No abstract available.
Defense Mechanisms*

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*

A case of a primary malignant melanoma of the right parietoccipital lobe is presented. The patient was a 49-year old man who had suffered headache, dizziness, recent memory disturbance & gait disturbance for 6 months. Total surgical removal of the lesion was performed without neurological deficit & the prognosis was good. Primary malignant melanoma of the brain are rarely reported in the literature. The possible etiology & management of the condition are discussed & literature is reviewed.
Brain ; Central Nervous System* ; Dizziness ; Gait ; Headache ; Humans ; Melanoma* ; Memory ; Middle Aged ; Prognosis

A reliable intravenous route is extremely important not only in surgical patients for prolonged administration of fluid and massive transfusion but also in patients with peripheral vascular collapse for hyperalimentation and critical patients. Since the subclavian vein catheterisation in a supraclavicular approach was introduced by J.K. Jeon in 1974 in our institution, it has been extremely popular for prolonged intravenous administration of fluids ratehr than for the measurement of central venous pressure. Therefore, the method of supraclavicular cannulation was modified by was of a more simple and easier method, using a 2inch Angiocath instead of an 8 inch intracath. We had 300 cases of supraclavicular subclavian vein cannulation which were done in various surgical patients of all ages. We have observed the following advantages of this method(2inch Angiocath) over the previous method. 1) No bleeding around the catheter 2) Simple and easy technique 3) Easy to fix the catheter 4) No need to wear gloves 5) Less complications such as air and catheter embolism 6) Bigger internal diasmeter in the Angiocath even with the sam size 7) Easy to keep the catheter open 8) Cheaper The subclavian vein is located within the costo-clavicular-scalene triangle and is approximately 3 to 4cm long and 1 to 2 cm in diameter in adults. The patient is placed in a supine and trendelenburg position to allow the subclavian vein to distend and to help prevent an air compolism when the vessel is cannulated. Follwing the preparation of the supraclavicular foses, a 2 inch Anglocath with a 10 cc syringe attached is inserted and advanced in the direction of the innominate vein, approximately 1cm from the junction of the clavicle and the lateral border of the sternocleidomastoid muscle(Clavisternomastoid angle. Fig.2). It is important to maintain a negative pressure while advancing the needle until a free flow of blood is observed in the syringe. When blood is observed in the syringe, a catheter is inserted and threaded all the way to the end then the needle is removed. The tip of the catheter is connected to the intravenous solution and fixed with adhesive tape. There is no need to press the puncture site or change the position in order to prevent bleeding around the catheter. The complications of a subclavian vein cannulation with an Anglocath are the same as with an Intracath. Those are pneumothorax, hydrothorax, hemothorax, catheter embolism, thrombosis and sepsis but the incidence is lower in this method. In the supraclavicular cannulation in our series, we have not experienced any of the above complications among the 300 cases done her due to the fact that only a few well qualified doctors have performed this technique.
Adhesives ; Administration, Intravenous ; Adult ; Brachiocephalic Veins ; Catheterization* ; Catheters ; Central Venous Pressure ; Clavicle ; Embolism ; Head-Down Tilt ; Hemorrhage ; Hemothorax ; Humans ; Hydrothorax ; Incidence ; Needles ; Pneumothorax ; Punctures ; Sepsis ; Subclavian Vein* ; Syringes ; Thrombosis

No abstract available.
Hypersensitivity*

The authors report their experiences of direct intracranial operation on 2 cases of ruptured giant middle cerebral artery aneurysm which have similar diameter size (over 2.5cm) and location (middle cerebral artery bifurcation area). On had showed subarachnoid hemorrhage at the right sylvian fissure and another had showed was operated 25 days after ictus because of generalized seizure attack and vasospasm on cerebral angiography, the latter was operated within 18 hours after ictus due to semicomatose mental state and intracerebral hematoma on the right temporal lobe. We have utilized on giant aneurysmal surgery with multiple tactics such as transient hypotension, temporary clipping, multiple clipping, puncture or incision of the aneurysmal body and removing of hematoma.
Aneurysm ; Cerebral Angiography ; Cerebral Arteries ; Hematoma ; Hypotension ; Intracranial Aneurysm ; Middle Cerebral Artery* ; Punctures ; Seizures ; Subarachnoid Hemorrhage ; Temporal Lobe

Bone metastasis of hepatocellular carcinoma appears to be peculiar when clinical manifestation of liver disease is not apparent, and initial diagnosis of metastatic hepatocellular carcinoma by fine needle aspiration cytology is rarely obtained. We experienced a case of 45-year-old man with metastatic hepatocellular carcinoma in the sacrum, which was diagnosed by fine needle aspiration cytology. The intrahepatic mass, measuring 1.2cm in diameter and kept unchanged in size for two years, was never proved to be hepatocellular carcinoma histopathologically. The aspirated neoplastic cells were mostly in sheets, showing abundant acidophilic cytoplasm and large, round, centrally located nuclei with single, prominent acidophilic mucleoli. In the cell block section, diagnosis of metastatic well-differentiated hepatocellular carcinoma was made without difficulty, and definite trabecular fashion with sinusoidal endothelial cell lining was found.
Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Cytoplasm ; Diagnosis ; Endothelial Cells ; Humans ; Korea* ; Liver Diseases ; Middle Aged ; Neoplasm Metastasis ; Prevalence* ; Sacrum

Two types of urine dipstick assays, Multistix-SG and Comber-9-Test RL, were compared for compatibility, accuracy, specificity and predictive values of a positive and negative test in 501 patients' urine and artificially prepared specimen. We found that the results of semiquantitative tests of Multistix-SG and Comber-9-Test RL performed were statistically similar in patients' specimen. The urinary leukocyte esterase tests of Comber-9-Test RL assays compared with urine sediment microscopy in regard to compatibility, sensitivity, specificity, and predictive values of a positive and negative test 83.7%, 48.1%, 90.3%, 47.4% and 90.1%, respectively. The urinary nitrite tests of Comber-9-Test RL assays compared with urine culture tests, in regard to compatibility, sensitivity, specificity, and predictive values of a positive and negative test were 90.3%, 19.4%, 84.7%, 53.8% and 94.1, respectively. For the urinary protein, the sulfosalicylic acid method was the most sensitive test for any kinds of protein, and Multistix-SG appeared more sensitive than Comber-9-Test RL for the albuminuria. For the urinary bilirubin and glucose, two dipstick assays were similar in their diagnostic efficiency. Finally in the urinary occult blood tests, Comber-9-Test RL assays was more sensitive than Multistix-SG.
Albuminuria ; Bilirubin ; Glucose ; Leukocytes ; Methods ; Microscopy ; Occult Blood ; Sensitivity and Specificity ; Urinalysis

No abstract available.

Rapid administration of solution containing dextroae results in marked hyperglycemia and osmotic diuresis hut a balanced electrolyte solution containing maltese does not increase blood sugar. 30 patients were chosen at random and divided into 3 groups j.e, one group received 5% dextrose in water, the second group received Hartmann solution and the third group, 5% maltose in a balanced electrolyte solution. The Patient's blood was collected in the operating room prior to the start l.V. infusion, for the measurement of blood sugar, insulin, osmolarity and electrolrtes in various conditions of N.P.O. Intravenous fluid was administered at a rate of 10 m1/kg/hour while anesthesia was induced and maintained with an endotracheal tube in place. Blood samples were taken one hour. 2 hours and 3 7ours f:on the time 1,V. infusion started, In the of 5% dextrose in water groups, the value of blood sugar and insulin was 88.5+/-12.1 mg% and 14.60+/-7.67 un/ml at NPO, 257.7+/-60.8mg% and 70.75+/-37.55 un/m1 at 1 hour, 298.8+/-84.4mg%: and 143.19+/-50.32 un/ml at 2 hours and 228.6+/-75.8% and 127.71+/-56.98 un/m1 at 3 hours. Although the b1ood sugar and insulin values increased markedly. but potassium and chloride were 4.74+/-0.55 mEq/l and 101.1+/-2.9 mEq/l and 4.11+/-0.31 mEq/l, 107.4+/-2.3 mEq/l and 3.75+/-0.41 mEq/l, 176.4+/-2.7mEq/l and 3.89+/-0.50mEq/l, 106.3+/-2.2 mEq/l and shoewed mild decrease, by the way, osmolarity and serum sodium did not changed. In contrast to the 5% dextrose in water groups, there are no changes in the blood glucose. insulin levels, osmolarity or and electrolrtes in the either Hartmann or Elitol (Elitol=5% maltose contained in a balanced electrolyte solution) groups. There was a slight increase in osmolarity with maltose but it was not significant. Accordingly it is concluded that rapid infusion of harmann or 5% maltose contained ina balanced electrolyte solution affects the blood sugar and insulin levels insignificantly compared to the dextrose cont5aining solution which increase the blood sugar and indulin levels markedly.
Anesthesia ; Blood Glucose* ; Diuresis ; Electrolytes* ; Glucose ; Humans ; Hyperglycemia ; Insulin* ; Maltose ; Operating Rooms ; Osmolar Concentration* ; Potassium ; Sodium ; Water