No abstract available.
Free Tissue Flaps* ; Head* ; Neck*

It is well known that after removal of one cerebral hemisphere all experimental animals, such as monkeys, dogs, cats and rabbits, circle in walking toward the side of the lesion with deviation of head and eyes to the same side for a while. However, the cause of circling gait following cerebral hemispherectomy is not clearly established. In this experiments physiological phenomena were observed in the dog and rabbit following unilateral or bilateral frontal or occipital lobectomies or partial ablations, parietal lobe lesions, section of unilateral optic nerve or optic tract. The results were as follows : 1) All experimental animals circled in walking toward the side of lesion with deviation of head and eyes to the same side for about one week following unilateral frontal lobectomy of partial ablation. There were transient motor weakness for a few days and pseudohemianopsia for about one week on the contralateral side. 2) Bilateral frontal lobectomies did not induce circling gait. But there was a lack of response to visual stimuli for a week. 3) Unilateral parietal lobe ablation did not induce circling gait nor pseudohemianopsia. 4) All experimental animals circled in walking toward the occipital lobectomized side for about 2 or 3 weeks, but deviation of head and eyes toward the side of lesion was not so evident as frontal lobectomized animals. The permanent neurological deficit was contralateral hemianopsia. 5) Bilateral occipital lobectomies was followed by a blindness in all experimental animals. They walked without a definite direction. 6) Section of unilateral optic nerve induced ipsilateral blindness. All experimental animals showed a tendency to walk toward the opposite side but did not circle in walking. 7) Section of unilateral optic tract induced permanent contralateral hemianopsia. All experimental animals circled in walking toward the side of the lesion of a while but deviation of the head was not evident. It is our conclusion that circling gait following cerebral hemispherectomy may be attributed by the permanent and transient hemianopsia and some neurological functional imbalance between the removed cerebral hemisphere, and the intact opposite cerebral hemisphere and brain stem.
Animals ; Blindness ; Brain Stem ; Cats ; Cerebrum ; Dogs ; Gait* ; Haplorhini ; Head ; Hemianopsia ; Hemispherectomy* ; Optic Nerve ; Parietal Lobe ; Physiological Phenomena ; Rabbits ; Visual Pathways ; Walking

No abstract available.
Pneumonia, Aspiration*

Esophageal perforation is a rare disease, which require emergent diagnosis and therapeutic procedure. In this paper, we present one case of esophageal perforation by traction of toothbrush which was swallowed during pharyngeal irritation. After the toothbrush was inserted to stomach by gastroscope, gastrostomy was performed for removal of toothbrush and the esophageal perforation was repaired by operation.
Diagnosis ; Esophageal Perforation* ; Gastroscopes ; Gastrostomy ; Rare Diseases ; Stomach ; Traction

The entity of nonketotic hyperglycemic hyperosmolar coma(NHHC) was described as a severe and often fatal complication in 1957 (Sament and Schwartz), but since then it has been observed as a complication of various primary diseases, both in diabetic and nondiabetic patients. Various predisposing factors in its development include administration of prolonged mannitol, steroid, Dilantin, hyperosmolar tube feeding, dehydration, and diabetes. Combination of these factors are frequently used I the management of patients with neurological disorders and cerebral edema, consequently, a higher prevalence of NHHC might be expected in these patients. We have recently experienced a case of typical NHHC, in whom treated by mannitol, steroid, and Dilantin after emergency craniotomy for head injury.
Brain Edema ; Causality ; Coma* ; Craniocerebral Trauma ; Craniotomy ; Dehydration ; Emergencies ; Enteral Nutrition ; Humans ; Mannitol ; Nervous System Diseases ; Phenytoin ; Prevalence

The entity of nonketotic hyperglycemic hyperosmolar coma(NHHC) was described as a severe and often fatal complication in 1957 (Sament and Schwartz), but since then it has been observed as a complication of various primary diseases, both in diabetic and nondiabetic patients. Various predisposing factors in its development include administration of prolonged mannitol, steroid, Dilantin, hyperosmolar tube feeding, dehydration, and diabetes. Combination of these factors are frequently used I the management of patients with neurological disorders and cerebral edema, consequently, a higher prevalence of NHHC might be expected in these patients. We have recently experienced a case of typical NHHC, in whom treated by mannitol, steroid, and Dilantin after emergency craniotomy for head injury.
Brain Edema ; Causality ; Coma* ; Craniocerebral Trauma ; Craniotomy ; Dehydration ; Emergencies ; Enteral Nutrition ; Humans ; Mannitol ; Nervous System Diseases ; Phenytoin ; Prevalence

No abstract available.
Free Tissue Flaps* ; Mouth* ; Oropharynx* ; Rectus Abdominis*

A 33-month-old girl was admitted to the department of Neurosurgery, Seoul National University Hospital complaining of progressively growing suboccipital mass of 14 months' duration. A round, rubbery, child-fist sized mass was situated at the suboccipital area slightly on the right side from midline. The mass was not tender, pulsatile, and bruits were not audibl. There were no significant neurological abnormalities. Simple skull x-ray showed the huge, blown-out osteolytic lesion at suboccipital area and right retrograde brachial angiogram demonstrated no vascularity within the mass. The thick grayish white, well encapsulated cystic mass was firmly adhered to the adjacent bone and underlying dura, and contained about 30cc of chocolate-like deep brownish red, greasy fluid, and soft grumous brownish materials representing organizing blood clots, and consisted of spongy or honeycombed, coarsely trabeculated architecture. The mass was totally extirpated. The report of biopsy was a typical aneurismal bone cyst. She had uneventful postoperative course.
Aneurysm* ; Biopsy ; Bone Cysts ; Child, Preschool ; Female ; Humans ; Neurosurgery ; Occipital Bone* ; Seoul ; Skull

A 33-month-old girl was admitted to the department of Neurosurgery, Seoul National University Hospital complaining of progressively growing suboccipital mass of 14 months' duration. A round, rubbery, child-fist sized mass was situated at the suboccipital area slightly on the right side from midline. The mass was not tender, pulsatile, and bruits were not audibl. There were no significant neurological abnormalities. Simple skull x-ray showed the huge, blown-out osteolytic lesion at suboccipital area and right retrograde brachial angiogram demonstrated no vascularity within the mass. The thick grayish white, well encapsulated cystic mass was firmly adhered to the adjacent bone and underlying dura, and contained about 30cc of chocolate-like deep brownish red, greasy fluid, and soft grumous brownish materials representing organizing blood clots, and consisted of spongy or honeycombed, coarsely trabeculated architecture. The mass was totally extirpated. The report of biopsy was a typical aneurismal bone cyst. She had uneventful postoperative course.
Aneurysm* ; Biopsy ; Bone Cysts ; Child, Preschool ; Female ; Humans ; Neurosurgery ; Occipital Bone* ; Seoul ; Skull

Retrospective analysis of reoperation and complication was made for 186 patients with lumbar herniated disc. The results showed complication rate of 7%(13 cases) and reoperation rate of 10.2%(19 cases). The primary complications were infections(9 cases), technical errors(2 cases), and scores(2 cases). Rate of discitis was 1.6%(3 cases). The outcomes of reoperation resulted in excellent recovery of 16%(3 cases) and good recovery of 58%(11 cases). The most common intraoperative findings of reoperation were inadequate disectomy or missed disc fragments 31.6% or 6 cases;epidural fibrosis 26.3% or 5 cases;and new herniation at other level 15.8% or 3 cases. Excellent and good results could be achieved in patients operated within 1 month or more than 6 months after while the patients who underwent reoperation between 1 month and 6 months showed poor results. The delicate perioperative menagement and complete discectomy, adequate bleeding control and laminectomy were considered to be essential in reducing the chance of complication and reoperation.
Discitis ; Diskectomy ; Fibrosis ; Hemorrhage ; Humans ; Intervertebral Disc Displacement ; Laminectomy ; Reoperation* ; Retrospective Studies