Morphological Changes of Cerebrum in Rabbits Exposed to Microwaves

The author measured the severity of brain damage of 36 rabbits irradiated 2.45 GHz microwave for 10 minutes, 20 minutes and 30 minutes, respectively. Electromicroscopic and light microscopic findings of just after, 1 weeks, 2 weeks and 4 weeks after irradiated brain were compared in each time. Swelling and vacualization of nerve cell and mitochondria were noted. Also these changes tend to increased severity along amount of radiation, but revealed reversible changes with time. Myelinated and unmyelinated nerve fibers were examined as same manner. These nerve fibers also revealed swelling and vascuolization, these findings also tend to increase severity with irradiation power and more prominent at unmyelinated nerve fibers. Reversability of these findings after each time period were more prominent in myelinated nerve fibers than unmyelinated nerve fibers.

Stereotactic Management of Spontaneous Infratenorial Hemorrhage: Part I:Stereotactic Evacuation and Gradual Urokinase Irigation for Spontaneous Brain Stem Hemorrhage

In spontaneous brain stem hemorrhage, efforts are being made to treat the hemorrhage by means of active medical treatment of intricate suboccipital craniectomy. But these efforts are still unsatisfactory in decreasing the high mortality and morbidity. Our recent efforts have got good results in the 11 cases of brain stem hemorrhage by removing the hemorrhage through the application of R.R.W. stereotactic system and gradual urokinase irrigation. The residual hemorrhage following the initial aspiration was completely evacuated by gradual urokinase irrigation through stereotactically placed catheter. Also this catheter was used for monitoring of intrahematomal intracranial pressure for an early stoppage of the increased intracranial pressure or early detecting of rebleeding. This kind of stereotactic evacuation and gradual irrigation with urokinase could remove the brain stem hemorrhage accurately and easily in a short time under the local anesthesia. Mean-while the normal brain tissue is subjected to less surgical trauma by this procedure, which can be interpreted as having a wide indication, a definite advantage, with a low mortality of 27.3%.

Experiences of Stereotaxic Endoscopy

Recently we experienced stereotaxic endoscopic biopsy and resection of intracranial tumors using the Brown-Robert-Wells system. Surgical exploration was undertaken under the local anesthesia:1 germinoma in pineal region, 1 arachnoid cyst in basal cistern. The method is described, and the its potential clinical applications is discussed.

A Case of Cerebral Sparganosis Operated by BRW Stereotaxic System / 영남의대학술지

A patient of cerebral sparganosis is reported: The patient, a 47-year-old female complained of frequent seizures and headache. The disease was involved on right frontal lobe, and the lesion was successfully removed by BRW stereotaxic system. The characteristic features of sparganosis are reviewed.

The Comparision of Histologic & Electrophysiologic Changing Area after Monopolar Coagulation in the Rabbit Brain

Lesions with controlled monopolar coagulation were generated in the cerebral cortex of 20 healthy rabbits. With 28 watts monopolar coagulation, average diameter of histologically changed area around lesion was aout 7.5mm with using Evans blue dye technique. At same time, EEGs in three points, which were 5mm, 10mm & 15mm distant from the coagulated lesion site, were cheched before and just after coagulation. In results, the frequency of EEG was slightly decreased after coagulation, but there were no relation with distance from lesion. But the amplitudes of EEG were decreased as 51.2 micro v(61.2%), 42.9 micro v(3.9) and 34.0 micro v(25.3%) after coagulation, which depended on the distance from site of coagulation. That means electrophysiologically changed area after coaguation was far beyond the histologically changed area.

The Comparision of Histologic & Electrophysiologic Changing Area after Monopolar Coagulation in the Rabbit Brain

Lesions with controlled monopolar coagulation were generated in the cerebral cortex of 20 healthy rabbits. With 28 watts monopolar coagulation, average diameter of histologically changed area around lesion was aout 7.5mm with using Evans blue dye technique. At same time, EEGs in three points, which were 5mm, 10mm & 15mm distant from the coagulated lesion site, were cheched before and just after coagulation. In results, the frequency of EEG was slightly decreased after coagulation, but there were no relation with distance from lesion. But the amplitudes of EEG were decreased as 51.2 micro v(61.2%), 42.9 micro v(3.9) and 34.0 micro v(25.3%) after coagulation, which depended on the distance from site of coagulation. That means electrophysiologically changed area after coaguation was far beyond the histologically changed area.

B.R.W. Stereotaxic Removal of Intracranial Foreign Body

Usually a intracranial foreign body eludes the most intent search despite of C-arm fluroscopy and ultrasonography in operative field. And the usual craniotomy increases brain damage by searching brain parenchyme for intracranial foreign body. Recently we experienced stereotaxic removal of intracranial foreign body with Brown-Roberts-Wells(B.R.W.) system. This approach has been used easily and accurately under the local anesthesia. And it was less traumatic procedure. We present a detailed technique of stereotaxic of intracranial foreign body.

Comparative Clinical Analysis of Surgically Treated Spontaneous Intracranial Parenchymal Hematoma between with Stereotaxic Evacuation and Free-Hand Craniectomy

From Jun, 1983 to Sep, 1986, we operated 127 cases of spontaneous intracranical parenchymal hematoma. Among them, 88 cases were operated by stereotaxic evacuation of hematoma with computed B.R.W. system and 39 cases by free-hand craniectomy and leucotomy. We compared results of both methods. Results are as followings : 1) Nearly 90%(112 cases) were over 40 years old. 2) Prevalence of both sex were nearly same. 3) Hypertension cases on admission were 93 cases(73.2%). 4) Favorite anatomical locations were putamen(55 cases ; 43.3%), thalamus(32 cases ; 25.2%), subcortical(29 cases ; 22.8%), pontine, cerebellum in frequency. 5) Amount of removed hematoma were mostly 10-30ml and upper most case was 145ml. 6) Irrigation with urokinase were done in cases. 7) Surgical complication were 7 cases(5.5%) : 6 cases of reblecding : 1 case of ventriculitis. 8) Mortality of total cases were 26.0%(33 cases). 9) Comparative results between B.R.W. group and F.H.C. group were as followings ;(tab)B.R.W. group(tab)(tab)F.H.C. group(tab)(newline)Mortality(tab)13.60%(tab)(tab)28.20%(tab)(newline)(tab)AD(tab)DC(tab)AD(tab)DC(newline)Glasgow coma scale(tab)11.23+/-3.14(tab)12.72+/-3.87(tab)8.56+/-3.33(tab)10.97+/-4.93(newline)Motor power(tab)2.59+/-1.14(tab)3.44+/-1.27(tab)3.05+/-1.21(tab)3.32+/-1.53(newline)Motor of Putaminal Hx(tab)2.38+/-0.85(tab)3.13+/-1.00(tab)3.20+/-0.94(tab)3.00+/-1.41(newline)

Comparison of Intracranial Pressure on Different Monitoring Sites

To compare intrahematomal pressure(IH) with epidural pressure(EP), lumbar subarachnoid pressure(LP) and intraventricular pressure(IV), 34 intracerebral hemorrhage patients from Dec. 1986 to Aug. 1987 were selected. We measured IH via stereotacically placed catheter and at the same time, we measured EP with fiberoptic sensor, LP by lumbar puncture and IV via stereotactically placed catheter during communication between hematoma and ventricle. The results obtained were as follows : 1) IH was the highest in most cases and IH, IV, LP and EP in orders by mean values. 2) In distribuion of EP, LP and IV compared with IH, EP had wide range of distribution(17~500%) compared to LP and IV. 3) There was a tendency of increased rate of higher IH than EP according to increased size of hematoma. 4) There was a tendency of increased rate of higher IH than EP in thalamic hemorrhage than putaminal hemorrhage. 5) ICP curves showed abrupt increase or decrease in cases of rebleeding or communication between hematoma and ventricle. 6) In analysis of low IH compared with EP and LP, the causes were due to checking of IH just after aspiration of large amount of hematoma(3 cases) and normal variations(6 cases). 7) In analysis of failed monitoring, EP was 5 cases(19%) and IH was 3 cases(8.8%) so more failed monitoring were found in EP than IH and there was no failed cases in LP and IV. From above results, we concluded that IH was the highest in most cases and EP was less reliable than other pressures.

Impedance on the Lesions and Parenchyma of the Brain: With Brain Stereotaxis

From Nov. 1986 to Sep. 1987, we operated 63 cases of intracerebral hemorrhage and brain tumor with B.R.W. stereotaxic method. Among them, the impedance was checked in 40 cases. Results are as followings. 1) In 89.3% of patients, the impedance of hematoma was 1.5 times higher than the mean cortical impedance, in 57.1% of patients it was 2 times higher, and in 32.1% of patients, it was 3 times higher. 2) In the relationship between impedance and nature of hematoma, the impedance of liquified hematoma was higher than clot. 3) In the relationship between impedance and glasgow coma scale, the impedance of patients who were below 9 in score was higher and who were above 10 in score was lower than the mean cortical impedance. 4) The impedance of the low density area surrounding the lesion was lower than the mean cortical impedance by 73%. 5) In the relationship between impedance of the hematoma lapsed over 12 hours was lower than hematoma before 12 hours. 6) In the impedance of the brain tumor, the impedance of the solid lesion was decreased to 85.7% and cystic lesion was decreased 48.3% of the cortical impedance.

The Application and Effect of the Brown-Roberts-Wells Stereotactic System in the Management of Intracranial Lesions / 영남의대학술지

In the past 10 years, modern technology has made deep seated obscure lesions visible. With development of computer technology and various stereotaxic techniques, many new procedures, refinement of old procedures, and development of new applications are possible. The authors are intended to provide a detailed description of our experience with the Brown-Roberts-Wells (BRW) stereotactic system in the evaluation and management of 90 patients with intracranial lesions, and to provide cases presentation of various inaccessible intracranial lesions.

Clinical Analysis of Chemonucleolysis for Treatment of Lumbar Disc Herniation / 영남의대학술지

During last 48 months, in our department 5 patients with single or multiple herniated lumbar discs have received chemonucleolysis. Forty-one of r51 cases have single level herniation and remaining cases have multiple level. Age distribution were from 19 to 59 years old. Over 4 months (longest case: 18 months) follow up revealed as follows: 40 cases (78%) revealed excellent results: 4 cases (7.8%) received discectomy 3-6 months after chemonucleolysis because of recurred symptoms: no anaphylaxis and no major complications were noted.