For the morphological analysis of DMBA (9,10-diemethyl-1,2-benzanthracene) induced tumor, thirty Sprague-Dawley rats were received 0.1 ml of a 2% paraffin solution of DMBA into the knee joint cavity, which was repeated three times at an interval of 4 weeks. The induced tumor masses were removed at the 12th week after the first injection. Histological and histochemical examinations (H & E, PAS, alcian blue, Van Gieson, prussian blue, reticulin, PTAH stain) and enzyme histochemical examinations (acid phosphatase, alkaline phosphatase, alpha-naphthyl acetate esterase) were performed. The results were as follows: 1) By the 12th week after the first injection of DMBA, the tumor incidence rate was 20 percent. 2) On histological and histochemical examination, most of the induced tumor disclosed the features of the fibrous histiocytoma originating from mesenchymal cells, and the remains sweat gland adenoma and adenocarcinoma originating from epithelial cells. 3) On enzyme histochemical examination, most of the mesenchymal cell-derived tumor cells showed positive reactions for acid phosphatase and alpha-naphthyl acetate esterase, which were similar characteristic features of enzyme stains as shown in the component cells of fibrous histiocytoma.
Rats ; Animals ; Incidence ; Adenocarcinoma ; Adenoma

Caroli's disease is associated with the combination of congenital dilation of the intrahepatic bile ducts, polycystic disease of the kidney and congenital hepatic fibrosis. The disease entity was first reported by Caroli and associates(1958) and was extensively reviewed in a monograph by Caroli and Corcos (1964). The original first description of Carolis disease is characterized by congenital saccular dilation of the intrahepatic bile ducts, a high incidence of stone formation and cholangitis, absence of hepatic fibrosis and portal hypertension but associated with renal tubular ectasia or other forms of cystic disease of the kidneys, possibly of the pancreas. However the pure form, as described above, has been uncommon. We have experience with a case of general anesthesia for a 12 year old female patient who had Caroli's disease, which was confirmed preoperatively by computerized tomography in Kyung Hee Medical Center. As the Carolis disease may involve hypofunction of the liver and kidney, anesthetics with less action on the liver and kidney are-preferable. This patient was premedicated with atropine and meperidine. Anesthesia was induced with thiopental and succinylcholine for intubation, then maintained with N2O-O2 pancuronium and meperidine. The anesthetic and immediate postoperative course was uneventful, but the patient expired with expected cardiac arrest one week later.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Atropine ; Bile Ducts, Intrahepatic ; Caroli Disease* ; Cholangitis ; Dilatation, Pathologic ; Female ; Fibrosis ; Heart Arrest ; Humans ; Hypertension, Portal ; Incidence ; Intubation ; Kidney ; Liver ; Meperidine ; Pancreas ; Pancuronium ; Succinylcholine ; Thiopental

Bacillus species are aerobic, gram-positive, spore forming rods that are widely distributed in soil, dust, stream, and other environmental sources and are regarded as natural organism. But certain species of the genus Bacillus, most notably B.cereus, which is associated with food-borne illness, occasionally have been implicated in the occurrence of fatal illness and complication in a compromised host. We roport a case of pneumonia and bacteremia caused by B.cereus in an 81 year-old man, who had no obvious immunologic compromise. The condition was treated with combination of roxithromycin and gentamicin.
Bacillus cereus* ; Bacillus* ; Bacteremia ; Dust ; Gentamicins ; Pneumonia* ; Rivers ; Roxithromycin ; Soil ; Spores

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of remote cerebellar hemorrhage (RCH), which was a complication after posterior decompression and lumbar interbody fusion (PILF). SUMMARY OF LITERATURE REVIEW: Remote cerebellar hemorrhage (RCH) after spinal surgery is a rare complication, and its cause is known to be due to a loss of cerebral spinal fluid (CSF) through the dural tear. Most of the literature has disclosed that early diagnosis and treatment of RCH is very important in the patient with suspicious symptoms. MATERIALS AND METHODS: A 57-year-old woman had posterior lumbar decompression and interbody fusion for the severe spinal stenosis at L4-5. During surgery, an accidental dural tear with CSF leakage occurred. The torn dura was sutured. Postoperatively, she developed nausea and a severe headache. Hypotension developed at postoperative 2 hours. A brain CT showed RCH. The patient was conservatively managed with clamping of the wound drainage. RESULTS: The nausea and severe headache were controlled and normal blood pressure could be maintained without dopamine therapy at postoperative day 2. The patient was discharged without any neurological deficit, and her consciousness was clear at postoperative 2 weeks. CONCLUSIONS: Persistent postoperative nausea, headache, and hypotension after repair of the torn dura may suggest that the treating surgeons pay careful attention due to the possibility of RCH, even though the amount of CSF leakage is small.
Blood Pressure ; Brain ; Consciousness ; Constriction ; Decompression* ; Dopamine ; Drainage ; Early Diagnosis ; Female ; Headache ; Hemorrhage* ; Humans ; Hypotension ; Lumbar Vertebrae ; Middle Aged ; Nausea ; Postoperative Nausea and Vomiting ; Spinal Stenosis ; Wounds and Injuries

PURPOSE: To evaluate the effectiveness of using Keratome in endonasal Dacryocystorhinostomy (DCR). METHODS: The authors used 3.0mm keratome, designed for cataract surgery, to incise medial wall of the lacrimal sac during endoscopic endonasal DCR in 11 patients with nasolacrimal duct obstruction. RESULTS: Surgical success rate was 90% with fast recovery time of nasal mucosa without specific complication. CONCLUSIONS: Lacrimal sac incision using keratome was more effective and non-invasive than using nasal forceps, with advantages such as shorter operation time and less nasal mucosa injury with rapid recovery time.
Cataract ; Dacryocystorhinostomy* ; Humans ; Nasal Mucosa ; Nasolacrimal Duct ; Surgical Instruments

No abstract available.
*Chromosome Aberrations ; Female ; Humans ; Leukemia/*genetics ; Male

Delayed peripheral polyneuropathy caused by organophosphorus intoxication is not uncommon. This is a case report of 32 years old female with peripheral polyneuropathy which is appeared two weeks after organophosphorus poisoning. It is characterized by calves pain followed by minmal sensory change and predominant motor weakness affecting the distal part of the limbs. The electrophysiologic and pathologic studies support the clinical diagnosis. The exact pathogenesis is still debated, but phosphorylation of neurotoxic esterase (NTE), followed by "aging" process was suspected to play a role in the development of axonal degeneration.
Adult ; Axons ; Diagnosis ; Extremities ; Female ; Humans ; Organophosphate Poisoning ; Phosphorylation ; Polyneuropathies*

Both interictal Tc-99m hexamethyl-propyleneamine oxime single photon emission computed tomography (HM-PAO SPECT) brain scintigraphy was done in a patient with the syndrome of chronic encephalitis and epilepsy. The low density area in the temporo-occipital lobe on brain CT scan revealed decreased radioactivity during interictal state and it was reversed to increased radioactivity during ictal state on HM-PAO SPECT brain imaging. In authors' opinion, ictal and interictal Tc-99m HM-PAO SPECT brain scintigraphy could be a safe and convincing study for Searching epileptogenic foci.
Brain* ; Encephalitis* ; Epilepsy* ; Humans ; Neuroimaging ; Radioactivity ; Radionuclide Imaging* ; Tomography, Emission-Computed, Single-Photon* ; Tomography, X-Ray Computed

Hypercholesterolemia is one of the major risk factors for atherosclerosis. Reduction of serum total and low density lipoprotein cholesterol(LDL-C) and the increase of high density lipoprotein cholesterol(HDL-C) are known to be associated with significant decrease of the incidence of atherosclerotic disease. HMG CoA reductase is known as rate limiting enzyme in the synthesis of cholesterol. Among many inhibitors of this enzyme pravastatin was recently released. To evaluate the efficacy and safety of this drug in Korean patients with hypercholesterolemia daily 5-40mg of pravstatin was administred in 30 patients after 4 weeks' wash-out and followed in 4 week-intervals up to 12 weeks. 1) Total cholesterol(TC) was decreased from 247.3+/-24,7mg/dl to 216.6+/-34.8mg/dl after 4 weeks, 214.3+/-36.7mg/dl after 8 weeks and 212,5+/-36.1mg/dl after 12 weeks(p,0.001, respectively). 2) Triglycrride(TG) was decreased from 191.3+/-77.9mg/dl to 161.4+/-61.4mg/dl after 4 weeks(p<0.005),155.4+/-74,8mg/dl after 8 weeks (p<0.05) but after 12 weeks the level of triglyceride was 165.5+/-70.3mg/dl, not significantly different from the basal level. 3) LDL-C was decreased from 155.0+/-29.3mg/dl to 129.8+/-34.4mg/dl after 4 weeks. 132.0+/-32.4mg/dl after 8 weeks and 125.9+/-38.1mg/dl after 12 weeks (p<0.01. respectively). 4) HDL-C was not significantly changed during the trial. 5) TC/HDI-C ratio was decreased from 4.8%+/-1.3 to 4.1+/-0.9 after 4 weeks. 4.3.+/-0.9 after 8 weeks and 4.1+/-1.1 after 12(p<0.01.respectivcly). 6) LDL-C/HDL-C ratio was decreased from3.0+/-1.0 to2.5+/-0.8 after 4 weeks(p<0.01).2.6+/-0.7 after 8 weeks(p<0.05) and 2.4+/-0.9 after 12 weeks(p<0.01). 7) The side effects of pravastatin were mild and transient, including 1 case of nausea, 1 headache, 1 flushing sensation on the face and 2 dizziness. 8) The laboratory studies including serum transaminases,uric acid, creatinine, creatine phoshokinase and blood glucose were not changed significantly. These results suggested that pravastatin is an effective and relative safe hypolipidemic agent in Korean adult patients with hypercholesterolemia.
Adult ; Atherosclerosis ; Blood Glucose ; Cholesterol ; Creatine ; Creatinine ; Dizziness ; Flushing ; Headache ; Humans ; Hydroxymethylglutaryl CoA Reductases ; Hypercholesterolemia* ; Incidence ; Lipoproteins ; Nausea ; Pravastatin* ; Risk Factors ; Sensation ; Triglycerides

PURPOSE: The purpose of our study is to evaluate characteristic features of 4th ventricular tumors in CT and MRI. MATERIALS AND METHODS: Pathologically proved 9 patients with 4th ventricular tumor were examined by CT and/or MRI. 4th ventricular tumors were epedymoma(4 cases), medulloblastoma(2 cases), choroid plexus papilIoma(2 cases), and oligodendroglioma(1 case). Included in our study were only those mass lesions that were located at surgery predominently within 4th ventricle with or without ventricular expansion. RESULTS: The origin of 4th ventricular tumor was the roof (epedymoma 3 cases, medulloblastoma 2 cases), the floor (epedymoma 1 case), and the undetermined(remaining 3 cases). On MRI, all tumors were hypointense exept ependymoma(3 cases) showing isointensity on T1WI. All tumors were hyperintense on PDWI and T2WI. On Gd-DTPA enhanced T1WI, strong enhancement was seen in all but epedymoma(1 case) which showed mild enhancement. On CT, as compared with MR images, various density on precontrast and postcontrast images were seen. Calcification was seen in choroid plexus papilloma(1 case) and oligodendroglioma(1 case). Hydrocephalus is seen in all cases exept ependymoma(2 cases) and oligodendroglioma(1 case). Hemorrhage within tumor was present only in epedymoma(2 cases). Cystic change or necrosis of tumor was seen in ependymomma(3 cases), choroid plexus papilloma(1 case), and oligodendroglioma(1 case). Peritumoral edema was seen in medulloblastoma(1 case). Extension through the foramen Luschka and the Magendie was seen in ependymoma(2 cases), choroid plexus papilloma(2 cases), and medulloblastoma(1 case). Seeding along the CSF pathway was seen only in ependymoma(2 cases). CONCLUSION: The results of our study may suggest that specific diagnosis of 4th ventricular tumor can be suggested preoperatively by analysing the origin in 4th ventricle, difference of CT density or MRI signal inten. sity, presence of extension or seeding through cerebrospinal fluid of the lesion.
Cerebrospinal Fluid ; Choroid Plexus ; Diagnosis ; Edema ; Gadolinium DTPA ; Hemorrhage ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Medulloblastoma ; Necrosis