Chronic idiopathic intestinal pseudo-obstruction syndrome is a clinical condition induced by an impaired function of intestinal motility. Although its clinical symptoms are those of intestinal obstruction, mechanical obstruction of the intestine cannot be found by vigorous studies, even by operative exploration. We have experienced nine cases of chronic idiopathic intestinal pseudo-obstruction syndrome. It will help in diagnosis and treatment of the pseudo-obstruction to present the patients with these syndromes. In all cases severely delayed intestinal transit times were noted in radiological gastrointestinal studies without evidence of mechanical obstruction. The most frequent tentative diagnoses were congenital megacolons. But all of the patients showed the presence of ganglion cells in the intestinal wall. Histological abnormalities of the muscle layer were found in three patients. We could not resolve the symptoms by the surgical decompression of the intestine (such as colostomy, ileostomy etc.). But the symptoms were improved after total colectomy in a patient whose main affected site was confined to the colon. The megacystis was the most frequent combined anomaly. All patients had been improved with NPO and total parenteral nutrition therapies were inevitable. The drugs which facilitate the intestinal activities such as cisapride could not resolve the symptoms of obstruction. Three patients were died with the complications of total parenteral nutrition, and four patients improved clinically. Early diagnosis and proper management will reduce the mortality and morbidity.
Child ; Cisapride ; Colectomy ; Colon ; Colostomy ; Decompression, Surgical ; Diagnosis ; Early Diagnosis ; Ganglion Cysts ; Gastrointestinal Motility ; Hirschsprung Disease ; Humans ; Ileostomy ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Intestines ; Mortality ; Parenteral Nutrition, Total

Schwannomas arising from the cranial nerves of the jugular foramen are rare, only 50 cases including 15 glossopharyngeal schwannomas have been reported. They may be confused with the far more common acoustic schwannoma because of the presenting symptom of hearing loss. With the symptoms and signs of the lower cranial nerve involvement, the characteristic radiographic findings of enlarged jugular foramen and normal internal acoustic meatus can make the diagnosis. The authors review the literature and present a unique case of glossopharyngeal schwannoma which had intra-and extracranial growth with intrapetrosal extension.
Acoustics ; Cranial Nerves ; Diagnosis ; Hearing Loss ; Neurilemmoma* ; Neuroma, Acoustic

The authors report 3 cases of primary intramedullary glioblastoma multiforme which is relatively rare among spinal cord tumors. They were located at the thoracolumbar, cervical and conus medullaris region respectively. Clinical, radiographic and pathological material are presented and the literature is discussed.
Conus Snail ; Glioblastoma* ; Prognosis ; Spinal Cord Neoplasms

One case of craniopharyngioma confined to the third ventricle is reported. His symptom was only headache without visual disturbance or endocrine dysfunction. The CT scan showed isodense round mass in the anterior portion of the third ventricle with strong homogeneous enhancement. There was no calcification.
Craniopharyngioma* ; Headache ; Third Ventricle ; Tomography, X-Ray Computed

An unusual case of glioependymal cyst radiographically simulating arachnoid cyst is reported. The cyst wall contained not only ependyma-like epithelium but also neuroglial tissue. The possible pathogenesis of this lesion is discussed.
Arachnoid ; Epithelium ; Fourth Ventricle

Two cases of cerebral infestation with Paragonimus westermani complicating obstructive hydrocephalus are presented. The diagnosis was aided by brain CT scan and Conray ventriculogram. Both cases showed a strong positive intradermal test with relevant histories of eating crayfishes in roast form. In simple skull X-ray, one showed characteristic shell-like calcifications over the temporo-occipital region and the other showed multiple round calcifications over the suboccipital region. Brain CT scan demonstrated much more characteristic calcifications with marked ventricular dilatation. Conray ventriculogram disclosed obstructive hydrocephalus in both cases, one at the level of the cerebral aqueduct and the other at the level of the fourth ventricle outlet. Both patients were subjected to ventriculoatrial shunts and concomitant Bithionol therapy with marked improvement. The case involving the cerebellum and the fourth ventricle outlet was submitted to the posterior fossa exploration to be verified as a rare cerebellar paragonimiasis.
Astacoidea ; Bithionol ; Brain ; Cerebellum ; Cerebral Aqueduct ; Diagnosis ; Dilatation ; Eating ; Fourth Ventricle ; Humans ; Hydrocephalus* ; Intradermal Tests ; Paragonimiasis ; Paragonimus westermani ; Skull ; Tomography, X-Ray Computed

Cysticercosis is a hardly manageable parasitic infestation of the central nervous system because of its diversity in clinical manifestation and unsatisfactory result in treatment. Leptomeningeal cysticercosis, less frequent clinically than parenchymatous or ventricular type has rarely been diagnosed preoperatively with conventional diagnostic procedures. We have recently experienced a case of cysticercosis in a large cisterna magna diagnosed with an aid of CT scan.
Central Nervous System ; Cisterna Magna* ; Cysticercosis* ; Tomography, X-Ray Computed*

BACKGROUND: This study was planned to evaluate the influence of propranolol and esmolol on cerebral circulation and to estimate clinical implications and usefulness. METHODS: This study was designed to measure vital signs, cerebrospinal fluid pressure, cerebral perfusion pressure and blood flow velocity of common carotid artery. This was measured by Doppler Flowmeter after intravenous administration of propranolol 12.5, 25, 50 microgram/kg (P-12.5, P-25, P-50, respectively), and esmolol 0.5, 1.0, 2.0 mg/kg (E-0.5, E-1.0, E-2.0 group, respectively) at 1 or 2 minute intervals for 14 minutes. RESULTS: In the propranolol group (P-12.5, P-25 and P-50), the systolic blood pressure (SBP) significantly decreased since postinjection 1 minute and this decreased pressure continued throughout the entire experiment. But in esmolol group (E-0.5, E-1.0 and E-2.0), the SBP decreased significantly and rapidly recovered within 4 minutes. Heart rate significantly decreased in the propranolol group and continued throughout the experiment, but in the esmolol group the heart rate decreased and rapidly recovered within 10 minutes. The duration of the decreased heart rate in the esmolol group was shortened by decreasing the dosage. The blood flow velocity of the common carotid artery significantly decreased at 1 to 14 minutes after the injection of propranolol, but in group E-1.0, it was significantly decreased at 1 to 2 minutes, and in group E-2.0 at 1 to 3 minutes. CONCLUSIONS: The esmolol group showed less changes of SBP, heart rate and common carotid artery flow, and shorter duration of effect than the propranolol group. Mean blood pressure, cerebrospinal fluid pressure and cerebral perfusion pressure had no significant differences between propranolol and esmolol groups.
Administration, Intravenous ; Blood Flow Velocity ; Blood Pressure ; Carotid Artery, Common* ; Cerebrospinal Fluid Pressure ; Flowmeters ; Heart Rate ; Perfusion ; Propranolol* ; Rabbits* ; Vital Signs*

No abstract available.
Cervical Ripening* ; Cervix Uteri* ; Dinoprostone* ; Female ; Misoprostol* ; Pregnancy ; Pregnancy*