No abstract available.
Child* ; Humans ; Hydrocephalus*

Proximal cerebrospinal fluid shuntmalfunction due to ventricular catheter occlusion remains the most common sourceof the shunt problem. The position of the hole-bearing segment of the catheter affects the long term patency of the ventricular catheter of a cerebrospinalfluid shunt.Placementof thissegmentnear thechoroidplexus or injured ependyma increases the probability of obstruction. Accurate locationof ventriculoperitoneal(V-P)shunt tip inrelation to foramen Monro canbe well establishedby plain radiographyregardless of agesor sizes and shapes of head dueto the fact that foramen Monro tothe spatial matrix of the skull is constant. Of 147patients who underwentV-P shunt operations, 49(33.3%)patients had more thanone operations. Radiologicgradingof theventricularcatheterposition is compared betweensingle operatedgroup andreoperated group.Single operated group showed excellentin 33.6%, good41.8%, poor 24.4%of accuracy rateof catheter tip position. Incases ofreoperation, placement ofcatheter tipresulted in excellent 12.5%, good21.8%, and poor 65.6%.These results indicatethat accurate location of ventricular catheter tip affects favorably to the patency of V-P shunt.
Catheters ; Cerebrospinal Fluid ; Ependyma ; Head ; Skull ; Ventriculoperitoneal Shunt*

Omental pregnancy is an extremely rare form of abdominal pregnancy that may cause life threatening massive hemorrhage in case of rupture. It may occur by primary implantation of the fertilized ovum in the omentum. The diagnosis is very difficult, but prompt surgical intervention is required when it is suspected, because perinatal mortality and maternal mortality in abdominal pregnancy were 85~95% and 0.5~6%. We experienced a case of omental pregnancy in the first times and reported it with brief review of literature.
Diagnosis ; Female ; Hemorrhage ; Maternal Mortality ; Omentum ; Perinatal Mortality ; Pregnancy* ; Pregnancy, Abdominal ; Rupture ; Zygote

Hyperglycemia during either global or regional ischemia is widely known to be detrimental, and ischemia induced release of diverse neurotransmitters and the ensuing activation of specific postsynaptic receptors have been suggested to play a important role in the development of ischemic selective vulunerability. This study was undertaken to investigate the influence of blood glucose change on tissue concentration of some catecholamines ; dopamine, norepinephrine, serotonin, of the transient ischemic rat's brain, estimated by high performance liquid chromatography(HPLC) assay system, following transient bilateral forebrain ischemia in the rat's model subjected to 20 minutes of normothermic ischemia by two vesseles occulusion plus profound cortex, hippocampus and striatum respectively by HLPC. The concentrations of catecholamines were significantly decreased in all sampled areas in experimental groups compared with the control group(p<0.05), respectively(average decrease rate : norepinephrine 71%, dopamine 89%, serotonin 80% in frontal cortex ; norepinephrine 71%, dopamine 93%, serotonin 81% in hippocampus ; norepinephrine 33%, dopamine 35%, serotonin 78% in striatum). Dopamine was relatively decreased in concentration in frontal cortex and hippocampus, and serotonin was relatively decreased in striatum. But no statistic significancy(p>0.05) of catecholamines level between each experimental group(hyper-, hypo- and normoglycemic group) according to the change of blood sugar. The results suggested that blood glucose level did not influence the tissue concentration of dopamine, norepinephrine and serotonin in frontl cortex, hippocampus and striatum of transient ischemic rat's brain.
Blood Glucose* ; Brain* ; Catecholamines ; Dopamine* ; Frontal Lobe* ; Hippocampus* ; Hyperglycemia ; Ischemia ; Neurotransmitter Agents ; Norepinephrine* ; Prosencephalon ; Serotonin*

Hyperglycemia has been reported to worsen the tolerance of the brain to ischemia, and it has therefore been recommended that patient undergoing neurosurgical procedures not receive glucose-containing solutions. Since ischemic events lead to increased lactate production and accumulation and hence neuronal damage, the present study was designed to test the effect of insulin-induced hypoglycemia and decreased lactate by 2-Deoxyglucose and Dichloroacetate on focal cerebral ischemia in rats. Although the pre and post-ischemic blood glucose levels of control group and Dichloroacetate group showed no change, the blood glucose level of 2-Deoxyglucose group showed a significant increase(p=0.001), and insulim group a significant decrease(p=0.004). The reducing effects on the infarct zone in these three treated groups were found with statistical significance. As compared with control group, the tissue lactate levels of treated groups were decreased in both infarct zone and border zone but these data did not show statistical significance. From these observations, it is suggested that reduction of lactate production and accumulation could be beneficial by affording neuronal protection in ischemic tissues.
Animals ; Blood Glucose ; Brain ; Brain Ischemia* ; Cerebral Infarction ; Deoxyglucose* ; Dichloroacetic Acid* ; Humans ; Hyperglycemia ; Hypoglycemia ; Insulin* ; Ischemia ; Lactic Acid ; Neurons ; Neurosurgical Procedures ; Rats*

We report a series of 19 consecutive patients with post-traumatic cerebral infarction. Post-traumatic cerebral infarction(PTCI) was diagnosed by CT within 24 hours of admission in 6 cases and up to 14 days after admission in 13 cases of 1092 patients who required cranial CT for trauma during the period. The frequency, vaascular territories, cause, and mortality rate of post traumatic cerebral infarction were discussed.
Cerebral Infarction* ; Humans ; Mortality

The purpose of this study was, first, to devise a new model for topical application of excitatory amino acids(EAAs) to rat cerebral cortex that successfully and repeatdly initiate the cortical spreading depression(CSD). Then, by using this model, six major EAAs that are known to act on single or multiple subtypes of EAA receptor were examined; glutamate, kainate, aspartate, N-methyl-D-aspartate(NMDA), quisqualate, and alpha-amino-3-hydroxy-5-methyl-4-isoxazoie-proprite(AMPA). Through the model, with a cone-shaped well buried in 1.5mm depth of the cerebral cortex, these chemical agents were topically applied to the cortical gray matter. A total of 50 Sprague-Dawley rats were used and divided into seven groups including the sham group. Doses of each EAA between 10(-7) and 10(-4)M concentrations were escalated for triggering the CSD and its rate of consistency in triggering was also evaluated. In the overall results. CSDs were repeatedly initiated in all experimental groups with relatively consistent rates. Duration of CSDs were 1-4 minutes(mean 2.2+/-1.4) and amplitudes were 20-40mV. Effective dose(50)(ED(50)), that trigger over 50% of CSD was 10(-5)M(n=8) for glutamate, 10(-7)M(n=8) for aspartate, 10(-5)M(n=7) for AMPA, 10(-5)M(n=7) for quisqualate, and 10(-4)M(n=7) for NMDA and kainate group. Among those acting on the single receptor, AMPA was shown to be the most effective in triggering CSD, and NMDA, and kainate were in descending orders. Aspartate that was known to act on multiple EAA receptors, showed the highest rate of triggering CSD among all groups, but glutamate, known to act on all receptors of its subtypes, showed the most consistent rate of triggering CSD at dose escalation. These results revealed that those EAA acting on multiple receptors, namely aspartate and glutamate, showed the highest and most consistent rate of triggering CSD. Among those acting on single channel of receptors. AMPA was the most effective, although its consistency and rate of triggering of CSD was somewhat lower than.
alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid ; Animals ; Aspartic Acid ; Cerebral Cortex ; Cortical Spreading Depression* ; Excitatory Amino Acids* ; Glutamic Acid ; Kainic Acid ; N-Methylaspartate ; Quisqualic Acid ; Rats ; Rats, Sprague-Dawley ; Receptors, AMPA

OBJECTIVES: To isolate and culture of human muscle cells by manipulating culture conditions. METHODS: Muscle samples were obtained during total hip replacement or bedside muscle biopsy. We isolated myoblasts from freshly obtained human muscle tissue by trypsin and collagenase digesion. RESULTS: Selective isolation of myoblasts was identified through histologic examination by light-microscope. We identified monoc]onal antibodies(Leu-19) as molecular markers in human skeletal muscle were expressed. CONCLUSIONS: This study demonstrated that it had been possible to culture morphologically and immunelogically identifiable myoblasts isolated from human skeletal muscle tissue.
Arthroplasty, Replacement, Hip ; Biopsy ; Collagenases ; Humans* ; Muscle Cells* ; Muscle, Skeletal ; Myoblasts ; Trypsin

OBJECTIVE: The anterior communicating artery(ACoA) is known to be the most frequent location of intracranial aneurysms, but the complex arterial anatomy of the ACoA region makes this aneurysm among the most difficult one to treat. In the treatment of ACoA aneurysms, the direction of aneurysmal fundus is known to be very important in the surgical tactics. All ACoA aneurysms in our series were classified according to its direction, and analyzed the clinical features in order to investigate the prognostic factors influencing upon the surgical outcome. METHODS: The authors reviewed 236 cases of ruptured ACoA aneurysms that were operated from 1990 to 1997, were classified according to Pia's classification. RESULTS: The incidence rate of the ACoA aneurysm was 35.1%(236/672). Ventral group was more common than dorsal group, especially in ventro-caudal projection subgroup(36.0%). Poor preoperative clinical grade(Hunt-Hess grade IV and V) patients were more common in dorsal group(13.1%) than ventral group(2.6%). Rebleeding and intracerebral hematoma were more commonly seen in ventral group. However, vasospasm, hydrocephalus, hyponatremia, and intraventricular hemorrhage were observed more frequently in dorsal group. Worse outcome was more common in dorsal group than ventral group, especially in dorso-caudal projection subgroup. Also, poor outcome was identified in patients with intracerebral hematoma, intraventricular hemorrhage, hyponatremia, and hypertension, although statistically insignificant. In cases with the A1 dominancy, there was no difference in surgical outcome between the right and left side approach. The higher the aneurysmal neck from the planum sphenoidale, the worse outcome via pterional approach. CONCLUSION: It seems that the preoperative clinical grade, aneurysmal direction, and the height of aneurysmal neck, especially in the pterional approach, would be the major prognostic factors, and that intracerebral hematoma, intraventricular hemorrhage, hyponatremia, hydrocephalus and the intraoperative aneurysmal rupture would be the minor prognostic factors.
Aneurysm ; Classification ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Hyponatremia ; Incidence ; Intracranial Aneurysm* ; Neck ; Rupture ; Temazepam

Neuroendocrine tumors are heterogeneous and potentially aggressive, and they must be distinguished from classic carcinoid tumors as the tumors share histologic features with their counterparts that occur in the lung, such as oat cell and intermediate cell carcinomas. Histopathologically, the oat cell neuroendocrine carcinoma displays itself in sheets, cord and rib-bons of small hyperchromatic, undifferentiated cells with very scanty cytoplasm. The intermediate cell is slightly larger than the oat cell and has more abundant cytoplasm. The authors report a case of a 52-year old patient with neuroendocrine carcinoma that occurred at the anterior cranial fossa extending into the nasal cavity. The patient presented with recurrent meningitis and seizure. Histological examination of the nasal biopsy tumor specimen confirmed neuroendocrine carcinoma, afterwhich the patient treated with a 4300 rad radiation therapy. Magnetic resonance imaging taken 2 years later showed an enlargement of the tumor mass at the anterior cranial fossa, and the patient was operated for removal of the intracranial tumor. The nasal cavity defect was reconstructed using rotation galeal flap technique.
Avena ; Biopsy ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Cranial Fossa, Anterior* ; Cytoplasm ; Humans ; Lung ; Magnetic Resonance Imaging ; Meningitis ; Middle Aged ; Nasal Cavity ; Neuroendocrine Tumors ; Seizures