Objective : A few anecdotal cases of mesenchyme-derived tumors which grow into a cranial cavity have been reported that disclosed a dismal prognosis, due to their critical location, aggressive biological behavior, and high rate of surgical morbidity. The aim of this study is to search clinical factors related to these tumors. Methods : Eight patients who underwent surgical removal of intracranial mesenchymal tumors between January 1993 and December 1997 were studied retrospectively. The tumors included are three chordomas, two chondrosarcomas, two rhabdomyosarcomas, and one hemangiopericytoma. Authors compared clinical features, treatment, and results of our cases with reported cases. The mean follow-up period was 20.5 months. Results : All cases showed nonspecific, location-related clinical findings and arose from sphenopetroclival region. Single stage operation was performed in 4 cases, and skull base approaches in 3 cases. Adjuvant therapies were done in 2 cases. Recurrence was seen in 3 cases(37.5%), and 3 patients died. Interdisciplinary approach with otologic surgeon was done in 2 cases. Conclusion : Recent advancement of refined tactics has made these tumors amenable and provides prolongation of progression-free survival. These are modified skull base approaches, multi-modality treatment options, and inter-disciplinary team approaches. Good results may be expected for these mesenchymal tumors by aggressive resection and adjuvant therapies according to their biological nature.
Background: Brain abscess is a life-threatening condition that occurs due to complications during a neurosurgical procedure, direct cranial trauma, or the presence of local or distal infection. Infection in the oral cavity can also be considered a source of brain abscess. Case presentation: A 45-year-old male patient was transported with brain abscess in the subcortical white matter. Navigation-guided abscess aspiration and drainage was performed in the right mid-frontal lobe, but the symptoms continued to worsen after the procedure. A panoramic radiograph showed alveolar bone resorption around the maxillary molars. The compromised maxillary molars were extracted under local anesthesia, and antibiotics were applied based on findings from bacterial culture. A brain MRI confirmed that the three brain abscesses in the frontal lobe were reduced in size, and the patient's symptoms began to improve after the extractions. Conclusion: This is a rare case report about multiple uncontrolled brain abscesses treated by removal of infection through the extraction of maxillary molars with odontogenic infection. Untreated odontogenic infection can also be considered a cause of brain abscess. Therefore, it is necessary to recognize the possibility that untreated odontogenic infection can lead to serious systemic inflammatory diseases such as brain abscess. Through a multidisciplinary approach to diagnosis and treatment, physicians should be encouraged to consider odontogenic infections as a potential cause of brain abscesses.
A vaginal speculum examination of a 17-month-old Holstein heifer with a history of repeated artificial insemination (AI) failures via the cranial vagina revealed the presence of an intact hymen (imperforate hymen) beyond the external urethral orifice, which resembled the vaginal wall. An ultrasonographic examination detected hypoechoic fluid within the vaginal cavity between the intact hymen and the cervix, indicating the presence of hydrocolpos. After sedation and epidural anesthesia, the intact hymen was incised using a scalpel and scissors and removed, while the incised portions were sutured using a simple interrupted method. The heifer became pregnant after three consecutive estruses with the intervals of approximately 20 days and concomitant AIs. The heifer gave birth to a healthy male calf with no complications after a 291-day gestation period. This case reports the presence of an imperforate hymen with hydrocolpos in a Holstein heifer, followed by successful insemination, conception and delivery after removal of the imperforate hymen.
The author studied to determine the sex and age of 8 ancient human skeletal remains, which had excavated from ancient tombs located in Yeanri, Kimhae. Some kinds of personal identification methods their skulls and teeth were used for this study and the results were obtained as follows : 1. Sex determination was possible in ancient teeth from 4th to 5th century, using detection of X-Y homologous amelogenin gene by polymerase chain reaction. 2. DNA analysis proved that the materials examined were all male, but which always did not coincide with the results from other methods for sex determination including comparison of sexual differentiation of cranium and teeth and use of discriminant functions in the dental measurement. 3. There was little difference of the estimated ages between the methods by regression of pulp cavity and attrition in teeth. The ages from these two methods always did not coincide with ones from evaluation closure of cranial and palatal sutures. 4. Sex and age of the materials were determined as follows ; $\cdot$ Y9 was estimated to be male in early sixties. $\cdot$ Yl2 was estimated to be male in late twenties to early thirties. $\cdot$ Y37 was estimated to be male in early forties. $\cdot$ Y70 was estimated to be male in early sixties. $\cdot$ Y87 was estimated to be male in late forties. $\cdot$ Y109 was estimated to be male in early forties. $\cdot$ Yl29 was estimated to be male in late thirties to early forties. $\cdot$ Yl42 was estimated to be male in late fifties to early sixties.
A female Green iguana (Iguana iguana) was brought to the small animal clinic in Hannover Veterinary school because of anorexia and convulsion. Two months ago, the owner bought two iguanas, one female and one male and had to take a female to the one of local small animal clinic because she, born in 19931 didn't eat well and showed the tremor of the legs. The veterinarian suspected it to have a calcium deficiency and gave an injection of calcium and vitamin D3. But still during the last two months, the female iguana did only eat some lettuce while the other male ate lettuce, fruits and commercial cat-food ($Whiskas^{\circledR}$, Effem, Verden). It was not possible to evaluate the rations of these different "food-components". They are kept in the terrarium with water container. By palpation of the abdomen, hard thing like stone was palpated in the mid-region. The blood test wasn't carried out because of the difficulties of getting blood and because of her bad condition. It was firmly diagnosed as cystic calculus through radiography. Since the animal is in shock state already, the prognosis after surgery was bad. It was assumed to be too late to expect its surviving with the surgery carried out or without it. Cystotomy was performed in the cranial ventral paramedian incision in order to preserve the large ventral abdominal vein in the linen alba region. After two stay sutures ("holding suture" ) with 5-0 polyglactin 910 ($Vicryl^{\circledR}, Ethicon$) on the bladder, cystotomy was carried out and the stone inside was removed. Then, the bladder was closed in one-layer sutures. The abdomen was closed in simple interrupted suture with same material after the instillation of 10 ml saline solution into the abdominal cavity. The cystic calculus was in a size of $5.8{\times} 5.O{\times} 3.5 cm$. The analysis of the stone was carried out in two ways which are the infrared spectroscopy of the stone and quick analysis by $Merckognost^{\circledR}$(Diagnostica Merck, Merck). In the result of the infrared spectroscopy, the stone wee composed of 10% ammonium urate and 90% dihydrated uric acid. This iguana wasn't able to survive.n't able to survive.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.14
no.1
/
pp.81-87
/
1984
This study was performed to observe the secondary images and to analyse the relationships between the primary and secondary images in panoramic radiograph. Using the Moritta's Panex-EC panoramic x-ray machine and the human dry skull, the author analysed 17 radiographs which were selected from 65 radiographs of the dry skull that attached the radiopaque materials, and the attached regions of the radiopaque materials were the normal anatomical structures which were important and selected as a regions for the evaluation of the secondary images effectively. The results were as follows; 1. The cervical vertebrae showed three images. The midline image was the most distorted and less clear, and bilateral images were slightly superimposed over the posterior border of the mandibular ramus. 2. In mandible, the secondary image of the posterior border of the ramus was superimposed on the opposite ramus region, and this image was elongated from the anterior border of the ramus to the lateral side of the posterior border of the ramus. The secondary image of the condyle was observed on the upper area of the coronoid process, the sigmoid notch and the condyle in opposite side. 3. In maxilla, the posterior region of the hard palate showed the secondary image on the lower part of the nasal cavity and the medial wall of the maxillary sinus. 4. The primary images of the occipital condyle and the mastoid process appeared on the same region, and only the secondary image of the occipital condyle was observed symmetrically on the opposite side with similar shape to the primary one. 5. In the cranial base, the anatomical structures of the midsagittal portions like a inferior border of the frontal sinus, sella turcica, inferior borderr of the sphenoid sinus and inferior border of the posterior part of the occipital bone showed the simillar shape between the primary and secondary images symmetrically. 6. The petrous portion of the temporal bone showed the secondary image on the lateral side of the sella-turcica, and the secondary images of the posterior border of lesser wing, superior border of greater wing of the sphenoid bone and posterior border were observed on the anterior-superior and inferior region of the sella-turcica.
Objective : Chronic subdural hematoma (CSDH) is known to have a significant recurrence rate. There are different criteria defining the recurrence of CSDH. We evaluated the postoperative course of CSDH and tried to propose the reasonable criteria of recurrence. Methods : We retrospectively examined the medical records and pre- and postoperative CT scans of 149 consecutive patients who underwent surgery from January 2005 to December 2009. Diagnosis was confirmed by CT scanning or MRI. The postoperative courses were either resolved or recurrent. The resolved CSDH was one of the three types; early resolution, delayed resolution, or late resolution. The recurrent CSDH was one of the four types; recurrence without resolution, early recurrence after resolution, late recurrence after resolution, or recurrent-and-resolved type. Results : The CSDH was resolved within 30 days after surgery in 58 (39%) patients, between 1 to 3 months in 62 (42%), and after 3 months in 11 (7%) patients. The CSDH was recurred in 18 (12%) patients. Late resolution or recurrence was more common in the aged. The recurrent hematoma was seen on the same side in 11 patients, on the different side in 7 patients. Recurrence was significantly more common in the thick hematomas. Conclusion : For a working criteria of the recurrence of CSDH, we propose the early recurrence as return of symptoms or reaccumulation of the hematoma after a surgery within 3 months regardless of the location, amount or repeated operations. The late recurrence can be defined as reappearance or enlargement of a liquefied hematoma within the cranial cavity surrounded by the membranes or persistent CSDH beyond 3 months after surgery.
Two-port laparoscopic ovariectomy (Lap-OVE) has been performed in small dogs, using 3-mm and 5-mm portal sites, and is associated with reduced surgical stress and postoperative pain. However, extension of the incision is often needed to extract the ovaries. In this study, we aimed to minimize invasiveness by using smaller-sized cannulas as well as a novel technique for ovary extraction. Lap-OVE was performed on six, healthy female dogs (range, 3 to 7.2 kg) using two 3-mm midline portals. The middle finger of a size M nitrile glove was cut at its base and sterilized preoperatively. The ovary was suspended at the body wall using a 1-0 blue nylon needle, and the ovarian pedicle and ligaments were transected using a 3-mm bipolar forceps. To facilitate the glove passing through the 3.9-mm port, it was turned inside out to expose the smooth inner surface, before being inserted into the abdominal cavity with an applicator. Both ovaries were placed inside, and the mouth of the glove was exteriorized through the port with a laparoscopic grasping forceps. The ovaries were morcellated inside the glove, using Adison-Brown tissue forceps and iris scissors, which enabled safe extraction without incision enlargement. Median incision lengths were 4.3 mm (3.5-mm cranial cannula) and 4.8 mm (3.9-mm caudal cannula). An advantage of this procedure was that there was no need for skin sutures. In conclusion, using our novel technique, sutureless Lap-OVE was possible in small dogs using two 3-mm portal sites without additional incision.
Journal of the korean academy of Pediatric Dentistry
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v.28
no.4
/
pp.709-727
/
2001
The pattern of programmed cell death(PCD) has been examined during the early developmental period of development in mouse embryos, from embryonic day 4.5(E4.5) to E11.5 Embryos from Balb/c breedings were harvested at various embryonic stages between E4.5 and El1.5. Cell death was analysed by in situ terminal deoxynucleotidyl transferase mediated dUTP nick end labeling(TUNEL) staining in tissue sections and whole embryos. At the blastocyst stage(E4.5), a very few apoptotic cells were found in the inner cell mass of the blastocyst. In the early egg cylinder stage(35.0-5.5), a few apoptotic cells were detected in the embryonic ectoderm, the embryonic endoerm and the proamniotic cavity. In the advanced egg cylinder stage(E5.5-6.5), TUNEL-posifive cells were observed in the extra-embryonic ectoderm and extra-embryonic endoderm as well as in the embryonic ectoderm, embryonic visceral endoderm and proamniotic cavity. In the streak stage(E6.75-7.75), many TUNEL-positive cells were found in the ectoplacental cone. In contrast, only very few apoptotic cells were found in the chorion and extra-embryonic endoderm in extra-embryonic regions. In intra-embryonic region, a few apoptotic cells were randomly found in the embryonic ectoderm, mesoderm and visceral endoderm. At the early somitogenesis stage(E8.0-8.5), most apoptotic cells were observed in the most cranial portion of neural fold (neural ectoderm and adjacent ectoderm). At the mid somitogenesis stage(39.0-9.5), the otic placode first showed TUNEL-positive at this stage. Small number of TUNEL-positive cells were also first seen around optic placode and branchial arches. Three streams of TUNEL-positive cells were clearly seen in the cranial region at 59.5-9.75. At E10.5, apoptotic cells were localized in the developing eye, the junctional portion of medial nasal, lateral nasal and maxillary processes, the lateral portion of branchial arches, the junction of bilateral mandibular processes, and apical ectodermal ridges of limb buds. At E11.5, apoptotic cells were noticeably decreased in most area, except the developing limbs and several somites in the tail region. In this study, the global temporospatial pattern of PCD throughout early development of mouse embryos was discussed. It may provide the basis for further studies on its role in the morphogenesis of the embryo.
To establish an animal model of intracranial sparganosis, the fate and behavior of the experimentally inoculated spargana were observed. A total of 102 scolices of spargana were injected into 22 cat brains, and the cats were sacrificed at 2 weeks, 1 month, 3 months and 6 months after the inoculation. Neurosparganosis was established in 77% of the cats. Of 43 recovered worms,19 (44%) were located in the subdural or subarachnoid space,16 (37%) in the brain Parenchyme, and 2 (5%) in the lateral ventricle. One was detected at the diploic space of the skull and 5 were outside the cranial cavity. All but one were alive, and had grown tails. They were distributed in the brain parenchyme randomly. There was no place which they could not invade. No adult was found in the intestine. Cerebrospinal fluid (CSF) was collected before inoculation, 1 week, 2 weeks, 1 month, 3 months and 6 months after inoculation. The level of anti-sparganum IgG antibody in CSF measured by ELISA began to increase above the criteria of positivity 1 month after inoculation. Three months after inocula- tion, the values markedly increased. The present findings reveal that intracranial inoculation of spargana into the brains of cats would be a good animal model of experimental neurosparganosis.
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