A Comparative Study of PCNA(Proliferating Cell Nuclear Antigen) and AgNORs(Argyrophilic Nucleolar Organizer Regions) in Malignancy of Brain Tumors

The authors studied the expression of proliferating cell nuclear antigen (PCNA) and the number of argyrophilic nucleolar organizer regions (AgNORs) in 94 cases of various brain tumors and in 5 cases of normal brains. PCN was recognized immunohistochemically in paraffin sections by the monoclonal antibody PC-10. AgNORs could be demonstrated using the silver impregnation method. The PCNA index was not significantly different from the histological grading of glioma(glioblastoma multiforme: 41.40+/-29.14%, anaplastic astrocytoma: 35.00+/-41.02%, and low grade astrocytoma: 22.37+/-30.85%) and there was a wide range of staining even in the same tissue section. However, the AgNORs count per cell correlated well with the pathologic grading of glioma (glioblastoma multiforme : 3.19+/-0.71, anaplastic astrocytoma : 2.06+/-0.16, and low grade astrocytoma : 1.27+/-0.29) with statistical significance. In meningiomas, AgNORs were useful to differentiate benign meningiomas(1.25+/-0.19) and malignant meningiomas(1.78+/-0.35) The authors suggest that the AgNORs count is a faster, less expensive, and a more predictive method in the malignancy of brain tumors than the PCNA immunochemistry expression.

A Case of Reticulum Cell Sarcoma of the Brain

A rare case of primary reticulum cell sarcoma of the brain in a 56-year-old male is reported. The tumor was located in the left temporoparietal lobe. Brain CT scan revealed well enhanced mass with surrounding brain edema in left temporoparietal area. Osteoplastic craniotomy was performed for removal of tumor. Then the patient received radiation therapy with a good result.

A Clinical study of the Intracranial Pressure Measurement by Use of a Fiberoptic Pressure Monitor

Continous monitoring of intracranial pressure can be one of the most inportant physical parameters in assesing patients who have or might develop intracranial hypertension. The authors has measured an intracranial epidural pressure by use of a Fiberoptic pressure monitor on 20 cases among brain damaged patients and evaluated it's effect by an epidural pressure change and Glasgow coma scale change after craniectomy and hypertonic solution infusion. Intracranial pressure was compared with signs of increased ICP on brain computed tomography. Also, complications were evaluated. The results are as follows ; 1) Average intracranial pressure was significantly decreased 48cmH2O during the first day after craniectomy. 2) Average intracranial pressure was significantly decreased 33cmH2O after infusion of 10% glycerol. 3) Improvement of the clinical states after craniectomy was not found in the cases above 20cmH2O in spite of decreasing intracranial pressure. 4) Sixteen of seventeen patients showing signs of increased intracranial pressure on brain computed tomography on admission developed elevated intracranial pressure. 5) The infection and intracranial hemorrhage were not found at the monitoring implement site three weeks after removing the intracranial pressure monitor.

Treatment of Traumatic Carotid-cavernous Fistula Using Debrun's Latex Detachable Balloon

A case of traumatic carotid-cavernous fistula treated by using Debrun's latex detachable balloon catheter is reported. The patient was a 28 year old man, who had complaints of headache, proptosis and chemosis of left eye 3 weeks after motor vehicle accident. The cerebral angiography showed direct fistula between intracavernous portion of internal carotid artery and cavernous sinus as high flow type. Following complete radiologic and neurologic examination, the fistulous opening was successfully occluded by Debrun's latex detachable balloon. Immediately after occlusion of the fistula the clinical symptoms were markedly improved.

A Case of Oligodendroglioma Presenting as Ventricular Hemorrhage After Head Injury

Oligodendroglioma constitutes about 4% of all gliomas. The usual symptoms of oligodendrogliomas are seizures, focal neurologic deficits, and increased intracranial pressure. They usually present with a gradual onset of symptoms and slow progression. The apopletic symptom due to sudden tumor bleeding is rare. The author review literatures and present a case of oligodendroglioma initially manifested as ventricular hemorrhage after head injury.

A Case of Subdural Tension Pneumocephalus after Operation

Tension pneumocephalus is rare complication is neurosurgical operation. But it should be treated promptly because of sudden neurological deterioration. Computed tomography permitted rapid diagnosis including localization of the air, thus facilitating prompt treatment. A case of subdural tension pneumocephalus after cranial operation under the impression of bifrontal subdural hygroma is presented.