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

We report a case of fatal duret hemorrhage (DH) in a patient with acute tentorial subdural hematoma and bilateral chronic subdural hematoma along the cerebral hemispheres. Preoperative CT angiography (CTA) revealed prominent parenchymal enhancement in the ventral pontomesencephalic area. After burr-hole drainage, a large hemorrhage developed in this area. The parenchymal enhancement in the CTA may reflect the pontomensencephalic perforating vessel injury, and may be a sign of impending DH of acute transtentorial downward herniation. Previous use of aspirin and warfarin might have potentiated the process of DH and increase the extent of the bleed.
Angiography ; Aspirin ; Cerebrum ; Drainage ; Glycosaminoglycans ; Hematoma, Subdural ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Warfarin

PURPOSE: Motion effects in parallel magnetic resonance imaging (MRI) are investigated. Parallel MRI is known to be robust to motion due to its reduced acquisition time. However, if there are some involuntary motions such as heart or respiratory motions involved during the acquisition of the parallel MRI, motion artifacts would be even worse than those in conventional (non-parallel) MRI. In this paper, we defined several types of motions, and their effects in parallel MRI are investigated in comparisons with conventional MRI. MATERIALS AND METHODS: In order to investigate motion effects in parallel MRI, 5 types of motions are considered. Type-1 and 2 are periodic motions with different amplitudes and periods. Type-3 and 4 are segment-based linear motions, where they are stationary during the segment. Type-5 is a uniform random motion. For the simulation, Cartesian and spiral grid based parallel and non-parallel (conventional) MRI are used. RESULTS: Based on the motions defined, moving artifacts in the parallel and non-parallel MRI are investigated. From the simulation, non-parallel MRI shows smaller root mean square error (RMSE) values than the parallel MRI for the periodic (type-1 and 2) motions. Parallel MRI shows less motion artifacts for linear (type-3 and 4) motions where motions are reduced with shorter acquisition time. Similar motion artifacts are observed for the random motion (type-5). CONCLUSION: In this paper, we simulate the motion effects in parallel MRI. Parallel MRI is effective in the reduction of motion artifacts when motion is reduced by the shorter acquisition time. However, conventional MRI shows better image quality than the parallel MRI when fast periodic motions are involved.
Artifacts ; Computer Simulation ; Heart ; Magnetic Resonance Imaging

Klinefelter' syndrome is a disorder of sexual differentiation in males, characterized by the presence of two or more X-chromosomes, hypogonadism, and lack of secondary sexual characteristics. The association between Klinefelter' syndrome and glomerulonephritis has been reported, while cases of glomerulonephritis associated with Klinefelter' syndrome are rare. We report the Korean case: a 31-year-old man with Klinefelter' syndrome who developed glomerulonephritis. The patient's urine analysis shows microscopic hematuria and the result of kidney biopsy was minimal change disease. The onset and course of his disease might have been influenced by the sex hormone imbalance.
Biopsy ; Glomerulonephritis ; Hematuria ; Humans ; Hypogonadism ; Kidney ; Male ; Nephrosis, Lipoid ; Sex Differentiation

For the experimental study of neural tube defect (NTD), a surgical model has advantages over other models in a few aspects. It causes less functional derangement of cells and the NTDs can be made selectively by surgery. The authors planned to use the surgical model for the experimental study of NTD. As the first step for the studies, the chronological changes of morphology during the early postoperative period were investigated using postincubation 3-day chick embryos. The objectives of this study are (1) the morphological evaluation of the surgical model as a method for studies of open NTD, and (2) the observation of morphological changes for the first 24 hours after surgery which include 'overgrowth' appearance and the continuity between the surface ectoderm and the neuroectoderm. The morphological changes were observed by light microscope and scanning electron microscope. Immediately after surgery, typical open NTDs were observed. Morphologically they were very similar to the appearance of spontaneous (non-surgical) open NTDs. The opened neural tubes were everted progressively and they looked rather flat at 24 hours after surgery. Cellular hyperplasia ('overgrowth' appearance) was noted within 24 hours after surgery and became more prominent during the 24 hours. There was increasing continuity between the surface ectoderm and the neural tissue until 24 hours after surgery when the continuity looked almost complete. In conclusion, surgically induced NTDs are morphologically very similar to spontaneous NTDs.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals ; Chick Embryo ; *Disease Models, Animal ; Evaluation Studies as Topic ; Neural Tube Defects/etiology/*pathology ; Postoperative Period

Juvenile nasopharyngeal angiofibroma is a histologically benign, but clinically troublesome neoplasm occurring in adolescent males. This neoplasm is a basically otolaryngeal disease, but at times makes problem in neurosurgical department because of intracranial extension. This neoplasm is diagnosed by history, clinical feature, cerebral angiography, and C.T. scan. But at present time there remains controversy in adjunctive surgical therapy and the role of radiotherapy in the treatment of this tumor. In spite of controversy in treatment, in the case of intracranial extension, many authors agree that the treatment of choice is radiation therapy. We experienced a case of nasopharyngeal angiofiboma with intracranial extension which occurred in female patient treated with radiation therapy.
Adolescent ; Angiofibroma* ; Cerebral Angiography ; Female* ; Humans ; Male ; Radiotherapy

PURPOSE: The IL-4 and IL-4 receptor alpha (IL-4Ralpha) genes are the key candidate genes for atopy and asthma susceptibility. Exposure to wheat flour can cause IgE sensitization and respiratory symptoms in bakery workers. Therefore, we hypothesized that IL-4 and IL-4Ralpha single nucleotide polymorphisms (SNPs) may be involved in the pathogenic mechanism of baker's asthma. METHODS: Clinical and genetic data from 373 bakery workers were analyzed. A survey questionnaire, spirometry, and skin prick tests with wheat flour were performed. Serum-specific IgE, IgG1, and IgG4 to wheat flour were determined using ELISA. Five candidate IL-4 (-729 T>G, 589 T>C, and 33 T>C) and IL-4Ralpha (Ile75Val A>G and Gln576Arg A>G) SNPs were genotyped and analyzed. RESULTS: Workers with the G allele of IL-4Ralpha Ile75Val A>G had a significantly higher prevalence of work-related lower respiratory symptoms than those with the AA genotype (P=0.004, 16.0% vs. 2.9%). In the skin prick test, workers with the AA genotype of IL-4Ralpha Gln576Arg A>G had a significantly higher positive rate to wheat flour (P=0.015, 8.2% vs. 1.1%) than those with AG/GG genotype. No significant associations were found in the three genetic polymorphisms of IL-4. For the predicted probabilities, workers with the AA genotype of Gln576Arg A>G had a higher prevalence of IgG1 and IgG4 in response to wheat flour, according to increased exposure intensity (P=0.001 for IgG1 and P=0.003 for IgG4). CONCLUSIONS: These findings suggest that the IL-4Ralpha Ile75Val and Gln576Arg polymorphisms may be associated with work-related respiratory symptom development.
Alleles ; Asthma ; Enzyme-Linked Immunosorbent Assay ; Flour ; Genotype ; Immunoglobulin E ; Immunoglobulin G ; Interleukin-4 ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Prevalence ; Receptors, Interleukin-4 ; Skin ; Spirometry ; Triticum ; Surveys and Questionnaires

PURPOSE: The IL-4 and IL-4 receptor alpha (IL-4Ralpha) genes are the key candidate genes for atopy and asthma susceptibility. Exposure to wheat flour can cause IgE sensitization and respiratory symptoms in bakery workers. Therefore, we hypothesized that IL-4 and IL-4Ralpha single nucleotide polymorphisms (SNPs) may be involved in the pathogenic mechanism of baker's asthma. METHODS: Clinical and genetic data from 373 bakery workers were analyzed. A survey questionnaire, spirometry, and skin prick tests with wheat flour were performed. Serum-specific IgE, IgG1, and IgG4 to wheat flour were determined using ELISA. Five candidate IL-4 (-729 T>G, 589 T>C, and 33 T>C) and IL-4Ralpha (Ile75Val A>G and Gln576Arg A>G) SNPs were genotyped and analyzed. RESULTS: Workers with the G allele of IL-4Ralpha Ile75Val A>G had a significantly higher prevalence of work-related lower respiratory symptoms than those with the AA genotype (P=0.004, 16.0% vs. 2.9%). In the skin prick test, workers with the AA genotype of IL-4Ralpha Gln576Arg A>G had a significantly higher positive rate to wheat flour (P=0.015, 8.2% vs. 1.1%) than those with AG/GG genotype. No significant associations were found in the three genetic polymorphisms of IL-4. For the predicted probabilities, workers with the AA genotype of Gln576Arg A>G had a higher prevalence of IgG1 and IgG4 in response to wheat flour, according to increased exposure intensity (P=0.001 for IgG1 and P=0.003 for IgG4). CONCLUSIONS: These findings suggest that the IL-4Ralpha Ile75Val and Gln576Arg polymorphisms may be associated with work-related respiratory symptom development.
Alleles ; Asthma ; Enzyme-Linked Immunosorbent Assay ; Flour ; Genotype ; Immunoglobulin E ; Immunoglobulin G ; Interleukin-4 ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Prevalence ; Receptors, Interleukin-4 ; Skin ; Spirometry ; Triticum ; Surveys and Questionnaires

We report a rare case of Williams syndrome accompanying moyamoya disease in whom postoperative global cerebral infarction occurred unpredictably. Williams syndrome is an uncommon hereditary disorder associated with the connective tissue abnormalities and cardiovascular disease. To our knowledge, our case report is the second case of Williams syndrome accompanying moyamoya disease. A 9-year-old boy was presented with right hemiparesis after second operation for coarctation of aorta. He was diagnosed as having Williams syndrome at the age of 1 year. Brain MRI showed left cerebral cortical infarction, and angiography showed severe stenosis of bilateral internal carotid arteries and moyamoya vessels. To reduce the risk of furthermore cerebral infarction, we performed indirect anastomosis successfully. Postoperatively, the patient recovered well, but at postoperative third day, without any unusual predictive abnormal findings the patient's pupils were suddenly dilated. Brain CT showed the global cerebral infarction. Despite of vigorous treatment, the patient was not recovered and fell in brain death one week later. We suggest that in this kind of labile patient with Williams syndrome accompanying moyamoya disease, postoperative sedation should be done with more thorough strict patient monitoring than usual moyamoya patients. Also, we should decide the revascularization surgery more cautiously than usual moyamoya disease. The possibility of unpredictable postoperative ischemic complication should be kept in mind.
Angiography ; Aortic Coarctation ; Brain ; Brain Death ; Cardiovascular Diseases ; Carotid Artery, Internal ; Cerebral Infarction* ; Child ; Connective Tissue ; Constriction, Pathologic ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Monitoring, Physiologic ; Moyamoya Disease* ; Paresis ; Pupil ; Williams Syndrome*

OBJECTIVE: Chronic subdural hematoma (CSDH) is a typical disease that is encountered frequently in neurosurgical practice. The medications which could cause coagulopathies were known as one of the risk factors of CSDH, such as anticoagulants (ACs) and antiplatelet agents (APs). Recently, the number of patients who are treated with ACs/APs is increasing, especially in the elderly population. With widespread use of these drugs, there is a need to study the changes in risk factors of CSDH patients. METHODS: We retrospectively reviewed 290 CSDH patients who underwent surgery at our institute between 1996 and 2010. We classified them into three groups according to the time of presentation (Group A : the remote period group, 1996-2000, Group B : the past period group, 2001-2005, and Group C : the recent period group, 2006-2010). Also, we performed the comparative analysis of independent risk factors between three groups. RESULTS: Among the 290 patients, Group A included 71 patients (24.5%), Group B included 98 patients (33.8%) and Group C included 121 patients (41.7%). Three patients (4.2%) in Group A had a history of receiving ACs/APs, 8 patients (8.2%) in Group B, and 19 patients (15.7%) in Group C. Other factors such as head trauma, alcoholism, epilepsy, previous neurosurgery and underlying disease having bleeding tendency were also evaluated. In ACs/APs related cause of CSDH in Group C, significantly less proportion of the patients are associated with trauma or alcohol compared to the non-medication group. CONCLUSION: In this study, the authors concluded that ACs/APs have more importance as a risk factor of CSDH in the recent period compared to the past. Therefore, doctors should prescribe these medications carefully balancing the potential risk and benefit.
Aged ; Alcoholism ; Anticoagulants ; Craniocerebral Trauma ; Epilepsy ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Neurosurgery ; Platelet Aggregation Inhibitors ; Retrospective Studies ; Risk Factors