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1.
Childs Nerv Syst ; 37(1): 319-323, 2021 01.
Article in English | MEDLINE | ID: mdl-32435889

ABSTRACT

INTRODUCTION: Primary intraosseous cavernous hemangiomas of the skull are very rare in the pediatric age group and usually slow-growing tumors. CASE REPORT: We present a case of 5-month-old girl with a left occipital cavernous hemangioma that is rapidly growing. The subcutaneous occipital tiny mass was first noted at birth, and the lesion became rapidly enlarged in size and became soft for 3 months. The left occipital subcutaneous lesion was 4.0 × 4.0 × 2.0 cm (AP × LR × HT) in size. There was no history of trauma or bone tumor in her family. She underwent resection of the lesion, and a pathologic diagnosis of calvarial cavernous hemangioma was made. No recurrence was seen 1 year after surgery. CONCLUSION: The rapid growth of the infant cavernous hemangioma might be related to not only bleeding and/or congestion of the lesion but the immature thin skull of the infant.


Subject(s)
Bone Neoplasms , Hemangioma, Cavernous , Skull Neoplasms , Child , Female , Hemangioma, Cavernous/diagnostic imaging , Hemangioma, Cavernous/surgery , Humans , Infant , Infant, Newborn , Neoplasm Recurrence, Local , Skull , Skull Neoplasms/diagnostic imaging , Skull Neoplasms/surgery
4.
Pediatr Blood Cancer ; 63(1): 152-5, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26305586

ABSTRACT

The benefit of postoperative chemotherapy for anaplastic ependymoma remains unknown. We report two pediatric patients with refractory anaplastic ependymoma treated with temozolomide (TMZ). We did not detect O(6) -methylguanine-DNA methyltransferase (MGMT) promoter methylation in tumor samples; however, MGMT protein expression was low. With TMZ treatment, one patient had a 7-month complete remission; the other, stable disease for 15 months. Three other patients did not respond to TMZ; two had high and one low MGMT expression, and two showed no MGMT promoter methylation. These findings suggest that TMZ may be effective for pediatric refractory anaplastic ependymoma with low MGMT protein expression.


Subject(s)
Antineoplastic Agents, Alkylating/therapeutic use , Brain Neoplasms/drug therapy , DNA Modification Methylases/analysis , DNA Repair Enzymes/analysis , Dacarbazine/analogs & derivatives , Ependymoma/drug therapy , Tumor Suppressor Proteins/analysis , Brain Neoplasms/chemistry , Child, Preschool , Dacarbazine/therapeutic use , Ependymoma/chemistry , Female , Humans , Immunohistochemistry , Infant , Male , Temozolomide
6.
Ann Thorac Surg ; 91(5): 1611-3, 2011 May.
Article in English | MEDLINE | ID: mdl-21524476

ABSTRACT

A sharp rise in intracranial pressure (ICP) was noted in a 6-year-old girl with Fontan circulation after surgical removal of a hematoma associated with intracranial hemorrhage. Inhalation of nitric oxide resulted in reduction of central venous pressure (CVP) and precipitous fall in ICP, which was otherwise resistant to conventional therapy. Specifically, the rate of fall of ICP (9 mm Hg) exceeded that of the CVP (3 mm Hg), indicating disproportionate CVP-ICP coupling. The present case provides not only a novel insight into cardio-cerebral interaction in Fontan physiology but also useful information regarding the treatment of Fontan patients in the setting of increased ICP.


Subject(s)
Fontan Procedure/adverse effects , Intracranial Hemorrhages/surgery , Intracranial Hypertension/etiology , Intracranial Hypertension/therapy , Nitric Oxide/therapeutic use , Administration, Inhalation , Central Venous Pressure/physiology , Cerebrovascular Circulation/physiology , Child , Female , Follow-Up Studies , Fontan Procedure/methods , Heart Defects, Congenital/diagnosis , Heart Defects, Congenital/surgery , Humans , Intracranial Hemorrhages/diagnostic imaging , Intracranial Hemorrhages/etiology , Intracranial Hypertension/physiopathology , Postoperative Care/methods , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgery , Risk Assessment , Severity of Illness Index , Tomography, X-Ray Computed/methods , Treatment Outcome
7.
J Neurosurg Pediatr ; 5(2): 210-2, 2010 Feb.
Article in English | MEDLINE | ID: mdl-20121374

ABSTRACT

Subdural hematoma (SDH) is a well-known sequela of ventriculoperitoneal shunt insertion for hydrocephalus, usually spreads out over the cerebral convexity, and appears as a crescent-shaped lesion on imaging. The authors report the rare case of an infant with a globular SDH, which MR imaging revealed as a round mass lesion. A 13-month-old girl with a history of severe congenital hydrocephalus associated with myeloschisis underwent ventriculoperitoneal shunt placement after repair of myeloschisis and developed convulsive seizure. Magnetic resonance imaging showed a large subdural round mass with a lesion like a pedestal in the left parietal region, suggesting a globular SDH surrounded by a thin cerebral mantle. Because of the seizures and because the hematoma did not respond to a change in valve pressure, the patient underwent a craniotomy to remove the hematoma and to resect the thick outer membranes of multiple layers. Postoperative MR imaging demonstrated the disappearance of the SDH, and no additional shunt complication was observed during a long follow-up period. To the authors' knowledge, this is the first report of a patient with globular SDH published in the literature. The authors postulate that the globular SDH was caused by the thin cerebral mantle associated with severe craniocerebral disproportion, and they discuss the possible mechanisms for this unique formation.


Subject(s)
Hematoma, Subdural, Chronic/etiology , Hematoma, Subdural, Chronic/pathology , Postoperative Complications/pathology , Ventriculoperitoneal Shunt/adverse effects , Adult , Cesarean Section , Female , Hematoma, Subdural, Chronic/surgery , Humans , Hydrocephalus/surgery , Infant, Newborn , Magnetic Resonance Imaging , Neurosurgical Procedures , Paraplegia/etiology , Pregnancy , Prenatal Diagnosis , Seizures/etiology , Spine/abnormalities
8.
Surg Neurol ; 72(5): 470-5; discussion 475, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19328534

ABSTRACT

BACKGROUND: Ultrasonic surgical aspirators have been used mainly for removing brain tumors. Because of their longitudinal and torsional tip, they are used for cutting the bone structures in spinal surgery installing a scalpel-type tip. The purpose of this report is to describe the effectiveness and surgical pitfalls of an ultrasonic bone curette in laminoplastic laminotomy and hemilaminotomy. METHODS: We present 12 patients who underwent laminoplastic laminotomy and hemilaminotomy. We used a SONOPET UST-2001 ultrasonic bone curette with HB-05S handpieces (M and M Co, Ltd, Tokyo, Japan). After a tumor was removed, titanium plates were used for the laminoplastic laminotomy and hemilaminotomy. The technical advantage of an ultrasonic bone curette and procedure-related complication were examined. RESULTS: There were no major procedure-related complications such as cord injury. Wound infection and subcutaneous fluid collection caused by cerebrospinal fluid leakage did not occur for reconstruction of posterior bony structure. In 1 patient with calcified dura mater associated with tumor, dural tear occurred. The width of the tip was narrow enough for resected laminae to be fused postoperatively, and spinal instability did not occur in all cases. CONCLUSION: The scalpel-type ultrasonic bone curette is useful for cutting bone and effective for reconstruction of the laminae. Laminotomy with an ultrasonic bone curette is safe and minimally invasive. To prevent dural tear, we recommend drilling laminae to make the bone thin as the first step, followed by cutting the remaining laminae using a bone curette especially in cases with calcified or tense dura mater.


Subject(s)
Curettage/instrumentation , High-Intensity Focused Ultrasound Ablation/instrumentation , Laminectomy/instrumentation , Spinal Cord Neoplasms/surgery , Spine/surgery , Adolescent , Adult , Aged , Bone Plates , Curettage/methods , Dura Mater/anatomy & histology , Dura Mater/surgery , Female , High-Intensity Focused Ultrasound Ablation/methods , Humans , Intraoperative Complications , Laminectomy/methods , Male , Middle Aged , Minimally Invasive Surgical Procedures/instrumentation , Minimally Invasive Surgical Procedures/methods , Postoperative Complications , Plastic Surgery Procedures/instrumentation , Plastic Surgery Procedures/methods , Spinal Cord Neoplasms/pathology , Spinal Cord Neoplasms/physiopathology , Spine/anatomy & histology , Spine/diagnostic imaging , Titanium/therapeutic use , Tomography, X-Ray Computed , Treatment Outcome , Young Adult
9.
No Shinkei Geka ; 34(3): 305-10, 2006 Mar.
Article in Japanese | MEDLINE | ID: mdl-16529025

ABSTRACT

The authors report a case of intratumoral hemorrhage in a pineal region choriocarcinoma during neuroendoscopic third ventriculostomy. A 12-year-old boy who presented with headache and vomiting had precocious puberty. Neuroimagings revealed a pineal region tumor with obstructive hydrocephalus and his serum HCG level was 4,280 mIU/ml. He was diagnosed as having choriocarcinoma and underwent neuroendoscopic third ventriculostomy for obstructive hydrocephalus. There were many tumor vessels observed on the tumor surface, some of which bled subcapsularly. Postoperative CT scan showed the tumor increased in size with the intratumoral hemorrhage. After irradiation and chemotherapy, the tumor disappeared with normalization of serum HCG level. His symptoms improved and no additional neurological deficit was observed in his clinical course. We might infer from this case that the intratumoral hemorrhage was induced by the intracranial pressure change during neuroendoscopic surgery. Perioperative management is very important for avoiding fetal intratumoral hemorrhage.


Subject(s)
Brain Neoplasms/surgery , Cerebral Hemorrhage/etiology , Choriocarcinoma/surgery , Neuroendoscopy , Pineal Gland , Ventriculostomy/adverse effects , Brain Neoplasms/complications , Brain Neoplasms/diagnosis , Child , Choriocarcinoma/complications , Choriocarcinoma/diagnosis , Combined Modality Therapy , Humans , Hydrocephalus/complications , Intraoperative Complications , Magnetic Resonance Imaging , Male , Neurosurgical Procedures/methods , Pineal Gland/pathology , Third Ventricle/surgery , Ventriculostomy/methods
10.
J Am Chem Soc ; 128(3): 743-7, 2006 Jan 25.
Article in English | MEDLINE | ID: mdl-16417363

ABSTRACT

Flat films of methyl methacrylate-fluoroalkyl methacrylate copolymers were prepared, and their hydrophobicity was investigated. It was revealed that the F concentration directly affects the static hydrophobicity on the flat polymer surface in a systematic manner. Furthermore, the sliding behavior of a water droplet on these surfaces depends on the static hydrophobicity; the sliding motion changes from constant velocity to constant acceleration with an increase in the water contact angle.

11.
Childs Nerv Syst ; 21(2): 150-5, 2005 Feb.
Article in English | MEDLINE | ID: mdl-15168054

ABSTRACT

CASE REPORT: A case of a histologically unclassified brain tumor in a 32-month-old boy is reported. He presented with vomiting, appetite loss, and right motor weakness. MR images revealed a huge mass in the left frontoparietal region that was enhanced after the administration of Gd-DTPA. The mass was removed three times because of its recurrence. RESULTS: Histologically, the tumor was composed largely of small-undifferentiated round cells without any patterns of differentiation. Immunohistochemically, the tumor cells were positive for cytokeratin and focally for epithelial membrane antigen (EMA). Glial fibrillary acidic protein (GFAP), S-100 protein and neuronal markers were negative. Electron microscopic investigations demonstrated no evidence of specific differentiation. MIB-1 staining index was 10-40%. The origin of the tumor was not detected. Expression of the hSNF5/INI1 of this tumor was not detected by reverse transcription-polymerase chain reaction (RT-PCR). The patient has been in a good condition for 7 years after the first operation. CONCLUSIONS: Based on the immunohistochemical findings, the tumor was descriptively diagnosed as an embryonal tumor with an epithelial immunophenotype. The hSNF5/INI1 gene has recently been reported to act as a tumor suppressor in atypical teratoid/rhabdoid tumors. The hSNF5/INI1 gene may lead to tumorigenesis in this case.


Subject(s)
Brain Neoplasms/metabolism , DNA-Binding Proteins/metabolism , Gene Expression Regulation, Neoplastic , Mucin-1/metabolism , Biomarkers , Brain Neoplasms/genetics , Child, Preschool , Chromosomal Proteins, Non-Histone , DNA-Binding Proteins/genetics , Gadolinium DTPA , Glial Fibrillary Acidic Protein/metabolism , Humans , Immunohistochemistry/methods , Keratins/metabolism , Magnetic Resonance Imaging/methods , Male , Parietal Lobe/pathology , RNA, Messenger/biosynthesis , Reverse Transcriptase Polymerase Chain Reaction/methods , SMARCB1 Protein , Tomography, X-Ray Computed/methods , Transcription Factors
12.
No Shinkei Geka ; 32(4): 345-53, 2004 Apr.
Article in Japanese | MEDLINE | ID: mdl-15227841

ABSTRACT

PURPOSE: The purpose of this article is to assess, in a 25-year retrospective study, the clinical outcome in children with craniopharyngioma. PATIENT AND METHODS: From 1978 to 2002, 12 children younger than 15-year-old underwent treatment with surgery and/or radiotherapy for craniopharyngioma. The clinical course and outcome were reviewed. RESULTS: The median age was 7.3 years (range, 3 to 12 years) at the time of initial surgical resection. With a mean follow-up period of 132 months (range, 29 to 255 months), 1 patient died of tumor progression due to malignant transformation at 205 months after the initial surgery and the overall outcome was good in 11 patients. Out of 12 patients 4 presented a recurrence of their tumor, 2 after an apparently gross total removal. Because of tumor recurrence, 2 received conventional radiation therapy and 3 received gamma knife radiosurgery. There was neither operative mortality nor major complication. All patients required hormonal replacement postoperatively. CONCLUSIONS: The goal in the treatment of craniopharyngiomas is to achieve total removal without morbidity. Our results compared favorably with the previous reports in the literature. MRI follow-up should be performed even in patients whose primary tumor is resected "completely". Suitable combination of open surgery, conventional radiotherapy and gamma knife radiosurgery may result in optimal functional outcome. Recovery from postoperative pituitary dysfunction can be occasionally expected.


Subject(s)
Craniopharyngioma/surgery , Hypophysectomy , Pituitary Neoplasms/surgery , Radiosurgery , Child , Child, Preschool , Craniopharyngioma/diagnosis , Craniopharyngioma/radiotherapy , Female , Humans , Hypophysectomy/methods , Magnetic Resonance Imaging , Male , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/radiotherapy , Retrospective Studies , Treatment Outcome
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