Dermoid cysts are very infrequent benign tumors of the spinal canal. They arise from epithelial cell rests that become sequestered during closure of the neural tube between the third and fifth fetal weeks. Consequently, they occupy midline or near midline position characteristically. If the cleavage of the cutaneous and neural ectoderm persists locally anywhere along the neuraxis, a dermal sinus is formed connecting the skin with neuraxis. We present a case of dermoid cyst at the conus medullaris which was confirmed on histologic examination. An eleven years old female patient was admitted to our department because of urinary incontinence and sensory disturbance at the saddle area. Motor weakness was absent. In the plain spine A-P view, widening of the interpedicular distance and flattening and erosion of the pedicle were noted at the L1 and L2 vertebra. The lumbar myelogram A-P view shows almost total obstruction with meniscus sign at the level of the L1 and L2 interspace. In the myelogram lateral view, the dye column was indented in a round fashion from the dorsal side at the L1 and L2 interspace. Under the impression of the intradural extramedullary mass, we performed total laminectomy and removal of the mass.
Conus Snail* ; Dermoid Cyst* ; Ectoderm ; Epithelial Cells ; Female ; Humans ; Laminectomy ; Neural Tube ; Skin ; Spina Bifida Occulta ; Spinal Canal ; Spine ; Urinary Incontinence

PURPOSE: We investigated the characteristics of the distribution of the serum prostate- specific antigen (PSA) and evaluated the factors influencing the serum PSA levels in healthy men under 50 years old. MATERIALS AND METHODS: A total of 5,701 healthy Korean men under 50 years old who visited the Health Promotion Center at our hospital for a routine health checkup were enrolled into a prospective study. All the men underwent a PSA determination using a Hybritech Tandem-R assay, anthropometric measurements, liver function tests, renal function tests, and other constituents. The risk factors associated with an increase in the serum PSA among these clinical parameters were investigated using univariate and multivariate logistic regression analyses. RESULTS: Almost no change was observed in the median and 95th percentiles serum PSA value in men under 50 years old. Univariate logistic regression analysis indicated that the hematocrit, sodium, potassium, osmolarity, albumin, and globulin levels were the risk factors associated with an increase in the serum PSA. In the multivariate model used, the hematocrit, potassium and albumin levels were found to be independent predictors of an increase in the serum PSA, whereas the sodium, and globulin levels, and the osmolarity had no statistical significance. CONCLUSIONS: Age does not appear to influence the serum PSA levels of healthy Korean men under 50 years old. The results also suggest that the chemical constituents in young adults may exert an influence on the serum PSA levels.
Health Promotion ; Hematocrit ; Humans ; Kidney ; Liver ; Liver Function Tests ; Logistic Models ; Male ; Middle Aged* ; Osmolar Concentration ; Potassium ; Prospective Studies ; Prostate-Specific Antigen* ; Risk Factors ; Sodium ; Young Adult

In this study, immunohistochemistry was used to examine the changes in the density of colonic endocrine cells - argyrophil and argentaffin cells, chromogranin A (CGA), serotonin, somatostatin and glucagon-containing cells in trinitrobenzene sulfonic acid (TNBS)-induced rat colitis. Ulcerative colitis was induced by the instillation of 10 mg of TNBS into the colonic lumen through the anus. To confirm the inducement of ulcerative colitis, the macroscopic and microscopic scores as well as the colonic myeloperoxidase (MPO) activities were monitored for 8 days after TNBS instillation in the colonic lumens. In addition, the number of argyrophil and argentaffin cells, CGA, serotonin, somatostatin and glucagon-immunoreactive cells were counted in the colonic mucosa, respectively. After TNBS instillation into the lumen of the colon from the anus in rats, increases in macroscopic and microscopic scores in the colon tissues were observed along with increases in the colonic MPO activities. Therefore, ulcerative colitis was relatively well induced by the TNBS instillations. Marked decreases in the number of colonic endocrine cells were detected in the TNBS-treated animal compared to the sham control. These results suggest that colonic endocrine cells were also disrupted by TNBS-induced ulcerative colitis.
Anal Canal ; Animals ; Chromogranin A ; Colitis ; Colitis, Ulcerative ; Colon ; Endocrine Cells ; Enterochromaffin Cells ; Immunohistochemistry ; Mucous Membrane ; Peroxidase ; Rats ; Salicylamides ; Serotonin ; Somatostatin

A 3-month-old female presented with anuria and abdominal distention for 1 day. The patient was twin and was delivered at 30 week-term with low birth weight. Emergent ultrasonography revealed both hydronephrosis and hyperechogenic mass within the both renal pelves. Urinoma around left kidney was also found. Computed tomography showed high density material filled dilated pelvises. Urinoma measured 3x4cm in the left prerenal space and urinary ascites in the right abdomen were found. Candida albicans was cultured from catheter drained urine. We started the care with percutaneous nephrostomy with amphotericin B irrigation, coupled with systemic antifungal therapy. And this management had a major role in the successful outcome.
Abdomen ; Amphotericin B ; Anuria* ; Ascites* ; Bezoars* ; Candida albicans ; Catheters ; Female ; Humans ; Hydronephrosis ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature* ; Kidney ; Nephrostomy, Percutaneous ; Pelvis ; Twins ; Ultrasonography ; Urinoma

Defects in the dura mater can be result from craniocerebral trauma, neoplastic or inflammatory destruction surgical removal and congenital absence. Materials used for closure of dural defects were variable. Of these, autogenous fascia lata have been used for a long time. It seems interesting to study the histologic fate of the autogenous grafted fascia lata in the dural defects. After autogenous fascia lata graft to dural defect in 18 rabbits, the histologic fate of the autogenous grafted fascia lata was observed microscopically. The results are as follows: 1) The adhesions among the grafted fascia lata, arachnoid, pia mater and brain cortex were usually mild. This result may be due to either short period of observation or autogenous substitutional material. 2) The grafted autogenous fascia lata was revealed minimal inflammatory response and was ultimately reabsorbed. 3) The grafted autogenous fascia lata was replaced by granulation tissue and fibroblast originated from the host mesenchymal tissue.
Arachnoid ; Brain ; Craniocerebral Trauma ; Dura Mater ; Fascia Lata* ; Fascia* ; Fibroblasts ; Granulation Tissue ; Pia Mater ; Rabbits* ; Transplants

Osteosarcoma is the most frequently encountered primary malignant tumor of the bone. But sarcoma of the skull are rare tumor to be observed even in an extensive neuropathological practice. We presents a case of skull neoplasm identified as osteosarcoma. A twelve year old male patient was admitted to our department because of the large palpable mass on the posterior parietal and occipital region with headache, nausea and vomiting. On admission moderate papilledema was noted in the both eyes. Other neurologic finding were within normal limits. Chest film and long bone series showed no evidence of abnormality. Skull films revealed a large round destructive area on the posterior parietal and occipital region and the right carotid angiogram revealed patch densities in the mass lesion which was supplied by the right occipital artery and possibly the right middle meningeal artery. Serum Alkaline Phosphatase was 14 BL Units. The findings on the pathology side was compatible with osteosarcoma.
Alkaline Phosphatase ; Arteries ; Headache ; Humans ; Male ; Meningeal Arteries ; Nausea ; Neurologic Manifestations ; Osteosarcoma* ; Papilledema ; Pathology ; Rabeprazole ; Sarcoma ; Skull Neoplasms ; Skull* ; Thorax ; Vomiting

A 12 years old boy was admitted with chief complaint of fever, vomiting, sweating and comatose state. Blood pressure ranged 200/150mmHg, and various tests, including 24 hour urinary VMA, regitine test, abdominal aortography and CT scan, showed pheochromocytoma on the left adrenal gland. After successful surgical removal of the tumor, he has been free of symptoms afterward. And diagnosis of pheochromocytoma was confirmed by pathologic study of the removed tumor mass.
Adrenal Glands ; Aortography ; Blood Pressure ; Child* ; Coma ; Diagnosis ; Fever ; Humans ; Hypertensive Encephalopathy* ; Male ; Phentolamine ; Pheochromocytoma* ; Sweat ; Sweating ; Tomography, X-Ray Computed ; Vomiting

BACKGROUND AND OBJECTIVES: Electrical dyssynchronicity (Dsyn) appears to be prognostic of survival in congestive heart failure (CHF). Recent study has shown some discrepancy between the electrical Dsyn and the Doppler tissue image (DTI) assessed mechanical Dsyn. The aim of our study was to evaluate the relationship between the QRS duration and DTI assessed Dsyn. SUBJCETS AND METHODS: One hundred and forty patients, with CHF and left ventricular ejection fractions < or =40%, were enrolled. DTI was performed on 5-basal and 5-mid segments to assess the time from the R-wave to the peak systolic velocity (RS time). A QRS duration >130 msec, standard deviation (SD) of the RS time >40 msec, or a difference in the maximal and minimal RS times (RS time-diff) >100 msec were indicators of'Dsyn'. RESULTS: The prevalence of myocardial Dsyn, by QRS duration, SD of the RS time and the RS time-diff were 19, 43 and 47%, respectively. The SD of the RS time (49.8+/-23.6 vs. 36.6+/-20.7, p<0.01) and the RS time-diff (139.2+/-63.2 vs. 98.0+/-54.3, p<0.01) were prolonged in the wide (>130 msec) compared with the narrow QRS group. There was also a weak positive correlation between the QRS duration and the SD of the RS time (R=0.34, p<0.001) and the RS time-diff (R=0.38, p<0.001). However, from a cross-tabulation analysis, more than one third of patients had a discrepancy between QRS duration and DTI assessed mechanical Dsyn. From a multivariate analysis, a major determinant of the SD of the RS time was the QRS duration. CONCLUSION: Although a major determinant of the DTI assessed Dsyn was the QRS duration, more than one-third of patients had a discrepancy between electrical and mechanical Dsyn. Therefore, not only the QRS duration, but the DTI assessed Dsyn, should be measured when considering cardiac resynchronization therapy.
Cardiac Resynchronization Therapy ; Diagnosis* ; Electrocardiography* ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Multivariate Analysis ; Prevalence ; Stroke Volume