Three cases of giant pituitray adenoma are reported. Two cases were operated by transsphenoidal approach and a case by transcranial approach. Transsphenoidal approach showed satisfactory results despite of marked suprasellar extension of tumors. We report rare giant pituitary adenomas with review of relevant literatures.
Adenoma ; Pituitary Neoplasms*

No abstract available.
Communicable Diseases* ; Zinc*

No abstract available.
Carcinoma, Transitional Cell*

The use of steroids has long been reported many side effects. Steroid-induced mental disorder is one of many complications associated with corticosteroid therapy. Steroid psychosis is not common disease but it may be more popular due to high steroid therapy such as pulse therapy or high dose steroid therapy. Euphoria, irritability, insomnia, and hallucination are predominating symptoms. The dosage, duration of the treatment may not be correlated with the time of the onset, duration, severity, or type of mental disturbances, but the risk of developing psychosis is increased to the high dose of steroid. It is usually reversible on dose reduction or discontinuation of the drug.
Euphoria ; Hallucinations ; Mental Disorders ; Psychotic Disorders* ; Sleep Initiation and Maintenance Disorders ; Steroids

PURPOSE: The purpose of this study was to analyze the characteristic MR findings of childhood metachromatic leukodystrophy. MATERIALS AND METHODS: Five female patients (10--29 months old;mean age, 21.8 months) of biochemically confirmed metachromatic leukodystrophy were included in this study. We evaluated the extent of white matter degeneration, which was shown as high signal intensity on T2-weighted image, and the presence or absence of the enhancement. Result.' All 5 cases showed high signal intensity in periventricular deep white matter and centrum semiovale which were bilateral, symmetric and confluent. Posterior predominace, sparing of subcortical U fibers and immediate periventricular white matter, and the involvement of splenium of corpus callosum were also noted in all cases. There were other manifestations, such as 'tigroid pattern' in centrum semiovale (n=4), the involvement of genu of corpus callosum(n=4), posterior limb of internal capsule(n=4), descending pyramidal tracts (n=3), deep cerebellar white matter(n=1), claustrum(n=2), and diffuse brain atrophy(n=1). In three cases with Gd-infusion, contrast enhancement of the lesion was not seen. CONCLUSION: In childhood metachromatic leukodystrophy, MRI can clearly demonstrate the chracteristic extent of the white matter lesion and other associated findings, facilitating the differential diagnosis from other similar leukodystrophies.
Brain ; Corpus Callosum ; Diagnosis, Differential ; Extremities ; Female ; Humans ; Leukodystrophy, Metachromatic* ; Magnetic Resonance Imaging* ; Pyramidal Tracts

Lesions with coronary artery aneurysm (CAA) can become complicated during percutaneous coronary intervention. Here, we report a case of a 78-year-old man who developed a rupture, and spontaneous sealing of the CAA occurred after stent implantation, as shown by computed tomography coronary angiography.
Aged ; Aneurysm ; Congenital Abnormalities ; Coronary Aneurysm ; Coronary Angiography ; Coronary Vessels ; Drug-Eluting Stents ; Ear ; Humans ; Percutaneous Coronary Intervention ; Rupture ; Stents

The authors analyzed and compared three prognostic factors of the intraparenchymal metastatic brain tumors, regardless of therapeutic modalities, to evaluate the value of time-interval between diagnosis of primary cancer and brain metastasis as a prognostic factor. Our of the 109 patients of metastatic brain tumor admitted to Kosin Medical College from 1984 to 1991, 93 patients were included in this retrospective study. The survival time of these patients was statistically evaluated according to each prognostic factor. The results were as follows. Patients with mild or no neurological deficits and patients with moderate neurological deficits showed longer survival than the patients with severe neurological deficits(P<0.001). The presence of systemic metastasis at the time of diagnosis also significantly shortened overall survival(P<0.0095). Primary-to-metastatic interval did not significantly affect overall survival(P<0.6164), but the patients with brain metastasis detected within 1 year after diagnosis of the primary cancer had a longer median survival than those detected after 1 year(P<0.001). We conclude that the primary-to-metastatic interval is not valuable as a prognostic factor for intraparenchymal metastatic brain tumor, and further prospective study tailored to each specific condition will be needed for more accurate evaluation of prognostic factors.
Brain Neoplasms ; Brain* ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Prognosis* ; Retrospective Studies

BACKGROUND: Herpes simplex virus encephalitis (HSVE) is a severe disease resulting in high mortality rates and residual sequelae; therefore, early diagnosis and treatment are very important. The purpose of this study was to evaluate the usefulness of polymerase chain reaction (PCR) assay of HSV DNA in cerebrospinal fluid (CSF) from patients with encephalitis for confirmatory diagnosis of herpes simplex virus encephalitis. MATERIALS AND METHODS: PCR analysis was done to detect DNA of HSV in 31 CSF samples obtained from 21 patients with encephalitis, admitted between November 1994 and June 1996, at the Seoul National University Children's Hospital. As controls, 15 samples from patients with proven diseases other than encephalitis were tested. Two different 22 bp- rimers, complementary to sequences within the DNA polymerase regions of HSV gene, were used. After amplification, PCR products were digested with DdeI to confirm the sequence. RESULTS: Three CSF specimens from 2 out of 21 patients with encephalitis were positive for HSV DNA, whereas all the control specimens were negative. PCR was positive in CSF samples obtained at 3 and 7 days after onset of symptoms from one patient and at 5 days from the other. PCR analysis yielded negative results in CSF samples collected at 10 and 14 days after acyclovir treatment. CONCLUSION: In this study, HSVE was diagnosed by PCR amplification of HSV genome from CSF obtained at early stage of the disease from patients with encephalitis. PCR assay of CSF samples could be used for early and confirmatory diagnosis of HSVE.
Acyclovir ; Cerebrospinal Fluid ; Diagnosis* ; DNA ; Early Diagnosis ; Encephalitis ; Genome ; Herpes Simplex* ; Humans ; Mortality ; Polymerase Chain Reaction* ; Seoul ; Simplexvirus*

Inflammatory pseudotumor is an uncommon lesion with unknown etiology characterized by sclerosing inflammation which clinically and radiographically mimics a neoplastic lesion. A 47-year-old man presented with sudden headache and dysarthria. Brain CT scan revealed a 2.6x2.2 cm sized, round, and hyperdense mass in the anterolateral wall of the left lateral ventricular trigone. On MR imaging studies, the mass showed low signal intensity in the wall of the trigone on T2-weighted image, central mixed (iso- and high-) signal intensity with peripheral low-signal intensity on T1-weighted image. Subtle staining of left choroid plexus with irregular shaped distal branch of anterior choroidal artery was found on the cerebral angiography. These findings suggested a small tumorous lesion originated from the left choroid plexus. During the hospital days, the mass manifested as repeated hemorrhages. The mass was successfully removed via left occipital transcortical approach. The histopathological report of the specimen was hemorrhage and fibrosis, with dense lymphoplasma cell infiltration, suggestive of an inflammatory pseudotumor.
Arteries ; Brain ; Cerebral Angiography ; Choroid ; Choroid Plexus ; Dysarthria ; Fibrosis ; Granuloma, Plasma Cell ; Headache ; Hemorrhage ; Humans ; Inflammation ; Lateral Ventricles ; Middle Aged

A case of rare symptomatic cerebellopontine angle lipoma treated by surgical decompression is described. In this 28-year-old male with intermittent facial pain 17 years, a mass was noted in the right cerebellopontine angle on C-T and MRI. Partial removal of the mass was made for decompression of the lesion from the trigeminal nerve root entry zone. The surgical biopsy results was lipoma. This represents, to our knowledge, the first lipoma in the cerebellopontine angle reportes in the Korean literature.
Adult ; Biopsy ; Cerebellopontine Angle* ; Decompression ; Decompression, Surgical ; Facial Pain ; Humans ; Lipoma* ; Magnetic Resonance Imaging ; Male ; Neuroma, Acoustic ; Trigeminal Nerve ; Trigeminal Neuralgia*