No abstract available.
Aneurysm* ; Humans ; Hydrocephalus*

No abstract available.
Spinal Cord Vascular Diseases*

No abstract available.
Sepsis* ; Yersinia*

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

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*

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

Ventriculitis is one of the most serious complication of the ventriculoperitoneal shunt, which may cause intelligence deterioration in children. The purpose of this study is to investigate the mechanism of the neural damage in lipopolysacciride(LPS)-induced ventriculitis in rat. Ventriculitis was induced by intraventricular injection of 1mg/Kg LPS in rat. H & E and Tunel stains were done on the day 1, 2 and 14 to access the microscopic changes of the periventricular tissue and apoptosis, respectively. TNF-alpha and IL-1beta mRNA expressions were studied using RT-PCR. HRP was injected into the femoral vein and electron microscopic examinations were performed to access the BBB changes. Light microscopic examination one day after LPS injection revealed neutrophilic infiltration, which diminished on day 4, and disappeared on 14. Tunel stain revealed apoptosis on day 1 and 4. TNF-alpha and IL-1beta were expressed on day 1, and diminished progressively thereafter. HRP histochemical electron microscopic examination revealed accumulation of HRP reaction in the interstitial space around the brain parenchyma. These findings suggest the opening of the BBB and increased capillary permeability in the periventricular tissue in the LPS induced ventriculitis. This can possibly damage the periventricular neural tissue. TNF-alpha and IL-1beta seemed to play an important role in the opening of the BBB.
Animals ; Apoptosis ; Blood-Brain Barrier ; Brain ; Capillary Permeability ; Child ; Coloring Agents ; Femoral Vein ; Humans ; In Situ Nick-End Labeling ; Injections, Intraventricular* ; Intelligence ; Interleukin-1 ; Neutrophils ; Rats ; RNA, Messenger ; Tumor Necrosis Factor-alpha ; Ventriculoperitoneal Shunt

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

Pediatric head injury is a leading cause of disability or death in children. Reducing morbidity and mortality require careful attention to the factors leading to poor prognosis. In this regards authors reviewed the clinical features of pediatric head injury to find out the prognostic factors. From 1992 to 1996, 96 pediatric head injury patients were admitted to our hospital. Seventy eight of them(81.3%) were transferred from the other hospitals. Pedestrian vehicle accident and fall were the leading causes. Clear or drowsy patients account for 42.7 %, stuporous, semicomatose or comatose, 57.3%. Early seizures were noted in 18(18.8%). Outcome were good in 68(70.8%), moderate to severe disability 18(18.8%), vegetative 3(3.1 %), and died 7(7.3%). Consciousness level was the most significantly related with poor prognosis. Radiological deterioration, hematoma or edema, was noted in thirteen patients, and their prognosis was significantly worse than others(p=0.01). Those patients with complications occurred during admission such as pneumonia or electrolyte imbalance showed poorer prognosis (p<0.05). In conclusion outcome of the pediatric head in Jury was significantly related to the initial mentality, worsening of hematoma or edema on follow up CT scan, and complications such as pneumonia and electrolyte imbalance during admission . Early recognition of these factors would contribute to the improvement of the outcome of the pediatric head injury patients.
Child ; Coma ; Consciousness ; Craniocerebral Trauma* ; Edema ; Follow-Up Studies ; Head* ; Hematoma ; Humans ; Mortality ; Pneumonia ; Prognosis ; Seizures ; Stupor ; Tomography, X-Ray Computed