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Biomedical subjects

B K Cho

Publications and source records attributed to B K Cho.

At least 145 records · Page 8Linked to original sources

Intracranial mesenchymal chondrosarcoma: a case report and literature review.

Intracranial mesenchymal chondrosarcoma is a rare entity. The case of a 13-year-old girl with mesenchymal chondrosarcoma which seemed to arise from the dura mater is presented here together with a review of the literature. In the present case, the tumor involved the superior sagittal sinus. It recurred 21 months after gross total removal of the mass and coagulation of the involved wall of the superior sagittal sinus. Reoperation was performed followed by radiation therapy.

Adolescent↗

Spinal cord ganglioglioma in childhood.

Two childhood cases of spinal cord ganglioglioma are described. Both cases showed a remarkable similarity in presentation, radiologically and morphologically. The first case was a 6 1/2-year-old boy who had ganglioglioma involving the entire length of the spinal cord. He has been suffering from a long span of scoliosis and gait disturbance since he was 1 year. The tumor contained multiple syrinx. The second case was a 3-year-old girl with ganglioglioma involving a large portion of the spinal cord from lower medulla to T3. This case also contained syringobulbia and syringomyelia in the multiple levels. She suffered from progressive motor weakness of all extremities. Owing to a good demarcation from normal spinal cord, the tumors could easily be removed by the microsurgical dissection through second stage operation in both cases. Histopathologically and ultrastructurally, the tumors were benign gangliogliomas. The symptoms improved a lot after surgery. Based on our two cases and literature review we confirmed that the spinal cord gangliogliomas are slowly growing tumors occurring in childhood or young adulthood. They often involve usually extensive level or entire length of the spinal cord and may be accompanied by scoliosis and gait disturbance when the tumor presents since infancy or early childhood as in our cases. They also often exhibit a cystic change of the tumor associated with large or small syringomyelia. Nearly total removal is possible due to a good demarcation from the normal spinal cord. Therefore, early diagnosis and surgical management are fundamental for the avoidance of unnecessary delay of surgery and a good result.

Child↗

Hearts with twisted atrioventricular connections: findings at MR imaging.

The "crisscross" heart and the heart with "superoinferior ventricles" are closely related congenital cardiac malformations that are characterized by twisted atrioventricular connections. The authors studied the morphologic characteristics of three hearts with twisted atrioventricular connections as seen on magnetic resonance (MR) images. The most important clue to the diagnosis was the distorted atrioventricular connections that were demonstrated on serial images. The axes of the atrioventricular connections through the atrioventricular valves were not parallel to each other. The presence of unusual recesses in the cardiac chambers, the angulated or curved configuration of the atrial and ventricular septa, and the unexpected great arterial relationship for the given combination of segmental connections supported the findings of twisted atrioventricular connections. MR imaging facilitated the precise morphologic diagnosis of these hearts.

Child, Preschool↗

Oligodendroglioma in childhood.

Fifteen pediatric (age under 16) cases of oligodendroglioma (ODG) were surgically proven from January 1985 to April 1992 at the Division of Pediatric Neurosurgery, Seoul National University Children's Hospital. To observe the proportion of ODG's in primary intracranial tumors, the location of ODG's and the prognostic significance of the histological grading of ODG's in childhood, the 15 cases of pediatric ODG's were retrospectively analyzed. ODG's accounted for 5.6% of pediatric primary intracranial tumors operated on during the same period. Nine tumors were located in the cerebral hemisphere (3 cases each in the frontal, temporal and parietooccipital lobes), 1 in the thalamus, 2 in the pons-medulla, 2 in the cerebellum and 1 in the thoracolumbar spinal cord. Four tumors were anaplastic and an additional case showed positive cerebrospinal fluid (CSF) cytology for tumor cells. All the cases of anaplasia or positive CSF cytology had a poor outcome. All the seven cases of benign ODG's in cerebral hemispheres presented with seizures which were controlled with or without medication after tumor removal.

Adolescent↗

Preenhanced computed tomographic findings in brain death.

A patient complying with the clinical criteria for brain death was studied by preenhanced computed tomography (CT). Preenhanced CT showed apparent increased density at the base of the brain along the course of the major arterial vessels, and abnormally dense-appearing deep venous structures, like those of contrast-enhanced CT. There was a diffuse decrease in brain density with a poorly delineated ventricular system. These CT findings were very characteristic. CT as a non-invasive method seems to be valuable in the diagnosis of brain death. The relevant literature is reviewed and mechanisms showing those CT findings are discussed.

Brain Death↗

Spinal congenital dermal sinus--experience of 5 cases over a period of 10 years.

Spinal congenital dermal sinus (CDS) is a rare entity which supposedly results from the failure of the neuroectoderm to separate from the cutaneous ectoderm during the process of neurulation. The lesions are most frequent at the lumbosacral followed by the occipital region. CDS of the thoracic region is very rare. The patients with spinal CDS present with meningitis and/or mass effect from the associated inclusion tumor. They are usually dermoid or epidermoid cysts. Teratoma is rarely associated. The authors experienced 5 cases of spinal CDS over a 10 year period. Of the 5 cases, 2 were at thoracic and 3 were at lumbosacral levels. Dermoid cyst, epidermoid cyst and teratoma were associated in one case each. Two cases presented with neurological deficit and meningitis while an additional case presented with neurological deficit and a history of probable meningitis. Pain was present in 2 cases. Magnetic resonance imaging played an important role in the diagnosis of the lesion and planning of surgery. All the cases showed a good response to surgery even though one patient had persistent neurological deficit.

Adolescent↗

Molluscum contagiosum occurring in an epidermal cyst--report of 3 cases.

We present three unusual cases of molluscum contagiosum occurring in epidermal cysts. All of them are asymptomatic, elevated, oval nodules diagnosed clinically as epidermal inclusion cyst or prurigo nodularis. Histology showed true epidermal cysts containing molluscum bodies throughout the cyst wall and some type of laminated material within the cyst itself. The lesion, in all three cases developed in the pubic area of young adult men.

Adult↗

Intraventricular neurocytoma: clinicopathological analysis of seven cases.

A retrospective analysis of seven patients with intraventricular neurocytoma is presented. Patient age at diagnosis ranged from 15 to 38 years (mean 24.6 years) and the male:female ratio was 6:1. Raised intracranial pressure due to hydrocephalus was the main cause of the clinical manifestations. An isodense mass with multiple intratumoral cysts and homogeneous contrast enhancement was the characteristic computerized tomography finding. The lesions commonly involved the lateral ventricle with or without extension to the third ventricle. Cerebral angiography showed homogeneous vascular staining in five patients. Magnetic resonance images revealed a mass isointense with the cerebral cortex on both T1- and T2-weighted images. Gadolinium-diethylenetriaminepenta-acetic acid-enhanced images showed homogeneous enhancement. Total removal of the tumor was possible in four patients. Pathologically, six cases were initially diagnosed as oligodendroglioma and the remaining case as ependymoma. However, immunohistochemical studies demonstrated strong positivity for neuron-specific enolase in all seven cases and for synaptophysin in five cases. On electron microscopy, three cases showed well-defined neurosecretory granules and 10-nm microtubules in their cytoplasm and cytoplasmic processes. One patient developed a recurrent tumor 18 months after surgery. The remaining six patients are free of recurrent tumors at 2 to 62 months after surgery. It is suggested that neurocytoma must be included in the differential diagnosis of intraventricular lesions, and that electron microscopic and immunohistochemical studies should be undertaken.

Adolescent↗

Congenital arteriovenous malformation associated with progressive hydrocephalus in a newborn.

Intracranial arteriovenous malformation is rarely presented in newborns or infants. We describe an unusual case of congenital arteriovenous malformation of the brain with multiple sequestered grape-like venous sacs presented with congenital hydrocephalus. This 4-month-old girl born with a large head, presented with progressive hydrocephalus over a period of 4 months. The brain CT showed multiloculated cysts with a high-density mural nodule and thin cerebral mantle. The right lateral ventricle was collapsed by the cystic lesion, and the contralateral ventricle was markedly dilated, which was thought to be due to aqueductal obstruction by the conglomerated nidus of the arteriovenous malformation. Surgical removal of both hemispheric masses, including the overlying thin mantle. The lesion was pathologically confirmed as the arteriovenous malformation which was composed of markedly dilated veins and multiple sequestered aneurysmal sacs. The overlying cerebral tissue was dysplastic and partly infarcted. This case shows that intracerebral arteriovenous malformation is indeed a congenital anomaly and suggests that intrauterine vascular compromise can result in focal or wide maldevelopment of the brain.

Female↗

Deep sylvian meningioma in a child.

Meningioma is a rare brain tumor in childhood, but one located deep in the sylvian fissure without any connection to the dura or ventricular system is even more unusual. A 2-year-old boy with a deep sylvian meningioma is presented. This is the youngest case as well as the third intrasylvian meningioma reported in the pediatric age group (up to age 15).

Child, Preschool↗

Surgical treatment of atrial myxomas: a report of 20 cases.

Twenty atrial myxomas were resected in 20 patients with the use of cardiopulmonary bypass, from the beginning of July 1966 through the end of June 1985, at Severance Hospital, Seoul, Korea. Nineteen patients had left atrial myxomas; 1 had a right atrial myxoma. Left atrial myxomas arose from the intra-atrial septum in 17 patients and from the left atrial appendage in 2 patients. The right atrial myxoma arose from the fossa ovalis. The 13 female and 7 male patients ranged in age from 14 to 63 years. Symptoms most often reported on presentation were those associated with mitral valve obstruction; other symptoms were associated with systemic embolization. The 1st 4 patients were tested with angiocardiography alone, and 3 of these were misdiagnosed. The last 16 were tested by angiocardiography, M-mode echocardiography, and 2-dimensional echocardiography, alone or in various combinations, and there were no further misdiagnoses. In our experience, 2-dimensional echocardiography was the most accurate method of diagnosing cardiac tumors. In 19 patients, surgical approach was through a median sternotomy; in the 20th patient, approach was through a left thoracotomy, due to a preoperative misdiagnosis of mitral stenosis. No intraoperative embolizations or deaths occurred. On follow-up of 17 patients during periods ranging from 6 months to 6 years, we had no late deaths, and only 2 patients suffered late complications: 1 had sudden right hemiparesis caused by an embolus 4 months after surgery (this improved upon conservative treatment); and 1 had a recurrence of tumor 3 years after surgery (the new myxoma was successfully resected). We conclude that patients who have undergone complete excision of benign myxomas now have an excellent prognosis, with minimal risk of intraoperative embolization and late recurrence. We conclude also that 2-dimensional echocardiography is an extremely accurate tool both in early diagnosis of intracardiac myxomas and in late follow-up after resection.

Journal Article↗

A case of Stewart-Treves syndrome.

Several months after left radical mastectomy without irradiation therapy for breast cancer, a 74-year-old woman developed severe edema on the homolateral arm extending to the axilla. Ten years later, purplish to brownish blotch and nodules accompanied with heating sensation and pain appeared and increased in size gradually on the left forearm. The patient was treated by irradiation therapy under the clinical and histopathologic diagnosis of Stewart-Treves syndrome and almost all of the skin lesions and symptoms disappeared after irradiation of 6450 rads.

Aged↗

Unusual case of an ectopic spleen.

A rare case of a very unusual position of a normally functioning spleen in the posterior aspect of the right lobe of the liver is reported. A 6-year-old boy was evaluated with echocardiography for congenital heart disease of coexisting atrial and ventricular septal defects with pulmonary hypertension. Other associated cardiac abnormalities on this child included a right-sided aortic arch, drainage of the azygous vein into the superior vena cava and an Eisenmenger complex. At the time of echocardiography, absence of the spleen in its normal location was noted. This prompted further investigation into localizing the spleen using 99mTc-sulfur colloid and heat denatured 99mTc-RBC scintigraphy. Both scans demonstrated the spleen to lie posterior to the right hepatic lobe.

Child↗

Effects of increased ICP on brain phosphocreatine and lactate determined by simultaneous 1H and 31P NMR spectroscopy.

In order to study the metabolic events surrounding ischemia induced by the graded increase of cerebrospinal fluid (CSF) pressure, the technique of simultaneous phosphorus-31- and hydrogen-1-enhanced nuclear magnetic resonance spectroscopy was applied to five cats as intracranial pressure (ICP) was gradually raised by the instillation of mock CSF. Threshold lactate rose at an average cerebral perfusion pressure (CPP) of 49 torr, and, in general, preceded a threshold decrease in phosphocreatine, which was observed at an average CPP of 29 torr. There was considerable variation among cats in the CPP at which failure of brain energy metabolism occurred, however, suggesting differences in the autoregulatory curves. It is concluded that, with elevated ICP, there is no universally "safe" CPP at which brain energy metabolism may be assumed to be uncompromised.

Animals↗

Effects of hydrocephalus and increased intracranial pressure on auditory and somatosensory evoked responses.

Recent studies in human and animal subjects have suggested a relationship between intracranial pressure (ICP) and ventricular dilatation and multimodality evoked responses which, if substantiated, would be of value to clinical practice as a noninvasive way of assessing the need for shunting in selected patients in whom computed tomography (CT) is not definitive. In an attempt to better define these changes, auditory evoked response (BAER) and somatosensory evoked response (SER) were performed on 16 cats as a base line, after which they were made hydrocephalic by the cisternal injection of kaolin. Nine cats survived, and CT or magnetic resonance scans were performed on them 4 to 6 weeks later. In those animals in which ventricular dilatation was noted, repeat evoked responses were recorded. In the 6 hydrocephalic cats, the ventricle was punctured to measure ICP, which in all cases was less then 5 mm Hg. The lumbar spinal dural sac was then ligated, which resulted in periodic plateau waves up to 75 to 100 mm Hg after 4 to 6 hours, lasting up to 10 minutes. In neither group of cats was any change in either BAER or SER observed until preterminally, when ICP was in the range of 75 to 100 mm HG and cerebral perfusion pressure was compromised. This suggests that the BAER and SER are not sensitive to either ventricular dilatation or intracranial hypertension.

Animals↗

Lipodystrophia centrifugalis abdominalis juvenilis.

8 Korean children exhibited well-defined depressed lesions of the skin accompanied by slight redness of the surrounding area. First these lesions appeared in the inguinal area and then spread peripherally to the navel region and the ipsilateral vulval area. In these 8 cases, 7 occurred in girls and 1 in a boy. The age of onset ranged from 2 to 9 years. Biopsy specimens taken from the well-depressed area showed a decrease in or absence of, subcutaneous fat and a mild inflammatory infiltrate of lymphocytes and histiocytes in the lower dermis and subcutis. These 8 cases are the first, to our knowledge, to be reported outside Japan and considering the age of onset of the dermatosis it is not confined to infants. Therefore, we would like to describe this entity under the title of lipodystrophia centrifugalis abdominalis juvenilis instead of lipodystrophia centrifugalis abdominalis infantilis.

Abdomen↗