No abstract available.

A 48 year-old male with back pain and foot drop had been treated. Studies for myelomatosis were all negative. A plain lumbar spin X-ray showed an erosion of the left pedicle of the first lumbar vertebra. A myelography via lumbar and cisternal routes revealed total block with feather appearance at the upper level of the L2 and the lower level of the T12 vertebra. Pathologic evaluation confirmed the diagnosis of solitary myeloma of the bone. After undergoing almost total excision, followed by radiation, the patient was still doing well.
Animals ; Back Pain ; Diagnosis ; Feathers ; Foot ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; Myelography ; Spine*

A 35-year-old man, with a previous history of intermittent generalized seizure attacks since 13 years of age, presented with status epilepticus and spastic right hemiparesis. Plain skull films showed a mottled, granular calcified core and a surrounding halo of calcification in the subcortical area of the central fissure, and a smooth erosion of the overlying skull inner table. Left carotid angiogram revealed neither definite mass effect nor abnormal vascularities. Surgery through a left parietal craniotomy was performed. Upon direct inspection of the brain a 2.5+/-3.0cm, stony hard, generally circular mass was noted within the left frontal lobe. Although embedded within the frontal lobe, the mass was partially covered by a gliotic cyst which might be made from cortical tissue. The tumor was obviously calcified, demonstrating numerous superficial white excrescences, and readily removed without difficulty. Microscopic, pathological evaluation confirmed the diagnosis of densely calcified arteriovenous malformation. The patient was discharged without any evidence of neurological deficit except dull mentality.
Adult ; Arteriovenous Malformations* ; Brain* ; Craniotomy ; Diagnosis ; Frontal Lobe ; Humans ; Muscle Spasticity ; Paresis ; Rabeprazole ; Seizures ; Skull ; Status Epilepticus

OBJECTIVE: In recent years, the neurosurgeon's role in managing cerebrovascular diseases (CVD) has becomes rapidly challenged and overlapped with other specialists. Furthermore, the patterns of CVD and patient recruitment have also changed. We conducted a retrospective study regarding the practical trends of CVD with reference to the management paradigms at our institute. METHOD: We reviewed all the available data, including the annual reports, the daily department records, the medical records and the radiographic films of the CVD patients who had been admitted to our Neurosurgery Department during the five years between Jan. 2004 and Dec. 2008. RESULTS: The total numbers of CVD operations showed a slight initial increase, but then they remained steady for the latter 3 years. The number of cases of non-angiomatous hemorrhage has been relatively steady, regardless of surgery. The total numbers of treated aneurysms increased, but the main body of this increment was attributed to the initiation of endovascular treatment and increased identification of unruptured vascular lesions. Vascular malformations were sustained with a small number of cases due to referring them to other institutes for radiosurgery, except for the cases that required urgent hemorrhagic evacuation. CONCLUSION: Hemorrhagic CVDs tended to decrease either due to increasing identification before rupture or shifting such patients into a large volume hospital. The increasing awareness of ischemic CVD, the early detection of unruptured aneurysms, and the separation of medical responsibilities from neurologists have all pushed neurosurgeons to make treatment plans in a more cooperative fashion, instead of a competitive way. Neurosurgeons should be furnished with several revolutionary surgical options to widen their scope of managing patients with CVD.
Academies and Institutes ; Aneurysm ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm ; Medical Records ; Neurosurgery ; Patient Selection ; Radiosurgery ; Retrospective Studies ; Rupture ; Specialization ; Subarachnoid Hemorrhage ; Vascular Malformations ; X-Ray Film

A 57 year-old female with severe right facial pain and ptosis, and diplopia had been treated. Neurologic signs showed marked loss of vision, total ophthalmoplegia of the right eye and paresthesia on the 1st division of the right trigeminal nerve. Simple skull X-ray revealed enlarged sella turcica, thining of dorsum sellae, excavation and sharpening of anterior clinoid process with depressed sella floow on the right side. Right carotid angiogram showed a giant aneurysm in the cavernous portion of the internal carotid artery with parital filling of the contrast dye along proximal portion of the internal carotid artery and considerable collateral circulation through the external carotid-ophthalmic artery route. The aneurysm was managed by the internal carotid ligation initially, and 20 days later, followed by thrombectomy and aneurysmorrhaphy successfully. Two months later of the operation, all neurological deficits were completely recovered.
Aneurysm* ; Arteries ; Carotid Artery, Internal ; Collateral Circulation ; Diplopia ; Facial Pain ; Female ; Humans ; Ligation ; Middle Aged ; Neurologic Manifestations ; Ophthalmoplegia ; Paresthesia ; Sella Turcica ; Skull ; Thrombectomy ; Trigeminal Nerve

To determine the incidence, clinical characteristics and coronary angiographic findings of postinfarction angina, clinical course and coronary angiogram were studied in 45 patients with acute myocardial infarction. During a mean follow-up period of 12 weeks, 17 patients(37.8%) developed angina. Of 5 patients with postinfarction angina within 1 week of infarction, 2 patients died during hospitalization, whereas all 12 patients with postinfarction angina which occured more than 1 week after acute myocardial infarction were discharge alive. The frequency of stenosis over 90% and multivessel disease by coronary angiography were 51.7% and 64.7% respectively in patients with postinfarction angina, and 25%, 28.5% respectively in patients without postinfarction angina.
Constriction, Pathologic ; Coronary Angiography ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Infarction ; Myocardial Infarction

OBJECTIVE: Depending on genetic or environmental effects over adolescent development, typical behavioral responses come out in adolescence. Also, alteration of nitric oxide (NO) levels in the brain has been associated with modifications of stress related behavior. Present study was designed to investigate the possible influence of chronic stress from restraint on the generation of depression in adolescent mice, and also to evaluate whether NO has modulatory roles in the behavioral and biological reactions. METHODS: ICR mice exposed to stressful restraint, 2 h per day, was treated with NG-nitro L-arginine methyl ester (L-NAME) (10 mg/kg), a non-selective NO synthase (NOS) inhibitor. To evaluate depression-like behavior in the mice, forced swim test and open field test were performed after the last restraint. To investigate stress-induced changes in the expression level of glial cell-derived neurotrophic factor (GDNF), free-floating immunohistochemistry was performed. RESULTS: The results showed that stressed group has longer immobility time and less crossing number in forced swimming and open field test, and that these stress responses were significantly prevented by L-NAME. Furthermore, decreased GDNF expression in the hippocampus by stress was prevented to that of controls within the L-NAME treated group. CONCLUSION: The results suggest that stress and NO signaling could be involved in generation of depression in adolescence. It also suggested that GDNF might contribute to prevent stress-related behaviors.
Adolescent ; Adolescent Development ; Animals ; Arginine ; Brain ; Depression ; Glial Cell Line-Derived Neurotrophic Factor ; Hippocampus ; Humans ; Immunohistochemistry ; Mice ; Mice, Inbred ICR ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Swimming

Papillary thyroid carcinoma (PTC) is a common lesion, accounting for 70-80% of all thyroid cancers, whereas mucosa-associated lymphoid tissue (MALT) lymphoma of thyroid gland is rare. A simultaneous occurrence of both malignancies is extremely rare. 57 years old Korean woman diagnosed with Hashimoto's thyroiditis at left lobe of thyroid gland where atypical cells of undetermined significance at right lobe. Later, left lobe was confirmed with malignant lymphoma during series of fine-needle aspiration biopsy. Right lobe was interpreted as malignant lesions, such as papillary thyroid carcinoma based on ultrasonography images and previous biopsy results. Total thyroidectomy was performed. Pathology reported papillary thyroid carcinoma at right lobe and MALT lymphoma at left lobe. There were no post-operative complications and no recurrence yet reported. Since an association between Hashimoto's thyroiditis and development of MALT lymphoma has been reported previously, a history of Hashimoto thyroiditis should be suspected MALT lymphoma.
Biopsy ; Biopsy, Fine-Needle ; Female ; Hashimoto Disease ; Humans ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Pathology ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyroiditis ; Ultrasonography

Papillary thyroid carcinoma (PTC) is a common lesion, accounting for 70-80% of all thyroid cancers, whereas mucosa-associated lymphoid tissue (MALT) lymphoma of thyroid gland is rare. A simultaneous occurrence of both malignancies is extremely rare. 57 years old Korean woman diagnosed with Hashimoto's thyroiditis at left lobe of thyroid gland where atypical cells of undetermined significance at right lobe. Later, left lobe was confirmed with malignant lymphoma during series of fine-needle aspiration biopsy. Right lobe was interpreted as malignant lesions, such as papillary thyroid carcinoma based on ultrasonography images and previous biopsy results. Total thyroidectomy was performed. Pathology reported papillary thyroid carcinoma at right lobe and MALT lymphoma at left lobe. There were no post-operative complications and no recurrence yet reported. Since an association between Hashimoto's thyroiditis and development of MALT lymphoma has been reported previously, a history of Hashimoto thyroiditis should be suspected MALT lymphoma.
Biopsy ; Biopsy, Fine-Needle ; Female ; Hashimoto Disease ; Humans ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Pathology ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyroiditis ; Ultrasonography