Cytochrome compounds which act as electron transfer agents in oxidation-reduction reactions. An important example is cytochrome c, which has a molecular weight of about 13,000 and contains one atom of iron per mol. Our attempt is to evaluate clinically the therapeutic effect of cytochrome c on the healing wound of the lesions which supposed to be oxygen concentration is lowered than in normal tissues in tissue respiration, and it used in neuropathy, muscle paralysis, retinopathy, vitreous hemorrhage, corneal chemical burns in ophthalmology. The patients included in the following series: They were five cases of retrobulbar optic neuritis, two cases of optic neuritis, one case of axial optic atrophy, two cases of simple optic atrophy, two cases of muscle paralysis, one case of central retinopathy, one case of chorio-retinal atrophy, one case of maculra degeneration, one case of diabetic retinopathy, one case of pigmentary degeneration of the retina, one case of vitreous hemorrhage, four cases of corneal chemical burn, and one case of corneal dystrophy. After intra-dermal injection with cytochrome c, evaluated the allergic character and it was given intra-venous injection. The results were as follows: 1) In total 23 cases, had excellent therapeutic effects on neuropathy, muscle paralysis, and corneal chemical burns. 2) In general, we found that it did not respond to central retinopathy and diabetic retinopathy. 3) We experienced that it have response to the old lesions. 4) It was interested that the night blindness could be disappeared by cytochrome c use in pigmentary degeneration of the retina. Yet there remain certain problems so far unsolved.
Atrophy ; Burns, Chemical ; Cytochromes c* ; Cytochromes* ; Diabetic Retinopathy ; Humans ; Iron ; Molecular Weight ; Night Blindness ; Ophthalmology ; Optic Atrophy ; Optic Neuritis ; Oxidation-Reduction ; Oxygen ; Paralysis ; Respiration ; Retina ; Vitreous Hemorrhage ; Wounds and Injuries

No abstract available.
Flow Cytometry* ; Immunophenotyping* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

The purpose of this paper is to call attention to the occasional occurrence of papilledema associated with typical albuminoytologic dissociation in spinal fluids. In view of the possible allergic etiology of the syndrome by Reitman, ACTH and corticosteroids have been tried. These drugs have yielded encouraging results when treatment was initiated early in the course of the illness, when nerve-root edema had caused only functional paralysis but the syndromes of my cases hadn't responded to prednisolone. It can be deduced that the illness is thought to be too advanced and the nerve-root had had organic destructions already. our cases revealed prolonged typical albuminocytologic dissociation in spinal fluids, increased intracranial pressure throughout the whole hospital course and papilledema. This condition is really a very common one but there is so much confusion about the criteria necessary for the diagnosis and so many different names are employed to designate it that its incidence is thought to be underestimated. A review of the literature dealing with Guillain-Barre syndrome reveals few references to papilledema. Occasional notes of "optic neuritis" are found but the descriptions are not sufficient to enadle one to dete mine whether there was papilledema or not. In the author's cases, the optic nerVe heads showed papilledema of 3 diopters or more with tortuosities of the veins and filling of the cups. There were no hemorrhages or exudates. Although not essential, the demonstration of an increased protein in cerebrospinal fluids with little or no elevation of cells is an appreciable aid in diagnosis on the Guillain-Barr'e syndrome. Certainly this patient, with a protein content of from 243 mg% to 1,200 mg% in 8 successive lumbar punctures with cell counts ranging from zero to 29 lymphocytes per cubic millimeter demonstrates typical albuminocytologic dissociation. Walsh postulated one more element to this syndrome and pointed out that increased intracranial pressure may occur in cases otherwise typical of the Guillain-Barre syndrome. It is scarecely necessary to add the cause of this condition, if indeed there is one cause and not many cases, is quite unknown. In the author's cases, the intracranial pressure revealed from 110 mm H2O to 520 mm H20 in 8 successive lumbar punctures.
Adrenal Cortex Hormones ; Adrenocorticotropic Hormone ; Cell Count ; Cerebrospinal Fluid ; Diagnosis ; Edema ; Exudates and Transudates ; Guillain-Barre Syndrome ; Hemorrhage ; Humans ; Incidence ; Intracranial Pressure ; Lymphocytes ; Optic Disk ; Papilledema* ; Paralysis ; Prednisolone ; Spinal Puncture ; Veins

No abstract available.
Kasabach-Merritt Syndrome*

PURPOSE: We observed the actual half life of the alpha-fetoprotein (AFP) had clinical meaning in that it reflected the long term prognosis more individually at a certain level of preoperative alpha-fetoprotein. METHODS: From preoperative and postoperative measurements of alpha-fetoprotein in 96 hepatocellular carcinomas the actual half lives were calculated with the formula: AHL T1/2 (days) = -0.3x(T/log(C1/C0)), where T was the time interval between C1 and C0, in which C1 meant the level of AFP at postoperative 7 day, C0 the original AFP level. We investigated overall survival and disease free survival rate between delayed AHL group and non-delayed AHL group under various definitions of delay. RESULTS: The average actual half life of all cases was 5.1+/-13.6 days. One, three and five year overall survival rates of the group with actual half life less than 4 days were 82.1%, 66.7%, 61.1% respectively, whereas those of the group with actual half life more than 4 days showed 83.0%, 36.5%, 18.2% respectively. The significance of different survival rates was much higher, when only the patients with preoperative alpha-fetoprotein above 100 ng/ml were taken into account (n=53, P=0.0019). The disease free five year survival rates were also significantly different. CONCLUSION: We can predict the elevated postoperative survival rate in the patients with actual half life of alpha-fetoprotein less than 4 days. And this has also relevant clinical meaning in the prognostication of disease free survival, if the preoperative alpha-fetoprotein of patients has elevated up to over 100 ng/ml. The measurement of actual half life of postoperative hepatocellular carcinoma patientscan be a clinical useful parameter for the prognosis of long term survival.
alpha-Fetoproteins* ; Carcinoma, Hepatocellular* ; Disease-Free Survival ; Half-Life* ; Humans ; Prognosis ; Survival Rate

BACKGROUND: Due to its high diagnostic accuracy, preoperative sonographic evaluation of gallbladder disease is accepted as the most reliable and effective procedure. However we have encountered, though not so often, cases in which the sonographic tumor revealed only sludge material in reality. METHODS: A retrospective review of 11 cases that had been preoperatively diagnosed as a gallbladder mass or stone focused on the features of the patients and the characteristics of the sonographic findings. RESULTS: Of the cholecystectomized 2486 cases in which gallstones or gallbladder polyps had been preoperatively diagnosed, 0.4% had only sludge in reality. Symptomatic patients were 7 (64%). Pseudo- tumorous lesions of the gallbladder resembled the shapes of the stones, as well as the shapes of polyps, in their echogenic characteristics. CONCLUSIONS: Gallbladder sludge alone can make the sonographic image of a stone or a polyp. The application of more advanced sonography, such as contrast-enhanced Doppler sonography, may contribute to the differential diagnosis of pseudo-tumorous lesions of the gallbladder; however, an indefinite lesion on sonography always deserves operative intervention.
Diagnosis, Differential ; Gallbladder Diseases ; Gallbladder* ; Gallstones ; Humans ; Polyps ; Retrospective Studies ; Sewage* ; Ultrasonography*

Fetal teratomas rarely complicate pregnancy,having an incidance of only 20,000:1 to 40,000:1 of live births. Overthere, cervical teratomas are rare and accounts for only 5.5% of all neonatal teratomas. We have experienced a large cervical immature teratoma and present this case with a brief review of literatures.
Live Birth ; Teratoma*

Cavernous transformation of the portal vein that is resulted as a collateral vessel formation from a portal hypoplasia is very rarely to be observed in human being. Such an abnormal transformation can be caused by congenital defect of vein formation in the early embryonal development or congenital hematologic hypercoagulability which gives rise to the cavernous development of cavernous collateral branches. Acute thrombosis of portal vein can also be the cause of acquired cavernous transformation. In most cases it extends into the parenchyme of liver, and often has porto-systemic shunt (with left gastropiploic vein and varices around spleen) or porto-portal shunt (with varices around gallbladder). A 48 years old male patient underwent splenectomy at the age of 24 owing to splenomegaly. He had liver cirrhosis without hepatitis and alcohol history. Intrahepatic stone in left lateral lobe of liver was diagnosed in the course of medical treatment. The cavernous transformation of portal vein with right lobe hypoplasia was confrimed during the operation.
Congenital Abnormalities ; Hepatitis ; Humans ; Liver Cirrhosis ; Liver* ; Male ; Middle Aged ; Portal Vein* ; Splenectomy ; Splenomegaly ; Thrombophilia ; Thrombosis ; Varicose Veins ; Veins

PURPOSE: The results of a combined approach of percutaneous nephrolithotomy (PNL) and shock wave lithotripsy (SWL) for the first treatment of staghorn calculi were analysed. MATERIALS AND METHODS: The primary PNLs, followed by secondary SWL when necessary, were performed in 31 complete and 19 partial staghorn stones. All stone sizes ranged from 344 to 3,224mm2 (mean 1,166.6mm2). The success rate and many other factors, including the initial size and completion of the stone, an associated calyceal dilatation, the debulking rate of PNL, etc were analyzed. The data over the past 7.5 years was compared with the data from the previous 6 years. RESULTS: The overall success rate was 88% (complete, 83.9%; partial, 94.7%), which was achieved by PNL alone in 19 cases and an additional SWL in 25 cases. Combination therapy showed the best results, when the area of the remnant stones was <=300mm2 or 20% of the initial stone after endoscopic debulking. Large stones, >=2,000mm2 in surface area, showed poor results in the combined treatment. Calyceal dilatation and ureteral stenting did not significantly affect the success rate. With time and experience, the success rate improved despite the decreased primary debulking rate, number of percutaneous procedures, and theater time, although this was no statistically significant. CONCLUSIONS: Combined treatment is a good choice. It is efficient and minimally invasive for managing most standard patients with staghorn calculi, especially those <=2,000mm2 in surface area. The remnant stones, in locations difficult to access with PNL, could be safely pulverized with a consecutive SWL rather than a more aggressive PNL.
Calculi* ; Dilatation ; Endoscopy ; Humans ; Kidney Calculi ; Lithotripsy* ; Nephrostomy, Percutaneous* ; Shock* ; Stents ; Ureter

BACKGROUND: In spite of the development of diagnostic tools, gallbladder carcinoma is often diagnosed at a late stage because of the lack of symptomatic awareness of patients in early stage. Early diagnosis and proper resectional treatment is, therefore, the most important factor for the prognosis. This study aims at the analysis of clinical characteristics and the effect of various modes of surgical treatment on long-term survival. METHODS: From January 1989 to December 1997 we operated on 132 patients with gallbladder carcinoma. Age, sex, stage distribution, clinical manifestations and mode of operations were analyzed. The cumulative survival rates were also analyzed for 107 patients who had been finally followed up, and the significance of survival difference was tested (p<0.05). RESULTS: The average age of 132 patients was 64 years old, and female patients suffered more frequent incidence than male patients by a ratio of 1.7:1. The distribution of patients according to the pathologic TNM staging showed early stage (stage 0 & I) accounted for only 9.8% whereas the advanced stages (stage II, III, IVa, IVb) accounted for the majority of the patients (90.2%). The chief complaints were abdominal pain (84.8%), indigestion, weight loss, palpable mass and so forth in a decreasing frequency order. Among the patients, 30 cases (22.7%) were irresectable, 50 cases (38%) were curative resected, and 52 cases (39%) were palliative resected. The overall cumulative survival rates of 107 patients were 53.7%, 41.7% and 30.1% for 1-year, 2-year and 5-year survival respectively. Although the 5-year survival rate of curative resected patients showed a significantly better survival rate (p<0.005) than that of non-curative resected patients, the different modes of combined radical surgery did not affect the survival rates. CONCLUSION: Combined curative resection ameliorated long-term survival of patients with gallbladder carcinoma. For the further evaluation of the efficacy of combined radical surgery on survival, more extensive data needs to be accumulated.
Abdominal Pain ; Dyspepsia ; Early Diagnosis ; Female ; Gallbladder* ; Hospital Distribution Systems ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Rate ; Weight Loss