Thirty six conseutive patients with recurrent hypertensive intracerebral hemorrhage were identified in a retrospective review of 307 cases of hypertensive intracerebral hemorrhage(HICH) treated at the Fatima hospital between September, 1989, and August, 1992. The recurrence rate was 1.7%. There were 14 males and 22 females, aged 38 to 83 years. Only one patient had recieved regular antihypertensive therapy after initial hemorrhage. The mean volume of hemorrhage was 21.7cc at first attack and 19.5cc at recurrent attack. The site of recurrent hemorrhage was putamen in 18 cases, thalamus in 12 cases, cerebellum in 8 cases and lobar in 3 cases. The most common pattern of recurrence was "Ganglionic-Ganglionic"(10 cases). Recurrent hemorrhage occurred at the same side in 54.8% and same side & same wite in 16.7% of recurrent hemorrhage. Mean interval between the hemorrhage was 17.4 months and 55.8% of recurrent hemorrhage occurred within 1 year. Initial condition was worse at recurrent hemorrhage and outcome also was worse regardless of treatment methods. We concluded that recurrent intracerebral hemorrhage in HICH patients was not a rare condition and regular follow up and antihypertensive therapy was important in prevention of recurrent hypertensive intracerebral hemorrhage.
Cerebellum ; Cerebral Hemorrhage ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension ; Intracranial Hemorrhage, Hypertensive* ; Male ; Putamen ; Recurrence ; Retrospective Studies ; Thalamus

A 18-month-old child admitted with neck pain, spasm and neck motion limitation after traffic accident. On C-spine lateral view, there was anterior angulation of odontoid process with anterior displacement of atlas. Neurologic examination showed no specific focal deficits. The patient was treated with Gardner-Wells tongs traction, skeletal traction with wiring, Halo vest for 2 months, Minerva cast for 2 months and cervical collar brace. Eight months after the trauma, follow-up dynamic C-spine lateral view showed bone fusion without false movement or growth retardation.
Accidents, Traffic ; Braces ; Child* ; Follow-Up Studies ; Humans ; Infant* ; Neck ; Neck Pain ; Neurologic Examination ; Odontoid Process* ; Spasm ; Traction

No abstract available.
Humans ; Infertility* ; Luteinizing Hormone, beta Subunit*

Matrix metalloproteinases are believed to play an important role in tumor invasion and metastasis. But little is known about the role of them in the gastric adenocarcinoma. We investigated the expression of matrix metalloproteinase-1,2,3 in eighty paraffin blocks of the primary gastric adenocarcinoma tissues with immunohistochemistry and analysed their correlation with lymph node metastasis and survival. MMP-1,2,3 were expressed most intensely in the fibroblasts around the tumor stroma. In our study the increased immunoreactivity of MMP-2 only showed statistically significant correlation with lymph node metastasis (P=0.0517, Odd's ratio=2.274). But MMP-1,2,3 all were correlated with survival. Type IV collagen was observed in the vascular basement membranes and tumor basement membranes and showed statistically significant correlation with lymph node metastasis (P=0.0002, Odd's ratio=0.194) and prognosis (P=0.0001). The immunoreactivity of MMP-2 and type IV collagen was inversely correlated (Kendall's Tau-b correlation = 0.37482, P=0.0001). Our results suggest that in human gastric adenocarcinoma the increased immunoreactivity of MMP-2 and the decreased immunoreactivity of type IV collagen has an important role in lymph node metastasis and prognosis. MMP-1,3 are not correlated with lymph node metastasis but correlated with survival. The mechanism responsible for the production of MMP by the host fibroblasts remains obscure and requires further investigation.
Adenocarcinoma* ; Basement Membrane ; Collagen Type IV* ; Fibroblasts ; Humans ; Immunohistochemistry ; Lymph Nodes* ; Matrix Metalloproteinases ; Neoplasm Metastasis* ; Paraffin ; Prognosis*

OBJECTIVE: Electrodiagnostic test has shown diagnostic sensitivity and specificity in carpal tunnel syndrome(CTS). This study was to evaluate the correlation between clinical outcome of endoscopic carpal tunnel ligament release(ECTR) and the predictive value of sensory nerve conduction. METHODS: From January 1998 to December 2004, 87 patients (44 right hand, 37 left hand, 6 bilateral hands) with CTS who underwent ECTR were followed up in our hospital for an average of 2.4 months. We retrospectively analyzed the results with previous medical records. All patients underwent electrodiagnostic test and ECTR. The patients were divided into three groups according to the electrodiagnostic test results. Group (A) was normal sensory nerve response, Group (B) was slowing sensory response and Group (C) was no sensory response. Improvement of the symptom after ECTR was assessed using a visual analogue scale(VAS) score. RESULTS: Differences between the three groups on the correlation of severity of sensory potential and duration of preoperative symptoms were significant. The mean value of improved VAS scores for the three groups were 6.0+/-0.96 in the Group A, 6.11+/-0.48 in the Group B and 6.14+/-0.53 in the Group C. There was no statistically significant difference between the severity of sensory nerve response and improvement in VAS score after ECTR. Complications included a wound infection, a case of skin necrosis, and two patients with persistent symptoms without any improvement. CONCLUSION: Although electrodiagnostic test has been known to be useful, sensory nerve response is considered not to be a good prognostic value for carpal tunnel syndrome after ECTR.
Carpal Tunnel Syndrome* ; Hand ; Humans ; Ligaments ; Medical Records ; Necrosis ; Neural Conduction* ; Retrospective Studies ; Sensitivity and Specificity ; Skin ; Wound Infection

This is to report a case of immediate reconstruction after hemimandibulectomy by using of bicorticocancellous block bone harvested from the iliac crest in the case of an ameloblastomaon the mandible. Because the lesion involved condylar area, it was reconstructed with titanium artificial condyle attached to A/O metal plate. Three weeks after the operation, infection developed with suppuration and was well treated with adequate antibiotic therapy and drainage. The patient has been followed up over a four-year period and taken an orthopantomogram every three or six month for the examination of mandibular movement, the potentiality of recurrence and the remodeling of the grafted bone. At present, the patient is satisfied with her appearence and has a normal occlusion with proper masticatory function, and there is no sign of recurrence.
Ameloblastoma* ; Drainage ; Humans ; Mandible ; Mandibular Osteotomy ; Recurrence ; Suppuration ; Titanium ; Transplants*

BACKGROUND: This study was designed to compare the hemodynamic changes in response to direct laryngoscopy of the McCoy blade and the Macintosh blade. METHODS: Sixty patients scheduled for elective gynecologic surgery were randomly allocated into two groups. The induction of anesthesia was done with thiopental sodium 5 mg/kg, fentanyl 2 mcg/kg, vecuronium 0.1 mg/kg. When the train of four arrived came at 0/4, the vocal cords were visualized with either the McCoy or the Macintosh laryngoscope blade for 10 seconds. Heart rate and blood pressure were recorded at 1 minute intervals for 5 minutes. RESULTS: Laryngoscopy caused significant increases in arterial blood pressure in both groups, while it had no effect on heart rate in either group. There were no significant differences in blood pressure and heart rate responses to laryngoscopy in the blades. CONCLUSIONS: The McCoy and the Macintosh blade show similar changes in heart rate and blood pressure after laryngoscopy.
Anesthesia ; Arterial Pressure ; Blood Pressure ; Female ; Fentanyl ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics* ; Humans ; Laryngoscopes* ; Laryngoscopy ; Thiopental ; Vecuronium Bromide ; Vocal Cords

Desmoplastic infantile astrocytoma is a huge cystic tumor, typically occurring in the cerebral hemispheres of infants. The authors report a 4-month-old baby presented with increased head circumference, bulging fontanel, and the setting-sun sign. Magnetic resonance imaging revealed a round mass with huge cystic component in the right cerebral hemisphere. Microsurgical gross total resection of the tumor was performed and pathological examination of the specimen showed features of desmoplastic infantile astrocytoma. The postoperative course was complicated by subdural hygroma which was managed by the placement of subduroperitoneal shunt. Although desmoplastic infantile astrocytomas are rare, it must be distinguished from other hemispheric tumors in infancy or childhood because of good prognosis.
Astrocytoma* ; Cerebrum ; Head ; Humans ; Infant ; Magnetic Resonance Imaging ; Prognosis ; Subdural Effusion

The distribution of enkephalin, dynorphin, substance P and neurotensin in the periaqueductal gray[PAG] has been well established by immunohistochemical methods. However, there is little information about the regional distribution of these neuropeptide mRNA-containing neurons in the PAG. The present study was undertaken [1] to elucidate the distribution of these neuropeptide mRNA-containing neurons and to determine of the PAG, [2] to know how peptide expression relates to the proposed functional subdivisions of the PAG and [3] to know how neuropeptide mRNA levels in the PAG change following peripheral neuropathy The results obtained are as follows ; 1. Preproenkephalin[pENK] mRNA-containing neurons are found mostly in the ventrolateral portion at all levels of the PAG. 2. Prodynorphin[pDYN] mRNA-containing neurons are concentrated mostly in the ventrolateral portion at the caudal level of the PAG. 3. Preprotachykinin[pTAK] mRNA-containing neurons are localized mainly in the ventrolateral portion at all levels of the PAG. There is small numbers of pTAK mRNA-containing neurons in the dorsolateral and dorsal portion at all levels of the PAG. 4. Proneurotensin[pNT] mRNA-containing neurons are concentrated mostly in the medial part of ventrolateral portion of the caudal and mid PAG. 5. Peripheral neuropathy induces an increase of pNT mRNA levels in the PAG, while pENK, pDYN and pTAK mRNAs levels show no change. The present results indicate that the pENK, pDYN, pTAK or pNT mRNA-containing neurons are found mainly in the ventrolateral PAG, the area where analgesia is most easily produced and that neurotensin in the PAG may play an important role in modulating chronic neuropathic pain.
Analgesia ; Animals ; Dynorphins ; Enkephalins ; Gene Expression* ; In Situ Hybridization ; Neuralgia* ; Neurons* ; Neuropeptides* ; Neurotensin ; Periaqueductal Gray* ; Peripheral Nervous System Diseases ; Rats* ; RNA, Messenger ; Substance P

Squamous cell carcinoma of the ovary is rare and usually arise from preexisting cystic teratomas, endometriosis or Brenner tumors which undergo carcinomatous degeneration in their epithelial elements. Some of squamous cell carcinoma of the ovary is known to be associated with cervical neoplasm, but the pathogenesis is still unknown. Recently we experienced one case of ovarian squamous cell carcinoma in patients with microinvasive squamous cell carcinoma of uterine cervix. We report this case with possible pathogenesis and brief review of literatures.
Brenner Tumor ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Endometriosis ; Female ; Humans ; Ovary ; Teratoma ; Uterine Cervical Neoplasms