An unusual case of glroependymal cyst involving the lateral ventricle, 3rd ventricle, cerebellopontine angle cistern and prepontine cistern, simultaneously, is reported. The glroependymal cyst is benign developmental cyst that mainly occurs in the cerebrospinal axis in relation to ventricle, but occasionally occurs in relation to extraventricular system, such as subarachnoid space, brain stem and cerebral parenchyme. The histological characteristics of ependymal cyst wall are ependyma-like epithelium and neuroglial tissue.
Axis, Cervical Vertebra ; Brain Stem ; Cerebellopontine Angle ; Epithelium ; Lateral Ventricles ; Subarachnoid Space

Interleukin-6 (IL-6) and its receptor are presumed to play important roles in the developing nervous system. However, little is known about their potential role(s) in the developing kidney. To investigate this, we have studied the expression of IL-6 and its receptor (IL-6R) in the developing rat kidney. Kidneys from 16- (F16), 18- and 20-day-old (F20) fetuses, 1- (P1), 3- (P3), 7- (P7) and 14-day-old (P14) pups, and adult rats were extracted. Renal expressions of IL-6 and its receptors were examined by immunohistochemistry and in situ hybridization respectively. Il-6 protein already appeared in F16. The early stage of renal development before birth, IL-6 showed strong immunoreactivity in the ureteric bud, metanephric mesenchymal cells (MMC) and developing glomerulus. The expression pattern of IL-6 in nephrogenic zone are very similar even after birth. In matured nephron after birth, IL-6 immunoreactivities were detected in distal tubules strongly, and collecting ducts moderately and thick ascending limb weekly. IL-6R hybridization signals have also already appeared in 16-day old fetal kidney. Before birth, IL-6R mRNAs were expressed in ureteric bud, MMC and developing glomerulus. In the matured nephron after birth, IL-6R mRNA was expressed in the thick ascending limb, distal tubules, collecting ducts and S3 segment of proximal tubule. These results suggest that IL-6 and its receptor may be involved in regulation of nephron formation in nephrogenic zone of rat, and play a role in distal nephron including collecting duct after birth.
Adult ; Animals ; Extremities ; Fetus ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Interleukin-6* ; Kidney* ; Nephrons ; Nervous System ; Parturition ; Rats* ; RNA, Messenger ; Ureter

BACKGROUND: The incidence of malignant melanoma in oriental countries is lower than that in western countries. But recently the incidence of malignant melanoma and related death rate are increasing in the world. Malignant melanoma on the palm and sole is known to have worse prognosis and sometimes radical surgery such as amputation is necessary. It is important to exclude malignant melanoma when pigmented patch is encountered, and biopsy is necessary in most cases. But histopathological features of benign melanocytic neoplasms occurring at palm or sole are known to be confusing, because they can resemble the features of malignant melanoma. But there has been no report on this item in Korean dermatological literature, to our knowledge. OBJECTIVE: We investigated the histopathological features of benign melanocytic neoplasms on the palm and sole with their clinical features. MATERIALS AND METHODS: A total of 23 benign melanocytic neoplasms that had been excised from the palm and sole at Inje University Sanggye Paik Hospital and Seoul National University Hospital between July 1991 and April 1998 were evaluated. The retrospective analysis of the clinical manifestation was performed. Histologically, hematoxylin and eosin stained tissue sections were reviewed with the following criteria: symmetry, circumscription, lentiginous hyperplasia, anastomosing rete ridges, pagetoid spread, papillary dermal fibroplasia, lymphocytic infiltrate, pigment in the dermis and the stratum corneum, cytologic atypia, and mitotic activity. RESULTS: Five patients were male and eighteen were female; the mean age was 27.6 years with a peak incidence in the fourth decades. Six lesions had asymmetric, irregular and geographic borders. The diameter of the lesions varied; 3 cases were larger than 9 mm in maximum diameter. Clinically, we suspected 7 cases to be malignant melanoma before biopsy. Histological diagnoses of 23 benign melanocytic neoplasms were as follows: 12 junctional nevi, 3 compound nevi, 1 intradermal nevus, 2 lentigines, 3 benign melanocytic hyperplasias, and 2 congenital melanocytic nevi. Microscopic findings showed single melanocytic proliferation at the dermo-epidermal junction in 17 cases(73.9%), lentiginous hyperplasia in 8 cases, upward migration of melanocytes in 8 cases(34.7%), and ill-defined lateral circumscription in 6 cases(26.0%). Mitotic figures and cytologic atypia were not present. Pigments were variously seen in the stratum corneum in all cases and conspicuous amounts of melanin where the melanocytes upwardly migrated were found in 8 cases. CONCLUSION: There has been a report that the diameter of lesions is very important in differential diagnosis of malignant melanoma when a pigmented lesion is present on the palm and sole and 9mm is the critical maximum diameter. But we encountered 3 cases of benign melanocytic neoplasm which were larger than 9mm in their diameters. We think 9mm is not a reliable critical diameter in the differential diagnosis of malignant melanoma. Histological analysis showed some features resembling malignant melanoma, such as single melanocytic hyperplasia, upward migration of melanocytes in epidermis, ill-defined lateral margin, abundant pigments in the stratum corneum, and lymphocytic infiltration in dermis. There was no case with cytological atypia or mitoses and we think this is an important feature to be studied in the future in the differentiation of malignant melanoma.
Amputation ; Biopsy ; Dermis ; Diagnosis ; Diagnosis, Differential ; Eosine Yellowish-(YS) ; Epidermis ; Female ; Hematoxylin ; Humans ; Hyperplasia ; Incidence ; Lentigo ; Male ; Melanins ; Melanocytes ; Melanoma ; Mitosis ; Mortality ; Nevus ; Nevus, Intradermal ; Nevus, Pigmented ; Prognosis ; Retrospective Studies ; Seoul

We have studied 286 cases of intracranial aneurysm patients, who were admitted, surgically treated and registered at Korea University Medical Center between January, 1980 and February, 1989. This report resents an analysis of 286 cases of surgically treated intracranial aneurysms. The following results were obtained; 1) Intracranial aneurysm was the most common in the 6th decade(100 cases, 35.0%) and the next order was in the 5th decade(82 cases, 28.7%). 2) The male to female ratio was 1 : 1.53, but male predominant below 4th decade. 3) Aneurysmal size was the most common between 3mm and 10mm(264 cases, 85.2%). 4) The most frequent site was anterior communicating artery(102 cases, 32.9%) and the next order was posterior communicating artery(90 cases, 29.0%). 5) The incidence of multiple aneurysm was 6.6%(19 cases). 6) The incidence of single unruptured aneurysm was 7.6%(19 cases), its most common initial symptom was 3rd cranial nerve palsy. 7) The initial clinical status of patients seems to parallel the postoperative prognosis. 8) The degree of cerebral vasospasm on angiography seems to parallel the postoperative prognosis. 9) Postoperative mortality was 10.8%, but it was 3.8% in operation cases after January, 1986. 10) The most common cause of postoperative mortality was cerebral vasospasm(38.7%), and the next order was rebleeding(19.4%).
Academic Medical Centers ; Aneurysm ; Angiography ; Cranial Nerve Diseases ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Korea ; Male ; Mortality ; Prognosis ; Vasospasm, Intracranial

PURPOSE: This study took a retrospective approach to investigate patients with catheter-associated urinary tract infection (CAUTI) over 2 years at a single hospital's intensive care unit (ICU) to identify meaningful risk factors and causative organisms. MATERIALS AND METHODS: A retrograde analysis was performed on patients with indwelling catheters between January 2009 and December 2010 in Yeouido St. Mary Hospital medical and surgical ICU. CAUTI was defined as isolated bacterial growth of 100,000 colony-forming units or more either 48 hours after transfer to the ICU if a urinary catheter was placed before the transfer or 48 hours after insertion if the catheter was inserted in the ICU. Only the patients whose culture results were negative before ICU admission were included. RESULTS: There were a total of 1,315 patients with indwelling urinary catheters in our hospital's medical and surgical ICU between January 2009 and December 2010. Of these patients, 241 had positive urine culture results, and 61 had CAUTI. Using multivariate logistic regression analysis, those with diabetes were 4.55 (p<0.001) times as likely to have occurrences of CAUTI than were those without and also had a 1.10-fold (p<0.01) longer duration of an indwelling catheter. Upon urine culture, among the 61 patients with CAUTI, Escherichia coli was the most common bacterium grown; it was identified in 24 patients (38.7%). CONCLUSIONS: The factors and causative organisms contributing to the development of CAUTI in the management of ICU patients must be considered to prevent the occurrence of UTIs in this setting.
Catheters ; Catheters, Indwelling ; Escherichia coli ; Humans ; Critical Care ; Intensive Care Units ; Logistic Models ; Retrospective Studies ; Risk Factors ; Stem Cells ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections

We report herein a case of subclavian steal syndrome due to occlusive disease in multiple branches of the aortic arch, which was successfully treated by axilloaxillary bypass and subclavian stent insertion. The hemodynamic changes were evaluated using duplex sonography and transcranial Doppler before and after each procedure. The waveform and parameters of blood flow revealed an objective improvement in cerebral perfusion. These findings correlated well with clinical outcome. Neurosonologic evaluation can provide objective evidence for improved hemodynamic status after treatment.
Aorta, Thoracic ; Hemodynamics ; Perfusion ; Stents ; Subclavian Steal Syndrome

PURPOSE: The conventional primary therapy for chronic bacterial prostatitis (CBP) is the use of antibiotics. However, the therapy has a low cure rate and long-term use of antibiotics can lead to adverse effects including bacterial resistance. For these reasons, a new therapy for CBP is strongly needed. MATERIALS AND METHODS: To evaluate the anti-inflammatory and antimicrobial effects of selenium-rich hot spring water on CBP, rats were divided into four groups and treatment was administered for four weeks as follows: (1) control (n=8), (2) ciprofloxacin (n=8), (3) selenium-rich hot spring water (n=8), and (4) selenium-rich hot spring water with ciprofloxacin (n=8). Drip infusion of bacterial suspension (E. coli Z17 O2:K1;H-) into Spargue-Dowley rats was then conducted to induce CBP. Four weeks later, the results of prostate tissue and urine culture and histological analysis on the prostate were analyzed in each group. RESULTS: The use of ciprofloxacin, and selenium-rich hot spring water with ciprofloxacin showed statistically significant decreases in bacterial growth and improvements in prostatic inflammation compared with the control group (p<0.05). The selenium-rich hot spring water with ciprofloxacin group showed a statistically significantly lower rate of bacterial growth and and greater improvements in prostatic inflammation than the ciprofloxacin group (p<0.05). CONCLUSIONS: These results suggest that spring water may be an effective material in the treatment of CBP. Notably, the combination treatment of selenium-rich hot spring water and ciprofloxacin has synergistic effects. Therefore, we can suggest that the combination of selenium-rich hot spring water and ciprofloxacin may be effective in the treatment of CBP, and with a higher success rate than ciprofloxacin alone.
Animals ; Anti-Bacterial Agents ; Ciprofloxacin ; Hot Springs ; Inflammation ; Infusions, Intravenous ; Prostate ; Prostatitis ; Rats ; Selenium

Dry mouth is a common symptom in over middle- aged women. Xerostomia itself can be caused by multifactorial etiolgy. Dry mouth may occur with the use of medications, as a complication of connective tissue and autoimmune disease, such as Sjogren's syndrome or sicca syndrome, with radiation therapy to the head and neck or diabetes mellitus, or with a number of other condition. Even stress and anxiety can lead to a dry mouth. Also, Abnormal liver function is associated with drugs, viral infection, alcohol, obesity, autoimmne disease and a number of other disease. A 41-year-old women complaining of xerostomia and known abnormal liver fuction since 1 year was admitted to our medical examination center. In this case, Final diagnosis was systemic lupus erythematosus with autoimmune hepatitis and secondary Sjogren's syndrome through characteristic clinical finding, liver biopsy, positive Schirmer's test, salivary gland biopsy, and salivary scintigraphy. The various immunosuppresant medication has taken and then liver function indices and clinical symptoms were improved.
Adult ; Anxiety ; Autoimmune Diseases ; Biopsy ; Connective Tissue ; Diabetes Mellitus ; Diagnosis ; Female ; Head ; Hepatitis, Autoimmune ; Humans ; Liver* ; Lupus Erythematosus, Systemic* ; Mouth ; Neck ; Obesity ; Radionuclide Imaging ; Salivary Glands ; Sjogren's Syndrome ; Xerostomia*

BACKGROUND: In our previous study, we demonstrated that transforming growth factor-beta 1 receptor II (TGF-beta1RII) may have a role in the formation of bullae. In this study, we investigated if expression of transforming growth factor-beta 1 (TGF-beta1) ligand was altered in a bullous lung tissue by immunohistochemical staining of bullous tissues from patients with primary spontaneous pneumothorax. MATERIAL AND METHOD: Bullous lung tissues were obtained from 36 patients with primary spontaneous pneumothorax, including 34 males and 2 females aged 14 to 38 years old. RESULT: Of the 36 patients, 19 were TGF-beta1 positive and 24 were transforming growth factor-beta 1 receptor II (TGF-beta1RII) positive. Among the 19 TGF-beta1 positives, 15 were also TGF-beta1RII positive, observation at high magnification showed that strong immunohistochemical stain was detected in the boundary region between the bullous and normal lung tissues. CONCLUSION: These results suggest that overexpression of TGF-beta1 may be involved in the formation of a bulla as well as the alteration of TGF-beta1RII expression. Further molecular studies are needed to elucidate the more detailed molecular mechanisms of the bulla formation.
Adult ; Female ; Humans ; Lung ; Male ; Pneumothorax* ; Transforming Growth Factor beta1*

PURPOSE: Because of the lack of conclusive and well-conducted randomized studies, the optimal therapy for high-risk prostate cancer remains controversial. We investigated the results of patients with high-risk prostate cancer after laparoscopic radical prostatectomy (LRP). MATERIALS AND METHODS: The records of 75 prostate cancer patients undergoing LRP between 2001 and 2008 with preoperative high-risk prostate cancer were reviewed. Patients who underwent radiation therapy for prostate cancer before LRP and patients with lymph node or distant metastases were excluded. High-risk prostate cancer was defined as a prostate-specific antigen (PSA) level of more than 20 ng/ml, a biopsy Gleason score of greater than 7, or a clinical stage greater than T2c. Biochemical recurrence (BCR)-free survival was plotted via the Kaplan-Meier method. RESULTS: After a mean follow-up of 36.1 months, 24 (32%) patients experienced PSA progression with a median time of 17.6 months. Twenty patients received adjuvant hormonal or external beam radiation therapy or both before BCR. The BCR-free survival calculated by the Kaplan-Meier method at 3 and 5 years was 47.4% and 33.8%, respectively. A total of 44.0% of the patients had stage pT2 disease and 56.0% had stage pT3 disease. Surgical margins were positive in 35 patients (46.7%), of whom 11 (31.4%) had positive margins of more than 1. Preoperative PSA, postoperative pathologic Gleason score, and stage were correlated with BCR. CONCLUSIONS: Our results suggest that LRP is a useful tool in the management of high-risk prostate cancer because it provides adequate local control of the prostate and pathological stage. Selection of patients with high-risk prostate cancer who require surgical treatment should be evaluated further in more studies.
Biopsy ; Follow-Up Studies ; Humans ; Laparoscopy ; Lymph Nodes ; Neoplasm Grading ; Neoplasm Metastasis ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Recurrence