No abstract available.
MELAS Syndrome*

63 cases of meningitis in children were reviewed to study correlation between brain CT findings and clinical course. We divided 63 cases into 3 groups according to clinical course, that is , Group I :Healed without significant sequelae. Group II: Discharged with sequelae such as neurologic deficit or complicated clinical course. Group III : Expired or considered to be expired after hopeless discharge. The CT finding were retrospectively analyzed and compared with each clinical group. We drawed several conclusions as follows; 1. The wrost prognostic CT finding is dirty basal cisternal enhancement. (Group I only 5%, Group II 50%, Group III 45%).2. Focal brain parenchymal lesion, especially multiple, such as granuloma and infarct shows unfavorable clinical outcome, that is, high rate of Group III and evident neurologic deficit, in contrast to only 7% of Group I. 3. In 7 cases of which CT finding is only hydrocephalus, the prognosis is rather favorable, that is, 57% were Group I, 43% were improved after V-P shunt (Group II) and no Group III. But hydrocephalus with dirty disternal enhancement results in grave prognosis, that is, Group I only 8%, Grouop II 54%, Group III 38%, With regard to overall hydrocephalus, predilectron for good or bad prognosis can't be mentioned. 4. No prognostic difference were noted between presence and absence of periventricular low desnity in hydrocephalus. 5. CSF pressure of hydrocephalus ismostly high (over 20cm H20). but normal pressure hydrocephalus were noted in 24%. CSF pressure of normal ventriclesize is mostly under 18cm H2O) but high pressure were noted in 18% of the nomral sized venticle (most of them shows intracranial space occupying lesion such as granuloma, acute infarct, subdural effusion, etc). 6. Most of diffuse braine swelling, diffuse brain atrophy and subdural effusion result in Group I, that is, favorable clinical outcome. 7. Normal CT findings ar found in 29%, of which 61% belong to Group I and 31% to Group II.
Atrophy ; Brain ; Child ; Granuloma ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure ; Meningitis ; Neurologic Manifestations ; Prognosis ; Retrospective Studies ; Subdural Effusion

We report a case of central neurocytoma that was located in the frontal lobe with high proliferative index. A 49-year old man was admitted complaining of a generalized seizure. On magnetic resonance imaging, a mass was detected in the right frontal and the preoperative radiological impression was oligodendroglioma. Light and electron microscopic with immunohistochemical examination revealed features of central neurocytoma. Radiotherapy was added because of the aggressive features of this tumor(Ki-67 labeling index 10%). Although cerebral central neurocytoma with a high proliferative index is rare and the long-term results of this tumors have not been studied, our case and other cases in the literatures suggest the need for postoperative radiotherapy.
Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurocytoma* ; Oligodendroglioma ; Radiotherapy ; Seizures

Carcinomatous meningitis is a relatively common late complication of systemic cancer but there is difficulty in diagnosis when there is no clinical evidence of primary malignant lesion. We have experienced a patient who entered our hospital with complaints of headache, vomiting and deteriorated consciousness. On neurological examination, both optic fundi showed hemorrhagic papilledema and central type facial palsy was observed on the right side. All routine laboratory and radiological examination revealed no abnormality except suspiciously dilated ventricles on Conray ventriculogram. She had been treated under the impression of pseudotumor cerebri. She went downhill course and expired on the 18 th. Hospital day. Autopsy was performed. Pathological findings were limited to the central nervous system. The brain was diffusely swollen and weighed 1510 gms. The cerebral hemispheres were cloudy throughout with dusky gray appearance. Sulci were tight and gyri became flat. No evidence of herniation was present. Coronal sections disclosed two foci of yellow and granular lesions in the left parieto-occipital cortex just under the menengeal coverings. These lesions were less than 0.5 cm in maximum dimensions. Microscopically almost entire cerebral, cerebellar and spinal cord leptomeninges were infiltrated by neoplastic cells that often formed glandular structures. These tumorous growths in the meninges were continuous with the subjacent tumor masses found in the cortex. No other foci of tumor were seen in the CNS. The ventricular system was mild to moderately dilated with slightly cloudy surface. Microscopically no tumor was seen along the ependyma. Search for the primary site of meningeal carcinomatosis included multiple sections of entire visceral organs with particular emphasis on the lung. There was a focus of metastatic papillary carcinoma in one of the left hilar lymph node. Meticulous gross dissection and multiple sections of the lungs, however, failed to show any tumor.
Autopsy ; Brain ; Carcinoma, Papillary ; Central Nervous System ; Cerebrum ; Consciousness ; Diagnosis ; Ependyma ; Facial Paralysis ; Headache ; Humans ; Lung ; Lymph Nodes ; Meningeal Carcinomatosis* ; Meninges ; Neurologic Examination ; Papilledema ; Pseudotumor Cerebri ; Spinal Cord ; Vomiting

No abstract available.
Epidermolysis Bullosa Dystrophica* ; Epidermolysis Bullosa*

Primary malignant lymphoma of the central nervous system which is characterized by high radiosensitiveness is rarely reported in the literature. We have experienced a case of recurred cerebellar lymphoma whose criginal site was septal area. Though septal tumor disappeared completely after radiation, a large cerebellar tumor was found 2 years thereafter. After decompressive suboccipital craniectomy and partial tumor removal the patient's general condition improved so secondary radiation and chemotherapy were started. In the course of port-op therapy, the patient abruptly deteriorated and succumbed.
Central Nervous System ; Cerebellar Neoplasms ; Cerebellum* ; Drug Therapy ; Humans ; Lymphoma* ; Septum of Brain

152 curative gastrectomy specimens from patients with gastric carcinoma were examined in an attempt to assess the prognostic value of c-erbB-2 and mutant p53 protein expressions. The labeled streptavidin-biotin method was applied to routinely fixed and paraffin-embedded tissue sections, using the polyclonal and monoclonal antibodies against the c-erbB-2 protein and the mutant form p53 protein, respectively. In this examination, staining of c-erbB-2 protein was found in 9.2% of these carcinomas. The c-erbB-2 stained tumors were significantly associated with the tumors whose diameters were smaller than 5cm, and were more likely to be associated with serosal invasion and nodal involvement than the unstained ones. However, there was little association between staining of c-erbB-2 protein and clinicopathologic findings such as age, sex, location, histology, gross type, lymph node status, depth of invasion, and stage. The survival analysis of 104 patients with stage III gastric carcinoma revealed no significant association between c-erbB-2 staining status and survival duration. The 5-year survival rates of the c-erbB-2 positive group and its negative group were 21% and 28%, respectively. Positive p53 protein expression was observed in 46% of 152 carcinomas. There was no significant association between p53 expression and parameters such as age, sex, location, histology, gross type, and size. The p53 stained tumors were more likely to be associated with lymph node metastasis, serosal invasion than p53 unstained ones; but this did not reach significance. The 5-year survival rates of the p53 positive group and counter part group were 27% and 31%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult ; Aged ; Female ; Human ; Male ; Middle Age ; Multivariate Analysis ; Prognosis ; Protein p53/*analysis ; Receptor, erbB-2/*analysis ; Stomach Neoplasms/*chemistry/mortality ; Survival Rate

PURPOSE: To report the clinical manifestations and computed tomography (CT) findings of patients with a trapdoor type medial orbital wall blowout fracture.METHODS: From March 2009 to October 2016, the clinical records and computed tomography findings of patients who underwent surgical treatment for a trapdoor type medial orbital wall blowout fracture were retrospectively analyzed.RESULTS: A total of eight patients (six males and two females) were enrolled with a combined mean age of 14.4 years. Clinical manifestations were eyeball movement limitation (abduction and adduction) and ocular motility pain (eight patients, 100%), diplopia (seven patients, 87.5%), and nausea and vomiting (four patients, 50%). On CT, the distance from the orbital apex to the fracture site was an average of 22.0 mm and occurred in the middle position of the entire wall. Two patients had missed rectus completely dislocated into the ethmoid sinus through the fracture gap and six patients had definite involvement in the fracture gap and edema of the medial rectus muscle. The medial rectus muscle cross-sectional area was 47.7 mm² which was edematous compared to the contralateral eye (40.1 mm²). Orbital wall reconstruction was performed an average of 4.1 days after the injury. In all patients with oculocardiac reflex-like nausea and vomiting immediately improved after surgery. Six out of eight patients who had eyeball movement limitations (abduction and adduction) preoperatively showed adduction limitation after surgery. The eyeball movement limitation and diplopia disappeared 11.7 days and 46.7 days after surgery, respectively.CONCLUSIONS: Patients with trapdoor type medial wall blowout fracture showed characteristic computed tomographic findings and clinical manifestations such as eyeball movement limitation, ocular motility pain, diplopia, and oculocardiac reflex. An understanding of clinical findings and quick surgical treatment are therefore required. The type of eyeball movement limitation was abduction and adduction limitation preoperatively and adduction limitation postoperatively.
Diplopia ; Edema ; Ethmoid Sinus ; Humans ; Male ; Nausea ; Orbit ; Reflex, Oculocardiac ; Retrospective Studies ; Vomiting

No abstract available.
Humans*

PURPOSE: We used optical coherence tomography (OCT) for longitudinal evaluation of structural changes in the peripapillary retinal nerve fiber layer (RNFL), the macular ganglion cell-inner plexiform layer (GC-IPL), and the macula in patients with traumatic optic neuropathy. METHODS: From May 2012 to April 2015, the medical records of 20 patients with monocular traumatic optic neuropathy who were followed up for over 6 months were retrospectively analyzed. Best-corrected visual acuity was checked and Cirrus high-definition optical coherence tomography (HD-OCT) was used to measure the thicknesses of the peripapillary RNFL, macular GC-IPL, and macula of both eyes at the first visit (within 4 weeks after trauma), at 10 and 24 weeks after trauma, and at the final visits. The differences over time in the parameters of the traumatic and fellow eyes were analyzed. RESULTS: The final best-corrected visual acuities of the traumatic and fellow eyes differed significantly from those at the first visit (p = 0.007). The average thicknesses of the peripapillary RNFL, the macular GC-IPL, and the macula differed significantly between the traumatic and fellow eyes commencing 10 weeks after trauma (p < 0.001, p = 0.002, p = 0.003, respectively). CONCLUSIONS: Significant changes in visual acuity preceded structural changes in the retina. Objective assessment of retinal structural changes using OCT yields helpful information on the clinical course of patients with traumatic optic neuropathy.
Ganglion Cysts ; Humans ; Medical Records ; Nerve Fibers ; Optic Nerve Injuries ; Retina ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity