PURPOSE AND BACKGROUND: Recently several clinical studies suggested that maternal treatment with magnesium sulfate had protective effects against cerebral palsy in premature infants. But previous studies with differing perinatal animal models resulted in inconclusive results with regard to magnesium neuroprotection. Our purpose was to study the neuroprotective effect of magnesium sulfate and optimal dosage on hypoxicischemic brain damage in the newborn rat. METHOD: Seven-day-old rats(n=68) underwent right carotid ligation, followed by 3 hours of hypoxia(8% oxygen in 92% nitrogen). Rats received magnesium sulfate immediately before and again after hypoxia(two doses, 150mg-600mg/kg/dose, n=39), or saline solution(n=29). Severity of injury was assessed 5 days later, by visual evaluation of ipsilateral hemisphere infarction and by measurement of bilateral hemispheric cross sectional areas. RESULTS: Magnesium sulfate pre-treatment reduced the incidence of liquefactive cerebral infarction and atrophy from 80.8% in controls to 22.2% with magnesium sulfate(450 mg/kg/dose, P<0.05). Quantitation of hemispheric areas confirmed these findings. Percent protection based on inter-hemisphere area differences by pre-treatment with magnesium sulfate 450mg/kg/dose ranged from 71.1%(hippocampus) to 90.8%(striatum). However higher dose of magnesium(600mg/kg/dose) did not attenuate hypoxic-ischemic brain injury in the newborn rat but increased mortality. CONCLUSION: Pretreatment of magnesium sulfate has neuroprotective effects against hypoxia-ischemia in the newborn rat and adequate dose of magnesium sufate is important to protect the brain. Magnesium pretreatment may be an effective strategy to decrease the severity of neonatal hypoxic-ischemic brain injury in the adequate dose.
Animals ; Atrophy ; Brain ; Brain Injuries ; Cerebral Infarction ; Cerebral Palsy ; Humans ; Incidence ; Infant, Newborn* ; Infant, Premature ; Infarction ; Ligation ; Magnesium Sulfate* ; Magnesium* ; Models, Animal ; Mortality ; Neuroprotective Agents* ; Oxygen ; Rats*

No abstract available.
Leg* ; Myocutaneous Flap*

Angiolymphoid hyperplasia with eosinophilia(ALHE) is a benign angiomatous neoplasm which usually arises from skin, blood vessel, soft tissue, heart and rarely from bone. The authors experienced a case of ALHE which involved the distal femur of 35-years old male and treated by marginal excision and autogenous cancellous bone graft with plate fixation.
Angiolymphoid Hyperplasia with Eosinophilia ; Blood Vessels ; Femur ; Heart ; Humans ; Hyperplasia ; Male ; Skin ; Transplants

PURPOSE: The purpose of this study was to evaluate the efficacy of percutaneous transluminal angioplasty (PTA) in facilitating maturation of autogenous arteriovenous fistulae. MATERIALS AND METHODS: There were 12 immature autogenous arteriovenous fistulae. We performed 15 PTAs transvenously. Post-intervention anatomic and clinical successes were estimated, and the 6-month and 1-year primary and secondary patency rates were calculated using Kaplan-Meier analysis. RESULTS: All immature fistulae had underlying stenosis (n=20): arteriovenous anastomosis (n=1) and venous outflow (n=19): 1) within 5 cm from the anastomosis (n=10); 2) more than 5 cm but less than 10 cm from the anastomosis (n=5); 3) more than 10 cm from the anastomosis, including central veins (n=4). Six fistulae had two or more stenoses. Repeat intervention was necessary in two patients. The anatomical success rate was 94.3%, and the clinical success rate was 86.7%. The 6-month and 1-year primary patency rates were 72.7% and 54.5%, and the secondary patency rates were 100% and 81.8%, respectively. CONCLUSION: All immature hemodialysis fistulae have underlying stenosis, most of which are located near the arteriovenous anastomosis. Early interventional procedures are helpful in the salvage and maintenance of immature arteriovenous fistulae, with a high degree of success.
Angioplasty ; Angioplasty, Balloon ; Arteriovenous Anastomosis ; Arteriovenous Fistula ; Constriction, Pathologic ; Fistula ; Humans ; Renal Dialysis ; Veins

The immunocompetence is important not only to kill the neoplastic cells but also to keep the neoplastic cells from growing further. T lymphocyte is plays the most important role in maintaining the tumor immunity efficiently. T lymphocyte has its specific functions depending in the subset of T lymphocytes. The author analyzed the T lymphocyte subsets in 31 brain tumor patients using anti-CD3, anti-CD4, anti-CD8 monoclonal antibodies and flow cytometry to determine the immunological status of brain tumor patients. All CD3, CD4 and CD8 subsets were reduced in both benign and malignant brain tumor patients but more signigicantly reduced in malignant tumor group. But in benign tumor group, the subtypes of T lymphocytes were not so different from those of normal healthy controls except the pituitary tumor patients, who showed the significant decrease in all the subtypes. In malignant tumor group, each subtype was signigicantly reduced and CD8 subtypes was markedly reduced in metastatic tumor patients, These analyses were considered to have the possibility to be contributable to planning the further immunotherapy and also the possibility to moniter the brain tumor patients clinically.
Antibodies, Monoclonal ; Brain Neoplasms* ; Brain* ; Flow Cytometry ; Humans ; Immunocompetence ; Immunotherapy ; Lymphocytes ; Pituitary Neoplasms ; T-Lymphocyte Subsets* ; T-Lymphocytes*

Cutaneous ulcers due to candida infection are very rare condition, occurring almost in immunocompromised host or occurring as cutaneous manifestation of systemic candidal infection. A 52-year-old woman presented with cutaneous ulcer on dorsum of left hand which had lasted for about 15 days. Bacterial culture showed nonpathogenic organism, Enterobacter cloacae. Mycologic studies including KOH mount and fungus culture were positive for pseudohyphae and colonies of Candida species. A biopsy specimen from the center of ulcer revealed numerous spores and fungal hyphae in the upper dermis and necrotic epidermis. Bacterial culture and fungus culture of patient's serum and urine were negative. Initial treatment with antibiotics had no effectiveness for 2 weeks. After then we treated with antifungal drug, itraconazole 100mg/day. After 6 weeks of antifungal therapy, the skin lesion was much improved. We report this case, because it showed cutaneous ulcer due to candida infection but had neither systemic candidal infection nor clinical sign of immunosuppression.
Anti-Bacterial Agents ; Biopsy ; Candida* ; Dermis ; Enterobacter cloacae ; Epidermis ; Female ; Fungi ; Hand ; Humans ; Hyphae ; Immunocompromised Host ; Immunosuppression ; Itraconazole ; Middle Aged ; Skin ; Spores ; Ulcer*

Vascularized fibular graft is one of the treatment option for avascular necrosis of femoral head (ANFH) and has been known as providing a strut mechanical support and new vascular bed. It is very important to evaluate a healing process in femoral head after vascularization procedure. But a plain radiographic finding has a problem to assess pathological changes of ANFH treated with vascularized fibular graft. Authors analyzed chronogical changes of Tc-99m-HDP bone scan in 31 cases of ANFH treated with vascularized fibular graft from April, 1991 to May, 1994 and following results were obtained. l. Until 2 months after surgery, no change in size of cold defect area and no significant change in extent of RI uptake in reactive zone were noted. 2. During 2 months and 6 months after surgery, slight decrease in size of cold defect area and minimal changes in extent of RI uptake in reactive zone were observed. 3. During 6 months and 12 months after surgery, size of cold defect area decreased to 1/2 and changes in extent and degree of RI uptake in reactive zone were observed. 4. During 1 year and 2 years after surgery, size of cold defect area were minimal and sometimes faded away. RI uptake with decreased density in reactive zone broadened and moved to subchondral area. 5. After 2 years after surgery, cold area faded away and small increased RI uptake were observed in same site. In conclusion, Tc-99m-HDP bone scan which is economic and easily applicable in a patient is very useful for follow up study in ANFH treated with vascularized fibular graft.
Follow-Up Studies ; Head* ; Hip ; Humans ; Necrosis* ; Transplants*

PURPOSE: To evaluate the postoperative changes occurring in the patellar tendon after reconstruction of the anterior cruciate ligament (ACL) using the central one-third of the patellar tendon together with patellar and tibial bony plugs. MATERIALS AND METHODS: Ten patients with ACL injury underwent sagittal and coronal T1-weighted MR imaging of both postoperative and normal knee joints. In all cases, reconstruction of the ACL was performed using the central one-third of the patellar tendon, together with patellar and tibial bony plugs. During the follow-up period of 6-27 months, patient were clinically stable. We compared the length, signal intensity and contour of both patellar tendons, as seen on MR images. RESULTS: No defects was found in harvested patellar tendons, and MR images showed high signal intensity within harvested tendons in six of the ten patients. In seven of ten, patellar tendons had irregular margins and were poorly delineated from adjacent tissue. The mean length of patellar tendons was 44.2+/-2.9 mm in normal knee and 43.9+/-3.1mm in postoperative knee, while their mean thickness in postoperative knee, measured at mid-portion, averaged 4.3+/-1.2 mm. There were no statistically significant differences (p>0.05). The greatest mean thickness of patellar tendon was 6.9+/-1.2 mm and 4.3+/-0.5mm in normal and postoperative knee, respectively. Thus, on average, postoperative patellar tendon was 161% thicker than normal tendon (p<0.05). CONCLUSION: In clinically stable patients, patellar tendons after graft harvesting had a higher signal intensity, worse-defined margins and a greater thickness than normal. We suggest that these are the normal postoperative findings.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Magnetic Resonance Imaging* ; Patellar Ligament* ; Tendons ; Transplants

PURPOSE: The purpose of this study is to compare the frequency with which pseudole-sions around the gallbladder (GB) fossa are revealed by multiphasic CT, by CT during arterial portography (CTAP), and by CT during hepatic arteriography (CTHA) and to determine their radiological characteristics. MATERIALS AND METHODS:Multiphasic CT, CTAP, and CTHA examinations of 81 patients without pathology of the GB and around the GB fossa were evaluated for pseudolesion around the GB fossa. The definition of pseudolesion was as follows: 1) hyperattenuation during the arterial phase and isoattenuation during the delayed phase of multipha-sic CT, or perfusion defect on CTAP and hyperattenuation on CTHA; 2) no Lipiodol tagging on Lipiodol CT; 3) all findings observed adjacent to the gallbladder fossa; and 4) no interval change on follow-up CTAP and CTHA. We compared the frequency of pseudolesions around the GB fossa, as seen on multiphasic CT, CTAP, and CTHA, and determined their size, location, and shape, as revealed by CTHA. RESULTS: The frequency of pseudolesion was 2.5% (2/81) on multiphasic CT, while on CTAP or CTHA, the frequency was 53.1% (43/81), and 58 pseudolesions were identi-fied. Of 58 pseudolesions, 56 were revealed by CTAP and 57 by CTHA. Forty-nine of 58 pseudolesions were larger and all pseudolesions showed more contrast to parenchyma on CTHA than on CTAP. The location of pseudolesions was segment V(32 of 58), IV (25 of 58), and VI (1 of 58), and their size ranged from 5 to 30 (mean, 17.5)mm. Pseudolesions were wedge-shaped (48 of 58), oval (6 of 58), bandlike (3 of 58), or round (1 of 58). CONCLUSION: CTAP and CTHA frequently revealed pseudolesion around the GB fossa. The radiological characteristics of these modalities help differentiate pseudolesions from true tumoral hepatic lesions.
Angiography ; Ethiodized Oil ; Follow-Up Studies ; Gallbladder* ; Humans ; Pathology ; Perfusion ; Portography

May-Thurner syndrome is a deep vein thrombosis of the ilio-femoral vein due to compression of the left common iliac vein by the overlying right common iliac artery. Although, catheter directed thrombectomy (CDT) and thrombolysis with stent insertion has become the standard treatment method for acute or subacute May-Thurner syndrome, because of technical feasibility and lower recurrence rate, however, sometimes this methods make fatal complications. Furthermore, there are few reports on optimal treatment strategies for patients in a chronic state of May-Thurner syndrome,. We now present two cases of chronic (>1 month since onset of symptoms) May-Thurner syndrome treated by surgical thrombectomy and femoral arteriovenous shunt with simultaneous stent insertion after failed endovascular treatment. This technique may provide a significant benefit for patients who are not suitable for conventional endovascular treatment.
Catheters ; Humans ; Iliac Artery ; Iliac Vein ; May-Thurner Syndrome ; Recurrence ; Stents ; Thrombectomy ; Thrombosis ; Veins ; Venous Thrombosis