A Case of Cerebral Cysticercosis

We presented a case of cerebral cysticercosis which involved the right frontal subcortical region. Five years old girl was admitted to the hospital because of repeated vomitings and severe headaches which developed and progressed gradually following head injury 15 days prior to admission. On admission, there were no localizing or lateralizing neurological abnormalities except for bilateral optic papilledemas and signs of increased intracranial pressure. Right carotid angiogram disclosed an avascular zone in the right frontoparietal region suggesting an intracranial space occupying lesion. At operation, rather well circumscribed mass, walnut sized, was found deeply in the right frontal subcortical area but no hematomas epidurally or subdurally. The mass was totally excised. Histological diagnosis of the specimen was cysticercosis to be granulomatous mass in big size. It would be controversial whether cerebral cysticercosis should be operated surgically or not, but surgery may be indicated if there are signs of increased intracranial pressure in the presence of single large granulomatous mass in the portion of the cerebral hemisphere.

A Case of Intracranial Chloroma

Clinical and pathological manifestation of leukemic involvement of the central nervous system have been known from any years. Infiltration and enlargement of organ is quite common in acute leukemia ; however, the formation of solid tumor masses is very rare. Most of the described tumor occur predominantly around the orbits or arise from bones, with only a few cases of soft tissue tumors reported. A case of chloroma is reported, in which a large solid tumor of immature granulocytic cells was over the cerebral convexity compressing the brain diffusely on the right and not preceded by myelogenic leukemia.

A Case of Intracranial Chloroma

Clinical and pathological manifestation of leukemic involvement of the central nervous system have been known from any years. Infiltration and enlargement of organ is quite common in acute leukemia ; however, the formation of solid tumor masses is very rare. Most of the described tumor occur predominantly around the orbits or arise from bones, with only a few cases of soft tissue tumors reported. A case of chloroma is reported, in which a large solid tumor of immature granulocytic cells was over the cerebral convexity compressing the brain diffusely on the right and not preceded by myelogenic leukemia.

Exprimental Injection Injury of the Sciatic Nerve: Part III Physiological Study

This experimental study was conducted in order to observe the change and degree of the functional disability of the sciatic nerve following injection of various drugs such as Rheumapyrine, Chloromycetin, Penicillin and physiological normal saline solution. In clinical practice a serious sciatic nerve injury may result from an erroneous injection of commonly used antibiotics and other therapeutic or prophylactic agents into the gluteal region which can occur at any age, especially common in infants, children and small debilitated patients. Thirty-six normal adult rabbits were divided into four groups depending on injected materials and also divided into two groups of simplex exposure and closure of the nerve and of simple puncture of the exposed nerve with injection needle. The drugs were injected into the right sciatic nerve intraneurally and around the left sciatic nerve perineurally. For the functional study in the nerve, needle electrode was inserted into the calf muscle which was a pick-up muscle, and nerve potential was recorded on an electromyography(EMG) and motor nerve conduction velocity(M.N.C.V.) was also measured in the calf muscle at interval of 3, 7, 10 and 14 days after the injection. In normal control group, electrical activity on EMG was silent in resting state of the muscle and was normal motor unit action potential(normal motor unit) in volition state by demonstrating biphasic or triphasic wave patterns. Distal latency average 1.1 msec and amplitude of action potential was average 6.4 mV. The experimental groups of simple exposure and closure of the nerve and of simple puncture of the exposed nerve with injection needle showed identical EMG findings with those in normal control group. In EMG findings of both groups of normal saline and Chloromycetin injections, there were no significant differences in comparison with those in normal control group. No abnormal E.M.G. findings were observed in the left side where the drugs were injected around the sciatic nerve perineurally. Abnormal EMG findings were observed in both Penicillin and Rheumapyrine injection groups, which showed fibrillation potential and positive sharp wave in resting state and decreased amplitude or reduced numbers of normal motor unit in volition state, along with delayed M.N.C.V. Two of five cases with Penicillin injection showed denervation potentials and delayed M.N.C.N. 10 days after the injection, while all cases with Rheumapyrine injection started to demonstrate the denervation patterns on EMG and delayed M.N.C.V. 3 days after the injection, and these abnormal findings were become more evident and severe to be partial or complete denervation as the time elapsed following the injection. It was postulated that functional and physiological disabilities recorded on E.M.G. were developed after the injection only when there was a severe degree of nerve damages on the basis of histopathological study.

Fibrous Dysplasia: Case Report

Fibrous dysplasia of bone is an uncommon condition of unknown etiology in which the bones become progressively thicker and lose their normal structure. The skull and the bones in other parts of the body are involed in a process characterized by small areas of bone destruction or massive sclerotic overgrowth. They appear denser, although actually are softer, and give a rather homogenous, smeary impression. There may be cyst like areas within the large, dense, homgenous-appearing amorphous bone. Although the skull may be the only area of involvement it is not uncommon to have similar but more cystic appearing lesions in many other bones. The authors report two cases of fibrous dysplasia involving frontal, orbital roof, ethmoid, zygoma and sphenoid bone in the left by which disfiguration of appearance of the face was resulted in association with exophthalmus.

Experimental Injection Injury of the Sciatic Nerve: Part I Histopathology

Sciatic nerve injury can result from intragluteal administration of any kind of antibiotics or other agents therapeutically or prophylactically. This experimental study was conducted in order to observe the histopathological findings of injured sciatic nerve following injection with normal saline, chloromycetin, penicillin and rheumapyrine. Fifty-five experimental normal adult rabbits were divided into 4 groups and various substances were injected intraneurally on the right side and perineurally on the left side. Pathological specimens were then taken at intervals of 1, 3, 7, and 21 days after injection. The results obtained were summarized as follows: 1. Rheumapyrine produced the greatest reaction, penicllin was the next and chlomycetin was the least damaging of the drugs in this study. 2. More conspicuous pathological changes were observed on the right side than on the left side. 3. It was thought that major source of damage to the sciatic nerve was chemical toxicity to the peripheral nerve. 4. Intraneural injections of rheumaphyrine induced irreversible damage on nervous tissue and perineural fibrosis. 5. Intraneural injection of penicillin caused transient reversible damage on nervous tissue with perineural deposition of collagen. 6. Intraneural injection of chloromycetin induced early reversible damage on nervous tissue with persistant inflammatory reaction in soft tissue. 7. Perineural injection of rheumapyrine, penicillin and chloromycetin induced mild damage on nerveus tissue and revealed moderate inflammatory reaction on soft tissue.

Experimental Studies in Cereral Edema: Part II

The experiments were carried out on 48 rabbits weighing between 1.7 and 2kg. The occurrence and changes of experimental brain edema have been studied by calculating wet weight, volume, dry weight, and percentage of both water content and swelling in the rabbits. The brain edema and swelling were produced by expansion of laminaria which was expanded gradually in the supratentorial extradural space of rabbit, and also, the brain edema with swelling were induced by intravenous injection of distilled water and pitressin. The effect of mannitol and steroid to these experimental brain edema with swelling and, especially, the effect and reaction of ethyl alcohol and diphenyl hydantoin on brain edema in distilled-water and pitressin groups were studied and the results obtained are as follows: The weight, volume, and percentages of water content and swelling in the compressed sides of hemisphere showed higher values compared them to the opposite noncompressed hemisphere in the "laminaria-compression" group and showed gradually increasing tendency as the time elapsed. The effect of mannitolization to "laminaria-compression" group showed anti-brain edema reaction while there showed no such effect after steroid injection. The acute brain edema with swelling was demonstrated in pitressin and distilled-water group by showing increased percentages of water and swelling than those of control group. Although the intravenous dilantin injection to these experimental groups showed no appreciable effect on anti-brain edema reaction and effect.