Tuberous sclerosis is a rare heredofamilial disease involving multiple organs, classically associated with the clinical triad of adenoma sebaceum, epilepsy, and mental retardation. We have recently experienced a case of tuberous sclerosis, 18-year-old male patient, who had typical adenoma sebaceum and generalized epileptic seizure. Plain skull film showed multiple calcified paraventricular subependymal nodules and brain CT scan disclosed characteristic calcified tubers adjacent to the frontal horn and body of the lateral ventricle.
Adolescent ; Animals ; Brain ; Epilepsy ; Horns ; Humans ; Intellectual Disability ; Lateral Ventricles ; Male ; Skull ; Tomography, X-Ray Computed ; Tuberous Sclerosis*

No abstract available.
Tuberculosis, Pulmonary*

Congenital cystic adenomatoid malformation and Extralobar Pulmonary sequestration are very rare congenital anomalies. We experienced a 4 year-old female patient who had Congenital cystic adenomatoid malformation in her lower lobe of left lung. We accidently found extralobar pulmonary sequestration associated with Congenital cystic adenomatoid malformation at operation field. The resection of the left lower lobe and the extralobar pulmonary sequestration were performed. The arterial supply of the extralobar pulmonary sequestration was one anomalous artery arised from the thoracic aorta. The Venous drainage of expralobar pulmonary sequestration was intercostal vein into the azygous vein. The patient was discharged without any problem.
Aorta, Thoracic ; Arteries ; Bronchopulmonary Sequestration* ; Child, Preschool ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Drainage ; Female ; Humans ; Lung ; Veins

To elucidate the early sequential morphogenetic progress of exencephaly and myeloschisis, rat embryos whose mothers had been treated with hypervitaminosis A were studied at 1-day interval from gestation day 10.5 to 15.5. In exposed animals sequential change was found in both exencephaly and myeloschisis as the embryos grew up. The 10.5-day old exencephalic embryos had still widely open cephalic neural tubes. Exencephalic embryos older than 13.5 days of gestation showed strikingly severe eversion and overgrowth of the cephalic neuroepithelium, thus failed in forming normal primitive brain. The convex dorsal surface of the exencephaly was covered with ependyma, which was connected directly with surrounding surface eqithelium at the periphery. The earliest morphologically recognized myeloschisis was in the 13.5-day old embryos. In myeloschisis, divergence at the roof plate and eversion of the spinal neural tube, disorganized overgrowth of the neuroepithelium, malformed and misplaced spinal ganglia and nerve roots, and absence of the neural arch and dermal covering were characteristic. It is suggested that exencephaly results from failure of the cephalic neural tube closure which is followed by eversion and overgrowth of the neuroepithelium. And failure in closure of the posterior neuropore and disturbance in the development of the tail bud probably play major role in the morphogenesis of myeloschisis.
Animals ; *Embryonic and Fetal Development ; Female ; Hypervitaminosis A ; Neural Tube Defects/chemically induced/*pathology ; Pregnancy ; Rats ; Rats, Inbred Strains ; Spinal Cord/*abnormalities/embryology

The infusion edema model was applied to study the effect of l-glutamic acid on the central conduction time of the cat somatosensory pathway which was compromised in the deep white matter by infusion known amount of l-glutamic acid and physiologic saline in the left and right frontal respectively. According to the different acidity of the l-glutamic acid three groups A(pH=3.22), B(pH=5.13), and C(pH=7.39) were made, but the concentration of glutamic acid was 20m Mol/L in all groups. Infusion of normal saline(0.9%, pH=5.11) into the right frontal deep white matter was common in all groups. During 4 hours of slow infusion of the infusates (average 0.48ml in each side totally) central conduction times were measured every hour via contralateral median nerve stimulation, bilaterally. Finally the cat was sacrificed and specimens of the edematous white matter obtained bilaterally. Finally the cat was sacrificed and specimens of the edematous white matter obtained bilaterally at the corresponding points and percentage water content was measured. The results were as follows : 1) Overall average percentage water content was 82.36% and there was no statistically significant differences between the glutamic acid and saline infusion sites in each group. 2) The I-N1 interpeak latency was labelled as central conduction time(CCT), and overal baseline CCT was 5.04msec, 5.09msec, left and right side respectively. 3) The differences of CCT between glutamic and saline infusion edema were statistically significant in group A and B at 2, 3, 4 hours infusion, but the differences of CCT from the baseline value in the same side were absent in group A and B. In contrast, group C showed no differences in CCT between glutamic acid and saline infusion edema, but CCT comparisons with baseline value among same infusate were significantly prolonged at 4 hours infusion on both sides. Intergroup unpaired t-test for checking intergroup differences among the three glutamic acid groups showed no intergroup differences in CCT. 4) In the combined group the CCT was significantly different between the glutamic and saline sides at 2 hours(P<0.005), 3 hours(P<0.005), 4 hours(P<0.025) infusion. The comparison of each hour CCT with the baseline value showed statistically significant prolongation of CCT only in glutamic side at 3,4 hours infusion. The results indicate the l-glutamic acid which is normally present in brain edema fluid can modulate local biochemical milieu of the brain as to increase the CCT.
Animals ; Brain Edema* ; Brain* ; Cats* ; Edema ; Evoked Potentials, Somatosensory* ; Glutamic Acid* ; Median Nerve

The purpose of this study is to present the physiological and anatomical observations on the effect of cerebral hemispherectomy and total hemispherectomy including ipsilateral thalamus in albino rabbits. In this study, twenty healthy male albino rabbits weighing 1.8-2.0 kg were subjected to one stage removal of one cerebral hemisphere including unilateral basal ganglia and thalamus (total hemispherectomy) and unilateral cerebral hemisphere preserving basal ganglia (cerebral hemispherectomy). In 8 albino rabbits, cerebral hemispherectomy was performed and in 12, total hemispherectomy. These experimental animals were frequently observed for periods varying from a few days to three weeks. The postoperative physiological findings were as follows : All survived experimental animals demonstrated early and rapid return of consciousness, giving evidence of awareness of environment noting objects in their remaining ipsilateral homonymous visual field. After recovery form anesthesia, all experimental animals were able to move their contralateral limbs, however when they attempted to walk they staggered to the opposite side for a while. A few days later they showed almost same motor function and walked making circle to the operated side. About two weeks later, they could walk as normal rabbits. Following unilateral cerebral hemispherectomy or total hemispherectomy, all animals were able to respond to painful stimuli on the contralateral side when they awoke from aneshesia. The grade of response to painful stimuli was gradually getting better until about one week postoperatively, but there were some deficit in the contalateral side comparing to the ipsilateral side when examined on postoperative three weeks. Contralateral homonymous hemianopsia was considered to be a permanent neurologic deficit in all experimental animals. The brain stem and spinal cord, removed during two or three weeks postoperatively, were stained with Luxol fast blue staining method, however, there was no evidence of bilateral pyramidal innervation in all experimental animals.
Anesthesia ; Animals ; Basal Ganglia ; Brain Stem ; Cerebrum ; Consciousness ; Extremities ; Hemianopsia ; Hemispherectomy* ; Humans ; Male ; Neurologic Manifestations ; Rabbits ; Spinal Cord ; Thalamus ; Visual Fields

It is well known that after removal of one cerebral hemisphere all experimental animals, such as monkeys, dogs, cats and rabbits, circle in walking toward the side of the lesion with deviation of head and eyes to the same side for a while. However, the cause of circling gait following cerebral hemispherectomy is not clearly established. In this experiments physiological phenomena were observed in the dog and rabbit following unilateral or bilateral frontal or occipital lobectomies or partial ablations, parietal lobe lesions, section of unilateral optic nerve or optic tract. The results were as follows : 1) All experimental animals circled in walking toward the side of lesion with deviation of head and eyes to the same side for about one week following unilateral frontal lobectomy of partial ablation. There were transient motor weakness for a few days and pseudohemianopsia for about one week on the contralateral side. 2) Bilateral frontal lobectomies did not induce circling gait. But there was a lack of response to visual stimuli for a week. 3) Unilateral parietal lobe ablation did not induce circling gait nor pseudohemianopsia. 4) All experimental animals circled in walking toward the occipital lobectomized side for about 2 or 3 weeks, but deviation of head and eyes toward the side of lesion was not so evident as frontal lobectomized animals. The permanent neurological deficit was contralateral hemianopsia. 5) Bilateral occipital lobectomies was followed by a blindness in all experimental animals. They walked without a definite direction. 6) Section of unilateral optic nerve induced ipsilateral blindness. All experimental animals showed a tendency to walk toward the opposite side but did not circle in walking. 7) Section of unilateral optic tract induced permanent contralateral hemianopsia. All experimental animals circled in walking toward the side of the lesion of a while but deviation of the head was not evident. It is our conclusion that circling gait following cerebral hemispherectomy may be attributed by the permanent and transient hemianopsia and some neurological functional imbalance between the removed cerebral hemisphere, and the intact opposite cerebral hemisphere and brain stem.
Animals ; Blindness ; Brain Stem ; Cats ; Cerebrum ; Dogs ; Gait* ; Haplorhini ; Head ; Hemianopsia ; Hemispherectomy* ; Optic Nerve ; Parietal Lobe ; Physiological Phenomena ; Rabbits ; Visual Pathways ; Walking

No abstract available.
Free Tissue Flaps* ; Head* ; Neck*

A statistical analysis was performed with 623 intracranial tumor cases of which diagnoses were confirmed at the Department of Neurosurgery of Seoul National University Hospital from Sep. 1957 to Apr. 1981. The authors classified the intracranial tumors according to Russell and Rubinstein's classification. Epidermiological factors were analysed in general, and especially for the changes after CT introduction. The results were as follows: 1. Intracranial tumors were found most frequently in middle age group(20.9%), and the ratio of male to female was 1.8:1. 2. Among the intracranial tumors, gliomas were found most frequently(20.9%), and followed by granulomatous lesions(15.7%), pituitary adenomas(14.3%), Meningiomas(10.9%), vascular tumors(10.0%), schwannomas(5.1%). 3. The incidence of gliomas was less than that of otjer countries, especially glioblastoma multiforme. Pituitary adenomas occupied 14.3% of all intracranial tumors and as a single entity these were the highest incidence. Granulomatous lesions occupied 15.7% of all intracranial tumors. 4. Intracranial tumors occurred more frequently in supratentorial region. The most frequent location was wellar and parasellar regions(19.9%), and followed by frontal(17.2%), cerebellar(14.4%), parietal(14.0%), temporal region(9.5%). 5. Gliomas are the most frequent tumors irrespective of age group and in children then comes granulomatous lesions, medulloblastomas, vascular tumors and in adults then comes pituitary adenomas, granulomatous lesions, meningiomas in that order. 6. Since the advent of CT scan, the detection rate of intracranial tumors was increased, but there was no specific change in proportion of tumors.
Adult ; Child ; Classification ; Diagnosis ; Female ; Glioblastoma ; Glioma ; Humans ; Incidence ; Korea* ; Male ; Medulloblastoma ; Meningioma ; Middle Aged ; Neurosurgery ; Pituitary Neoplasms ; Seoul ; Tomography, X-Ray Computed

The computed tomographic scan has revolutionized the management of head trauma and has been established as an accurate diagnostic modality. The computed tomography was performed in 308 head injured patients and those findings were retrospectively analyzed. A wide spectrum of traumatic abnormalities was demonstrated by computed tomography. Seventy-six percent of patients had abnormal scans. The yield of abnormal scans varied with Glasgow coma scale at the time of scan:GCS 15-13, 66%:GCS 12-9, 91%:GCS 8-6, 94:GCS 5-3, 100%. Not significant correlation was found between the score of GCS and the extent of the midline shifting on the CT scan(P>0.05). Acute subdural hematoma and intracerebral hematoma were commonly associated with the other lesions, and over 2/3 of intraecrebral hematoma combined acute subdural hematoma.
Craniocerebral Trauma* ; Glasgow Coma Scale ; Head* ; Hematoma ; Hematoma, Subdural, Acute ; Humans ; Retrospective Studies