No abstract available.
Spinal Cord Vascular Diseases*

No abstract available.
Aneurysm* ; Humans ; Hydrocephalus*

No abstract available.
Sepsis* ; Yersinia*

BACKGROUND: The purpose of this study was to investigate plasma levels of endostatin and vascular endothelial growth factor (VEGF) in normal subjects and in patients with pituitary adenoma and to evaluate change in these levels following stereotactic radiosurgery (SRS) for pituitary adenoma. METHODS: Peripheral venous blood was collected from five patients with pituitary adenoma before SRS using Gamma Knife and at the 1 week and 1 month follow-up visits. Plasma endostatin and VEGF levels were measured using commercially available enzyme-linked immunosorbent assay kits. Peripheral blood samples were obtained from 10 healthy volunteers as controls. RESULTS: Mean baseline plasma endostatin level (105.3 ng/mL, range, 97.0-120.2 ng/mL) in patients with pituitary adenoma was higher than that of the healthy controls (86.6 ng/mL, range, 71.3-98.2 ng/mL) (p=0.001). Mean plasma VEGF level was 89.5 pg/mL (range, 24.1-171.8 pg/mL) in patients with pituitary adenoma at baseline and 29.3 pg/mL (range, 9.2-64.3 pg/mL) in the control group (p=0.050). Plasma endostatin level changed to 106.6 ng/mL 1 week after SRS and decreased to 95.9 ng/mL after 1 month. Plasma VEGF level following SRS decreased to 74.1 pg/mL after 1 week and 79.0 pg/mL after 1 month. There was a trend toward decreased plasma endostatin and VEGF concentrations 1 month after SRS compared to baseline levels (p=0.195, p=0.812, respectively). CONCLUSION: Plasma endostatin and VEGF levels in patients with pituitary adenoma were significantly elevated over controls at baseline, which decreased from baseline to 1 month after SRS for pituitary adenomas.
Endostatins* ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Healthy Volunteers ; Humans ; Pituitary Neoplasms* ; Plasma ; Radiosurgery* ; Vascular Endothelial Growth Factor A*

OBJECTIVE: The purpose of this study was to evaluate whether 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can be used to assess the therapeutic response of brain abscess. METHODS: A study was conducted on 10 consecutive patients with brain abscess. Magnetic resonance imaging (MRI) with diffuse-weighted imaging (DWI) was performed at 3 and 6 weeks after surgical treatment and intravenous antibiotics therapy and FDG-PET at 6 weeks after treatment. The extent of the abscess, signal changes on MRI, and FDG-PET standardized uptake values were analyzed and correlated with the response to therapy. RESULTS: Aspiration or craniotomy with excision of the abscess followed by intravenous antibiotics for 6-8 weeks resulted in good recovery with no recurrence. In 10 patients, two had low signal intensity on the DWI; one had no uptake on FDG-PET imaging after 6 weeks antibiotics and discontinued intravenous treatment, but the other patient had diffuse, increased uptake on FDG-PET imaging after 6 weeks antibiotics and underwent an additional 2 weeks of intravenous antibiotics. The remaining eight patients had high signals on the DWI. Four had no uptake on FDG-PET imaging and the treatment period varied from 6 to 8 weeks (mean, 6.75 weeks). Among the other four patients, FDG was accumulated in a diffuse or local area corresponding to a high signal area within the DWI and 2 weeks of intravenous antibiotics was added. CONCLUSION: MRI plus FDG-PET improved the accuracy of assessing therapeutic responses to antibiotics treatment of brain abscess and aided in optimizing therapy.
Abscess ; Anti-Bacterial Agents ; Brain ; Brain Abscess ; Craniotomy ; Electrons ; Humans ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Recurrence

Although the survival rate in childhood cancer is increased with current improvements of diagnostic and therapeutic methods, the incidence of second malignancy is now increasing. Therefore close follow-up with high index of suspicion for second malignancies are important for cancer survivng patients. We report our experiences of 3 second malignancies which were glioblastoma multiforme after treatment of acute lymphoblastic lymphoma, Philadelphia positive leukemia after treatment of osteosarcoma and acute myelogenous leukemia occuring in the course of chemotherapy for acute lymphoblastic leukemia. It is imperative that survivors of childhood cancer be closely followed for the detection of not only the relapse of original disease but also the occurrence of second malignancy.
Drug Therapy ; Follow-Up Studies ; Glioblastoma ; Humans ; Incidence ; Leukemia ; Leukemia, Myeloid, Acute ; Neoplasms, Second Primary* ; Osteosarcoma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Radiotherapy ; Recurrence ; Survival Rate ; Survivors

26 pediatric patients of spinal injury, below the age of 15 were admitted to KyungPook National University Hospital from Jan. 1972 to Jun. 1987, which accounted for 5.2% of the entire cases of spinal injury during the same period. Most number of cases fell in the age brackets of 2-8 and 12-24. Causes of the cases were in the order of traffic accident(48%), falling, direct blow. sports. and stab injury. The sites ran in such order as cervical( 30.8%), thoracic, lumbar and thoracolumbar spine. The breakdown of clinical findings was: Grade I-8, Grade II-5, Grade III-4, and Grade IV-8. Forty percent of the cases were found with no radiological abnormalities, still keeping the neurological deficits. Fracture was classified as: simple-6, dislocation-7, and subluxation-2. Methods of treatment were: conservative-l4, traction-5, laminectomy-5, and fusion-1. All patients in the categories from Grade I to III recovered to a good state. In Grade N, one each for good and fair recovery was achieved, five were poor and one expired from complication of head injury.
Child* ; Craniocerebral Trauma ; Gyeongsangbuk-do ; Humans ; Laminectomy ; Spinal Injuries* ; Spine ; Sports

OBJECTIVE: Central nervous system has unique inflammatory responses to the exposure to the endotoxin and immature brain may have a different response with that of the mature. The authors conduct this experiment to elucidate the characteristics of inflammatory response in immature brain. METHODS: Lipopolysaccharide(LPS) was injected in the right caudate nucleus in 7-day-old and adult Sprague-Dawley rats. The doses were 1 microliter of 0.1, 0.5, and 2.0mg/ml of LPS and the same amount of saline for controls. The rats were sacrificed 24hours after injections. Light microscopic examination was performed to evaluate the leukocyte recruitment, and reverse transcriptase-polymerase chain reaction(RT-PCR) to measure the expression of interleukin-1beta(IL-1beta) and tumor necrosis factor-alpha(TNF-alpha) mRNA. RESULTS: Light microscopic examination revealed more pronounced leukocyte infiltration in neonatal brain than in adult, even though lower than in peripheral tissue. RT-PCR revealed dose dependent expression of IL-1beta and TNF-alpha mRNA in both neonatal and adult brain as in peripheral tissue. CONCLUSION: These results support that the immature brain is more vulnerable to the LPS induced inflammation in terms of leukocyte infiltration and possibly resultant brain damage. However, the mechanism of inflammatory response in immature brain should be studied further in association with the research of the activity of microglia, astrocyte, blood brain barrier, chemokine, and adhesion molecule in immature brain.
Adult ; Animals ; Astrocytes ; Blood-Brain Barrier ; Brain* ; Caudate Nucleus ; Central Nervous System ; Humans ; Inflammation ; Interleukin-1beta ; Leukocytes ; Microglia ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Tumor Necrosis Factor-alpha

Because of the possibility of increased the risk of soft tissue or bone infection, surgeon have been somewhat reluctant to use the anterior cervical approach in spinal injury patients who had previously undergone tracheostomy. The authors investigated whether the use of a Caspar plate in such patients during anterior cervical fixation altered the risk of infection. We analyzed the mechanism and level of injury, operative procedures, post-operative course and infection in 12 cervical injury patients with previous tracheostomy. The procedure had been performed on the day of injury because of semicoma resulting from combined head injury in two cases, and because of multiple rib fracture with hemothorax, and old age with chronic obstructive lung disease in one case each; it had been performed between 1-6 days after injury because of high fever with pneumonia and atelectasis in eight cases. The interval between tracheostomy and anterior fixation was 5-20(average, 13) days. During clinical follow-up at 8-21 (average, 16) months, bone union without infection was observed in all patients. The authors concluded that in patients with cervical cord injury, tracheostomy did not increase the risk of infection in subsequent anterior cervical fixation using a Caspar plate.
Craniocerebral Trauma ; Fever ; Follow-Up Studies ; Hemothorax ; Humans ; Pneumonia ; Pulmonary Atelectasis ; Pulmonary Disease, Chronic Obstructive ; Respiratory Insufficiency ; Rib Fractures ; Spinal Injuries ; Spine* ; Surgical Procedures, Operative ; Tracheostomy*

OBJECTIVE: The tethered cord syndrome results in progressive neurological deficits. Although it may remain controversial, many physicians recommend definitive surgery to untether the cord as soon as this condition is identified. We retrospectively evaluate the pre-operative and post-operative course of 38 tethered cord patients with spinal dysraphism in an attempt to learn the natural history of the disease and to determine the effectiveness of the surgical treatment. METHODS: The medical records, operation notes and radiographs were evaluated. The follow up period ranged from 4 months to 12 years with a mean follow-up of 28.6 months. Twenty-seven patients were younger than 15 years of age. RESULTS: At presentation, 26 of the patients were asymptomatic. In three of 11 adult symptomatic patients, their neurological deficits worsened after trauma or exercise. Improvement of motor strength was documented in two out of 5 patients. Five of nine patients with bladder symptoms improved, however, none had a complete return of their bladder function. CONCLUSION: Childhood patients were less symptomatic than the adult patients. Adult patients showed progression of their symptoms that were not improved even after the operation in most of the cases. Asymptomatic tethered spinal cord can be symptomatic as time passes by and even at an old age. Future research should be focused on the operative methods to prevent the delayed deterioration after surgery, rather than on the usefulness of preventive surgery in asymptomatic patients.
Adult ; Follow-Up Studies ; Humans ; Medical Records ; Natural History ; Neural Tube Defects ; Retrospective Studies ; Spinal Cord* ; Spinal Dysraphism ; Urinary Bladder