pancreatic pseudocyst have been frequently confused with other retroperitoneal mass, but recently with clinical application of ultrasound and CT scan, more accurate diagnosis can be obtained. The brief results are as follows; 1. Male to female ratio was 3:2 in 15 patients. Incidence was most common in young adult age. Most frequent symptom was epigastic pain, and which was noted in 11 cases of patients. 7 cases of patients had past history of abdominal trauma and past history of pancreatitis was only in 1 case. Most common laboratory finding was leukocytosis in 8cases of patients and elevated serum amylase was also noted in 7 cases. 2. In each 5 cases of patients, plain chest roentgenologic evidence of left side pleural effusion and hemidiaphragm elevation were observed. 3. On flat abdomen film, soft mass shadow was visualized in 8 cases of patients. On UGI series, evidence of retrogastric space widening was observed in 11 cases of patients. 4. The location of pseudocyst is mainly in body and tail of pancrease in 11 cases of patients. 5. More accruable diagnosis can be obtained through application of ultrasound and CT scan.
Abdomen ; Amylases ; Diagnosis ; Female ; Humans ; Incidence ; Leukocytosis ; Male ; Pancreas ; Pancreatic Pseudocyst ; Pancreatitis ; Pancrelipase ; Pleural Effusion ; Tail ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; United Nations ; Young Adult

PURPOSE: There have been some efforts to diagnose intracranial aneurysm through a non-invasive method using MRA, although the process may be difficult when the lesion is less than 3mm. The present study prospectively compare the results of high resolution, fast speed slice interpolation MRA and DSA therapy examing the potentiality of primary non-invasive screening test. MATERIALS AND METHODS: A total of 26 cerebral aneurysm lesions from 14 patients with subarachnoid hemorrhage from ruptured aneurysm (RA) and 5 patients with unruptured aneurysm(UA). In all subjects, MRA was taken to confirm the vessel of origin, definition of aneurysm neck and the relationship of the aneurysm to nearby small vessels, and the results were compared with the results of DSA. The images were obtained with 1.5T superconductive machine(Vision, Siemens, Erlangen, Germany) on 4 slabs of MRA using slice interpolation. the settings include TR/TE/FA=30/6.4/25, matrix 160x512, FOV 150x200, 7minutes 42seconds of scan time, effective thickness of 0.7mm and an entire thickness of 102.2mm. The images included structures from foramen magnum to A3 portion of anterior cerebral artery. MIP was used for the image analysis, and multiplanar reconstruction(MPR) technique was used in cases of intracranial aneurysm. RESULTS: A total of 26 intracranial aneurysm lesions from 19 patients with 2 patients having 3 lesion, 3 patients having 2 lesions and the rest of 14 patients having 1 lesion each were examined. Among those, 14 were RA and 12 were UA. Eight lesions were less than 2mm in size, 9 lesions were 3-5mm, 7 were 6-9mm and 2 were larger than 10mm. On initial exams, 25 out of 26 aneurysm lesions were detected in either MRA or DSA showing 96% sensitively. Specificity cannot be estimated since there was no true negative of false positive findings. When MRA and MPR were used concurrently for the confirmation of size and shape, the results were equivalent to those of DSA, while in the confirmation of aneurysm neck and parent vessels, the concurrent use of MRA and MPR was far superior to the sole use of either MRA or DSA. CONCLUSION: High resolution MRA using slice interpolation technique showed equal results as those of DSA for the detection of intracranial aneurysm, and may be used as a primary nin-invasive screening test in the future.
Aneurysm ; Aneurysm, Ruptured ; Angiography* ; Angiography, Digital Subtraction* ; Anterior Cerebral Artery ; Foramen Magnum ; Humans ; Intracranial Aneurysm* ; Mass Screening ; Neck ; Parents ; Prospective Studies ; Sensitivity and Specificity ; Subarachnoid Hemorrhage

OBJECTIVES: MDM-2 is an oncoprotein that inhibits p53 tumor suppressor protein. Amplication and over- expression of its protein have been observed in human malignancies, and these abnormalities have a role in tumorigenesis through inactivation of p53 function. To elucidate the role of p53 and MDM-2 protein in cervical neoplasia we investigated the expression rates of MDM-2 and p53 protein in surgically resected specimens. METHEDS: Immunohistochemical studies using anti-p53 and anti-MDM-2 protein in the paraffin embedded section of 62 cases including cervical intraepithelial neoplasm(CIN) and invasive cervical cancer were performed. RESULTS: Expression rates of p53 protein were 25% in CIN I& CINII, 20% in CINIII, and 44% in invasive carcinoma, respectively. The MDM-2 protein were 33% in CIN I & CIN II, 16% in CIN III, and 48% in invasive carcinoma, respectively. There was no evident correlation between p53 positivity and MDM-2 positivity(p>0.05). However, correlation between MDM-2 negativity and p53 negativity was statistically significant(p=0.002) CONCLUSION: These data suggest that the expression of p53 protein is presumed to be necessarily correlated with MDM-2 protein expression in cervical neoplasia.
Carcinogenesis ; Humans ; Paraffin ; Proto-Oncogene Proteins c-mdm2* ; Tumor Suppressor Protein p53 ; Uterine Cervical Neoplasms

PURPOSE: To analyze angiearchitecture of arteriovenous malformations(AV malformation) in order to clarify the angiegraphic risk factors for intracerebral hemorrhage and other nonhemorrhagic symptoms. MATERIALS AND METHODS: Eighty-five patients with angiegraphically-proved brain arteriovenous malformation were included in this study. Retrospective review of clinical history and angiography was done. Topographic analysis and evaluation of 17 angiearchitectural characteristics were conducted. RESULTS: Deep-seated and cortico-callosal type, small nidus size, intranidal pouch, one draining vein, deep venous drainage only venous stenosis and venous aneurysm were the most discriminating or predictive characteristics of hemorrhage in brain arteriovenous malformation. And those with large nidus size, dural supply and venous hypertension were correlated with nonhemorrhagic symptoms such as seizure, headache and neurologic deficit. CONCLUSION: Detailed analysis of the angiearchitecture of brain arteriovenous malformations is needed to identify the features that are correlated with prognostic implications for the treatment of patients with ^V malformations.
Aneurysm ; Angiography ; Arteriovenous Malformations* ; Brain* ; Cerebral Hemorrhage ; Constriction, Pathologic ; Drainage ; Headache ; Hemorrhage ; Humans ; Hypertension ; Neurologic Manifestations ; Retrospective Studies ; Risk Factors ; Seizures ; Veins

A 67-year-old male presented with a subarachnoid hemorrhage and was found to have a basilar artery (BA) tip aneurysm, which was incorporated to both posterior cerebral arteries (PCAs). First, he was treated with the single stent, which was deployed from P1 segment of the right PCA to BA, and coil embolization was done. Follow-up angiogram at 18 months revealed coil compaction of the aneurysm. Therefore, we accomplished the Y-configured dual stent assisted coil embolization. Follow-up angiogram at 30 months revealed no recanalization of aneurysm and patent blood flow of both PCAs. In conclusion, staged Y-shaped stents assisted coil embolization is an alternative treatment option in a wide-neck basilar tip aneurysm decreasing the extent of coil compaction of aneurysm and preserving an incorporated vessel.
Aged ; Aneurysm* ; Basilar Artery ; Embolization, Therapeutic* ; Follow-Up Studies ; Humans ; Male ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery ; Stents* ; Subarachnoid Hemorrhage

A new radiopharmaceutical, technetium-99m hexamethylpropyleneamine oxime(99mTc-HMPAO), has been reported to cross the blood-brain-barrier and to distribute in brain in proportion to regional blood flow. Measurement of cerebral blood flow with single photon emixxion computed tomography(SPECT) was performed using 99mTc-HMPO in 46 patients and clinical analysis was done. Decreased regional cerebral perfusion was observed in 41 cases. Moreover eight cases of them who had normal X-ray C-T scan revealed positive finding on SPECT. We porpose that 99mTc-HMPAO SPECT seems to be a useful diagnostic method for evaluation of ischemic cerebral lesions.
Brain ; Diagnosis* ; Humans ; Perfusion ; Regional Blood Flow ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: The p53 protein is a tumor supressor gene, and its mutation is associated with biologic aggressiveness. CD44v6, one of the CD44 family, is a cell surface glycoprotein that plays a role in cancer invasion and metastasis. Vascular endothelial growth factor (VEGF) is another recently identified growth factor with significant angiogenic properties. The purpose of this study was to investigate p53, CD44v6, and VEGF expressions to determine whether degree of expression was related to pathological parameters such as Lauren's classification, depth of invasion, and lymph node metastasis. MATENRIALS AND METHODS: Immunohistochemical stains of p53, CD44v6, and VEGF in formalin-fixed paraffin-embedded tissue sections of 125 gastric adenocarcinomas were done. RESULTS: The overall expression rates of p53, CD44v6, and VEGF were 54.4% (68/125), 36.8% (46/125), and 48.0% (60/ 125), respectively. The p53, not CD44v6 and VEGF was higher in intestinal-type gastric carcinomas by Lauren's classification. The expressions of p53, CD44v6, and VEGF were statistically correlated with depth of tumor invasion. The expression of CD44v6 was higher in the lymph node metastatic group than in the negative group. The p53 expression was significantly associated with VEGF expression. CONCLUSIONs: These data suggest that the expressions of p53, CD44v6, and VEGF are biologically related to malignancy. The p53 and CD44v6 expressions are independent; however, p53 gene mutation is one of the contributing factors to VEGF expression in gastric adenocarcinoma.
Adenocarcinoma* ; Classification ; Coloring Agents ; Genes, p53 ; Humans ; Immunohistochemistry ; Lymph Nodes ; Membrane Glycoproteins ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*