Several of the newer broad-spectrum, potent antibiotics are currently being used for the treatment of meningitis, ventriculitis and shunt-tract infection. The risk of complications following intrathecal administration of some of this newer antibiotics varies considerably. Possible complications of immediate or delayed seizure, cortical electric depression, radiculopathy, transverse myelopathy, and arachnoiditis after intrathecal or intraventricular administration must be weighed against the potential value of this route. These risks may influence the therapeutic management of a specific clinical situation. The author studied the effect of the first generation of cephalosporins(cepalothin, cefazolin, cepharadine, cephapirin), the second generation of cephalosporins(cefamandole, cefmetazole), and the third generation of cephalosporins(cefotaxime, cetriaxone, cefotetan), on electrocortical activity of cerebral cortex. The results are as follows : 1) The topical application of cephalothin, cefazolin, cephapirin 8mg/ml shows electrocortical spike activity. In higher concentration, each cases show intense electrocortical spike activity. The topical application of cephradine 100mg/ml shows electrocortical spike activity and in higher concentration, electrocortical spike activity continued. 2) The topical application of cefamandole 64mg/ml shows electrocortical spike activity first and that of cefmetazole 100mg/ml shows electrocortical spike activity and in higher concentration of each cases, intense electrocortical spike activity continued. 3) The topical application of cefotaxime 16mg/ml shows electrocortical spike activity and that of ceftriaxon 200mg/ml and cefatetan 100mg/ml shows mild electrocortical spike activity. In higher concentration of each cases, electrocortical spike activity continued. In conclusion, the degrees of epileptogenic effect was most severe in the first generation of cephalosporins and the second generation of cephalosporins and the third generation of cephalosporins on the decreasing order.
Anti-Bacterial Agents ; Arachnoid ; Arachnoiditis ; Cefamandole ; Cefazolin ; Cefmetazole ; Cefotaxime ; Ceftriaxone ; Cephalosporins* ; Cephalothin ; Cephapirin ; Cephradine ; Cerebral Cortex* ; Depression ; Meningitis ; Radiculopathy ; Seizures ; Spinal Cord Diseases

Ganglionneuroma is slow-growing benign neoplasm that orignates from the sympathetic nervous system. A case of dumb-bell shaped Ganglionneuroma at first and second cervical areas is presented on this paper with chief complaint of neck pain and quadriparesis. The tumor was totally removed under operating microscope and the diagnosis was pathohistologically confirmed. The postoperative result was good and relative literatures were reviewed.
Diagnosis ; Ganglioneuroma* ; Neck Pain ; Quadriplegia ; Sympathetic Nervous System

BACKGROUND: Programmed death-ligand 1 (PD-L1), a transmembrane protein, binds to the programmed death-1 (PD-1) receptor, and anti-PD-1 therapy enables immune responses against tumors. This study aimed to assess clinical characteristics of PD-L1 expression using immunohistochemistry among Korean patients with lung cancer. METHODS: We retrospectively reviewed the data of patients with pathologically proven lung cancer from a single institution. PD-L1 expression determined by Tumor Proportion Score (TPS) was detected using 22C3 pharmDx (Agilent Technologies) and SP263 (Ventana Medical Systems) assays. RESULTS: From July 2016 to July 2017, 267 patients were enrolled. The main histologic type was adenocarcinoma (69.3%). Most participants were smokers (67.4%) and had clinical stage IV disease (60.7%). In total, 116 (42%) and 58 (21%) patients had TPS ≥1% and ≥50%, respectively. The patients were significantly older in TPS ≥1% group than in TPS <1% group (64.83±9.38 years vs. 61.73±10.78 years, p=0.014), not in TPS ≥50% cutoff value (64.69 ± 9.39 vs. 62.36 ± 10.51, p= 0.178). Regarding histologic grade, higher proportions of poorly differentiated tumor were observed in the TPS ≥1% (40.8% vs. 25.8%, p=0.020) and TPS ≥50% groups (53.2% vs. 27.2%, p=0.004). Among 34 patients examined with 22C3 and SP263 assays, 27 had positive results in both assays, with a cutoff of TPS ≥1% (r=0.826; 95% confidence interval, 0.736–0.916). CONCLUSION: PD-L1 expression, defined as TPS ??%, was related to older age and poorly differentiated histology. There was a similar distribution of PD-L1 expression in both 22C3 and SP263 results.
Adenocarcinoma ; Asian Continental Ancestry Group ; Carcinoma, Non-Small-Cell Lung ; Gene Expression ; Humans ; Immunohistochemistry ; Lung Neoplasms ; Lung ; Retrospective Studies

BACKGROUND: Programmed death-ligand 1 (PD-L1), a transmembrane protein, binds to the programmed death-1 (PD-1) receptor, and anti-PD-1 therapy enables immune responses against tumors. This study aimed to assess clinical characteristics of PD-L1 expression using immunohistochemistry among Korean patients with lung cancer. METHODS: We retrospectively reviewed the data of patients with pathologically proven lung cancer from a single institution. PD-L1 expression determined by Tumor Proportion Score (TPS) was detected using 22C3 pharmDx (Agilent Technologies) and SP263 (Ventana Medical Systems) assays. RESULTS: From July 2016 to July 2017, 267 patients were enrolled. The main histologic type was adenocarcinoma (69.3%). Most participants were smokers (67.4%) and had clinical stage IV disease (60.7%). In total, 116 (42%) and 58 (21%) patients had TPS ≥1% and ≥50%, respectively. The patients were significantly older in TPS ≥1% group than in TPS <1% group (64.83±9.38 years vs. 61.73±10.78 years, p=0.014), not in TPS ≥50% cutoff value (64.69 ± 9.39 vs. 62.36 ± 10.51, p= 0.178). Regarding histologic grade, higher proportions of poorly differentiated tumor were observed in the TPS ≥1% (40.8% vs. 25.8%, p=0.020) and TPS ≥50% groups (53.2% vs. 27.2%, p=0.004). Among 34 patients examined with 22C3 and SP263 assays, 27 had positive results in both assays, with a cutoff of TPS ≥1% (r=0.826; 95% confidence interval, 0.736–0.916). CONCLUSION PD-L1 expression, defined as TPS ??%, was related to older age and poorly differentiated histology. There was a similar distribution of PD-L1 expression in both 22C3 and SP263 results.