No abstract available.
Facial Paralysis* ; Humans

No abstract available.
ACTH Syndrome, Ectopic* ; Wilms Tumor*

No abstract available.
Biopsy, Fine-Needle*

Though non-tumoral stenosis of the aqueduct has long been described as a common cause of hydrocephalus in infants and young children, its occurrence in adults has been recorded infrequently. In adults, the general picture of the clinical features is of chronic hydrocephalus such as impaired memory, epilepsy, unsteady gait, headache and other features of increased intracranial tension and endocrine disorders and features indicative of hypothalamic involvement. Plain skull X-rays show the signs of increased intracranial tension. The diagnosis if confirmed by ventriculography with or without lumbar encephalography. Recently cerebral angiography is stressed in diagnosis of aqueductal stenosis. We have seen two cases of aqueductal stenosis which can be regarded as non-tumoral origin. They were females and 29 and 34 years old respectively. Their symptoms were similar. It was headache for several months' duration which were aggrevated as time progress and combined with convulsions. Bilateral papilledema was the only finding in neurological examination. In conray ventriculography, the third ventricles were markedly enlarged and involved the salla tursica, and conray was not filled the caudal part of the aqueduct in two cases. The first case, following Torkildsens ventriculocisternal shunt did well for several days, however, patient died in spite of massive antibiotic therapy and ventriculostomy after removal of shunt tube which was regarded as infective. Autopsy showed periaqueductal gliosis without neoplasmic infiltration. Second case was improved with anterior third ventriculostomy.
Adult* ; Autopsy ; Cerebral Angiography ; Child ; Constriction, Pathologic ; Diagnosis ; Epilepsy ; Female ; Gait Disorders, Neurologic ; Gliosis ; Headache ; Humans ; Hydrocephalus* ; Infant ; Memory ; Neurologic Examination ; Papilledema ; Seizures ; Skull ; Third Ventricle ; Ventriculostomy

Though non-tumoral stenosis of the aqueduct has long been described as a common cause of hydrocephalus in infants and young children, its occurrence in adults has been recorded infrequently. In adults, the general picture of the clinical features is of chronic hydrocephalus such as impaired memory, epilepsy, unsteady gait, headache and other features of increased intracranial tension and endocrine disorders and features indicative of hypothalamic involvement. Plain skull X-rays show the signs of increased intracranial tension. The diagnosis if confirmed by ventriculography with or without lumbar encephalography. Recently cerebral angiography is stressed in diagnosis of aqueductal stenosis. We have seen two cases of aqueductal stenosis which can be regarded as non-tumoral origin. They were females and 29 and 34 years old respectively. Their symptoms were similar. It was headache for several months' duration which were aggrevated as time progress and combined with convulsions. Bilateral papilledema was the only finding in neurological examination. In conray ventriculography, the third ventricles were markedly enlarged and involved the salla tursica, and conray was not filled the caudal part of the aqueduct in two cases. The first case, following Torkildsens ventriculocisternal shunt did well for several days, however, patient died in spite of massive antibiotic therapy and ventriculostomy after removal of shunt tube which was regarded as infective. Autopsy showed periaqueductal gliosis without neoplasmic infiltration. Second case was improved with anterior third ventriculostomy.
Adult* ; Autopsy ; Cerebral Angiography ; Child ; Constriction, Pathologic ; Diagnosis ; Epilepsy ; Female ; Gait Disorders, Neurologic ; Gliosis ; Headache ; Humans ; Hydrocephalus* ; Infant ; Memory ; Neurologic Examination ; Papilledema ; Seizures ; Skull ; Third Ventricle ; Ventriculostomy

Xanthogranulomatous cholecystitis is an uncommon inflammatory disease of the gall baldder characterised by a focal or diffuse destructive inflammatory process. The pathogenesis is uncertain, but an inflammatory response to extravasated bile due to acute inflammation and obstruction is likely. Macroscopically, the gall bladder wall is invariably thickened, and extensive adhesions to adjacent organs are frequent. Clinically, xanthogranulomatous cholecystitis can mimic gall bladder carcinoma and radiologic differential diagnosis is extremely difficult. Fistula to skin and duodenum was reported. We report the first case of cholecysto-colonic fistula due to xanthogranulomatous cholecystitis.
Bile ; Cholecystitis* ; Diagnosis, Differential ; Duodenum ; Fistula* ; Inflammation ; Skin ; Urinary Bladder

The radiofrequency has been used for percutaneous cordotomy in patient having intractable pain. Recently the use of this radiofrequency has been extended to include other neurosurgical procedures, which in the past were done with chemical agents or mechanical methods etc. We treated one case of trigeminal neuralgia with the radiofrequency. The gasserian ganglion was punctured through the foramen ovale using a modified Hartel technique and the radiofrequency lesion was made in the second and third branches of the right trigeminal nerve selectively. The postoperative result was satisfactory. We reviewed the literature and described the technical procedures and complications.
Cordotomy ; Foramen Ovale ; Humans ; Neurosurgical Procedures ; Pain, Intractable ; Trigeminal Ganglion ; Trigeminal Nerve ; Trigeminal Neuralgia*

A 62-year-old man was transferred to our emergency room because of acute encephalopathy. He was a nondrinker with history of a gastrectomy nineteen years ago. Two weeks before his visit, he had experienced transient poor oral intake due to gastroesophageal reflux (GER). His brain MRI showed definite lesions compatible with Wernicke Encephalopathy (WE). A trivial event like GER can complicate the marginal equilibrium of thiamine and, after a long latent interval following a gastrectomy, may induce delayed-onset WE.
Brain ; Emergencies ; Gastrectomy ; Gastroesophageal Reflux ; Humans ; Middle Aged ; Thiamine ; Wernicke Encephalopathy

Solid and papillary neoplasms of the pancreas, a rare tumor usually found in young female patients, seldom presents with metastasis since it is a tumor with low potential for malignancy. The prognosis for this lesion is much more favorable than that for other pancreatic neoplasms. In an attempt to understand the characteristics and prognosis of this lesion, we reviewed twenty cases treated at the Department of Surgery, Severance Hospital, Yonsei University from 1985 to 1994. The mean age of the patients was 25.6 years (range: 13 to 39 years), and 19 (95%) were women. Chief complaints were palpable mass (50%), pain (45%), and indigestion(5%). In laboratory studies, tumor markers, including CEA, CA125, CA19-9, and aFP were studied in eight patients, and found negative. Other laboratory findings were also nonspecific. These tumors may occur anywhere in the pancreas. In our studies, the tumor was most often located in the tail (45%), and the head (40%) of the pancreas. These were treated by distal pancreatectomy and splenectomy (55%), Whipple's operation (20%), pylorus preserving pancreatoduodenectomy (10%), enucleation (10%) or excision (5%). Significant morbidity or mortality was not observed during hospitalization, and no recurrence or malignant degeneration occurred during the mean follow-up period of 4 years (range: 1 month to 9 years). In conclusion, this study has suggested that the patients with a solid and papillary neoplasm of the pancreas have a good prognosis for successful treatment, if the disease is diagnosed early and the tumor is completely resected. A higher index of suspicion, and more aggressive diagnostic workups are needed in dealing with this disease entity.
Adolescent ; Adult ; Carcinoma, Papillary/diagnosis/*pathology/surgery ; Female ; Follow-Up Studies ; Human ; Male ; Pancreatic Neoplasms/diagnosis/*pathology/surgery

Cavernous hemangioma of the uterus is an uncommon mesenchymal tumor. Most cases have been reported in young, pregnant women and the condition is very rare in a postmenopausal patient. An 81-year-old woman presented with a huge pelvic mass. Abdominal computed tomography and magnetic resonance imaging results suggested a leiomyoma with degenerative change and hemorrhage. Microscopically, large, thick-walled and variable-sized vascular channels were evident in the majority part of myometrium; the lining cells were immunohistochemically reactive for CD31. Vascular tumors of the female genital tract should be cautiously excised due to the profuse intra-operative bleeding. The pathological examination of a hysterectomy specimen is the only method to confirm the diagnosis of this tumor.
Aged, 80 and over ; Animals ; Caves ; Female ; Hemangioma, Cavernous ; Hemorrhage ; Humans ; Hysterectomy ; Leiomyoma ; Magnetic Resonance Imaging ; Mice ; Myometrium ; Pregnant Women ; Uterus