Subfalcial herniation secondary to a unilateral supratentorial space occupying lesion is frequently seen on the brain CT scan, however, the development of distal anterior cerebral artery infarction following compression of the terminal branches of the pericallosal artery against the falx during the period of subfalcial herniation is uncommon. For the last three years, we have experienced three cases of distal anterior cerebral artery infarction caused by subfalcial herniation on the brain CT scan. All patitnts had acute subdural hematomas resulting in subfalcial herniation on the first CT scan and subsequently developed focal infarctions in the ipsilateral paracentral lobule. The patients did not improve clinically and died several days after operation. The development of such infarction may reflect severe cerebral injury and portend a poor clinical outcome.
Anterior Cerebral Artery* ; Arteries ; Brain ; Hematoma, Subdural, Acute ; Humans ; Infarction* ; Infarction, Anterior Cerebral Artery ; Tomography, X-Ray Computed

No abstract available.
Meniere Disease*

PURPOSE: We wanted to investigate the efficacy of percutaneous radiofrequency (RF) neurotomy of the medial branch for the management of chronic low back pain due to lumbar zygapophysial joint dysfunction. MATERIALS AND METHODS: Thirteen patients who had unremitting chronic low back pain for more than 6 months and whose VAS scores were over 7 were selected on the basis of double comparative nerve blocks. The patients consist of three males and 10 females, and their nean age was 67 years. Sensory stimulation was performed to detect the "pathologic branches" that were responsible for pain generation. RF neurotomy was performed using a lesion generator at 80 C for 90 seconds. The postoperative outcome was classified, depending on the degree of pain reduction, as excellent (> or = 75%), good (50-75%), and poor (<50%). Follow-up evaluation was performed at 6 weeks, 3 months and 6 months after surgery. RESULTS: The mean number of medial branches was 6.2. Eleven patients had bilateral disease and two had unilateral disease. Sensory stimulation was positive in all patients with a mean amplitude of 4.5V (range: 0.15-6 V). The L5 dorsal ramus was the most frequently involved segment, and this was followed by L4, L3 and L2. The number of lesionings for each medial branch was 3.7. The surgical outcome was graded as excellent (53%), good (23%), and poor (24%) after 6 months of follow-up. Transient backaches were noticed in two patients; however, complications were not observed. Recurrences were not demonstrated during the follow-up period CONCLUSION: We conclude that RF neurotomy of the medial branches is an efficient method to substantially alleviate the chronic low back pain caused by zygapophysial joint dysfunction.
Arthralgia* ; Back Pain ; Female ; Follow-Up Studies ; Humans ; Joints* ; Low Back Pain ; Male ; Nerve Block ; Recurrence ; Spine

BACKGROUND: The purpose of this study is to evaluate and analyze the surgical results in patients undergoing operations for multiple for multiple valvular heart diseases. MATERIAL AND METHOD: From April 1982 to June 1997 multiple valve replacement was performed in 150 patients mitral and aortic valve replacement were done in 135 patients mitral and tricuspid valve replacements in 10 patients triple replacements in 4 patients and aortic and tricuspid valve replacement in 1 patient. Of the valves implanted 157 were St. Jude 104 Duromedics 20 Carpenter-Edwards 6 Bjork-Shiley 6 Ionescu-Shiley and 2 Medtronics. RESULT: The hospital mortality rate was 10.7% (16/150) and the late mortality rate was 7.2% (8/134) The mortality rate was high in early operative period but decreased with time. The causes of death were low cardiac output in 9 sudden death in 3 congestive heart failure in 3 bleeding in 2 cerebral thrombosis in 1 leukemia in 1 multiorgan failure in 1 and so on . The actuarial survival rate excluding operative death was 83.1% at 15 years. CONCLUSIONS: With a follow-up now extending to 15 years the multiple valve replacement continues to be reliable procedure with relatively low mortality and morbidity.
Aortic Valve ; Cardiac Output, Low ; Cause of Death ; Death, Sudden ; Follow-Up Studies ; Heart Failure ; Heart Valve Diseases ; Hemorrhage ; Hospital Mortality ; Humans ; Intracranial Thrombosis ; Leukemia ; Mortality ; Survival Rate ; Tricuspid Valve

No abstract available.
Leukemia* ; Skin*

Cutaneous horn is the clinical term for a circumscribed, conical, markedly hyperkeratotic lesion. We report a case of cutaneous horn occuring on the face in a 81 year old women. An about 1.2 X1.3 cm sized dark brownish conical horn was developed on her face 1 year before. Histopathologic findings showed marked hyperkeratosis, parakeratosis, and papillornatosis of the epidermis, and some cells of straturn mslpighii showed pleornorphism and nuclesr atypis. This case was considered to be cutaneous horn arising from actinic keratosis, and we performed minimal local excision.
Actins* ; Aged, 80 and over ; Animals ; Epidermis ; Female ; Horns* ; Humans ; Keratosis, Actinic* ; Parakeratosis

No abstract available.

No abstract available.

No abstract available.
Tretinoin*

The authors investigsted the effects of azelaic acid on human melanoma cells (G 361 melanoma cell line) and cultured normal melanocytes obtained from the prepuce of newborn. The results were as follows : 1. The proliferation of melanoma cells was decreased, but not in a dose-and time- ependent fashion. The cell population of melanoma cells after 2, 4, and 6 days of culture was decreased to 3.80 x 10(5)cells/well, 4.55 x 10(5)cells/well, and 4.30 X 10(5)cells/ well, respectively, in the presence of 10(-2)M azelaic acid. The proliferation of mormal elanocytes of normal melanocytes was decreased in a dose-dependent, but not in a time-dependent fashion. The cell population of normal melanocytes after 2, 4, and 6 days of culture was significantly decreased to 6.38 x 10(5)+/-1.37 x 10(5) cells/well, 5.33 x 10(5)+/-0.73x10(5) cells/well, and 7.20x10(5)+/-1,11 x10(5)cells/well, respectively, in the presence of 10(-2) M azelaic acid(p<0,05, p<0.01). 2. A dose-and time-dependent inhibition of DNA synthesis was not found in either group. However, DNA synthesis in melanoma cells was decreased to 92710+5188 CPM, 16268+/-15S5 CPM, 8518+/-996 CPM, respectively, after 2, 4, and 6 days of culture, and in normal melanocytes was decreased to 9398+/-2279 CPM(p>0.05) and 6953+/-1217 CPM (p<0.05) after 4 and 6 days of culture in the prensence of 10(-2) Mazelaic acid, 3. There was no difference in melanin content per well at various concentrations in either group, but the melanin content per individual melanocyte of the melanoma cells was increased to 0.0303 ng/cell, 0.0253 ng/cell, and 0.0377 ng/cell, respectively, and that of normal melanocytes was signifieantly increased to 0.0754+/-0.0215 ng/cell, 0.0719+/-0.0144 ng/cell(p<0.05), and 0.1089+/-0.0185 ng/cell(p<0.05), respectively, after 2, 4, and 6 days of culture in the presence of 10(-2) M azelaic acid.
DNA ; Humans ; Infant, Newborn ; Melanins ; Melanocytes* ; Melanoma