We have experienced 10 cases of intracranial tuberculoma which were confirmed by CT scan in National Medical Center from Jan. '79 to Aug. '82. The analysis is based on 10 cases with intracranial tuberculoma on whom operation was performed in 7 cases and conservative treatment was done in 3 cases. Extracranial disease or a past history of tuberculosis are evident in half of patients. The common presenting features are intracranial hypertension and papilledema. These are usually located in the supratentorial region. The use of CT brain scanning can be of great help in diagnosis and follow up more than others. The current treatment consists of medical therapy such as combined antituberculous agents, but surgical exploration may be reserved for intractable seizure, suspected brain tumor and medical failure or severe intracranial hypertension.
Brain ; Brain Neoplasms ; Diagnosis ; Follow-Up Studies ; Humans ; Intracranial Hypertension ; Papilledema ; Seizures ; Tomography, X-Ray Computed ; Tuberculoma, Intracranial* ; Tuberculosis

We report a case of disseminated calcific cysticercosis of brain, accompanied with marked hydrocephalus. Histopathologically, the calcific spots consisted of mummified scolex and bladder of cysticercus cellulosae with a diffuse calcification, but no area of cystic change were noted. Surrounding brain tissue showed a dense fibrous reaction and gliosis with little foreign body reaction.
Brain* ; Cysticercosis ; Cysticercus ; Foreign-Body Reaction ; Gliosis ; Hydrocephalus ; Urinary Bladder

Complications of tracheal intubation are well documented. However, iatrogenic aspiration of a broken metallic stylet following tracheal intubation has been infrequently reported. A 60-year-old woman, 10 days after shoulder arthroscopic surgery under endotracheal general anesthesia, was admitted to our hospital because of right chest pain. Chest radiographs showed a 8 cm length of metallic foreign body in the lower lobe of the right lung. Attempts at retrieval, including thoracoscopy, were unsuccessful. Open thoracostomy was performed. The removed foreign body was a part of metallic stylet. We report a case of iatrogenic aspiration of a broken metallic stylet.
Anesthesia, General ; Arthroscopy ; Chest Pain ; Female ; Foreign Bodies ; Humans ; Intubation ; Lung ; Middle Aged ; Radiography, Thoracic ; Shoulder ; Thoracoscopy ; Thoracostomy

Carotid body tumor is uncommon and has been a source of fear and curiosity to the surgeon for many years. This puzzling tumor attaches itself so intimately to the carotid artery system that its routine removal is often associated with serious consequences. The justification for its extirpation has been debated vigorously. Recently, we have experienced a case of carotid body tumor and obtained good result after total removal. We report our case with a brief review of the articles.
Carotid Arteries ; Carotid Body Tumor* ; Carotid Body* ; Exploratory Behavior

A rare case of intradural cerebellar vermian schwannoma has been reported. A 43 years old woman admitted to our hospital because of headache and weakness of upper extremities. CT brain scan showed an irregular lower density with intermixed high density at the middle posterior fossa, and large lower density with peripheral irregular thickness of rim enhancement after contrast media. CT cervical spine showed a lower density with displaced cord to the right side on the dorsal surface at C1 portion. Total enucleation of irregular brownish-gray large cystic mass resulted in uneventful recovery. There was no attachment to any nerve root.
Adult ; Brain ; Contrast Media ; Female ; Headache ; Humans ; Neurilemmoma* ; Spine ; Upper Extremity

Some aneurysms with peculiar shapes, large sized or in unusual location cannot be obliterated by ordinary methods. We present four cases using two kinds of fenestrated clips. There were 4 aneurysms in the 4 patients:3 saccular and 1 fusiform aneurysm. Two aneurysms were located in anterior communicating artery, one left carotico-opthalmic artery, and one distal middle cerebral artery. All of the aneurysms were successfully obliterated. Our results suggest that the various shape of fenestrated clips may be benefit for clipping difficult aneurysms, which would not be clipped with ordinary one.
Aneurysm ; Arteries ; Intracranial Aneurysm* ; Middle Cerebral Artery

OBJECTIVE: During the last several years, such as Photofrin(R), Photogem(R), HpD, and 5-aminolevulenic acid (ALA) has been used as photosensitizers for a wide range of malignant tumors as well as non-malignant disease. A new photosensitizer, 9-Hydroxypheophorbide-a (9-HpbD-a) was derived from Spirulina platensis. The aim of this study was to evaluate the anticancer effect and mechanism of photodynamic therapy in vitro using 9-HpbD-a and 670 nm diode laser on a HT-3 cervical cancer cell line. METHODS: We studied the cytotoxic effect of 9-HpbD-a and 670 nm diode laser in HT-3 cervical cancer cell line. The cultured HT-3 cells were treated with serial concentrations of 9-HpbD-a followed by various irradiation time (0, 5, 15, 30 min) and by various interval times (0, 3, 6, 9, 12 24 hours) until laser irradiation, then 3- (4,5-dimethylthiazol-2-yl) -2,5-diphenyl-tetrazolium bromide (MTT) assay was applied to measure the relative inhibitory effect of PDT. RESULTS: Optimal condition for laser irradiation time was 15 minutes and the cytotoxic effect according to the incubation time after 9-HpbD-a treatment was increased until 6 hours. Under confocal microscopy, to observe intracellular localization of 9-HpbD-a, cells dual-stained with 9-HpbD-a and panel of organelle-specific fluorescence probes (MitoTracker, LysoTracker, ER-Tracker), endoplasmic reticulum (ER) as a major accumulation organelle site in HT-3 cervical cell line for this new photosensitizer. CONCLUSION: The anticancer effect of PDT using 9-HpbD-a is effective in HT-3 cervical cancer cell line. This agent therefore represents a promising photosensitizing prodrug for the treatment of cervical cancer with PDT in clinical setting for the future.
Amines ; Cell Line ; Endoplasmic Reticulum ; Fluorescence ; Lasers, Semiconductor ; Microscopy, Confocal ; Organelles ; Photochemotherapy ; Photosensitizing Agents ; Spirulina ; Triazenes ; Uterine Cervical Neoplasms

Neonatal Gaves disease is a relatively rare condition due to transplacental passage of Thyroid-stimulating antibody(TSAb) from a mother with active or inactive Graveses disease or autoimmune thyroiditis. A 11-day-old female newborn was referred to our department of pediatrics from a local clinic because of low level T4(3.55microg/dl) concurrent with high level TSH (501.74uIU/ml) on the 5th day neonatal metabolic screening. But, our repeated laboratory data showed very high serum T4(59.6microg/dl), T3(1,600ng/dl), suppressed TSH(0.43uIU/ml), and the presence of TSH receptor antibody. Her mother was treated with propylthiouracil(PTU) for Graves disease during pregnancy. Therefore, we thought it was a delayed-onset neonatal hyperthyroidism, because the fetal thyroid gland was initially suppressed by antithyroid drug taken during pregnancy. After initiating antithyroid drug therapy for the hyperthyroid nature, TSH levels became elevated again, while thyroid hormone levels decreased. Maternal and infant blood samples at the 23th day after birth were examined for serum autoantibodies directed towards the TSH receptor(Thyrotropin-binding inhibitory immunoglobulin:TBII, Thyroid-stimulating antibody:TSAb, Thyroid-stimulating blocking antibody:TSBAb) and high levels of TBII and TSAb were detected. About 2 months after birth, TBII and TSAb decreased within normal limit, and then we could stop antithyroid medication in safety. We report here a case of neonatal Graveses disease with very high level of T4 and T3, but firstly presented as hypothyroid nature on neonatal screening because of the maternally transferred antithyroid drug, PTU.
Autoantibodies ; Drug Therapy ; Female ; Graves Disease ; Humans ; Hyperthyroidism ; Infant ; Infant, Newborn ; Mass Screening ; Mothers ; Neonatal Screening ; Parturition ; Pediatrics ; Pregnancy ; Receptors, Thyrotropin ; Thyroid Gland ; Thyroiditis, Autoimmune

The authors describe the case of a man who presented with T2-T3 disc herniation. The lesion was successfully identified by computed tomography with iopamidol myelogram and other radiological examinations. A posterolateral approach was tried and made successful result by the aids of microsurgical divices.
Iopamidol

The mortality rate of aneurysmal surgery had recently been reduced due to modern microsurgical technique and refinement of the timing of operation. Despite recovery without neurological deficits, many patients remain with emotional and psychological sequelae postoperatively. We evaluated 33 patients, operated on intracranial aneurysm for recent 2 years, about quality of life and degree of cognitive function. For proper evaluation of outcome of aneurysmal surgery, in addition to the neurological outcome, psychological aspects must be considered.
Aneurysm ; Humans ; Intracranial Aneurysm* ; Mortality ; Quality of Life