PURPOSE: Prostaglandins(PGs) are known to produce a remarkably broad spectrum of effects that embraces practically every biological function, and has a particular physiological role in the central nervous system. Significant increases of PGs levels are seen in certain diseases, such as febrile infection, stroke, schizophrenia, and epilepsy. Prostaglandin is also increased in a response to rising body temperature, and prostaglandin E-2(PGE-2) in lumber cerebrospinal fluid is also increased in febrile convulsion. Intracerebroventricular injection of PGE produces a rise in body temperature and also antagonizes convulsions induced by pentylenetetrazole, penicillin, electric shock. Therefore we studied PGE-2 levels in cerebrospinal fluid of afebrile children, children with febrile convulsion, and febrile children without convulsion. METHODS: The subjects comprised 57 cases with febrile convulsion, 24 cases of afebrile diseases and 9 febrile children without convulsion. All patients were undergoing lumbar puncture and PGE-2 levels in CSF were determined by highly specific radio-immunoassay(Prostaglandin E2 [125I] assay system, Biotra Assays, Amersham Inc.). RESULTS: 1) The CSF PGE-2 levels were significantly higher in children with febrile convulsion(147.3+/-79.3pg/ml) than those in febrile children without convulsion(72.4+/-75.4pg/ml) and afebrile children(19.2+/-28.4pg/ml)(p<0.05). 2) There were no statistical significances of the CSF PGE-2 levels between age and fever in both groups. 3) The CSF PGE-2 levels within 4 hours(176.5+/-65.7pg/m1) after convulsions were significantly higher than those 4 hours after convulsion(93.3+/-74.9pg/ml). CONCLUSION: The CSF PGE-2 levels were significantly higher in children with febrile convulsion than those in febrile children without convulsion and those in afebrile child ran. The CSF PGE-2 levels within 4 hours after convulsion were significantly higher than those 4 hours after convulsion.
Body Temperature ; Central Nervous System ; Cerebrospinal Fluid* ; Child* ; Epilepsy ; Fever ; Humans ; Penicillins ; Pentylenetetrazole ; Prostaglandins E ; Prostaglandins I ; Schizophrenia ; Seizures ; Seizures, Febrile* ; Shock ; Spinal Puncture ; Stroke

Hyperkeratosis of the renal pelvis and ureter is a rare condition and is explained by the metaplastic change from transitional to cornified squamous epithelium. This lesion is frequently associated with, and perhaps caused by chronic urinary infection, but potentially premalignant, accompaning with carcinoma in about 10 to 20 per cent of the cases at the time of diagnosis. A case of hyperkeratosis of renal pelvis & ureter which was clinically suspected of carcinoma in a 49-year old woman with a long history of chronic pyelonephritis is presented with review of literature.
Female ; Humans

No abstract available.
Child* ; Epilepsy* ; Humans

A rate com;lication of hysterectomy is complete prolapse and inversion of vagina. This can occur whether the hysterectomy was abdominal or vaginal and cystocele and/or enterocele is often associated with this condition. Traditionally, prolapse has been treated by surgery, the types of operation for prolapse are generally but not always, carried out through the vaginal rather than through the abdominal surgical route. We experienced five cases who had repair of posthysterectomy vaginal vault prolapse by transabdominal sacral colpopexy and report with brief review of literatures.
Cystocele ; Hernia ; Hysterectomy* ; Pelvic Organ Prolapse* ; Prolapse ; Vagina

Primary angiosarcoma of the female reproductive system is extremely rare, and its management is not well understood. We experienced a very rare case of angiosarcoma arising in the uterus of a 37-year-old woman who presented abdominal distension. At laparotomy, the uterus was observed to be enlarged and deformed by multilobulated hemorrhagic mass. Tumor deposits were present on both ovaries and the omentum. The operation consisted of total abdominal hysterectomy with salpingo-oophorectomy, and omentectomy. Microscopic examination showed that the tumor consisted mostly of solid sheets of pleomorphic and spindle cells forming irregular, communicating cleft-like spaces. Well-formed vascular channels lined by atypical endothelial cells were seen in differentiated areas. Some vessels were partially lined by normal endothelial cells and partially by neoplastic endothelial cells. Papillary architecture composed of epithelioid tumor cells was noted in a focal area. The tumor cells were immunoreactive for factor VIII-related antigen, Ulex europaeus agglutinin-1, CD31 and CD34. Weibel-Palade bodies were not seen in the tumor cells. She received adjuvant chemotherapy, but died 13 months after the diagnosis.
Adult ; Chemotherapy, Adjuvant ; Diagnosis ; Endothelial Cells ; Female ; Hemangiosarcoma* ; Humans ; Hysterectomy ; Laparotomy ; Omentum ; Ovary ; Ulex ; Uterus* ; von Willebrand Factor ; Weibel-Palade Bodies

No abstract available.
Humans ; Osteosarcoma*

Miller-Dieter syndrome consists of severe type I lissencephaly, abnormal facial appearance, and sometimes other birth defects. Lissencephaly is a brain malformation manifested by a smooth cerebral surface, thickened cortical mantle, and microscopic evidence of incomplete neuronal migration. It comprises the agyria-pachygyria spectrum of malformation, thus excluding polymicrogyria and other cortical dysplasia. Type I lissencephaly results from abnormal migration between about 10 and 14 weeks gestaion. The brain is often small, and the ventricle is enlarged posteriorly The corpus callosum may be small or absent. The structural pattern of the cerebral hemispheres and ventricles is distintly immature, reminiscent of fetal brain. The superficial cellular layer resembles an immature cortex, with some separation into zones similar to layers III, V, and VI of normal cortex, although the cell population is decreased. In 1963 Miller described a malformation syndrome in a brother and sister with postnatal growth deficiency, craniofacial defects, and serious abnormalities of neurologic function. Autopsy at 3 and 4month of age, respectively, revealed lissencephaly. Subsequently, Dieker reported four additional patients with this disorder and referred to it as the 'lissencephaly syndrome'. We have experienced a case with this syndrome. Then we report this rare case with brief review of literature.
Autopsy ; Brain ; Cerebrum ; Congenital Abnormalities ; Corpus Callosum ; Humans ; Lissencephaly ; Malformations of Cortical Development ; Neurons ; Siblings

We experienced a case of adenocarcinoma arising in sacrococcygeal teratoma. The patient was a 52-year-old woman. She was admitted due to one month of sacral pain. She had a sacral mass since birth. On physical examination, anal fistula was present at the perianal area and pus drainage was noted. MR image showed multiple variable-sized cysts with inhomogeneous density. Resected specimen, mesuring 12.5 7.0 cm in diameter, showed multiple variable-sized cystic lesions admixed with grayish solid portion. The cysts contained mucoid material. The microscopic examination showed mature teratoma composed of cysts lined by pseudostratified ciliated columnar epithelium, intestinal mucosa, mature cartilage, bone, and fat tissue. A moderately differentiated adenocarcinoma developed from the cystic area in the mass.
Adenocarcinoma* ; Adult ; Cartilage ; Drainage ; Female ; Humans ; Intestinal Mucosa ; Middle Aged ; Mucous Membrane ; Parturition ; Physical Examination ; Rectal Fistula ; Suppuration ; Teratoma*

No abstract available.
Fontan Procedure* ; Heart Ventricles*

PURPOSE: To verify the usefulness of left portal vein angle (LPVA) on CT scan in the diagnosis of liver cirrhosis and to compare its diagnostic value with that of caudate to right lobe ratio (C/RL ratio). MATERIALS AND METHODS: LPVA, an angle formed by a vertical line and a line connecting the center of the vertebral body to the umbilical point of the left portal vein, and C/RL ratio were measured on CT scans of 100 cirrhotic and 100 normal livers. Diagnostic values of LPVA and C/RL ratio were compared statistically. RESULTS: The mean of LPVA was 18.9 degrees(SD; 7.6) for normal livers and 25.8 degreesSD; 8.4) for cirrhotic livers (P<0.001). The mean of C/RL ratio was 0.47(SD; 1.10) for normal livers and 0.58(SD;0.14) for cirrhotic livers (P<0.001). When LPVA was greater than 30 degreesliver cirrhosis was diagnosed with 36% sensitivity and 92% specificity. When C/RL ratio was greater than 0.60, the diagnose of liver cirrhosis was with 41% sensitivity and 90% specificity. There was no significant difference of the diagnostic accuracy between LPVA and C/R L ratio in ROC analysis. CONCLUSION: Both LPVA and C/RL ratio are useful diagnostic indices of liver cirrhosis on CTscan. LPVA is more convenient to measure than C/RL ratio.
Diagnosis* ; Fibrosis ; Liver Cirrhosis* ; Liver* ; Portal Vein* ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed