[Simultaneous combined intra- and extracranial operation to skull base lesions with both intracranial and extracranial extensions (author's transl)].
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Biomedical subjects
Publications and source records attributed to S Ban.
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Three patients with pulmonary metastases of osteosarcoma underwent treatment with intravenous or intramuscular administration of human leukocyte interferon. In 2 cases, the size of the metastasized tumor mass diminished temporarily six or eight months after interferon treatment, and serum alkaline phosphatase levels decreased to normal. In 1 case, the tumor cell from the pleural exudate 1 could be isolated and cultivated in vitro. When 2,000 IU of interferon was added to the tumor cell culture, marked inhibition of tumor cell growth resulted. In the other case, interferon had no effect on the metastasized lung tumor.
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A 51-year-old female presented herself with complaints of mis-swallowing, hoarseness, speech disturbance and right stiff shoulder of 3 months duration. She had left breast cancer operated on elsewhere 10 years previously. Pertinent neurological findings were 9th, 10th, 11th and 12th cranial nerve palsies on the right (the Collet-Sicard syndrome). Cerebral angiography, retrograde jugular venography, polytomography of the skull base and bone scintigraphy with 99mTc-MDP raised a question of metastasis of the breast cancer to the skull base of the right mastoid region. Following right retromastoidal suboccipital craniectomy, partial removal of the metastatic skull tumor of the deep mastoid region was done. No intracranial extension of the tumor was confirmed. Multiple cranial nerve palsies above mentioned resolved following irradiation with betatron of 5000 rads. Pathology report was that of metastatic adenocarcinoma to the skull, which was similar to the histology of the breast cancer resected 10 years previously. Skull base metastasis of the breast cancer causing the Collet-Sicard symdrome is rare. To the author's knowledge, only 7 cases of the Collet-Sicard syndrome caused by metastatic tumors have been reported in the English and Japanese literatures. Primary lesions were as follows: The one was from the lung and the rest were all from the prostate. We are reporting the first case of the Collet-Sicard syndrome due to metastatic adenocarcinoma of the breast to the skull base.
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Two cases of postoperative systemic candidiasis in neurosurgical practice are reported. Postoperatively these patients showed signs and symptoms of systemic infection and unfortunately died in spite of intensive chemotherapy. In both cases systemic candidiasis became evident by histological examinations at autopsy. Long use of antibiotics and aggressive nosocomy were supposed to be the cause of the systemic candidiasis. The authors emphasized a high possibility of opportunistic fungal infection in neurosurgical practice. The symptomatology, treatment and prevention of this disease are also discussed.
During the past nine years the authors have seen 140 cases of ruptured intracranial aneurysm. In order to assess the EEG abnormalities in the chronic period after SAH, 45 patients were examined with 108 serial EEG recordings. Cases of early death were excluded from this study. Seven cases of SAH of unknown origin were also examined as a control group. Range of age was from 28 to 79 years. All of these patients except one were able to return to their previous activities. Results and conclusion were as follows. (1) The period of EEG study varied from a few weeks to nine years after SAH with the average being ten months. (2) The overall incidence of abnormal EEG was 82.4% in Group A (aneurysm) and 83.3% in Group B (unknown origin). (3) EEG abnormalities were divided into two patterns: focal slow wave (sporadic, polymorphous theta and delta wave) and focal spike, located mainly in the frontal and/or temporal areas. (4) Symptomatic epilepsy occurred in 6 cases of this series (13.3%) with onset from 8 months to 3 1/2 years after SAH. (5) Recent papers on microsurgical treatment of intracranial aneurysms have reported excellent results. Few studies, however, have dealt with EEG in the chronic period after SAH. The importance of EEG in the follow-up study of SAH is stressed because of the high incidence and long persistence of EEG abnormalities and because of the occurrence of epilepsy after SAH.
A case of massive intracerebral hemorrhage caused by an asymptomatic focus of recurrent meningioma is reported. The mechanism of hemorrhage is briefly discussed.
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