No abstract available.
Brain Stem* ; Cysticercus* ; Granuloma*

Gallbladder carcinoma is the most common primary hepatobiliary carcinoma and the fifth most common malignancy of the GI tract. The most common type of gallbladder carcinoma is adenocarcinoma. Squamous cell carcinoma of the gallbladder is rarer and is responsible for up to 12.7% of gallbladder tumors. A 78-year-old man was incidentally suspected of having a gallbladder mass on an abdominal CT scan and underwent laparoscopic cholecystectomy. Pathology results confirmed the mass as a squamous cell carcinoma. Here we report a case of keratinizing squamous cell carcinoma of the gallbladder and review the literature.
Adenocarcinoma ; Aged ; Carcinoma, Squamous Cell ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Gallbladder ; Gastrointestinal Tract ; Humans ; Keratins

We report two cases of mucocele of the frontal sinus presenting with exophthalmos and diplopia. Total removal involved the transfrontal approach and neurological deficits were eliminated. Details of clinical manifestations are presented, and a review of the literature is included.
Diplopia ; Exophthalmos ; Frontal Sinus* ; Mucocele*

We report two cases of mucocele of the frontal sinus presenting with exophthalmos and diplopia. Total removal involved the transfrontal approach and neurological deficits were eliminated. Details of clinical manifestations are presented, and a review of the literature is included.
Diplopia ; Exophthalmos ; Frontal Sinus* ; Mucocele*

Glioblastomas rarely occur in the posterior fossa. The authors present clinical and pathological findings in a 59-year-old female patient with a glioblastoma growing primarily in the cerebello-pontine angle. The patient presented with a 1-month history of diplopia. Neurological examination revealed right-sided trigeminal and abducens nerve paresis. Cerebral magnetic resonance imaging showed a well-enhancing mass at cerebello-pontine angle. Following near total removal via petrosal approach, the pathological examination revealed a glioblastoma. To the authors knowledge, this represents the first case of glioblastoma arising at cerebello-pontine angle, probably originating from the most proximal part of abducens nerve.
Abducens Nerve ; Diplopia ; Female ; Glioblastoma* ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Examination ; Paresis

Background: Preoperative verification of fracture morphology is essential for determining the definitive fixation strategy in the management of a pilon fracture. This study aimed to determine the correlation between fibular injury patterns and fracture morphologies and introduce clinical implications. Methods: Computed tomography scans of 96 pilon fractures were retrospectively analyzed and divided into three types: intact fibula, simple fracture, and multifragment fracture. The principal fracture line and comminution zones were illustrated on a plafond template and diagrammatized on a 6 × 6 grid using PowerPoint software as fracture mapping. Correlations between fibular injury patterns and fracture morphologies, including comminution zones and principal fracture lines, were analyzed. Results: The thickest comminution zone was most often located in the anterolateral quadrant. According to fibular injury patterns, the comminution zone of the multifragment group was placed two grids more lateral than that of other groups. Lateral exits of the principal fracture line in the multifragment group were much more concentrated within the fibular incisura. Conclusions In pilon fractures, a more complex fibular fracture pattern was related to the valgus position. Moreover, the articular fracture pattern of pilon fractures differed according to coronal angulation and fibular fracture pattern. These differences should influence the operative approach and placement of the plate.

In this report, we descrbed a case of multiple brain abscesses associated with diffuse congenital pulmonary arteriovenous malformations (PAVM). Although the cases of brain abscesses associated with congenital PAVM are very rare, the brain abscess could be an initial clinical manifestation in asymptomatic PAVM as in the case presented in this report. PAVM may contribute to the development of a brain abscess by allowing easy bacterial access to systemic circulation through the right-to-left pulmonary vascular shunt, bypassing the filtering effect of the pulmonary capillaries. Hence, this association should be considered in cases with brain abscesses of undetermined etiologic factors.
Arteriovenous Malformations/*complications/radiography ; Brain Abscess/*etiology/radiography ; Capillaries ; Child ; Humans ; Male ; *Pulmonary Circulation ; Tomography, X-Ray Computed

Cytokines and growth factors are important regulatory proteins controlling the growth and differentiation of normal and malignant glial cells. In this study, we investigated the expression and origin of tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta 1 (TGF-beta 1) in the subacute brain injury after a single high-dose irradiation using 60 Sprague-Dawley rats. The right cerebral hemispheres of rats were exposed to a single 10 Gy dose of gamma rays using Ir-192. The radiation effect was assessed at 1 week, 2 weeks, 4 weeks, 6 weeks, and 8 weeks after irradiation, and the results were compared with those in sham operation group. Histological changes characteristic of radiation injury were correlated with the duration after the single dose irradiation. The loss of cortical thickness also increased with the lapse of time after irradiation. The TNF-alpha expression in the irradiated cerebral hemispheres was significantly increased compared with that in the sham operation group. TGF-beta 1 expression was also increased in the irradiated hemispheres. Immunohistochemical study revealed that TGF-beta 1 was expressed predominantly by infiltrating macrophages and astrocytes around the necrotic areas. These findings indicate that TNF-alpha and TGF-beta 1 may play prominent roles in the radiation injuries after a single high-dose irradiation.
Animals ; Brain/immunology/pathology/*radiation effects ; Dose-Response Relationship, Radiation ; Immunohistochemistry/methods ; Rats ; Rats, Sprague-Dawley ; Time Factors ; Transforming Growth Factor beta/*biosynthesis ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha/*biosynthesis

OBJECTIVE: This study was performed to elucidate the technical and patient-specific risk factors for postoperative ischemia in patients undergoing temporary arterial occlusion (TAO) during the surgical repair of their aneurysms. METHODS: Eighty-nine consecutive patients in whom TAO was performed during surgical repair of an aneurysm were retrospectively analyzed. The demographics of the patients were analyzed with respect to age, Hunt and Hess grade on admission, Fisher grade of hemorrhage, aneurysm characteristics, timing of surgery, duration of temporary occlusion, and number of temporary occlusive episodes. Outcome was analyzed at the 3-month follow-up, along with the occurrence of symptomatic and radiological stroke. RESULTS: In overall, twenty-seven patients (29.3%) had radiologic ischemia attributable to TAO and fifteen patients (16.3%) had symptomatic ischemia attributable to TAO. Older age and poor clinical grade were associated with poor clinical outcome. There was a significantly higher rate of symptomatic ischemia in patients who underwent early surgery (p = 0.007). The incidence of ischemia was significantly higher in patients with TAO longer than 10 minutes (p = 0.01). In addition, patients who underwent repeated TAO, which allowed reperfusion, had a lower incidence of ischemia than those who underwent single TAO lasting for more than 10 minutes (p = 0.011). CONCLUSION: Duration of occlusion is the only variable that needs to be considered when assessing the risk of postoperative ischemic complication in patients who undergo temporary vascular occlusion. Attention must be paid to the patient's age, grade of hemorrhage, and the timing of surgery. In addition, patients undergoing dissection when brief periods of temporary occlusion are performed may benefit more from intermittent reperfusion than continuous clip application. With careful planning, the use of TAO is a safe technique when used for periods of less than 10 minutes.
Aneurysm ; Brain Ischemia ; Craniotomy ; Demography ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm ; Ischemia ; Reperfusion ; Retrospective Studies ; Risk Factors ; Stroke ; Troleandomycin

No abstract available.
Lymphoma, Non-Hodgkin* ; Spinal Cord Compression* ; Spinal Cord*