External Rhinoplasty Approach for Transsphenoidal Surgery of Pituitary Tumor

The sublabial approach for transseptal transsphenoidal surgery of pituitary tumors has been the most popular procedure since Cushing first introduced this technique in early 1900's. In recent years, various modifications for transseptal route and their obvious advantages over the sublabial approach have been reported. Currently, in our institute, the preferred method is the external rhinoplasty approach, suggested by Braint and descried by McCurdy. After experiencing 54 cases since 1995 DEC, we found this technique simple, providing good exposure and short distance for instrumentation, preserving nasal tip projection, avoding postoperative numbness of upper teeth and especially beneficial to revision surgery when septal cartilage has been removed by a previous sublabial approach and to surgery for acromegaly patients.

A Case of Parital Sinus Pericranii

Sinus pericranii is a rare vascular anomaly which is defined as a group of abnormal communications between the extracranial and intracranial venous systems, usually involving the superior sagittal sinus. A case of parietal sinus pericranii is presented which was developed spontaneously. This 33-year-old woman presented with a soft fluctuant mass in the right parietal region adjacent to the midline. She complained of headache and dizziness. The preoperative radiologic findings of simple skull, bone scan, computed tomography and angiography are presened. The presence of vascular endothelium in the pathologic examination suggested a congenital origin. The lesion, pericranial blood sinus was removed completely and then mutiple, small vascular connections through the underlying skull were obliterated by air-powered drilling.

A Study of AgNORs(Argyrophilic Nucleolar Organizer Regions) on Prediction of the Prognosis in Intracranial Meningiomas

A silver staining technique was used in the study of nucleolar organizer regions(AgNORs) from the paraffin sections of 26 meningiomas. The specimens were divided into four groups as follows:benign(n=16), atypical(n=5), anaplastic or malignant(n=5) and recurrent without atypical histological findings(n=2) groups, and the mean number of AgNORs in each group was 1.47+/-0.27, 1.93+/-0.4, 2.00+/-0.27 and 1.49+/-0.53 respectively. We noted that the mean number of AgNORs reflected the cellular kinetics of a tumor and was related to histological grade. There was no significant difference between non-recurrent & recurrent benign meningiomas and it was thought that the main cause of recurrence in benign meningiomas was not perhaps cell proliferation but incomplete surgical removal.

Anesthesia for Tetralogy of Fallot - Pathophysiological view / 대한마취과학회지

The tetralogy of Fallot is the commonest cyanotic congenital heart disease and is not a single entity but is classified according to variations in clinical and hemodynamic findings based primarily on the degree of pulmonary stenosis and the size of the ventricular septal defect. Total surgical correction was performed with Sarns 500 pump oxygenator, hypothermia 28 to 30 C and perfusion flow rates of 2. 4 L/min/m2. A successfully performed tetralogy of Fallot discussed mainly fromthe pathophysiological view.