The occurrence of fistulous tract between the thoracic subarachnoid space and the pleural cavity due to injury is uncommon. The one was developed after traffic accident and treated by surgical repair of the fistula : The other was post-operative complication of costotransversectomy for T2 sympathectomy. The complication was realized by the surgeon who was aware of the small leakage of cerebrospinal fluid from the dura propria of the T2 nerve root at the time of surgery. Intermittent pleural punctures for drainage and semisitting position were followed by spontaneous closure of the fistula. These cases were reported so that the uncommon condition might be added to the differential diagnosis of pleural effusion.
Accidents, Traffic ; Cerebrospinal Fluid ; Diagnosis, Differential ; Drainage ; Fistula* ; Pleural Cavity ; Pleural Effusion ; Punctures ; Subarachnoid Space ; Sympathectomy

No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Metallothionein*

To characterize the immunopathologic phenotype of the cells in the lesional ti.:sue and to further examine the mechanism of the development of the annular lesions in leprosy, we have studied immune cells (T lymphocyte and its subsets, Langerhans cells, and HLA-DR antigen expressing cells) at different anatomical sites inside, active border, and outside normal skin in the annular lesions of leprosy. We took biopsy specimens from 4 patients of BT type, then processed the specimens by the staining methods eif indirect immunoperoxidase with monoclonal antibodies. In the active border the number of T cell was over 50g of the total cells infiltrated in the dermis. Helper T cells were dominant in number, and about three fourths of the cells were positive for HLA-DR staining. In two patients they had expression of DR antigen on the surfaces of the keratinocytes in the epidermis, in contrast to that of the inside, even the intensities were not. strong. At the inside of the annular lesions T cells were about 40% and the ratio of helper/suppressor T cell was approxiinately 1: 1, However, HLA-DR positive immune cells were not more than 10g among the total infiltrates. Langerha,ns cells were increased in number and in size either in the border or at the inside of the annular lesions. With these results we presume that the T cell mediated imrnune responses against Mycobacterium leprae may play an important role in the formation and extension of the annular lesions in leprosy.
Antibodies, Monoclonal ; Biopsy ; Dermis ; Epidermis ; HLA-DR Antigens ; Humans ; Keratinocytes ; Langerhans Cells ; Leprosy* ; Lymphocytes ; Mycobacterium leprae ; Phenotype ; Skin ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer

Tension pneumocephalus is rare while pneumocephalus is relatively common. The former has sudden or insidious deterioration in neurologic symptoms and signs comparing to self-limited pneumocephalus. This report is of a 19 years old male with tension pneumocephalus in the right frontal lobe two underwent right frontal osteoplastic craniotomy.
Craniotomy ; Frontal Lobe ; Humans ; Male ; Neurologic Manifestations ; Pneumocephalus* ; Young Adult

Ewing's sarcoma is an uncommon malignant neoplasm of the bone, which is rather infrequent in childhood and represented only 2% of all neoplasm under the age of 15 years. Clinical picture was that of progressive paraplegia associated with localized pain. The authors have experienced a case of primary Ewing's sarcoma of the first and second lumbar vertebrae in a 26-year-old male.
Adult ; Humans ; Lumbar Vertebrae ; Male ; Paraplegia ; Sarcoma, Ewing* ; Spine*

Benign Schwannoma rarely involves the vertebral bodies extensively. Two cases of widespread involvement of cervical vertebral bodies by Schwannoma are reported. Despite of huge amount of neoplastic mass and severe destructive bony changes, the neurologic deficits were minimal and postoperative result was not discouraging. Finding of plain X-rays, cervical CT scan and tumor pathology were discussed as well as surgical approach.
Neurilemmoma* ; Neurologic Manifestations ; Pathology ; Tomography, X-Ray Computed

The ventriculoatial shunt consists of diverting the cerebrospinal fluid from one lateral ventricle to the right atrium of the heart by means of a subcutaneous valve regulated drainage system. Of the numerous drainage systems so far devised, two, Holter and Pudenz, can be cited as having received widespread acceptance. This study is a clinical investigation of the 18 cases of ventriculoatrial shunts performed at Hanyang University Hospital between May 1972 and December 1978. Of them 17 cases and the Holter System, and one the Pudenz System. Ventricular catheter tip was placed in the frontal horn and cardiac catheter tip in the upper margin of the 6th thoracic vertebra. Postoperatively immediate neurological improvement usually took place in most instances. However, four complications developed. One of them was ventricular catheter obstruction with small brain tissue particles which was removed by revision. The other ventricular catheter obstruction was the result of thickening of the cerebral mantle and reduction in size of the ventricle. This shunt was made patient again byshortening the ventricular catheter to place inside the shrunk ventricle. The third was shunt infection. In this case, the whole shunting system was removed and reapplied into a peritoneal route, after infection subsided. The last was postoperative epidural hematoma developed due to incomplete hemostasis which required emergency surgery. Shunt obstruction was said as an inevitable complication in many instances, but it may easily restored by revision. Shunt infection was also surgically amenable. Although the necessity of revision was inevitable in some instances, ventriculoatrial shunt still seemed to be the most effective method so far devised.
Animals ; Brain ; Cardiac Catheters ; Catheter Obstruction ; Catheters ; Cerebrospinal Fluid ; Drainage ; Emergencies ; Heart ; Heart Atria ; Hematoma ; Hemostasis ; Horns ; Humans ; Hydrocephalus* ; Lateral Ventricles ; Spine

The case is reported of a 2 1/2-year-old femal with headache, vomiting and paraparesis. Clinical feature and operative findings are quite different from those of classic medulloblastoma in its lateral location, well-circumscribed tendency, non-invasiveness, no CSF metastasis, and favourable prognosis after surgical removal. Histological features are the combination of those of classic, and desmoplastic medulloblastoma. Review of literature was done.
Child* ; Headache ; Humans ; Medulloblastoma* ; Neoplasm Metastasis ; Paraparesis ; Prognosis ; Vomiting

The authors describe a case of tuberculous cerebellar abscess in 21-year-old male patient with previous history of military tuberculosis and tuberculous meningitis. Verified bacteriologically and histologically was this tuberculous cerebellar abscess. In reference to the literature, tuberculous brain abscess are extremely rare among the tuberculomas of the brain.
Abscess* ; Brain ; Brain Abscess ; Humans ; Male ; Military Personnel ; Tuberculoma ; Tuberculosis ; Tuberculosis, Meningeal ; Young Adult