Histopathological diagnosis of brain stem glioma should be performed for the purpose of the determination of its management and clinical course, but its surgical biopsy has been followed by high mortality and morbidity. We performed the tissue sampling for histological examination with BRW stereotaxic system under local anesthesia successfully.
Anesthesia, Local ; Biopsy* ; Brain Stem* ; Brain* ; Diagnosis ; Glioma* ; Mortality

No abstract available.

No abstract available.
Erythroblastosis, Fetal* ; Humans ; Immunoglobulin G* ; Infant, Newborn ; Infant, Newborn* ; Mothers*

With improvement of computerized tomography(CT), stereotaxic surgery has been applied for neurosurgery ; aspiration of deep-seated brain lesions, radiotherapy using a small radiogenic sources, and evacuation of hematoma. And so, a prototype Brown-Roberts-Wells(BRW) CT stereotaxic system has been avaible to us. We report its utilization in evaluation and management of less accessible brain lesions. Surgical exploration was undertaken in 25 patients with various less accessible brain lesions using BRW system : 9 superficial lesions including the motor cortex and multiple lesions, 5 deep-seated lesions, 3 parasellar lesions, 8 brain stem lesions. Histologically, there are 5 gliomas, 4 metastatic cancers, 8 hematomas, 3 brain abscesses, 1 medulloblastoma, 1 malignant melanoma, 1 cryptic AVM, and 2 undiagnosed cases. There are two complications : 1 intratumoral bleeing, 1 rebleeding. The diagnostic rate is 92%. There is no mortality in this series. This BRW CT-guidance stereotaxic approach for less accessible lesions have following advantages ; 1) accurate, simple and safe ; 2) performed under local anesthesia ; 3) less traumatic and low cost ; 4) easily diagnosed ; 5) relatively no limitation in lesion sites.
Anesthesia, Local ; Brain Abscess ; Brain Stem ; Brain* ; Glioma ; Hematoma ; Humans ; Medulloblastoma ; Melanoma ; Mortality ; Motor Cortex ; Neurosurgery ; Radiotherapy

Craniopharyngioma is one of the most challenging, Frustrating, and humbling benign intracranial tumors of childhood. Its behavior is a clinical malignancy even though it is benign tumor in microscopically. There is no single treatment of craniopharyngioma and there must be a plan customized for eacg patient. This decision may, be made from diagnostic studies alone, but in most cases exploration of the tumor and the testing of its adherence to its surroundings will be the only thorough and fair way to determine whether it can be totally excised or not. So the choice of treatment is "individualize". We experienced one case of giant cystic craniopharyngioma and performed combined operaion whih were percutaneous intermittent drainage of cystic fluid through Ommaya reservoir and following microsurgical radial excision. There was no complication and marked intellectual and psychological improvement until todays for 20 months.
Craniopharyngioma ; Drainage* ; Humans

Clinodactyly is defined as an angulation of a digit in the radio-ulnar plane. This anomaly can be congenital, dominantly inherited, or acquired due to trauma or inflammation. Although the deformity usually causes little functional impairment, correction is made because of cosmetic problems. Male subject, with polydactyly on thumb(Wassel's type VII) received first surgery at the age of one. And at the age of six, abnormal growth on the radial side of the first metacarpal bone and ulnar deviation of the distal phalanx of the thumb at the interphalangeal joint had developed. The authors used the growing bony segment from the first metacarpal bone as a bone graft for the correction of clinodactyly on thumb. Z-plasty incision was made on the concave(ulnar) side of thumb and a wedge osteotomy was made on the distal phalanx. The bone graft was inserted into the gap of the distal phalanx of the thumb and fixed it with K-wires. Deformity of the metacarpal bone and clinodactyly on thumb was corrected effectively without donor site morbidity with noticible growth of the grafted metacarpal bone 12 months after surgery.
Congenital Abnormalities ; Humans ; Inflammation ; Joints ; Male ; Osteotomy ; Polydactyly* ; Thumb* ; Tissue Donors ; Transplants*

The incidence of multiple meningiomas found prior to the introduction of CT was 1~2%, the incidence since the introduction of CT was 8.9%. The authors report a case of multiple meningiomas without evidence of von Recklinghausen's disease. The possible presence of more than 1 tumor in a patient with an intracranial meningiomas must always be kept in mind. The pathogenetic factors related to true multiple meningiomas in unknown. We report a patient with multiple meningiomas which was confirmed by operation.
Humans ; Incidence ; Meningioma ; Neurofibromatosis 1

Astrocytoma in the thalamus in not so frequent in incidence (1%). Moreover, bilateral thalamic tumor is rare. Certain tumors of the thalamus are considered resectable but most of thalamic tumors are thought to be untouchable. Bilateral thalamic astrocytoma with hydrocephalus was diagnosed by stereotactic biopsy and ventriculoperitoneal shunt operation was done with result of improvement. We report a case of astrocytoma in the bilateral thalamus with literature review.
Astrocytoma* ; Biopsy ; Hydrocephalus ; Incidence ; Thalamus* ; Ventriculoperitoneal Shunt

Usually cases of brain stem hemorrhage reveal high mortality and poor prognosis in spite of meticulous medical or surgical treatment. Recently we experienced stereotaxic evacuation of brain stem hemorrhage with Brown-Robert-Wells(B.R.W.) system in four cases. If there were residual hemorrhage after initial aspiration, those were evacuated with Urokinase irrigation via stereotaxically placed catheter in the hematoma. The entry point of our operation get on the crossing point of midpupillary line and 1cm behind coronal structure. Preliminary results : 1) Volume of removed hematoma : 5ml(average). 2) Dates of urokinase irrigation : 2 to 4 days after operation. 3) No hydrocephalus, no surgical mortality. 4) Average Glasgow coma scale was improved from 6 in preoperative state to 12 in postoperative state. 5) Operation was performed within 24 hours. 6) Advantages of our procedure. (1) Accurate, simple and safe. (2) Under local anesthesia. (3) Less traumatic procedure. (4) Could remove hematoma completely with Urokinase.
Anesthesia, Local ; Brain Stem* ; Brain* ; Catheters ; Glasgow Coma Scale ; Hematoma ; Hemorrhage* ; Hydrocephalus ; Mortality ; Prognosis ; Urokinase-Type Plasminogen Activator

PURPOSE: Autologous fat grafting is a popular procedure for the correction of the soft tissue depression and deformity. But there are several issues required to be carefully considered in relation to this procedure, mainly about the unpredictability and the low survival rate of the grafted fat due to absorption and partial necrosis. Sphingosine-1-phosphate (S1P) is a lysophospholipid mediator that has been proposed to promote angiogenesis and to regulate the differentiation of adipose derived stromal cells (ASCs). In this study, we analyzed the viability of the grafted fat tissue mixed with S1P into each 12 nude mice (cann.cg-fox1nu/crlori) compared to the group of mice grafted fat tissue only. METHODS: Human aspirated fat was grafted subcutaneously into the backs of 8-week-old nude mice with or without S1P. Eight weeks later, the grafted fat was harvested and the weight and volume were checked. The fat was stained with hematoxylin-eosin and 4',6-diamidino-2-phenylindole. RESULTS: S1P group weighed significantly more than the control group (p=0.009), and the volume from the S1P group was considerably larger than that of the control group (p=0.004) either. In histological features, the surviving layer of the S1P group was thicker than the control group and microvasculature appeared to be prominent in the S1P group, especially in the outer layers. CONCLUSION: These findings suggest that S1P plays a vital role in the soft tissue augmentation, potentially providing a novel point of the control in adipose tissue for microfat graft.
Absorption ; Adipose Tissue ; Animals ; Congenital Abnormalities ; Depression ; Humans ; Indoles ; Lysophospholipids ; Mice ; Mice, Nude ; Microvessels ; Necrosis ; Sphingosine ; Stromal Cells ; Survival Rate ; Transplants