Immature teratoma accounts for less than I percent of all ovarian teratomas and occurs commonly in young individuals, the peak incidence being in the second decade. It contains a variable mixture of mature and immature tissues in which neuroectodermal elements almost always predominate. Gliomatosis peritonei, miliary implants of mature glial tissues on the peritoneum or omentum, is an infrequently reported complication of mature or immature ovarian teratomas. We describe the first case in Korea of a 12-year-old girl with an immature teratoma and numerous glial peritoneal implants.
Incidence

This report describes a case of ileal obstruction in a 31-year-old male with acute abdominal pain. A plain film of the abdomen showed segmental obstruction of small intestine. The patient underwent laparoscopic resection of the segment. Microscopic examination demonstrated foci of ulceration, submucosal edema, transmural inflammation, mural and neural hyperplasia and noncaseating granulomas, mimicking Crohn's disease. However, there were microabscesses predominantly composed of eosinophils. Furthermore, a section of an adult heterophyid trematode was identified in the crypt. Heterophydiasis usually causes diffuse enteritis. Therefore, this case with intestinal obstruction seems to be a rare manifestation of intestinal heterophydiasis.
Adult ; Male ; Female ; Humans

Chondroid syringoma is a rare primary skin tumor arising from eccrine sweat gland. In 1982, Nasse had found a primary skin tumor having similar morphology as in the mixed tumor of the salivary glands. In 1961, Hirsch and Helwig proposed more descriptive diagnostic term, "Choindroid syringma". The authors experienced two cases of chondroid syringma. The first case was a 47 year old male patient who had had a subcutaneous nodule in the right forehead for two months. It was a well circumscribed mass, that showed tan gray myxoid cut surface with firm consistency. Microscopically, it was a wel diagnosed as chondroid syringoma with tubular, branching lumina. The second case was a 51 year old female patient who had had a subcutaneous nodule in the left forehead for 3 months. It was well circumscribed, ad easily shelled out. It had a typical microscopic features of chondroid syringoma with small, tubular lumina.
Female ; Male ; Humans

PURPOSE: Although both platinum-based drugs and third-generation drugs are commonly used as first-line therapy for patients with advanced, unresectable non-small cell lung cancer, their effectiveness and clinical outcomes vary. We investigated whether epidermal growth factor receptor (EGFR) and HER-2 were correlated with the chemoresponse and survival after treatment with a cisplatin plus paclitaxel regimen. MATERIALS AND METHODS: Forty-nine tumors were analyzed by chromogenic in situ hybridization (CISH) for EGFR and HER-2 gene amplification. RESULTS: Twenty-eight patients (57%) achieved a partial response (PR), 13 (27%) showed stable disease (SD) and 8 (16%) had progressive disease (PD). EGFR and HER-2 amplification was identified in 43% and 57% of the tumors, respectively. EGFR amplification revealed no association with either a chemoresponse or survival, whereas HER-2 was amplified more frequently in the patients with PD (88% vs. 54%, respectively, p=0.06) and in the patients with shorter survival (12 months vs. 20 months respectively, p=0.027). CONCLUSION: The evaluation of HER-2 gene amplification is a promising approach for identifying those patients who are most likely to benefit from combination chemotherapy with cisplatin and paclitaxel
Carcinoma, Non-Small-Cell Lung ; Cisplatin ; Drug Therapy, Combination ; Genes, erbB-2 ; Humans ; In Situ Hybridization ; Paclitaxel ; Receptor, Epidermal Growth Factor

Lung cancer is the most common fatal malignant lesion in both sexes. Detection of the solitary pulmonary nodule is important because surgical series up to a third of solitary pulmonary nodules are bronchogenic carcinoma. Bronchioloalveolar cell carcinoma is a rare primary lung cancer and surgery is treatment of choice in brochioloalveolar cell carcinoma. We experienced a case of broschioloalveolar cell carcinoma in solitary pulmonary nodule with cavitary lesion in chest CT scan, which is an uncommon finding in brochioloalveolar cell carcinoma.
Carcinoma, Bronchogenic ; Lung Neoplasms ; Solitary Pulmonary Nodule ; Tomography, X-Ray Computed

BACKGROUND: The percutaneous pleural needle biopsy have been regarded as cornerstone in the diagnosis of lymphocyte dominant pleural effusions of which acid fast bacilli smear and cytologic exam was negative. However, the complications of percutaneous pleural needle biopsy is not rare arid its diagnostic efficacy is not always satisfactory. Recently, pleural fluid adenosine deaminase (ADA) and carcinoembryonic antigen (CEA) are widely accepted as markers of tuberculous pleurisy arid malignant pleural effusion respectively. We designed this study to re-evaluate the role of percutaneous pleural needle biopsy in the diagnosis of lymphocyte dominant exudative pleural effusions whose APE smear, cytologic exam was negative. METHODS: Retrospective analysis of 73 cases of percutaneous pleural needle biopsy in case of lymphocyte dominant exudative pleural effusions whose AFB smear and cytoloic exam was negative from Jan 1994 to Feb 1996 was done. RESULT: In 35 cases, specific diagnosis was obtained(all cases were tuberculous pleurisy), arid in 3(1 cases specific diagnosis was not obtained in spite of getting adequate pleural tissues, and in the other 8 cases, percutaneous pleural biopsy failed to get pleural tissues. In 9 cases, complications were combined including pneuomothorax and hemothorax. All 49 cases of pleural effusions whose ADA value was higher than 40IU/L and satisfying other categories were finally diagnosed as tuberculous pleurisy, however, the pleural biopsy confirmed only 28 cases as tuberculous pleurisy. In 6 cases of pleural effusions of which CEA value is higher than l0ng/ml, the pleural biopsy made specific diagnosis n no case. Final diagnosis of above 6 cases consisted of 4 malignant of fusions, I malignancy associated effusion and I tuberculous pleurisy. CONCLUSION: In the diagnosis of 73 cases of lymphocyte dominant pleural effusions of which acid fast bacilli smear and cytologic exam was negative, percutaneous pleural biopsy diagnosed only in 35 cases. In the diagnosis of tuberculous pleurisy, the positive predictive value of higher ADA than 40 IU/L in lymphocyte dominant pleural effusion with negative AFB smear and negative cytologic exam was l00%. And the diagnostic efficacy of pleural biopsy was 57%. In cases of effusions with high CEA than 10ng/ml 83% and 0% respectively. Finally, we concluded that percutaneous pleural needle biopsy in the diagnosis of APE smear negative and cytologic exam negative lymphocyte dominant exudative pleural effusion was not obligatory especially in effusions with high ADA and low CEA value.
Adenosine Deaminase ; Biopsy ; Biopsy, Needle* ; Carcinoembryonic Antigen ; Diagnosis* ; Hemothorax ; Hominidae ; Humans ; Lymphocytes* ; Needles* ; Pleural Effusion* ; Pleural Effusion, Malignant ; Retrospective Studies ; Tuberculosis, Pleural

Leiomyosarcomas of the stomach are unusual tumors, accounting for 1% to 3% of all malignant tumors and 17% to 20% of all smooth muscle tumors of the stomach. It is difficult to diagnosis these tumors preoperatively because of its vague symptoms and signs or producing symptoms only late. Despite their rarity and difficulty in diagnosis, thier diagnosis is important due to more favorable prognosis aasociated with these tumors than that of gastric carcinoma. Recently, endoscopy is being used with increasing frequency, but because these are submucosal lesions the diagnosis of thease tumors cannot be easily made through the endoscope. We experienced a case of relatively full-brown leiomyosarcoma in gastric fundus. Endoscopy showed 6x6cm sized, definite margined, protruding mass on gastric fundus, with central deep ulceration coated with blood clots. The mucosa overlying the mass was intact, smoothly effaced and the bridging fold was also visible. Postoperative ultrasound showed large protruding mixed echogenic solid mass with contral deep excavation due to ulcer, and intact serosa, so suggestive of endogastric tumor. We believed endoscopy combined with endoscopic ultrasound is probably useful method in early diagnosis of gastric submucosal tumors, especially exogastric type or early small tumors
Camellia ; Diagnosis ; Early Diagnosis ; Endoscopes ; Endoscopy ; Gastric Fundus ; Leiomyosarcoma* ; Mucous Membrane ; Prognosis ; Serous Membrane ; Smooth Muscle Tumor ; Stomach* ; Ulcer ; Ultrasonography

BACKGROUND: Atracurium is a benzylisoquinolium nondepolarizing neuromuscular blocking drug. It releases histamine upon the rapid administration of more than 2 x ED95. Cisatracurium is about three to four times more potent than atracurium, less likely to release histamine, and has weaker cardiovascular or autonomic effects. Mivacurium releases histamine to about the same degree as atracurium at the same dose. This study was undertaken to reevaluate the experimental model for the evaluation of effects on the autonomic nervous system, and to determine the neuromuscular blocking profiles and the vagolytic effects of atracurium, cisatracurium and mivacurium in cats. METHODS: Cats, either sex, anesthetized with pentobarbital, were used. Neuromuscular blocking effects were assessed using the effects on the anterior tibialis muscle twitch evoked with supramaximal stimuli (0.2 ms-duration, 0.1 Hz). Inhibition of the parasympathetic nervous system was assessed in response to bradycardia to vagal nerve stimulation with ten-second trains of square-waves (0.5 ms-duration, 20 Hz). The dose-response curves for both neuromuscular blocking and vagolytic actions were determined for each animal. The dose-response curves were constructed in cumulative fashion. The response for vagal stimuli was measured two minute after each dosing. Vagal ID50 (The doses that produced 50% inhibition of the response to vagus nerve stimulation) were determined. RESULTS: NMB ED95 and NMB ED50, respectively, were 102.0 +/- 28.3 and 143.7 +/- 40.5 microgram/kg for atracurium, 81.4 +/- 13.3 and 110.7 +/- 18.8 microgram/kg for cisatracurium, and 56.8 +/- 17.4 and 74.2 +/- 25.0 microgram/kg for mivacurium. Vagal ID50 was 2,654 +/- 1,651 microgram/kg for atracurium, 655 +/- 389 microgram/kg for cisatracurium, and 606 +/- 182 microgram/kg for mivacurium. The vagal ID50/NMB ED95 and vagal ID50/NMB ED50 were 18.5 and 26.0 for atracurium, 5.9 and 8.1 for cisatracurium, and 8.2 and 10.7 for mivacurium. CONCLUSIONS: Atracurium has a wider margin of safety only for vagal stimulation as compared with cisatracurium and mivacurium. However, we couldn't exclude that either sympathetic stimulation or histamine release might contribute to heart rate.
Animals ; Atracurium* ; Autonomic Agents ; Autonomic Nervous System ; Bradycardia ; Cats* ; Heart Rate ; Histamine ; Histamine Release ; Models, Theoretical ; Neuromuscular Blockade* ; Parasympathetic Nervous System ; Pentobarbital ; Vagus Nerve ; Vagus Nerve Stimulation

BACKGROUND: Since the demonstration of the fact that vascular relaxation by acetylcholine(Ach) results from the release of relaxing factor from the endothelium, the identity and physiology of this endothelium-derived relaxing factor(EDRF) has been the target for many researches. EDRF has been identified as nitric oxide(NO). With the recent evidences that EDRF is an important mediator of vascular tone, there have been increasing interests in defining the role of the EDRF as a potential mediator of hypoxic pulmonary vasoconstriction. But the role of EDRF in modulating the pulmonary circulation is not compeletely clarified. To investigate the endotbelium-dependent pulmonary vasodilation and the role of EDRF during hypoxic pulmonary vasoconstriction, we studied the effects of N(G)-monornethyl-L-arginine(L-NMMA) and L-arginine on the precontracted pulmonary arterial rings of the rat in normoxia and hypoxia. METHODS: The pulmonary arteries of male Sprague Dawley(300~350g) were dissected free of surrounding tissue, and cut into rings. Rings were mounted over fine rigid wires, in organ chambers filled with 20ml of Krebs solution bubbled with 95 percent oxygen and 5 percent carbon dioxide and maintained at 37℃. Changes in isometric tension were recorded with a force transducer(FT. 03 Grass, Quincy, USA). RESULTS: 1) Precontraction of rat pulmonry artery with intact endothelium by phenylephrine(PE, 10(-6)M) was relaxed completely by acetylcholine(Ach, 10(-9) -10(-5)M) and sodium nitroprusside (SN, 10(-9) -10(-5)M), but relaxing response by Ach in rat pulmonary artery with denuded endothelium was significantly decreased. 2) L-NMMA(10-4M) pretreatment inhibited Ach(10(-9) -10(-5)M)-induced relaxation, but L-NMMA(10-4M) had no effect on relaxation induced by SN(10(-9) -10(-5)M). 3) Pretreatment of the L-arginine(10(-4)M) significantly reversed the inhibition of the Ach(10(-9) -10(-5)M)-induced relaxation caused by L-NMMA(10(-4)M). 4) Pulmonary arterial contraction by PE(10(-6)M) was stronger in hypoxia than normoxia but relaxing response by Ach(10(-9) -10(-5)M) was decreased. 5) With pretreatment of L-arginine(10(-4)M), pulmonary arterial relaxation by Ach(10(-9) -10(-5)M) in hypoxia was reversed to the level of relaxation in normoxia. CONCLUSION: It is concluded that rat pulmonary arterial relaxation by Ach is dependent on the intact endothelium and is largely mediated by NO. Acute hypoxic pulmonary vasoconstriction is related to the suppression on NO formation in the vascular endothelium.
Animals ; Anoxia ; Arginine ; Arteries ; Carbon Dioxide ; Endothelium ; Endothelium, Vascular ; Humans ; Male ; Nitric Oxide* ; Nitroprusside ; omega-N-Methylarginine ; Oxygen ; Physiology ; Poaceae ; Pulmonary Artery ; Pulmonary Circulation ; Rats* ; Relaxation* ; Vasoconstriction* ; Vasodilation

Supernumerary teeth, which is described as teeth or tooth substance that develops in excess of deciduous and permanent teeth, most commonly involve the anterior maxilla. Mesiodens are one type of supernumerary teeth that develops in paramedian space of premaxilla. Sometimes mesiodens can be inverted with its crown facing the nasal cavity. Because of its own pathology and possible disruption of neighboring normal teeth, supernumerary teeth should be removed regardless of its eruption. We experienced two cases of mesiodens detected in the nasal floor and so report these cases with a review of literature.
Crowns ; Maxilla ; Nasal Cavity* ; Pathology ; Tooth ; Tooth, Supernumerary