In spite of technical advances in neuroradiology, neuroanesthesiology, and microneurosurgery, the treatment of giant aneurysms remains problematic. Between 1983 and 1995, the authors encountered 42 consecutive cases of giant aneurysms, and this study focuses on their clinical manifestations, management, and outcome. The patients' ages ranged from 5 to 73 years, with peak incidence in the sixth decade ; the male to female ratio was 12 : 30. The follow-up period was from 2 to 110(mean, 36) months. The most common presenting symptom was a mass effect found in 22 patients(52%), followed by subarachnoid hemorrhage in 16(38%). Thirty patients underwent a surgical or interventional radiological procedure, comprising direct neck clipping(n=13), proximal clipping(n=7), detachable balloon occlusion(n=4), wrapping(n=3), trapping(n=1), and partial clipping with thrombectomy(n=2). The mortality rate was 16.7% and the morbidity rate, 40% ; the most common postoperative complication was distal cerebral infarction. At the last follow-up, 22 patients(73%) were able to perform daily activities without assistance. In this clinical study, the authors reviewed general aspects of the treatment of giant aneurysms. In conclusion, treatment of giant aneurysms should-for best results-be tailored to patients' individual requirements, determined after thorough examination. Despite advanced neurosurgical techniques, morbidity and mortality rates remain high.
Aneurysm* ; Cerebral Infarction ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mortality ; Neck ; Postoperative Complications ; Subarachnoid Hemorrhage

BACKGROUND: Becker's mealanosis is not an uncommon entity, and many cases are probably not reported because the diagnosis is usually made clinically and the condition is benign with cosmetic significance only. the etiology remains obscure. OBJECTIVE: The purpose of this study is to establish the clinicopathologic characteristics of Becker's melanosis in Korean. METHODS: Thirty-six patients with Becker's melanosis were retrospectively studied. RESULTS: The clinical and histopathologic findings observed in our cases were similar to previous reports except for the following. Nine patients(25%) had abnormal findings in their hair follicles : dilatation of the infundibular portion filled with abnormal keratin, Pityrosporum orbiculare and bacteria(19.4%); formation of intrafollicular cyst(5.6%). Three patients(8.3%) had granulomatous infiltration. Twenty-two patients(61.1%) had increased smooth muscle bundles. CONCLUSION: The findings associated with dermal hair follicles may be related to the pathogenesis of Becker's melanosis.
Diagnosis ; Dilatation ; Hair Follicle ; Humans ; Malassezia ; Melanosis* ; Muscle, Smooth ; Retrospective Studies

The use of recombinant DNA technology to produce human growth hormone has resulted in a marked increase in availability of Growth Hormone(GH) to treat short stature due to GH deficiency and other conditions, such as Turner syndrome, familial short stature, chronic renal insufficiency and intrauterine growth retardation (IUGR). But, the GH therapy may result in the adverse events such as sodium and water retention, pseudotumor cerebri, slipped capital femoral epiphysis, growth of nevi, recurrence of tumor. We experienced a case of severe hypertension associated with GH therapy in a 14-year-old male who presented high blood pressure up to 190/100 mmHg and normalized at 2-3 weeks after discontinuation of GH. Therefore, we think that the blood pressure should be carefully monitored during GH therapy.
Adolescent ; Blood Pressure ; DNA, Recombinant ; Fetal Growth Retardation ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hypertension* ; Male ; Nevus ; Noonan Syndrome ; Pseudotumor Cerebri ; Recurrence ; Renal Insufficiency, Chronic ; Slipped Capital Femoral Epiphyses ; Sodium

No abstract available.
Child* ; Epidemiologic Studies* ; Gastroenteritis* ; Humans ; Rotavirus*

BACKGROUND: Korean ginseng (KG) has been used as a general tonic, and for voiding dysfunction for a long time in oriental society. However, scientific basic studies on the use of KG, have been rare, especially for voiding and erectile dysfunction. This study was performed to investigate the effects of KG on voiding and erectile function by examining the effects of total saponin (TS) on the bladder, urethral and penile cavernosal smooth muscle. MATERILAS AND METHODS: To examine the effects of TS, NewZeland white rabbits were used to obtain tissue strips from the smooth muscle of the bladder, proximal urethra and corpus cavernosum. Adult Sprague Dawley rats were used to examine the changes in urodynamic findings and penile erection after administration of TS. RESULTS: In proximal urethral strips, the rate of relaxation of the proximal urethra was increased from 9.0+/-2.9 to 33.7+/-4.8% in a dose-dependent manner when the concentration of TS was added accumulatively from 0.25 mg/ml to 4.0 mg/ml (p<0.05). However, no significant response was observed in the bladder strips within these concentration ranges. For the corpus cavernosal strips, the rate of relaxation ranged from 5.8+/-2.1 to 36.7+/-5.8%, increasing in a dose-dependent manner when TS was increased from 1.0 mg/ml to 4.0 mg/ml (p<0.05). After administration of 0.1 ml of TS (32 mg/ml) in the rat, the bladder pressure was 37.5+/-8.5 mmHg at 52.1+/-7.0 sec. during isovolumetric bladder contraction, showing no significant differences from 35.7+/-7.8 mmHg and 50.7+/-7.2 sec, respectively, before treatment. However, when 0.1 ml of TS (32 mg/ml) was administered, the relative reduction of urethral pressure was 6.9+/-0.5 mmHg at 62+/-7.5 sec, which was significantly higher compared to 4.6+/-1.1 mmHg at 45+/-10 sec before treatment (p<0.05). For the cavernosal injection study, the change in intracavernosal pressure (delta ICP) was examined after administering 0.1 ml of TS. The cumulative additions of TS at concentrations from 0.5 mg/ml to 32 mg/ml increased delta ICP from 1.3+/-0.5 to 21.3+/-7.8 mmHg in a dose-dependent manner (p<0.05). The duration of tumescence was from 0.3+/-0.1 to 5.2+/-0.2 min, showing dose-dependent increase (p<0.05). Furthermore, the cumulative addition of TS at concentrations from 0.5 mg/ml upto 32 mg/ml did not cause any significant change in systemic blood pressure. CONCLUSION: These results suggest that ginseng improves voiding functions, which is mainly achieved by TS relaxing the proximal urethra, the most important part of the bladder outlet function. In addition, ginseng safely induced a penile erection hemodynamically by relaxing the corpus cavernosum.
Adult ; Animals ; Blood Pressure ; Erectile Dysfunction ; Humans ; Male ; Muscle, Smooth* ; Panax* ; Penile Erection ; Rabbits ; Rats ; Rats, Sprague-Dawley ; Relaxation* ; Saponins* ; Urethra ; Urinary Bladder ; Urinary Tract* ; Urodynamics

It is well known that the medullary carcinoma of the breast is one of the special types of breast carcinoma with a good prognosis. At present, the medullary carcinoma of the breast is subclassified into 3 types: typical medullary, atypical medullary and nonmedullary carcinoma. Among them, the former has the best prognosis. We reviewed the film mammographic and ultrasonomammographic findings of 13 patients according to the reevaluated histopathologic diagnosis. Typical medullary carcinoma shows a well circumscribed mass with surrounding halo on film mammogram, and well defined mass with central intermediate echogenicity and peripheral low echogenicity and posterior acoustic enhancement on ultrasonomammogram. Atypical medullary carcinoma shows relatively well circumscribed mass with partial marginal obliteration on film mammogram, and irregular bordered mass with inhomogeneous echogenicity due to focal necrosis in the mass and associated findings of thick boundary, asymetrical lateral shadowing on ultrasonomammogram. Nonmedullary carcinoma shows lobulated mass with surrounding parenchymal distortion and skin thickening on film mammogram, and relatively well defined lobulating mass with surrounding parenchymal distortion and marked heterogeneous internal echogenicity on ultrasonomammogram. Therefore, differentiation between typical medullary carcinoma with good prognosis and atypical medulary or nonmedullary carcinoma with poor prognosis, may be possible by various diagnostic imaging modalities preoperatively. But further collective study shall be needed in near future.
Acoustics ; Breast Neoplasms ; Breast* ; Carcinoma, Medullary* ; Classification* ; Diagnosis ; Diagnostic Imaging ; Humans ; Necrosis ; Prognosis ; Shadowing (Histology) ; Skin

No abstract available.
Intracranial Arteriovenous Malformations* ; Risk Factors*

Apoptosis is an intrinsic and fundamental biological process that plays a critical role in the normal development of multicellular organisms and in maintaining tissue homeostasis. Some of the well known regulators of apoptosis are cytokines of the tumor necrosis factor(TNF) ligand family, such as Fas ligand(Fas L) and TNF, which induce apoptosis by activation of their corresponding receptors, Fas and TNFR-1. Recently, a new member of the TNF family known as TRAIL (TNF-related apoptosis-inducing ligand) was identified and shown to induce p53-independent apoptosis in a variety of tumor cell lines but not in normal cells, Four human receptors for TRAIL were also recently identified and designated TRAIL-R1, -R2, -R3, and -R4. The aim of this study is to examine whether TRAIL and TRAIL receptots(-R1, -R2, -R3) are expressed in uterine cervical cancer and whether it is correlated with apoptosis, TRAIL and TRAIL receptors. The subjects were 20 patients who were diagnosed with cervical cancer. Western blotting was performed in 9 cases, immunohistochemical staining for TRAIL and TRAIL receptors(-R1, -R2, -R3) and TUNEL method for detection of apoptosis in 11 cases. There were proteins for TRAIL, TRAIL-R1, -R2, and -R3 in tissues from cervical cancer. All TRAIL receptors were expressed in both normal cervical epithelium and tumor cells, and TRAIL-Rl and -R2 were more strongly expressed in tumor cells than normal epithelium(p<0.05). Apoptosis correlated with expression of TRAIL-Rl and -R2(p<0.05). This study suggests that TRAIL induces apoptosis in cervical cancer through its receptors.
Antigens, CD95 ; Apoptosis ; Biological Processes ; Blotting, Western ; Cell Line, Tumor ; Cytokines ; Epithelium ; Homeostasis ; Humans ; In Situ Nick-End Labeling ; Necrosis ; Receptors, TNF-Related Apoptosis-Inducing Ligand* ; Uterine Cervical Neoplasms*

This study was intended to investigate the pre-and postoperative profile of seizures in the patients with cerebral arteriovenous malformatins(AVM's), and to evaluate various preoperative factors to predict the postoperative occurrence of seizures. The patients consisted of 46 consecutive cases with supratentorial AVM's operated on from May 1987 to May 1993. Their mean follow-up duration was 40 months. The pre- and postoperative seizure profiles were similar to each other. The overall incidence of patients experiencing seizure were 50% preoperatively and 52% postoperatively, and the incidence of intractable seizure was 15%, which was the same in both the pre-and postoperatively period. The presence of preoperative seizure and large size of AVM were significant indicators of high incidence of postoperative seizures(P<0.05), while other factors such as preoperative intracerebral hemorrhage or embolization showed no significant influence on the occurrence of postoperative seizures. About 70% of the patients with preoperative seizures also had postoperative seizures, while those without preoperative seizures developed new ones only in 35% of the cases postoperatively. The mean size of the AVM's in the group, with postoperative seizures was larger than that of the group without postoperative seizures(4.56 vs. 3.02 cm). Regarding postoperative intractable seizures, 57% of the group with preoperative intractable seizures remained intractable postoperatively and groups with preoperatively controlled and groups without seizures demonstrated postoperative intractablity only in 13% and 4% respectively. In conclusion, surgery of AVM's did not change the overall incidence of seizures, both controlled and intractable, and patients with preoperative and large sized AVM's and significantly higher possibility of postoperative seizures. Patients with preoperative intractable seizures resulted in control of seizures in 43% after removal of AVM, while 57% remained intractable. Extirpation of epileptic focl, after localization with preoperative study, seems to be needed to improve the outcome of the postoperative seizures.
Cerebral Hemorrhage ; Follow-Up Studies ; Humans ; Incidence ; Intracranial Arteriovenous Malformations* ; Seizures*

No abstract available.
Humans ; Seoul*