No abstract available.
Talus*

Hyponatremia is frequently seen in intracranial hemorrhagic patients and has been often attributed to inappropriate secretion of antidiuretic hormone. But in recent years, a number of studies have shown that hyponatremia in many patients with intracranial disease may actually be caused by cerebral salt wasting (CSW) syndrome and circulating Atrial natriuretic peptide (ANP) and Brain natriuretic peptide (BNP) are probably involved. This report describes a patient who developed bacterial meningites caused by pseudomonas aeruginosa and CSW syndrome after removal of pituitary adenoma. CSW syndrome resolved by fluid and salt replacement after 4 months.
Humans ; Hyponatremia ; Meningitis* ; Meningitis, Bacterial ; Natriuretic Peptide, Brain ; Pituitary Neoplasms* ; Pseudomonas aeruginosa ; Pseudomonas* ; Wasting Syndrome*

PURPOSE: Complete resection of the tumor nodule(mural nodule or solid portion of the tumor) is the essential goal of surgical treatment for heman-gioblastoma. The purpose of this study was to classify the morphologic types of intracranial hemangioblastoma on MRI and to compare the location and contour of tumor nodule on MRI with those on angiography. MATERIALS AND METHODS: The MRI findings of 34 lesions(38 lesions if 4 spinal cord lesions were included) in 26 patients(17 males and 9 females, range of age, 18-67 years, mean, 39 years) with surgically and histopathologically proved intracranial hemangioblastomas were reviewed. Seventeen patients underwent CT scanning in a short interval. Contrast-enahnced T1 -weighted imaging pa- tterns of hemangioblastoma were classified according to Ho's morphologic types. The location and contour of tumor nodule were compared between MRI and angiography in 15 patients(24 lesions). RESULTS: By location, cerebellar hemisphere was predominated(55%), followed by cerebellar vermis(26%), supratentorial region(5%), and medulla oblongata (3%). Spinal cord lesions(11%) were seen in 3 patients of 5 von HippeI-Lindau diseases. The frequency of morphologic types was as follows; Type 1 (purely cystic), 3%, Type 2(mural nodule), 50%, Type 3(cyst with wall enhancement), 3%, Type 4 (cystic nodule), 15%, Type 5(solid with internal cyst), 9%, and Type 6(solid), 20%. All tumor nodules(33 lesions) enhanced intensely with intravenous contrast material on MRI, of which 24 lesions(in 15 patients) revealed hypervascular masses fed by pial arteries on angiography. They were superficial and abutted pia mater partially or in large portion on both MR I and angiography. CONCLUSION: Over 70% of intracranial hemangioblastomas had a surrounding cyst, and superficial, pial-based location and number of the tumor nodules on MRI was correlated well with those on angiography. MRI is the examination of choice for preoperative evaluation of intracranial hemangioblastoma.
Angiography ; Arteries ; Female ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging* ; Male ; Medulla Oblongata ; Pia Mater ; Spinal Cord ; Tomography, X-Ray Computed

The protection afforded against CO2 and KTP(potassium titanium phosphate) laser-induced combustion by six different types of tracheal tubes was evaluated. Some of them were wrapped with aluminum foil. They were compared before and after the application of human blood to their external surfaces. The difference of protective efficacy against laser between normal saline filled and air filled cuff was evaluated, too. The tracheal tubes tested were laser-resistant tubes such as Bivona Fome-Cuf (Group 1), Xomed Laser-shield 11 (Group 2) and Mallincrodt Laser Flex (Group 3) tubes. Aluminum foil wrapped Rusch red rubber (RR) (Group 4) and Mallincrodt reinforced Polyvinylchloride (PVC) (Group 5) tubes and unwrapped Baxter plain PVC (Group 6) tubes were also tested. CO2 loser set to 38W in continuous mode and KTP laser set to 15W were directed at the shaft of the tracheal tube under study, which had 5L/min. of oxygen flowing through it. The laser was actuated for 90 seconds or until combustion or melting occurred. Bivona tubes (Group 1) resulted in combustion in 5 tubes before and after blood application with CO2 laser, but unaffected before blood and resulted in combustion in 4 of 5 after blood application with KTP laser. Laser-shield 11 tubes (Group 2) offered good protection form both laser before and after application of blood except 1 case. At one case in Group 2, combustion occurred after blood application with CO2 laser. A combustion occured in 1 of 5 prior to application of blood and 5 of 5 after blood in Laser Flex tubes (Group 3) with CO2 laser, but occurred no tube with KTP laser. Wrapped RR (Group 4) and reinforced PVC tubes (Group 5) were unaffected by both laser, but application of blood to the foil wrapped tube shaft resulted in melting in 4 of 5 tubes. Unwrapped PVC tube (Group 6) resulted in immediate combustion in all tubes tested with both laser. Saline inflated cuffs were not perforated only in Group 2 and 3 in KTP laser and perforated immediately in other groups, but there was no combustion with saline in all groups. Air filled cuffs were all perforated in both laser, and combustion occurred. The presence of blood on the surface of metallic foil wrapped or special laser-resistant tracheal tubes may make laser-induced combustion more likely during airway surgery. However, the Laser-shield 11 and aluminum foil wrapped tracheal tube provided good protection from even when covered with blood. In addition, Mallincrodt stainless steel Laser-Flex tube provided good protection from KTP laser only. The saline filling cuffs served as a heat sink that will absorb the lasers energy, thus preventing combustion of cuffs.
Aluminum ; Freezing ; Hot Temperature ; Humans ; Lasers, Gas ; Lasers, Solid-State ; Oxygen ; Rubber ; Stainless Steel ; Titanium

Pulmonary embolism is a serious complication, which is well known in patients undergoing total hip or total knee arthroplasty or lower extremity fracture surgery. But, there are few literatures concerning pulmonary embolism after upper extremity surgery. Pulmonary embolism after minor upper extremity fracture surgery is extremely rare. We report a case of 66-year-old female patient that developed pulmonary embolism after percutaneous cannulated screw fixation for a greater tubercle fracture of the proximal humerus with literature review.
Aged ; Arthroplasty ; Female ; Fracture Fixation ; Hip ; Humans ; Humerus* ; Knee ; Lower Extremity ; Pulmonary Embolism* ; Shoulder Fractures ; Upper Extremity

Brachial plexus injury is regarded as one of the most devastating injuries of the upper extremity. Accurate diagnosis is important to obtain the successful results. Basic preoperative evaluation includes simple radiography, cervical myelography. Magnetic resonance imaging, angiography, electrophysiologic studies and intraoperative studies. Furthermore, proper timing of surgery, surgical indication, plan and sufficient understanding of patients about the prognosis are the key for the satisfactory outcomes. This article provides an overview of the evaluation, diagnosis, intraoperative monitoring, and proper surgical planning for the treatment of posttraumatic brachial plexus injuries.
Angiography ; Brachial Plexus* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Monitoring, Intraoperative ; Myelography ; Prognosis ; Radiography ; Upper Extremity

Some aneurysms with peculiar shapes, large sized or in unusual location cannot be obliterated by ordinary methods. We present four cases using two kinds of fenestrated clips. There were 4 aneurysms in the 4 patients:3 saccular and 1 fusiform aneurysm. Two aneurysms were located in anterior communicating artery, one left carotico-opthalmic artery, and one distal middle cerebral artery. All of the aneurysms were successfully obliterated. Our results suggest that the various shape of fenestrated clips may be benefit for clipping difficult aneurysms, which would not be clipped with ordinary one.
Aneurysm ; Arteries ; Intracranial Aneurysm* ; Middle Cerebral Artery

OBJECTIVE: During the last several years, such as Photofrin(R), Photogem(R), HpD, and 5-aminolevulenic acid (ALA) has been used as photosensitizers for a wide range of malignant tumors as well as non-malignant disease. A new photosensitizer, 9-Hydroxypheophorbide-a (9-HpbD-a) was derived from Spirulina platensis. The aim of this study was to evaluate the anticancer effect and mechanism of photodynamic therapy in vitro using 9-HpbD-a and 670 nm diode laser on a HT-3 cervical cancer cell line. METHODS: We studied the cytotoxic effect of 9-HpbD-a and 670 nm diode laser in HT-3 cervical cancer cell line. The cultured HT-3 cells were treated with serial concentrations of 9-HpbD-a followed by various irradiation time (0, 5, 15, 30 min) and by various interval times (0, 3, 6, 9, 12 24 hours) until laser irradiation, then 3- (4,5-dimethylthiazol-2-yl) -2,5-diphenyl-tetrazolium bromide (MTT) assay was applied to measure the relative inhibitory effect of PDT. RESULTS: Optimal condition for laser irradiation time was 15 minutes and the cytotoxic effect according to the incubation time after 9-HpbD-a treatment was increased until 6 hours. Under confocal microscopy, to observe intracellular localization of 9-HpbD-a, cells dual-stained with 9-HpbD-a and panel of organelle-specific fluorescence probes (MitoTracker, LysoTracker, ER-Tracker), endoplasmic reticulum (ER) as a major accumulation organelle site in HT-3 cervical cell line for this new photosensitizer. CONCLUSION: The anticancer effect of PDT using 9-HpbD-a is effective in HT-3 cervical cancer cell line. This agent therefore represents a promising photosensitizing prodrug for the treatment of cervical cancer with PDT in clinical setting for the future.
Amines ; Cell Line ; Endoplasmic Reticulum ; Fluorescence ; Lasers, Semiconductor ; Microscopy, Confocal ; Organelles ; Photochemotherapy ; Photosensitizing Agents ; Spirulina ; Triazenes ; Uterine Cervical Neoplasms

The authors describe the case of a man who presented with T2-T3 disc herniation. The lesion was successfully identified by computed tomography with iopamidol myelogram and other radiological examinations. A posterolateral approach was tried and made successful result by the aids of microsurgical divices.
Iopamidol

Neonatal Gaves disease is a relatively rare condition due to transplacental passage of Thyroid-stimulating antibody(TSAb) from a mother with active or inactive Graveses disease or autoimmune thyroiditis. A 11-day-old female newborn was referred to our department of pediatrics from a local clinic because of low level T4(3.55microg/dl) concurrent with high level TSH (501.74uIU/ml) on the 5th day neonatal metabolic screening. But, our repeated laboratory data showed very high serum T4(59.6microg/dl), T3(1,600ng/dl), suppressed TSH(0.43uIU/ml), and the presence of TSH receptor antibody. Her mother was treated with propylthiouracil(PTU) for Graves disease during pregnancy. Therefore, we thought it was a delayed-onset neonatal hyperthyroidism, because the fetal thyroid gland was initially suppressed by antithyroid drug taken during pregnancy. After initiating antithyroid drug therapy for the hyperthyroid nature, TSH levels became elevated again, while thyroid hormone levels decreased. Maternal and infant blood samples at the 23th day after birth were examined for serum autoantibodies directed towards the TSH receptor(Thyrotropin-binding inhibitory immunoglobulin:TBII, Thyroid-stimulating antibody:TSAb, Thyroid-stimulating blocking antibody:TSBAb) and high levels of TBII and TSAb were detected. About 2 months after birth, TBII and TSAb decreased within normal limit, and then we could stop antithyroid medication in safety. We report here a case of neonatal Graveses disease with very high level of T4 and T3, but firstly presented as hypothyroid nature on neonatal screening because of the maternally transferred antithyroid drug, PTU.
Autoantibodies ; Drug Therapy ; Female ; Graves Disease ; Humans ; Hyperthyroidism ; Infant ; Infant, Newborn ; Mass Screening ; Mothers ; Neonatal Screening ; Parturition ; Pediatrics ; Pregnancy ; Receptors, Thyrotropin ; Thyroid Gland ; Thyroiditis, Autoimmune