Msny clinical and experimental studies trying to elucidate the cause of idiopathic scoliosis have been carried out. There, however, is no established theory to explain it. This paper is aimed at approaching one of various causes of idiopathic scoliosis by producing thoracic scoliosis in growing rabbits with unilateral resection of thoracic spinal nerves. All 43 rabbits were divided into four different groups. The first group(11 rabbits) consisted of rsbbits whose primary anterior and posterior divisions of the unilateral thoracic spinal nerves were resected. The second(11 rabbits) and the third(11 rabbits) were groups of rabbits whose primary anterior and posterior devisions were resected respectively. The fourth(10 rabbits) was the control group. The first group of rsbbits showed the most prominent curvature of the spine. The group of resection of primary posterior division showed less severe scoliosis than the first group but more marked scoliosis than the group of resection of primary anterior division. The biopsy of the denervated muscles included in the scoliosis revealed atrophy. It is concluded from the animal experiments with 43 growing rabbits that unilateral paralysis of the thoracic spinal nerves could be one csuse of iniopathic scoliosis and the primary posterior division of the thoracic spinal nerve contributed to the production of scoliosis more than the primary anterior division.
Animal Experimentation ; Atrophy ; Biopsy ; Muscles ; Paralysis ; Rabbits ; Scoliosis ; Spinal Nerves ; Spine

BACKGROUND: The purpose of this study was to describe potential pitfalls in the diagnosis of metastatic adenocarcinoma in cerebrospinal fluid (CSF) and to suggest additional work in association with cytokeratin immunocytochemistry for the proper diagnosis, especially in the specimens with low cellularity. METHODS: We collected 267 cytologic specimens of CSF from patients, who were diagnosed over a 9-month period. Each of the individual samples were divided into half the sample size and processed via both, ThinPrep (TP) with Papanicolau stain and cytocentrifugation-based preparation (cytospin, CP) with immunocytochemical stain for cytokeratin. RESULTS: Amongst the 267 cases, 45 cases from 22 patients were diagnosed to be positive for metastasis adenocarcinoma in CSF. TP with Papanicolau stain showed satisfactory cytomorphology when compared with specimen of CP preparation and cytokeratin immunocytochemical staining. All the TP processed cases belonged to satisfactory/superior categories based on the assessment of technical artifact, which potentially helps in decreasing diagnositc errors. However, in 10 out of 45 cases, diagnostic atypical cells were present only in one of the two slides. CONCLUSIONS: Immunocytochemical stain for cytokeratin along with TP processed specimen helps in decreasing potential diagnostic errors in the cytological diagnosis of metastatic carcinoma in CSF specimen.
Adenocarcinoma ; Artifacts ; Diagnostic Errors ; Humans ; Immunohistochemistry ; Keratins ; Neoplasm Metastasis ; Sample Size

Williams syndrome is a congenital disorder characterized by mental retardation, loquacious personalities, dysmorphic face, and vascular and valvular abnormalities. The etiology of this syndrome was one allelic loss of elastin gene, exhibiting a submicroscopic deletion, at 7q11.23. Sudden death is an infrequently recognized complication. The mechanism of sudden death is explained by myocardial ischemia, decreased cardiac output, and arrhythmia by anatomical abnormality of coronary artery stenosis and severe biventricular outflow tract obstruction. We report an autopsy case of a 80 day-old male with Williams syndrome. Five days before admission, cardiac murmur was detected incidentally on ascultation at a local clinic during a visit for vaccination. He was transferred to our hospital and cardiac catheterization was done. He died suddenly next day. Postmortem examination revealed a dysmorphic face and multiple cardiovascular abnormalities including supravalvular aortic stenosis with narrowed coronary artery ostia, supravalvular pulmonic stenosis, secundum type of atrial septal defect, right ventricular hypertrophy, and renal artery stenosis. Histologically, aorta and pulmonary, bronchial, and renal arteries showed markedly hyperplastic medial elastic laminae approximately three times thick compared to those of age-matched normal artery. The elastic fibers of the innermost two thirds of media were disposed in a normal orderly parallel fashion. In outer third of the media, the elastic fibers had lost the normal orderly arrangement.
Aorta ; Aortic Stenosis, Supravalvular ; Arrhythmias, Cardiac ; Arteries ; Autopsy* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Output ; Cardiovascular Abnormalities ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Coronary Stenosis ; Coronary Vessels ; Death, Sudden ; Elastic Tissue ; Elastin ; Heart Murmurs ; Heart Septal Defects, Atrial ; Humans ; Hypertrophy, Right Ventricular ; Infant* ; Intellectual Disability ; Loss of Heterozygosity ; Male ; Myocardial Ischemia ; Pulmonary Valve Stenosis ; Renal Artery ; Renal Artery Obstruction ; Vaccination ; Williams Syndrome*

Williams syndrome is a congenital disorder characterized by mental retardation, loquacious personalities, dysmorphic face, and vascular and valvular abnormalities. The etiology of this syndrome was one allelic loss of elastin gene, exhibiting a submicroscopic deletion, at 7q11.23. Sudden death is an infrequently recognized complication. The mechanism of sudden death is explained by myocardial ischemia, decreased cardiac output, and arrhythmia by anatomical abnormality of coronary artery stenosis and severe biventricular outflow tract obstruction. We report an autopsy case of a 80 day-old male with Williams syndrome. Five days before admission, cardiac murmur was detected incidentally on ascultation at a local clinic during a visit for vaccination. He was transferred to our hospital and cardiac catheterization was done. He died suddenly next day. Postmortem examination revealed a dysmorphic face and multiple cardiovascular abnormalities including supravalvular aortic stenosis with narrowed coronary artery ostia, supravalvular pulmonic stenosis, secundum type of atrial septal defect, right ventricular hypertrophy, and renal artery stenosis. Histologically, aorta and pulmonary, bronchial, and renal arteries showed markedly hyperplastic medial elastic laminae approximately three times thick compared to those of age-matched normal artery. The elastic fibers of the innermost two thirds of media were disposed in a normal orderly parallel fashion. In outer third of the media, the elastic fibers had lost the normal orderly arrangement.
Aorta ; Aortic Stenosis, Supravalvular ; Arrhythmias, Cardiac ; Arteries ; Autopsy* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Output ; Cardiovascular Abnormalities ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Coronary Stenosis ; Coronary Vessels ; Death, Sudden ; Elastic Tissue ; Elastin ; Heart Murmurs ; Heart Septal Defects, Atrial ; Humans ; Hypertrophy, Right Ventricular ; Infant* ; Intellectual Disability ; Loss of Heterozygosity ; Male ; Myocardial Ischemia ; Pulmonary Valve Stenosis ; Renal Artery ; Renal Artery Obstruction ; Vaccination ; Williams Syndrome*

No abstract available.
Child* ; Humans ; Pheochromocytoma*

In a conservative treatment of lumbar disc herniation, authors customarily had included the flexion exercise untill 1991. Thereafter, the extension exercise started to be included for the selected patients and this study was designed to assess the clinical outcome of the extension exercise compared to the flexion exercise in the conservative treatments of lumbar disc herniations. 55 consecutive patients (31 males and 24 females having ages ranging from 19-68 years with a mean of 37.2) were included in this prospective study. Criteria for inclusion in this group were: 1. Contained herniations of a single lumbar disc, documented by CT or MRI; 2. no other concurrent spine pathology; 3. conservative treatments with an uniform program including the extension exercise; 4. follow-up for a minimum of one year. For comparison with this prospective group, another 62 consecutive patients (36 males and 26 females having ages ranging from 17-63 years with a mean of 35.7) were selected who were treated during 1991 with flexion exercise before this study was designed and who were matched with the designed criteria except for the direction of exercise. Apart from the therapeutic exercise, the conservative treatments also included medication, physiotheraphy, epidural injection, and back school in the both groups uniformly. The clinical outcome of the extension exercise group indicated that 28 (50.9%) patients excellent, 23 (41.8%) patients good, three (5.5%) patients fair, and one (1.8%) patient failed outcomes. In the flexion exercise group, there were 23 (37.1%) excellent, 27 (43.5%) good, seven (11.3%) fair, and five (8.1%) failed outcomes. From these results, it would seem to follow that the extension exercise group had superior clinical outcome compared to the flexion exercise, i.e. higher excellent and good outcomes (92.7% vs. 80.6%) and lower poor and failed outcomes (7.3% vs. 19.4%), respectively, Moreover, the excellent outcome in terms of full recovery without any pain and disability was more common in the extension exercise group (50.9% vs. 37.1%). A better clinical outcome was obtained in the extension exercise group of patients who were younger than 40 years and who had a history of three months or less compared with those who were older and had longer history of disease. The sizes of disc protrusion did not affect the clinical outcome. In conclusion, we would recommend that the extension exercise, instead of the flexion exercise, should be included in the conservative treatment of a contained herniation of lumbar disc for a better clinical outcome.
Female ; Follow-Up Studies ; Humans ; Injections, Epidural ; Magnetic Resonance Imaging ; Male ; Pathology ; Prospective Studies ; Spine

Cryptococcus neoformans is the most common microorganism found in cerebrospinal fluid (CSF) cytology and causes life-threatening infections in immunocompromised hosts. Although its cytomorphologic features in conventional smear cytology have been well described, those in liquid-based cytology have rarely been. A 73-year-old woman with diffuse large B-cell lymphoma presented with mental confusion and a spiking fever. To rule out infectious conditions, CSF examination was performed. A cytology slide that was prepared using the ThinPrep method showed numerous spherical yeast-form organisms with diameters of 4–11 μm and thick capsules. Occasional asymmetrical, narrow-based budding but no true hyphae or pseudohyphae were observed. Gomori methenamine silver staining was positive. Cryptococcosis was confirmed in blood and CSF through the cryptococcal antigen test and culture. Liquid-based cytology allows for a clean background and additional slides for ancillary testing, facilitating the detection of microorganisms in CSF specimens, particularly when the number of organisms is small.
Aged ; Capsules ; Cerebrospinal Fluid ; Cryptococcosis ; Cryptococcus neoformans ; Female ; Fever ; Humans ; Hyphae ; Immunocompromised Host ; Lymphoma, B-Cell ; Meningitis, Cryptococcal ; Methenamine ; Methods

PURPOSE: This treatment planning study was undertaken to evaluate the impact of beam angle configuration of intensity-modulated radiotherapy (IMRT) on the dose of the normal liver in hepatocellular carcinoma (HCC). MATERIALS AND METHODS: The computed tomography datasets of 25 patients treated with IMRT for HCC were selected. Two IMRT plans using five beams were made in each patient; beams with equidistance of 72degrees (Plan I), and beams with a 30degrees angle of separation entering the body near the tumor (Plan II). Both plans were generated using the same constraints in each patient. Conformity index (CI), homogeneity index (HI), gamma index, mean dose of the normal liver (Dmean_NL), Dmean_NL difference between the two plans, and percentage normal liver volumes receiving at least 10, 20, and 30 Gy (V10, V20, and V30) were evaluated and compared. RESULTS: Dmean_NL, V10, and V20 were significantly better for Plan II. The Dmean_NL was significantly lower for peripheral (p = 0.001) and central tumors (p = 0.034). Dmean_NL differences between the two plans increased in proportion to gross tumor volume to normal liver volume ratios (p = 0.002). CI, HI, and gamma indices were not significantly different for the two plans. CONCLUSION: The IMRT plan based on beams with narrow separations reduced the irradiated dose of the normal liver, which would allow radiation dose escalation for HCC.
Carcinoma, Hepatocellular ; Humans ; Liver ; Radiotherapy, Intensity-Modulated ; Tumor Burden

PURPOSE: To evaluate the efficacy, safety, stability and complications of the foldable iris-fixated phakic intraocular lens (Artiflex(R), Ophtec BV, Groningen, Netherlands) implantation for the correction of myopia with astigmatism. METHODS: The present study included 40 eyes of 20 patients who underwent Artiflex lens implantation, and 20 eyes of 10 patients who underwent Toric Artiflex lens implantation and were followed up for 1 year. We retrospectively examined visual acuity, refraction, any changes in astigmatism, efficacy, safety and corneal endothelial cell density. A correlation coefficient analysis of the factors that affected the changes was performed. RESULTS: The mean preoperative refractive spherical equivalent was -9.18 +/- 2.27 D and reached -0.45 +/- 0.45 D at 1 year after surgery. Postoperatively, 99.9% of the eyes showed improved visual acuity of more than 0.8. In patients with Toric Artiflex lens implantation, the preoperative mean astigmatism was -2.67 +/- 0.87 D, and at 1 year postoperatively -0.76 +/- 0.40 D, showing a statistically significant decrease (p < 0.001). The preoperative mean endothelial cell density was 2,850 +/- 230 cells/mm2 and decreased 1.3% on the final follow-up (2,812 +/- 261 cells/mm2) but without statistical significance (p = 0.456). Statistically significant correlation was not observed between endothelial cell loss and anterior chamber depth (r2 = -0.146, p = 0.267). CONCLUSIONS: Implantation of the iris-fixed intraocular lenses, Artiflex and Toric Artiflex, was safe and effective for correcting high myopia and astigmatism.
Anterior Chamber ; Astigmatism ; Endothelial Cells* ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Myopia ; Phakic Intraocular Lenses* ; Retrospective Studies ; Visual Acuity

PURPOSE: To evaluate the efficacy, safety, stability and complications of the foldable iris-fixated phakic intraocular lens (Artiflex(R), Ophtec BV, Groningen, Netherlands) implantation for the correction of myopia with astigmatism. METHODS: The present study included 40 eyes of 20 patients who underwent Artiflex lens implantation, and 20 eyes of 10 patients who underwent Toric Artiflex lens implantation and were followed up for 1 year. We retrospectively examined visual acuity, refraction, any changes in astigmatism, efficacy, safety and corneal endothelial cell density. A correlation coefficient analysis of the factors that affected the changes was performed. RESULTS: The mean preoperative refractive spherical equivalent was -9.18 +/- 2.27 D and reached -0.45 +/- 0.45 D at 1 year after surgery. Postoperatively, 99.9% of the eyes showed improved visual acuity of more than 0.8. In patients with Toric Artiflex lens implantation, the preoperative mean astigmatism was -2.67 +/- 0.87 D, and at 1 year postoperatively -0.76 +/- 0.40 D, showing a statistically significant decrease (p < 0.001). The preoperative mean endothelial cell density was 2,850 +/- 230 cells/mm2 and decreased 1.3% on the final follow-up (2,812 +/- 261 cells/mm2) but without statistical significance (p = 0.456). Statistically significant correlation was not observed between endothelial cell loss and anterior chamber depth (r2 = -0.146, p = 0.267). CONCLUSIONS: Implantation of the iris-fixed intraocular lenses, Artiflex and Toric Artiflex, was safe and effective for correcting high myopia and astigmatism.
Anterior Chamber ; Astigmatism ; Endothelial Cells* ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Myopia ; Phakic Intraocular Lenses* ; Retrospective Studies ; Visual Acuity