No abstract available.
Acetabulum*

A 24-year-old man with tuberculosis meningitis developed acute paraplegia and sensory disturbances 5 weeks after receiving conventional antituberculous therapy. Magnetic resonance imaging revealed an intradural extramedullary long segmental mass mimicking en plaque meningioma at the T2-T6 vertebrae levels. Prompt surgical decompression was performed. A histology examination of the mass revealed a tuberculoma. After surgery, the patient showed improved motor power and a normal bladder function. Intradural extramedullary tuberculoma of the spinal cord is rare complication of tuberculosis meningitis, which can occur as a response to conventional antituberculous therapy.
Diagnosis, Differential ; Humans ; Male ; Meningeal Neoplasms/*diagnosis ; Meningioma/*diagnosis ; Spinal Cord Diseases/*diagnosis/surgery ; Thoracic Vertebrae ; Tuberculoma/*diagnosis/surgery ; Tuberculosis, Meningeal/*diagnosis/surgery ; Young Adult

OBJECTIVE: The aim of this study is to investigate abnormal findings of social brain network in Korean children with autism spectrum disorder (ASD) compared with typically developing children (TDC). METHODS: Functional magnetic resonance imaging (fMRI) was performed to examine brain activations during the processing of emotional faces (happy, fearful, and neutral) in 17 children with ASD, 24 TDC. RESULTS: When emotional face stimuli were given to children with ASD, various areas of the social brain relevant to social cognition showed reduced activation. Specifically, ASD children exhibited less activation in the right amygdala (AMY), right superior temporal sulcus (STS) and right inferior frontal gyrus (IFG) than TDC group when fearful faces were shown. Activation of left insular cortex and right IFG in response to happy faces was less in the ASD group. Similar findings were also found in left superior insular gyrus and right insula in case of neutral stimulation. CONCLUSION: These findings suggest that children with ASD have different processing of social and emotional experience at the neural level. In other words, the deficit of social cognition in ASD could be explained by the deterioration of the capacity for visual analysis of emotional faces, the subsequent inner imitation through mirror neuron system (MNS), and the ability to transmit it to the limbic system and to process the transmitted emotion.
Amygdala ; Brain* ; Autism Spectrum Disorder* ; Child* ; Cognition ; Humans ; Limbic System ; Magnetic Resonance Imaging* ; Mirror Neurons

BACKGROUND: Definite criteria for determining severity of organophosphate poisoning have not been made. Discovery of the third neuromuscular syndrome, the intermediate syndrome, have made it more complicating then ever. Objectives of this study is to determine early prognostic factors of outcome and development of a new treatment algorithm. METHOD: 74 patients admitted to Severance hospital with acute organophosphate poisoning during 5 years were included. We made a protocol concerning the initial consciousness level, QTc interval, PVC, serum cholinesterase, the intermediate syndrome, total hospital, ICU day, length of ventilator support, disposition and have done a study retrospectively. Multiple regression and Chi-square was used as statistical analysis. Significant statistical P-value was 0.05. RESULTS: The total hospital days were prolonged as serum cholinesterase levels were lower, the age was older and mental status graver.(p<.05) The length of ventilatory support was prolonged when patient's serum cholinesterase level was very low, they were unconscious and serum cholinesterase level not recovered to 500 IU/ml within initial 3 days. The intermediate syndrome was significantly related to the prolonged cholinesterase inhibition. CONCLUSION: As an early prognostic factor for the length of ventilatory support in organophosphate poisoning, 1) level of concsiousness and 2) serum cholinesterase level at admission, 3) recovery to more than 500 IU/ml within initial 3 days are useful. Especially when the serum cholinesterase level is not recovered to more than 500 IU/ml within initial 3 days, it is essential to observe closely for the possibility of an intermediate syndrome.
Cholinesterases ; Consciousness ; Humans ; Organophosphate Poisoning* ; Retrospective Studies ; Ventilators, Mechanical

BACKGROUND: The dipstick methodology is the most fundamental urinalysis but interfered by many factors. We evaluated the effect of semen contamination on the urine dipsticks. METHODS: Thirty-two specimens for semen analysis were enrolled. After semen was directly applied on urine dipsticks, residual samples were diluted in pooled normal urine. Urine dipsticks were performed at each dilution titer. Seminal plasma separated by centrifugation of semen were also tested in the same manner. RESULTS: All semen showed positive results for blood, protein and leukocytes. The intensities of reaction for blood and leukocytes were correlated with sperm concentration. The negative conversion of blood and protein occurred at 1:100, and that of leukocytes occurred at 1:50. Seminal plasma showed nearly the same findings. CONCLUSIONS: Semen contamination of urine may cause false positive reaction especially for blood and protein on the urine dipsticks. It should therefore be considered when assessing unexplained, transient hematuria or proteinuria.
Centrifugation ; False Positive Reactions ; Hematuria ; Leukocytes ; Proteinuria ; Semen Analysis ; Semen* ; Spermatozoa ; Urinalysis

Omental cyst is a rare disease and its accurate time and cause of outbreak has not been reported. This disease is known as can be afflicted with postnatally and in case of being afflicted with pre-natally the abdominal cavity and thoracic organ of fetus are oppressed due to fetal abdominal distention leading to fetal death caused by organ dysgenesis. No medical report has yet been published on congenital omental cyst of fetus. This study was conducted on a case of congenital omental cyst of fetus we have experienced in a mother with 16weeks of gestational period and the result is hereby reported along with literally documents.
Abdominal Cavity ; Fetal Death ; Fetus ; Humans ; Mothers ; Rare Diseases

No abstract available.
Anesthesia* ; Bronchial Spasm* ; Humans ; Infant, Newborn ; Infant, Premature* ; Ventilation*

BACKGROUND: Allogeneic blood transfusion has risks from transfusion-transmitted pathogens. Blood management programs are widely used for cardiovascular or orthopedic surgery, but there have been few studies that have focused on blood conservation during brain tumor resection surgery. The purpose of this study was to evaluate the benefits of blood management for brain tumor surgery. METHODS: A total of 26 patients undergoing brain tumor resection surgery were included in the study. Thirteen patients with meningiomas, 10 patients with malignant gliomas and 3 patients with other tumors were included. The surgical blood loss was estimated by preoperative imaging studies, and the tumors that could be operated with minimal bleeding were excluded. Preoperative autologous donation (PAD) was done when the expected amount of surgical bleeding surpassed 300 mL. Preoperative embolization was performed in the patients with meningiomas whenever it was technically feasible. Six percent hydroxyethyl starch 130/0.4 (Voluven) was administered during anesthesia for expanding the blood volume and we performed meticulous surgical techniques for minimizing the blood loss. RESULTS: The amount of bleeding was less than 300 mL in 69.2% of the patients. Preoperative autologous blood was donated by 10 patents and 20% of the PAD units were discarded. Five patients with meningimas received preoperative embolization. None of the patients, except for one patient who had massive bleeding of 7,000 mL, were transfused allogeneic blood. Eighty one percent of the patients received Voluven without complications. CONCLUSION: Multiple strategies that include preoperative embolization, proper surgical techniques for minimizing blood loss, PAD and hydroxyehtyl starch could effectively decrease the amount of allogenic blood transfused during brain tumor resection surgery.
Anesthesia ; Blood Loss, Surgical ; Blood Transfusion ; Blood Transfusion, Autologous ; Blood Volume ; Brain ; Brain Neoplasms ; Glioma ; Hemorrhage ; Hetastarch ; Humans ; Meningioma ; Orthopedics ; Starch

BACKGROUND: The long-term prognosis of patients with hepatocellular carcinomas is still disappointing primarily because of intrahepatic recurrence. Among many factors, portal vein invasion is considered to be the most important risk factor leading to recurrence, and it is thought to be the direct evidence of tumor invasiveness. In clinical aspects, it seems to be more practical to determine the factors associated with portal vein invasion. METHODS: Three hundred and seventy-one patients who underwent a curative hepatic resection for hepatocellular carcinomas between 1991 and 1995 at Seoul National University Hospital were included in this study. Portal vein invasion was identified histopathologically. The prognostic factors of hepatocellular carcinoma and the risk factors linked to portal vein invasion were analyzed by both univariate and multivariate analyses. RESULTS: Portal vein invasion was detected in thirty seven patients (10%), and the 5-year overall and disease-free survival rates in this group were 39.9% and 6.5%, respectively. The 5-year overall and disease-free survival rates of patients without portal vein invasion were 60.1% and 36.8%, respectively. In multivariate analysis using Cox's proportional hazards model, portal vein invasion was proven to be the most important risk factor in both overall and disease-free survival. In a multiple stepwise logistic regression analysis, the size and the number of the tumors were strong independent predictors of portal vein invasion by a hepatocellular carcinoma. CONCLUSIONS: Intrahepatic recurrence and patient survival in cases of hepatocellular carcinomas were closely related to portal vein invasion. Patients with tumor sizes larger than 4 cm or with multiple tumors should be monitored closely for early recurrence.
Carcinoma, Hepatocellular* ; Disease-Free Survival ; Humans ; Logistic Models ; Multivariate Analysis ; Portal Vein* ; Prognosis ; Proportional Hazards Models ; Recurrence ; Risk Factors* ; Seoul

Purpose: Appropriate preclinical mouse models are needed to evaluate the response to immunotherapeutic agents. Immunocompetent mouse models have rarely been reported for gastric cancer. Thus, we investigated immunophenotypes and responses to immune checkpoint inhibitor (ICI) in immunocompetent mouse models using various murine gastric cancer cell lines. Materials and Methods: We constructed subcutaneous syngeneic tumors with murine gastric cancer cell lines, YTN3 and YTN16, in C57BL/6J mice. Mice were intraperitoneally treated with IgG isotype control or an anti–programmed death-ligand 1 (PD-L1) neutralizing antibody. We used immunohistochemistry to evaluate the tumor-infiltrating immune cells of formalin-fixed paraffin-embedded mouse tumor tissues. We compared the protein and RNA expression between YTN3 and YTN16 cell lines using a mouse cytokine array and RNA sequencing. Results: The mouse tumors revealed distinct histological and molecular characteristics. YTN16 cells showed upregulation of genes and proteins related to immunosuppression, such as Ccl2 (CCL2) and Csf1 (M-CSF). Macrophages and exhausted T cells were more enriched in YTN16 tumors than in YTN3 tumors. Several YTN3 tumors were completely regressed by the PD-L1 inhibitor, whereas YTN16 tumors were unaffected. Although treatment with a PD-L1 inhibitor increased infiltration of T cells in both the tumors, the proportion of exhausted immune cells did not decrease in the non-responder group. Conclusion We confirmed the histological and molecular features of cancer cells with various responses to ICI. Our models can be used in preclinical research on ICI resistance mechanisms to enhance clinical efficacy.