Diastematomyelia, a form of spinal dysraphism, is characterized by a division of the spinal cord or canda equina resulting the form a bony or cartilaginous spur which transfixes the neural elements and dura. The presence of a structure of neural crest origin in the subarachnoid space connecting the spicules suggested that the anomaly resulted from delayed closure of the neural tube and its investments. The cinical finding are presumed due to its restriction, tethering of the normal apward migration of the spinal cord. Congenital anomalies of one or both lower extremities and spine are frequently found with this condition. The surgical removal is recommended as a prophylactic measure against further progressive neurological damage. The purpose of this paper is to presented becanse it was associated with clubfoot and adds to understanding of teratogenesis of diastematomyelia.
Clubfoot ; Investments ; Lower Extremity ; Neural Crest ; Neural Tube ; Neural Tube Defects ; Spinal Cord ; Spinal Dysraphism ; Spine ; Subarachnoid Space ; Teratogenesis

The author used in vivo P nuclear magnetic resonance spectroscopy to determine the effect of cerebral air embolization and nimodipine, phenylephrine, pentobarbital and ketamine on changes of pH and PCr/Pi in 35 cats After anesthetizing animals by 15mg/kg/hr iv of pentobarbital in control, nimodipine, nimodipine plus phenylephrine and phenylephrine group or 6 mg/kg/hr of ketamine iv in ketamine group, air was introduced into the carotid artery and 10 ug iv of nimodipine every 6 min or 0.1% phenylephrine iv infusion to maintain mean arterial blood pressure were given. There were tendencies that mean arterial blood pressure increased immediately after infusion of air and recovered baseline value in phenylephrine, nimodipine plus phenylephrine and ketamine groups but remained lower than baseline vaIue in pentobarbital and nimodipine group(P<0.05). The pH decreased in 6 min and returned to baseline within 24 min in all groups and PCr/Pi decreased in all cats in 6 min and recovered baseline value but remained low values in control and nimodipine group without statistical significance. The results suggest that cerebral ischemia by air embolism was aggravated by vasodilating and hypotensive action of nimodipine and was ameliorated by maintaining or elevating blood pressure by phenylephrine, and also ketamine anesthesia showed faster recovery of brain metabolism than pentobarbital anesthesia, but these findings were only the tendencies and further study is recommended.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure ; Brain ; Brain Ischemia ; Carotid Arteries ; Cats* ; Embolism, Air ; Energy Metabolism* ; Hydrogen-Ion Concentration ; Ketamine* ; Magnetic Resonance Spectroscopy* ; Metabolism ; Nimodipine* ; Pentobarbital* ; Phenylephrine* ; Spectrum Analysis*

Gastrointestinal stromal tumor (GIST) is known as considerable controversal tumor about it's histogenesis, differentiation and biologic behavior. It is traditionally regarded as smooth muscle tumor. To evaluate and clarify the origin of tumor, we performed immunohistochemical study of 23 cases of GIST on CD34 antigen, alpha-smooth muscle actin, S-100 protein, and compared the result with 4 cases of typical leiomyoma of GI tract. The results were as follows. CD34 antigen expression was noted in 21 cases (91.3%) of GIST, while typical leiomyoma was all negative. There were no difference of CD34 expression according to the biologic behavior. However, it's staining pattern was significantly different (p<0.05). Focal or multifocal expression was dominant in benign GIST (58.3%), while diffuse expression was dominant in malignant GIST (80%). Actin was expressed in 5 cases of benign GIST (38.5%) and 1 of malignant GIST (16.7%) focally. All typical leiomyoma showed diffuse strong positivity on alpha-smooth muscle actin. S-100 protein was expressed in 2 cases of benign GIST (16.7%) only. The pattern of CD34 expression was focal in the actin or S-100 protein positive cases. In conclusion CD34 antigen is useful marker in the separation of GIST, from typical smooth muscle tumor. Also it suggest that most GISTs are histogenetically primitive mesenchymal cell origin. However, CD34 expression was unrelated with biologic behavior of GIST.
Actins ; Antigens, CD34* ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Leiomyoma ; S100 Proteins ; Smooth Muscle Tumor

Transitional cell carcinoma of the urinary bladder is the most common cancer of the urinary tract and is characterized by frequent recurrence. Like the other malignant tumor, the genetic alterations leading to neoplastic transformation of the urothelium are related with the activation of oncogenes and loss of functional tumor suppressor genes. Cyclin D1 is a putative protooncogene as cell cycle regulator essential for G1 phase progression and is frequently overexpressed in several human tumor. In this study we performed immunohistochemical stainings of cyclin D1 and p53 in both primary and recurrent transitional cell carcinomas of urinary bladder from 56 patients including 20 cases of recurrent tumor, and compared their results with histopathologic features. The results were as follows. Cyclin D1 immunoreactivity was found in 10 of 10 cases (100%) of grade 1, 25 of 41 (61%) cases of grade 2, and 11 of 25 (44%) cases of grade 3 transitional cell carcinomas. p53 immunoreactivity was found in 40% of grade 1, 63% of grade 2, and 87% of grade 3 lesions. Cyclin D1 expression was significantly higher in Ta and T1 lesions than T2 to T4 by pathologic tumor stage. Conversely p53 immunoreactivity was increased in proportion to the T classification. Cyclin D1 was de creased in recurrent transitional cell carcinomas, compared with primary transitional cell carcinomas. However, there was no statistical significance. In conclusion, cyclin D1 immunoreactivity is associated with low histologic grade and low tumor stage. And there is inverse relationship between the cyclin D1 and p53 overexpression.
Carcinoma, Transitional Cell* ; Cell Cycle ; Classification ; Cyclin D1* ; Cyclins* ; G1 Phase ; Genes, Tumor Suppressor ; Humans ; Oncogenes ; Recurrence ; Urinary Bladder* ; Urologic Neoplasms ; Urothelium

Intracerebroventricular(ICV) bupivacaine produces dysrhythmias and hypertension by altering autonomic nervous system outflow from the CNS. Author evaluated the effect of ICV infusion of saline(0.15 ml), midazolam(0.75 mg), droperidol(0.375 mg), and clondine(0.0225 mg) on dysrhythmia and hypertension induced by ICV bupivacaine in 20 cats. After ICV infusion of bupivacaine, all cats in 4 groups(5 cats in each) developed dysrhythmia and hypertension. Dysrhythmia disappeared within 5 minutes in midazolam, droperidol and clonidine group except saline group but recurred in two of the five cats in midazolam group. Mean arterial pressure decreased more significantly in droperidol and clonidine group than midazolam group<0.05), and heart rate decreased significantly in c1onidine group after ten minutes(p < 0.01). It is concluded that clonidine and droperidol are more potent and effective than midazolam on hypertension and dysrhythmia caused by ICV bupivacaine.
Animals ; Arterial Pressure ; Autonomic Nervous System ; Bupivacaine* ; Cats* ; Clonidine* ; Droperidol* ; Heart Rate ; Hypertension* ; Midazolam*

No abstract available.
Humans ; Irritable Bowel Syndrome*

The effect of single dose clonidine premedication on the vapour requirement for isoflurane induced hypotension in 20 patients undergoing spine surgery was evaluated. The patients given 5 ug/kg of clonidine P.O. at 90 minutes before operation required a mean expired isoflurane concentration of 1.2+/-0.5 vol% to induce hypotension compared with 2.1+/-0.6 vol% in 0.2 mg/kg of diazepam predmedication group(P<0.05). To achieve satisfactory hypotension, six out of ten patients in diazepam premedication group and l out of 10 patients in clondine premedication group are required supplementary infusion of sodium nitroprusside. In conclusion, clonidine premedication is recommended in isoflurane induced hypotensive anesthesia.
Anesthesia* ; Clonidine* ; Diazepam ; Humans ; Hypotension ; Isoflurane* ; Nitroprusside ; Premedication* ; Spine

No abstract available.
Defense Mechanisms*

Chordoma is a rare distinctively malignant tumor thought to be histogenetically related to the primitive notochord, It is locally infiltrative but does not metastasize until late. The usual initial symptom is pain or some symptom caused by involvement of the nervous system. Involed in the order of frequency are the sacro-coccygeal area, the spheno-occipital area, and the other vertebral area. This case is a sacro-coccygeal chordoma that is confirmed by histologic examination. The lesion was treated by complete excision.
Chordoma ; Nervous System ; Notochord

BACKGROUND: The VDRL is used as a screening test for syphilis worldwide. In addition, reactive rates of the VDRL test are used to estimate the incidence of syphilis. The prevalence of syphilis reported in Korea varies according to the study population, district and time. Reports on prevalence of syphilis indicate that reactive rates of the serologic test for syphilis showed an increasing tendency in the 1960s and has steadily decreased in the 1990s. We have already reported VDRL positive rates periodically since the late 1970s in similar areas with similar population groups and methods in order to standardize the results for accurate analysis of the prevalence of syphilis in Korea. OBJECTIVE: This study was performed utilizing the VDRL test in order to find out if the decreasing trend of syphilis prevalence is still continuing. METHODS: The ser ologic tests for syphilis were carried out on 13,426 apparently normal adults aged twenty-years-old or over(8,250 blood donors in the Seoul area, 2,461 physical examinees examined at Severance Hospital, Yonsei University and 2,715 pregnant women at delivery at Severance Hospital, Yonsei University ) from January to December 1995. We hve performed the VDRL quantitative test in VDRL-reactive persons among blood donors and pregnant women. RESULTS: The reactive rate of the serum VDRL test was 0.2% in 13,426 healthy adults(blood donors.0.2%, physical examinees:0,2%, pregnant women:0.3%). There was a statistically decreasing tendency compared to 0.4% in 1990(p<0.001). The VDRL quantitative test resulted in levels below the 1:2 titer in 92% of the VDRL-reactive physical exarninees and pregnant women. CONCLUSION: From the comparison of VDRL reactive rates for syphilis in an apparently normal Korean population obtained by the present author group since 1977, i.e., 2.5% in 1977, 1.1% in 1981, 0.6% in 1986, 0.4% in 1990 and 0.2% in 1995, it is clear that the prevalence of syphilis has been rapidly decreasing since the mid 1970s in Korea.
Adult ; Blood Donors ; Female ; Humans ; Incidence ; Korea* ; Mass Screening ; Population Groups ; Pregnant Women ; Prevalence* ; Seoul ; Serologic Tests ; Syphilis*