The medulloblastoma, a neoplastic emtity which was first identified and described in 1925 by Bailey and Cushing, is a highly malignant, rapidly growing tumor mainly confined to the first decade of life. The medulloblastoma rarely calcifies. Many investigator have reported that medulloblastoma may exhibit calcification only on microscopic examination. Roentgenographic evidence of calcification was found in one case of 54 patients with medulloblastomas by McRae, and in only one case of 96 patients with medulloblastomas by Kalan. A twelve-year-old Korean male was admitted to Seoul National University Hospital on May 1, 1972 with the complaints of severe occipital headache, vomiting, and unsteady gait of five months duration. Neurological examination revealed bilateral papilledema of 3 diopters, signs of cerebellar dysfunction on the left side including truncal ataxia, adiadochokinesia, positive Romberg test and markedlv distured tandem gait. Horizontal nystagmus with quick component directed to the left side was also found. Plain skull films showed suture separation and an abnormal calcific shadow measuring about 2 by 2.5cm in the posterior fossa. Reflux brachial angiogram showed marked bowing of anterior cerebral artery, and elevation of middle and posterior cerebral arteries suggesting a large mass in the posterior fossa causing obstruction of CFS pathways resulting in marked dilatation of ventricular system. Exploring the posterior fossa, a soft grayish tumor mass was removed partially. Microscopic diagnosis was medulloblastoma of desmoplastic type with calcification. Postoperatively CSF leakage through the incision site was encountered, but was controlled to be healed up by compression bandage. The patient showed no significant change of neurological status by the time of discharge. The patient was scheduled to undergo Co60 radiation therapy after discharge.
Anterior Cerebral Artery ; Ataxia ; Cerebellar Diseases ; Compression Bandages ; Diagnosis ; Dilatation ; Gait ; Gait Disorders, Neurologic ; Headache ; Humans ; Male ; Medulloblastoma* ; Neurologic Examination ; Nystagmus, Pathologic ; Papilledema ; Posterior Cerebral Artery ; Research Personnel ; Seoul ; Skull ; Sutures ; Vomiting

In modern society, characterized by variability of daily life, complicated industrial structure and surprisingly increased traffics, the danger of unexpected accident if always threatening the people. In America, for instance, almost 0.5% of the whole population annually suffers from head injury. About two thirds of traffic accident patients have head injury of various forms. Among the head injury patients due to traffic accidents, the commonest cause of death is head injury itself in about 70%. In this study, 585 cases of adult head injury patients over 15 years of age, observed at the Department of Neurosurgery, Seoul National University Hospital during the period from January, 1966 till September, 1971 were reviewed. 1) There were 447 men and 138 women; male female ratio was 3:1.2) The commonest cause of head injury was traffic accident (57.3% of the total patients). A second common cause was "falls"(25.5%). 3) In skull fracture patients, vault fractures were twice as frequent as basal skull fracture. The incidence of simple fractures was remarkably higher than that of compound fractures, the ratio being 7:4. The incidence of linear fractures was slightly higher than that of depressed fractures, the ratio being 6:5. Most of linear fractures were simple fractures, but about 79% of depressed fractures were compound fractures. 4) Among the intracranial hemorrhagic lesion, subdural hematoma occupied about half of the total cases, most of whom were acute cases. The predilection site of subdural hematoma was the cerebral convexity (frontal, parietal and temporal areas). The epidural hematoma , of which the predilection site was temporal area, occupied about 30 % of the total intracranial hemorrhage lesions. Temporal lobe was the predilection site of intracerebral hematoma. 5) About half of the patients with intracranial hemorrhagic lesions were accompanied by skull fractures. About 28% of the cases with skull fractures were accompanied by intracranial hemorrhagic lesions. 6) Altered consciousness was observed in about 90% of the total patients. Lucid interval was observed in 26% of the cases with intracranial hemorrhagic lesion. Vomiting occurred in a quarter of the total patients and early convulsive attacks were noticed in 5%. 7) Overall mortality rate of all the head injury patients was 12.3% and their operative mortality rate was 20.1%. The mortality rate in the patients with skull fractures was five times as high as in the patients without skull fractures. The mortality rate in the patients with intracranial hemorrhagic lesions was nearly three times as high as in those without. The mortality rate in the patients with linear skull fractures was about three times as high as in those with depressed skull fractures. 8) Sequelae were noticed in about half of the total patients. The most frequent one was postconcussion syndrome, the incidence being 36% of the total patients. 9) Associated injuries were found in about 10% of the total patients. The frequent ones were clavicle fracture, tibia/fibula fracture and mandible fracture, in order.
Accidents, Traffic ; Adult* ; Americas ; Cause of Death ; Clavicle ; Consciousness ; Craniocerebral Trauma* ; Female ; Fractures, Open ; Hematoma ; Hematoma, Subdural ; Humans ; Incidence ; Intracranial Hemorrhages ; Male ; Mandible ; Mortality ; Neurosurgery ; Rabeprazole ; Seoul ; Skull Fracture, Depressed ; Skull Fractures ; Temporal Lobe ; Vomiting

In the last years, according to the increasing incidence of measles and other viral diseases, it have been needed to study on not only the fundamental epidemiological characteristics of mumps and measles but also judgement on the effectiveness of vaccine that meet our domestic situation. The author carried out questionnaire to obtain epidemiological characteristics and vaccine efficacy of mumps on epidemics of mumps in one primary school in Hwasung-kun, Kyonggi Do from Feb. to July, 1994. The results are summarized as follows: 1. Total students was 556, but 446(78.4%) responded to the questionnaire. Among that 446,130(29. 1%) have suffered from mumps. From 9 to 10 year old students had the high attack rates, especially 10 year olds has the highest(39. 7%). 2. From Feb. 2, 1994, first case was on, to July 6, 1994, the epidemic was continues, and attack rate was higest in May(50. 5%). 3. Among the 130 mumps patients, 5 have suffered from complication(3.8%) : encephalitis 3(2 in male, 1 in female). 4. Vaccination rate was 91%, and as ages were lowered, the rates were higher. 5. Attack rate was higher in group who had time interval after vaccination less than 5 years than total attack rate, and was higher in group who had been vaccined after 5 year old. 6. Attack rate in vaccinated group was 27.3%. 7. Vaccine efficacies, be judged by three methods of analysis according to case definition and vaccination status, were 37.4 39. 2%. 8. Factors that have significantly affected the mumps epidemic were vaccination status and vaccination age.
Child ; Child, Preschool ; Encephalitis ; Epidemiologic Studies* ; Gyeonggi-do* ; Humans ; Incidence ; Male ; Measles ; Mumps* ; Vaccination ; Virus Diseases ; Surveys and Questionnaires

PURPOSE: To evaluate the efficacy of color Doppler ultrasound (US) in the diagnosis of gestational trophoblastic neoplasia (GTN). MATERIALS AND METHODS: Intralesional color flows and resistive index (RI) on color Doppler US were prospectively analyzed in 21 consecutive suspected GTN cases. RI of the intralesional artery was investigated on the basis of the presence or absence of mass and metastasis. Correlation between RI of intralesional artery and urinary beta-hCG was also investigated. RESULTS: Intralesional color flows were identified in 15 patients with GTN. On operation, intralesional color flows were observed in one of two patients in whom the presence of completely necrotic tissue was confirmed. Intralesional color flows, however, were not detected in four patients who were proved not to be GTN sufferers. Sensitivity, specificity, accuracy, positive and negative predictive values, and accuracy were 100%, 83%, 95%, 94% and 100%, respectively. Significant correlation between RI of the intralesional artery and urinary beta-hCG was not established(p=0.49, r=0.19). RI of this artery was not substantially different between groups with and without mass, and between groups with and without metastasis(p=0.32, p=0.82). CONCLUSION: The current study demonstrates that color Doppler US is a sensitive and useful method for the diagnosis of GTN.
Arteries ; Diagnosis ; Gestational Trophoblastic Disease* ; Humans ; Neoplasm Metastasis ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography*

BACKGROUND: A correct estimate of the tracheal tube insertion depth can prevent complications, including endobronchial intubation and vocal cord trauma. We evaluated a new topographical method for endotracheal tube positioning relative to the carina, using a well-known prior topographical method for comparison. METHODS: One hundred adult (male 50, female 50) patients were studied. The comparison topographic length (in cm) was measured by adding the distance between the right mouth corner and the right mandibular angle to the distance between the right mandibular angle and the center of the sternal manubrium. The new endotracheal tube insertion depth (in cm) was determined by adding the distance between the right mouth corner and the vocal cords, measured with the endotracheal tube itself, to the distance between the thyroid prominence and the manubriosternal joint, and then subtracting 4 cm. After intubation, the endotracheal tube was positioned properly at the right mouth corner and the endotracheal tube tip was evaluated using a fiberoptic bronchoscope at the carina. RESULTS: The distances from the tip of the endotracheal tube to the carina were not significantly different between the methods in the same gender. However, our method allowed endotracheal tube tip placement between 3 cm and 5 cm, above the carina more frequently than the prior method in males. CONCLUSIONS: The new topographical method can be used as a guide to positioning the endotracheal tubes.
Adult ; Bronchoscopes ; Female ; Humans ; Intubation ; Joints ; Manubrium ; Mouth ; Thyroid Gland ; Vocal Cords

No abstract available.
Meningocele*

No abstract available.
Choriocarcinoma* ; Female ; Neoplasm Metastasis* ; Pregnancy

A Clinical analysis was carried out with 340 cases of craniocerebral injuries under 15 years of age, admitted at the Department of Neurosurgery, Seoul National University Hospital in 12 years between Jan., 1987 and Dec., 1969. The matrial was classified four groups according to main lesions, i.e. (1) mild cerebral contusion without skull fractures. (2) moderate or severe cerebral contusion without skull fractures. (3) various types of skull fractures. (4) intracranial hemorrhagic lesions, representing such lesions as follows: a. epidural hematoma, b. subdural hematoma, c. subdural hygroma, d. intracerebral hematoma, e. traumatic subarachnoid hemorrhage. The results were as follows: 1) The age incidence was greatest in 6 years of age, and 120 cases (32.6% of the total) were included in the age group between four and six. 2) Males outnumbered females by almost 2 to 1. 3) The accident occurred mostly between 1 p.m. and 4 p.m. in a day. 4) The craniocerebral injuries were caused by traffic accident(173 cases; 50.8%), falls from heights(108 cases; 31.8%), hit(55 cases; 10.9%), firearms(2 cases; 0.6%) and birth injury (2 cases; 0.6%). 5) Early convulsion was the frequent symptom in the age group between 2 and 7. It was felt that convulsions frequently occurred in epidural and subdural hematoma patients. 6) Forty eight per cent of patients had no deterioration of consciousness on admission examination. 7) Epidural hematoma was the common finding in most of the depressed skull fracture cases. 8) The location of skull fractures in the order of frequency were parietal, temporal, frontal and occipital bone. 9) The epidural hematoma was most common lesion in the 13 to 15 year-old group. 10) The over-all mortality rate was 7.1%. In the surgical group(79 cases) the operative mortality was 11.4%(9 cases): the mortality rate of the subdural hematoma, 25.0%(3 cases); the epidural hematoma, 11.1%(2 cases); the compound depressed fracture, 7.8%(2 cases). In the non-surgical group(261 cases) it was 5.8%. The mortality rate of those who and been unconscious after injuries was significantly high(75.0%). 11) The period of hospitalization was two weeks on an average.
Adolescent ; Birth Injuries ; Child* ; Consciousness ; Contusions ; Craniocerebral Trauma* ; Female ; Hematoma ; Hematoma, Subdural ; Hospitalization ; Humans ; Incidence ; Infant* ; Male ; Mortality ; Neurosurgery ; Occipital Bone ; Rabeprazole ; Seizures ; Seoul ; Skull Fracture, Depressed ; Skull Fractures ; Subarachnoid Hemorrhage, Traumatic ; Subdural Effusion

BACKGROUND: Increasing age and loss of teeth weaken oral muscle strength. This study aimed to investigate the positive effects of orofacial myofunctional training on elderly people.METHODS: Thirty six elderly individuals in a welfare center and a senior citizen center were included in this study. A survey regarding lip and tongue strength suvsequent to orofacial myofunctional training and oral health-related quality of life was conducted from April to June, 2019. Data were analyzed using PASW statistics ver. 18.0.RESULTS: The experimental group, showed an increase in lip strength (from 9.79 to 10.31) and tongue strength (from 41.26 to 43.97) after orofacial myofunctional training. The perception of oral health-relatedquality of life was enhanced (from 2.26 to 2.07). In particular, the frequency of dry cough for food removal while swallowing decresed due to an incresed in the secretion of saliva (p<0.05). Correlation analysis showed that the number of functional teeth was positively related to oral health-related quality of life.CONCLUSION: Orofacial myofunctional training for improving lip and tongue strength is effective in the elderly. In older societies, oral strength should be maintained to improve oral health-related quality of life. It also suggests the interest of oral health workers and applying orofacial myofunctional training programs.
Aged ; Cough ; Deglutition ; Education ; Humans ; Lip ; Muscle Strength ; Myofunctional Therapy ; Oral Health ; Quality of Life ; Saliva ; Tongue ; Tooth

This is the first case report of a patient with a large serous cystadenoma accompanied by a juvenile granulosa cell tumor that was discovered in the remaining ovarian tissue. A 25-year-old female was presented with constipation and amenorrhea. Ultrasonography revealed a large cystic mass in the left ovary with a normal uterus. The remaining ovarian tissue seemed normal at first look after cystectomy, but showed abnormal consistency on palpation. The remaining ovarian tissue was removed and granulosa cell tumor was confirmed by pathologic examination. The patient has been followed up for 30 months without evidence of recurrence. We would like to emphasize the importance of inspection, and palpation of remaining ovarian tissue during operation to avoid risks of remaining ovarian pathology.
Adult ; Amenorrhea ; Constipation ; Cystadenoma, Serous* ; Cystectomy ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Humans ; Ovarian Neoplasms ; Ovary* ; Palpation ; Pathology ; Recurrence ; Ultrasonography ; Uterus