The secretary meningioma is a distinct variant of meningioma that revealed characteristic light microscopic, immunohistochemical and ultrastructural features of epithelial and secretary differentiation, which was named as a distinct subtype of meningioma by Alguacil-Garcia et al in 1986. We experienced 2 cases of secretary meningioma. One was a 53-year-old female who had suffered from sudden onset of dizziness for I day. The computerized tomography revealed a sharply marginated well enhanced mass in temporal lobe. The other was a 59-year-old female who had suffered from dizziness for 8 years. The computerized tomography revealed a well demarcated lobulated mass in petrosal ridge. In both cases, multiple hyaline inclusions were scattered in the background of meningothelial meningioma. They were PAS positive, diastase resistant, stained yellow with van Gieson, and did not stain with reticulin in contrast to Psammoma bodies. The immunohistochemistry revealed positive reaction for EMA, CEA, a-FP and cytokeratin. T'he electron microscopic study revealed interdigitation with desmosomes and abundant intracellular lumina. They were lined by numerous microvilli and filled with granular material which was composed of electron dense homogenous material, me branous material, and small membrane-bound vesicles. Microvilli were filled with electron dense material identical to the material in the lumina, and some of them were interconnected with electron dense material in the lumina. It was concluded that secretary activity of the meningothelial cells and degenerated microvilli were involved in the pathogenesis of hyaline inclusions.
Female ; Humans ; Meningioma

No abstract available.
Meconium*

BACKGROUND: CSF can be leaked from the nose or ear due to fractures, tumors or surgical procedures in the skull base region, and the threat of impending meningitis necessitates early identification of it. Since 2-transferrin occurs practically in cerebrospinal fluid (CSF) and not in other body fluid, its detection from the rhinorrhea or otorrhea can be used for the diagnosis of CSF leakage. We carried out immunofixation-silver stain (IF-SS) method for detection of 2-transferrin in the CSF in order to know optimal identification condition of specific cerebrogenic marker. METHODS: The fresh CSF sample was collected by spinal tapping. 2-Transferrin was estimated by quantifying the total transferrin by nephelomertry (Behring, Germany). 2-Transferrin of CSF was identified by electrophoresis using Titan gel high resolution protein system (Beckman, USA), immunofixation with anti-human transferrin antibody (Dako, Denmark) and then stained with silver nitrate. Serial dilutions of CSF were performed to know the detection limit of 2-transferrin. To know the influence of blood mixing, tests for mixed specimen of serum and hemolysate in CSF were performed. To evaluate the specimen storage condition, tests for different temperature and storage time were performed . RESULTS: By IF-SS method, identification limit of 2-transferrin was 0.5 mg/dL in 1:4 diluted CSF with distilled water. And 2-transferrin could be detected in condition of mixing serum protein (7.5 g/dL) or hemoglobin (13 g/dL) with CSF up to 6 : 4. At various sample storage condition, such as 37degrees C, room temperature, and 4degrees C, band intensity decreased abruptly after 1 day, and it was not detected 5 days later. Mean while, in -20degrees C and -70degrees C, 2-transferin band was detected after 10 days. CONCLUSIONS: IF-SS method was sufficiently sensitive and specific for invalidation by blood contamination, and seems to be used as effective identification of 2-transferrin in the CSF without sample concentration, less diagnostic test for CSF leakage.
Body Fluids ; Cerebrospinal Fluid* ; Diagnosis* ; Diagnostic Tests, Routine ; Ear ; Electrophoresis ; Limit of Detection ; Meningitis ; Nose ; Saturn ; Silver Nitrate ; Skull Base ; Spinal Puncture ; Transferrin* ; Water

This study investigated whether propofol, an intravenous, non-barbiturate anesthetic, could reduce brain damage following global forebrain ischemia. Transient global ischemia was induced in gerbils by occlusion of bilateral carotid arteries for 3 min. Propofol (50 mg/kg) was administered intraperitoneally 30 min before, immediately after, and at 1 h, 2 h, 6 h after occlusion. Thereafter, propofol was administered twice daily for three days. Treated animals were processed in parallel with ischemic animals receiving 10% intralipid as a vehicle or with sham-operated controls. In histologic findings, counts of viable neurons were made in the pyramidal cell layer of the hippocampal CA1 area 4 days after ischemia. The number of viable neurons in the pyramidal cell layer of CA1 area was similar in animals treated with a vehicle or a subanesthetic dose of propofol. In terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end-labeling (TUNEL) assay, semiquantitative analysis of dark-brown neuronal cells was made in the hippocampal CA1 area. There was no significant difference in the degree of TUNEL staining in the hippocampal CA1 area between vehicle-treated and propofol-treated animals. These results show that subanesthetic dose of propofol does not reduce delayed neuronal cell death following transient global ischemia in Mongolian gerbils.
Animals ; Brain ; Carotid Arteries ; Cell Death ; DNA Nucleotidylexotransferase ; Gerbillinae* ; In Situ Nick-End Labeling ; Ischemia* ; Neurons* ; Propofol* ; Prosencephalon* ; Pyramidal Cells

No abstract available.
Radiosurgery* ; Trigeminal Neuralgia*

Unilateral adsence of a pulmonary artery is frequently undiagnosed. Unless this entity is recognized, a patient with a potentially curable lesion may become inoperable. The importance of considering unilateral absence of a pulmonary artery in the diffirential diagnosis of cyanotic congenital heart disease and pulmonary hypertension has become clear. We exeperienced a case of congenital isolated unilateral absence of it. pulmonary artery confirmed by clinical features, lung scan, echocardiogram and angiogram.
Diagnosis ; Heart Defects, Congenital ; Humans ; Hypertension, Pulmonary ; Lung ; Pulmonary Artery*

Arteriovenous malformation (AVM) of the scrotum is a rare vascular lesion, which is distinguished histologically by ambiguous vessels displaying both arterial and venous characteristics and abnormal muscularization of variable sized ectatic vessels. Complete excision is recommended as a definitive treatment. Here, a case of arteriovenous malformation involving the scrotal vessels is reported.
Arteriovenous Malformations* ; Scrotum

No abstract available.
R Factors* ; Shigella*

BACKGROUND: Delayed treatment of acute bacterial meningitis often causes death or serious neurological defects. Rapid and accurate diagnosis is very important for effective treatment. Although the Gram stain and latex agglutination test for major causative bacteria, Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus agalactiae, are useful for early detection of acute bacterial meningitis, their sensitivity is not satisfactory. In this study, we purpose to develop a PCR strategy for the simultaneous detection of N. meningitidis, H. influenzae, S. pneumoniae and S. agalactiae. METHODS: Primers were designed from the 16S rRNA genes of N. meningitidis, H. influenzae, S. pneumoniae and S. agalactiae, which were constituted with 3 senses and 5 antisenses, and 7 primer pairs. The PCR assay was divided into two steps, the first PCR resulted in a general bacterial amplicon with universal primers, and the second were performed with species specific primer pairs in four combination reaction tubes. PCR sensitivity and specificity were tested to clinical isolates of 4 N. meningitidis, 3 H. influenzae, 14 S. pneumoniae, 6 S. agalactiae, 14 Staphylococcus epidermidis, and 25 reference strains of different species. RESULTS: The species specific primer pairs showed specific DNA amplification to all clinical isolates tested. All 25 reference strains of different species and S. epidermidis were distinguished from N. meningitidis, H. influenzae, S. pneumoniae and S. agalactiae except for Pseudomonas aeruginosa, Neisseria and Candida species, The PCR detection limit for S. agalactiae was 200 CFU. CONCLUSIONS: The seminested PCR using bacterial 16S rRNA gene was sensitive and specific for the detection of Neisseria species, H. influenzae, S. pneumoniae and S. agalactiae. This results warranted the application of this method to cerebrospinal fluids to diagnose bacterial meningitis.
Bacteria ; Candida ; Cerebrospinal Fluid ; Diagnosis ; DNA ; Genes, rRNA* ; Haemophilus influenzae* ; Haemophilus* ; Influenza, Human ; Latex Fixation Tests ; Limit of Detection ; Meningitis, Bacterial ; Neisseria meningitidis* ; Neisseria* ; Pneumonia ; Polymerase Chain Reaction ; Pseudomonas aeruginosa ; Sensitivity and Specificity ; Staphylococcus epidermidis ; Streptococcus agalactiae* ; Streptococcus pneumoniae* ; Streptococcus*

OBJECTIVE: The purpose of this study is to identify risk factors related to the fusion failure after halo-vest immobilization of odontoid fracture type III. METHODS: We retrospectively analyzed ten patients who underwent halo-vest immobilization for acute traumatic odontoid fracture between October 2002 and December 2011. All patients had type III odontoid fracture using the Anderson and D'Alonzo classification. We reviewed digital radiographs and analyzed the images during conservative treatment with halo-vest immobilization. RESULTS: The patients consisted of nine men and one woman, with mean age of 40.2 years (range: 25-56), who had no history of medical comorbidity and significant neurologic deficit. The mean follow-up period was 6 months (range: 4-11). All patients were initially treated by halo-vest immobilization. Seven patients showed union of fractured site on radiologic findings after halo-vest immobilization only. However, other 3 patients underwent surgery for fixation due to fusion failure. Among the factors we analyzed such as, radiographic characteristics and clinical feature, presence of comminuted fracture, instability of fractured fragment and failed reduction of misalignment were the factors related to fusion failure. CONCLUSION: The fusion rate of halo-vest immobilization of odontoid fracture type III seem to be incomplete, but clinical decision using the risk factors such as comminution, instability of fractured fragment and failed reduction of misalignment improves the outcome with conservative management.
Comorbidity ; External Fixators ; Female ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Ununited ; Humans ; Immobilization ; Male ; Neurologic Manifestations ; Odontoid Process ; Retrospective Studies ; Risk Factors ; Spinal Fractures