No abstract available.
Brain* ; Nitrogen* ; Oxygen*

Even though the brain has been considered to be an immunologically privileged organ, recent reports showed that certain cells of the brain may be involved in immunological process in the brain. For example, some cells of the brain can present antigen to T-lymphocytes, to express class II major histocompativility antigen, and secrete interleukin-1 and -3 molecules. In addition, they are capable to phagocytose particles and possess receptors for the Fc portion on IgG. In this study, the authors tried to isolate the microglial cells from new born mice and characterize them. The isolated cells could produce such reactive oxygen intermediates(ROIs) an superoxide and hydrogen peroxide that were measured by luminometer after amplification by lucigenin and luminol respectively and could secrete reactive nitrogen intermediates(RNIs), when the cells were incubated with r-IFN plus LPS. The cells could also ingest fluorescent particles and raise intracellular calcium after stimulation with agonists when measured by flow cytometer. Our data showed that the microglial cells of the brain may belong to a member of mononuclear phagocytic system(MPS) of the body that are responsible for the host defence against invading microorganisms.
Animals ; Brain ; Calcium ; Hydrogen Peroxide ; Immunoglobulin G ; Interleukin-1 ; Luminol ; Mice ; Nitrogen ; Oxygen ; Superoxides ; T-Lymphocytes

Septo-optic dysplasia is an uncommon developmental disorder consisting of septum pellucidum angenesis, optic nerve hypoplasia, congenital nystagmus, seizure and multiple endocrine dysfunction. Clinically mild forms of septo-optic dysplasia and syndrome of absent septum pellucidum are now easily detected by computed tomography. We report two cases of septo-optic dysplasia with consistent radiographic findings with the anomaly.
Nystagmus, Congenital ; Optic Nerve ; Seizures ; Septo-Optic Dysplasia* ; Septum Pellucidum

Baclofen, a derivative of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), is used for the treatment of muscle spasm, intractable hiccups and multiple sclerosis. It is mostly excreted by glomerular filtration with a clearance that is proportional to creatinine clearance. Early hemodialysis is a treatment of the choice for baclofen-induced neurologic complication in renal failure patients. We experienced a 57-year-old hemodialysis patient with right arm muscle spasm who developed baclofen-associated encephalopathy by a single dose of oral baclofen (10 mg). He admitted to the hospital with the symptom of stuporous mental status with no specific focal neurologic signs. Brain CT imaging and blood biochemistry showed no specific abnormality. EEG revealed the typical metabolic encephalopathy findings, such as triphasic wave and frontal lobe syndrome with delta wave. After daily hemodialysis for 3 days, there was a complete recovery of an altered mentality. After one month later, the follow-up EEG showed normal finding with the resolution of abnormal waves. We report this case with a review of relevant literature. Baclofen should be used carefully, and rather recommended not to be administered in patients with renal failure.
Arm ; Baclofen ; Biochemistry ; Brain ; Brain Diseases, Metabolic ; Creatinine ; Electroencephalography ; Filtration ; Follow-Up Studies ; Frontal Lobe ; gamma-Aminobutyric Acid ; Hiccup ; Humans ; Middle Aged ; Multiple Sclerosis ; Neurologic Manifestations ; Neurotransmitter Agents ; Renal Dialysis* ; Renal Insufficiency ; Spasm ; Stupor

Baclofen, a derivative of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), is used for the treatment of muscle spasm, intractable hiccups and multiple sclerosis. It is mostly excreted by glomerular filtration with a clearance that is proportional to creatinine clearance. Early hemodialysis is a treatment of the choice for baclofen-induced neurologic complication in renal failure patients. We experienced a 57-year-old hemodialysis patient with right arm muscle spasm who developed baclofen-associated encephalopathy by a single dose of oral baclofen (10 mg). He admitted to the hospital with the symptom of stuporous mental status with no specific focal neurologic signs. Brain CT imaging and blood biochemistry showed no specific abnormality. EEG revealed the typical metabolic encephalopathy findings, such as triphasic wave and frontal lobe syndrome with delta wave. After daily hemodialysis for 3 days, there was a complete recovery of an altered mentality. After one month later, the follow-up EEG showed normal finding with the resolution of abnormal waves. We report this case with a review of relevant literature. Baclofen should be used carefully, and rather recommended not to be administered in patients with renal failure.
Arm ; Baclofen ; Biochemistry ; Brain ; Brain Diseases, Metabolic ; Creatinine ; Electroencephalography ; Filtration ; Follow-Up Studies ; Frontal Lobe ; gamma-Aminobutyric Acid ; Hiccup ; Humans ; Middle Aged ; Multiple Sclerosis ; Neurologic Manifestations ; Neurotransmitter Agents ; Renal Dialysis* ; Renal Insufficiency ; Spasm ; Stupor

OBJECTIVE: Angiogenesis, the proliferation of capillary endothelial cells, is a vital component in the development, progression, and metastasis of many human tumors. Vascular endothelial growth factor(VEGF) is an endothelial cell-specific mitogen and induces angiogenesis and vascular permeability. The features of glioblastoma, distinct from low grade astrocytomas, are the presence of necroses and vascular endothelial proliferation. In this study, we investigated VEGF expression in the different grades of astrocytomas and determined whether VEGF expression correlates with development of glioblastoma and progression of astrocytomas. PATIENTS AND METHODS: Forty seven patients with astrocytic tumors(24 males and 23 females), aged 3 to 65 years, were evaluated. Immunohistochemical staining was carried out using labelled streptavidin biotin method and primary antibody was a antirabbit polyclonal Ab against N-terminus region of VEGF165(Oncogene research product, MA, USA). Immunoreactivity(IR) was classified into no IR(absent or a trace of stain), moderate IR and intense IR by level of staining amount and intensity. RESULTS: Six pilocytic astrocytomas showed 3 no IR and 3 moderate IR, 10 astrocytomas showed 2 no IR, 6 moderate IR and 2 intense IR, 12 anaplastic astrocytomas showed I no IR, 7 moderate IR and 4 intense IR and 19 glioblastomas showed 1 no IR, 11 moderate IR and 7 intense IR. Immunoreactivity was significantly different between low and high grade of tumors but there was no significant difference between anaplastic astrocytomas and glioblastomas. Gemistocytic tumor cells represented the predominent VEGF-immunoreactive cell types, as compared with compactly-arranged small tumor cells. In glioblastomas VEGF IR was observed in both perinecrotic and vital tumor areas. CONCLUSION: VEGF seems to be a important angiogenic factor in anaplastic astrocytomas and glioblastomas and VEGF expression may contribute to neovascularization of human astrocytomas.
Angiogenesis Inducing Agents ; Astrocytoma ; Biotin ; Capillary Permeability ; Endothelial Cells ; Glioblastoma ; Humans ; Male ; Necrosis ; Neoplasm Metastasis ; Streptavidin ; Vascular Endothelial Growth Factor A*

Transcorticamrnotro aphasia is(TMA) a syndrome of nonfluent aphasia with good comprehension and preserved repetition. Language profiles and CT or MRI anatomy in 6 cases of TMA were studied. Their speech was characterized by impaired spontaneous speech and naming with well preserved comprehension and excellent repetition. Most of cases(4/6) had a tendency to repeat everything slavishly, namely echolalia. Perseveration was also common feature(4/6). Four patients showed quick recovery within a few weeks so as to communicate without much difficulty in daily living. The findings on computerized tomography(CT) and magnetic resonance maging(MRI) revealed that the main lesion sites were in the supplementary motor area(SMA) or in the subcortical white matter connecting between SMA and frontal perisylvian zone of Broca's area.
Aphasia ; Aphasia, Broca* ; Comprehension ; Echolalia ; Humans ; Magnetic Resonance Imaging

Combined liver-kidney transplantation has gained increasing popularity and applied for the patient with end-stage liver and kidney disease. There are some controversies about the sequence of transplantation. In general, the liver allograft is temporary placed before the kidney allograft. This method may provide some immunologic advantages that liver allograft may protect concomitantly transplantated kidney from rejection. In our opinion, kidney-liver sequence may provide several benefits in hemodynamic stability, safer monitoring and planned fluid replacement by urine flow assessment. Combined liver-kidney transplantation requires only conventional immunosuppressive drug dosage as in kidney transplantation alone. And combined liver-kidney transplantation can be performed with acceptable morbidity and mortality, and have exellent long term result. We present two cases of combined liver-kidney transplantation performed by kidney- liver sequence for complex end organ failure.
Allografts ; Hemodynamics ; Humans ; Kidney Diseases ; Kidney Transplantation ; Kidney* ; Liver* ; Living Donors* ; Mortality

Spontaneous rupture of the kidney, Wonderlich syndrome, is a rare event but potentially life-threatening condition. The most comman causes are clear cell carcinoma, benign angiomyolipoma and vascular disease. Among this event, acute pyelonephritis is a very unusual cause. A 67-year-old diabetic woman was admitted with high fever and left flank pain due to acute pyelonephritis. She had uterine prolapse for 10 years with both renal hydronephrosis before this event. Abdominal ultrasonography and CT scan showed fluid collection around left kidney with a rupture of renal parenchyme at lower pole. The renal angiography showed displaced capsular artery due to subcapsular hematoma and decreased blood flow at lower pole. The percutaneous needle aspiration revealed blood collection around left kidney, which confirmed spontaneous rupture of the kidney. We report this case with a review of the relevant literature.
Aged ; Angiography ; Angiomyolipoma ; Arteries ; Female ; Fever ; Flank Pain ; Hematoma ; Humans ; Hydronephrosis ; Kidney* ; Needles ; Pyelonephritis* ; Rupture ; Rupture, Spontaneous* ; Tomography, X-Ray Computed ; Ultrasonography ; Uterine Prolapse ; Vascular Diseases

PURPOSE: Although there has been recent progress in surgical techniques, such as perioperative management, immunosuppresive regimen and intervention radiology, a liver retransplantation remains as the only therapeutic option for patients with a failing liver allograft. The purpose of this study was to review our clinical experiences of liver retransplantation, performed at the Asan Medical Center. METHODS: Between August 1992 and March 2001, 400 cases of liver transplantations, including 331 in adults and 69 in pediatrics, were performed. Of the 331 adult cases, 10 cases of liver retransplantation, during the same period, were retrospectively analyzed. RESULTS: In the 331 cases of adult liver transplantation, 232 cases of living donor and 99 of cadaveric liver transplantations were carried out. The 331 adult cases also included 10 liver retransplantations. Therefore, the overall liver retransplantation rate was 3%. Primary non-function (PNF) was the leading cause of retransplantation. The conversion of living donor liver transplantation to a cadaveric liver retransplantation was the most common type of retransplantaion, with a cadaveric to cadaveric type the second most common. The in-hospital mortality was 40%. The causes of in-hospital mortality were hepatic artery pseudoaneurysm rupture, Aspergillus pneumonia, and multiple organ failure, initiated by jejuno-jejunostomy site bleeding and massive hepatic necrosis. CONCLUSION: In the current era of extreme organ shortage, retransplantation is the only therapeutic alternative for irreVersible graft failure, especially if the patient has no multiple organ failure (MOF) prior to the operation. Therefore, the careful selection of patients for a retransplantation is required. They should be given superurgent priority if the circumstances permit, and living donor liver transplantation (LDLT) offer a promising alternative.
Adult ; Allografts ; Aneurysm, False ; Aspergillus ; Cadaver ; Chungcheongnam-do ; Hemorrhage ; Hepatic Artery ; Hospital Mortality ; Humans ; Liver Transplantation ; Liver* ; Living Donors ; Massive Hepatic Necrosis ; Multiple Organ Failure ; Pediatrics ; Pneumonia ; Retrospective Studies ; Rupture ; Transplants