The primary malignant melanoma arising in the leptomeninges of the central nervous system is extremely rare. We report a case of malignant melanoma, apparently thought to be originated from leptomeninges, with diffuse neoplastic process widely spreaded over the leptomeninges of 42 years old man, who had suffered severe headache, nausea and left hemiparesis. This patient is free of the symptoms for six months after operation. The literature on this subject is briefly reviewed.
Adult ; Central Nervous System ; Headache ; Humans ; Melanoma* ; Nausea ; Paresis

The thoracic and lumbar spine fractures were usually combined with neurological deficit. But the prognostic factors in degree of neurological damage and process of the recovery are controversial. The purpose of this study is to evaluate the factors affected neurological injury and the recovery. The 31 cases who had been performed surgical interventions due to traumatic thoracic or lumbar spine fractures with the neurological deficits were studied according to the radiographic findings of the spinal columns and neurological changes of the injured cord and/or the roots. The duration of mean follow-up was 32.6 months, and all cases were evaluated by motor index score and Frankel grade. Total cases were divided into complete paralytic (N=8) and partial paralytic(N=23) group. In incomplete paraplegia group, the neurological recovery rate was better than complete group(P < 0.001) and neurological recovery period was shorter than complete group (P=0.005). The neurologic deficits according to the Frankel grade were higher in Chance fracture, flexion-distraction and translation (complete paraplegia: 4/7 cases, 57.1%) than unstable bursting fracture (complete paraplegia: 4/24 cases, 16.7%)(P=0.031). The recovery rate of Chance fracture, flexion-distraction and translation were worse than unstable bursting fracture (0.001). The fracture which occurred in T5-11 showed higher incidence of complete paraplegia(75%) compared with that of the T12-L1(30.8%) & L2-4(7.1%)(p=0.021). The neurological recovery in motor index score in L2-4 was higher than T5-11 or T12-L1(P=0.0017). There was no correlation in kyphotic deformity and anterior body height loss between complete and incomplete paraplegia groups. But the A-P diameter of compromised neural canal showed significant difference between complete and incomplete paraplegia group(P=0.027)
Body Height ; Congenital Abnormalities ; Follow-Up Studies ; Incidence ; Neural Tube ; Neurologic Manifestations ; Paraplegia ; Spine

Until recently almost exclusively clinicochemical urine parameters have been used to determine the risk of urinary stone formation, because the urinary stone disease is considered as one of metabolic disorders. But the morpholgy of renal pelvocalyceal system also affects on the formation of stone particle and its growth, mainly by establishing urinary stasis. We reviewed 163 excretory urograms retrospectively, and pelvocalyceal systems of healthy persons and urinary stone formers were compared with regard to their morphology. In summary of the study, the majority of pelvocalyceal systems of urinary stone formers showed (1) an increased number of papillae; (2) a greater cranial and caudal exlension of pelvocalyceal sysrem:(3) an increased circular radius of the pelvocalyceal system and hence an increased pelvocalyceal system volume ;(4) an increased pelvic area, especially an enlarged total calyx area and hence a larger total area. (5) a higher degree of ramification and a higher number of branches in the calyx groups ; (6) a more sharp angle between the most caudally situated calyx neck and the direction of pelvic outlet :(7) a highly situated origin or the ureter more frequently ;(8) more frequent ampullary patterns of pelvocalyceal system. But the number of major calyx, the total calyx angle and the angle between the direction of pelvic outlet and the main direction of the ureter showed no statistically significant difference between the urinary stone formers and the healthy persons. The results indicate that the study on the morphology of the renal pelvocalyceal system by excretory urography may be used as a screening test to determine the risk of urinary stone formation.
Humans ; Mass Screening ; Neck ; Radius ; Retrospective Studies ; Ureter ; Urinary Calculi* ; Urography*

No abstract available.
Animals ; Brain* ; Rats*

PURPOSE: Thoracic ultrasonography (US) is an emerging tool for diagnosing pneumothorax (PTX), and the possible application of color Doppler to ultrasonography is another new development. The aim of this study is to analyze the possible contribution of color Doppler to thoracic US and to the estimation of pneumothorax volume. METHODS: Patients who were admitted to emergency department underwent chest X-ray and thoracic US with color Doppler. They were also evaluated by computed tomography, if needed, US was performed at four chest sites by emergency medicine faculty and resident, and concordance between color Doppler and lung sliding was analyzed. The number of sites with abnormal findings was correlated with the volume of PTX at each sites. Statistical analysis was performed with Pearson correlation. RESULTS: Sixty-three of 151 PTX cases were included in our study. The sensitivity of US was for PTX detection was 92.1% (58 of 63), and the concordance between color Doppler and lung sliding was 99.4%. The number of sites per patient with abnormal findings increased with the average volume of the PTX. The average PTX volume in the 5 cases with normal findings was 7.0%, which is a smallsized PTX. CONCLUSION: The use of color Doppler is not more accurate than lung sliding, but it may helpful in diagnosing PTX. The volume of a PTX is proportional to a patient's number of sites with abnormal US findings.
Emergency Medicine ; Emergency Service, Hospital ; Humans ; Lung ; Pneumothorax* ; Thorax ; Ultrasonography

Although the obstruction of the right colon is usually handled by primary anastomosis following resection, fear of the increased incidence of septic complication, especially anastomotic leakage with sepsis has turned surgeons away from doing anastomosis in the face of acute obstruction of the left colon. However, from recent reports, enough experiences have been accumulated to show that primary anastomosis is associated with minimum morbidity and mortality in the acute obstruction of the left colon. We experienced 54 cases of colon cancer obstruction at Holy Family Hospital from January 1988 to December 1997. Twenty six cases of them were right colon cancers, 24 cases were left colon cancers and 4 cases were rectal cancers. We reviewed these three groups for evaluation of the safety of one-stage resection and anastomosis of left colon cancer obstruction. The postoperative complication rate was 18% in right colon obstruction versus 38% in left colon obstruction. The most common complication was wound infection(43%). In using of primary resection and anastomosis, complication of right colon revealed 15% and left colon was 29%. But in a method of primary resection and anastomosis with decompression, complication of right colon was 17% and left colon was 13%. Especially on the left colon, primary resection and anastomosis with decompression revealed lower complication(13%) than that without decompression(67%). The mortality of colon cancer obstruction was 2% but this was a patient who had a poor general condition and took a primary resection and anastomosis without decompression. In cases of left colon cancer obstruction primary resection and anastomosis with decompression of left colon cancer obstruction can be a safe operation method with low morbidity and mortality.
Anastomotic Leak ; Colon* ; Colonic Neoplasms* ; Decompression ; Humans ; Incidence ; Mortality ; Postoperative Complications ; Rectal Neoplasms ; Sepsis ; Wounds and Injuries

Malignant melanoma of the urinary bladder is very rare, 7 cases were reported in the literature. The tumor shows early metastasis with poor prognosis. Treatment measures include surgical extirpation, radiotherapy and chemotherapy but the results were bad.Herein, we report a case of malignant melanoma of the urinary bladder in a 45-year-old man which was managed by transurethral resection and combination chemotherapy.
Drug Therapy ; Drug Therapy, Combination ; Humans ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Urinary Bladder

No abstract available.
Laryngectomy*

Cleft Lip ; Congenital Abnormalities ; Humans ; Palate ; Rhinoplasty

The proposed factors that affect the prognosis of osteosarcoma are the patient's age, site and size of the primary lesion, pathologic features(type and grade), duration of symptoms, spread of disease (local or regional extension, distant metastasis) at diagnosis, the patient's sex, serum alkaline phos- phatase(ALP) and lactic dehydrogenase(LDH) levels, chromosomal number or DNA index, response to initial chemotherapy, location of the lesion on the bone, presence or absence of pathologic fracture, and mode of therapy. The purpose of this study is to analyze the factors that affect the 5-year survival rates of osteosarcoma. Total 25 patients were included in this study who had treated form Jan. 1988 to Apr. 1994. The overall 5-year survival rate of 25 patients was 65.43%, and the 5-year survival rates were sig- nificantly higher(P < 0.1) in the groups in which limb salvage operation with neoadjuvant chemothera- py were performed(66.67%), with longer duration of symptoms(>2 months; 83.33%), with lower serum level of LDH( < 300 U/L; 100%), and with smaller mass size( < 10cm; 72.92%). However there were no significant differences in the 5-year survival rates according to age and sex of the patients. We also suggest that the better prognosis will be observed in the patients with the favorable radiologic response to the preoperative chemotherapy.
Diagnosis ; DNA ; Drug Therapy ; Fractures, Spontaneous ; Humans ; Limb Salvage ; Osteosarcoma ; Prognosis ; Survival Rate