Ependymomas constitute no more than 5 to 7% of all primary CNS neoplasm and their biologic behavior is difficult to predict by microscopic appearances. Recently, many studies have attempted to correlate biologic behavior with tumor proliferation index, tumor suppressor gene and oncogene using immunohistochemical stains. We evaluated 25 cases of surgically resected intracranial ependymomas for the proliferation activity using Ki-67, and expression of p53 and bcl-2 protein with regard to the prognosis. The cases were divided into 17 ependymomas (WHO Grade II), 3 papillary ependymomas (WHO Grade II), and 5 anaplastic ependymomas. Clinically, the patients were divided into two groups, recurrent (18 cases) or non-recurrent (7 cases). The Ki-67 proliferation index was significantly higher in the recurrent group (p<0.05) and in the younger ages (correlation index=0.534). Although Ki-67 proliferation index was higher in anaplastic ependymoma, it was not significant statistically (p>0.05). p53 protein expression tended to increase in the patients who had anaplastic ependymoma and in the recurrent group. bcl-2 expression was not correlated with histologic grade or recurrence of the tumor. We conclude that Ki-67 proliferation index and p53 expression are important markers for predicting biologic behavior of ependymoma.
Coloring Agents ; Ependymoma* ; Genes, Tumor Suppressor ; Humans ; Oncogenes ; Prognosis ; Recurrence

No abstract available.
Pica*

No abstract available.
Isoelectric Focusing* ; Polymorphism, Genetic*

No abstract available.

The deformed and rigid spine presenting moderate to severe kyphosis and scoliosis results in a restriction of function of the lung best characterized spirographically by a reduction in vital capacity. When the lesion involves the thoracic spine, restriction of function is more marked. Spinal deformities such as kyphosis and scoliosis develop from various causes. Tuberculous spondylitis, a main cause of kyphosis and scoliosis, is increasingly found in Korea. Cardiorespiratory dysfunction caused by spinal deformity poses another problem besides the spinal deformity perse. To perform therapeutic measures such as Harrington instrumentation, with or without preoperative localizer cast and halofemoral traction, as well as anterior interbody fusion, evaluation of pulmonary function and arterial gas analysis preoperatively is helpful to prevent and reduce postoperative cardiorespiratory failure or complications. The authors have reviewed the results of arterial gas analyses and pulmonary function tests on 35 cases of scoliosis and 60 cases of kyphosis done at the Department of Orthopedic Surgery, Seoul National University Hospital, from January 1975 to February 1978. The results were as follows: 1. Average degree of scoliosis in 35 cases was 89; vital capacity 60% of normal, and maximum breathing capacity 72%. Average degree of dorsal spine kyphosis in 38 cases was 93.5; vital capacity 38%, and maximum breathing capacity 73% Average degree of lumbar spine kyphosis of 22 cases was 79; vital capacity 77%, and maximum breathing capacity 84%. 2. Static values for pulmonary function such as vital capacity and dynamic values such as maximum breathing capacity hed a significant negative correlation with the severity of scoliosis and kyphosis. 3. Decrease in vital capacity due to scoliosis and kyphosis correlated positively with decrease in maximum breathing capacity. 4. Arterial oxygen saturation had a significant negative correlation with the severity of scoliosis and kyphosis.
Congenital Abnormalities ; Korea ; Kyphosis ; Lung ; Orthopedics ; Oxygen ; Respiration ; Respiratory Function Tests ; Scoliosis ; Seoul ; Spine ; Spondylitis ; Traction ; Vital Capacity

Nesidioblastosis, also known as persistent hyperinsulinemic hypoglycemia of infancy(PHHI) or familial hyperinsulinsm, is the most common cause of recurrent severe hypoglycemia in infancy. It is an autosomal recessive disorder characterized by irregular insulin secretion leading to inappropriately raised plasma insulin concentration compared to blood glucose levels. Recently, mutations in the sulfonylurea receptor(SUR) have been described in association with PHHI. The mainstay of medical treatment is glucose infusion and diazoxide or long acting somatostatin. If medical treatment fails in preventing hypoglycemia, near total pancreatectomy is recommended. We report one case of nesidioblastosis cured by near total pancreatectomy with brief review of literatures.
Blood Glucose ; Congenital Hyperinsulinism* ; Diazoxide ; Glucose ; Humans ; Hypoglycemia ; Infant, Newborn* ; Insulin ; Nesidioblastosis* ; Pancreatectomy ; Plasma ; Somatostatin

No abstract available.
Humans ; Muscle Spasticity*

Diastematomyelia, a form of spinal dysraphism, is characterized by a division of the spinal cord or canda equina resulting the form a bony or cartilaginous spur which transfixes the neural elements and dura. The presence of a structure of neural crest origin in the subarachnoid space connecting the spicules suggested that the anomaly resulted from delayed closure of the neural tube and its investments. The cinical finding are presumed due to its restriction, tethering of the normal apward migration of the spinal cord. Congenital anomalies of one or both lower extremities and spine are frequently found with this condition. The surgical removal is recommended as a prophylactic measure against further progressive neurological damage. The purpose of this paper is to presented becanse it was associated with clubfoot and adds to understanding of teratogenesis of diastematomyelia.
Clubfoot ; Investments ; Lower Extremity ; Neural Crest ; Neural Tube ; Neural Tube Defects ; Spinal Cord ; Spinal Dysraphism ; Spine ; Subarachnoid Space ; Teratogenesis

The authors present 31 patient with acute epidural hematoma who had been admitted from January, 1987 to June. 1989 managed by consevative treatment. The results were as follows ; 1) The age of patients was distributed evenly, most patients were male (26 cases) and the most common mechanism of injury was traffic accidents(14 cases). 2) Sites of hematoma were mostly the temporal and parietal area and the maximum thickness of hematoma was not different from each site. 3) On admission, all patients presented GCS score above 13 except 2 cases. 4) All patients did not undergo delayed up, due to the enlargement of the hematoma or neurological deterioration. 5) The maximum thickness of hematoma was under 20 mm in all patients. 6) The hematoma was resolved within 30 days in all cases. This was confirmed with brain CT scan.
Brain ; Hematoma* ; Humans ; Male ; Rabeprazole ; Tomography, X-Ray Computed

The authors compared the changes of morphology, blood brain barrier alteration, pathology, arterial blood lactate content and cerebrospinal fluid lactate content between an intermittent brain retraction group and a continuous brain retraction group in 56 mongrel cats. The results were as follows ; 1) Microscopically, hemorrhages were punctate in 15 cases among 25 cases in the intermittent retraction group. However, there were multiple or large hemorrhages in 13 cases among the 25 cases in the continuous brain retraction group. 2) All cases of the intermittent retraction group showed 0~25% Evans blue staining of the coronal section crossing the retraction site. However, 8 cases among the 25 cases of the continuous retraction group showed 51~75% Evans blue staining and 4 cases of this group showed 76~100% staining. 3) With photomicroscopy, the authors noted small hemorrhage and cellular swelling in the intermittent retraction group instead of pyknosis, hemorrhagic necrosis, vacuolation in the continuous retraction group. 4) The change of arterial blood lactate content was from 1.22+/-0.24mmol/L at preretraction time to 1.42+/-0.26mmol/L at 90 minutes after release of retractor in the intermittent retraction group(p<0.01). In the continuous retraction group, the authors noted a change in the lactate content from 1.20+/-0.38mmol/L to 3.15+/-0.97mmol/L for the same time as above(p<0.001). 5) The change of CSF lactate content in the intermittent retraction group was from 1.39+/-0.29mmol/L at preretraction time to 1.43+/-0.23mmol/L at 90 minutes after release of retractor(p>0.05). In the continuous retraction group, this author noted change in the lactate content from 1.37+/-0.28mmol/L to 2.11+/-0.52mmol/L for the same time as described above(p<0.01). From the above results, the superiority of the intermittent brain retraction was demonstrated as compared with the continuous brain retraction. Also the possible utilization of this experimental method was discussed for other wxperimental studies on ischemia.
Animals ; Blood-Brain Barrier ; Brain* ; Cats* ; Cerebrospinal Fluid ; Evans Blue ; Hemorrhage ; Ischemia ; Lactic Acid ; Necrosis ; Pathology