The size of unruptured intracranial aneurysms is an important factor that determines their rupture potential; however, the critical threshold size remains to be established. Some useful informations for determining the threshold size have been provided by the reports on the long-term follow-up of previously diagnosed unruptured aneurysms and clinical or autopsy studies on the size of ruptured aneurysms. Among the ninety-eight patients with ruptured cerebral aneurysms the authors managed during the last 4 years and the size of which were identified neuroradiologically and/or intraoperatively, eight cases(8.2%) had very small (maximum diameter less than 5mm) aneurysms. Their clinical features were not remarkably different from the usual aneurysmal SAH. As for the morphology, all of the eight had thin wall and narrow neck; in five cases the aneurysmsal sac had elongated shape. Several clinical reports on the ultimate rupture of previously diagnosed very small unruptured aneurysms and the formidable incidence of very small ruptured aneurysms in such clinical studies as this suggest that very small aneurysms also have a definite risk of rupture. The clinical significance of the narrow neck and elongated sac of the very small ruptured aneurysms observed in the authors' cases seems to be characteristic enough to deserve further investigation.
Aneurysm* ; Aneurysm, Ruptured ; Autopsy ; Follow-Up Studies ; Humans ; Incidence ; Intracranial Aneurysm ; Neck ; Rupture

No abstract available.
Myopathy, Central Core*

No abstract available.
Drug Therapy* ; Granulocytes* ; Humans*

No abstract available.
Cisplatin*

BACKGROUND: Increase of immunocompromised patients and frequent use of indwelling catheters cause staphylococcal bacteremia, especially due to coagulase-negative staphylococci (CNS), in contrast with Staphylococcus aureus in the past. And, infections of methicillin-resistant staphylococci have been increasing in number from 1970s. In this study, species of staphylococcal isolates from blood were demonstrated, and their methicillin susceptibilities were evaluated for the empirical choice of antibiotics. METHODS: One hundred and seventy-five staphylococcal strains isolated from blood culture at Pusan National University Hospital during the year 1999 were included. Species identification, susceptibility tests by agar dilution and disk diffusion methods, and mecA gene detection by polymerase chain reaction were performed. RESULTS: S. aureus (41%), S. epidermidis (30%), S. auricuralis, S. intermedius, S. haemolyticus, S. capitis, S. simulans, S. sciuri, S. homis, and S. warneri were identified. Thirty-one stains (43.4%) of S. aureus, 43 stains (83%) of S. epidermidis, and 24 stains (46%) of other CNS are resistant to oxacllin. The results of disk diffusion test were consistant with agar dilution tests in all S. aureus strains and 95.5% of CNS strains. The results of mecA gene detection were consistant with agar dilution methods in 96.8% of S. aureus and 89.6% of CNS. CONCLUSIONS: Not only S. aureus and S. epidermidis but also other various species of staphylococci were recovered from blood, and methicillin-resistant strains reached 43.2% of S. aureus, and 64.4% of CNS. These results would help for physicians to choose primary empirical therapeutic agents of patients who are suggestive of staphylococcal bacteremia.
Agar ; Anti-Bacterial Agents ; Bacteremia ; Busan ; Catheters, Indwelling ; Coloring Agents ; Diffusion ; Humans ; Immunocompromised Host ; Methicillin ; Methicillin Resistance ; Oxacillin* ; Polymerase Chain Reaction ; Staphylococcus ; Staphylococcus aureus

No abstract available.
Drug Therapy* ; Granulocytes* ; Humans* ; Lung* ; Neutropenia*

No abstract available.
Cyclosporine* ; Drug Resistance, Multiple* ; Humans* ; Lung Neoplasms* ; Lung* ; Tamoxifen* ; Verapamil*

PURPOSE: Leptomeningeal carcinomatosis occurs in about 5% of patients with solid tumor and is being diagnosed with increasing frequency as patients live longer and as neuro-imaging studies improve. In general, the most commom cancers that involved the leptomeninges are breast cancer, lung cancer, and malignant melanoma. MATERIALS AND METHODS: We investigated 25 patients presented with multiple neurologic symptoms and signs who were diagnosed with leptomeningeal carcinomatosis at the Yonsei Cancer Center from January 1990 to December 1999. RESULTS: The primary disease of leptomeningeal carcinomatosis were stomach cancer (10 cases), breast cancer (7 cases), lung cancer (5 cases), unknown primary cancer (2 cases) and common bile duct cancer (1 case). All patients were presented with multiple neurologic symptoms and signs involving the central nervous system (CNS), cranial nerve or spinal nerves. Twenty-one of twenty- five patients were treated with intrathecal chemotherapy, radiotherapy, or combination therapy. Fourteen of them (66.7%) experienced improvement or stabilization of neurologic symptom and sign. The median survival was 122 days (10-2190). CONCLUSION: In conclusion, although early diagnosis and active treatment of leptomeningeal carcinomatosis may improve the quality of life in selected patients, the median survival was relatively short. Therefore, new diagnostic and therapeutic strategy for leptomeningeal carcinomatosis were needed.
Breast Neoplasms ; Central Nervous System ; Common Bile Duct ; Cranial Nerves ; Drug Therapy ; Early Diagnosis ; Humans ; Lung Neoplasms ; Melanoma ; Meningeal Carcinomatosis* ; Neurologic Manifestations ; Quality of Life ; Radiotherapy ; Spinal Nerves ; Stomach Neoplasms

The expression of p-glycoprotein (p-gp) was evaluated in pre- and post-chemotherapy states after the administration of adriamycin-based chemotherapy in 24 gastric cancer patients. Among them, group A was composed of twelve patients who relapsed after surgery plus adjuvant chemotherapy and group B was composed of another twelve patients who received neoadjuvant chemotherapy plus surgery. Pre-chemotherapy p-gp was evaluated in 18 out of 24 patients (6 patients had no pre-chemotherapy paraffin blocks) and post-chemotherapy p-gp was evaluated from all 24 patients. Pre- and post-chemotherapy p-gp was expressed in 5 of 18 patients (27.8%), and 9 of 24 patients (37.5%), respectively, with immunohistochemical stain using monoclonal antibody JSB-1. No differences of disease-free survivals were observed in Group A based on post-chemotherapy p-gp expression from relapsed lesions. In Group B, there was a higher relapse rate (p = 0.04) and a lower one-year disease-free survival rate (p = 0.04) in post-chemotherapy p-gp positive patients when adjuvant treatment was done with the same regimen as neoadjuvant chemotherapy. In all patients studied, post-chemotherapy p-gp expression correlated with a higher systemic recurrence (p = 0.04). These data suggest that p-gp can be induced by an adriamycin-based chemotherapy in gastric cancer. Thus, we suggest that the prognosis of gastric cancer may be poor if a multidrug resistance (MDR)-related regimen is used in the presence of p-gp after neoadjuvant chemotherapy with an adriamycin-based regimen, even if the initial response is good.
Adult ; Aged ; Combined Modality Therapy ; Dose-Response Relationship, Drug ; Doxorubicin/administration & dosage/*therapeutic use ; Drug Resistance ; Female ; Human ; Immunohistochemistry ; Male ; Middle Age ; Neoplasm Recurrence, Local ; P-Glycoprotein/*metabolism ; Stomach Neoplasms/*drug therapy/*metabolism/surgery ; Survival Analysis

No abstract available.
Carcinoma, Hepatocellular* ; Cell Line* ; Genes, p53* ; Humans