• Title/Summary/Keyword: Brain cysts

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Risk factor for pituitary dysfunction in children and adolescents with Rathke's cleft cysts

  • Lim, Han-Hyuk;Yang, Sei-Won
    • Clinical and Experimental Pediatrics
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    • v.53 no.7
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    • pp.759-765
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    • 2010
  • Purpose: This study evaluated the clinical manifestations of and risk factors for pituitary insufficiency in children and adolescents with Rathke's cleft cysts. Methods: Forty-four patients with Rathke's cleft cysts younger than 19 years who visited Seoul National University Children's Hospital between January 1995 and September 2009 were enrolled. Rathke's cleft cysts were confirmed histologically through an operation in 15 patients and by brain magnetic resonance imaging (MRI) in 29 patients. The clinical, hormonal, and imaging features were reviewed retrospectively. Results: The clinical presentation of symptomatic patients was as follows: headache (65%), endocrinopathy (61%), and visual disturbance (19%). Endocrinopathy included central precocious puberty (18%), diabetes insipidus (14%), general weakness (11%), and decreased growth velocity (7%). After surgery, hyperprolactinemia resolved in all patients, but growth hormone insufficiency, hypothyroidism, and diabetes insipidus did not improve. Pituitary insufficiency except gonadotropin abnormality correlated significantly with severe headache, visual disturbance, general weakness, and cystic size. Suprasellar extension of cysts and high signals in the T2-weighted image on brain MRI were related to hypothyroidism, hypocortisolism, and diabetes insipidus. Multivariable linear regression analysis showed that only general weakness was a risk factor for pituitary insufficiency ($R^2$=0.549). Conclusion: General weakness is a risk factor for pituitary insufficiency in patients with Rathke's cleft cysts. When a patient with a Rathke's cleft cyst complains of general weakness, the clinician should evaluate pituitary function and consider surgical treatment.

A 6-YEAR RETROSPECTIVE STUDY ABOUT CYSTS IN THE ORAL AND MAXILLOFACIAL REGION (구강악안면영역의 낭종에 대한 6년간의 후향적 임상 연구)

  • Choi, Guen-Ho;Jang, Jung-Rok;Park, Young-Jun;Moon, Hyea-Won;Kim, Young-Joon;Yu, Min-Gi;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.401-407
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    • 2009
  • Purpose : This study was designed to evaluate the clinical aspect of cysts which arised in the oral and maxillofacial region. Patients and Methods : We reviewed clinical record, radiograph, histopathologic and operative report of 155 patients who had been diagnosed as cysts and treated at the department of oral and maxillofacial surgery in Chonnam National University Hospital from January 2003 to December 2008. Gender, age, classifiaction, anatomic distribution, clinical sign and symptoms, treatment, complications and recurrence rate were studied. Results : 1. Among 155 patients, the male patients(64.5%) were more than the female(35.5%). 2. The average age ofthe patients was 37.2 years(ranging from 5 to 79 years). 3. In pathologic classification, radicular cyst and dentigerous cyst were most common cysts, irrespective of 73 cases(48.3%) and 35 cases(23.2%). 4. The frequently involved cystic regions were followed as mandibular molars(38.1%), and maxillary incisors(30.2%). 5. The frequent sequence of clinical symptoms was edema(29.9%), no symptom(18.9%), tenderness(13.9%), pain(11.5%) and abscess(9.4%). 6. The most prevalent treatment was the combination operation, such as cyst enucleation with extraction or endodontic treatment of the causative tooth(76.8%) 7. Among 155 cases, 2 cases that were treated using enucleation method were recurred(1.3%).

Microcystic Meningiomas: Its Immunohistochemical and Genetic Aspect

  • Koo, Sang-Keun;Han, Jin-Yeong;Kim, Su-Jin;Kim, Ki-Uk
    • Journal of Korean Neurosurgical Society
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    • v.39 no.2
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    • pp.136-140
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    • 2006
  • The authors report three microcystic meningiomas with its characteristic immunohistochemical findings and chromosomal pattern. Three patients with surgically treated microcystic meningioma were studied for its radiological, histopathological findings, and chromosomal analysis was done in the one patient. Tumors were convexity meningioma in the frontal area. The tumors were enhanced homogenously in the two, and enhanced in homogenously with multiple small cysts in the other one on preoperative magenetic resonance image. Pathological examination showed marked nuclear pleomorphism, many small cysts, hyaline thickening in blood vessel wall, and mucinous background, compatable to microcystic type. EMA and vimentin were positive on the immunohistochemical stain. Chromosomal analysis showed tetrasomies of chromosome 5, 13, 17, and 20, and trisomies of chromosome 6, 7, 9, 11, 12, 16, 19, and 21, which are quite different from those of benign meningioma.

Down syndrome with asymptomatic neuroglial cyst: A case report and review of the literature

  • Yang, Seung Do;Lee, Seung Ju;Lee, Dong Hwan;Hong, Yong Hee
    • Journal of Genetic Medicine
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    • v.14 no.2
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    • pp.67-70
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    • 2017
  • Down syndrome (DS, trisomy 21) is associated with neuroanatomical abnormalities, including choroid plexus cysts and various types of brain tumors. Trisomy 21 is associated with oncogenic factor, especially in brain tumor. The brain of DS patients had a smaller volume of gray and white matter and an unbalanced cerebellum volume, indicating a smaller volume overall than normal. We report a case of a DS male patient who had an incidentally discovered neuroglial cyst in left cerebellar vermis. He visited our hospital with gait disturbance and fatigue. But, the neurologic exam was normal. To the best of our knowledge, this is the first reported case of a neuroglial cyst in a trisomy 21 patient. As the developmental mechanisms of a cyst and the choroid plexus are related, more research is needed.

Effects of iNOS inhibitor on $IFN-{\gamma}$ production and apoptosis of splenocytes in genetically different strains of mice infected with Toxoplasma gondii

  • Kang, Ki-Man;Lee, Gye-Sung;Lee, Jae-Ho;Choi, In-Wook;Shin, Dae-Whan;Lee, Young-Ha
    • Parasites, Hosts and Diseases
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    • v.42 no.4
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    • pp.175-183
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    • 2004
  • To evaluate the role of nitric oxide (NO) in $IFN-{\gamma}$ production and apoptosis of splenocytes in genetically different strains of mice with toxoplasmosis, BALB/c (a toxoplasmosis resistant strain) and C57BL/6 (a toxoplasmosis susceptible strain) mice were infected with Toxoplasma gondii cysts orally and subsequently injected intraperitoneally with aminoguanidine, an iNOS inhibitor (AG; 35 mg/kg per mouse daily for 14 days). When BALB/c or C57BL/6 mice were infected with T. gondii without AG treatment, number of brain cysts, NO and IFN-y production by splenocytes, and percentages of apoptotic splenocytes were increased compared to uninfected control mice without AG treatment. AG treatment increased the number of brain cysts, and reduced NO and $IFN-{\gamma}$ production in T. gondii-infected C57BL/6 mice. In contrast, in T. gondii-infected BABL/c mice, the number of brain cysts, and NO and $IFN-{\gamma}$ production of splenocytes was not altered by treatment with AG. However, the percentages of apoptotic splenocytes in T. gondii-infected BALB/c or C57BL/6 mice were not affected by AG treatment. These results suggest that NO modulates $IFN-{\gamma}$ production in T. gondii-infected C57BL/6 mice, and that NO is involved in mediating a protective response in toxoplasmosis susceptible, but not resistant, mice strain during acute infection.

The Magnetic Resonance Images and Clinical Features of the Asymptomatic Pineal Cysts (무증상 송과체 낭종의 임상적 양상 및 자기공명영상 소견)

  • Lim, Kang-Taek;Park, Se-Hyuck;Shin, Dong-Ik;Cho, Byung Moon;Oh, Sae Moon;Hwang, Do Yun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.113-117
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    • 2000
  • Objective : Asymptomatic cyst of the pineal gland is a common incidental finding in adults on computerized tomography or magnetic resonance image(MRI) or at postmortem examination. This study was conducted to identify MRI findings of the benign pineal cysts and to determine the proper management of asymptomatic pineal cysts. Methods : From January 1995 to March 1999, 13 cases of asymptomatic pineal cysts were diagnosed incidentally on MRI. The mean age of the patients at diagnosis was 43 years(ranged 8 to 69 years). Five patients were females and eight patients were males. We analyzed the clinical presentations and MRI findings. Results : Clincal features were not related to pineal cysts in all 13 cases included posttraumatic headache in seven cases, headache related to brain tumor in two cases, one of facial palsy, one of diabetic neuropathy, and two of other diseases. MRI demonstrated a well-demarcated mass lesion(mean 1.3cm in diameter) of low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Gadolinium-enhanced MRI, performed in 10 cases, demonstrated a rim enhancement. Hydrocephalus was not present in all cases. Follow-up MRI(ranged 12 to 36 months) obtained in 3 of the 13 patients showed stability of cyst size. After symptomatic treatment, presenting symptoms were resolved in all patients and symptom related to pineal cysts have not been developed during follow up period(mean 27 months). Conclusion : The long-term behavior of asymptomatic pineal cysts is still unknown. But we advocate conservative management of these benign pineal cysts that may be developmental variants of normal pineal gland.

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The detection of Toxoplasma gondii ME49 infections in BALB/c mice using various techniques

  • Hae-Ji Kang;Jie Mao;Min-Ju Kim;Keon-Woong Yoon;Gi-Deok Eom;Ki-Back Chu;Eun-Kyung Moon;Fu-Shi Quan
    • Parasites, Hosts and Diseases
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    • v.61 no.4
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    • pp.418-427
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    • 2023
  • Toxoplasma gondii infections are primarily diagnosed by serological assays, whereas molecular and fluorescence-based techniques are garnering attention for their high sensitivity in detecting these infections. Nevertheless, each detection method has its limitations. The toxoplasmosis detection capabilities of most of the currently available methods have not been evaluated under identical experimental conditions. This study aimed to assess the diagnostic potential of enzyme-linked immunosorbent assay (ELISA), real-time polymerase chain reaction (RT-PCR), immunohistochemistry (IHC), and immunofluorescence (IF) in BALB/c mice experimentally infected with various doses of T. gondii ME49. The detection of toxoplasmosis from sera and brain tissues was markedly enhanced in mice subjected to high infection doses (200 and 300 cysts) compared to those subjected to lower doses (10 and 50 cysts) for all the detection methods. Additionally, increased B1 gene expression levels and cyst sizes were observed in the brain tissues of the mice. Importantly, IHC, IF, and ELISA, but not RT-PCR, successfully detected T. gondii infections at the lowest infection dose (10 cysts) in the brain. These findings may prove beneficial while designing experimental methodologies for detecting T. gondii infections in mice.

Progressively Enlarged Intracerebral Ependymal Cyst Presenting with Movement Disorder

  • Lee, Seong-Jun;Hong, Chang-Ki;Ahn, Jung-Yong;Lee, Kyu-Sung
    • Journal of Korean Neurosurgical Society
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    • v.41 no.4
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    • pp.252-254
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    • 2007
  • Ependymal cysts are neuroepithelial cysts, typically found in the central white matter of the temporoparietal and frontal lobes. Clinical symptoms usually result from neurological deficits referable to these regions, from seizures, and chronic headaches associated with increased intracranial pressure. We describe here a case of ependymal cyst on the right fronto-parietal lobe, presenting with tremor and weakness. The cyst was resected surgically and presurgical neurological abnormalities were improved. An exploratory surgery with establishment of an adequate route of drainage and histological examination of the cyst wall are mandatory in the management of patients with a progressive and symptomatic intraparenchymal cyst.

Midline Glioblastoma Multiforme With Bilateral Symmetric Cysts

  • Lee, Hai-Ong;Koh, Eun-Jeong;Oh, Young-Min;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.43 no.2
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    • pp.105-108
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    • 2008
  • Cystic glioblastoma multiforme (GBM) is a rare disease. Its exact prevalence has not yet been reported. Also, the mechanism of cyst formation remains to be elucidated. We report a case of GBM with a large peripheral cyst. A 43-year-old woman visited our clinic with a 3-month history of severe headache, memory impairment and general weakness. T1-weighted gadolinium-enhanced magnetic resonance (MR) image revealed a midline enhanced solid mass and bilateral symmetric banana-shaped peripheral cysts. A centrally enhanced mass was measured $2{\times}4$ cm in size and both mass and cysts as $7{\times}7$ cm. Both the frontal lobe and the frontal horn were severely compressed inferiorly and posteriorly. We resected a midline solid tumor and cysts via the bilateral interhemispheric transcortical approach. Histopathologic examination revealed GBM. The patient was subsequently treated with fractionated conventional brain radiation therapy, followed by temozolomide chemotherapy. Eighteen months later, there was no tumor recurrence and no neurological deficits were noted. Our patient showed no tumor recurrence and a long survival at a long follow-up.

Isolation and Genotyping of Toxoplasma gondii Strains in Ovine Aborted Fetuses in Khorasan Razavi Province, Iran

  • Danehchin, Leila;Razmi, Gholamreza;Naghibi, Abolghasem
    • Parasites, Hosts and Diseases
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    • v.54 no.1
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    • pp.15-20
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    • 2016
  • Toxoplasmosis is an important zoonotic disease that can cause abortion in humans and animals. The aim of this study was isolation and subsequent genotyping of Toxoplasma gondii isolates in ovine aborted fetuses. During 2012-2013, 39 ovine aborted fetuses were collected from sheep flocks in Khorasan Razavi Province, Iran. The brain samples were screened for detection of the parasite DNA by nested PCR. The positive brain samples were bioassayed in Webster Swiss mice. The serum samples of mice were examined for T. gondii antibodies by IFAT at 6 weeks post inoculation, and T. gondii cysts were searched in brain tissue samples of seropositive mice. The positive samples were genotyped by using a PCR-RLFP method. Subsequently, GRA6 sequences of isolates were analyzed using a phylogenetic method. The results revealed that T. gondii DNA was detected in 54% (20/37, 95% CI 38.4-69.0%) brain samples of ovine aborted fetuses. In bioassay of mice, only 2 samples were virulent and the mice were killed at 30 days post inoculation, while the others were non-virulent to mice. The size of cysts ranged $7-22{\mu}m$. Complete genotyping data for GRA6 locus were observed in 5 of the 20 samples. PCR-RLFP results and phylogenetic analysis revealed that all of the isolated samples were closely related to type I. For the first time, we could genotype and report T. gondii isolates from ovine aborted fetuses in Khorasan Razavi Province, Iran. The results indicate that the T. gondii isolates are genetically related to type I, although most of them were non-virulent for mice.