Massive hemorrhage into an intracranial neurinoma is a rare event. A 42-year old man noticed hearing loss, nystagmus, diplopia and paresthesia on the left side of the face. A computerized tomography scan demonstrated a large high density mass in the left cerebellopontine angle. The tumor was successfully removed and postoperative course was favorable. Such a case of acoustic neurinoma which revealed itself through intratumoral hemorrhage has not been previously reported in Korea.
Adult ; Cerebellopontine Angle ; Diplopia ; Hearing Loss ; Hemorrhage* ; Humans ; Korea ; Neurilemmoma* ; Neuroma, Acoustic ; Paresthesia

No abstract available.
Agaricales* ; Morus*

PURPOSE: Angiogenesis is an integral part of wound healing, which is an unwanted process in the postoperative period after trabeculectomy. It was the aim of this study to report on the subconjunctival use of bevacizumab (Avastin(R)) as an antiproliferative agent to augment trabeculectomy. CASE SUMMARY: This clinical interventional case study included 2 patients with secondary glaucoma associated with uveitis who underwent antiglaucomatous filtering surgery combined with a subconjunctival injection of bevacizumab. Limbal-based trabeculectomy was performed, and subconjunctival injections (1.25 mg/0.05 ml) were given at the end of the surgery adjacent to the bleb, which was raised using a single-use 26 gauge needle. At 1 and 2 weeks and 1, 3, and 6 months after surgery, intraocular pressure was reduced in both patients to 11 mmHg with functioning filtering blebs. No complications were observed. CONCLUSIONS: The results suggest that subconjunctival bevacizumab injection may be helpful in reducing the risk of postoperative scarring of the filtering bleb.
Antibodies, Monoclonal, Humanized ; Blister ; Cicatrix ; Filtering Surgery ; Glaucoma ; Humans ; Intraocular Pressure ; Needles ; Postoperative Period ; Trabeculectomy ; Uveitis ; Wound Healing ; Bevacizumab

6 patients underwnet CT-guided stereotactic biopsy or hematoma aspiration procedure for posterior fossa lesions. Trajectory for biopsy or aspiration was transcerebellar approach. The patients were placed under general endotracheal anesthesia and positioned prone or sitting. No complications were encountered in the postoperative period when this technique was used. Stereotaxic transcerebellar multiple biopsy can safely provide tissue conformation of the neoplastic nature of a posterior fossa lesion thought to be a tumor. In addition, hematoma aspiration has been demonstrated to be safe, reliable, and efficient.
Anesthesia ; Biopsy ; Hematoma ; Humans ; Postoperative Period

Chondrosarocoma is a malignant, relatively slow-growing cartilaginous tumor that generally has a long natural history. From Feb. 1986 to Jan. 1993, 29 cases of chondrosarcoma were registered in the Department of Orthopedic Suergery of Korea Cancer Center Hospital. We reviewed 23 cases of chondrosarcoma which were treated surgically, aimed at curative procedure. Fourteen patients were male and 9 female. The average age at the time of diagnosis was 31.9(17-59) years. The pelvis was the most frequent site(7 patients) followed by femur(6), scapula(4), tibia(2), and each one case of spine, rib, humerus, and finger. The Enneking s surgical stage was II B (18 cases), II A (1), I B (3) or I A (1). The histological grades were as follows : 4 cases of grade 1; 3 grade 2 and 16 grade 3. Local resection with or without reconstruction were done for 20 cases and amputation or disarticulation 3. Chemotherapy was done in four cases and was not effective. The average follow-up period was 34.2(9-81) months. As complications, local recurrence occurred in 4(17.3%) cases, infection 2(8.7%), fracture 1(4.3%), lymphedema 1 and rediation necrosis of soft tissue 1, Distant metastasis occurred in 7(30.0%) cases: 6 cases to lung and 1 to brain. At final follow up 15 cases were continuous disease free, 3 alive with disease, 4 died of disease and 1 no evidence of disease. The Kaplan-Meier's estimated 5-year actuarial survival rate of total 23 cases was 66. 9%. Seven cases with histopathologic grade less than 2 showed 100% of 5 year actuarial survival rate, even one case is alive with disease at final follow up of 62 months. Fifteen cases of surgical stage II B with histopathologic grade 3 had 55.4% of 5 year actuarial survival rate: ten cases with wide surgical margin 87.5%o five cases with intralesional or marginal surgical margin 25%. Early surgical excision of chondrosarcoma with enough wide surgical margin can prevent local recurrence and metastasis.
Amputation ; Brain ; Chondrosarcoma ; Diagnosis ; Disarticulation ; Drug Therapy ; Female ; Fingers ; Follow-Up Studies ; Humans ; Humerus ; Korea ; Lung ; Lymphedema ; Male ; Natural History ; Necrosis ; Neoplasm Metastasis ; Orthopedics ; Pelvis ; Recurrence ; Ribs ; Spine ; Survival Rate

No abstract available.
Head* ; Hypopharynx* ; Mouth* ; Neck* ; Oropharynx*

There are 3 basic methods for surgical treatment of axillary osmidrosis; 1) method that removes only subcutaneous cellular tissue without removing skin 2) method that removes skin and subcutaneous cellular tissue en bloc, and 3) method that partially removes skin and subcutaneous cellular en bloc as well as removing the subcutaneous cellular tissue of the adjacent region. We studied the results of partial removal of the skin and subcutaneous cellular tissue en bloc, as well as the removal of subcutaneous cellular tissue of the adjacent region to compare the results of the bipedicled flap with the graft conversion method. There was no difference between two methods in results and complication rates. There are 3 advantage to this procedure. First, about 70-80% of apocrine glands were centrally distributed among the axillary hairbearing region therefore, resection of the central portion of axillary hair distribution area is important for good result. Second, the preservation of the subdermal plexus with careful excision of adjacent underlying subcutaneous tissue under the aid of the magnifying surgical loupe, is important for good wound healing. Third, the central excision of the axillary hair distribution area provides good exploration for undermining and defatting of the undersurface of the adjacent area, therefore it tooks a shorter operation time.
Apocrine Glands ; Hair ; Skin ; Subcutaneous Tissue ; Transplants ; Wound Healing

PURPOSE: We report a patient with intraocular silicone oil leakage into the subconjunctival space and orbit through an Ahmed glaucoma valve implant. METHODS: A 47-year-old male with high myopia and traumatic retinal detachment underwent in the left eye, pars plana vitrectomy, lensectomy and ultimately intraocular silicone oil placement for traumatic retinal detachment. Subsequently, he developed intractable glaucoma and underwent a superotemporal Ahmed glaucoma tube implant, left eye. RESULTS: Intraocular silicone oil migrated through the Ahmed valve into the subconjunctivalspace and orbit. The Ahmed glaucoma valve was removed with excisional biopsy. CONCLUSIONS: Silicone oil migration through an Ahmed valve may be observed after retinal detachment repair with intraocular silicone oil. An Ahmed valve implantation should be done with great care.
Biopsy ; Glaucoma* ; Humans ; Male ; Middle Aged ; Myopia ; Orbit* ; Retinal Detachment ; Silicone Oils* ; Vitrectomy

PURPOSE: We report the results of embolization in 42 cases of brain arteriovenous malformation and discuss the technical problems. MATERIALS AND METHODS: Flow-guided microcatheter for the superselection of the feeding arteries and nbutyl cyanoacrylate as an embolic agent were used. Wire guided microcatheter and microparticle were used in two exceptional cases. As preembolization functional evaluation, 30--50mg of thiopental sodium solution was injected into the feeding arteries through superselected microcatheters in 40 cases with supratentorial lesions. RESULTS: There was no local arterial complication by injection of thiopental solution. Embolization caused a permanent neurologic deficit(mild to moderated hemiparesis) in 2 patients (4.8%) by a reflux of embolic agent or probable spasm of main arterial trunk. In 8 patients(19%), the AVMs were completely obliterated and 25 patients(60%) showed anglographic obliterations of 50--90% of the lesions. Embolization induced venous occlusion was demonstrated at post-embolization angiography in 6 patients, and 3 patients of them showed delayed and transient neurologic deficits. CONCLUSION: Embolization of cerebral AVM can be performed effectively and safely by a superselective method and appropriate functional evaluation. Superselective thiopental sodium injection is a safe and reliable test for the evaluation of local brain function before embolization.
Angiography ; Arteries ; Arteriovenous Malformations ; Brain* ; Cyanoacrylates ; Humans ; Neurologic Manifestations ; Spasm ; Thiopental

Recent advent of 64-multidetctor (MD) CT enables more coverage of Z-axis in the perfusion imaging. The purpose of this study was to evaluate the clinical usefulness of perfusion CT by using 64-MD CT in detecting the lesion in patients with acute stroke. The perfusion CT was performed by using 64-MD CT in 62 consecutive patients who were initially suspected to have subacute ischemic stroke symptoms during the period of recent 9 months. These patients had subacute stroke (n=62). CT scanning was conducted with Jog Mode which provided 16 imaging slices with 5 mm of slice thickness, and 8 cm of coverage in Z-axis. Scan interval was 1 seconds for each imaging slice and total 15 scans were repeated. After CT scanning, perfusion maps (CBV, CBF, MTT and TTP) were created at Extended Brilliance Workstation. The CBV and CBF maps showed that lesions were smaller images. While on the MTT and TTP map lesions were seen to be larger fifty-one were large than they appeared on these images. Two slices of perfusion maps obtained at the level of the basal ganglia were chosen to simulate conventional older perfusion CT with 8 cm of coverage in Z-axis. TTP and MTT maps may be clinically useful for evaluation of the penumbral zone in cases of aubacute cerebral ischemic stroke. The perfusion CT is useful in the assessment of acute stroke as an initial imaging modality.
Basal Ganglia ; Humans ; Perfusion Imaging ; Perfusion* ; Stroke* ; Tomography, X-Ray Computed