No abstract available.
Carbamazepine* ; Haloperidol*

Pulmonary mucinous cystic tumor of borderline malignancy is very rare and distinguished from bronchogenic cyst or adenocarcinoma of bronchoalveolar type. We present the case of a 63-year-old woman with a right lower lobe mass, found by chest radiographs. The preoperative diagnosis was made as bronchoalveolar cancer by percutaneous needle aspiration of mass. Right lower lobectomy and lymph node dissections were performed. The lobectomy specimen contained variable sized multilocular cystic mucous masses, filled with mucus. Microscopically, the cystic masses are lined with tall columnar mucinous epithelium but some area contains focal cellular atypism and bronchoalveolar cancer like foci. This foci are lack of cellular atypism consistent with bronchoalveolar cancer cell. After lobectomy the patient has remained free from recurrence and distant metastasis for following 12 months period. Pulmonary mucinous cystic tumor of borderline malignancy appears to have a favorable prognosis and should be distinguished from other lung neoplasms.
Adenocarcinoma ; Bronchogenic Cyst ; Diagnosis ; Epithelium ; Female ; Humans ; Lung ; Lung Neoplasms ; Lymph Node Excision ; Middle Aged ; Mucins* ; Mucus ; Needles ; Neoplasm Metastasis ; Prognosis ; Radiography, Thoracic ; Recurrence

PURPOSE: To evaluate the clinical usefulness of a home-made histographic analysis system using a lung volume controller. MATERIALS AND METHODS:Our study involved ten healthy volunteers, ten emphysema patients, and two idio-pathic pulmonary fibrosis (IPF) patients. Using a home-made lung volume controller, images were obtained in the upper, middle, and lower lung zones at 70%, 50%, and 20% of vital capacity. Electron beam tomography was used and scanning parameters were single slice mode, 10-mm slice thickness, 0.4-second scan time, and 35 -cm field of view. Using a home-made semi-automated program, pulmonary parenchyma was isolated and a histogram then obtained. Seven histographic parameters, namely mean density (MD), density at maximal frequency (DMF), maximal ascending gradient (MAG), maximal ascending gradient density (MAGD), maxi-mal descending gradient (MDG), maximal descending gradient density (MDGD), and full width at half maxi-mum (FWHM) were derived from the histogram. We compared normal controls with abnormal groups includ-ing emphysema and IPF patients at the same respiration levels. RESULTS: A normal histographic zone with +/-1 standard deviation was obtained. Histographic curves of normal controls shifted toward the high density level, and the width of the normal zone increased as the level of inspi-ration decreased. In ten normal controls, MD, DMF, MAG, MAGD, MDG, MDGD, and FWHM readings at a 70% inspiration level were lower than those at 20% (p<0.05). At the same level of inspiration, histograms of emphysema patients were located at a lower density area than those of normal controls. As inspiration status decreased, histograms of emphysema patients showed diminished shift compared with those of normal con-trols. At 50% and 20% inspiration levels, the MD, DMF, and MAGD readings of emphysema patients were significantly lower than those of normal controls (p<0.05). Compared with those of normal controls, his-tograms of the two IPF patients obtained at three inspiration levels were located in an area of higher density. CONCLUSION: Using a home-made histographic analysis system which included a lung volume controller, pa-tients with diffuse parenchymal lung disease could be distinguished from normal controls. The method may be useful for the diagnosis and follow up of diffuse parenchymal lung diseases.
Diagnosis ; Emphysema ; Healthy Volunteers ; Humans ; Lung Diseases* ; Lung Diseases, Interstitial ; Lung* ; Pilot Projects* ; Pulmonary Emphysema ; Pulmonary Fibrosis ; Reading ; Respiration ; Tomography, X-Ray Computed ; Vital Capacity

OBJECTIVE: This paper describes our experience and implant technique for cranioplasty of a large cranial defects using a porous polyethylene implant(Medpor) and compares the results with polymethylmethacrylate(PMMA). METHODS: Sixteen cranioplasties were performed using Medpor(n=10) and PMMA(n=6) implants between June 2003 and January 2005. The criterion for patient enrollment was a defect larger than 10cm in diameter. This study compared the operation times and complications. RESULTS: The operation times ranged from 105 to 250minutes(Mean 180 degrees +/-44minutes) in Medpor and from 185 to 460minutes (mean 128minutes) in PMMA. The absolute operation times were shorter using the Medpor implant and the differences were statistically significant(P=0.030). Satisfactory cosmetic results were obtained in all cases using the Medpor implant and with no implant-related complications. Bone ingrowth to the medpor implant was presumed to be the result on an increase in Houndsfield units of the implant, particularly at the marginal areas in the serial follow-up brain computed tomography images. CONCLUSION: It is believed that the properties of a Medpor implant make this implant an good alternative to the existing methods of a cranial contour correction. However, a further follow-up study will be needed.
Brain ; Follow-Up Studies ; Humans ; Polyethylene* ; Polymethyl Methacrylate

This is a clinical study on 72 cases of purpura hospitalized at Han Il Hospital during the period from Jan., 1970 to Dec, 1979. The authors obtained the following results : 1) Allergic purpura (25 cases, 34.7%) was the most common disease, followed by I.T.P. (20 cases, 27.8%), Ieukemia (10 cases, 13.9%), meningoccemia (7 cases, 9.7%), and aplastic anemia (5 cases, 6.9%) in order of frequency. 2) The most prevalent age group was 6 to 9 one (45 cases), and sex ratio of male to female revealed 1.67 : 1(45:27). 3) The main clinical features in thrombocytopenic purpura were anemia abdominal pain fever and epistaxis ; while those in non-thrombocytopenic purpura were abdominal pain fever melena hematuria and headache. 4) The hemoglobin level was below 7 gm.% in leukemia and aplastic anemia, but normal or slightly decreased in allergic purpura and idiopathic thrombocytopenic purpura. The W.B.C. count was markedly increased in the most cases of sepsis and leukemia, decreased in aplstic anemia, and within normal range in allergic purpura. The platelet count was below 10,000/mm2 in 97% cases of the thrombocytopenic purpura, while within normal range in non-thrombocytopenic purpura. 5) The bleeding time and the clotting time were within normal ranges in most of all cases. The Rumpel-Leede test revealed positive result in 85% cases of I.T.P., while in only 20% of allergic purpura.
Abdominal Pain ; Anemia ; Anemia, Aplastic ; Bleeding Time ; Child* ; Epistaxis ; Female ; Fever ; Headache ; Hematuria ; Humans ; Leukemia ; Male ; Melena ; Platelet Count ; Purpura* ; Purpura, Schoenlein-Henoch ; Purpura, Thrombocytopenic ; Purpura, Thrombocytopenic, Idiopathic ; Reference Values ; Sepsis ; Sex Ratio

This is a clinical study on 72 cases of purpura hospitalized at Han Il Hospital during the period from Jan., 1970 to Dec, 1979. The authors obtained the following results : 1) Allergic purpura (25 cases, 34.7%) was the most common disease, followed by I.T.P. (20 cases, 27.8%), Ieukemia (10 cases, 13.9%), meningoccemia (7 cases, 9.7%), and aplastic anemia (5 cases, 6.9%) in order of frequency. 2) The most prevalent age group was 6 to 9 one (45 cases), and sex ratio of male to female revealed 1.67 : 1(45:27). 3) The main clinical features in thrombocytopenic purpura were anemia abdominal pain fever and epistaxis ; while those in non-thrombocytopenic purpura were abdominal pain fever melena hematuria and headache. 4) The hemoglobin level was below 7 gm.% in leukemia and aplastic anemia, but normal or slightly decreased in allergic purpura and idiopathic thrombocytopenic purpura. The W.B.C. count was markedly increased in the most cases of sepsis and leukemia, decreased in aplstic anemia, and within normal range in allergic purpura. The platelet count was below 10,000/mm2 in 97% cases of the thrombocytopenic purpura, while within normal range in non-thrombocytopenic purpura. 5) The bleeding time and the clotting time were within normal ranges in most of all cases. The Rumpel-Leede test revealed positive result in 85% cases of I.T.P., while in only 20% of allergic purpura.
Abdominal Pain ; Anemia ; Anemia, Aplastic ; Bleeding Time ; Child* ; Epistaxis ; Female ; Fever ; Headache ; Hematuria ; Humans ; Leukemia ; Male ; Melena ; Platelet Count ; Purpura* ; Purpura, Schoenlein-Henoch ; Purpura, Thrombocytopenic ; Purpura, Thrombocytopenic, Idiopathic ; Reference Values ; Sepsis ; Sex Ratio

STUDY DESIGN: This retrospective study was designed to investigate the effectiveness of surgical procedure for degenerative lumbar scoliosis. OBJECTIVES: To evaluate surgical outcome on symptomatic degenerative lumbar scoliosis and to analyze the cause of decompensation of the curve at the above segment adjacent to fused vertebra. SUMMARY OF LITERATURE REVIEW: Few studies evaluated the surgical outcome of patients with symptomatic degenerative lumbar scoliosis, and observed the postoperative deompensation of the curve at adjacent segment. MATERIALS AND METHODS: Thirty patients were retrospectively reviewed. All patients underwent decompressive laminectomy, transpedicular screw fixation, and intertransverse fusion by autogenous bone graft. Scoliotic angle within curves and within fused segments were measured by Cobb's method. Changes of the adjacent segment were analyzed. RESULTS: The overall satisfactory clinical results was noted in 25(83%) of 30 patients. The curve preoperative averaged 13.3 degrees +/- 4.0 degrees, 5.5 degrees +/-3.2 degrees after surgery and curves at final follow-up 8.6 degrees +/-6.2 degrees. In six patients(20%) decompensation of the curve with more than 5degrees occurred at the adjacent segment above to the fused segments. This decompensation of the curve closely correlated to the lateral translation at adjacent segments and postoperative pain. Sagittal profile was not significantly improved following surgery. CONCLUSIONS: Uncorrected lateral translation at the unfused adjacent segment resulted in progression of the coronal deformity at upper adjacent segment to fused vertebrae. Therefore, in fusion operation upper end vertebra with lateral instability should be included to prevent the postoperative decompensation.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Laminectomy ; Pain, Postoperative ; Retrospective Studies ; Scoliosis* ; Spine ; Transplants

Angiosarcoma is a rare malignant vascular tumor that most commonly arises in the skin and superficial soft tissues of the head and neck. It accounts for less than 1% of all sarcomas, and 50% of these lesions occur in the head and neck. There are some clinical characteristics, such as insidious presentation, multifocal nature, aggressive behavior and poor prognosis. We report a case of angiosarcoma in a temporal region. A 75-year-old man presented with a 2-month history of left bloody otorrhea. Previously, he had two operations for the left chronic otitis media at a local clinic. After the second operation, bloody otorrhea began and was not controlled. We conducted revision canal wall down operation again, but failed to control bloody otorrhea. Biopsy was performed at the posterior portion of the open cavity. Histologic examination showed necrosis and atypical vascular proliferation, consistent with angiosarcoma.
Aged ; Biopsy ; Head ; Head and Neck Neoplasms ; Hemangiosarcoma* ; Humans ; Neck ; Necrosis ; Otitis Media ; Prognosis ; Sarcoma ; Skin

OBJECTIVE: The principle operation of acute subdural hematoma (ASDH) is a craniotomy with hematoma removal, but a trephination with hematoma evacuation may be another method in selected cases. Trephine drainage was performed for ASDH patients in subacute stage using urokinase (UK) instillation, and its results were evaluated. METHODS: Between January 2016 and December 2018, the trephine evacuation using UK was performed in 9 patients. The interval between injury and operation was from 1 to 2 weeks. We underwent a burr hole trephination with drainage initially, and waited until the flow of liquefied hematoma stopped, then instilled UK for the purpose of clot liquefaction. RESULTS: The mean age of patients was 71.6 years (range, 38–90 years). The cause of ASDH was trauma in 8 cases, and supposed a complication of anticoagulant medication in 1 case. Four out of 8 patients took antiplatelet medications and one of them was a chronic alcoholism. The range of the Glasgow Coma Scale score before surgery was from 13 to 15. Most of patients, main symptom was headache at admission. The Glasgow Outcome Scale score was 5 in 8 cases and 3 in 1 case. CONCLUSION: It is thought to be a useful operation method in selected patients with ASDH that the subdural drainage in subacute stage with UK instillation. This method might be another useful option for the patients with good mental state regardless of age and the patients with a risk of bleeding due to antithrombotic medications.
Alcoholism ; Craniotomy ; Drainage ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Headache ; Hematoma ; Hematoma, Subdural, Acute ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Methods ; Trephining ; Urokinase-Type Plasminogen Activator

OBJECTIVES: Schizophrenia, commonly developed in adolescence and young adulthood, is one of the most common mental diseases in psychiatry. The etiology or pathogenesis of this disease is uncertain yet, but the dysfunction of dopaminergic system in the brain has been proposed. However, there is no direct evidence of dysfunction of brain dopaminergic systems in schizophrenic patients because the direct assessment of brain dopaminergic systems is almost impossible at present. To overcome this problem, recently founded dopamine receptors and their mRNAs in peripheral lymphocytes was used. The purpose of this study was to define whether the dopamine receptors of peripheral lymphocytes can be the peripheral markers of schizophrenia or not. METHODS: The total numbers of subjects are 87 schizophrenic patients. Among them 44 patients were schizophrenics who had been taking antipsychotic drugs for more than 3 years(medicated patients) 43 schizophrenics who recently are not taken antipsychotic drugs for more than 3 months(drugfree patients) For controls age and sex matched 31 healthy persons were enrolled. Sequential reverse transcription and quantitative polymerase chain reaction of the mRNA were used to investigate the expression of dopamine receptors in peripheral lymphocytes. The gene expression of dopamine receptors were compared in each groups and after starting antipsychotic medicines in drug-free patients, the clinical scales and the dopamine receptors of peripheral lymphocytes were sequentially studied before, 2 weeks after and 8 weeks after medication. RESULTS: 1)In drug-free schizophrenics, D3 dopamine receptor mRNA expression of peripheral lymphocytes was significantly increased comparing with that of controls and drug-medicated schizophrenics and D5 dopamine receptor mRNA expression was increased comparing with only that of drug-medicated schizophrenics. There was no difference between controls and drug-medicated schizophrenics. 2)After antipsychotic medication, dopamine receptors of lymphocytes were increased tendency. 3)Drug-free patients were divided into two groups according to dopamine receptor expression in controls to evaluate the significance of increased dopamine receptor expression. The group of patients with increased dopamine receptor expression had following clinical characteristics. (1)More severe psychiatric symptoms (2)Poor pharmacological response of pBPRS on medicines (3)Severe extrapyramidal side effects after pharmacological treatment CONCLUSION: These results revealed that the molecular biologically determined dopamine receptors of peripheral lymphocytes were reactive, and increased expression of dopamine receptor in peripheral lymphocyte had clinical significance for subgrouping and prognostication. These findings suggested that dopamine receptors of peripheral lymphocyte may represent dopamine receptors of the brain, even the location cannot be determined.
Adolescent ; Antipsychotic Agents ; Brain ; Dopamine* ; Gene Expression ; Humans ; Lymphocytes* ; Polymerase Chain Reaction ; Receptors, Dopamine* ; Reverse Transcription ; RNA, Messenger* ; Schizophrenia ; Weights and Measures