OBJECTIVE: The factors that influence the prognosis of patients with hemifacial spasm (HFS) treated by microvascular decompression (MVD) have not been definitely established. We report a prospective study evaluating the prognostic factors in patients undergoing MVD for HFS. METHODS: From January 2004 to September 2006, the authors prospectively studied a series of 293 patients who underwent MVD for HFS. We prospectively analyzed a number of variables in order to evaluate the predictive value of independent variables for the prognosis of patients undergoing MVD. The patients were followed-up at regular intervals and divided into as cured and unsatisfactory groups based on symptom relief. Uni- and multivariate analyses were performed using logistic regression models. RESULTS: A total 273 of 293 (94.2%) patients achieved symptom relief within one year after the operation. Intraoperatively, the indentation of the root exit zone was observed in 259 (88.5%) patients. Uni- and multivariate analyses revealed that the symptoms at postoperative 3 months (p<0.001) and indentation of the root exit zone (p=0.036) were associated with good outcomes. CONCLUSION: The intraoperative finding of root exit zone indentation will help physicians determine the prognosis in patients with HFS. To predict the prognosis of HFS, a regular follow-up period of at least 3 months following MVD should be required.
Follow-Up Studies ; Hemifacial Spasm ; Humans ; Logistic Models ; Microvascular Decompression Surgery ; Multivariate Analysis ; Prognosis ; Prospective Studies

OBJECTIVE: To determine the rationale for treating pure unruptured intracranial aneurysms(UIAs), it is mandatory to know the risk of each treatment modality. The purpose of this study is to evaluate the surgical risk for treating UIAs. METHODS: Between December 1994 and May 2005, 147 unruptured aneurysms in 135 patients were treated. The majority of these cases (94.6%) were treated with aneurysmal neck clipping. The remainder received aneurysmal wrapping (2.7%), trapping with bypass (2.0%), or proximal occlusion (0.7%). The clinical outcomes were evaluated in each patient by the Glasgow Outcome Scale at one month post-surgery. RESULTS: The patient pool consisted of 41 males and 94 females. The mean age was 55.9 years (range: 16~82). The aneurysms were located at middle cerebral artery in 63 (42.9%), anterior communicating artery 30 (20.4%), posterior communicating artery in 26 (17.7%), internal carotid artery(ICA) in 14 (9.5%), anterior choroidal artery in 4 (2.7%) and others in 10 (6.9%). One hundred fifteen (78.2%) of aneurysms were small (<10mm). Others were large (10 to 25mm) and giant (>25mm); 29 (19.7%) and 3 (2.1%) respectively. More than ninety percent (91.1%) of all patients recovered well. Mild to severe disability was seen in 8.7% of the patients. One patient succumbed to complications following injury to the ICA. CONCLUSION: The mortality and morbidity associated with UIA surgery at our hospital compared very favorably to the previous reported literature and with the previously established natural history of this disease.
Aneurysm ; Arteries ; Choroid ; Female ; Glasgow Outcome Scale ; Humans ; Intracranial Aneurysm* ; Male ; Middle Cerebral Artery ; Mortality ; Natural History ; Neck

We report a very rare case of atypical granular cell tumor arising in the neurohypophysis of a 56-year-old woman. The tumor was seen on radiology to be lobulated, soft and diffusely enhanced, the same as pituitary macroadenoma, but it was anatomically localized within the posterior part of the hypophysis. We partially removed the tumor via the transsphenoidal approach. The pathology showed nuclear pleomorphism, spindling features, and lymphoplasmacytic infiltration. Ki-67 and S-100 protein were focally positive in tumor cells. Histological diagnosis confirmed an atypical granular cell tumor in the sellar region, which is a rare tumor that often has the clinical appearance of a pituitary adenoma. Ophthalmologic symptoms are the most common, followed by endocrinologic manifestations. Here we describe its symptoms and radiological and pathological features.
Central Nervous System ; Diagnosis ; Female ; Granular Cell Tumor* ; Humans ; Middle Aged ; Pathology ; Pituitary Gland ; Pituitary Gland, Posterior ; Pituitary Neoplasms ; S100 Proteins

No abstract available.
Bicuspid* ; Echocardiography*

Dendritic cells (DCs) play a role in natural killer (NK) cell activation, while NK cells are also able to activate and mature DCs. Toll-like receptors (TLRs) on the surface of DCs and NK cells induce the maturation and activation of these cells when engaged with their cognate ligand. We investigated to generate potent DCs by maturation with NK cells in the presence of TLR agonist in vitro and tested the efficacy of these DC vaccinations in mouse colon cancer model. The optimal ratios of DCs versus NK cells were 1:1 to 1:2. Immature DCs were mature with NK cells in the presence of lipopolysaccharide, which is TLR4 agonist, and further addition of IL-2 induced phenotypically and functionally mature bone marrow-derived DCs. These potent DCs exhibited not only high expression of several costimulatory molecules and high production of IL-12p40 and IL-12p70, but also high allogeneic T cells stimulatory capacity, and the induction of the high activities to generate tumor-specific CTLs. Consistently, vaccination with these DCs efficiently inhibited CT-26 tumor growth in mouse colon cancer model when compared to other vaccination strategies. Interestingly, combination therapy of these DC-based vaccines and with low-dose cyclophosphamide showed dramatic inhibition effects of tumor growth. These results suggest that the DCs maturated with NK cells in the presence of TLR agonist are potent inducer of antitumor immune responses in mouse model and may provide a new source of DC-based vaccines for the development of immunotherapy against colon cancer.
Animals ; Cancer Vaccines/immunology/metabolism ; Carcinoma/immunology/pathology/*therapy ; Cell Line, Tumor ; Cells, Cultured ; Colonic Neoplasms/immunology/pathology/*therapy ; Dendritic Cells/*drug effects/*immunology/transplantation ; Female ; Immunotherapy, Adoptive/*methods ; Killer Cells, Natural/*immunology/physiology ; Lipopolysaccharides/pharmacology ; Mice ; Mice, Inbred BALB C ; Toll-Like Receptor 4/agonists ; Toll-Like Receptors/*agonists