The VATER syndrome is a group of congenital anomalies with a nonrandom tendency for concurrence. Defects include vertebral, anorectal malformation, tracheoesophageal fisutla with esophageal atresia, radial-limb, vascular, and renal abnormalities. The critical period of organogenesis is at or before the sixth or seventh week of gestation. We experienced one case of VATER syndrome in a 1 day old male neonate having vertebral anomalies, esophageal atresia with tracheoesophageal fistula to the distal esophageal segment, imperforated anus, left renal dysplasia with hydronephrosis of the right kidney and both hydroureter, patent ductus arteriosus. We report a case of VATER syndrome with brief review of related literature.
Anal Canal ; Critical Period (Psychology) ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Humans ; Hydronephrosis ; Infant, Newborn ; Kidney ; Male ; Organogenesis ; Pregnancy ; Tracheoesophageal Fistula

No abstract available.
Tuberculosis, Miliary*

The distributions and morphological characteristics of neurons displaying immunoreactivity to the catecholamine synthetic enzymes tyrosine hydroxylase (TH), dopamine-beta-hydroxylase (DBH), and phenylethanolamine-N-methyltransferase (PNMT) were examined in the adjacent sections of the whole brain in the Striped Field Mouse (Apodemus agrarius coreae) The medulla oblongata were divided into 3 parts (rostral medulla oblongata, area postrema portion of medulla oblongata and caudal medulla oblongata) in this study. In the rostral medulla oblongata, adrenergic (TH-, DBH- and PNMT-positive) neurons were found in dorsal motor nucleus of vagus, nucleus tractus solitarius, dorsal strip and medial longitudinal fasciculus. In the ventrolateral medullary tegmentum of rostral medulla oblongata, adrenergic neurons were found between gigantocellular reticular nucleus and paragigantocellular reticular nucleus. In the area postrema portion of medulla oblongata, noradrenergic neurons were found in the nucleus tractus solitarius, and area postrema. And dopaminergic or adrenergic neurons were also found in dorsal motor nucleus of vagus. In the caudal medulla oblongata, noradrenergic neurons were found in the medial part of nucleus tractus solitarius and superior part of the lateral reticular nucleus.
Adrenergic Neurons ; Animals ; Area Postrema ; Brain ; Immunohistochemistry ; Medulla Oblongata* ; Mice ; Murinae* ; Neurons* ; Solitary Nucleus ; Tyrosine 3-Monooxygenase* ; Tyrosine*

The purpose of this study was to evaluate the effects of surface conditioning with 10% polyacrylic acid, etching with 38% phosphoric acid, and polishing with a slurry of pumice on shear bond strengths of light-cured glass ionomer cement, chemically cured glass ionomer cement, and a composite resin to enamel, and to observe the failure patterns of bracket bondings. Shear bond strengths of glass ionomer cements were compared with that of a composite resin. Metal brackets were bonded on the extracted human bicuspids after enamel surface treatments, and samples were immersed in the 37degrees C distilled water bath, and shear bond strengths of glass ionomer cements and a composite resin were measured on the Instron machine after 24hrs passed, and the deboned samples were measured in respect of adhesive remnant index. Scanning electron micrographs were taken of enamel surfaces after various treatments. The data were evaluated and tested by ANOVA and Duncan's multiple range test, and those results were as follows. 1. Shear bond strength of light-cured glass ionomer cement showed statistically higher than that of chemically cured glass ionomer cement. 2. Shear bond strengths of light-cured and chemically cured glass ionomer cements to enamel treated with 10% polyacrylic acid and 38% phosphoric acid showed statistically higher than those with a slurry of pumice. 3. According to scanning electron micrographs, enamel surface conditioned with 10% polyacrylic acid is slightly etched and cleaned, that etched with 38% phosphoric acid is severely etched, and that polished with a slurry of pumice is irregulary scretched and not completely cleaned. 4. After debonding, light-cured glass ionomer cement to enamel treated with 10% polyacrylic acid showed less residual materials on the enamel surface than composite resin to enamel etched with 38% phosphoric acid. 5. There was no significant difference in the shear bond strength of light-cured glass ionomer cement to enamel treated with 10% polyacrylic acid and that of composite resin to enamel etched with 38% phosphoric acid.
Adhesives ; Baths ; Bicuspid ; Dental Enamel* ; Glass Ionomer Cements* ; Glass* ; Humans ; Water

This is to report the technique of reversed iliac leg stent-graft in endovascular treatment for isolated internal iliac artery (IIA) aneurysm, which had significant size discrepancy between the common iliac artery (CIA) and external iliac artery (EIA) in 3 patients from different hospitals. Three patients were a 85- and two 82-year-old men. Treated were right IIA aneurysms, sized 6.5x6.2 cm, 5.0x4.0 cm, and 4.1 cm in longest diameter, respectively. The diameters of the right CIA and right EIA measured 21 mm/11 mm, 15 mm/11 mm, and 20 mm/10 mm, respectively. In all cases, reversed iliac leg stent-grafts were prepared on-site; unsheathed and mounted upside-down manually, and deployed in each right CIA. Post-stent-graft angiograms showed complete exclusion of the aneurysms, except for minimal type 1 endoleak in one case. This technique is a useful treatment option in patients with isolated IIA aneurysm.
Aged, 80 and over ; Aneurysm* ; Endoleak ; Endovascular Procedures ; Humans ; Iliac Aneurysm ; Iliac Artery* ; Leg* ; Male

The cyto-histologic correlation and cytologic accuracy are reported in thirty cases of consecutive aspirated cells and their biopsied tissues of patients with clinical and neuroradiologic evidences of central nervous system tumors and other lesions investigated at the Pathology and Neurosurgery Department, Korea University Hospital, from Apr. 1987 to Apr. 1988. The series comprised of 17 benign and 12 malignant histopathologically verified brain neoplasms and 1 infectious lesion. In 78% of the cases, the cytologic diagnosis was concordant with the histologic diagnosis provided adequate sample was obtained. In 17 benign tumors, the diagnostic rate was 87% ; the diagnostic accuracy for 12 malignant CNS tumors was 63% cytologically. In almost all cases, differentiation of non-neoplastic lesion from neoplastic one and that of benign tumors from malignant ones were possible. Most discordance stemmed from failure to distinguish different types of malignant tumors. In meningioma, neurilemmoma, pituitary adenoma, and medulloblastoma, cytologic diagnostic accuracy was high, but germinoma, malignant ependymoma, and hemangioblastoma were difficult to diagnose by cytology alone.

The authors describe a technique consisting of subfascial temporalis dissection and performing a pedicled bone flap in pterional craniotomy. This technique provides reliable preservation of the frontalis nerve, does not necessitate the reconstruction of the temporalis muscle at the end of the surgery, and does not compromise the operative exposure.
Craniotomy

In recent years there has been a tendency to abandon repeat cerebral angiography in patients with subarachnoid hemorrhage(SAH) if the initial angiogram is normal because prognosis is said to be excellent. Our experiences does not support such a conclusion. In 291 cases with subarachnoid hemorrhage(SAH), four vessel cerebral angiography was performed to investigate a source of the hemorrhage. The first four vessel study on admission revealed 234 cases(80.4%) of ruptured cerebral aneurysms. Fifty-five of 291 patients with primary subarachnoid hemorrhage(SAH) did not show vascular lesion in initial pan-angiography studies. In order to define the benefit of control angiography these patients were reviewed. Among 41 patients who underwent repeat angiography, a second angiography showed an aneurysm in 24(58.5%). Twelve of the twenty-four cases had aneurysms in the anterior communicating artery. But the age, sex, initial clinical grade and CT grade of patients with aneurysm in repeat angiography were indistinguishable from thoses of patients without aneurysm. Even in the patients who showed angiographic vasospasm in intial angiography, probability of revealing an aneurysm was not different from those without spasm. We conclude that repeat angiography is necessary in the cases of SAH with normal initial angiogram regardless of the CT findings and the presence of vasospasm.
Aneurysm ; Angiography* ; Arteries ; Cerebral Angiography ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Prognosis ; Spasm ; Subarachnoid Hemorrhage*

Of the many potential source of free radial generation, the enzyme xanthine oxidase has been shown to be important in ischemia in non-cerebral tissues. Oxygen-derived free radicals have been implicated in various pathological conditions including ischemia. Xanthine oxidase serve as a source of oxidizing agents such as superoxide radical and hydrogen peroxide. It is investigated that the effect of a specific xanthine oxidase inhibitor, allopurinol, on infarct size in a model of continuous partial cerebral ischemia in rats. Infarct volume was measured by triphenyl tetrazolium chloride staining of brains removed 24 hours after middle cerebral arterial occlusion. Cortical tissue was more effectively protected than basal tissue, especially in allopurinol pretreated group. On histological examinations, hemispheric swelling, PMN cell infiltration and endothelial damage were noted irrespective of allopurinol treatment. It was speculated that free radicals are important in infarction secondary to partial continuous cerebral ischemia and that xanthine oxidase may by the primary source of these radicals.
Allopurinol* ; Animals ; Brain Infarction* ; Brain Ischemia ; Brain* ; Free Radicals ; Hydrogen Peroxide ; Infarction ; Infarction, Middle Cerebral Artery* ; Ischemia ; Middle Cerebral Artery* ; Oxidants ; Rats ; Superoxides ; Xanthine Oxidase

OBJECTIVE: The purpose of this study was to determine differential findings between Type I degenerative endplate changes and diskitis on MR images. MATERIALS AND METHODS: MR images(T1, T2 weighted or Gradient echo) of L-spine in twelve patients with a Type I degenerative endplate change and nine patients with diskitis were reviewed for the morphologic and signal intensity changes of intervertebral disc, vertebral endplate and vertebral body. RESULTS: involvement of the marrow of one side of intervertebral disk was noted in 33%(4/12) of Type I endplate changes, and 11%(1/9) of diskitis. Decreased signal intensity of intervertebral disc was seen in 92% (11/12) of Type I endplate changes, and 11%(1/9) of diskitis on T2 weighted or Gradient echo image. Loss of intranuclear cleft signal was noted in 17%(2/12) of Type I endplate changes, and 78%(7/9) of diskitis. Even disc space narrowing was seen in all cases of Type I endplate changes, but uneven narrowing was seen in 44%(4/9) of diskitis. Only partial cortical disruption was noted in 42%(5/12) of Type I endplate changes, while partial or total cortical disruption was noted in 89%(8/9) of diskitis. The extent of marrow involvement more than 2/3 was noted in 8%(1/12) of Type I endplate changes, but 56%(5/9) of diskitis. The margin of signal intensity change was well defined in 33%(4/12) of Type I endplate changes, but that of diskitis was ill defined in all cases(9/9). Gadolinium enhancement was homogeneous in all cases(5/5) of Type I endplate changes, and 63%(5/8) of diskiris. CONCLUSION: We conclude that involvement of one side of endplate, decreased signal intensity of intervertebral disc on T2 weighted or gradient echo image, even narrowing of disc space, lesser extent of marrow involvement, well defined margin and homogeneous enhancement pattern are the findings of Type I degenerative endplate changes on MR images.
Bone Marrow ; Diagnosis, Differential* ; Discitis* ; Gadolinium ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging*