Developmental venous anomalies are congenital anomalies of the intracranial venous drainage and clinically asymptomatic. Cavernous hemangiomas are vascular malformations composed of dilated vascular channels lined with a single layer of endothelial cells without any intervening normal neural tissue. Although, cavernous hemangioma may be clinically silent, but frequently cause variable neurologic manifestations; intracranial hemorrhage, seizures, and focal neurologic deficits. Frequent association of these two diseases has already been reported and it has been suggested that cavernous hemangiomas not the developmental venous anomalies that cause the acute clinical symptoms. A 4 year old girl with sudden onset of headache, vomiting, gait disturbance and signs of unilateral cerebellar dysfunction 2 days before admission showed a 2.5x2.5cm sized hematoma with heterogenous signal intensity both in CT and MRI in the left cerebellar hemisphere. Four-vessel cerebral angiography revealed characteristic findings of developmental venous anomalies. Pathologic findings of the surgically removed hematoma disclosed typical feature of cavernous hemangioma. Based on the findings in this case and review of the literatures, we concluded that the possibility of other diseases such as cavernous hemangiomas must be considered in patients who has intracranial hemorrhage due to the developmental venous anomalies.
Cerebellar Diseases ; Cerebral Angiography ; Child, Preschool ; Drainage ; Endothelial Cells ; Female ; Gait ; Headache ; Hemangioma, Cavernous* ; Hematoma ; Hemorrhage* ; Humans ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Seizures ; Vascular Malformations ; Vomiting

This study was undertaken to investigate the recovery of epidermal Langerhans cells in relation to time after UVA irradiation through different amounts and ways of exposure in CH mice. We irradiated the ears of C2H mice with UVA 200J/cm2 and 400J/cm2 in a single dose at one time or 5 fractionated doses for 5 days and performed biopsies on the ears of the control and experimental groups after 2, 7, 14, 21days of irradiation and stained them with immunoperoxidase method. The results are summarized as follows, l. We observed a significant decrease in the number of the Ia-positive epidermal Langerhans cells in the single-dose-exposed group compared to the fractionated- dose-exposed group on 7th and 14th days irradiated with UVA 200J/cm. 2. There was no significant difference in the change in the number of the Ia- positive epidermal Langerhans cells until 21 days of exposure between the single- dose-exposed group and the fractionated-dose-exposed group irradiated with UVA 400 J/cm 3. In the group irradiated with UVA 2003/cm, the reduced number of the Ia-positive epidermal Langerhans cells returned to normal on the 14th day after irradiation in the fractionated-dose-exposed group and on the 21st day in the single- dose-exposed group. In the group irradiated with 400J/cm, the number returned to normal on the 21st day of irradition both in the fractionated-dose-exposed group and in the single-dose-exposed group.
Animals ; Biopsy ; Ear ; Langerhans Cells* ; Mice ; Mice, Inbred C3H*

No abstract available.
Humerus*

A clinical study was carried out on patients with tuberculous meningitis who were admitted to the Department of Pediatrics, Kwangju Christian Hospital during a 9 year period from January, 1971 to December, 1979. The following results were obtained. 1) About 3/4 of all cases were under the age of 6, the majority being between the age of one and three. The male-to-female ratio was 1.3:1. 2) Seasonal incidence was in the order of spring, summer, winter and autumn, but no sign ificant differences were noted. 3) A family history of tuberculosis was found in 41.5%, usually in one of the parents. 4) A history of B.C.G. vaccination was found in 16.7% of tuberculous meningitis cases. The tuberculin test was positive in 28.9%. 5) The most frequent symptoms on admission were vomiting, fever, convulsion and headache, in that order. 6) The major neurologic findings were unconsciousness(34.0%), neck stiffness(76.4%), and positive Kernig's sign(63.2%). 7) Leukocytes in the C.S.F. on admission were generally elevated, but below the range of 500/mm3 in 74.5% of cases, and the mean count was 278.7/mm3 with 66.7% lymphocytes. Mean protein level in the C.S.F. was 162.5mg/dl, and 94.3% of all cases were over 50mg/dl. Sugar in the C.S.F. was definitely reduced to less than 120 mEq/L in 78.3%, with the mean level being 112.8mEq/L. 8) Chest X-ray revealed tuberculous lesions in 69.8% and miliary tuberculosis was found in 36.8% of cases. 9) The highest mortality was seen in young infants. Among 26 patients of clinical stage I on admission, 21(80.3%) recovered, and 35(79.5%) of 44 patients of stage II recovered, whereas only 13(36.1%) out of 36 patients of stage III were cured. Over-all mortality rate was 5.7% of those followed.
Fever ; Gwangju ; Headache ; Humans ; Incidence ; Infant ; Leukocytes ; Lymphocytes ; Mortality ; Neck ; Neurologic Manifestations ; Parents ; Pediatrics ; Seasons ; Seizures ; Thorax ; Tuberculin Test ; Tuberculosis ; Tuberculosis, Meningeal* ; Tuberculosis, Miliary ; Vaccination ; Vomiting

OBJECTIVE: The purpose of this study is to find out what is the effect of epidural corticosteroid injection on bone metabolism. METHOD: We have assessed the systemic effects of a single epidural triamcinolone acetonide injection on biochemical indices of bone formation and resorption in patients with lumbosacral radiculopathy. Twenty patients who had lumbosacral radiculopathy and free from exposure to corticosteroid for at least 6 weeks were selected for this study. Patients were classifed as two groups; 1) epidural block with 2% lidocaine 3 ml and 0.9% normal saline 15 ml (4 men, 5 women; mean age 47.2+/-7.6 years) and 2) combination of triamcinolone acetonide 40 mg (5 men, 6 women; mean age 49.6+/-8.2 years). Fasting serum and the second voided urine were collected at 0, 1, 3, 7 and 14 days after the single epidural injection for bone-related biochemicalmarkers measurements. RESULTS: 1) Level of serum osteocalcin showed a significant time trend in the epidural corticosteroid injection group. Osteocalcin decreased dramatically from 11.2+/-3.4 ng/ml on day 0 to 5.9+/-2.8 ng/ml on day 1, 6.1+/-1.5 ng/ml on day 3 (p<0.05). After the initial drop, the level recovered to 9.8+/-3.7 ng/ml by day 7, and returned to preinjection level on day 14, at 10.9+/-4.1. 2) Urinary deoxypyridinoline levels did not show any significant changes. CONCLUSION: According to the above results, the epidural injection of corticosteroid may be a better therapeutic mode, with less potential for harmful effects to bone metabolism, in providing effective relief of symptoms to patients with lumbosacral radiculopaties.
Fasting ; Female ; Humans ; Injections, Epidural ; Lidocaine ; Male ; Metabolism* ; Osteocalcin ; Osteogenesis ; Radiculopathy ; Triamcinolone Acetonide

OBJECTIVE: In patients with spinal cord injury, it is more susceptible to osteoporosis because bone resorption is more prominent than bone formation. Thus we evaluated the change of biochemical markers and bone mineral densities (BMDs) according to the duration of injury, the spinal cord injury level, and the injury severity. METHOD: The subjects were included 26 patients with spinal cord injury and 22 healthy men. We measured serum osteocalcin and urine deoxypyridinoline (DPYD) in 2 hours after awakening and measured BMDs in lumbar vertebrae, femur, and distal forearm in patients and control group. The patients were 21 men, 5 women, mean age 43.2+/-14.3 years, and mean duration 28.3+/-45.0 months, who were divided by injury level and injury severity respectively. RESULTS: The biochemical markers of bone metabolism in patients group had significant differences comparing to control group (p<0.05). The urine DPYD and BMDs in femur showed significantly negative correlation with the duration of spinal cord injury (p<0.05). CONCLUSION: In patients with spinal cord injury, urine DPYD and BMDs in femur had significant correlation with the duration of injury. But, the injury level and injury severity had no significant correlation with the markers of bone metabolism and BMDs.
Biomarkers ; Bone Density* ; Bone Resorption ; Female ; Femur ; Forearm ; Humans ; Lumbar Vertebrae ; Male ; Metabolism* ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Spinal Cord Injuries* ; Spinal Cord*

Osteoarthritis of the knee is a common cause of disability in the aging population. Traditional nonoperative treatment options include exercise, physical therapy, weight reduction, nonsteroidal antiinflammatory drugs, analgesics and corticosteroid injection. In recent years, intra-articular injection of hyaluronate-derived products has gained popularity as a palliative modality for the treatment of osteoarthritis of the knee. The common adverse reaction are mild pain or swelling at the site of injection that may occur up to 20% of patients. Severe local inflammation, warmth and joint effusion are rare and no systemic complication have been reported, to our knowledge. We presented one case in which synovial inflammation was observed following intra-articular injection of the knee.
Aging ; Analgesics ; Exercise ; Humans ; Inflammation ; Injections, Intra-Articular* ; Joints ; Knee ; Osteoarthritis* ; Weight Loss

PURPOSE: The optimal timing of a surgery for well-differentiated thyroid carcinoma detected during pregnancy remains controversial. This study was performed to determine the optimal timing of surgery for a well-differentiated thyroid carcinoma detected during pregnancy. METHODS: Betwwen July 1991 and June 2004, 20 cases diagnosed with a well-differentiated thyroid carcinoma during pregnancy were retrospectively analyzed. All 20 patients had undergone surgery. The patients were divided into three groups according to the timing of their surgery. Group I (n=9) had a thyroidectomy after delivery, group II (n=6) had a thyroidectomy during the second trimester, and group III (n=5) had a thyroidectomy after an abortion. Group III was excluded from the study as our particularly interest was in determining the optimal timing of surgery during pregnancy. RESULTS: No significant differences were noted between groups I and II with regard to age, tumor size, TNM stage and the timing of diagnosis. There were no TNM stage changes in group I, although a slight increase in tumor size during pregnancy was noted. There were no significant differences in the surgical outcomes between groups I and II with regard to types of operation, operation times, perioperative complications, length of hospital stays and treatment outcomes. CONCLUSION: The treatment of a well-differentiated thyroid carcinoma detected during pregnancy can be delayed until after delivery in most patients.
Diagnosis ; Female ; Humans ; Length of Stay ; Pregnancy Trimester, Second ; Pregnancy* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

Atypical hemolytic uremic syndrome (HUS) in adults is a life-threatening disorder characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia, which is not related to E. coli. Digital gangrene is one of the grave signs in emergency medicine because it requires prompt evaluation and treatment. We describe a 37 year-old Thailand woman, initially treated for suspected Neisseria septicemia, who went on to develop renal complications, thrombocytopenia and hemolytic anemia, which made the diagnosis of atypical hemolytic uremic syndrome. The patient was complaining of dysesthesia on all extremities and severe pain in both legs. Serologically, she was diagnosed as systemic lupus erythematosus (SLE). She was treated with plasma exchanges using fresh frozen plasma, parenteral steroid, anticoagulant and antibiotics, successfully. This is the first report of digital gangrene complicated by atypical HUS in a patient with SLE in Korea.
Acute Kidney Injury ; Adult ; Anemia, Hemolytic ; Anti-Bacterial Agents ; Emergency Medicine ; Extremities ; Female ; Gangrene ; Hemolytic-Uremic Syndrome ; Humans ; Korea ; Leg ; Lupus Erythematosus, Systemic ; Neisseria ; Paresthesia ; Plasma ; Plasma Exchange ; Sepsis ; Thailand ; Thrombocytopenia

No abstract available.
Acid-Base Equilibrium* ; Acidosis*