BACKGROUNDS: Headache is one of the common symptoms complained by patients at the emergency department. Postural headache is the characteristic symptom that is aggravated at upright position and relieved at recumbent position. This postural headache is associated with low cerebrospinal fluid (CSF) pressure. Spontaneous intracranial hypotension(SIH) is an unusual syndrome of postural headache and low CSF pressure without a precipitating event. The diagnosis of SIH is confirmed by 60mmH2O or less CSF opening pressure on lumbar puncture. However, the cases of SIH with normal CSF opening pressure have been reported. so it is needed to complement the diagnostic criteria of SIH. METHODS: A retrospective descriptive study with reviewing medical records of 10 patients who had been admitted at Asan Medical Center from Apr. 1995 to Jul. 1999 was done. Analyses were done on 22 variables of age, sex, clinical symptoms, spinal analysis findings, radiologic findings and therapeutic modality. Fisher's exact test and Mann-Whitney test were applied for statistical analysis (p-value < 0.05). RESULTS: 1. The male to female ratio was 3 : 7, and the mean age was 37.30+/-5.96 years. 2. Postural headache was characteristic symptom & complained by all patients. 3. The mean CSF pressure was 22.8+/-30.8 mmH2O. 4. Brain MRI demonstrated the pachymeningeal enhancement in all patients. 5. Radioisotope cisternography demonstrated slow ascent of tracer to the cerebral convexity in 88.9% patients, early soft tissue uptake suggestive of CSF leakage & rapid urinary accumulation of tracer in 66.7% patients, respectively. 6. 90.0% of all patients were recovered with autologous epidural blood patches, and 10.0% were recovered with conservative management. CONCLUSION: The SIH is an unusual syndrome. but we can diagnose the SIH in the patient, complains of a postural headache, if any following two or more criteria are present. 1. 60mmH2O or less CSF opening pressure on lumbar puncture. 2. Brain MRI finding : the pachymeningeal enhancement. 3. Cisternography findings : slow ascent of tracer to the cerebral convexity, early soft tissue uptake suggestive of CSF leakage & rapid urinary accumulation of tracer.
Blood Patch, Epidural ; Brain ; Cerebrospinal Fluid ; Chungcheongnam-do ; Complement System Proteins ; Diagnosis ; Emergency Service, Hospital ; Female ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Male ; Medical Records ; Retrospective Studies ; Spinal Puncture

Primary germ cell tumor of the testis is rare, which occupies 1 to 2% of all reported malignant male neoplasms. Combined primary germ cell tumor of the testis composed of embryonal carcinoma and seminoma is more rare tumor. The authors experienced a case of 50-year old male who presented with painless enlargement of right testicle. He has had radical orchiectomy and diagnosed by pathologically as combined germ cell tumor of testis. The testicle is measuring 180 gm in weight and 9×6×5 cm in dimension, and almostly replaced by tumor mass. Grossly the tumor is rubbery solid smooth tumor mass, with variegated cut surface with geographically outlined diffuse necrotic area. Histologically the tumor is composed of two components of tumor, which are solid growth pattern of large round to polyhedral cells with clear or granular cytoplasm and distinct cell border, and anastomosing glandular and papillary arrangement of anaplastic epithelial cells. The former corresponds to seminoma, and the latter to embryonal carcinoma. Each tumor lobule is separated by abundant fibrous stroma.
Carcinoma, Embryonal ; Cytoplasm ; Epithelial Cells ; Germ Cells* ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal* ; Orchiectomy ; Seminoma ; Testis*

This study was conducted to evaluate prevalence of intestinal helminthic infections and skin tests and Paragonimus and Clonorchis in tuberculosis(TB) patients in Korea. Stool examinations by formalin-ether technique and intradermal tests were carried out in 2 areas; Masan TB hospital and Kong-Ju TB hospital. The positive rate of intestinal helminths of any kind was 51.7 percent among 329 patients in Masan hospital, but 18.1 percent among 215 patients in Kong-Ju hospital. The infection rates of Trichocephalus trichiurus and Clonorchis sinensis were 20.7 percent and 17.6 percent respectively in Masan hospital patients, but the infection rates of T. trichiurus and C. sinensis were 6.5 percent and 6.0 percent respectively in Kong-Ju hospital patients. In skin tests, positive reactions to Paragonimus and Clonorchis antigens were 22.0 percent and 37.6 percent respectively in Masan hospital patients. On the contrary, Kong-Ju hospital patients showed the positive rates of 15.2 percent for Paragonimus and 27.2 percent for Clonorchis respectively.
parasitology-helminth-trematoda ; Ascaris lumbricoides ; Trichuris trichiura ; hookworm ; Trichostrongylus orientalis ; Clonorchis sinensis ; Paragonimus westermani ; Metagonimus yokogawai ; Taenis sp. ; Hymneolepis nana ; epidemiology ; skin test

The authors present the one case of a 22-year-old man admitted with intermittent quadriparesis and respiratory difficulty. On investigation, atlantoaxial instability and upper cervical cord compression due to abnormal soft tissue were revealed. We have performed transoral decompression and biopsy, and then posterior transarticular facet screw fixation with interspinous wiring and fusion. We could obtain immediate and long-term postoperative stability with Philadelphia collar only. The pathologic examination reveald connective soft tissue hypertrophy due to chronic mechanical irritation.
Biopsy ; Decompression* ; Humans ; Hypertrophy ; Quadriplegia ; Young Adult

No abstract available.
Lymphangioma, Cystic* ; Turner Syndrome* ; Ultrasonography*

This case report describes a patient with semipedunclated granuylar cell tumor(granular cell myoblastoma) of the proximal ascending colon removed by endoscopic polypectomy. A 39-year old femalie was visited to our hospital for intermittent abdominal pain and loose stool. Colonoscopic examination showed a semipedunclated lesion covered with yellowish white smooth mucosa in the proximal ascending colon. The tumor was removed by endoscopic polypectomy. The collected specimen was 0.9x0.8 cm in size. The cut surface of the specimen showed a white round firm tumor covered with mormal epithelium of the colon. Using immunohistochemical study, the tumor cells were to be positively stained by S-100 protein and negatively stained by desmin, which supports the concept of the Schwann cell origin of granular cell tumor. In Korea, 2 cases of granular cell tumor of the colon and rectum, which were treated by surgical removal, have been reported. This case in the first endoscopic polypectomy of granular cell tumor of the colon and retum in Korea. The endoscopic polypectomy is thought to be useful for the therapy of small pedunclated or semipedunclated granular cell tumor, intracolonic type.
Abdominal Pain ; Adult ; Colon ; Colon, Ascending* ; Desmin ; Epithelium ; Granular Cell Tumor* ; Humans ; Korea ; Mucous Membrane ; Rectum ; S100 Proteins

The large amount of hospital dat makes management complicated and nowadays the data can barely be managed without computerization. The authors classified and encoded the neurosurgical diseases to develop the "Autocode System", the automatic code transformation system using Fox-ProR, which is a database management program. Any diagnostic entity which is input by the user is transformed into a specific code automaticall. Such a procedure excludes the input error originating from mistyping or naming an unclassified entity. This program is not perfect yet, but it is thought to be effective in the neurosurgical department for data storage and searching. Further modification, functional improvement, and ultimately, unifying the system among the hospitals can make cooperative study and systematic data analysis possible.
Classification* ; Humans ; Information Storage and Retrieval ; Microcomputers* ; Neurosurgery ; Statistics as Topic

OBJECTIVE: Our previous study demonstrated that the placental GnRH and GnRH mRNA did not parallel the time course of hCG secretion, though it is thought to be one of the potential paracrine regulators of hCG secretion from the trophoblasts. The present study was designed to examine the potential variation in GnRH-receptor mRNA expression in the placenta, which may account for the GnRH-mediated action of hCG secretion during pregnancy. METHODS: Human placentas in firt, second, and third trimester of normal pregnancy were obtained. These placentas were fixed with 4% paraformaldehyde and embedded in OCT compound, and sectioned by cryostat. For in situ hybridization, S labeled RNA probes were used and followed by autoradiography. RESULTS: The GnRH-receptor mRNA signals were present in both cytotrophoblast and syncytiotrophoblast cell layers. Signal intensities varied with gestational ages and were abundant at 6-7 weeks, peaked at 9-12weeks, declined at 14 and 24 weeks, and were barely detectable at term. The present study demonstrates that GnRH-receptor mRNA exhibits changes paralleling the time course of hCG secretion during pregnancy CONCLUSION: These data provide mechanistic understanding that the paracrine/autocrine regulation of hCG secretion by placental GnRH is mediated through an increase followed by a decline in GnRH-receptor mRNA expression from the first trimester to term placenta.
Autoradiography ; Female ; Gestational Age ; Gonadotropin-Releasing Hormone ; Humans ; In Situ Hybridization ; Placenta* ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Pregnancy* ; RNA Probes ; RNA, Messenger* ; Trophoblasts

OBJECTIVE: To investigate the change of placental apoptosis and the expression of their mediator in preeclampsia women. METHODS: Placental tissues from 10 cases of preeclampsia and 15 cases of normal pregnancy were analyzed using terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling(TUNEL) staining. Expressions of bcl-2, bax, caspase-3 was also assessed using immunohistochemistry. RESULTS: In TUNEL staining, the number of apoptotic nuclei were significantly increased in the trophoblast of preeclampsia than normal pregnancy. Bcl-2 was mainly expressed in syncytiotrophoblast and bax was mainly expressed in cytotrophoblast. Bcl-2 expression was decreased and bax expression was increased in the preeclampsia than normal, but the difference was not significant. Caspase-3 was mainly expressed in the cytotrophoblast and expression was significantly increased in the preeclampsia than normal pregnancy(p<0.05). CONCLUSION: Placental apoptosis, especially accompanied with increased expression of caspase-3 in cytotrophoblast, might be related with in the pathogenesis of preeclampsia.
Apoptosis* ; Caspase 3 ; Deoxyuridine ; Female ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Placenta ; Pre-Eclampsia* ; Pregnancy ; Trophoblasts

BACKGROUND: Trichomonas vaginalis is a pathogenic protozoa infecting human genitourinary tract. Metronidazole is currently the drug of choice to treat T. vaginalis infection. However, because of the side effects and the occurrence of resistant strains of metronidazole, it is needed to investigate alternatives. METHODS: The antiprotozoal effect of aquatic extract from Sophora flavescens on the growth and fine structure of T. vaginalis was examined by using trypan blue exclusion assay and electron microscopy. RESULTS: One hour after the addition of 4 mg/mL extract and half hour after the addition of 5 mg/mL showed antiprotozoal effect. One to two hours after the addition of 3 mg/mL extract, the movement of flagella and axostyle had disappeared, but death of the cells had not occurred until two hours after the addition. The fine structure of the cytoplasm was also changed half an hour to two hours after addition. The number of polyribosome decreased when that of single ribosomes in the cytoplasm increased. CONCLUSION: These results indicated that S. flavescens had the antiprotozoal effect on T. vaginalis by inhibition of cell multiplication as well as an impairment of protein synthesis.
Cell Proliferation ; Cytoplasm ; Flagella ; Humans ; Metronidazole ; Microscopy, Electron ; Polyribosomes ; Ribosomes ; Sophora* ; Trichomonas vaginalis* ; Trichomonas* ; Trypan Blue