The application of stereotactic techniques and endoscopy dates back to the beginning of this century and is almost as old as neurosurgery itself. However, endoscopic techniques progressed slowly for several reasons. A reappraisal of endoscopic techniques become popular about 1985. The major indication of endoscope in neurosurgical field is intraventricular procedures. Recently it can be used selectively in the intraaxial mass lesion associated cavity. For example, cystic mass, with liquefied necrosis, blood clot can be approached with endoscope. Authors present its intraaxial application in basal ganglionic hematoma in three patients. Conventional stereotactic guidance of neuroendoscope was done and the hematoma was gently removed through continuous irrigation and suction under video-guidance. The clinical course was uneventful. Brief overview is given of this intraaxial neuroendoscopic procedure.
Endoscopes ; Endoscopy ; Ganglion Cysts* ; Hematoma* ; Humans ; Necrosis ; Neuroendoscopes ; Neurosurgery ; Stereotaxic Techniques ; Suction

Chemotherapeutic agents were evaluated for their effect on the development of urinary bladder tumors, induced by N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) in female Sprague-Dawley rats. For 16 weeks, 0.05% BBN was administered orally, and then chemotherapeutic agents (adriamycin and cisplatin) were injected intraperitoneally for 12 weeks. In our preliminary experimental series, an experimental bladder tumor model induced by BBN was useful in evaluating the effectiveness of chemotherapeutic agents. Cisplatin appears to be effective in inhibiting precancerous histologic changes and carcinoma in rat urinary bladder mucosa by BBN. However, the effectiveness of adriamycin was inconclusive.
Animals ; Carcinogenesis* ; Cisplatin ; Doxorubicin ; Female ; Humans ; Injections, Intraperitoneal* ; Mucous Membrane ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: There was no controlled study on botox injection and neurectomy for treatments of muscle hypertrophy. Although many studies have shown the clinical effects of each treatment, it was not able to evaluate and compare the effects of each treatment because there was no comparison of the two treatments under the same experimental condition. Hence, the aim of this study is to com METHODS: The study was carried out on 21 rabbits. 9 rabbits received botox injection(botox injection group), and neurectomy was performed to another 9 rabbits (neurectomy group). 3 rabbits did not receive any treatment(control group). To compare and analyze the effects of muscular atrophy, muscle was stained with NADH-TR, and the changes in size of the muscle fiber were examined. And the electromyography was examined. In each group, muscle fiber was stained and electromyography was performed 2, 3, and 6 months after injection or operation. RESULTS: In histological test and electromyography, in the neurectomy group, the size of muscular fiber and amplitude of electromyography decreased until 2 months after neurectomy. And decreased results were maintained with the passage of time. It showed irreversible aspect. On the other hand, in the botox injection group, the decrease in the size of muscular fiber and amplitude of electromyography was observed until 2 months after injection. In 3 months after the injection, it was slowly getting back to original size and had almost recovered by 6 months after the injection. It showed reversible aspect. CONCLUSION: This study shows researches about clinical effect of botox injection and neurectomy coincide with the results of experiment under the same experimental condition.
Botulinum Toxins, Type A ; Electromyography ; Hand ; Hypertrophy ; Muscle, Skeletal ; Muscles ; Muscular Atrophy ; Rabbits

No abstract available.
Fractures, Compression* ; Vertebroplasty*

Most anterior communicating artery aneurysms arise in association with ipsilateral, dominant, proximal anterior cerebral artery(A1) segments and, as direct extensions of those vessels, are often somewhat directed toward the contralateral cerebral hemispheres. We classified the directions of the anterior communicating artery aneurysms based on three dimensional orientations of neck orifices and fundus projections which were then described schematically to demonstrate spatial orientations. We also analyzed 32 cases of anterior communicating artery aneurysm who had been operated on during recent 3.5 years according to this classification. Only the difference in the size of aneurysm in relation to the site of aneurysmal neck was statistically significant(p=0.0116), and there were no correlations between A1 hypoplasia and the site of aneurysmal neck, the projection of aneurysmal fundus and the size of aneurysm, and the intraoperative rupture and the projection of the aneurysmal fundus. Although meaningful clinical results could not be obtained, we believe this classification can be very helpful in planning traditional or endovascular surgeries for, and in understanding spatial directions of anterior communicating artery aneurysms.
Aneurysm ; Cerebrum ; Classification* ; Intracranial Aneurysm* ; Neck* ; Rupture

The authors report two cases of high cervical spinal chordomas that were removed via the median labiomandibular glossotomy(MLG) approach. One patient was a 62-year-old female in whom an extradural chordoma was found at the level of C3 vertebra with huge prevertebral extension, and causing dyspnea and dysphagia; the other was a 47-year-old female, found to be suffering from a chordoma of C2 vertebral body, which was found incidentally. After removal of the tumors, ventral instrumented fusions were performed in both patients, who showed good recoveries with only minor complications. The MLG approach is radical, and rarely performed by neurosurgeons, but for treatment of an expanded high cervical lesion that needs ventral surgery and seems to be inaccessible via the conventional transoropharyngeal or anterolateral retropharyngeal route, it should be considered. The authors discuss the clinicopathological characteristics of spinal chordomas and general considerations of the MLG approach to high cervical lesions, and briefly describe the surgical techniques involved in this approach.
Chordoma* ; Deglutition Disorders ; Dyspnea ; Female ; Humans ; Middle Aged ; Spine

For surgical stabilization of thoracolumbar instability either posterior transpedicular fixation or anterior interbody fixation is commonly performed. On some occasions, however, combined ventral and dorsal stabilization is needed, in which case surgery is usually performed in separate stages. To achieve this goal in a single operation, the authors used the crossed-screw fixation technique, with the pedicle screw-rod system, in eight patients. Their thoracolumbar instabilities were caused by trauma(n=6), tumor(n=1), and congenital deformity(n=1). In all patients, signs of myelo- and/or radiculopathy were present, and as this required extensive ventral and dorsal decompression, combined ventral and dorsal stabilizations was considered necessary. Surgery involved the lateral extracavitary approach: for dorsal stabilization, the conventional transpedicular fixation method, with pedicle screws of 5.5-mm diameter, was used. For ventral stabilization, interbody struts were grafted, using rib autograft or in the case of tumor fibula allograft, supplemented with transverse fixation of the vertebral body with pedicle screws of 7.5-mm diameter. The two stabilization systems, ventral and dorsal, were interconnected with cross-linking plates. Follow-up 12 to 26 (average 18) months after surgery revealed no hardware failures, and all patients showed improvement in their neurological functions during this period. Due to congenital deformity, graft dislodgement occurred in one patient. On the basis of these results the authors believe that the crossed-screw fixation technique is a viable option for three-dimensional stabilization of the thoracolumbar spine.
Allografts ; Autografts ; Congenital Abnormalities ; Decompression ; Fibula ; Follow-Up Studies ; Humans ; Radiculopathy ; Ribs ; Spine* ; Transplants

Uterine sarcoma is a rare female neoplasm that accounts for about 2-4% of all uterine malignancies. According to the classification of Norris and Taylor, the subgroup of endometrial stromal sarcoma (ESS), comprising approximately 7-15% of all uterine sarcomas, can be divided into low-grade ESS and high-grade ESS and is characterized by proliferations composed of cells with endometrial stromal cell differentiation. We experienced this infrequent malignant tumor in a 52-year old woman and was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adriamycin chemotherapy. We present a case of low-grade ESS with a brief review of the literature.
Classification ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Middle Aged ; Sarcoma ; Sarcoma, Endometrial Stromal* ; Stromal Cells

Uterine sarcoma is a rare female neoplasm that accounts for about 2-4% of all uterine malignancies. According to the classification of Norris and Taylor, the subgroup of endometrial stromal sarcoma (ESS), comprising approximately 7-15% of all uterine sarcomas, can be divided into low-grade ESS and high-grade ESS and is characterized by proliferations composed of cells with endometrial stromal cell differentiation. We experienced this infrequent malignant tumor in a 52-year old woman and was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adriamycin chemotherapy. We present a case of low-grade ESS with a brief review of the literature.
Classification ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Middle Aged ; Sarcoma ; Sarcoma, Endometrial Stromal* ; Stromal Cells

OBJECTIVE: to determine the frequency of the multiple consecutive rib fracture after blunt chest trauma. DESIGN, MATERIALS, AND METHODS: We retrospectively reviewed all the radiographs and medical charts of 87 patients with rib fractures after blunt chest trauma. Rib fractures were divided into single aud multiple. The multiple rib fractures were subclassified as consecutive, interrupted continuous, or random. RESULTS: Thirteen cases of single and 83 cases of multiple rib fractures were present. Among the 83 cases of multiple fractures, there were 73 cases (88%) of consecutive fractures, 5 cases (6%) of interrupted continuous fractures and 5 cases (6%) of random fractures. CONCLUSION: Among the multiple rib fractures consecutive rib fractrues are much more common than noncontiguous rib fractures. We recommend that if one find an apparently nonfractured rib between contiguously fractured upper and lower ribs, one should meticulously search for possible fracture of an apparently normal rib with high-index of suspicion.
Humans ; Retrospective Studies ; Rib Fractures* ; Ribs* ; Thorax*