No abstract available.
Proteinuria*

MR finding of melanoma shows peculiar signal intensity based on paramagnetic effect of melanin or intratumoral hemorrhage, which displays decreased T1 and T2 relaxation times in many cases. Authors report MR findings in two cases of intracranial metastatic melanoma, which is pathologically confirmed by operation.
Hemorrhage ; Magnetic Resonance Imaging* ; Melanins ; Melanoma* ; Relaxation

Multiple cerebral infarction developed in a 36-year-old woman with adenocarcinoma of the right lung with direct cardiac invasion. Neurological examination and brain MRI showed findings of ordinary infarction. Transesophageal echocardiography showed left atrial pedunculated mass which was the potential source of embolism. We report a rare case who had such multiple spontaneous tumor emboli large enough to result in clinically detectable cerebral infarction.
Adenocarcinoma ; Adult ; Brain ; Cerebral Infarction* ; Echocardiography, Transesophageal ; Embolism ; Female ; Humans ; Infarction ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Neoplastic Cells, Circulating ; Neurologic Examination

Primary pulmonary hypertension is a rar, incurable, and progressive clinical entity. When associated with pregnancy, the prognosis of primary pulmonary hypertension is worsened with maternal mortality rates of at least 50%. The patient was a 29-year-old mother in her 2nd pregnancy, with previous uncomplicated gestation, 5 years ago. She had been well until the 28th week of present gestation when she was admitted because of increasing dyspnea on exertion. She was a housewife with no remarkable family and past histories. We have experienced a patient with primary pulmonary hypertension in pregnancy. She was treated with an oral calcium-channel blocker and low-molecular-weight heparin and was delivered vaginally with good maternal and fetal outcome. So we report a case of primary pulmonary hypertension associated with pregnancy and review literature.
Adult ; Dyspnea ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary* ; Maternal Mortality ; Mothers ; Pregnancy* ; Prognosis

The purpose of this study was to prove the relationship between arthrographic and clinical features in temporomadibular joint disorders. In order to carry out this study, ninety-eight arthrographic examinations of temporomandibular joints were performed in eighty-two patients who had the temporomandibular joint disorders. As the arthrographic examination, the cases were classfied in three groups, disk displacement with reduction, disk displacement without reduction, within normal limit. After this, the cases were clinically exanmined, and the results were compared and analyzed in each other group. The obtained results were as follows ; 1. As the classification by arthrographic examination, three groups (disc displacement with reduction, disc displacement without reduction, within normal limit) were 41%, 54%, 5% of total cases in this study, respectively. 2. The third decade(65%) was most frequent in this study. The average age of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 24, 28, 21, and disc displacement without reduction group was higher than any other group. 3. In the chief complaint, pain was the most frequent in all three groups. Joint sound was also frequent in disc displacement with reduction group, but in disc displacement without reduction group, limitation of mouth openimg was more frequent. 4. Of the various pain, the movement pain was most frequent(61%) in this study. In joint sound, click(63%) was the most frequent in disc displacement with reduction group, but sound history(42%) and no sound(31%) were more frequent in disc displacement without reduction group. 5. The average maximum opening of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 44mm, 32.9mm, 44mm, and disc displacement without reduction group was less than any other group. 6. The masticatory disturbance of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 53%, 79%, 40%, and the trauma history of each group was 50%, 40%, 60%.
Arthrography* ; Classification ; Humans ; Joints ; Mouth ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*

BACKGROUND: Acute normovolemic hemodilution (ANH) is known as the easieat and most economical and the quality of autologous blood saved by it is the best of all methods of autotransfusion. To investigate the efficacy of ANH, we studied whether it could reduce the transfusion requirement in spinal surgery. METHODS: Forty patients were randomly divided into 2 groups. In the hemodilution group (n=20), 2 or 3 units of autologous blood were procured immediately before or after anesthetic induction while Ringer's lactate and pentastarch were infused to maintain normovolemia. All patients received deliberate hypotension induced by labetalol. Perioperative changes of hemoglobin, hematocrit and platelets, the transfusion requirement and the amount of postoperative drainage were compared between each group. RESULTS: Perioperative changes of hemoglobin, hematocrit and platelet showed no significant differences between each group. Less packed RBC were used in the hemodilution group (1.9 2.0 units) than in control group (5.9 6.8 units) (p<0.05). In the control group, 4 patients were transfused with fresh frozen plasma (mean 4.8 units), 3 patients with platelets (mean 13 units) and 1 patient with cryoprecipitate (10 units) while only one patient was transfused with 3 units of fresh frozen plasma in the hemodilution group. Postoperative drainage was significantly less in the hemodilution group (1,494 488 ml) than in the control group (2,476 1,730 ml). CONCLUSION: ANH seems to decrease the transfusion requirement in spinal surgery. Reduction of postoperative wound drainage appears to play an important role in that.
Blood Platelets ; Blood Transfusion, Autologous ; Drainage ; Hematocrit ; Hemodilution* ; Humans ; Hydroxyethyl Starch Derivatives ; Hypotension ; Labetalol ; Lactic Acid ; Plasma ; Wounds and Injuries

The purpose of this study was to aid in the prediction of tumor cell tolerance to radiotherapy and/or chemotherapy. For this study, cell surviving curves were obtained for human epidermoid carcinoma A-253 cell line using semiautomated MTT assay. 2, 4, 6, 8, 10 Gy were irradiated at a dose rate of 210 cGy/min using 60Co Irradiator ALDORADO 8. After irradiation, A-253 cell lines(2x10(4) cells/ml) were exposed to bleomycin or cisplatin for 1 hour. The viable cells were determined for each radiation dose with/without 2 ug/ml of drug at the 3rd day. And they were compared to control values. The results were obtained as follows: 1. The surviving curve with gentle slope was obtained after irradiation of 2, 4, 6, 8, 10 Gy on A-253 cell line. 2. The cytotoxicity of bleomycin or cisplatin at the concentration of 2 ug/ml was great on A-253 cell line. But, there was no significant difference between the cytotoxicity of bleomycin and that of cisplatin. 3. There were significant differences of surviving fractions after irradiation with 2 ug/ml of bleomycin compared with irradiation only on A-253 cell line. 4. There were significant differences of surviving fractions after irradiation with 2 ug/ml of cisplatin compared with irradiation only on A-253 cell line. 5. There were no significant differences of surviving fractions between the groups of irradiation with bleomycin and the groups of irradiation with cisplatin on A-253 cell line.
Bleomycin ; Carcinoma, Squamous Cell ; Cell Line* ; Cisplatin ; Drug Therapy ; Humans ; Radiation Tolerance* ; Radiotherapy

PURPOSE: To observe the histologic changes and clusterin expression in the acinar cells of the submandibular gland in streptozotocin-induced diabetic rat following irradiation. MATERIALS AND METHODS: Mature Sprague-Dawley rats were divided into three groups: control, diabetic, and diabetic-irradiated groups. Diabetes mellitus was induced in the Sprague-Dawley rats by injecting streptozotocin, while the control rats were injected with citrate buffer only. After 5 days, rats in diabetic-irradiated group were irradiated with single absorbed dose of 10 Gy to the head and neck region. The rats were killed at 1, 3, 7, 14, 21, and 28 days after irradiation. The specimen including the submandibular gland were sectioned and observed using histologic and immunohistochemical methods. RESULTS: Morphologic change of acinar cells was remarkable in the diabetic group, but was not observed in the diabetic-irradiated group. Necrotic tissues were observed in the diabetic-irradiated group. Coloring of toluidine blue stain was most increased at 14 days in the diabetic group, however there were no significant change throughout the period of the experiment in the diabetic-irradiated group. Expression of clusterin was most significant at 14 days in the diabetic group, but gradually decreased with time after 7 days in the diabetic-irradiated group. Degeneration of clusterin was observed in the diabetic-irradiated group. CONCLUSION: This experiment suggests that the acinar cells of submandibular gland in rats are physiologically apoptosed by the induction of diabetes, but that the apoptosis is inhibited and the acinar cells necrotized after irradiation.
Acinar Cells* ; Animals ; Apoptosis ; Citric Acid ; Clusterin ; Cranial Irradiation ; Diabetes Mellitus ; Head ; Neck ; Rats* ; Rats, Sprague-Dawley ; Salivary Glands ; Streptozocin ; Submandibular Gland* ; Tolonium Chloride

Objective: : Gamma Knife radiosurgery (GKRS) is an effective and noninvasive treatment for high-risk arteriovenous malformations (AVMs). Since differences in GKRS outcomes by nidus type are unknown, this study evaluated GKRS feasibility and safety in patients with brain AVMs. Methods: : This single-center retrospective study included patients with AVM who underwent GKRS between 2008 and 2021. Patients were divided into compact- and diffuse-type groups according to nidus characteristics. We excluded patients who performed GKRS and did not follow-up evaluation with magnetic resonance imaging or digital subtraction angiography within 36 months from the study. We used univariate and multivariate analyses to characterize associations of nidus type with obliteration rate and GKRS-related complications. Results: : We enrolled 154 patients (mean age, 32.14±17.17 years; mean post-GKRS follow-up, 52.10±33.67 months) of whom 131 (85.1%) had compact- and 23 (14.9%) diffuse-type nidus AVMs. Of all AVMs, 89 (57.8%) were unruptured, and 65 (42.2%) had ruptured. The mean Spetzler-Martin AVM grades were 2.03±0.95 and 3.39±1.23 for the compact- and diffuse-type groups, respectively (p<0.001). During the follow-up period, AVM-related hemorrhages occurred in four individuals (2.6%), three of whom had compact nidi. Substantial radiation-induced changes and cyst formation were observed in 21 (13.6%) and one patient (0.6%), respectively. The AVM complete obliteration rate was 46.1% across both groups. Post-GKRS complication and complete obliteration rates were not significantly different between nidus types. For diffuse-type nidus AVMs, larger AVM size and volume (p<0.001), lower radiation dose (p<0.001), eloquent area location (p=0.015), and higher Spetzler-Martin grade (p<0.001) were observed. Conclusion : GKRS is a safe and feasible treatment for brain AVMs characterized by both diffuse- and compact-type nidi.

Functional paraganglioma of the mediastinum is an uncommon tumor of the paraganglion system that causes symptoms and signs of episodic catecholamine release. It has not been reported in Korea. We experienced a case of a 17 years old man with a history of diaphoresis and paroxysmal hypertension refractory to therapy since 14 years old. Urinary execretion of catecholamine and its metabolites were elevated. Computed tomography(CT) scan revealed high density mass located on the posterior mediastinum in the area of the right fifth intercostal space. At thoracotomy, a 3X3X4cm sized lesion was resected and confirmed as a paraganglioma.
Adolescent ; Humans ; Hypertension* ; Korea ; Mediastinum* ; Paraganglioma* ; Pheochromocytoma ; Thoracotomy