We report a case of postpartum choriocarcinoma from a 23-year old primiparous woman which was preceded by fetal anemia and intrauterine fetal death at 37 weeks' gestation. It has not been previously described in Korean literatures. The placenta, weighing 550 gm, contained multiple intervillous thrombi with laminated fibrin residue and pale cut curface. Histologic evidence of choriocarcinoma was not found in the placenta or in any fetal organs at autopsy, but large number of nucleated red blood cells and immature hemopoietic cells in the fetal capillaries of the placenta suggested the presence of fetal anemia. It was assumed that feto-maternal transfusion might had played a major role of fetal anemia and death.
Female ; Infant, Newborn ; Humans

Small cell carcinoma of the ovary is rare malignancy occurring in women under 40 years of age(average, 23 years), which is associated with hypercalcemia in two thirds of cases. Its histogenesis is uncertain, but the possibilities of common epithelial, neuroendocrine, sex cord stromal and germ cell origin are suggested. All reported cases were proved to have rapid fatal course despite various therapy and 5 years suvival rate was only 10%. We report one case of a 20-year old woman with primary small cell carcinoma of the left ovary. The ovary was markedly enlarged and completely replaced by a mass, measuring 21x16x8 cm. Microscopic examination revealed dimorphic population of small and large malignant cell producing immature follicle-like structure which is characteristic of small cell carcinoma of the ovary. These pathological findings were similar to those of granulosa cell tumor, which is required to make differential diagnosis from small cell carcinoma. Immunohistochemical stains for cytokeratin and vimentin were positive, but those for S-100 protein and NSE were negative. One month after the initial operation, the tumor has recurred and the second and the second palliative operation followed by 3 cycles of chemotherapy was done. The patient showed disseminated metastasis at present time.
Female ; Humans ; Diagnosis, Differential ; Neoplasm Metastasis

No abstract available.
Female ; Humans ; Premenstrual Syndrome*

Richter's syndrome is generally accepted taht lymphoma or leukemia of low grade malignancy, during their course, may alter both their morphologic and clinical appearance and evolve into highly malignant neoplasia. The pathogenesis is not clear, however, dedifferentiation by the emergence of a new clone of cells of higher maligancy similar to the blastic transformation in chronic myelocytic leukemia is suggested as possible mechanism. A case of Richter's syndrome is described. This 45 year old female had been diagnosed as chronic lymphocytic leukemia by absolute peripheral lymphocytosis 5 months before, developed sudden severe abdominal pain and was received segmental resection of ileum under the clinical impression of intestinal perforation with peritonitis. Histologically, the ulcer margin was diffusely infiltrated by polymorphic cells composed of large atypical cells having vesicular nuclei, multinucleated giant cells and Reed-Sternberg like cells admixed with mature lymphocytes. These atypical and multinucleated cells of the paraffin section showed strong monoclonal immunoreactivity for IgG and lambda light chain by PAP method and was interpreted as malignant lymphoma, diffuse, large cell, immunoblastic, polymorphous.
Female ; Humans

Leydig cell tumor of the ovary is a very rare tumor which usually occurs in the postmenopausal age, and which is frequently associated with virilization. It has been classified as a lipid cell tumor due to the presence of intracytoplasmic lipids. However, since up to 25% of these tumors contain little or no lipid, the new term "steroid cell tumor" is proposed for this type of neoplasm. We report a case of Leydig cell tumor of the ovary in a 16 year old girl. The patient exhibited recently recognized hirsuitism and secondary amenorrhea. Physical examination revealed moderate obesity with moderate amounts of coarse hair over the whole body and a deepening of the voice. Testosterone and dehydroepiandrosterone sulfate levels were markedly elevated in the peripheral blood. Pelvic ultrasonography revealed a right ovarian tumor. The resected ovary showed a well demarcated, golden yellow to orange colored solid mass, measuring 7 cm on the cut surface. Microscopically, the tumor was composed of solid and diffuse sheets of tumor cells having abundant eosinophilic cytoplasm, and large round nuclei with frequent crystalloids of Reinke in the cytoplasm. To our knowledge this is the first case of Leydig cell tumor of the ovary in a young girl in the Korean literature.

No abstract available.
Animals ; Cadmium Chloride* ; Cadmium* ; Nasal Mucosa* ; Rats*

Liver biopsies are used routinely in the assessment of graft dysfunction following liver transplantation and generally considered to be the most reliable method for the diagnosis of posttransplant complications with overlapping clinical and laboratory findings. To investigate posttransplant complications causing graft dysfunction and usefulness of liver biopsy, we analysed clinicopathologic features of 65 posttransplant liver biopsies, 2 autopsies and an explanted liver, taken from 20 patients. The frequencies of posttransplant complications were acute cellular rejection in 9 patients (45%), postoperative infection in 11 patients (55%), of which cytomegalovirus (CMV) infection and systemic invasive aspergillosis with candidiasis occured in 10 patients (50%) and 1 patient (5%), respectively. Remainders were hepatic arterial thrombosis in two (10%), primary graft dysfunction due to fatty donor liver in one (5%), and posttransplant lymphoproliferative disorder (PTLD) in two (10%). There were no chronic rejection or recurrent disease. Postoperative mortality was 25%. Histologic grade by Banff schema was well correlated with clinical parameters associated with unfavorable short term prognosis. CMV infection was associated with acute cellular rejection in 6 out of 10 patients (60%). Immunohistochemical staining for CMV was more sensitive method than CMV in situ hybridization or histologic detection of viral inclusion on tissue section. It was unique that one case of PTLD developed under the circumstances of the lowest dosage of immunosuppression and took grave outcome. Based on these results, we concluded that clinicopathologic correlation with integration of all the clinical and laboratory findings is necessary in the interpretation of accurate and early diagnosis of posttransplant liver biopsies. The interrelationship between chronic rejection and CMV infection as well as pathogenetic factors of PTLD remains to be clarified through further ongoing observation.
Aspergillosis ; Autopsy ; Biopsy* ; Candidiasis ; Cytomegalovirus ; Diagnosis ; Early Diagnosis ; Humans ; Immunosuppression ; In Situ Hybridization ; Liver Transplantation ; Liver* ; Lymphoproliferative Disorders ; Mortality ; Primary Graft Dysfunction ; Prognosis ; Thrombosis ; Tissue Donors ; Transplants

PURPOSE AND BACKGROUND: Recently several clinical studies suggested that maternal treatment with magnesium sulfate had protective effects against cerebral palsy in premature infants. But previous studies with differing perinatal animal models resulted in inconclusive results with regard to magnesium neuroprotection. Our purpose was to study the neuroprotective effect of magnesium sulfate and optimal dosage on hypoxicischemic brain damage in the newborn rat. METHOD: Seven-day-old rats(n=68) underwent right carotid ligation, followed by 3 hours of hypoxia(8% oxygen in 92% nitrogen). Rats received magnesium sulfate immediately before and again after hypoxia(two doses, 150mg-600mg/kg/dose, n=39), or saline solution(n=29). Severity of injury was assessed 5 days later, by visual evaluation of ipsilateral hemisphere infarction and by measurement of bilateral hemispheric cross sectional areas. RESULTS: Magnesium sulfate pre-treatment reduced the incidence of liquefactive cerebral infarction and atrophy from 80.8% in controls to 22.2% with magnesium sulfate(450 mg/kg/dose, P<0.05). Quantitation of hemispheric areas confirmed these findings. Percent protection based on inter-hemisphere area differences by pre-treatment with magnesium sulfate 450mg/kg/dose ranged from 71.1%(hippocampus) to 90.8%(striatum). However higher dose of magnesium(600mg/kg/dose) did not attenuate hypoxic-ischemic brain injury in the newborn rat but increased mortality. CONCLUSION: Pretreatment of magnesium sulfate has neuroprotective effects against hypoxia-ischemia in the newborn rat and adequate dose of magnesium sufate is important to protect the brain. Magnesium pretreatment may be an effective strategy to decrease the severity of neonatal hypoxic-ischemic brain injury in the adequate dose.
Animals ; Atrophy ; Brain ; Brain Injuries ; Cerebral Infarction ; Cerebral Palsy ; Humans ; Incidence ; Infant, Newborn* ; Infant, Premature ; Infarction ; Ligation ; Magnesium Sulfate* ; Magnesium* ; Models, Animal ; Mortality ; Neuroprotective Agents* ; Oxygen ; Rats*

No abstract available.
Enterotoxigenic Escherichia coli* ; Enterotoxins*

BACKGROUND: Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 µg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]). METHODS: Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany) was used to assess cardiac output (CO) and systemic vascular resistance (SVR). Six minutes after intubation, baseline heart rate (HR), systolic blood pressure (BP), diastolic BP, mean arterial pressure (MAP), CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 µg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. RESULTS: No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. CONCLUSIONS: For patients under general anesthesia receiving dopamine at 10 µg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Dopamine* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Jugular Veins ; Saphenous Vein ; Vascular Resistance ; Veins*