Cysticercosis is the most frequent parasitosis of the central nervous system. A considerable group of patients require surgical procedures, especially in cases of neural compression, intracranial hypertension, or epilepsy. Recently stereotactic endoscopic removal of small intraaxial lesions using a stereotactic guiding tube and a fine endoscope was reported. We tried to control the symptomatic neurocysticercosis using the stereotactic endoscopic system. Since the introduction of this styem, we had operated on 4 cases of neurocysticercosis. Enzyme linked immunoserological assay of cerebrospinal fluid(CSF ELISA), electroencephalogram(EEG), enhanced computerized tomogram(CT) and magnetic resonance image(MRI) were done. The result of CSF ELISA were positive in 3 patients, negative in 1 patients. All patients showed abnormal patterns of preoperative EEG. CT and MRI scans showed single intraparenchymal lesion in 2 cases, multiple intraventricular cysts with obstructive hydrocephalus in 1 case and mixed in 1 case. A ll patients showed seizures;partial sensory type in 3 cases who had reciprocal intraparenchymal lesions, generalized type in 1 case who had dobstructive hydrocephalus by multiple ventricular cysts. For parenchymal lesions, we planned stereotactic open system endoscopic surgery with variable forceps, laser, and suction. Cystic forms were removed successfully but solid forms needed additional transgyral microscopic removal. In intraventricular lesions, we first placed a stereotactic guiding tube via the frontal burr hole, then replaced this with a 14 Fr peel-away catheter. Through the peel-away catheter we inserted closed system endoscopy and removed the cysts with variable forceps and suction. All intraparenchymal and intraventricular lesions were removed without specific complications except one who showed transient chemical meningitis. After 6 months, seizure was improved in all patients:3 patients can stop their medication;1 patient can reduce the dosage of his medication. Stereotactic endoscopic surgery ma kes it possible to operate cystic lesions without degeneration(vesicular stage) wherever they ware located. We believe that it may be the first option for the treatment of intraventricular and intraparenchymal cerebral neurocysticercosis especially in the early stages of degeneration.
Catheters ; Central Nervous System ; Cysticercosis* ; Electroencephalography ; Endoscopes ; Endoscopy ; Enzyme-Linked Immunosorbent Assay ; Epilepsy ; Humans ; Hydrocephalus ; Intracranial Hypertension ; Magnetic Resonance Imaging ; Meningitis ; Methods ; Neurocysticercosis ; Seizures ; Suction ; Surgical Instruments

Pyelocaliceal diverticula are eventuations of the upper collecting system, lying within the renal parenchyma and communicating with the main collecting system via a narrow channel. They are smooth-walled and are lined by transitional cell epithelium. Their lining is nonsecretory but they contain urine derived by passive filling from the adjacent collecting system. The vast majority of these lesions are small, measuring below 1cm in diameter. A pyelocaliceal diverticulum containing multiple sandy stones is presented with review of literature.
Deception ; Diverticulum* ; Epithelium

OBJECTIVE: To observe the prognostic value of brainstem auditory evoked potentials (BAEP) for prediction of cerebral palsy (CP) in the high-risk neonates. METHOD: Eighty-one high-risk neonates were subjected to take the history of illness, neurological examination, developmental assessment, BAEP study within one month after birth. They had been checked for detection and management of the CP in period of 12 to 56 months after birth. Associating factors were observed about their gestational age at birth, 1-minute Apgar score, history of asphyxia and/or intubation, and hyperbilirubinemia and/or exchange transfusion. RESULTS: Abnormal BAEP findings were seen in 38 of 81 (46.9%) high-risk neonates and 6 of 81 (7.4%) were diagnosed as a CP. Five of 6 CPs and 42 of 75 non-CPs had been abnormal in BAEP study. Neonatal BAEP study showed 83.3% sensitivity, 44% specificity, 98.4% false positive and 2.9% false negative in predicting CP. Asphyxia showed high correlation with abnormality of BAEP and CP (p<0.01). Gestational age, low birth weight, toxemia, germinal matrix hemorrhage (GMH) grade II and intubation were correlated with CP (p<0.05) but not with the abnormality of BAEP. CONCLUSION: It is suggested that BAEP study of high-risk neonate is useful in prediction of CP because of low false negative and high sensitivity.
Apgar Score ; Asphyxia ; Brain Stem* ; Cerebral Palsy ; Evoked Potentials, Auditory, Brain Stem* ; Gestational Age ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Infant, Low Birth Weight ; Infant, Newborn* ; Intubation ; Neurologic Examination ; Parturition ; Sensitivity and Specificity ; Toxemia

STUDY DESIGN: A new classification system for throacolumbar spine injury, Thoracolumbar Injury Classification and Severity Score (TLICS) was evaluated retrospectively. PURPOSE: To evaluate intrarater and interrater reliability of newly proposed TLICS schemes and to estimate validity of TLICS's final treatment recommendation. OVERVIEW OF LITERATURE: Despite numerous literature about thoracolumbar spine injury classifications, there is no consensus regarding the optimal system. METHODS: Using plain radiographs, computed tomography scanning, magnetic resonance imaging, and medical records, 3 clssifiers, consisting of 2 spine surgeons and 1 senior orthopaedic surgery resident, reviewed 114 clinical thoracolumbar spine injury cases retrospectively to classify and calculate injury severity score according to TLICS. This process were repeated on 4 weeks intervals and the scores were then compared with type of treatment that patient ultimately received. RESULTS: The intrarater reliability of TLICS was substantial agreement on total score and injury morphology, almost perfect agreement on integrity of the posterior ligament complex (PLC) and neurologic status. The interrater reliability was substantial agreement on injury morphology and integrity of the PLC, moderate agreement on total score, almost perfect agreement on neurologic status. The TLICS schems exhibited satisfactory overall validity in terms of clinical decision making. CONCLUSIONS: The TLICS was demonstrated acceptable intrarater and interrater reliability and satisfactory validity in terms of treatment recommendation.
Consensus ; Decision Making ; Humans ; Injury Severity Score ; Ligaments ; Magnetic Resonance Imaging ; Medical Records ; Reproducibility of Results ; Retrospective Studies ; Spine

BACKGROUND: Polymerase chain reaction (PCR) methods from direct specimen are widely used for the rapid and accurate detection of mycobacteria infection. In this study, we evaluated two domestically developed detection kits for Mycobacterium tuberculosis (MTB) and nontuberculous mycobacteria (NTM) using real-time PCR. METHODS: A total of 348 samples from patients with suspected tuberculosis were tested with real-time PCR over seven months. We performed real-time PCR using the recently developed Anyplex plus MTB/NTM Detection kit (Seegene) with the CFX 96TM Realtime PCR System (Bio-Rad Laboratories) and the conventional AdvanSure TB/NTM real-time PCR kit (LG Life Sciences) with the SLAN Real-time PCR detection system (LG Life Sciences) to evaluate their performance for detecting MTB and NTM. RESULTS: The two real-time PCR systems showed 96.8% concordance rate for MTB-positive, NTM-positive, and negative results. Based on culture results, the sensitivity and specificity for the detection of MTB using PCR were 71.0% and 94.9% for Anyplex plus, and 78.1% and 93.9% for AdvanSure, respectively. For the detection of NTM, the sensitivity and specificity were 33.3% and 98.4% for Anyplex plus, and 51.7% and 97.9% for AdvanSure. Both PCR systems showed high MTB positive results in bronchial washing and sputum samples. CONCLUSION: In detecting MTB and NTM, Anyplex plus MTB/NTM (Seegene) and AdvanSure TB/NTM real-time PCR (LG Life Sciences) showed high concordance rate with each other in all samples. Therefore both detection kits can be used as rapid and reliable detection tool for MTB.
Humans ; Mycobacterium tuberculosis* ; Nontuberculous Mycobacteria* ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Sputum ; Tuberculosis

We experenced a case of cystic pancreatoblastoma associated with congenital hemihypertrophy in a 4 months old male. The mass was located on the anterior side of pancreatic head without any connection to the pancreas. After exision of cystic pancreatoblastoma, chemotherapy(FAM regimen) was performed 15 times due to capsular tumor invasion. Until this time there was no drug side effect and metastasis. The patient's general condition is stable.
Head ; Humans ; Infant ; Male ; Neoplasm Metastasis ; Pancreas