An 89-Year-old female patient had had a pea-sized encrusted ulcer on the vermillion border of her right upper lip for 4 years. Histopathological features of the biopsy specimen consisted of tumor islands with peripheral, palisading basaloid cells, some of which had become transformed into atypical, dyskeratotic squamous cells with ample eosinophilic cytoplasm in their centers. Total excision was advised.
Aged, 80 and over ; Biopsy ; Carcinoma, Basal Cell ; Carcinoma, Basosquamous* ; Cytoplasm ; Eosinophils ; Female ; Humans ; Islands ; Lip ; Ulcer

Epilepsy surgery in Korea began as early as in the 1940s and continued to develop through the second half of the 20th century. Introduction of neuroimaging modalities, establishment of epilepsy monitoring units and the epilepsy team approach contributed to the rapid development. �or about 300�- 400 operations carried out yearly��, t�here i��s at �prese�nt suffi���cien�t n�umb ��er of ep�ileps� y surg�ery cen�ters�� an�d q�ualifi��ed neurosurgeons in Korea. However, Korean neurosurgeons should adapt themselves to changing recent trends. Etiologies of epilepsy have dramatically changed from head trauma and infectious diseases to tumors and developmental abnormalities. Although traditional resective surgery still constitutes the main bulk of the operations, new therapeutic procedures based on neuro�modulation are emerging as alternative treatments. There should also be participation in basic science research which would leads to future innovations in treatment of epilepsy.

We describe a 23-year-old man showing typically clinical and histological features of targetoid hemosiderotic hemangioma. About 35 cases of this newly-described entity have been reported since the first description by Santa Cruz and Aronherg in 1988. It is important to distinguish these tumors from patch stage Kaposi's sarcoma, retiform hemangioendothelioma and progressive lymphangioma.
Hemangioendothelioma ; Hemangioma* ; Humans ; Lymphangioma ; Sarcoma, Kaposi ; Young Adult

Authors experienced 36 cases of middle cerebral artery aneurysms in 35 patients. Among 36 cases, M1 aneurysms were 4 cases, M1 bi-or trifurcation aneurysms 30 cases, and distal aneurysms 2 cases. The majority of M1 bi-or trifurcation aneurysms were operated upon by the superior temporal gyrus approach. Trans-sylvian approach was used only in M1 aneurysms, in cases of short M1, in associated anterior circulation aneurysms, and in second operation to the unruptured middle cerebral artery aneurysms. Our results were encouraging. Mortality was 5.6%, and morbidity was also 5.6%.
Aneurysm ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery* ; Mortality

Lichen aureus is a rare disorder classified as a pigmented purpuric dermatosis. This case report is of a 46-year-old female in whom a coin sized, gold tinted, erythematous maculopapule developed on the right lower quadrant of the abdomen l0 years ago which showed characteristic histological findings of lichen aureus consisting of lymphohistiocytic infiltration in the upper dermis and extravasation of red blood cells.
Abdomen ; Dermis ; Erythrocytes ; Female ; Humans ; Lichens* ; Middle Aged ; Numismatics ; Skin Diseases

In order to define the hospital course and the best surgical timing for the poor grade subarachnoid hemorrhage(SAH) patients, 131 patients(from 1989 to 1991) whose clinical grade on admission were Hunt and Hess grade III to V were analyzed. Their admission grades was III(90 patients), IV(30 patients), and V(11 patients). Patients were grouped into the early surgery group(within 3 days of the last hemorrhage), the intermediate group(4 to 14 days), the late surgery group(14 days after the last hemorrhage), and non-surgical group. Early surgery was performed on 17 patients, intermediate on 31 patients, and late on 54 paients. Twenty-nine patients did not undergo surgery. This non-surgical group had a high mortality rate(72.4%). During the waiting period for a delayed surgery(later than 3 days), 21% improved their clinical state, 53.5% were stationary and 25.5% became worse. Morbidity and mortality were compated among these three surgical groups and the non-surgical group, with sratistical analysis using chi square test and Fisher's exact test. No statistical differences were noted between the management groups in terms of associated disease, location of aneurysms, Fisher's grade, occurrence of hydrocephalus or symptomatic vasospasm. The mortality rate was significantly lower in the combined surgical groups than in the non-surgical group(p<0.05). Mortality was related to the timing of surgery. It was higher after early surgery than in the other two gorups, but it was not different between the intermediate and late surgery groups. Morbidity was not different among the three surgery groups. The major cause of morbidity and mortality in the early surgery group was brain swelling, while rebleeding, hydrocephalus, and vasospasm, were the main causes in the intermediate and delayed surgery groups. It is concluded that it is not recommended that early surgery must be done in all the poor grade SAH patients. However three days after the last hemorrhage, it is better to perform surgery as soon as possible, because there were no statistically significant differences between the intermediate group and the late surgery groups in the mortality and the morbidity rates.
Aneurysm ; Brain Edema ; Hemorrhage ; Humans ; Hydrocephalus ; Mortality ; Subarachnoid Hemorrhage*

Microgyria is one type of cortical dysplasia with dyslaminations and anomalous cell densities, which could be produced experimentally. In a normal rat cortical development, overproduced neuroblasts gradually die by apoptosis. Thus, the diminished apoptosis may lead to the anomalous cell densities and dyslaminations. This study examined the ontogeny of cell densities in rat microgyria, in homotopic contralateral cortex and in control cortex. Multiple applications of cold probe (-70degrees C) on the right hemisphere in postnatal day (PN) 0 rat pups produced unilateral microgyria. Cell densities had decreased from PN 1 to 2 in microgyria, in the contralateral left hemisphere, and in the control cortex. From PN3 to PN10, while the cell density of the microgyria had increased (p<0.001), cell densities of the control and homotopic area continued to decrease. Apoptosis was greater in the microgyria than in the control and left hemisphere from PN1 to 3 and then remarkably decreased (p<0.001). These results suggest that the increased cell density in microgyria is not from decreased apoptosis, but probably caused by the increased proliferation or migration.
Animals ; Apoptosis* ; Cell Count ; Cell Movement ; Malformations of Cortical Development* ; Rats*

OBJECTIVE: The incidence and prevalence of spinal metastases are increasing, and although the role of radiation therapy in the treatment of metastatic tumors of the spine has been well established, the same cannot be said about the role of stereotactic radiosurgery. Herein, the authors present a systematic review regarding the value of spinal stereotactic radiosurgery in the management of spinal metastasis. METHODS: A systematic literature search for stereotactic radiosurgery of spinal metastases was undertaken. Grades of Recommendation, Assessment, Development, and Education (GRADE) working group criteria was used to evaluate the qualities of study datasets. RESULTS: Thirty-one studies met the study inclusion criteria. Twenty-three studies were of low quality, and 8 were of very low quality according to the GRADE criteria. Stereotactic radiosurgery was reported to be highly effective in reducing pain, regardless of prior treatment. The overall local control rate was approximately 90%. Additional asymptomatic lesions may be treated by stereotactic radiosurgery to avoid further irradiation of neural elements and further bone-marrow suppression. Stereotactic radiosurgery may be preferred in previously irradiated patients when considering the radiation tolerance of the spinal cord. Furthermore, residual tumors after surgery can be safely treated by stereotactic radiosurgery, which decreases the likelihood of repeat surgery and accompanying surgical morbidities. Encompassing one vertebral body above and below the involved vertebrae is unnecessary. Complications associated with stereotactic radiosurgery are generally self-limited and mild. CONCLUSION: In the management of spinal metastasis, stereotactic radiosurgery appears to provide high rates of tumor control, regardless of histologic diagnosis, and can be used in previously irradiated patients. However, the quality of literature available on the subject is not sufficient.
Humans ; Incidence ; Neoplasm Metastasis ; Neoplasm, Residual ; Prevalence ; Radiation Tolerance ; Radiosurgery ; Reoperation ; Spinal Cord ; Spine

There are many factors affecting surgical results of cervical spondylotic myelopathy. Age, duration of symptom, neurologic status, and direction of surgical approach are side to have prognostic implications. Also a high signal intensity on T2 weighted magnetic resonance imaging(HSI on T2WI) is insisted as a poor prognostic factor. We analyzed these factors in 56 patients treated over a 10-year period retrospectively. Statistical analysis was done using chi square, Mantel-Haenszel. Cochran-Mantel-Haenszel, Wilcoxon, and logistic procedure. We preferred anterior decompression when compressive lesions existed ventrally. However posterior decompression was performed in a 4 or more level stenosis. Age ranged from 22 to 74 year(mean : 50.8). 25 patients underwent the anterior procedure, 33 patients the posterior procedure, and 2 both procedures. Neurologic status was graded both preoperatively and at follow-up using the Nurick grading system from 1 to 5. The preoperative Nurick grade was 2.75+/-0.16(mean+/-SE). Mean follow-up period was 13.8 months(SE 0.14). The follow-up Nurick grade was 2.125+/-0.14, and these was noted an improvement of 0.63+/-0.12. The amount of improvement was equivalent between the anterior and the posterior approaches(0.52 vs. 0.73 respectively, p=0.67). There was no mortality. Uni- and multivariant analysis demonstrated that age, duration of symtom and HSI on T2WI had no significant effect on either follow-up Nurick grade or amount of improvement, but the preoperative Nurick grade had a significant effect(p<0.000). Comparable results can be obtained with either approaches if chosen properly. Only the preoperative Nurick grade has the prognostic value.
Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Humans ; Mortality ; Neurologic Manifestations ; Prognosis ; Retrospective Studies ; Spinal Cord Diseases ; Spondylosis

No abstract available.
Spinal Cord Diseases* ; Spinal Cord*