The authors carried out various treatment modalities in 74 consecutive patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage and were admitted to the Department of Neurosurgery. Konkuk University Hospital, from Jan. 1991 to Dec. 1993. A variety of prognostic factors that influence mortality were observed. The locaton of hematoma was at the basal ganglia in 47 cases and at the thalamus in 27 cases. The prognosis gets poorer as the hematoma extended wider and deeper. The prognosis was unfavorable when the hematoma was over 30cc(P<0.001). The mortality rate was higher in cases with IVH than in cases without IVH(P<0.005). In cases with IVH, 19 cases(26%) showed dilated 4th ventricular hemorrage and higher mortality rate(P<0.001). Cases in which the GCS were less than 9 on admission showed higher mortality rate(P<0.0001). The mortality rate was also higher if the midline shift was more than 10mm on the initial brain CT scan(P<0.005). THe group where the unilateral or bilateral pupillary light reflex was unreactive(35cases) showed poorer prognosis than the group where the bilateral pupillary light reflex was reactive(P<0.0001). The ventriculocranial ratio(VCR), hydrocephalus, surrounding edema edema around the heamtoam, and treatment modality were not related to the prognosis. The significant prognostic factors in patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage were location and type of hematoma, whether or not the volume of hematoma is more than 30cc, IVH, dilated 4th ventricular hemorrhage, Graeb's score of more than 7, GCS of less than 9, midline shift of more than 10mm, and reactivity of pupillary light reflex.
Basal Ganglia ; Brain ; Cerebral Hemorrhage* ; Edema ; Ganglion Cysts* ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Prognosis ; Reflex ; Thalamus

PURPOSE: As neoplasia is the result of unbalanced cell growth and cell death, alternations in the growth control pathway including the immunity within the individual host-tumor relationship has been attributed to the development of breast cancer. Interferon(IFN)-gamma based immunity was recently reported to have an antitumor effect and some new methods to assess the state of interferon-gamma based immunity have been introduced. Interferon regulatory factor(IRF)-1 and interferon regulatory factor(IRF)-2 are transcriptional factors that mediate the effects of Interferon-gamma. It was suggested that the loss of IRF-1 expression is associated with the loss of tumor suppression and the development of IRF-2 expression is associated with oncogenic activation. Thus, we studied the significances of the IRF-1 and IRF-2 expressions as they are related with some clinicopathological parameters to determine the biological behavior of breast cancer including the menopausal status, tumor size, lymph node status, histologic grade, the expression of steroid receptors, the expression of c-erb B2 oncoprotein and the expression of p53 protein. METHODS: Formalin-fixed paraffin embedded specimens from 82 patients with invasive ductal carcinoma were used to evaluate the expression of IRF-1 and IRF-2 by performing immunohistochemical staining with using an avidin-biotin-peroxidase complex technique. RESULTS: The expression of IRF-1 was observed in 80.5 % of the study group. However, the expression of IRF-1 did not show any correlation with menopausal status, tumor size, histologic grade, the expression of steroid receptors, the expression of c-erb B2 oncoprotein and the p53 expression. Only lymph node metastasis showed a decreasing tendency of IRF-1 expression, but this was without statistical significance (p=0.075). The expression of IRF-2 was observed in 58.5% of the study group and it did not show any significant relationship with any of the above mentioned clinicopathological parameters. CONCLUSION: This study suggests that the expression of IRF-1 and IRF-2 does not affect the previously established parameters for determining such biological behaviors of breast cancer as the tumor size, lymph node metastasis, the histologic grade, the expression of steroid receptors, the expression of c-erb B2 and the expression of p53. In spite of these results, We'd like to recommend that another study be done to evaluate the role of IRF-1 and IRF-2 for the proper selection of the patients who are suitable for immunotherapy.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Cell Death ; Humans ; Immunotherapy ; Interferon Regulatory Factors* ; Interferon-gamma ; Interferons* ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Receptors, Steroid

Coccidioidomycosis is a disease by airborne exposure of Coccidioides(C.) immitis, and endemic in the Southwest United States. Primary infection site is lung, and dissemination of the disease can occur depending on the host factors: race, immune status, pregnancy, etc. We report a Korean man with coccidioidomycosis disseminated to the skin, presenting the granulomatous papules on the face and trunk in addition to the pulmonary symptoms. Fungal spherules in the dermis were detected on the skin tissue section, and C. immitis were cultured from the skin tissue. The clinical symptoms were gradually improved with the systemic treatment of antifungal agents (amphotericin B and caspofungin). After more than 6 months of treatment, all of the pulmonary and cutaneous lesions were cleared, but fever persisted.
Antifungal Agents ; Coccidioidomycosis* ; Continental Population Groups ; Dermis ; Fever ; Humans ; Lung ; Pregnancy ; Skin ; United States

OBJECTIVES: The prevalence of malaria is increasing in recent years and also multidrug resistant malaria is increasing around the world and there is an increasing concern about imported malaria in nonendemic areas. Now many drugs are tried to find out effect on multidrug resistant malaria. We performed this study to investigate the thrapeutic effect of halofantrine in the treatment of chloroquine resistant imported malaria. METHODS: From Feb. 1992 to May 1995, we experienced 35 patients infected with malaria and treated 14 patients among 35 patients with halofantrine. RESULTS: 1) All 14 patients were sailor with a mean age of 39.4 years and infected with malaria. 2) The majority of patients were infected with malaria at Africa. 3) 10 patients were infected with Plasmodium falciparum and the remainder were undetermined. 4) In the 11 cases of chloroquine resistant malaria treated with quinine plus tetracycline combination therapy or Fansidar, 4 cases could not be tolerable due to side effects and resistance to the therapy, we substituted halofantrine for above regimens. 5) In the 10 cases, treated after May 1994, halofantrine was the first choice of treatment because they were the cases of malaria infected in the mid-Africa where the prevalence of chloroquine resistant malaria is high. 6) With halofantrine, all 14 cases were treated with minimal side effects suc4 as nausea, vomiting, anorexia, abdominal pain and fatigue. CONCLUSION: We think halofantrine is a simple and effective regimen against chloroquine resistant malaria and consider this agent as an alternative therapeutic regimen on chloroquine resistant malaria.
Abdominal Pain ; Africa ; Anorexia ; Chloroquine* ; Fatigue ; Humans ; Malaria* ; Military Personnel ; Nausea ; Plasmodium falciparum ; Prevalence ; Quinine ; Tetracycline ; Vomiting

The mainstay of treatment in primary breast cancer is still a radical mastectomy. In the case of advanced breast cancer, preoperative chemotherapy is an alternative treatment method to induce surgical therapy. Although the number of elderly patients with breast cancer is increasing, the knowledge about the possible differences in the biology and clinical outcomes of breast cancer according to age is limited. In addition, elderly patients have difficulties with surgical treatment because of the higher rate of coincident systemic illness, high anesthetic risk and high rate of operation refusals for an operation than those in young patients. As it was well known that elderly patients have better prognoses than younger patients and more estrogen and progesterone receptors in tumor tissue, it was expected that oral chemoendocrine and radiation therapy could be an alternative in elderly patients who refuse surgery. Good results were experienced in our three elderly breast cancer patients when applying these non-surgical treatments.
Aged* ; Biology ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Estrogens ; Female ; Humans ; Mastectomy, Radical ; Prognosis ; Receptors, Progesterone

Extramedullary plasmacytoma (EMP) is a plasma cell tumor located outside of the bone marrow. It most often occurs in the upper respiratory tract (85%), as well as the head and neck, and very rarely occurs in the retroperitoneum. Here we report the case of a 57-year-old woman with retroperitoneal EMP.
Bone Marrow ; Female ; Head ; Humans ; Middle Aged ; Multiple Myeloma ; Neck ; Plasmacytoma* ; Respiratory System ; Retroperitoneal Fibrosis ; Retroperitoneal Space

Crossed fused renal ectopia is an uncommon congenital anomaly. The patients have often another congenital anomalies that may make the diagnosis. We report a case of crossed fused renal ectopia with review of literatures.
Diagnosis ; Humans

PURPOSE: To assess outcomes from patients who underwent radical prostatectomy and had their indwelling urinary catheter removed on postoperative day (POD) 4 or 7. MATERIALS AND METHODS: The medical records of 107 consecutive patients receiving radical prostatectomy (RP), were retrospectively reviewed. Patients were categorized into two groups according to length of catheterization. Group 1 (n=40) had the urethral catheter removed on postoperative day (POD) 4, and group 2 (n=67) had the catheter removed on POD7. Group 1 had urethral catheter removal following no leakage on intraoperative leak testing and POD4 cystography, whilst group 2 exhibited leakage at POD4 and instead had routine POD7 urethral catheter removal if there was evidence of no leakage of POD7 cystography. Incontinence was checked according to the use of protective pad. RESULTS: The mean age of the study population was 67.0 years. acute urinary retension (AUR) following catheter removal occurred in 6 of the cohort (5.6%); 3 patients (7.5%) from group 1 and 3 (4.5%) from group 2 (p=0.669). The overall continence rate was 39.3%, 68.2%, 80.4%, and 91.6% at 1, 3, 6, and 12 months respectively. Importantly, the incontinence recovery pace of group 1 was notably higher than that of group 2 (p=0.001). Neither group exhibited bladder neck contracture. Intraoperative factors influencing the decision to remove catheter at POD4 following RP, are bladder neck reconstruction (OR=3.792, p=0.010) and nerve sparing (OR=6.646, p=0.008). CONCLUSIONS: Selective early urethral catheter removal may shorten the length of incontinence recovery, without increasing the risk of AUR and bladder neck contracture.
Catheterization ; Catheters ; Cohort Studies ; Contracture ; Humans ; Medical Records ; Neck ; Prostatectomy* ; Prostatic Neoplasms ; Retrospective Studies ; Urinary Bladder ; Urinary Catheters*

Infected nonunion of the long bone, while less common today than in the past, continues to challenge orthopaedic surgeons. Various treatment methods including current techniques of internal fixation, bone graft, electrical stimulation and external fixation have been tried, but results are not always satisfactory. Authors reported successful treatment of infected nonunion by rigid internal fixation with one plate and autogenous bone graft in previous volumes 1989. Recently we adopted dual plate method, by which we overcame a greater amount of bone defect and obtained more rigid internal fixation. We have treated 14 cases of infected nonunion with this method from Oct. 1992 to Oct. 1994, and the results are as follows; 1. Tibia fractures were 9 cases, and femur fractures were 5 cases. 2. Six cases showed large bone defect. The average bone defect was 4.5cm in length and we could overcome it by Dual plate method and autogenous bone graft. 3. Six cases which showed large bone defect were united in average 5 months. 4. In remaining 8 cases, union was obtained in average 3 months.
Electric Stimulation ; Femur ; Tibia ; Transplants

Purpose: This study examined the prevalence of osteoarthritis of the knee after curettage and polymethylmethacrylate (PMMA) application for giant cell tumor of the bone (GCTB) and factors affecting the development of osteoarthritis of the knee. Materials and Methods: Fifty-five patients with GCTB of the distal femur who were treated with curettage and PMMA filling between June 2001 and June 2016 were reviewed retrospectively. The development of osteoarthritis of the knee, as Kellgren–Lawrence grade 3 or 4, was determined by radiography of the latest follow-up data. This study evaluated the influence of the factors on the development of osteoarthritic changes. Only patients followed up for more than five years were included and the median follow-up was 77 months (range, 60–237 months). Results: Osteoarthritis of the knee was observed in 10 patients (18%) of whom three showed preoperative arthritic changes and did not progress. Seven (13%) patients experienced progression of the arthritic changes after surgery at a median of five years (range, 4–12 years). On the other hand, none of them received total knee arthroplasty. Among seven patients who showed progression of arthritis, four patients presented with a pathologic fracture initially and showed arthritic changes at a median of 4.5 years after surgery. The other three patients showed arthritic changes after ten years or more. Pathologic fractures (p=0.0001) and subchondral bone involvement (p=0.011) were significant risk factors for the development of osteoarthritis. Conclusion The incidence of development of osteoarthritis of the knee after curettage and PMMA application at distal femoral GCTB was 13%, but none of these patients received further surgery, such as total knee arthroplasty. The pathologic fracture and subchondral bone involvement are risk factors for arthritic changes in the midterm follow-up.