Aspergillosis is a rare disease of fungal infection produced by the genus Aspergillus in immunocompromised patients. It mainly involves the lung and may disseminate by invasion of biood vessels into the gastrointestinal tract. Brain and kidney. We report a case of the disseminated aspergillosis in malignant lymphoma affecting the lung. Brain and thyroid gland.
Aspergillosis* ; Aspergillus ; Brain ; Gastrointestinal Tract ; Immunocompromised Host ; Kidney ; Lung ; Lymphoma* ; Rare Diseases ; Thyroid Gland

Early detection of neoplastic disese and metastatic spred is very important. Carcinoma of the breast is knownto readily metastasize to the bone. The use of Tc-99m-phophate as bone imaging agent has been shown to demonstrate early evidence of bone metastasis well before radiographic evidence is visualized and as thus become a very usefultechnique for establishing and monitoring the bony metastatic element of breast cancer. In this study, serial boneimaging studies were performed to monitor the management of 84 breast cancer patients before and after mastectomyand biopsy. We attempted to analyse bone scans of breast cancer and to correlated the scan findings with theclinical stage, status of lymphnodes, distanat metastasis, bone pain, and laboratory datas. The following useful patterns were emerged: 1. Postive bone scan rate was definitely higher in clinical stage III and IV (42, 57%) thatin stage I and II(4, 18%) in initital studies. However, no correlation between positive bone scan rate andclinical stage was found in follow up studies. 2. Positive bone scan rate was high in both groups with locallyadvanced tumor(T3 & T4) and distant metastasis. 3. No correlation between postive bone scan and status oflymphnode involvement was noted. 4. Positive bone scan rate was also very high in patients with bone pain andabnomral laboratory data.
Biopsy ; Breast Neoplasms ; Breast ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radionuclide Imaging

Since Maisonneuve mentioned osteomyelitis by typhoid fever for the first time in 1835, numerous investigators had reported salmonella osteomyelitis. But these are very rare in its incidence ; only 0.82% of patients with typhoid infections have skeletal involvement. The authors recently experienced a case of salmonella osteomyelitis in lumbar spine respectively caused by salmonella typhi D group. A 48 year-old female was admitted to our Dept. of Neurosurgery with 4 months history of severe lumbago. On hospitalization her emperature raised upto 39 degrees C once and widal test showed salmonella typhosa OH 640x. Lumbar spine X-ray films demonstrated irregular bony destruction of L2 and L3 with mild degree of narrowing of intervertebral space of L2-3. Pus evacuation and currettage of involved vertebrae surgically were performed. Salmonella osteomyelitis involving intervertebral space was confirmed by culture of pus obtained from pathologic lesion and by biochemical test. Satisfactory result is obtained by surgical and antibiotic therapy.
Female ; Hospitalization ; Humans ; Incidence ; Low Back Pain ; Middle Aged ; Neurosurgery ; Osteomyelitis* ; Research Personnel ; Salmonella typhi ; Salmonella* ; Spine* ; Suppuration ; Typhoid Fever ; X-Ray Film

We presented two cases of entrapment neuropathy which were confused with herniated lumbar disc syndrome. One was "meralgia paresthetica in association with lumbar disc herniation", and "the other inguinal neuritis along with obturator neuritis". Syndromes of these entrapment neuropathies were confirmed by subcidence of pain and creation of progressively longer pain-free intervals after analgesic blocks of the corresponding nerves by infiltration of Xylocaine and prednisolone.
Lidocaine ; Nerve Compression Syndromes ; Neuritis ; Prednisolone

Although there are differences in the mode of onset, symptomatology and clinical course in the various types of cerebrovascular lesions, the general picture may be quite similar and it is often difficult to determine the nature of the lesion in any individual case from the clinical data. In the vast majority of cases the symptoms of a cerebrovascular accident are of sudden onset and reach maximum intensity within few minutes or a few hours at the most. Locksley, et al. have reported autopsies on people who died from spontaneous intracerebral or subarachnoid hemorrhage, and they found that a primary or metastatic brain tumor was the cause of hemorrhage in only 2%~3% of their necropsy. We presented our experience with two such patient whose clinical pictures before the surgery were quite similar with those of cerebrovascular accident. Cases with a large chronic subdural hematoma and cerebral glioblastoma multiforme demonstrated a sudden and dramatic onset of coma and focal neurological symptoms immediately before admission to the hospital. The responsible mechanism or etiology for the mode of such sudden dramatic onset of symptoms may be derangement of intracranial pressure mechanism and sudden hemorrhage in the tumor.
Autopsy ; Brain Neoplasms ; Coma ; Glioblastoma ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Intracranial Pressure ; Stroke* ; Subarachnoid Hemorrhage

A case is presented in which left-sided hemiparesis was caused by a fibromuscular dysplasia of the right internal carotid artery in the neck, and it used as a basis for discussion of the angiographic features. The 24-year-old woman was admitted to our Department of Neurosurgery, Korea University hospital, with the complaints of headache and left-sided hemiparesis which developed abruptly about one month before this admission. The carotid angiography was performed by puncture of the right common carotid artery under the clinical impression of cerebral thrombosis, which showed no gross intracranial abnormalities. But the characteristic findings were observed under and widening of the arterial lumen which are so-called loose stocking appearance or 'string of beads' appearance and are the typical feature of fibromuscular dysplasia. No surgical interventions such as arterial reconstruction and grafting, or arterial dilatation with bougies were applied on the patient, and she was discharged from the hospital three days after the admission. Fibromuscular dysplasia is a rare sclerotic, noninflammatory lesion of unknown etiology involving the wall of large arteries. This disease is found most frequently in early adult life and women are afflicted more often than men, This condition has been described most often in the renal arteries, where it has been found to be a cause of hypertension. Among the involvement of carotid system, the cervical portion of the internal carotid artery is most often affected, and the involvements are often bilateral. When localized to the internal carotid arteries, it can give symptoms of intermittent or permanent cerebral ischemia, but is usually asymptomatic. The typical angiographic appearance is the main parameter for diagnosis of fibromuscular dysplasia.
Adult ; Angiography ; Arteries ; Brain Ischemia ; Carotid Artery, Common ; Carotid Artery, Internal* ; Diagnosis ; Dilatation ; Female ; Fibromuscular Dysplasia* ; Headache ; Humans ; Hypertension ; Intracranial Thrombosis ; Korea ; Male ; Neck ; Neurosurgery ; Paresis ; Punctures ; Renal Artery ; Transplants ; Young Adult

Surgery of the facial nerve may be required for the restoration of function when the nerve is paralyzed from trauma or disease and to reduce or abolish function when the muscle it supplies are involved in severe spasm. A case of facial-hypoglossal anastomosis is reported, in which intracranial injury and destruction of the left facial nerve were resulted from the operation with complete removal of a large acoustic neurinoma in the cerebellopontine angle. The anastomosis was required for innervation of the paralyzed facial musculature following the operation. The anastomosis is preferred to the accessory-facial combination because of the extensive muscular atrophy of the upper trapezius and sternocleidomastoid muscle. Using operating microscpe, the proximal hypoglossal nerve was approximated to the distal facial nerve below the posterior belly of the digastric muscle, and the descendens hypoglossal was anastomosed to the distal hypoglossal nerve to prevent some of the glossal hemiatrophy.
Cerebellopontine Angle ; Equipment and Supplies ; Facial Nerve ; Hypoglossal Nerve ; Muscular Atrophy ; Neuroma, Acoustic ; Spasm ; Superficial Back Muscles

Surgery of the facial nerve may be required for the restoration of function when the nerve is paralyzed from trauma or disease and to reduce or abolish function when the muscle it supplies are involved in severe spasm. A case of facial-hypoglossal anastomosis is reported, in which intracranial injury and destruction of the left facial nerve were resulted from the operation with complete removal of a large acoustic neurinoma in the cerebellopontine angle. The anastomosis was required for innervation of the paralyzed facial musculature following the operation. The anastomosis is preferred to the accessory-facial combination because of the extensive muscular atrophy of the upper trapezius and sternocleidomastoid muscle. Using operating microscpe, the proximal hypoglossal nerve was approximated to the distal facial nerve below the posterior belly of the digastric muscle, and the descendens hypoglossal was anastomosed to the distal hypoglossal nerve to prevent some of the glossal hemiatrophy.
Cerebellopontine Angle ; Equipment and Supplies ; Facial Nerve ; Hypoglossal Nerve ; Muscular Atrophy ; Neuroma, Acoustic ; Spasm ; Superficial Back Muscles

By the expansion of stalk of laminaria inserted into the right epidural space of the rabbit head, cerebral compression and edema were produced. The studies of the occurrence and changes of experimental brain edema have been observed by weighing the wet and dry brain tissue, and by calculating the percentage of water content and that of swelling, with rate of per cent water content to that of control group. The percentage of water content and swelling of cerebral gray and white matters in the compressed site showed higher values than those in control and in non-compressed groups. As compared with normal group, the rate of per cent water content of cerebral gray matter at the site of compression showed gradually increasing tendency as time elapsed by 12 hours, while that of white matter demonstrated a increase of it by 24 hours and decreased gradually thereafter. Cerebral edema induced by laminaria compression was more evident and severe in the white matter than in the gray. Oxygen and glucose that are utilized the brain are two of the most important substances and play very important roles in the brain to form high energy bond and nucleic acid. Authors have attempted to measure oxygen consumption in normal rabbit brain and diseased brain that are produced by the expansion of stalk of laminaria in the intracranial epidural space. The value of oxygen consumption of cerebral gray and white matters in the compressed hemispheres showed higher values than those in control group, and they revealed a tendency of rather rapid increases at early experimental stages, an of gradual decrease thereafter.
Brain Edema* ; Brain* ; Edema ; Epidural Space ; Glucose ; Head ; Laminaria ; Oxygen ; Oxygen Consumption

Bleeding into the subarachnoid space is one of frequent complications in neurosurgical practice and most frequently caused by rupture of meningeal by trauma to the head. Hemorrhage into the subarachnoid space may occur in patient with blood dyscrasias, intracranial tumors, vascular anomalies, certain toxic or infectious disease of the nervous system, and intracerebral hemorrhages. In may be worthy academic interest and clinical practice to estimate the age of blood after hemorrhage into cerebrospinal fluid (CSF). The age was estimated and assessed by an immunological method with hemoagglutination activity using native Korean phytoagglutinin. The age of the red blood cells in RBC-CSF suspension of normal subjects was assessed and estimated by the hemoagglutination of phytoagglutinin in vitro. Vicia PHA and Clerodendron PHA chosen from among 18 different varieties of PHA are panhemoagglutinin and demonstrated the agglutination reaction most effectively. The agglutination activity of PHA with RBC-CSF suspension decreased gradually as time elapsed and activity subsided on 7~8th day. The age of RBC in CSF can be estimated by titration. The agglutination activity of PHA to RBC in CSF suspension continued for a longer period than that of PHA to either RBC in normal saline or anti-serum A and B in CSF. It would be well to say that the experimental results can be applied to clinical situations, especially subarachnoid hemorrhage.
Agglutination ; Cerebral Hemorrhage ; Cerebrospinal Fluid* ; Clerodendrum ; Communicable Diseases ; Erythrocytes ; Head ; Hemorrhage ; Humans ; Nervous System ; Rupture ; Subarachnoid Hemorrhage ; Subarachnoid Space ; Vicia