Evaluation of cardiac sympathetic nerve function by myocardial 123I-metaiodobenzylguanidine scintigraphy before and after endoscopic sympathectomy.

Object: The purpose of this study was to analyze the change in cardiac sympathetic function by performing a 123I-metaiodobenzylguanidine (MIBG) imaging study after endoscopic upper thoracic sympathectomy (EUTS) in patients with palmar hyperhidrosis before and after surgery.

Methods: Between February 1999 and February 2002, 135 patients underwent bilateral EUTS to treat palmar hyperhidrosis. Between September 2001 and February 2002, 12 of these consecutively enrolled patients were also included in a 123I-MIBG imaging study.

Transaqueductal aspiration of pontine hemorrhage with the aid of a neuroendoscope. Technical note.

The authors advocate the use of a 1.7-mm fiberscope to evaluate a hypertensive bilateral tegmental pontine hemorrhage that has ruptured, in part, into the fourth ventricle. In applying this new technique, a fiberscope, which contains a guide tube in the working channel, is inserted into the aqueduct.

Endoscopically assisted harvesting of the superficial temporal artery: technical note.

Objective: We developed an endoscopic method for harvesting the superficial temporal artery (STA) through a small incision away from the artery. This method was used to harvest the frontal branch of the STA through an incision made along the parietal branch.

Methods: A 7-cm linear incision is made along the parietal branch of the STA.

Endoscopically aided retroperitoneal placement of a lumboperitoneal shunt. Technical note.

The authors developed a method for retroperitoneal placement of a lumboperitoneal (LP) shunt with the aid of endoscopic monitoring. To perform this procedure, the patient is positioned laterally, the retroperitoneum is entered and dilated with a balloon through a small incision in the flank, and the space is maintained with CO2 insufflation. A peritoneal catheter is introduced into the cavity from the lumbar incision, through which the spinal catheter has been inserted.

Peritoneal shunt migration into the pulmonary artery--case report.

A 48-year-old man underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to left vertebral artery dissection, which had been successfully treated by trapping. The peritoneal catheter was correctly positioned via a right upper abdominal incision, and symptoms related to the hydrocephalus disappeared. One month later, the patient began to complain of pain on the right side of the neck.

Osteomyelitis of the odontoid process associated with meningitis and retropharyngeal abscess--case report.

A 52-year-old man complaining of headache and nuchal pain was treated initially under a diagnosis of bacterial meningitis. The meningitis resisted antibiotic therapy, and one week later was complicated by a ruptured retropharyngeal abscess, which led to the correct diagnosis of osteomyelitis of the odontoid process of the axis. His neck was immobilized in a high neck collar and the retropharyngeal abscess was treated by repeated drainage and irrigation.

Endoscopic cranioplasty with calcium phosphate cement for pterional bone defect after frontotemporal craniotomy: technical note.

Objective: Postoperative pterional depression is a minor but unpleasant sequela of frontotemporal craniotomy. We developed a simple method for repair of this condition with the use of an endoscope and calcium phosphate cement.

Methods: The cranial defect was approached by means of endoscopic visualization through a small incision within the hairline.

[Extracorporeal ventriculoatrial shunt with the use of one-way ball valve].

We developed a simple system of an "extracorporeal" ventriculoatrial (VA) shunt using a one-way ball valve (Acty valve II, Kaneka Medix) to release the patient from postoperative constraint during the ventricular drainage. The system is constructed in such a way that the ventricular drainage tube is connected to the central venous catheter via a one-way valve. The CSF is regulated by using the valve and is diverted into the systemic circulation as in the conventional ventriculoatrial shunt.