No abstract available.
Bromodeoxyuridine* ; Hep G2 Cells* ; Kinetics* ; Tretinoin*

From March 1986 to December 1994, 30 out of 1930 patients with lumbar HIVD or lumbar stenosis were diagnosed as discitis after laminectomy(total or hemilaminectomy) and discectomy in the Department of Neurosurgery, Kyung Hee University Hospital. The author had analysed the clinical features and diagnostic procedure of discitis. Furthermore, changes in ESR were continuously monitored in patients following laminectomy, with or without complications. The incidence of discitis following lumbar laminectomy was relatively rare(1.6%). Severe back pain and muscle spasm were characteristic symptoms. Patients with discitis showed elevations of ESR to its maximum after 2 weeks and then decreased slowly. However patients without discitis reached maximum rate in the 9th day and decreased rapidly to within normal value 2 weeks after. Therefore, continuous increase of ESR after operation strongly suggests discitis and we believe that serial examination of ESR will be helpful in the early detection of discitis. Compared with discitis patients, to determined the normal changes of the ESR after laminectomy, 100 patients(50 females, 50 males) were randomly selected and serial erythrocyte sedimentation rate were recorded during the first 4 weeks after operation. The parameters which affect postoperative ESR were operation time, sex, age, and postoperative steroid therapy. The operative time, sex and postoperative steroid therapy had no effect on the postoperative ESR changes significantly(p>0.05), but the more increase of age(over 40 years), the ESR was elevated significantly(p<0.05).
Back Pain ; Blood Sedimentation ; Constriction, Pathologic ; Discitis* ; Diskectomy ; Female ; Humans ; Incidence ; Laminectomy ; Neurosurgery ; Operative Time ; Reference Values ; Spasm

The presently available neuroradiological techniques including computed tomography and 4-vessel angiography, fail to identify any causes in 13% to 22% of patients with a subarachnoid hemorrhage. Recently, we experienced two small unexpected internal carotid artery aneurysms during the anterior communicating artery aneurysm and basilar tip aneurysm surgery respectively. In general, the approach for aneurysm surgery was confined to the local aneurysm site with local cisternal opening. But we had performeda wide cisternal opening for the anterior communicating and basilar tip aneurysm surgery and we found unexpected angiogrram-negative aneurysm. These findings lead us to propose to a surgical approach of usual intracranial aneurysms. Therefore we recommend the approach of opening predilection sites(including MCA knee portion, ICA bifurcation area) of intracranial aneurysms during all intracranial aneurysm surgery.
Aneurysm* ; Angiography ; Carotid Artery, Internal ; Humans ; Incidental Findings* ; Intracranial Aneurysm ; Knee ; Subarachnoid Hemorrhage

Subdural empyema of the brain is an uncommon disorder that occurs more frequently in children than in adult. Authors report a very rare of subdural empyema following the subdural hygroma after mild head injury. The exact mechanism of infection is not known. However, we have to consider subdural infection as one of differential diagnosis in elderly patient with subdural hygroma when new abnormal density lesion is developed in the subdural space.
Adult ; Aged ; Brain ; Child ; Craniocerebral Trauma ; Diagnosis, Differential ; Empyema, Subdural ; Escherichia ; Escherichia coli ; Humans ; Subdural Effusion ; Subdural Space

Somatosensory evoked potential(SSEP) has been recorded during 31 operations for intracranial aneurysm. We had monitored the SSEP in each stage of aneurysm surgery(preoperative, anesthetic induction, dura opening, temporary vascular occlusion, aneurysm neck clipping and 30 minute after aneurysm neck clipping). Temporary occlusion of intracranial arteries have performed in 21 cases. In cortical amplitude of more than 50% as compared with induction was considered to be "significant" SSEP change. Eleven out of 21 cases of temporary vascular occlusion showed significant decrease of amplitude. Three out of 4 cases with flat wave had new neurologic deficits postoperatively. We studied the relationship between SSEP changes and postoperative neurologic deficit and concluded as follows: 1) The monitoring of amplitude of SSEP may help control the duration and number of application in temporary clipping during aneurysm surgery. 2) Decreased in amplitude with temporary clipping, especially flat wave, is a strong suggestion of the postoperative neurologic deficit. These results indicate that monitoring of SSEP during aneurysm surgery would be helpful to reduce the incidence of postoperative neurologic deficits.
Aneurysm* ; Arteries ; Incidence ; Intracranial Aneurysm ; Neck ; Neurologic Manifestations

OBJECTIVE: This study aimed to assess the results of surgical and endovascular treatments in aneurysmal subarachnoid hemorrhage (SAH) patients older than 70 years. METHODS: This study included 18 patients, more than 70 years of age, treated for ruptured cerebral aneurysms between April 2004 and March 2009. In most cases, patients underwent the early obliteration procedure for each aneurysm, and we compared the clinical results according to the obliteration method (clipping or coiling). We assessed neurological outcomes at 6 months post-procedure according to the modified Rankin Scale (mRS): favorable (mRS score > 2) or unfavorable (mRS score > 2). RESULTS: Of the 18 patients, 12 (66.6%) underwent obliteration of the aneurysm sac via microvascular clipping patients, and 6 (33.3%) underwent endovascular coiling. At 6 months post-procedure, the clinical outcomes were favorable in 6 patients (33.3%), 5 (41.7%) who received microvascular clipping and 1 (16.7%) who underwent endovascular coiling. Unfavorable outcome was not statistically associated with poor initial clinical state, poor Fisher grade, occurrence of stroke, or hydrocephalus, although we frequently noted these variables in the unfavorable outcomes. CONCLUSIONS: In this study, aneurysm obliteration method (microvascular clipping vs. endovascular coiling) did not seem to significantly affect clinical outcomes. A poor initial clinical state, poor Fisher grade, occurrence of stroke, and hydrocephalus seemed to be associated with poor clinical outcomes.
Aged ; Aneurysm ; Humans ; Hydrocephalus ; Intracranial Aneurysm ; Stroke ; Subarachnoid Hemorrhage ; Treatment Outcome

Four cases of primary transitional cell carcinoma (TCC) arising in the ovary (3 cases) and the parovarium (1 case) were collected for clinicopathologic analysis. The mean age was 46.2 years (range, 39-57 years). Two patients complained abdominal discomfort and vaginal discharge, respectively. Other 2 cases were incidentally found from routine check. Grossly, the tumors were solid and cystic (2 cases), solid (1 case) and surface papillary growth on capsule (1 case). Microscopically, the tumor showed almostly same to the histologic features of TCC of urinary bladder. Three cases were pure TCC, and one was mixed TCC and serous carcinoma. FIGO stage were 1 IIa, 2 IIc, and 1 IIIc. Treatment was surgery with adjuvant chemotherapy. Two patients are alive with no evidence of disease, and two have lung or brain metastasis.
Brain ; Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Ovary ; Urinary Bladder ; Vaginal Discharge

Meningioma associated with intratumoral hemorrhage is rarely reported. We present two patients with intratumoral hemorrhage. One 70-year-old man was admitted to our department with a decreased level of consciousness and left hemiparesis. CT scan and MRI scan revealed huge tumor with intratumoral hemorrhage in the frontal lobe. After surgical removal of the tumor, histopathological diagnosis was a meningotheliomatous meningioma. The other seemed patients was 56-year-old woman with headache and vomiting. She showed no specific neurological deficit. CT and MRI scan revealed large size tumor with intratumoral hemorrhage that looks like meningioma. The patient died suddenly before surgery. We reviewed the relevant literature and discussed the possible mechanism of hemorrhage in the meningioma.
Aged ; Consciousness ; Diagnosis ; Female ; Frontal Lobe ; Headache ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Middle Aged ; Paresis ; Tomography, X-Ray Computed ; Vomiting