No abstract available.
Stroke*

CT guided stereotactic biopsies were carried out in 41 patients with tumorous CT findings during past 2 years. In 27 tumorous CT conditions impressed glioma, meningioma, metastatic ca, chondroma, germinoma and craniopharyngioma, 16 cases were disclosed correctly in preoperative cinicalradiological diagnosis comparing with pathological diagnosis confirmed by means of stereotactic biopsy, but other 11 cases, showed the preoperative diagnostic error which pathological diagnosis were infarction, cryptical AVM, abscess, granuloma, and tumors such ad lymphoma, oligodendroglioma, GBM, chordoma. Among 12 granulomatous CT lesions 3 cases showed preoperative diagnostic error, which were, confirmed infarction, multiple sclerosis by pathological diagnosis. The pathological findings of 2 vascular lesions that were impressed as infarction and old hematoma were confirmed as granuloma and GBM. The error of preoperative clinical - CT diagnosis was 39% of total 41 patients. The advantage of preoperative stereotactic biopsy is to confirm the correct histological diagnosis, while it can help the patient and surgeon for the planning of further proper therapy.
Abscess ; Biopsy* ; Chondroma ; Chordoma ; Craniopharyngioma ; Diagnosis ; Diagnostic Errors ; Germinoma ; Glioma ; Granuloma ; Hematoma ; Humans ; Infarction ; Lymphoma ; Meningioma ; Multiple Sclerosis ; Oligodendroglioma

OBJECT: In this study, murine mesechymal stem cells (MSC) was grafted to cerebral ischemia rats, the differentiation of the transplanted MSC was assessed, and at that time, the association of the level of the recovery of neurological function. METHODS: As experimental animals, the transient middle cerebral artery occlusion (MCAo) rat model was used, and MSC collected from the bone marrow of C57/Bl6 mice were cultured, 5microliter(105 microliter) cells marked with the fluorescent substance 3.3'-dilinoleyloxacarbocyanine(DIO) were transplanted into the ischemic cortex. Angiogenesis and neurogenesis were examined and the neurobehavioral evaluation were done. To assess the differentiation level of MSC, and it was evaluated as the percentage of the mean area of stained cells within each region of interest (ROI). RESULTS: In the MCA transplanted group, Neurobehavioral score was improved to twelve points one hour, one day, and three days after transplant, and seven days and fourteen days after transplant, to eleven points and nine points, respectively. The result of immunohistochemical staining showed that the angiogenesis on the day seven was 3.15% and on the day fourteen was 4.26%, the neurogenesis on the day seven was 2.29% and on the day fourteen was 3.82%. CONCLUSION: On the day seven and fourteen after MCS transplantation, the phenomenon of the actively ongoing angiogenesis and neurogenesis was detected, and it was found that at that time, the recovery of neurological function occurred. However, the level of differentiation from MSC was small, and thus it was not statistically significant.
Animals ; Bone Marrow ; Brain Ischemia ; Brain* ; Infarction, Middle Cerebral Artery ; Mesenchymal Stromal Cells* ; Mice ; Models, Animal ; Neurogenesis* ; Rats* ; Stem Cells ; Transplants

No abstract available.
Brain Abscess* ; Brain* ; Catheters*

Moyamoya disease is characterized by progressive cerebrovascular occlusion at the peripheral internal carotid artery and development of abnormal collateral circulation at the cerebral basal region. Although abnormal thrombogenesis, inflammation and autoimmune process might be involved in the etiology, the genetic pathogenesis of Moyamoya disease is still unknown. To evaluate the association of Moyamoya disease with HLA alleles in the Korean population, we investigated HLA class I and class II alleles in 28 Moyamoya patients and 198 unrelated healthy controls. The frequency of HLA-B35 allele was significantly increased in the patients compared to the controls (32.1% vs. 10.1%, RR=4.2, p<0.008). Further analysis of HLA-B35 on onset age and sex showed that this allele was significantly increased compared to the controls in both late-onset and female group. Especially, HLA-B35 was the most significantly increased in female of late-onset group compared to the controls. These results suggest that HLA-B35 may be an useful genetic marker for Moyamoya disease, and particularly in females of late onset group in the Korean population.
Adolescent ; Adult ; Age of Onset ; Aged ; Child ; Child, Preschool ; Female ; Gene Frequency ; *Genes, MHC Class I ; *Genes, MHC Class II ; Genetic Markers ; Genetic Predisposition to Disease ; Genotype ; HLA Antigens/*genetics ; Human ; Korea ; Male ; Middle Aged ; Moyamoya Disease/*genetics/*immunology ; Retrospective Studies ; Support, Non-U.S. Gov't

Although anterior cervical plates are thought to be good tools, their clinical results have not been compared with those of anterior cervical fusion without a plating system in the domestic scientific literature. As there are some advantages as well as shortcomings in these two surgical methods, it is imperative to know which one might be better in terms of the postoperative complications and management. Therefore, the authors reviewed 80patients undergoing anterior cervical fusion during the period of January 1992 to May 1994. Top plate placement was made in 25 and simple fusion without a plating system was applied in 55. The average follow-up period was 9.6 months. In the patients undergoing simple cervical fusion, thirty-two patients(58%) needed rigid braces such as halo braces and Minerva casts for 3 months postoperatively. Thirteen patients(24%) showed graft complications including graft extrusion, whereas patients undergoing plate placement needed only semi-rigid Philadelphia braces for 4 to 8 weeks pos toperatively. Two patients(8%) showed graft setting and screw breakage without any indication of reoperation. However there appeared no difference in the immediate postoperative course of clinical symptoms and the fusion rate(95 vs 96%) at the final follow-up day between the simple fusion and the plate placement patients. The authors conclude that a plating system in anterior cervical fusion may be safe in spite of more extensive operations, and is more likely to offer postoperative stability in the cervical spine and early ambulation and rehabiliation without rigid braces.
Braces ; Early Ambulation ; Follow-Up Studies ; Humans ; Postoperative Complications ; Reoperation ; Spine ; Transplants

Although anterior cervical plates are thought to be good tools, their clinical results have not been compared with those of anterior cervical fusion without a plating system in the domestic scientific literature. As there are some advantages as well as shortcomings in these two surgical methods, it is imperative to know which one might be better in terms of the postoperative complications and management. Therefore, the authors reviewed 80patients undergoing anterior cervical fusion during the period of January 1992 to May 1994. Top plate placement was made in 25 and simple fusion without a plating system was applied in 55. The average follow-up period was 9.6 months. In the patients undergoing simple cervical fusion, thirty-two patients(58%) needed rigid braces such as halo braces and Minerva casts for 3 months postoperatively. Thirteen patients(24%) showed graft complications including graft extrusion, whereas patients undergoing plate placement needed only semi-rigid Philadelphia braces for 4 to 8 weeks pos toperatively. Two patients(8%) showed graft setting and screw breakage without any indication of reoperation. However there appeared no difference in the immediate postoperative course of clinical symptoms and the fusion rate(95 vs 96%) at the final follow-up day between the simple fusion and the plate placement patients. The authors conclude that a plating system in anterior cervical fusion may be safe in spite of more extensive operations, and is more likely to offer postoperative stability in the cervical spine and early ambulation and rehabiliation without rigid braces.
Braces ; Early Ambulation ; Follow-Up Studies ; Humans ; Postoperative Complications ; Reoperation ; Spine ; Transplants

No abstract available.
Thorax*

Recently, intracranial atherosclerosis has become a major cause of ischemic stroke, appearing more frequently in Koreans than Caucasians. Symptomatic or asymptomatic intracranial atherosclerosis is a disease that could recur readily even during the treatment with anti-platelet agents. When the symptoms develop, ischemic stroke can not be recovered readily. Therefore, aggressive treatments such as endovascular therapy and bypass surgery are required in addition to medical treatment for the intracranial artery stenosis. Recent intracranial stenting and drug eluting stenting have shown as very advanced effective therapeutic modalities. Nevertheless, until now, a randomized controlled study has not been conducted. Regarding bypass surgery, since the failed EC-IC bypass surgery study performed 20 years ago, extensive studies on its efficacy has not been conducted yet, and thus it has to be performed strictly only in hemodynamically compromised patients. Unless breakthrough drugs that suppress the progression of intracranial atherosclerosis and the formation of thrombi, and facilitate the regression of the arterial stenosis, the treatment concept of the recovery of the blood flow of stenotic arterial territory by mechanical recanalization or bypass surgery would be remained for the prevention as well as treatment of ischemic stroke caused by intracranial atherosclerosis.
Arteries ; Constriction, Pathologic ; Humans ; Intracranial Arteriosclerosis ; Stents ; Stroke

In gliomas, the most frequently studied tumor suppressor gene is the p53 gene which has been found to be mutated in a considerable fraction of astrocytomas and glioblastomas. Mutations that alter the function of the p53 gene product are thought to play a critical role in glial tumorigenesis. The murine double minute 2(MDM2) gene has been shown to code for a cellular protein that forms a complex with the p53 tumor suppressor gene product and inhibits its function. The fact that MDM2 can negatively regulate p53 suggests MDM2 could function as an oncogene when overexpressed. We investigated the expression of p53, MDM2 and proliferative activity of the tumor cells in 71 cases of gliomas(17 cases of differentiated astrocytomas. 25 cases of anaplastic astrocytomas and 29 cases of glioblastomas). Their paraffin-embedded tissue sections were immunostained with monoclonal antibody(p53 and PCNA, proliferating cell nuclear antigen) and polyclonal antibody(MDM2) for detection of p53, MDM2 and PCNA respectively. The results were as follows: The p53 staining was positive in 28 cases(39.4%) and MDM2 staining in 5 cases(7.0%) of 71 gliomas. The p53 positive-staining was detected in 2 cases(11.8%) of 17 differentiated astrocytomas, 9 cases(36.0%) of 25 anaplastic astrocytomas and 17 cases(58.6%) of 29 glioblastomas. The p53 expression was associated with malignancy grade(p<0.005) and proliferative activity was strongly associated with malignancy grade(p=0.0001). The p53 expression was closely associated with proliferative activity : p53-positive tumors had significantly higher median PCNA-labeling index than p53-negative tumors(40.6+/-10.1% versus 19.6+/-15.0%)(p=0.0001). But, MDM2 expression was not associated with proliferative activity(p=0.4575). The proportion of p53 immunoreactivity had significant association with proliferaive activity: the more the proportion of p53 immunoreactivity increased, the higher PCNA-labeling index elevated(p=0.0001). None of the tumors with MDM2 expression showed immunoreactivity for p53. These results suggest that the mutation of p53 gene plays a critical role in malignant transformation in glioma and it could be the prognostic factor for histologically same grade gliomas and that a subset of human gliomas escapes from p53-regulated growth control by amplification and overexpression of MDM2. Therefore gene study targeting these genes may be useful for the management of human glioma as a diagnostic modality.
Astrocytoma ; Carcinogenesis ; Genes, p53 ; Genes, Tumor Suppressor ; Glioblastoma ; Glioma* ; Humans ; Oncogenes ; Proliferating Cell Nuclear Antigen ; Proto-Oncogene Proteins c-mdm2 ; United Nations