Intravascular Papillary Endothelial Hyperplasia (Masson tumor) of the Skull : Case Report and Literature Review

A 10-year-old female patient presented with a rapidly growing nodular mass lesion on her right frontal area. On skull radiography and computed tomography (CT) imaging, this mass had a well-demarcated punch-out lesion with a transdiploic, exophytic soft tissue mass nodule on the frontal scalp. Magnetic resonance (MR) imaging revealed the presence of a 1.5x1.2x1 cm sized calvarial lesion. This lesion was hypointense on T1 and heterogenous hyperintense on T2 weighted MR images, and exhibited heterogeneous enhancement of the soft tissue filling the punch-out lesion after intravenous administration of gadolinium. En block removal of the tumor with resection of the rim of the normal bone was performed. The pathological diagnosis was intravascular papillary endothelial hyperplasia (IPEH). After surgery, no recurrence was found for 8 months. IPEH is a rare and benign reactive lesion usually found in thrombosed subcutaneous blood vessels. Involvement of skull bone is rare. In this article, we present a case of IPEH involving the calvarium, in a 10-year-old woman.

Aspect Ratio(dome/neck) of Ruptured and Unruptured Aneurysms in Relation to Their Sizes and Sites and Ages of Patients: Clinical Research / 대한뇌혈관외과학회지

OBJECT: This study was undertaken to assess the reliability of aspect ratio (AR: the maximum dimension of the dome/width of the neck of an aneurysm) in predicting aneurysm rupture. The authors sought to evaluate the utility of these measures for differentiating ruptured and unruptured aneurysms. METHODS: Patients were retrospectively selected for this study based on the availability of angiograms and a clear diagnosis of an unruptured or ruptured aneurysm. 106 patients with 140 aneurysms were included. 19 patients harbored only unruptured lesions, 70 patients only ruptured lesions, and 17 both ruptured and unruptured lesions. The size of the aneurysms and their ARs were determined by examining the angiographic films. Patient's age and sex, and the location of the aneurysm were also recorded. RESULTS: The ruptured aneurysms were larger and had greater ARs. The mean size of unruptured aneurysms was 4.94 mm and that of ruptured ones was 5.53 mm; the corresponding mean ARs were 1.50 and 1.96, respectively. The odds ratio for rupture rose progressively only for the AR. Only 38.3% of ruptured aneurysms had an AR less than 1.80 compared with 74.0% of unruptured lesions. The odds of rupture were 28-fold greater when the AR was larger than 2.07 compared with an AR with an AR less than or equal to 1.30. Only 9.3% of ruptured aneurysms had and AR less than 1.30 compared with 48.1% of unruptured lesions. CONCLUSION: A high AR might reasonably influence the decision to treat actively an unruptured aneurysm independent of its maximum size, so great care should be taken for patients with unruptured intracranial aneurysms with AR of more than 1.80.

Correlation Between Actual and Estimated Prostate Weight by Transrectal Ultrasonography with 14 Separate Methods of Volume Estimation in Patients with Benign Prostate Hyperplasia / 대한비뇨기과학회지

A precise estimation of prostate volume with transrectal ultrasound would help to determine the appropriate therapy. To determine the most accurate means of volume estimation 39 patients underwent transrectal ultrasound with 14 separate methods of volume estimation. All patients underwent subsequent suprapubic prostatectomy. Prostate specimen weights were compared with the results of each volume estimation method. The most accurate method to estimate prostate weight (r = 0.94) was the ellipsoid volume formula, widely used as an alternative to planimetry, which overestimated the weight of the prostate in 33 of 39 cases (84.5%) with an average error of 7.5 gm. (13.6%). A large portion of the error in the application of this ellipsoid volume formula was the inclusion of transverse dimension.

An Experimental Study of Partial Nephrectomy with Application of Microwave Tissue Coagulator (M.T.C.) to Mongrel Dogs / 대한비뇨기과학회지

The Microwave Tissue Coagulator (M.T.C.) is one of the most sophisticated systems that have been developed and contributing to the modern medical treatments and practices. It is equipped with a magnetron specially developed and designated for medical purpose and with help of this oscillation device, produces microwave electricity of fine and high quality in frequency of 2,450 MHz with 12 cm of each wave in length. The power output can be adjusted upto the maximum of 100 watts. The microwave current, once generated by the magnetron is delivered tn a monopolar electrode through coaxial cable, and then proceeded to the electrode is picked into under living organic tissue and switched on to emit microwave current, the organic substances in the living organic tissue are attracted to the electromagnetic force and inclined to make a congestion in and around the field of force near the electrode tip. In the meantime, reacting to the extremely high frequency of energy shifting of 2,450 x 10(6) times in a second within itself the electrically loaded tip starts to be heated up, and this heat, in turn, acts upon organic tissues and effects their coagulation. It is known that this M.T.C. application has been practiced for a quite some time these days in the operation for the diseases of liver and spleen in surgical part, and also in the management of gastrointestinal bleeding in medical part. For further advent in the line, I had intended to try M.T.C. on partial nephrectomy with an aim of developing an effective new way of revivifying treatment of renal disease. As a mean of basic and preliminary, study for this project, an adult mongrel dogs had been experiment. The renal tissue of dogs had been applied with M.T.C. and made it to be in coagulated condition, and then the partial nephrectomy was performed. The objects had been closely examined histologically and the healing processes carefully checked through periodic autopsy of the dogs. The result of the experiment had been rather encouraging in that no significant unfavorable granulomatous changes such as proliferation of capillaries, fibrosis, etc. could be traced in the object, and in that the affected tissues were obsessed to have proceeded a smooth and gradual contraction process to recover their normal conditions. As conclusion, it is able to state that the application of M.T.C. on partical nephrectomy affects organic tissues only to a negligible degree, and further pursuance in my attempt could be very succesful one.

A Clinical Observation on Transurethral Resection of the Prostate with Suprapubic Cystostomy / 대한비뇨기과학회지

A clinical observation was made on 143 cases who received transurethral prostatic resection in the Department of Urology. Korea University College of Medicine during the period of 4 years and 8 months from Jan. 1970 to Aug. 1975. Previous to the transurethral resection of prostate, the suprapubic cystostomy was accomplished in 79 cases among them and following advantageous results were obtained. 1. For the fast recovery of uremic condition and bladder tonicity for over distended bladder, the suprapubic cystostomy is inevitable. 2. It minimizes bleeding of the prostate during transurethral prostatic resection as the drainage of suprapubic cystostomy induces to subside the congestion, inflammation and swelling of the prostatic glands. 3. It tends to minimize and prevent absorptive complications. Complications from absorption of large quantities of irrigating fluids into the circulatory system include hyponatremic shock, water over loading of the vascular system or hypervolemia and hemolysis. By lessening intravesicular pressure and operative time, it thereby reduces the amount of irrigating fluid absorbed. 4. It provides clear view of surgical landmarks with greater margin of safety since water flow is always maximal. S. By eliminating the time spent for evacuation of the bladder, eye accommodation and re-establishment of surgical landmarks, it permits transurethral resection of larger glands within recognized safety guidelines. 6. It reduces operative time. This decreases operative risk, since complication rates, especially in elderly patients, rise in direct proportion to the length of the surgical procedure. 7. It provides a new light source such as fiberoptic cystoscope through the opening of suprapubic cystostomy 8. Make it possible to observer the technique of operation by the lens system inserted through the suprapubic opening.

Clinical Observation in Patients of Whom Gold thread Acupuncture has been Applied / 대한비뇨기과학회지

Gold thread acupuncture has been applied mainly in patients with low back pain, flank pain, nedica1, neurological and orthopedic problems by herb doctors in Korea. since 1962. K.U.B. was taken in 2,725 cases among 5.334 patients who visited Urology department, Korea University Woo Sok Hospital during the period of 3 years and 7 months from tan. 197O to July 1973 and 60 cases were found to have gold threads in their paravertebral region. The 60 cases were analyzed and the following results were obtained. 1. 41 out of 60 cases (63.8%) have been complaining of low back pain and/or flank pain. 2. 17 cases (28.3%) had urinary tract calculi, 14 (23.3%) revealed B.P.H. and 13 (2l.7%) tad diseases of the bladder. 3. The gold threads were seen through out the level of 7th cervical vertebra to coccygeal vertebra. 4. The number of gold thread implanted in one person varied between one to thirty eight. 5. 27 patients (45.O%). of v-horn gold thread acupuncture have been applied previously. received urological operation and instrumentation with good results.