Three cases of giant pituitray adenoma are reported. Two cases were operated by transsphenoidal approach and a case by transcranial approach. Transsphenoidal approach showed satisfactory results despite of marked suprasellar extension of tumors. We report rare giant pituitary adenomas with review of relevant literatures.
Adenoma ; Pituitary Neoplasms*

No abstract available.
Communicable Diseases* ; Zinc*

PURPOSE: The purpose of this study was to analyze the characteristic MR findings of childhood metachromatic leukodystrophy. MATERIALS AND METHODS: Five female patients (10--29 months old;mean age, 21.8 months) of biochemically confirmed metachromatic leukodystrophy were included in this study. We evaluated the extent of white matter degeneration, which was shown as high signal intensity on T2-weighted image, and the presence or absence of the enhancement. Result.' All 5 cases showed high signal intensity in periventricular deep white matter and centrum semiovale which were bilateral, symmetric and confluent. Posterior predominace, sparing of subcortical U fibers and immediate periventricular white matter, and the involvement of splenium of corpus callosum were also noted in all cases. There were other manifestations, such as 'tigroid pattern' in centrum semiovale (n=4), the involvement of genu of corpus callosum(n=4), posterior limb of internal capsule(n=4), descending pyramidal tracts (n=3), deep cerebellar white matter(n=1), claustrum(n=2), and diffuse brain atrophy(n=1). In three cases with Gd-infusion, contrast enhancement of the lesion was not seen. CONCLUSION: In childhood metachromatic leukodystrophy, MRI can clearly demonstrate the chracteristic extent of the white matter lesion and other associated findings, facilitating the differential diagnosis from other similar leukodystrophies.
Brain ; Corpus Callosum ; Diagnosis, Differential ; Extremities ; Female ; Humans ; Leukodystrophy, Metachromatic* ; Magnetic Resonance Imaging* ; Pyramidal Tracts

No abstract available.
Carcinoma, Transitional Cell*

The use of steroids has long been reported many side effects. Steroid-induced mental disorder is one of many complications associated with corticosteroid therapy. Steroid psychosis is not common disease but it may be more popular due to high steroid therapy such as pulse therapy or high dose steroid therapy. Euphoria, irritability, insomnia, and hallucination are predominating symptoms. The dosage, duration of the treatment may not be correlated with the time of the onset, duration, severity, or type of mental disturbances, but the risk of developing psychosis is increased to the high dose of steroid. It is usually reversible on dose reduction or discontinuation of the drug.
Euphoria ; Hallucinations ; Mental Disorders ; Psychotic Disorders* ; Sleep Initiation and Maintenance Disorders ; Steroids

Lesions with coronary artery aneurysm (CAA) can become complicated during percutaneous coronary intervention. Here, we report a case of a 78-year-old man who developed a rupture, and spontaneous sealing of the CAA occurred after stent implantation, as shown by computed tomography coronary angiography.
Aged ; Aneurysm ; Congenital Abnormalities ; Coronary Aneurysm ; Coronary Angiography ; Coronary Vessels ; Drug-Eluting Stents ; Ear ; Humans ; Percutaneous Coronary Intervention ; Rupture ; Stents

PURPOSE: To compare the intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness and central corneal thickness (CCT) in healthy individuals and patients with chronic renal failure (CRF) undergoing hemodialysis, and to evaluate the changes in each parameter before and after hemodialysis in patients with CRF. METHODS: Thirty-six eyes of 36 patients with CRF undergoing hemodialysis were included in the hemodialysis group and 54 eyes of 54 healthy subjects were recruited as the control group. All subjects underwent a complete eye examination, including best-corrected visual acuity (BCVA), slit lamp examination, dilated funduscopic examination, gonioscopy, automated perimetry, IOP measurement, corneal pachymetry, and evaluation of RNFL thickness. In the hemodialysis group, IOP, RNFL thickness, and CCT were measured again within 1 hour of hemodialysis. RESULTS: Age, sex, BCVA, cup-to-disc ratio, IOP, and CCT were not statistically different between the 2 groups. The RNFL of the hemodialysis group was statistically significantly thinner than the control group (p < 0.001). The IOP decreased from 16.52 +/- 2.95 mm Hg to 14.88 +/- 2.03 mm Hg after hemodialysis (1.63 +/- 3.27 mm Hg; p = 0.005). The changes in RNFL thickness and CCT were not statistically significant (p = 0.148, p = 0.352). CONCLUSIONS: In CRF patients with hemodialysis, RNFLs were thinner in the control group and hemodialysis induced significant IOP reduction. The results from the present study should be considered for the proper evaluation of ocular disorders in CRF patients with hemodialysis.
Corneal Pachymetry ; Eye ; Gonioscopy ; Humans ; Intraocular Pressure ; Kidney Failure, Chronic ; Nerve Fibers ; Renal Dialysis ; Retinaldehyde ; Visual Acuity ; Visual Field Tests

Unlike other soluble receptors, the soluble interleukin-6 receptor (sIL-6R) cooperates with IL-6 to activate gp130 of effector cell. As the IL-6 and sIL-6R are important in the rheumatoid disease, this study was designed to measure concentration of IL-6 and sIL-6R in synovium and synovial fluid of the degenerative arthritis. The synovium and synovial fluid were obtained during total knee replacement arthroplasty. The synovium was taken from eleven patients, and synovial fluid taken from sixteen patients. Same patients between two groups were seven. Tissue cultures of the synovial tissues were done with 10% FBS for 72 hours. After irrigation, thery were incubated for 48 hours without FBS, and the culture media and the synovial fluid were collected after centrifuged at 2500rpm for 10 minutes. The level of IL-6 and sIL-6R were measured by quantitative sandwich enzyme immunoassay technique. RESULTS: In the synovium, the IL-6 level was 5.1+/-0.12ng/ml, and the sIL-6R level was 0.41+/-0.25ng/ml. In the synovial fluid, the IL-6 level was 0.09+/- 0.15ng/ml, and the sIL-6R level was 10.37+/-3.28ng/ml. These results show that IL-6 concentration was measured highly in two groups, especially in synovium (sixty times), and the sIL-6R concentration was measured significantly high in synovial fluid (twenty-five times). CONCLUSION: The IL-6 and sIL-6R were elevated in degenerative arthrits. We confirmed the source of IL-6 was synovium (very high in synovial tissue culture media), but we need further study for the source of sIL-6R as it was remarkably elevated as IL-6 and its level was lower than serum.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Culture Media ; Humans ; Immunoenzyme Techniques ; Interleukin-6* ; Osteoarthritis ; Synovial Fluid ; Synovial Membrane

Tubuolointerstitial inflammation and tubular injury account for most types of glomerulonephritis. The injury is characterized by an infiltration of mononuclear cells with atrophy and dilation of tubules and increased deposition of collagen in the interstitium. Despite the fact that the degree of tubulointerstitial injury in glomerular diseases may be the best predictor of overall outcome, the pathogenic mechanism by which the tubular injury develops remains unknown. Osteopontin, a highly acidic, phosphorylated, secreted glycoprotein, is up-regulated in renal cortex in many experimental models of tubulointerstitial fibrosis. In this study, we examined the expression of osteopontin in tubulointerstitium in experimental renal failure mouse, FGS/KIST. Mice were assigned three groups and sacrificed at 1 month, 2 months, and 3 months, in each. Proteinuria, GFR, the degree of tubulointerstitial inflammation, tubular atrophy, glomerulosclerosis and osteopontin expression were measured. Three-month-old group showed severely decreased GFR and marked tubulointerstitial inflammation and glomerulosclerosis compared with other groups. The expression of osteopontin increased with the severity of tubulointerstitial injury. These data suggest that osteopontin may act as a chemotactic or adhesive factor in the recruitment of the monocyte/macrophages and have a role in the pathogenesis of the tubulointerstitial injury.
Adhesives ; Animals ; Atrophy ; Collagen ; Fibrosis ; Glomerulonephritis ; Glycoproteins ; Inflammation ; Mice ; Models, Theoretical ; Osteopontin* ; Proteinuria ; Renal Insufficiency*

Presented here in are two cases of chronic subdural hematoma in children which were spontaneously resolved. The first case has developed as the complication of a ventriculoperitoneal shunt in bilateral cerebral convexities of a 14-year-old boy while in the other case, the hematoma was developed in the posterior fossa of a 19 days-old neonate are complication of delivery. The etiology, clinical couse, treatment and mechanism of spontaneous resolution of chronic subdural hematomas in children and adult are discussed.
Adolescent ; Adult ; Child* ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Infant, Newborn ; Male ; Ventriculoperitoneal Shunt