We reviewed 13 patients treated in the Department of Neurosurgery of the Presbyterian Medical Center from 1979 to 1982 who had tumors in the region of the pineal body. The treatment of such tumors has been in a state of flux between conservative therapy(cerebro-spinal fluid shunting and radiotherapy) and direct surgical removal. We compared both modes of treatment and analysed the patients in terms of clinical, pathological and radiological points of view. Good results were obtained by supracerebellar and infratentorial surgical approach.
Humans ; Neurosurgery ; Pineal Gland ; Protestantism ; Radiotherapy

It has been suggested that hormonal manipulation may be proved to be an alternative mode of therapy, especially in cases of unresectable or recurrent meningiomas, and the effect of the endocrinological therapy may be influenced by the presence or absence of hormone receptors in meningiomas. The assessment of biological behavior of the tumors is important to plan postoperative adjuvant therapy and follow-up schedules, and the evaluation of cell proliferative activities has been known to be valuable in prediction of recurrence and aggressiveness of meningiomas. The purpose of this study was to investigate the status of hormone receptors and cell proliferative activities, and to determine the relationship between nucleolar organizer regions(AgNORs) and flow-cytometric methods in evaluating cell kinetics of meningiomas. Cytosolic estrogen receptors(ER) and progesterone receptors(PR) were studied in meningiomas removed from 43 patients. Cell proliferative index(PI) based on tumor cell-cycle stage(%S+%G2M) was calculated by flow-cytometic studies of paraffin- embedded meningioma tissue blocks, and the mean number of AgNORs per cell was measured by silver-colloid staining technique. Evaluable results of hormone receptors, PI, and AgNORs could be obtained in 40, 37, and 41 of original meningiomas, respectively. Significant levels of ER(ER+) were found in 27.5% of the patients, while significant PR levels(PR+) were detected in 40%, PR+ were found in 14(40%) of 35 benign meningiomas but in all of the one atypical and one malignant meningiomas. It appeared with the anaplastic histological features of necrosis or brain infiltration had higher incidence of PR+ than the tumors without them, and the higher the cell proliferative activities, the higher the incidence of PR+PI of two atypical and one malignant menigiomas were rather higher but the number of AgNORs of them were significantly higher than thoes of thirty benign meningiomas(p<0.05). The tumors with the histological feature of mitotic figures had proliferative activities than those without mitotic figures(p<0.05). Thirty-three percent of the benign meningiomas had the PI value higher than 30%, and about twelve percent of the benign meningiomas had the AgNORs greater than 2.5 per cell. a linear correlation was demonstrated between PI and the number AgNORs(r=0.71, p<0.001). These results suggest that antiprogesterone therapy may be of use in treatment of highly proliferative or aggressive meningiomas, and the number of AgNORs showing correction with PI may reflect the cell kinetics well and be of value in predicting recurrence of meningmas and in planning postoperative adjuvant therapy.
Appointments and Schedules ; Brain ; Cytosol ; Estrogens* ; Humans ; Incidence ; Kinetics ; Meningioma* ; Necrosis ; Nucleolus Organizer Region ; Progesterone* ; Receptors, Progesterone* ; Recurrence

Prostatic adenocarcinoma is a common genitourinary malignancy which frequently is assiciated with bony metastasis at initial diagnosis. The detection of bony metastasis is important because it often alters the therapeutic strategy. The radionuclide one scintigraphy is known to be the most sensitive diagnostic method in detecting bony metastasis from prostatic adenocarcinoma. In the histologic grading of prostatic adenocarcinoma, the Gleason's grading system is the most widely employed one which is based on the degree of glandular differentiation and the growth patterns of tumor in relation to the prostatic stroma. The purpose of this study is to know the correlation of Gleason's grade and bone scintigraphic findings in prostatic carcinoma. We analyzed 99mTc-diphosphonate bone scintigraphies of 19 cases with prostatic adenocarcinoma confirmed by transurethral prostatic biopsy. Ten of the 19 cases showed asymmetrical multiple radioisotope uptake suggesting bony metastases and their Gleason's grade were 4 or 5 in seven cases. The remaining three cases were Gleason's grade 2 or 3. Another nine cases showed symmetrical radioisotope uptake with normal renal imaging suggesting no bony metastases and their Gleason's grade were 1,2 or 3 in seven cases. The remaining two cases of these nine cases were Gleason's grade 4 and 5. As the results, there was a correlation between the Gleason's grade and bone scintigraphic findings. The asymmetrical multiple skeletal uptake of radioisotope may suggest that the Gleason's grade is likely to be higher.
Adenocarcinoma ; Biopsy ; Diagnosis ; Methods ; Neoplasm Metastasis ; Radionuclide Imaging

A lesion in the cervico-thoracic junction can be of interest to neurosugeons, not only because its incidence is quite low, but also because there is not a published proper anterior approach. Currently the authors have experienced two cases of degenerative disease and one case of traumatic dislocation of the cervico-thoracic junction, in which the main lesions were located in the interspace or posterior portion of vertebral bodies at the junction between the cervical and thoracic spines and an anterior approach to the lesions should be considered. A supraclavicular approach has applied to these cases, by which a good surgical field was obtained. Furthermore the surgical results were good without any serious complication.
Dislocations ; Incidence ; Spinal Fusion ; Spine

No abstract available.
Blood Glucose ; Diabetes Mellitus, Type 2 ; Humans

No abstract available.
Fractures, Compression* ; Vertebroplasty*

BACKGROUND AND OBJECTIVES: Abundance of Japanese cedars (JC) in Cheju Island has caused some of the island's residents to suffer from severe allergic symptom in the spring time. This study was carried out to verify the presence of JC allergic rhinitis (AR) in the island. Materials and Method: We performed a history survey, skin testing and nasal provocation test to JC and other common allergens for 170 residents who have symptom of AR. We also performed the same tests in 18 Japanese who had history of AR to JC and have lived in Korea more than 3 years. And as a control, skin tests were performed for 581 patients who live in Seoul. RESULTS: Positive reactions to JC were seen in 22.4% of the resident group. The prevalence rate was remarkable in the state capital of Cheju. These reactions were associated with conjunctivitis, dermatitis, asthma and food allergy. All the 18 Japanese patients were sensitive to JC. However, the allergic symptoms disappeared within 1 year after the move to Korea. And there were no patients sensitive to JC in the control subjects. Conclusions: We confirmed the presence of AR of JC in Cheju island. The distribution is comparatively coincided with JC and/or air pollution and this result indicate that environmental factors can be involved in the manifestation of the disease.
Air Pollution ; Allergens ; Asian Continental Ancestry Group* ; Asthma ; Conjunctivitis ; Cryptomeria* ; Dermatitis ; Food Hypersensitivity ; Humans ; Jeju-do* ; Korea ; Nasal Provocation Tests ; Prevalence ; Rhinitis* ; Seoul ; Skin Tests

Fifteen cases of diffuse axonal injury(DAI) brought about by nonmissile head injury in humans are analyzed. All cases were subjected to comprehensive clinical studies such as measurement of cerebral blood flow by SPECT, continuous intracranial pressure monitoring and multimodality evoked potentials(MEPs). In the patients with DAI, a high incidence of low cerebral perfusion and abnormal MEPs. especially auditory evoked potentials, were found, with high incidence of high velocity traffic accident injury mechanism. On the other hand, a low incidence of increased intracranial pressure was found and dehydrating agents such as glycerol and mannitol did not exert a beneficial influence upon the clinical courses or the outcomes. The outcome of the patients with DAI depended upon the duration of coma and whether or not brain stem signs were noted.
Accidents, Traffic ; Axons ; Brain Stem ; Coma ; Craniocerebral Trauma ; Diffuse Axonal Injury* ; Evoked Potentials* ; Evoked Potentials, Auditory ; Glycerol ; Hand ; Humans ; Incidence ; Intracranial Pressure* ; Mannitol ; Perfusion ; Tomography, Emission-Computed, Single-Photon

CSF shunting procedures are widely employed in the treatment of hydrocephalus and other disturbances of the dynamics of CSF such as a rachnoid cyst and syrinx. The relative simplicity of this operation with respect to other neurosurgical procedures is matched by a high incidence of complications. Many kinds of shunt devices have been developed to reduce complications. Yet, this operation frequently requires surgical revision. Traditional shunts were primarily designed to manage hydrocephalus by regulating intracranial pressure. Those devices, in some circumstances, can cause to underdrain or overdrain CSF and may need a surgical revision to adjust the pressure Authors have treated 28 patients with the disturbaces of CSF dynamics using pressuread justable valve system (Codman-Medos p rogrammable Hakim valve system). Two patients had arachnoid cysts and the others had hydrocephalus with various etiologies. Subdural hygroma was developed in 5 patients and underdrainage was observed in 9 patients on CT scan. By adjusting the pressure, Authors achieved clinical improvements without a need for surgical revision. The optimum pressure was 97.4+17.4mmHO for the patients with hydrocephalus with various etiologies in adults. In conclusion, the incidence of shunt revision by using this shunt device for the treatment of hydrocephalus and arachnoid cysts was decreased.
Adult ; Arachnoid Cysts ; Humans ; Hydrocephalus ; Incidence ; Intracranial Pressure ; Lymphangioma, Cystic ; Neurosurgical Procedures ; Reoperation ; Subdural Effusion ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt*

We reviewed the cases of 9 patients with vascular lesions in thalamus, 5 hemorrhage and 4 infarctions that were confirmed clinical and CT findings. Generally CT scan and clinical datas proved to be helpful to the diagnosis and prognosis to thalamic lesion. However, these findings are not exactly correlated to prognosis of patients. We can gain more informative factors to our patients for Multimodal evoked potential examination (MEP) to analysis. Especially in our cases, MEP findings proved to be the most effective results in the determinations of the prognosis. We review the literature and discuss the treatment and discuss the treatment and prognosis in thalamic lesion. Emphasis is placed on the current and optimal method of the evaluation of prognosis in thalamic lesions using MEP combined with the finding of CT scan and clinical status.
Diagnosis ; Evoked Potentials* ; Hemorrhage ; Humans ; Infarction ; Prognosis ; Thalamus* ; Tomography, X-Ray Computed