Granulocytic sarcoma is an uncommon extramedullary localized tumor composed of granulocytic precursor cells. The majority of cases have been reported in association with acute myeloid leukemia(AML) especially in children, but infrequently may occur in patients with myeloproliferative disorders or myelodysplastic syndromes. Most common sites of involvement were bone, soft tissue, lymph nodes and skin, but gastrointestinal tract, testis, central nervous system are also involved rarely. We present an unusual case of granulocytic sarcoma of the intracranium and the retro-orbital soft tissue occurring in a patient with concurrent myelodysplastic syndrome, diagnosed by brain magnetic resonance images and ultrasound guided needle biopsy.
Biopsy, Needle ; Brain ; Central Nervous System ; Child ; Gastrointestinal Tract ; Granulocyte Precursor Cells ; Humans ; Lymph Nodes ; Myelodysplastic Syndromes* ; Myeloproliferative Disorders ; Sarcoma, Myeloid* ; Skin ; Testis ; Ultrasonography

The choroid plexus papillomas are uncommon neoplasms of the central nervous system, and constitute 0.5~0.6 percent of intracranial tumors. These tumor are surgically treatable and the encouraging results of surgical removal justify an aggeressive surgical approach. We present a case of lateral ventricle choroid plexus papilloma in a child with communicating hydrocephalus.
Central Nervous System ; Child* ; Choroid Plexus* ; Choroid* ; Humans ; Hydrocephalus ; Lateral Ventricles* ; Papilloma, Choroid Plexus*

Preoperative assessment of electrocardiographical(EKG) abnormalities in the patients with subarachnoid hemorrhage(SAH) is importment. Authors analyzed 58 SAH patients who had EKG abnormalities of neurogenic origin. EKG abnormalities consisted of T wave abnormality, arrhythmia, ST segment change, QT prolongation and U wave. Five patients were dead in this study because of brain swelling(3 cases) and cerebral spasm(2 cases). EKG abnormalities were normalized 13 days after aneurysmal SAH. Radioactive nuclear(99mTc-pyrophosphate) scan of myocardial revealed normal findings in the patients with EKG abnormalities of neurogenic origin. It is concluded that life-saving surgical intervention need not be delayed in the patients with EKG abnormalities of neurogenic origin. On the other hand, patients who had cardiac origin EKG abnormalities need a careful and detailed preanesthetic cardiac evaluation.
Aneurysm* ; Arrhythmias, Cardiac ; Brain ; Electrocardiography* ; Hand ; Humans ; Subarachnoid Hemorrhage

Tooth is formed by the reciprocal interactions between the ectoderm and ectomesenchyme derived from neural crest. It has not been clear that neuronal factors involved in the morphogenesis and differentiation of tooth. To identify the roles of neuronal factors during the tooth development, the expression patterns and localization of Uchl1 were investigated in the developing mouse tooth germ by in situ hybridization and immunohistochemistry. Uchl1 transcripts were weakly expressed in the oral epithelium and dental lamina at bud stage. However, expression of Uchl1 was not found in the oral epithelium from cap stage and observed in the inner enamel epithelium, stellate reticulum and dental papilla. From the bell stage, Uchl1 was expressed in the inner enamel epithelium and ameloblasts. Uchl1, was appeared to be localized in the inner enamel epithelium and differentiating ameloblasts of molar and incisors at neonates. Uchl1 was localized strongly in the fully differentiated ameloblasts and adjacent papillary layer whereas localized weakly in the odontoblasts of the molar at postnatal day 5. From these results, Uchl1 was expressed and localized in the differentiating dental epithelium and ameloblasts during tooth development. The results suggest that neuronal protein, Uchl1 may play roles in the histo- and cyto-differentiation of non-neuronal dental epithelium.
Ameloblasts ; Animals ; Dental Enamel ; Dental Papilla ; Ectoderm ; Epithelium* ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Incisor ; Infant, Newborn ; Mice* ; Molar ; Morphogenesis ; Neural Crest ; Neurons ; Odontoblasts ; Reticulum ; Tooth Germ ; Tooth*

PURPOSE: To evaluate the effect of vitrectomy in IOL power calculation for cataract surgery in the eyes that previously performed vitrectomy. METHODS: This study comprised 41 eyes of 37consecutive patients who underwent cataract surgery after previous vitrectomy. IOL power calculation with the measurement of axial length and corneal power was conducted before vitrectomy and before cataract surgery. Target refractions at each surgery, assuming that the same power of IOL was implanted, were compared to actual manifest refraction after cataract surgery. RESULTS: There was no statistically significant change in both axial length and corneal power after vitrectomy (p>0.05). Before vitrectomy, target refraction was -0.22+/-0.61D compared to -0.37+/-0.52D before cataract surgery. The actual refraction after cataract surgery was -0.47+/-0.94D, and there were no significant differences among the three refractions (p>0.05). CONCLUSIONS: In the eyes that underwent vitrectomy, vitrectomy itself does not have an influence on calculating IOL power for cataract surgery.
Cataract ; Eye ; Humans ; Refractive Errors ; Vitrectomy

The development and differentiation of cells in the spinal ganglion were studied by electron microscopy in human fetuses ranging from 12 mm to 260 mm crown rump length. At 12 mm embryo the primitive neuroblasts which had a single process, contained a large numbers of free ribosome and mitochondria but very little rough endoplasmic reticulum. At 30 mm fetus, the primitive spinal ganglion consisted of bipolar neuroblasts, satellite cells and undifferentiated cells. Spindle-shaped bipolar neuroblasts formed spinal ganglion of loosely grouped cells at 50 mm fetus. Two neuroblast cell types, a small cell contained large clumps of rough endoplasmic reticulum at periphery, could be distinguished. At 80 mm fetus, the spinal ganglion constituted of bipolar neuroblast with apparently random distribution of small and large neurons with processes, together with satellite cells and blood vessels. The presences of a large numbers of neurotubules in the Golgi-central region were one of the first sign of further maturation of the neuroblast. During next prenatal stage from 120 mm on fetus, the ganglion cells were large and contained much rough endoplasmic reticulum, neurotubules and extensive Golgi complex. A large number of neuroblasts became transformed into unipolar cells from 180 mm to 260 mm feuts. Nissl bodies appeared during this stage. The ganglion-satellite cell boundary became complicated with increasing age, then enlarging in parallel with the increase in volume of the nerve cell. During next prenatal stage up to 180 mm fetus, the unipolar ganglion cell increased in number and size, and the cytoplsm contained all intracytoplasmic structures which were also found in mature spinal ganglion except for large pigment granules.
Blood Vessels ; Crown-Rump Length ; Embryonic Structures ; Endoplasmic Reticulum, Rough ; Fetus* ; Ganglia, Spinal* ; Ganglion Cysts ; Golgi Apparatus ; Humans* ; Microscopy, Electron ; Mitochondria ; Neurons ; Nissl Bodies ; Ribosomes

Urinary obstructions from ureteral calculi are one of the causes of postrenal acute kidney injury (AKI). Here we present a case of AKI caused by a 4 mm ureteral calculus with postobstructive diuresis following the spontaneous passage of the calculus. A 13-year-old girl who underwent nephrectomy for the removal of a neuroblastoma eight years previously, visited our institution because anuria had developed over the preceding five days. The serum creatinine level was elevated at 13.4 mg/dL. Radiological examinations showed the right solitary kidney with moderate hydronephrosis and a 4 mm calculus in the upper right ureter. The patient immediately underwent hemodialysis. After the ureteral calculus was passed spontaneously on day 2 of hospitalization, urinary output increased to more than 5,200 mL per day. Intravenous fluid replacement with careful monitoring of weight, intake, output, and serum and urine electrolytes was performed. On day 5 of hospitalization, the patient's condition stabilized.
Acute Kidney Injury* ; Adolescent ; Anuria ; Calculi ; Creatinine ; Diuresis* ; Electrolytes ; Female ; Hospitalization ; Humans ; Hydronephrosis ; Kidney ; Nephrectomy ; Neuroblastoma ; Polyuria ; Renal Dialysis ; Ureter ; Ureteral Calculi ; Urinary Calculi*

A quantitative assessment of the density of the protein gene product 9.5 (PGP9.5), the neural cell adhesion molecule (NCAM), and the low-affinity nerve growth factor receptor (NGFR) expressing nerve fibers in the circular muscle layer in the colon was carried out by morphometric analyses from 13 patients with Hirschsprung's disease (HD). The difference in the nerve fiber density between the ganglionic and aganglionic segments was compared by calculating the ratio of the sum of the areas occupied by positively stained nerve fibers per unit area of the muscle after immunohistochemical staining on paraffin embedded tissue sections using computer software. There was an obvious difference in the density of the PGP9.5 stained nerve fibers between the ganglionic (0.0380 +/- 0.0171) and aganglionic segments (0.0143 +/- 0.01661). The NCAM-positive nerve fibers were fewer in number than those of both the PGP9.5-positive fibers and NCAM-positive fibers, which were also markedly lower in number in the aganglionic segment (0.0066 +/- 0.0076) than in the ganglionic segment (0.0230 +/- 0.0195). Immunostaining for low-affinity NGFR revealed much fainter staining in the ganglionic and aganglionic segment without a statistically significant difference in their density. Considering the fact that PGP9.5 is a very sensitive marker for nerve fibers, the results of this study reaffirm the innervation failure of the proper muscle in HD. The decreased NCAM expression level in the aganglionic segment appears to be caused not by the selective down-regulation of NCAM expression among the nerve fibers but by a markedly reduced number of nerve fibers.
Colon/*innervation ; Hirschsprung Disease/*pathology ; Human ; Muscle, Smooth/*innervation ; Nerve Fibers/*chemistry/pathology ; Neural Cell Adhesion Molecules/*analysis ; Receptor, Nerve Growth Factor/analysis ; Thiolester Hydrolases/*analysis

Recently anterior spinal device in the treatment of the unstable thoraco-lumbar spine has been used. We have experienced 11 patients of the unstable thoraco-lumbar spine, which were composed of 8 patients with burst fracture and 3 patients with tuberculous spondylitis. The 11 patients with neurological deficit were treated with an one stage anterior operation consisting of anterior decompression through vertebrectomy, realignment with Kanedae device. No patient showed neurologic deterioration after surgery. The anterior spinal instrumentation with Kaneda device afford enough stability to enable early ambulation with good alignment and solid fusion.
Decompression ; Early Ambulation ; Humans ; Spine ; Spondylitis

Recent studies in man and animal models have demonstrated that TCR-gamma delta-bearing T cells (gamma delta T cells) are activated by mycobacteria and accumulate in the sites of mycobacterial infection. Although the function of gamma delta T cells remains unclear, some data suggest a potential role for these cells in the granulomatous immune response. To address the presence of gamma delta T cells within the BCG granulomas, we have characterized the TCR phenotype of T-lymphocytes present in the BCG granulomatous lesion immunohistochemically using a monoclonal antibody to TCR delta 1 and others. Fairly large numbers of gamma delta T cells were located at the periphery of the BCG granulomas without necrosis and most of them also expressed CD8. However, gamma delta T cells were rarely present in the granulomas with central caseous necrosis, calcification and fibrotic changes. With these results, it might be speculated that the CD8+ gamma delta T lymphocytes participate in the BCG granuloma formation mainly in the early stage.
Female ; Granuloma/immunology/*pathology ; Human ; Infant ; Lymph Nodes/pathology ; Male ; *Mycobacterium bovis ; Receptors, Antigen, T-Cell, gamma-delta/*analysis ; T-Lymphocytes/*immunology ; Tuberculosis/immunology/*pathology