A 63-year-old man had a huge verrucous protruding mass over the suprasternal area. The lesion enlarged rapidly over 3 mooths, and measured about 10×8 cm. The histologic finding of the biopsy specimen showed nests of squamous epithelium with central keratinization, infiltrating the dermis. The neoplasm was treated successfully with surgical excision.
Biopsy ; Dermis ; Epithelium ; Humans ; Keratoacanthoma* ; Middle Aged

PURPOSE: To evaluate MRI(Magnetic Resonance Imaging) findings of miliary tuberculosis of the brain. MATERIALS AND METHODS: Six patients with miliary tuberculosis of the brain diagnosed by characteristic clinical or laboratory findings were studied with spin echo MRI before and after contrast enhancement. We retrospectively evaluated MRI findings acording to the appearance, distribution, location, and enhancement pattern of the granulomas as well as associated other abnormalities. RESULTS: In six patients, contrast-enhanced MRI of thebrain showed numerous punctate, contrast enhancing lesions scattered throughout the brain. Unenhanced MRI failed to demonstrate small granulomas except a few small foci of high signal intensity on T2-weighted images. The shapes of enhancing granulomas were homogeneous nodular enhancement in 86% of cases and small ring enhancement in 14%.98% of granulomas were smaller than 3-mm and 2% were larger. Although several lesions were located in the basalganglia, thalamus, and brain stem, the majority were located in the subpial and subarachnoid space. There was no significant difference in distribution of granulomas between the supratentorial and the infratentorial areas. Other associated abnormalities were focal meningitis in five cases and focal cerebritis in one. On chest radiograph, all patients had miliary tuberculosis in the lungs. CONCLUSION: Contrast-enhanced T1-weighted MRimaging showed numerous round, very small enhancing lesions scattered throughout the brain. The majority of lesions were located in the subpial and subarachnoid space. Contrast-enhanced T1-weighted images are helpful inthe detection and diagnosis of miliary disseminated tuberculous granulomas and meningitis.
Brain Stem ; Brain* ; Diagnosis ; Granuloma ; Humans ; Lung ; Magnetic Resonance Imaging* ; Meningitis ; Subarachnoid Space ; Thalamus ; Tuberculosis, Central Nervous System ; Tuberculosis, Miliary*

PURPOSE: Apoptosis is a process of natural cell death that can occur under both normal and neoplastic conditions and increased apoptosis in neoplastic conditions is a feature of the increasing malignant potential. We investigated the possible relationship between the apoptotic index(AI) and Gleason grade, T stage of prostatic carcinoma. MATERIALS AND METHODS: A total of 31 patients with untreated prostatic carcinoma diagnosed by TURP, transrectal needle biopsy and radical prostatectomy was evaluated. We used in situ end labeling method for apoptotic staining. AI was compared with Gleason grade and T stage. RESULTS: The values of mean AI according to Gleason grade were grade I, 1.3+/- 0.13, II, 1.38+/-0.11, III, 1.92+/-0.20, IV, 2.0+/-0.20, V, 2.01 +/-0.28. A positive correlation was noted between apoptotic index and Gleason grade, but not between apoptotic index and T stage. CONCLUSIONS: We found a positive correlation between AI and Gleason grade and the possibility that AI may serve as an important morphological marker to predict the behavior of prostatic carcinoma.
Apoptosis ; Biopsy, Needle ; Cell Death ; Humans ; Prostate* ; Prostatectomy ; Prostatic Neoplasms ; Transurethral Resection of Prostate

We present a case of meningeal and brain metastasis of multiple myeloma. A 60-year-old woman who had been diagnosed as multiple myeloma two years ago, was referred to neurosurgery department because of headache and nausea. The magnetic resonance image of the brain showed a large epidural mass and the parenchymal enhancement. The patient received an operation of tumor removal and cranioplasty. A histological diagnosis of metastatic multiple myeloma was made.
Brain ; Diagnosis ; Female ; Headache ; Humans ; Immunoglobulin G* ; Middle Aged ; Multiple Myeloma* ; Nausea ; Neoplasm Metastasis ; Neurosurgery ; Plasmacytoma*

The incidence of distal anterior cerebral artery(ACA) aneurysm is relatively rare, and only a few cases of bilateral symmetrical distal ACA aneurysms which were adhered together have been reported. They are also called kissing aneurysms. We treated bilateral symmetrical distal ACA kissing aneurysms in a 44-year-old woman. We successfully clipped the double aneurysmal sacs individually by interhemispheric approach in spite of intraoperative aneurysmal rupture. The patient was discharged without any neurological deficits two weeks after the operation.
Adult ; Aneurysm* ; Anterior Cerebral Artery* ; Female ; Humans ; Incidence ; Rupture

This study is a retrospective clinical analysis of 134 cases of anterior communicating artery aneurysms surgically treated in the Department of Neurosurgery, Chungnam National University Hospital from January 1990 to December 1996. The results of analysis were summarized as follows; 1) Peak age incidence was in the sixth decade and male to female ratio was 1: 1.2, showing female predominancy. 2) There was no statistically significant relationship between direction of aneurysm and Fisher's grade, and occurrence of hydrocephalus, and also between the direction, size and shape of aneurysm and preoperative Hunt-Hess grade. 3) There was statistically significant relationship between the shape of aneurysm and angiographic vasospasm; there was high incidence of vasospasm in lobulated and oval shape of aneurysm. But there was no statistically significant relationship between the direction, size of aneurysm and angiographic vasospasm. 4) The correlations between outcome and preoperative Hunt-Hess grade, and occurrence of angiographic vasospasm, and temporary clipping were statistically significant; the outcome was good in cases of no vasospasm, temporay clipping and better preoperative Hunt-Hess grade. 5) The direction, shape and size of aneurysm, existence or not of abnormality in circle of willis, timing of surgery and operative procedure had no statistically significant relationship with outcome. 6) Postoperative complications were vasospasm and infarction(18.7%), brain edema, hydrocephalus, in order of frequency, and the mortality rate was 3%.
Aneurysm ; Brain Edema ; Chungcheongnam-do ; Circle of Willis ; Female ; Humans ; Hydrocephalus ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Neurosurgery ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative

Hemorrhage due to capillary telangiectasia is rare. We report a case of capillary telangiectasia presenting with repeated cerebellar hemorrhage in a 38-year-old male. To our knowledge this is the first case of repeated cerebellar hemorrhage from the capillary telangiectasia. At the first operation, we removed hematoma only, but rebleeding occurred repeatedly in the same area. Finally, we evacuated the recurrent hematoma and vascular mass of capillary telangiectasia at the second operation under surgical microscope. Based on the findings of this case and a review of the literature, we conclude that capillary telangiectasia can be the cause of the massive repeated hemorrhage.
Adult ; Capillaries* ; Hematoma ; Hemorrhage* ; Humans ; Male ; Telangiectasis*

OBJECTIVE: The goal of this study is to assess the safety and efficacy of the Codman Hakim programmable valve versus differential pressure valve in the treatment of patients with hydrocephalus. METHODS: The authors conducted a retrospective study of 83 patients who were implanted the Codmam Hakim programmable valve and differential pressure valve between January 1996 and April 2001. We analyzed complications, the number of shunt revision, and prognosis between the two groups. We analyzed initial pressure setting, the cause of reprogramming, and the number of reprogramming in Codman Hakim programmable valve. RESULTS: No statistically significant difference was apparent between the Codmam Hakim programmable valve group and a differential pressure valve group in complications, primary disease entities in shunt revision cases and prognosis(p>0.05). And statistically difference was not apparent in the number of shunt revision(p=0.07). The average pressure and range of initial pressure setting in the Codmam Hakim programmable valve was 97.1mmH2O and 50~150mmH2O, respectively. The number of cases of reprogragmming in the Codmam Hakim programmable valve was 12 in total, 1 time in 9 cases , 2 times in 2 cases, and 3 times in 1case. CONCLUSION: The Codmam Hakim programmable valve can decrease shunt revision caused by underdrainage and overdrainage complications. The optimal pressure settting is the key point to decreasing reprogramming and complications in the Codmam Hakim programmable valve and a differential pressure valve.
Humans ; Hydrocephalus* ; Prognosis ; Retrospective Studies

Two cases of aneurysms in the P3 segment of the posterior cerebral artery are described. These were managed by the subtemporal approach. One giant aneurysm in a 47-year-old male was treated by clipping the afferent artery, and the other small saccular aneurysm in a 41-year-old female was treated by clipping the aneurysmal neck. There were no complications after surgery, and the patients were discharged without neurological deficit. The operative approaches and procedures are also discussed in relation to the anatomy of posterior cerebral artery aneurysms.
Adult ; Aneurysm ; Arteries ; Female ; Humans ; Intracranial Aneurysm* ; Male ; Middle Aged ; Neck ; Posterior Cerebral Artery*

OBJECTIVES: With the growing elderly population, there is an increasing interest in the oral and general health of elderly individuals. Loss of teeth is representative of oral disease in elderly individuals and is associated with medical and dental problems. The purpose of this study was to investigate the relationship between the number of remaining functional teeth and cognitive function. METHODS: A total of 456 (111 public health centers, 261 senior centers, 84 sanatoriums) older adults (aged ≥65 years) residing in Korea were included. A mental health nurse examined the cognitive function using the Korean version of the Mini-Mental State Examination. A dentist examined the number of functional teeth and denture status through an oral examination, while a dental hygienist surveyed the subjective masticatory level using a questionnaire. RESULTS: The mean age of the participants was 79.5 years (range 65–97 years), and 76.1% of them were women. Participants with a small number of functional teeth had lower cognitive function. In these participants, the odds ratio with poor cognitive function was 2.30 times higher; it was 2.74 times higher after adjusting for age, sex, residence, education, and denture use, and was statistically significant. CONCLUSIONS: Our study suggested that the number of functional teeth was associated with cognitive function in the Korean elderly population.
Adult ; Aged ; Cognition ; Dental Hygienists ; Dentists ; Dentures ; Diagnosis, Oral ; Education ; Female ; Humans ; Korea ; Mental Health ; Odds Ratio ; Public Health ; Senior Centers ; Tooth