No abstract available.
Intracranial Hypotension*

BACKGROUND: Leptin, produced in the adipose tissue, is involved in the regulation of body weight. The release of the leptin is increased in obese adults even in children. This study investigated whether the serum leptin in cord blood was related to babys birth weight and metabolic parameters. METHODS: 71 pairs of singleton pregnancy babies and their mother were studied. Babies are classified in LGA (large for gestational age), AGA (appropriate for gestational age), SGA (small for gestational age) three groups. After delivery, cord blood and maternal venous blood samples were drawn. We measured the plasma leptin, insulin-like growth factor (IGF)-1, insulin and proinsulin in cord and maternal serum. RESULTS: The concentration of leptin from cord blood was increased in LGA babies and decreased in SGA babies compued with the level in AGA babies. There was positive correlatian (r=0.55, p<0.01) between the plasma leptin level in cord and birth weight. There were positive correlatian between both the plasma proinsulin (r=0.37, p<0.01) and IGF-1 (r=0.32, p<0.01) and birth weight, too. But there was no difference between female and male baby's cord blood leptin level. In multiple regression analysis, cord blood leptin level was found independent factor related to birth weight ( p=0.001) CONCLUDION : The plasma leptin, proinsulin and IGF-1 is correlates to the birth weight. These data provide evidence that leptin and proinsulin are highly related to the nutritional status already during the fetal periods, and effect on the intrauterine fetal growth.
Adipose Tissue ; Adult ; Birth Weight* ; Body Weight ; Child ; Female ; Fetal Blood* ; Fetal Development ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Leptin* ; Male ; Mothers ; Nutritional Status ; Parturition* ; Plasma ; Pregnancy ; Proinsulin

No abstract available.

No abstract available.

It is often assumed that a parenchymal brain lesion which shows no contrast enhancement on magnetic resonance imaging(MRI) is a"low-grade tumor". We investigated a series of 20 patients with nonenhancing cerebral gliomas ; all underwent stereotactic biopsy or open resection, and histological diagnoses were astrocytoma(n=7), anaplastic astrocytoma(n=7), oligodendroglioma(n=5), and ganglioglioma(n=1). Before surgery, 11 patients underwent [18F] fluorodeoxyglucose positron emission tomography(FDG-PET), and this showed hypermetabolic features in two of four patients with anaplastic astrocytomas and in one of seven with astrocytomas or oligodendrogliomas. Among 17 patients, the mean Ki-67 labeling index was 4.4+/-4.3(range : 0.1-16.7), and the standard error was 1.04. These results indicate that in cerebral gliomas, the enhancing pattern seen on MRI cannot predict the degree of malignancy, and we suggest that even if imaging is consistent with "low-grade glioma", histological verification and close follow-up of clinical course are both important.
Anaplasia ; Astrocytoma ; Biopsy ; Brain ; Diagnosis ; Electrons ; Follow-Up Studies ; Glioma* ; Humans ; Magnetic Resonance Imaging ; Oligodendroglioma

To elucidate the factors associated with surgical outcome, the authors analyzed a consecutive series of 30 acromegalic patients treated between October, 1995 and May, 1997. The mean follow-up period for hormonal evaluation was 14.1(range: 2-30) months. We evaluated the surgical outcome according to the established prognostic factors such as basal growth hormone(GH) level, preoperative insuline-like growth factor-I(lGF-I) level, tumor size, extrasellar extension(grade), suprasellar growth(stage), and immunohistological findings. The criteria of achieving a postoperative basal GH below 5ng/ml, glucose-suppressed growth hormone level of 2ng/ml or less, and/or normalizat1on of IGF-1 level were used to indicate remission. The mean preoperative basal growth hormone level was 39.55(range 2.1-70ng/ml). The mean long diameter of tumors was 16.5mm(range 6-31.1mm). Utilizing the postoperative growth hormone determination, 15(50%) of 30 patients were in remission. Tumor size, extrasellar extension and suprasellar growth were correlated with remission. But preoperative growth hormone level, lGF-1 level, and immunohistochemical findings were not correlated with remission. Even though surgical excision is the most effective therapy currently available for acromegaly, the tumor size and growth pattern may influence on the surgical outcome.
Acromegaly* ; Follow-Up Studies ; Growth Hormone ; Humans ; Insulin-Like Growth Factor I ; Pituitary Neoplasms

The best treatment modality for spontaneous intracerebral hemorrhage still remains to be controversial. Stereotactic surgery can be performed safely and easily but its indication and optimal timing of operation have to be determined. We treated 80 patients with spontaneous intracerebral hemorrhage by stereotactic surgery from October 1994 to December 1997. We investigated clinical status of the patients before and after surgery, amount of hematoma, evacuation rate, timing of operation, transcranial Doppler sonography(TCD), and computerized tomography(CT) findings. The results were as follows: 1) The outcome of early surgery(within 24 hours of bleeding) was better than that of late surgery(after 24 hours of bleeding)(p=0.034). 2) The outcome was better in the patient with higher evacuation rate(p=0.014). 3) TCD monitoring showed beneficial effect of surgery on hemodynamic status. We conclude that the early surgery within 24 hours after bleeding is correlated with the better outcome, and TCD monitoring is useful for evaluation of perioperative hemodynamic change.
Cerebral Hemorrhage* ; Hematoma ; Hemodynamics ; Hemorrhage ; Humans

BACKGROUND: Topographic mappings of somatosensory evoked potentials (SEP) on subdural electrodes help identify the motor cortex quickly during chronic subdural recordings or during the operation. We tried to assess the ease and reliability of the routine use of SEP for identification of the sensorimotor cortex depending on pathology and location of the lesion. METHODS: We reviewed 75 SEP studies of 63 patients who needed functional mappings of the sensorimotor area. The phase reversal (PR) of SEP around the 20 msec latency in response to contralateral median nerve stimulations by subdural electrodes was used to identify the position of the central sulcus. The patients included 20 with nonlesional epilepsy, 30 with tumor, 12 with arteriovenous malformation (AVM), and 1 with cavernous angioma. RESULTS: SEP-PRs were successfully recorded in 67 SEP among 75 studies (89.3%). SEP-PRs were recorded in 37 of 43 patients with lesions (86.0%), and in all patients without lesions (100.0%). In regards to pathology, the absence of SEP-PR was noted in 3 out of 12 patients with AVM (25.0%), 3 out of 30 patients with tumor (10.0%), and 0 out of 1 patient with cav-ernous angioma (0.0%). The SEP-PRs were obtained the least frequently for the location of lesions when the lesions involved both the frontal and parietal areas. CONCLUSIONS: Intraoperatively, the SEP-PR can be easily obtained and the median nerve SEP is an useful test for confirming the identification of the central sulcus. SEP-PR can be detected more frequently in patients without lesions rather than in those with lesions, especially patients with AVM or whose lesions are over the frontoparietal areas.
Arteriovenous Malformations ; Brain Mapping ; Electrodes* ; Epilepsy ; Evoked Potentials ; Evoked Potentials, Somatosensory* ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Median Nerve ; Motor Cortex ; Neurosurgery ; Pathology ; Rabeprazole

BACKGROUND: We hypothesized that a number of clinical and radiologic parameters could influence the reducibility of varus deformity in total knee arthroplasty. The aim of this study was to identify the factors correlated with reducibility of varus deformity and predict more accurately the amount of medial soft tissue release required in varus deformity total knee arthroplasty. METHODS: One hundred forty-three knees with preoperative varus alignment and medial osteoarthritis were included in this retrospective study. The total knee arthroplasties were performed using a navigation system (OrthoPilot) by single surgeon. To assess varus deformity, the authors measured preoperative mechanical axis angles and valgus stress angles. Mechanical tibial angles, mechanical femoral angles, femoral osteophyte sizes, and tibial osteophyte sizes were measured. The Ahlback grading scale was applied for radiologic parameters, and clinical parameters (age, body mass index, sex, duration of pain, and preoperative range of motion) were documented. Correlations between these factors and preoperative valgus stress angle were analyzed. RESULTS: A negative correlation was found between preoperative mechanical axis angle and preoperative valgus stress angle (p < 0.01, r = -0.38), and a positive correlation was found between the preoperative mechanical tibial angle and preoperative valgus stress angle (p = 0.01, r = 0.19). CONCLUSIONS: The present study shows that preoperative varus deformity and proximal tibial vara (measured by preoperative mechanical axis angle and mechanical tibial angle, respectively) are correlated with reducibility of varus deformity (measured by preoperative valgus stress angle), and clinical parameters (age, range of motion, duration of pain and body mass index) and other radiologic parameters (osteophyte size, severity of osteoarthritis and angulation of distal femoral joint surface) were not significantly correlated with reducibility of varus deformity.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/*methods ; Bone Malalignment/radiography/*surgery ; Female ; Humans ; Knee Joint/radiography/*surgery ; Male ; Middle Aged ; Osteoarthritis, Knee/radiography/*surgery ; Retrospective Studies ; Stereotaxic Techniques ; Surgery, Computer-Assisted

BACKGROUND: In contrast to a healthy person, patients who have acute lower pespiratory tract infection with underlying pulmonary diseases have various pathogens, a rapidly progressie downhill course, and a poor response to prior antimicrobial therapy. Broad spectrum antivacterial therapy is needed for full evaluation. MATERIALS AND METHODS: To evaluate the efficacy and safety of cefpirome, we administered 1gm cefpirome, twice a day to 30 patients who had signs and symptoms of acute lower repiratory infection regardless of their underlying disease, except to those who had an allergic history to antibiotics or severe systemic diseases. RESULTS: The results were as follows : 1) Among 30 cases, 21 cases(70.0%) showed excellent improvement, and 7 cases(23.3%) showed good improvement in their symptoms and signs of acute lower respiratory infection. 2) In 14 cases with isolated pathogens, we observed bacteriologic eradication in 11 cases(78.6%). 3) Significant side effects were not found CONCLUSION: Above results suggest that cefpirome was effective as a monotherapy in patients with acute lower respriatory infection, especially on those with as underlying chronic obstructive pulmonary disease(COPD).
Anti-Bacterial Agents ; Humans ; Lung Diseases ; Pulmonary Disease, Chronic Obstructive