Tai-Ngar Lui

Wan Fang Hospital

Purpose Pediatric hydrocephalus is the most common cause of surgically treatable neurological disease in children. Controversies exist whether endoscopic third ventriculostomy (ETV) or cerebrospinal fluid (CSF) shunt placement is the most appropriate treatment for pediatric hydrocephalus. This study aimed to compare the risk of re-operation and dea...

Medulloblastoma (MB) is the most common type of malignant childhood brain tumor. We previously showed that inhibitors of apoptosis proteins (IAP) small‐molecule inhibitors (LCL161 or LBW242) combined with chemotherapy have synergistic antiproliferative effects on MB cells. The synergistic antitumor effects of combination treatments happen through i...

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Sciatica due to contained herniated discs can be managed with epidural neuroplasty which has emerged as a minimally invasive technique for the treatment of low back pain. Epiduroscopy also provides an alternative minimally invasive technique that offers diagnostic and therapeutic advantages. However, both procedures are not free of complications. T...

Background: Medulloblastoma (MB) is the most common pediatric primary malignant brain tumor. Approximately one-third of MB patients succumb to treatment failure and some survivors suffer detrimental side effects. Hence, the purpose of this study is to explore new therapeutic regimens to overcome chemotherapeutic agent resistance or reduce chemothe...

Caspase-3 inhibition reverses combination treatment-induced cell apoptosis in MB cells. (A) DAOY and D283MED cells were treated with combination therapy (vincristine or cisplatin plus 10 μM LCL161) or DMSO /and or caspase-3 inhibitor (40 μM Z-DEVD-FMK) for 72 hr. Cell apoptosis was detected by Annexin V/PI and FACS. (B) The bar graphs illustrate th...

ED50 values of chemotherapeutic agents or in combination of IAP inhibitors in CD133+ cells. (DOC)

Combination of IAP inhibitors and chemotherapies has a mild effect on normal astrocytes. HA-h cells (normal astrocytes) were treated with different concentrations of vincristine or cisplatin combined with LCL161 (10 μM) or LBW242 (10 μM) or DMSO. The cell viability was measured by MTT assay after treatments for 72 hr. The data are represented as th...

Expressions of cancer stem cell markers appear in CD133+ MB cells. CD133+ MB cells expressed higher cancer stem cell markers including Nestin, CD44, SOX2, and Oct4 relative to their CD133- cells and parental cells. (*p < 0.05, **p < 0.001, and ***p < 0.005). (TIF)

Endoscopic endonasal transsphenoidal surgery for pituitary tumors has been the standard therapy for decades. This approach offers surgeons an effective, safe, and wide exposure to the pituitary gland, with a relatively low mortality rate and acceptable complication rates. However, severe complications, including cerebrospinal fistula, meningitis, n...

Objective. The goal of the present study was to examine the clinical results of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar surgery for patients with adjacent segment degeneration (ASD) and recurrence of disc herniation. Methods. From December 2011 to November 2013, we collected forty-three patients who underwent repeated lumba...

Intracranial osteomas are uncommon lesions that usually arise from the inner table of the cranium. There are few reports in the literature of intracranial osteomas with meninges attachment and without direct relation with the skull bone; these osteomas were mostly attached with dura. We report a rare osteoma with falx attachment.Case: A 64-year-old...

Background Glioblastoma multiforme (GBM) is the most aggressive type of glioma and carries the poorest chances of survival. There is therefore an urgent need to understand the mechanisms of glioma tumorigenesis and develop or improve therapeutics. The aim of this study was to assess the possible prognostic value of cyclin-dependent kinase 6 (CDK6)...

An osteoporotic fracture (OF) in the second to fifth lumbar vertebrae with spinal stenosis may be an indication for surgical treatment, but carries the risks of instability or instrumentation failure. Modified surgical procedures have been developed to manage patients with challenging OF. We retrospectively studied 12 patients (three male, nine fem...

An in vivo motion analysis of active and passive kinematic cervical flexion-extension. The study was aimed at investigating the differences between the active and passive kinematic sagittal motions of the subaxial cervical spine. The biomechanical behavior of the cadaver spinal column is different from that of the in vivo spine. Two major issues we...

Guanidine, the active ingredient extracted from Galega officinalis, is introduced as a ligand for imidazoline I2 receptor (I2R) because guanidine decreased plasma glucose via an activation of I2BR to increase glucose uptake into skeletal muscle isolated from Wistar rats. However, the signals for this action of guanidine remained obscure. In the pre...

Stereotactic biopsy is a widely used surgical technique for the histological diagnosis of intracranial lesions. Potential risks of this procedure, such as hemorrhage, seizure, and infection have been established, and different risk factors have been characterized. However, these risks have been addressed by only few studies conducted in Asian count...

Among patients with medulloblastoma, an unrare aggressive central nervous system (CNS) tumor found mostly in the posterior fossa, drop metastasis from primary location to anatomically lower sites including whole spinal cord is known as a potential way for tumor to spread. There were already lots of extensive discussions regarding diagnosis and trea...

The authors sought to evaluate the treatment outcome of children with medulloblastoma at a single institution. Forty-two children were analyzed. Eighty-six percent of the children who received chemotherapy were treated with cisplatin-based chemotherapy. No factors were found to affect outcome significantly. Compared with children treated before 199...

Congenital dermal sinuses are relatively uncommon, and result from abnormal neurulation. A lack of awareness about this problem causes these patients to manifest significant mortality and morbidity. Spinal intramedullary abscesses are rare and potentially devastating lesions. Intraspinal epidermoids are also unusual lesions. We report on a boy, age...

Hypotension is a common complication of the sitting position during anesthesia, and is often counteracted by decreasing anesthetic depth, thereby exposing patients to the risk of being inadequately anesthetized. Baroreceptor unloading and the consequent sympathoexcitation, as during head up tilt, decreases pain threshold and arouses the central ner...

Endodermal cysts of the central nervous system are unusual lesions. Most reported cysts develop in the spinal canal, whereas others, which occur intracranially, are usually located in the posterior fossa. Although endodermal cysts are considered congenital, a prenatal diagnosis has not been reported. In this report the authors present an extremely...

Supratentorial subdural effusion is common after infection and trauma, but rarely occurs in the posterior fossa, and is even less commonly unilateral. The authors report a rare case of unilateral traumatic posterior fossa subdural effusion with secondary hydrocephalus. A 6-month-old female infant presented with lethargy, poor appetite, and persiste...

Hypertensive encephalopathy is believed to be caused by an abrupt elevation in systemic blood pressure. It rarely occurs in children and can be neurologically devastating if it is not recognized and treated immediately. This report describes an 11-year-old male who presented with edema and a cerebellar lesion, with acute obstructive hydrocephalus r...

Spinal cord injury without radiological abnormality (SCIWORA) was defined in the era when magnetic resonance (MR) images were not popularly used as diagnostic tools. Although it is generally accepted that MR imaging can effectively illustrate the level and severity of spinal cord injury in the acute phase of trauma, only a few reports of MR imaging...

The authors report a 12-year-old girl who presented with a 2-year progressive painless thoracic scoliosis. Her previous development had been normal with no significant past history of illness. MRI revealed a thoracic ganglioneuroma, which was confirmed by surgical pathology. Ganglioneuroma might cause progressive spinal deformity mimicking adolesce...

Both botulinum toxin type A (BTA) injection and selective posterior rhizotomy (SPR) are well-recognized treatments for children with spastic cerebral palsy (CP); however, there has been no study in which the long-term effectiveness of these two approaches has been compared. The study population comprised 62 ambulatory children with spastic diplegic...

Carpal tunnel syndrome is the most common entrapment neuropathy in humans today. For patients in whom conservative treatment fails, surgical decompression is indicated. Among the various surgical techniques currently in use, endoscopic techniques are becoming increasingly popular. Due to the rapid postoperative recovery shown after endoscopic opera...

The optimal postoperative management of pediatric intracranial ependymomas is controversial. We analyzed clinical prognostic factors for their influence on outcome in such children. Our retrospective series included 15 with supratentorial and 28 with infratentorial tumors. Twenty ependymomas were grade II, and 23 were anaplastic. Complete resection...

Spinal epidural abscess (SEA) is uncommon but has a potentially disastrous outcome. Its early recognition and management may lead to satisfactory results. We analyzed the clinical manifestations, sources of infection, and outcomes of patients with SEA. Between 1997 and 2003, 17 patients in the Department of Neurosurgery at Keelung Chang Gung Memori...

Cervical laminectomy is one of the most common procedures performed in the sitting position. However in the presence of intracranial hypotension, a negative intradural pressure develops when the patients are in the sitting position. They are therefore at risk of developing cervical spinal epidural hematomas after cervical laminectomy. We report a c...

Spontaneous spinal epidural hematoma (SSEH) is a rare disease entity. Although many cases have been reported in the literature, controversy persists as to its origin, diagnosis, and timing of treatment. The authors conducted a study in patients treated in their hospital and report the results. Clinical data obtained in 35 patients with SSEH were re...

Spontaneous cervical epidural hematoma is an uncommon cause of acute spinal cord compres- sion. It usually occurs with sudden cervical or interscapular pain. Typically, increasing compression of the spinal cord leads to paralysis within minutes to hours after the onset of symptoms. The authors report a case of spontaneous cervical epidural hematoma...

This 16-year retrospective study review sought to determine the factors influencing prognosis and treatment results of all patients with primary intracranial germ cell tumors treated at our hospital who were younger than 17 years of age at the time of diagnosis. A total of 44 patients were treated during the study period, including 32 males and 12...

This report assesses the efficacy and safety of percutaneous vertebroplasty for osteoporotic vertebral compression fractures and reports on preliminary results of its use. The technique was used on 50 patients with 86 painful vertebral fractures, all of which had failed to respond to earlier conservative medical treatment. The technique involves pe...

Percutaneous trigeminal ganglion compression for the relief of trigeminal neuralgia is a technically simple, non-painful procedure, carried out under brief general anesthesia. The patients could tolerate well during the treatment. The operation successful rate is high, and the procedure can be repeated at the next day if the symptom was not relieve...

Study Design. This is a report of a 63-year-old woman with a retrodental fibrocartilaginous mass and myelopathy. Objective. To describe the pathophysiology of the retrodental fibrocartilaginous mass formation and its association with the C2-C3 disc. Summary of Background Data. High cervical disc protrusion is an uncommon condition and presents even...

Objective: C1-C2 is the predominant level of cervical spine injuries in children and adolescents. Either a fracture of the dens or atlantoaxial dislocation (AAD) without fracture of the dens can occur. We present a number of cases to compare their clinical presentations and discuss the preferred method of treatment. Material and Methods: There were...

A 39-year-old man presented with a 10-year history of psoriatic arthritis, and more recently a progressive high cervical myelopathy. The development of the myelopathy syndrome was unassociated with trauma or any other specific inciting cause. Cervical spine x-rays demonstrated a significant atlantoaxial subluxation. Other x-ray features of the spin...

Background: Olfactory groove meningiomas (OGMs) account for about 10% of all intracranial meningiomas. We report on the clinical outcomes and recurrence rate of OGMs after surgical treatment in our neurosurgery department. Methods: The authors searched the database at the Department of Neurosurgery, Chang Gung Memorial Hospital, Chang Gung Universi...