Inflammatory pseudotumors are tumor-like, benign lesions of uncertain pathogenesis and have most commonly been reported in the lungs. They occur rarely in the gastrointestinal tract and may cause small bowel obstruction due to intussusception or, less commonly, as an incidental finding on radiologic examination or screening endoscopy. We present a case of surgically proven jejunal intussusception caused by inflammatory pseudotumor.
Endoscopy ; Gastrointestinal Tract ; Granuloma, Plasma Cell* ; Incidental Findings ; Intussusception* ; Jejunum* ; Lung ; Mass Screening

There have been several reports of more than one type of porokeratosis occurring in the same family or the same individual. We hope to support the view of different phenotypic expressions of a common genetic aberration by describing an additional case of porokeratosis of Mibelli on the perianal area and DSAP on the face, forearms occurring in a 45-year-old man.
Actins* ; Forearm ; Hope ; Humans ; Middle Aged ; Porokeratosis*

Purpose: The purpose of this study was to compare the concurrent validity and test-retest reliability of ‘KPIMT Torticollis Protractor’, a smart phone and I-pad application for convenient range of motion measurement, and ‘Image J’, an analysis software with high reliability and validity, according to head tilt and active cervical rotation angle. This was done to determine the clinical utility of ‘KPIMT Torticollis Protractor’. Methods: Head tilt and active cervical spine rotation angles of 40 children with congenital muscular torticollis were measured using Image J and KPIMT Torticollis Protractor, respectively. The level of concurrent validity and inter-rater and intra-rater reliability between the two measurement methods were analyzed. Results: For forty participants, the concurrent validity between Image J and KPIMT Torticollis Protractor showed very high validity with ICC of ICC 0.977 (0.995-0.999), 0.994 (0.994-0.998), CVME% 0.71-0.72%, SEM% 0.31-0.34%, MDC% 0.86-0.94%. The test-retest intra-rater reliability showed very high reliability ICC 0.911 (0.911-0.966), CVME% 0.71%, SEM% 0.34-0.36%, MDC% 0.81-0.94%. The test-retest inter-rater showed very high reliability ICC 0.936 (0.933-0.957), CVME% 0.70%, SEM% 0.34-0.35%, MDC% 0.81-0.83%. Conclusion The KPIMT Torticollis Protractor, a smart phone and IPD application, is a highly reliable and valid device for angle measurement in children with congenital myotonia and can be easily used in clinical practice.

The authors present a case of cervical syringomyelia associated with cerebellar mixed oligoastrocytoma in an 18-month-old boy who was normally delivered at full-term. The child presented with an increasing incidence of vomiting and irritability, and a poor truncal control. Preoperative magnetic resonance imaging of the brain revealed cerebellar vermian tumor with an obstructive hydrocephalus and a small-sized syringomyelia at the 6th cervical vertebral level. The tumor was completely removed via suboccipital craniectomy. Histologically, the tumor consisted of mixed oligo-astrocytoma. The cervical syringomyelia was conservatively managed with no specific operative treatment. At two months postoperatively, magnetic resonance imaging of the cervical spine showed a remarkable reduction in size of the syringomyelic cavity.
Astrocytoma ; Brain ; Cerebellar Neoplasms ; Child ; Humans ; Hydrocephalus ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Spine ; Syringomyelia* ; Vomiting

The authors describe a technique consisting of subfascial temporalis dissection and performing a pedicled bone flap in pterional craniotomy. This technique provides reliable preservation of the frontalis nerve, does not necessitate the reconstruction of the temporalis muscle at the end of the surgery, and does not compromise the operative exposure.
Craniotomy

PURPOSE: To evaluate the HRCT findings and to correlate the findings with the results of a pulmonary function test (PFT) in patients with reactive airway dysfunction syndrome (RADS). MATERIALS AND METHODS: On March 2003, a fire at a boarding house of primary school soccer players caused a multiple casualty disaster. After 8 months, nine boys that presented with chronic cough and dyspnea were treated, and were subjected to follow-up evaluations. Eight patients underwent a chest radiograph, HRCT, and a PFT. Two patients with severe symptoms received extended follow-up after 1 year. Two radiologists retrospectively reviewed the chest radiographs and the follow-up HRCT scans. We correlated the HRCT findings with the results of the PFT. RESULTS: Six patients with an inhalation injury were diagnosed with RADS. On the chest radiographs, eight patients showed no abnormal findings. On an HRCT scan, four patients showed abnormal findings. The abnormal findings were mosaic air trapping (n = 4), bronchial wall thickening (n = 1), and parenchymal consolidation (n = 1). In all four patients that showed abnormal findings in the HRCT scan, abnormal results of the PFT were also seen. The two patients that received extended follow-up showed an improvement of the clinical symptoms, as seen by the PFT, and had a decreased extent and degree of mosaic air trapping, as seen on HRCT. CONCLUSION: An HRCT scan is an essential modality for the diagnosis and follow-up of patients with RADS. Both a full expiratory and inspiratory HRCT scan must be performed for an accurate diagnosis.
Bronchial Hyperreactivity ; Cough ; Diagnosis ; Disasters ; Dyspnea ; Fires ; Follow-Up Studies ; Humans ; Inhalation* ; Lung ; Radiography, Thoracic ; Respiratory Function Tests* ; Retrospective Studies ; Smoke Inhalation Injury ; Soccer ; Thorax*

The author has performed an experimental study in order to investigate the effect of nimodipine on the production of CSF in 12 cats. The cats were divided into 2 groups, one for nimodipine intravenous infusion and the other for its vehicle infusion group. Using ventriculo-cisternal perfusion method, nimodipine and its vehicle were examined for their effects on CSF formation rate respectively. Baseline CSF formation rate was 22.5+/-2.9 microliter/min(S.E.) and it gradually reduced to 17.0+/-3.4 microliter/min(S.E.) after final infusion of nimodipine at 60 microgram/kg/min. Vehicle infusion revealed no significant change in CSF formation rate. Although the nimodipine insuion revealed declining tendency in CSF formation rate along with increment of nimodipine concentration, it was not statistically different from that of vehicle infusion group. Systolic blood pressure was significantly reduced after nimodipine infusion(133+/-31.8mmHg at baseline, 93.9+/-19.1mmHg at the end of the experiment) on oneway ANOVA test and it was significantly different from that in vehicle infusion group(p<0.01).
Animals ; Blood Pressure ; Cats ; Infusions, Intravenous ; Nimodipine* ; Perfusion

The author has examined the effect of cortical spreading depression(CSD) on the changes in extracellular concetration of aspartate and glutamate in the neocortex of anesthetized rats using microdialysis and high performance liquid chromatography(HPLC). The rats were prepared by halothane anesthesia and artificial ventilation. Rats were placed in a stereotaxic frame, and craniotomies were performed over the frontal and parietal cortexes on one side. The CSD was elicited by local application of KCI-soaked small pellets to the frontal cortex. The CSD was monitored by the changes of direct current(DC) potential in the parietal cortex. The microdialysis probe was implanted in the anterior part of the parietal cortex. Amino acids were analyzed by HPLC and fluorescence detection. Baseline concentration of the aspartate was 34.9+/-15.9nM and that of glutamate was 189.8+/-29.1nM(mean standard deviation). The perfusate for analysis was obtained 30 minutes after the beginning of the 300mM KCl induced CSD. Aspartate was found to increase to 146+/-55% baseline, glutamate up to 173+/-30% baseline(mean standard deviation). The increment of glutamate was statistically significant(p<0.05). Then 2M KCI-doaked pellets were applied for more frequent CSD amd the samples were collected. Aspartate increased up to 258+/-97% baseline, glutamate up to 174+/-57% baseline(mean standard deviation), The increment of glutamate and aspartate accompanying 2M KCI induced CSD were also statistically significant(p<0.05). These data suggest that the excitatory amino acids were released during the CSD and this may explain the various aspects of CSD that could contribute to the secondary neuronal damage in the compromised nerve cell.
Amino Acids ; Anesthesia ; Animals ; Aspartic Acid* ; Cerebral Cortex* ; Chromatography, High Pressure Liquid ; Cortical Spreading Depression* ; Craniotomy ; Excitatory Amino Acids ; Fluorescence ; Glutamic Acid* ; Halothane ; Microdialysis ; Neocortex ; Neurons ; Rabeprazole ; Rats* ; Ventilation

Spontaneous intracerebral hemorrhage(ICH) is one of the most common neurosurgical disorders associated with high morbidity and mortality. However, the treatment of the disease remains controversial. While aggressive removal of the blood clot is advocated by some, supportive care without clot removal is recommended by others. This dichotomy in therapeutic approaches undoubtedly derives from a poor understanding of the pathophysiological mechanisms that result in brain injury following intracerebral hematoma. Thus, effective animal model of intracerebral hematoma is necessary so that the injury mechanisms can be identified and the specific therapy developed. In an attempt to establish the highly reliable and reproducible experimental model of intracerebral hematoma, various amount(sham. 25microliter, 50microliter and 100microliter) of autologous blood was injected stereotactically into the left basal ganglia of the anesthetized rats. 16 Sprague-Dawley rats were divided into 4 groups. The sham operation and injections of 25microliter, 50microliter and 100microliter of autologous arterial blood were performed on each group. The animals were assessed for the size and pattern of the hematoma and the neurological outcome at 24 hours after the formation of intracerebral hematomas. The 25microliter-injection group showed the more reproducible size and shape of the hematoma confined to the basal ganglia with better neurological outcome, Additionally, the perihematomal ischemic zone was observed after intracardiac perfusion with 2% 2,3,5-triphenyltetrazolium chloride(TTC). Another 18 rats were assessed for the histopathological changes during the hyperacute stage of the intracerebral hematoma with Hematoxylin-Eosin staining. Finally another 24 rats were divided into 6 groups and injected with 25microliter of blood. They underwent intravenous infusion of Evans blue and were sacrificed at 1, 3, 6, 12, 24 and 72 hours after the formation intracerebral hematomas. The Evans blue extra asation was noted around the needle tract and hematoma that meant disruption of the blood-brain barrier. Significant increment of the water content with resultant brain edema was noted on the ipsilateral brain 6-12 hours after the formation of the intracerebral hematoma.
Animals ; Basal Ganglia ; Blood-Brain Barrier ; Brain ; Brain Edema ; Brain Injuries ; Evans Blue ; Hematoma* ; Infusions, Intravenous ; Models, Animal ; Models, Theoretical* ; Mortality ; Needles ; Perfusion ; Rats* ; Rats, Sprague-Dawley

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*