No abstract available.
Anemia* ; Erythropoietin* ; Humans*

The authors present a case of solitary dural plasmacytoma. A 43-year-old woman was admitted our department due to headache. Brain magnetic resonance(MR) image showed homogeneous enhanced lesion at the left occipital area. We performed surgical excision and it was confirmed plasmacytoma, histologically. The solitary dural plasmacytomas are exceedingly rare. Before this case report, only 17 cases had been reported in the literature
Adult ; Brain ; Dura Mater ; Female ; Headache ; Humans ; Multiple Myeloma ; Plasmacytoma*

OBJECTIVES: Three-dimensional computed tomographic angiography(3D-CTA) is recently developed diagnostic imaging modality. We have studied this noninvasive method for possible role in replacing conventional angiography(CA) in the detection of aneurysms of the circle of Willis in patients with subarachnoid hemorrahge(SAH). METHODS: We studied retrospectively, the 100 patients with SAH or unruptured aneurysms admitted to our hospital from October 1997 to December 1998. Among there, 85 patients underwent CTA, 82 patients underwent CA and 67 patients underwent both of CTA and CA. 3D-CTA was obtained using maximum intensity projection(MIP) and shaded-surface display(SSD) reconstruction. RESULTS: Total 107 aneurysms were detected in 92 patients, and 64 aneurysms were detected in 67 patients underwent both CTA and CA. In five cases of those 67 cases, aneurysms were detected by CA but not by 3D-CTA. The detection rate of aneurysms(91.8%) and the detection rate of parent artery in cases of anterior communicating artery aneurysms(86.9%) with total 3D-CTA were relatively compatible with that of CA. But 3D-CTA was not enough in detection of posterior communicating artery aneurysms, internal carotid artery aneurysms as well as small sized aneurysm(<3mm). Conclusion : We consider CTA is valuable in as a screening test for cerebral aneurysm and follow-up test. And it is also valuable in early surgery for patients with aneurysmal rebleeding because of simple, quick, non-invasive method.
Aneurysm* ; Angiography* ; Arteries ; Carotid Artery, Internal ; Circle of Willis ; Diagnostic Imaging ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Mass Screening ; Parents ; Retrospective Studies ; Subarachnoid Hemorrhage*

OBJECTIVE: Distal anterior cerebral artery(DACA) aneurysms are relatively uncommon, and have special aspects. We discuss clinical features and surgical results of DACA aneurysms with review of literatures. METHODS: Among 725 cases of intracranial aneurysms operated from 1989 to 2001 in our hospital, 38 cases of DACA aneurysms were studied retrospectively. The clinical presentations, neurological findings, operative approaches and outcome were analyzed. RESULTS: The incidence of the DACA aneurysm was 5.2% of total 725 aneurysms. Multiple aneurysms were found in 10 patients. Among the 38 patients, 15 were men and 23 were women. The mean age was 49.8 years. 2 aneurysms were located at frontobasal artery, 5 at the origin of frontopolar artery, 28 at the bifurcation between callosomarginal and pericallosal artery, 3 at the origin of pericallosal artery. 32 patients had good outcomes after surgery. 4 patients remained disabled, and 2 patients died. Postoperative complications were vasospasm, cerebral infarction, intracranial hemorrhage, pneumonia. CONCLUSION: The incidence of DACA aneurysm was relatively rare than other location. We think that unilateral interhemispheric approach is useful for aneurysm in most DACA, and approaches should be chosen according to the location of aneurysm and presence or absence of multiple aneurysms. The Glasgow Outcome Scale score was good in patient with low Hunt & Hess grade preoperatively. And early operation can reduce the rate of rebleeding and improve outcome of DACA aneurysms.
Aneurysm ; Anterior Cerebral Artery* ; Arteries ; Cerebral Arteries ; Female ; Glasgow Outcome Scale ; Humans ; Incidence ; Infarction ; Intracranial Aneurysm* ; Intracranial Hemorrhages ; Male ; Pneumonia ; Postoperative Complications ; Retrospective Studies ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial

The authors present a case of post-traumatic tension pneumocephalus of delayed onset. A 23-year-old man fell down and was admitted to our hospital with initial diagnosis of basal skull fracture associated with small amounts of pneumocephalus on brain computerized tomography(CT). At admission, the consciousness was alert without focal neurological deficit. During conservative therapy, headache was slowly progressive and consciousness became drowsy on 13th day after admission. The brain follow-up CT showed huge low air density lesion in the right frontal area. We performed unilateral subfrontal craniotomy with duroplasty for removal of air and dural repair with galea aponeurotica and abdominal fat. Postoperatively, the condition was recovered.
Abdominal Fat ; Brain ; Consciousness ; Craniocerebral Trauma ; Craniotomy ; Diagnosis ; Follow-Up Studies ; Headache ; Humans ; Pneumocephalus* ; Skull Fractures ; Young Adult

Between 1 and 2% of benign cystic teratomas undergo malignant transformation. This occurs most frequently in postmenopausal women, who account for only 10% of benign cystic teratoma. A wide variety of neoplasms arise in the mature tissues of otherwise benign teratomas. Of the malignancies arising in teratomas, squamous carcinoma is the most common (83%) with sarcomas accounting for 7%, adenocarcinoma and carcinoid tumors make up most of the others. The presentation in Stage I disease does not differ from that of benign cystic teratoma, except that ascites is occasionally present. In the more advanced neoplasms, the symptoms are those of epithelial ovarian cancer of the same stage. Differential diagnosis between squamous cell carcinoma and benign mature teratoma is difficult but seems to be related to age, size, serum tumor marker (SCC, CA125, CEA). Prognosis of squamous cell carcinoma in mature cystic teratoma was reported much poorer than other epithelial ovarian cancers In the early stages, treatment is possible through surgical intervention alone, but when advanced, 5 year survival rate shows less than 15 percent. We experienced two cases of squamous cell carcinoma of ovary arising in mature teratoma and present with a brief review of literature.
Adenocarcinoma ; Ascites ; Carcinoid Tumor ; Carcinoma, Squamous Cell* ; Diagnosis, Differential ; Female ; Humans ; Ovarian Neoplasms ; Ovary* ; Prognosis ; Sarcoma ; Survival Rate ; Teratoma*

Pseudomyxoma peritonei is a rare condition characterized by mucinous ascites associated with peritoneal and omental implants. This is most commonly originated from mucinous tumor of the ovary or appendix. We have experienced a case of pseudomyxoma peritonei associated with borderline mucinous tumor of both ovaries and appendix. We concluded that the appendix is the primary lesion of pseudomyxoma peritonei by various immunohistochemical stains and therefore reporting this case with the brief review of literatures.
Appendix* ; Ascites ; Coloring Agents ; Female ; Mucins* ; Ovary* ; Pseudomyxoma Peritonei*

Cis-dichlorodiammine platinum II (Cisplatin), an effective chemotherapeutic agent, induces acute renal failure by unknown mechanisms. To investigate direct toxic effects of cisplatin on the renal proximal tubular transport system, LLC-PK-1 cell line was selected as a cell model and the sugar transport activity was evaluated during a course of cisplatin treatment. Cells grown to confluence were treated with cisplatin for 60 min, washed, and then incubated for up to 5 days. At appropriate intervals, cells were tested for sugar transport activity using alpha-methyl-D-(14C)glucopyranoside (AMG) as a model substrate. In cells treated with 100 micrometer cisplatin, the AMG uptake was progressively impaired after 3 days. The viability of cells was not substantially changed with cisplatin of less than 100 micrometer, but it decreased markedly with 150 and 200 micrometer. In cisplatin-treated cells, the Na+/-dependent AMG uptake was drastically inhibited with no change in the Na+/-independent uptake. Kinetic analysis indicated that Vmax was suppressed, but Km was not altered. The Na+/-dependent phlorizin binding was also decreased in cisplatin-treated cells. However, the AMG efflux from preloaded cells was not apparently retarded by cisplatin treatment. These data indicate that the cisplatin treatment impairs Na+/-hexose cotransporters in LLC-PK-1 cells and suggest strongly that defects in transporter function at the luminal plasma membrane of the proximal tubular cells constitute an important pathogenic mechanism of cisplatin nephrotoxicity.
Acute Kidney Injury ; Animals ; Cell Line ; Cell Membrane ; Cisplatin* ; Epithelial Cells* ; LLC-PK1 Cells ; Phenobarbital ; Phlorhizin ; Platinum ; Swine

Renal transplantation is the optimal treatment for end stage renal disease and it has been improved through the development of operative methods and immunosuppressants. However some patients must receive dialysis or undergo retransplantation after a loss of the primary graft due to rejection or other causes. Recently the frequency of retransplantation has begun to increase gradually. Some articles have reported that retransplantation results do not significantly differ in comparison with initial transplantation results when living related donor kidneys are used. Our study focused on the outcome of 445 first transplantation and 12 retransplantation cases. The sex distribution of retransplanted patients was 11 male and 1 female. The mean age (yrs) for recipients was 32.3 at the first transplantation and 39.1 at the retransplantation. The underlying causes of end stage renal disease were presumed to be chronic glomerulonephritis in all retransplantion patients; the mean duration of graft survival (mo) for first transplantation was 77.92. The causes of previous graft failure were as follows: 10 due to chronic rejection, 1 due to recurrent glomerulonephritis, 1 resulted from a graft rupture due to a motorcar accident. The interval (mo) between graft failure and retransplantation averaged 6.7 and 9 out of 12 patients underwent regrafting within 1 year of their previous graft loss. Recipient-donor relationships in first transplantations were as follows: 9 were living related and 3 were living non-related. Recipient-donor relationships in second transplantations were as follows: 4 were living related and 8 were living non-related. Acute rejection within 1 month of transplantation occurred in 4 primary transplantation patients and 2 retransplantation patients. The incidence of acute rejection within 1 month was as follows: 23% of 445 first renal transplantation patients, 16.7% of 12 second transplantation patients. The 1 year and 2 year graft survival rate was 100% and the mean survival duration (mo) was 33 for retransp
Dialysis ; Female ; Glomerulonephritis ; Graft Survival ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney* ; Male ; Rupture ; Sex Distribution ; Tissue Donors ; Transplants