To provide ideas for the recognition of neonatal and infantile liver diseases caused by cytomegalovirus(CMV) infection, histopathological examinations were made on hepatic tissues obtained by biopsy or autopsy from 23 patients. All patients were sero-positive for IgM anti CMV and had no other known or suggested etiologic factors for their liver disease. There were five different types of liver diseases: 8 cases of giant cell hepatitis(34.8%), 4 cases of biliary atresia(17.4%), 5 cases of biliary atresia with changes of neonatal hepatitis(21.7%), 4 cases of diffuse hepatic fibrosis(17.4%) and 2 cases of hepatic necrosis with CMV inclusion(8.7%). The diffuse hepatic fibrosis involved both the hepatic lobules and portal areas without evidences of regeneration. This type of liver disease appeared to be a chronic progressive illness that began during the first week of life, and in 3 of 4 cases, the liver biopsy was dong at 5 to 9 months after birth. The two patients showing CMV inclusion in their liver were premature of debilitated, and died within I month after birth. Diffuse hepatic necrosis as well as the cytomegalic change of bile duct epithelium was characteristic. The findings suggest that the pattern of CMV liver disease depends on the major site of hepatic injury, the status of status of patient's defense mechanism and the chronicity of illness.
Infant ; Male ; Female ; Infant, Newborn ; Humans ; Biopsy

BACKGROUND: Astrocytoma in spinal cord is rare, comprising only 1% of all primary central nervous system tumors. Malignant astrocytomas( grades III and IV) account for only 7.5% of intramedullary glioma occuring in all age. Dissemination from malignant astrocytoma in spinal cord to the cerebral subarachnoid space has been rarely reported. CASE DESCRIPTION: A 22-year-old male was brought for evaluation of a back pain and progressive left leg weakness over 40 days. MRI of the thoracolumbar spine showed intramedullary mass lesion(T11-L1). Concurrent cranial CT and CSF cytology showed no abnormal findings. The tumor was removed partially. At that time, pathologic diagnosis was low grade astrocytoma. He was given regional irradiation. Six months after surgery the patient was reevaluated because of seizure. CSF cytology revealed malignant cells. Brain MRI showed leptomeningeal carcinomatosis with hydrocephalus. A second pathology of the tumor revealed malignant astrocytoma. CONCLUSION: We report a arae case of spinal intramedullary malignant astrocytoma with intracranial seeding.
Astrocytoma* ; Back Pain ; Brain ; Central Nervous System Neoplasms ; Diagnosis ; Glioma ; Humans ; Hydrocephalus ; Leg ; Magnetic Resonance Imaging ; Male ; Meningeal Carcinomatosis ; Pathology ; Seizures ; Spinal Cord ; Spine ; Subarachnoid Space ; Young Adult

BACKGROUND: Astrocytoma in spinal cord is rare, comprising only 1% of all primary central nervous system tumors. Malignant astrocytomas( grades III and IV) account for only 7.5% of intramedullary glioma occuring in all age. Dissemination from malignant astrocytoma in spinal cord to the cerebral subarachnoid space has been rarely reported. CASE DESCRIPTION: A 22-year-old male was brought for evaluation of a back pain and progressive left leg weakness over 40 days. MRI of the thoracolumbar spine showed intramedullary mass lesion(T11-L1). Concurrent cranial CT and CSF cytology showed no abnormal findings. The tumor was removed partially. At that time, pathologic diagnosis was low grade astrocytoma. He was given regional irradiation. Six months after surgery the patient was reevaluated because of seizure. CSF cytology revealed malignant cells. Brain MRI showed leptomeningeal carcinomatosis with hydrocephalus. A second pathology of the tumor revealed malignant astrocytoma. CONCLUSION: We report a arae case of spinal intramedullary malignant astrocytoma with intracranial seeding.
Astrocytoma* ; Back Pain ; Brain ; Central Nervous System Neoplasms ; Diagnosis ; Glioma ; Humans ; Hydrocephalus ; Leg ; Magnetic Resonance Imaging ; Male ; Meningeal Carcinomatosis ; Pathology ; Seizures ; Spinal Cord ; Spine ; Subarachnoid Space ; Young Adult

BACKGROUND: The aim of this study was to assess the efficacy and toxicity of thalidomide-containing regimens as the first-line therapy for patients with multiple myeloma. METHODS: A total of 60 patients were initially treated with thalidomide-containing regimens at three institutions. Thalidomide was given with two different regimens: the TD regimen (thalidomide and dexamethasone) and the TCD regimen (thalidomide, cyclophosphamide, and dexamethasone). Autologous peripheral blood stem cells (PBSC) were collected after mobilizing with G-CSF with or without cyclophosphamide. RESULTS: Of all the patients, 56 patients (TD regimen: 12 patients, TCD regimen: 44 patients) who received at least 4 cycles or more were evaluated for response and toxicity. The median age of the patients was 65.5 years (age range: 39~80 years). The overall response rate for the thalidomide-containing regimens was 85.5%. There were 3 (25%) complete responses and 6 (50%) partial responses for the TD regimen and there were 17 (38.6%) complete responses and 21 (47.7%) partial responses for the TCD regimen, respectively. The toxicity, according to the NCI-CTC (grade 3/4) included neutropenia in 7 patients (12.5%), thrombocytopenia in 4 patients (7.1%), infection in 6 patients (10.7%) and neuropathy in 10 patients (17.8%). In addition, there were 2 patients (3.6%) with thrombosis. Thirteen patients, who achieved more than a partial response to the thalidomide-containing regimen, proceeded to PBSC collection and the median number of CD34+ cells collected was 3.8 x 106/kg. CONCLUSION: Thalidomide-based combination chemotherapy is a safe, well tolerated and effective regimen for patients with newly diagnosed multiple myeloma, and it showed a high response rates, relatively low toxicity and sufficient collection of PBSCs.
Cyclophosphamide ; Drug Therapy, Combination ; Granulocyte Colony-Stimulating Factor ; Humans ; Multiple Myeloma* ; Neutropenia ; Stem Cells ; Thalidomide* ; Thrombocytopenia ; Thrombosis