No abstract available.
Goldenhar Syndrome*

No abstract available.
Ear* ; Humans ; Tissue Donors* ; Transplants*

PURPOSE: This study evaluated the treatment effectiveness and proper radiation dose of helical tomotherapy (HT) in spine oligometastases from gastrointestinal cancers. MATERIALS AND METHODS: From 2006 to 2010, 20 gastrointestinal cancer patients were treated with HT for spine oligometastases (31 spine lesions). The gross tumor volume (GTV) was the tumor evident from magnetic resonance imaging images fused with simulation computed tomography images. Clinical target volume (CTV) encompassed involved vertebral bodies or dorsal elements. We assumed that the planning target volume was equal to the CTV. We assessed local control rate after HT for 31 spine metastases. Pain response was scored by using a numeric pain intensity scale (NPIS, from 0 to 10). RESULTS: Spine metastatic lesions were treated with median dose of 40 Gy (range, 24 to 51 Gy) and median 5 Gy per fraction (range, 2.5 to 8 Gy) to GTV with median 8 fractions (range, 3 to 20 fraction). Median biologically equivalent dose (BED, alpha/beta = 10 Gy) was 52 Gy10 (range, 37.5 to 76.8 Gy10) to GTV. Six month local control rate for spine metastasis was 90.3%. Overall infield failure rate was 15% and outfield failure rate was 75%. Most patients showed pain relief after HT (93.8%). Median local recurrence free survival was 3 months. BED over 57 Gy10 and oligometastases were identified as prognostic factors associated with improved local progression free survival (p = 0.012, p = 0.041). CONCLUSION: HT was capable of delivering higher BED to metastatic lesions in close proximity of the spinal cord. Spine metastases from gastrointestinal tumors were sensitive to high dose radiation, and BED (alpha/beta = 10 Gy) higher than 57 Gy10 could improve local control.
Disease-Free Survival ; Gastrointestinal Neoplasms ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Radiotherapy, Intensity-Modulated ; Recurrence ; Spinal Cord ; Spine ; Treatment Outcome ; Tumor Burden

BACKGROUND: Mild cognitive impairment (MCI) represents a transitional state between the cognitive changes of normal aging and very early dementia. Recently, the published MCI classification in `The Current Concepts in MCI Conference' suggested subtypes of MCI (amnestic, single nonmemory domain, multiple domains slightly impared) based on recognized heterogeneity. The purpose of this study was to ascertain the existence of subtypes of MCI and investigate their relative prevalence and clinical characteristics. METHODS: We recruited the MCI patients according to the consensus criteria of MCI. We classified them into 3 subtypes of MCI by our working criteria based on the definitions of MCI subtypes and then calculated their respective prevalence. We described their various clinical variables including demographic features, symptoms on the first visit, neuroimaging findings, and the genotype of apolipoprotein E. RESULTS: Sixty patients (36 females and 24 males) were enrolled as MCI and analyzed. The prevalence of each subtype (amnestic, single nonmemory domain, multiple domains slightly impared) were 13 (21.67%), 24 (40.0%), and 23 (38.33%) respectively, suggesting the most prevalent type was the single nonmemory domain type. MCI cases with subcortical vascular features were 18 (11 single nonmemory domain and 7 multiple domains slightly impaired). The ApoE epsilon4 carriers were about 50% of tested patients. CONCLUSIONS: We ascertained the existence of MCI subtypes and investigated their prevalence and various clinical features. In evaluation of MCI patients, we should keep the notion of heterogeneity and subclassification in mind.
Aging ; Apolipoproteins ; Apolipoproteins E ; Classification ; Consensus ; Dementia ; Female ; Genotype ; Humans ; Mild Cognitive Impairment* ; Neuroimaging ; Population Characteristics ; Prevalence

No abstract available.
Hemangioma, Cavernous* ; Occipital Lobe* ; Status Epilepticus*

We describe a case of anterograde and retrograde amnesia resulting from probable herpes simplex encephalitis. In retrograde amnesia, dissociations not only between episodic and semantic memories, but also between semantic memories for personal and public things were observed. We postulated, using FDG-PET, that the former was caused by mesial temporal lesions, based on `multiple trace theory', and the latter, by bilateral lateral temporal lesions, which were probably related to the retrieval of semantic memory, especially for public things.
Amnesia, Retrograde* ; Encephalitis, Herpes Simplex ; Encephalitis, Viral* ; Humans ; Memory ; Semantics

A gastric intramural hematoma is very rare and commonly associated with trauma, anticoagulation therapy, coagulopathy, pancreatic disease, aneurysm and peptic ulcer disease. This is a case of gastric intramural hematoma which occurred in a patient taking aspirin after hypertonic saline-epinephrine injection for bleeding from a biopsy site. We describe a case of gastric intramural hematoma that was successfully managed with conservative therapy.
Aneurysm ; Aspirin ; Biopsy ; Epinephrine ; Hematoma* ; Hemorrhage ; Hemostasis* ; Humans ; Pancreatic Diseases ; Peptic Ulcer ; Saline Solution, Hypertonic

Hypercarbia is a potential complication during laparoscopic surgery. However, is more likely to occur in extraperitoneal surgery than in intraperitoneal surgery because insufflated CO2 gas can diffuse easily into the surrounding tissues. We report the anesthetic course and complications encountered during endoscopic harvesting of a saphenous vein with CO2 insufflation in coronary artery bypass surgery. Although the surgery was successful, the patient developed signs and symptom of CO2 absorption: tachycardia, hypertension, hypercarbia and acidosis. Possible mechanisms are presented, along with a discussion of the prompt diagnosis and treatment. For the management of laparoscopic extraperitoneal surgery, care must be taken to monitor the CO2 insufflation pressure, perform a routine examination and palpation of the chest wall, use of N2O with caution, increase the level of ventilation to eliminate CO2, and excluding other causes of subcutaneous emphysema and hypercarbia.
Absorption ; Acidosis ; Coronary Artery Bypass* ; Coronary Vessels* ; Diagnosis ; Endoscopy ; Humans ; Hypertension ; Insufflation ; Laparoscopy ; Palpation ; Saphenous Vein* ; Subcutaneous Emphysema ; Tachycardia ; Thoracic Wall ; Ventilation

Chronic hypoxia has been associated with change in neurovascular behavior, mediated, in part, by erythropoietin (EPO). EPO, a hematopoietic growth factor, could act as a neurotrophic factor. In the present study, we investigated the characteristics of EPO and erythropoietin receptor (EPOR) expressions by cortical neuron in vivo and in vitro and tested the hypothesis that EPO serves protective functions under chronic hypoxia. E18, P5 and P7 mice for 3 days and primary cultured neurons for 6 days were incubated in hypoxic conditions consisted of a mixture of 10% O2, 5% CO2, 85% N2. To study expressions of EPO, EPOR, caspases, pAKT, pERK, and PARP, immunohistochemical stainning and western blotting were carried out. In addition to expressing EPO and EPOR under normoxic conditions, neurons increased their expression of EPO and EPOR under hypoxia. The effects of recombinant EPO appeared to be mediated via the phosphatidylinositol (PI) 3- kinase-AKT pathway, correlated directly with activation of caspase 3. Also recombinant EPO decreased expression of caspase 8, but not caspase 9. Finally, recombinant EPO decreased apoptosis of cultured neurons as evaluated by expression of PARP. These data support a role for EPO in maintenance of cortical neuron under chronic hypoxia.
Animals ; Anoxia* ; Apoptosis ; Blotting, Western ; Caspase 3 ; Caspase 8 ; Caspase 9 ; Caspases ; Erythropoietin ; Mice ; Neurons* ; Phosphatidylinositols ; Receptors, Erythropoietin

Renal artery stenosis (RAS) is defined as a narrowing of main renal artery or its major branches over 50%, and can be the cause of pulmonary edema, renal failure, malignant hypertension and cerebrovascular diseases. The renin-angiotensin-aldosterone system works as a key role. In this paper, we report a case of a 53 year-old patient with left middle cerebellar peduncle infarction, who showed malignant hypertension and RAS. The RAS was diagnosed by renal artery computed tomography angiography and treated with renal artery angioplasty, stenting and antihypertensive medication. In a young patient with ischemic stroke who has refractory hypertension against antihypertensive medications, RAS should be suspected and evaluated.
Angiography ; Angioplasty ; Cerebral Infarction ; Humans ; Hypertension ; Hypertension, Malignant ; Hypertension, Renovascular ; Infarction ; Pulmonary Edema ; Renal Artery ; Renal Artery Obstruction ; Renal Insufficiency ; Renin-Angiotensin System ; Stents ; Stroke