Congenital Abnormalities ; Dentofacial Deformities ; Humans ; Maxilla ; Molar ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Le Fort ; Vertical Dimension

OBJECTIVES: This study was designed to examine whether melatonin has a neuroprotective effect against hippocampal neuronal damage following transient global ischemia in a gerbil. Polyamine is known to play a role in the pathophysiology of ischemic neuronal damage, we evaluated the influences of melatonin on the polyamine level as well as histology. MATERIAL AND METHODS: Male Mongolian gerbils (60-80 g) were used in this study. Transient global ischemia was induced by occlusion of the bilateral common carotid arteries for 3 min with microclips. Melatonin was administered immediately after occlusion. The animals were decapitated 24 h after the occlusion for polyamine measurement by a high performance liquid chromatography (HPLC) and 4 days after the occlusion for histological evaluation (hematoxylin and eosin staining). A histological examination was performed by a blinded investigator. RESULTS: The hippocampal putrescine level increased compared to sham-operated animals and the increase of putrescine was attenuated by 20 mg/kg melatonin administration. Spermidine and spermine levels didn't show significant changes after ischemia. Hippocampal neuronal damage in the CA1 region was markedly observed in vehicle-treated animals compared to sham-operated animals. Melatonin administration (10 or 20 mg/kg) significantly inhibited hippocampal CA1 neuronal damage after ischemia compared to corresponding vehicle-treated animals (p<0.05 and p<0.01, respectively). CONCLUSION: Melatonin attenuates the putrescine level after transient global ischemia and may have putative neuroprotective effects against global ischemia induced neuronal damage.
Animals ; Brain* ; Carotid Artery, Common ; Chromatography, Liquid ; Eosine Yellowish-(YS) ; Gerbillinae* ; Hippocampus ; Humans ; Ischemia* ; Male ; Melatonin* ; Neurons* ; Neuroprotective Agents ; Putrescine ; Research Personnel ; Spermidine ; Spermine

Halothane was introduced in 1956. It has been used worldwidely as a relatively safe inhalation anesthetic but it is generally accepted that it can cause decrease of liver function. But the causative factor has not yet been pinpointed. Enflurane also seems to decrease liver function but the exact cause is not yet known. In order to study the effects of enflurane and halothane on liver function, we used 10 cases of spinal anesthesia as a control group, and 20 cases each of enflurane and halothane anesthesia respectively as experimental group. We then checked serum GOT, GPT, total bilirubin, alkaline phosphatase, and eosinophil count in peripheral venous blood before oeration and 6 days after operation and looked for the existence of high fever of more than 39 degrees C 3 days postoperatively. The results are as follows: 1) We found statistical significant change of serum GOT, GPT, total billirubin alkaline phosphatase and eosinophil count in spinal, enflurane, or halothane anesthesia beofre and after operation. There was no statistically significance between the control and experimental groups. 2) No patient developed high fever of more than 39 degrees C until 3 days after anesthesia in any group. 3) No significant change of mean arterial blood pressure was observed before and during anesthesia in each group. In this study no definite conclusion that enflurane and halothane might have affected the liver function.
Alkaline Phosphatase ; Anesthesia ; Anesthesia, Spinal ; Anesthetics* ; Arterial Pressure ; Bilirubin ; Enflurane* ; Eosinophils ; Fever ; Halothane* ; Humans ; Inhalation ; Liver*

Cerebral salt-wasting syndrome (CSWS) is a rare disease characterized by a extracellular volume depletion and hyponatremia induced by marked natriuresis. It is mainly reported in patients who experience a central nervous system insult, such as cerebral hemorrhage or encephalitis. The syndrome of inappropriate antidiuretic hormone secretion is a main cause of severe hyponatremia after hematopoietic stem cell transplantation, whereas CSWS is rarely reported. We report 3 patients with childhood acute leukemia who developed CSWS with central nervous system complication after hematopoietic stem cell transplantation. The diagnosis of CSW was made on the basis of severe hyponatremia accompanied by increased urine output with clinical signs of dehydration. All patients showed elevated natriuretic peptide and normal antidiuretic hormone. Aggressive water and sodium replacement treatment was instituted in all 3 patients and 2 of them were effectively recovered, the other one was required to add fludrocortisone administration.
Central Nervous System ; Cerebral Hemorrhage ; Dehydration ; Diagnosis ; Encephalitis ; Fludrocortisone ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Hyponatremia ; Leukemia ; Natriuresis ; Polyuria ; Rare Diseases ; Sodium ; Water

Five cases of complete visual loss related to papilledema were presented. The diagnoses of cases were an intracranial arachnoid cyst(1 case), brain tumors(3 cases) and benign intracranial hypertension(BIICP) followed by a minor head trauma(1 case). All cases had marked papilledema at admission and their range of age was from 4 to 27 years. The timings of visual loss were preadmission in 2 cases, during admission following removal of posterior fossa tumor(1 case) and revision of cysto-peritioneal shunt in a case of an arachnoid cyst(1 case), and during follow-up after conservative management of a minor head trauma(BIICP) in 1. Their visual function had not improved during the follow-up from 3 months to 9 years. Optic nerve sheath decompression should be considered in the case of BIICP for improving the vision. In cases who have well developed chronic papilledema, visual loss that is abrupt may be followed by cranial decompression. We stress neurosurgeons should predict a tragic outcome of visual loss during the management of cases who have well developed chronic papilledema, especially in children and young adult patients.
Arachnoid ; Brain ; Child ; Decompression ; Diagnosis ; Follow-Up Studies ; Head ; Humans ; Optic Nerve ; Papilledema ; Pseudotumor Cerebri ; Young Adult

No abstract available.

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that has been reported in systemic organs and in the skin as a biologically "borderline" neoplasm with intermediate malignant potentials. Skin involvement in EHE is rare, but when present, it occurs most commonly in the upper and lower extremities, presenting as a solitary, slightly painful, soft tissue mass. Skin involvement is often associated with underlying soft tissues or bone tumors. Histopathological study reveals cords and nests of epithelioid endothelial cells in a myxoid or hyalinized background and small intracytoplasmic vacuoles containing red blood cells. There have been no reported cases yet describing the dermoscopic features of EHE. Herein, we describe a young woman who developed cutaneous EHE that enlarged during pregnancy, we provided the dermoscopic findings and a review of the relevant literature.
Dermoscopy ; Endothelial Cells ; Erythrocytes ; Female ; Hemangioendothelioma, Epithelioid ; Humans ; Hyalin ; Lower Extremity ; Pregnancy ; Skin ; Vacuoles

Although congenital syphilis can be prevented with prenatal screening, the disease remains problematic. Currently, there are no cases that describe hematuria and pneumonia related to congenital syphilis. We report a case of congenital syphilis that involved nephrotic syndrome and pneumonia alba in a 22-day-old male infant whose mother did not receive adequate prenatal care. The congenital syphilis diagnosis was confirmed with a serologic test and the patient recovered with penicillin treatment. Clinical findings may be subtle in neonates and delayed recognition occurs frequently, thus complete prenatal screening is critical for congenital syphilis prevention. Immediate serologic testing should be performed to obtain a differential diagnosis if an infant is delivered by a mother that has not received appropriate prenatal examinations.
Diagnosis ; Diagnosis, Differential ; Exanthema* ; Hematuria* ; Humans ; Infant ; Infant, Newborn ; Male ; Mothers ; Nephrotic Syndrome ; Penicillins ; Pneumonia* ; Prenatal Care ; Prenatal Diagnosis ; Serologic Tests ; Syphilis, Congenital*

Clear cell acanthosis is a reaction pattern of the epidermis that can be observed as the chief histopathologic finding in clear cell acanthoma and as a focal change in other epidermal lesions, such as verruca vulgaris and seborrheic keratosis. Dermoscopy is a useful noninvasive tool that permits the visualization of key vascular structures that are usually not visible to the naked eye. A 63-year-old Korean man was presented with 2 year of a well-circumscribed, dome-shaped nodule on the nipple. Our patient represents patterns of both a clear cell acanthoma and a seborrheic keratosis on dermoscopic and histopathologic finding, but, notably, on dermoscopy vascular structures were more irregular linear distribution than classic clear cell acanthoma and different from dotted vessels shown in psoriasis. In this report, we describe a case of clear cell acanthosis in seborrheic keratosis for whom dermoscopy was used as a valuable diagnostic tool.
Acanthoma ; Dermoscopy ; Epidermis ; Eye ; Humans ; Keratosis, Seborrheic ; Nipples ; Psoriasis ; Warts

No abstract available.
Kyphosis* ; Spine* ; Tuberculosis*