Angiographic procedures and their applications maybe divided into following roups: I) procedures used to increased blood folw, as the angioplasty, II) procedures used to decreased blood flow, as the embolization and local infusion of vasoconstrictors and III) miscellaneous procedures. Transcatheter vessel occlusion was first performed in 1930 by Brook to occlude the carotid cavernous fistula by embolization of the surgically exposed carotid artery with muscle marked with a sliver clip injected directly into the internal carotid artery. Autologous clot, first used by Doppman(1968) to occlude a spinal arteriovenous malformation was quickly adopted use in traumatic hemorrhage with pelvic fracture, nonoperable aneurysm, gastrointerstinal hemorrhage and diagnosis and treatment of the tumors. In Kores, there have been several reports of transcatheter vessel occlusion after Han(1978) made a first report in the radiology part. In orthopedics part of Korea, Kim(1981) and Yoo(1982) reported the cases of surgical treatments of arteriovenous malformation without embolization. Also, in Korea, there has been no report of transcather embolizations of vascular diseases of the extremities, such as huge arterial aneurysm and dilated varicose vein. We reported the 4 cases who were treated at the Chonbuk National University Hospital between January 1987 and April 1988. Transcatheter vessel occlusion have such advantages : 1. The vascular status of the mass can be recognized prior to operation, such as biopsy. 2. Since the bleeding can be reduce, the operation can be performed easily. 3. Nonoperable huge arterial aneurysm could sometimes be treated only with transcatheter vessel occlusion adequately. 4. It can make a differential diagnosis with other vascular anomaly easy.
Aneurysm ; Angioplasty ; Arteriovenous Malformations ; Biopsy ; Carotid Arteries ; Carotid Artery, Internal ; Diagnosis ; Diagnosis, Differential ; Extremities ; Fistula ; Hemorrhage ; Jeollabuk-do ; Korea ; Orthopedics ; Varicose Veins ; Vascular Diseases ; Vasoconstrictor Agents

No abstract available.
Adenocarcinoma* ; Optic Nerve*

No abstract available.
Brain Edema* ; Brain* ; Decompressive Craniectomy*

Anterior clinoid process is a small bony structure but it is very important regarding its location and relationships with neighboring neurovascular, dural, and bony structures. Removal of this process has been used in various modification of standard pterional approach. The authors have speculated how much expansion of operative window could be obtained with anterior clinoidectomy, so we measured the lengths of optic nerve, internal carotid artery, and the length and width of optico-carotid triangle(OCT) before and after extradural anterior clinoidectomy 17 times in 10 cadaveric heads. This procedure provided about two fold increase in the length of optic nerve and OCT, and over three fold expansion in the width of OCT. The results indicate that the addition of this relatively simple and easy procedure to standard approach makes the operative field more comfortable and safe than expected. We believe this procedure can be used routinely with or without combination of wide skull base exposure in cases of such lesions as belows: 1) lesions causing optic nerve or chiasmatic compression, 2) lesions encircling/covering the optic nerve and internal carotid artery, 3) lesions arising from or extending into the optic canal, orbital apex, and paraclinoid region, 4) suprasellar/parasellar lesions with limited operative windows(e.g. prefixed chiasm, infra-optic or subchiasmatic locations or adherence).
Cadaver* ; Carotid Artery, Internal* ; Head ; Optic Nerve* ; Orbit ; Skull Base

Ipriflavone (isoprofoxyisoflavone), a synthetic derivative from soy isoflavone diazein, has been shown to inhibit bone resorption and perhaps stimulate bone formation. This study was performed to examine the effects of ipriflavone on the proliferation and bone remodeling in rat calvarial cells in vitro. The rat calvarial cells were isolated from fetus aged 20 to 21 days and cultured in BGJb media. The graded concentration of ipriflavone (10(-9)-10(-5) M) was administered into cultured cells. When the cell proliferation was estimated through the measurement of MTT assay, there was no increase in cellular proliferation of the rat calvarial cell at any ipriflavone concentration. The cellular activity was evaluated through the formation of mineralized nodules stained by alizarin red. The formation of mineralized nodules significantly increased at concentrations of 10(-8) M, 10(-7) M and 10(-6) M ipriflavone. Reverse transcription-polymerase chain reaction analyses (RT-PCR) were done at 7 and 14 days after culture to detect the expression of Bone Sialoprotein (BSP), Type I Collagen (COL I) and Osteocalcin (OCN). As a result, the expressions of BSP and COL I increased on the 7th day of culture and the expression of OCN increased on the 14th day of culture. These results indicate that ipriflavone facilitates the bone remodeling process by promoting rat calvarial cell differentiation and stimulating mineralization through increased expression of extracellular matrix genes, such as BSP, COL I and OCN.
Animals ; Bone Remodeling* ; Bone Resorption ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Collagen Type I ; Extracellular Matrix ; Fetus ; Integrin-Binding Sialoprotein ; Osteocalcin ; Osteogenesis ; Rats*

Among the radiographs for temporomandibular joint, transcranial radiograph is widely used for screening and diagnosing temporomandibular disorder because it has sharp image and it is easy to take. This study was performed to compare condylar position and image sharpness in standard and individually corrected transcranial radiographs using Accurad-200 headholder. Submentovertex view, Reverse-Towne view, Standard and individually corrected transcranial radiographs of 45 university students who were randomly selected were traced, measured and analyzed. The results were as follows: 1. The means of condylar axes and lateral slopes were 16.8degrees and 22.5degrees respectively. There were no differences between male and female or right and left side. 2. Individually corrected radiographs showed smaller posterior joint space and larger anterior joint space than standard radiographs, but superior joint space did not show a statistical difference between standard and individually corrected radiographs. 3. While a large number(42.2%) of the standard radiographs showed concentric condylar position, lots of(57.8) condylar positions were retropositioned in the individually corrected radiographs. 4. The image sharpness was inferior in the individually corrected radiographs to that of the standard radiographs.
Female ; Humans ; Joints ; Male ; Mass Screening ; Radiography* ; Temporomandibular Joint Disorders ; Temporomandibular Joint*

Usually, acute subdural hematomas (ASDHs) result from head trauma and require urgent surgical treatment. However, there have been many reports of rapid spontaneous resolution of ASDHs since 1986. Recently, we experienced a case of a massive ASDH that resolved spontaneously within 1.5 days. A 76-year-old man was admitted to a local hospital after a head injury. According to his clinical records, his initial neurologic status was good (Glasgow Coma Scale score of 14). However, his head computer tomography (CT) scan demonstrated a massive ASDH to the right, with a significant midline shift. Based on his neurological status and general condition, surgery was not considered, and the patient was closely monitored in the intensive care unit. The next day, the patient was transferred to our hospital as requested by his family, after which his neurological state stabilized, and the customary follow-up brain CT was performed. It was about 32 hours after the patient's head injury, and it revealed an unexpected finding, near-total resolution of the ASDH. Herein, we review previously reported similar cases and relevant mechanisms of rapid resolution of the ASDH. We believe that neurosurgeons should comprehensively assess the patient's condition and CT findings and provide appropriate treatment, especially when surgical intervention is unnecessary.

Cysticercosis is a relatively common disease in Korea. Racemose cysticercosis, a peculiar form of the neurocysticercosis usually occurs as meningeal forms and rarely involves the cerebral parenchyme. The authors present a case of cerebral parenchymal racemose cysticercosis in a 55 year-old man with generalized seizure. Brain CT and MRI showed a large multilobulated cyst in the right frontal lobe. At surgery, we removed cyst covered by milkish white, multiple septated membranes completely. Histological dignosis of surgical specimen was racemose cysticercosis without scolex.
Brain ; Cerebrum ; Cysticercosis* ; Frontal Lobe ; Humans ; Korea ; Magnetic Resonance Imaging ; Membranes ; Middle Aged ; Neurocysticercosis ; Seizures

OBJECTIVE: In severe head injury or postoperative patients with increased intracranial pressure(IICP) in spite of indroducing barbiturate coma therapy, mannitol, and diuretics infusion, we try hypertonic saline infusion therapy as a new treatment modality and observe its relating results and complications. METHODS: Eleven patients that were treated using hypertonic saline infusion were analyzed. They showed decreased Glasgow coma scale(GCS) or aggravated brain swelling on brain CT scan in spite of conventional therapy for IICP using barbiturate coma and mannitol infusion. We infused 3% hypertonic saline with the rate of 40~60cc/hour. Our goal in using 3% hypertonic saline is to increase the serum sodium level in the range of 150 to 155mEq/l. Serum electrolyte level were monitored every 6 hours and the rate of infusion was controlled according to the current serum sodium level. The therapy was continued until each patient demonstrated clinical improvement, complication of therapy, or lack of response. RESULTS: Six cases showed improvement of GCS. One case was expired due to lung problem even though GCS was improved. Two cases showed persistent vegetative state and other 2 cases never showed any response. All expired cases were head injury patients whose GCS score were lower than 5. There was no hypertonic saline infusion related complications. CONCLUSION: Hypertonic saline therapy are very easy and effective adjunctive therapeutic modality for the patient with severely IICP that is refractory to conventional method. To establish this method as standard therapeutic regimen for the intracranial hypertension, more cases analysis should be necessary to confirm the safety and effectiveness.
Brain ; Brain Edema ; Coma ; Craniocerebral Trauma ; Diuretics ; Humans ; Intracranial Hypertension ; Intracranial Pressure* ; Lung ; Mannitol ; Persistent Vegetative State ; Sodium ; Tomography, X-Ray Computed

Rathke's cleft cysts are believed to be derived from remnants of Rathke's pouch, a dorsal invagination of the stomodeum. Although these cysts are characteristically small, asymptomatic and intrasellar in location, they occasionally provoke symtoms with enlargement to compress surrounding structures. It is characteristically lined by stratified squamous epithelium with keratinization on a layer of connective tissue. The cells of the anterior pituitary lobe, from which pituitary adenomas develop, are also formed by the proliferation of the anterior wall of Rathke's pouch. Thus, Rathke's cleft cyst and pituitary adenomas are considered to have a common ancestry. We report a rare case in which the preoperative diagnosis was pituitary adenoma, but the pathologic diagnosis was a combination of a Rathke's cleft cyst and a coincidental pituitary adenoma.
Adenoma* ; Central Nervous System Cysts ; Connective Tissue ; Diagnosis ; Epithelium ; Pituitary Neoplasms*