Progressive renal fibrosis is considered to be the final common pathway leading to chronic renal insufficiency, however, the mechanism regarding renal fibrosis in renal injury is not well understood. Recently, several kinds of cytokines have been known to be related to fibrosis after renal injury. The interaction between elements regulating fibrogenesis would be better understood by looking at the effect of TGF-beta1 on the synthesis and accumulation of extracellular matrix, especially collagenous proteins. Crescentic glomerulonephritis (CGN) was induced in New Zealand White rabbits by administration of guinea pig anti-GBM IgG after sensitization with guinea pig IgG; and their kidneys were analyzed for the development of crescents and fibrosis through sequential renal biopsies. Serum creatinine levels in a time course progressively increased until day 15. We semi-quantitatively assayed the levels of the expression of alpha1(I) collagen mRNA and TGF-beta1 mRNA factored for GAPDH mRNA using RT-PCR. We observed a progressive interstitial fibrosis and the expression of collagen I both in the cortex and medulla. The effect of repeated renal biopsy itself on pathology and on the expression of alpha1(I) collagen mRNA and TGF-beta1 mRNA in a time course were not significant, but a very mild increase of the expression of alpha1(I) collagen mRNA was noted at day 15. Histology showed a progressive crescent formation and interstitial fibrosis in a time course that roughly paralleled the expression of alpha1(I) collagen mRNA in both cortex and medulla. TGF-beta1 mRNA was hardly expressed at day 0 in cortex as well as in medulla. It was elevated from day 1, peaked at day 7, and then decreased. In medulla, TGF-beta1 mRNA was noticeably expressed at day 1, peaked at day 4, and then decreased. The expression of alpha1(I) collagen mRNA was seen even before inducing CGN. It was gradually and continuously increased until day 15 both in cortex and medulla. These results suggest that the expression of TGF-beta1 mRNA precedes that of alpha1(I) collagen mRNA in the early stage of CGN and has a central role for provoking the accumulation the collagen I, the most representative interstitial extracellular matrix, in the rabbit model CGN induced by anti-GBM antibody. We conclude that the measurement of the expression of TGF-beta1 mRNA and/or alpha1(I) collagen mRNA in a biopsy sample can be a useful predictor for renal outcome.
Animals ; Anti-Glomerular Basement Membrane Disease ; Biopsy ; Collagen ; Creatinine ; Cytokines ; Extracellular Matrix* ; Fibrosis ; Glomerulonephritis* ; Guinea Pigs ; Immunoglobulin G ; Kidney ; Pathology ; Rabbits ; Renal Insufficiency, Chronic ; RNA, Messenger* ; Transforming Growth Factor beta ; Transforming Growth Factor beta1

No abstract available.
Esophageal Achalasia*

Magnetic Resonance image(MRI) is used as the diagnostic modality for evaluation of suspected intramedullary tumors and differential diagnosis of these tumors at the spinal cord. We experienced intramedullary astrocytoma of cerviced cord with large syrinx and multiple peritumoral cysts consisted of subacute and chronic hemorrhage at the margin and within the syrinx and cysts on MRI.
Astrocytoma* ; Diagnosis, Differential ; Hemorrhage* ; Magnetic Resonance Imaging ; Spinal Cord*

PURPOSE: To seek adequate sequence of MR angiography (MRA) on developmental venous anomaly in the brain. MATERIAL AND METHODS: We collected ten cases who demonstrated developmental venous anomaly on MR image. Eight patients among them, both 3D time-of-flight (TOF) with or without Gadolinium-DTPA enhancement and phase contrast(PC) were performed: TOF without enhancement in five, TO F with enhancement in six, and PC with 10 cm/sec in five, PC with 30 cm/sec in three, and PC with 5 cm/sec velocity encoding (VNEC) in two cases. RESULTS: On enhanced 3D TOF, both dilated collecting veins and medullary veins were well depicted in five of six cases, however, the signal intensity of the collecting and medullary veins are less than arteries. Dilated hyperintense collecting veins were well demonstrated on 3D PC with below the 10cm/sec VNEC in all seven cases, but the medullary veins were poorly defined. Unenhanced 3D TOF IVIRA could not reveal any dilated collecting and medullary veins in all five cases. CONCLUSION: Enhanced 3D TO F could demonstrate the collecting and medullary veins of developmental venous anomaly, however, 3D PC with below the 10 cm/sec VN EC could showthe dilated collecting and larger draining veins. We considered that combined enhanced 3D TOF MRA and PC with VENC 10cm/sec can substitute for conventional anglogram in the diagnosis of developmental venous anomaly.
Angiography* ; Arteries ; Brain ; Central Nervous System Venous Angioma* ; Diagnosis* ; Humans ; Veins

A 42-year-old male with headache, right homonymous hemianopsia, seizure, and right hemiparesis had been treated. A CT scan revealed a large ovoid well-definded area of cerebrospinal fluid densty in the left posterior parietal lobe, which appeared to communicate with the body of the ipsilateral lateral ventricle. A conray ventriculogram showed a cavity of 6+/-5cm in the left posterior parietal lobe, and a communication with the body of the ipsilateral lateral ventricle was visualized. The porencephaly was managed by creation of as large a window as possible to the ipsilateral ventricle, because the communication with the body of the lateral ventricle was very narrow. Microscopic, pathological evaluation confirmed the diagnosis of porencephaly due to an inflammatory lesion of an undetermined origin. The patient was discharged without any evidence of neurological deficit except the right homonymous hemianopsia.
Adult ; Cerebrospinal Fluid ; Diagnosis ; Headache ; Hemianopsia ; Humans ; Lateral Ventricles ; Male ; Paresis ; Parietal Lobe ; Seizures ; Tomography, X-Ray Computed

A 27-year-old female with low back pain and paresthesia on the left lower extremity had been treated. Lumbar myelography showed total block of the dye column at the L3 vertebral body level with a brush border. After myelography, total laminectomy on the L3 and L4 vertebrae was done. The result of operation and biopsy revealed an extradural meningioma of angioblastic type. 9 days after the surgery all neurological deficits were completely recovered.
Adult ; Biopsy ; Female ; Humans ; Laminectomy ; Low Back Pain ; Lower Extremity ; Meningioma* ; Microvilli ; Myelography ; Paresthesia ; Spine

A rare case of primary reticulum cell sarcoma(microglioma) of the brain in a 30-year-old female is reported. The tumor was located in the left parietal lobe. Brain CT scan showed a slightly high attenuated area with well demarcation in the left parietal lobe, and a tumor staining was appeared in the delayed arterial phase of the left carotid angiogram. Osteoplastic craniotomy on the left parietal area was performed for removal of tumor. Then the patient received radiation therapy with a good result.
Adult ; Brain* ; Craniotomy ; Female ; Humans ; Parietal Lobe ; Rabeprazole ; Reticulum* ; Tomography, X-Ray Computed

A case of the tuberous sclerosis, 14-years old boy, was observed. In his father and sister, the cerebral tubers were noted by brain computerized tomography. This disease has been reported occasionally in dermatologic and psychiatric department because of adenoma sebaceum, mental retardation and epilepsy respectively, but it has not been reported at neurosurgical department in Korea. The histopathology of the brain lesion showed atypical cell(tuberous sclerosis cell), gliosis and nonspecific calcification which confirmed the diagnosis of tuberous sclerosis.
Adolescent ; Brain ; Diagnosis ; Epilepsy ; Fathers ; Gliosis ; Humans ; Intellectual Disability ; Korea ; Male ; Sclerosis ; Siblings ; Tuberous Sclerosis*

Fifty four preparations of the cavernous sinus from twenty seven cadavers were studied in detail under microscopic magnification, with special attention to nerves and arteries related to the wall of the sinus. Significant findings were: 1) Three types of relationship between the nerves and arteries in relation to the wall of the sinus were found. Type I: The nerves III, IV and V-1 were embedded in the lateral wall, and the internal carotid artery(I.C.A.) and nerve IV passed through the cavity of the sinus(26 specimens, 48%), Type II: The cavity of the sinus was divided into two compartments by a septum close to the lateral wall, with nerves VI and V-I located within the septum(18 specimens, 33%), Type III: Anatomy was similar to the type I, except that the I.C.A. was included in the medial or lateral wall(10 specimens, 19%). 2) Arterial variations branching from the intracavernous portion of the I.C.A. were classified into four types. Type I: Meningohypophyseal trunk arising from I.C.A.(28 specimens). Type II: Dorsal meningeal artery from I.C.A.(10 specimens). Type III:Tentorial artery from I.C.A.(4 specimens). Type IV: Meningohypophyseal trunk from I.C.A. in addition, the artery of inferior cavernous sinus(12 specimens). 3) The main three brahcnes of the intracavernous portion of the I.C.A. were the meningohypophyseal artery, which was presented presented in 100% of our specimens, the artery of inferior cavernous sinus(78%), and McConnell's capsular artery(43%). Intracavernous origin of the ophthalmic artery were observed in four specimens(8%). 4) The surgical triangle spaces were found to be present in all our specimens, which were formed by the superior margin of it with the lower margin of nerve IV and by the inferior margin with the upper margin of nerve V-I.
Arteries ; Cadaver ; Cavernous Sinus* ; Meningeal Arteries ; Ophthalmic Artery

The authors introduce a extremely rare case of xanthoma in the lateral ventricle which combined with the arachnoid cyst, aneurysm, and osteoma. This 11-year-old girl has been suffered the Rt. Sided motor weakness, the slurred speech and seizures before 1 year. The simple skull AP view showed the elevation of left sphenoidal ridge bulging temporal bone(Lt.), the localized sclerotic margin and centrally osteolytic change in the Lt. frontal bone. Brain computed tomogram revealed a relatively well circumscribed, moderately enhanced mass in the trigone of the left lateral ventricle accompanying with irregular low density in the left temporal lobe. At left carotid angiogram, multiple aneurysm of the Genu of the middle cerebral artery was found without spasm of adjacent vessels. The patient had operation for removal of the tumor, Arachnoid cyst and for wraping of the Aneurysm. The pedunculated reddish white mass was completely removed. The patient had improvement and discharged without another neurologic deficits. The motor mass was the Xanthoma.
Aneurysm* ; Arachnoid* ; Brain ; Child ; Female ; Frontal Bone ; Humans ; Lateral Ventricles ; Middle Cerebral Artery ; Neurologic Manifestations ; Osteoma* ; Seizures ; Skull* ; Spasm ; Temporal Lobe ; Xanthomatosis*