The authors report two cases of aneurysms of basilar bifurcation approached by modified frontolateral transsylvian route: each aneurysm was clipped successfully through the space between internal carotid artery and posterior communicating artery in case 1 and the space between internal carotid artery, posterior communicating artery and oculomotor nerve in case 2. Historical background and surgical approaches are discussed.
Aneurysm* ; Arteries ; Carotid Artery, Internal ; Oculomotor Nerve

A case of Tuberculous abscess in cerebrum, in a 17 years-old male, is presented, which was confirmed Pathologically and microbiologically. At present, tuberculous infection progressively decrease, and especially occurs rarely tuberculous abscess in central nerve system. The prognosis is known to be poor. We have experienced a case of tuberculous abscess in cerebrum and obtained a good result after surgery. So, we report our case with a brief review of the articles.
Abscess* ; Adolescent ; Cerebrum* ; Humans ; Male ; Prognosis

Background: This study aimed to investigate the association between type 2 diabetes mellitus (T2DM) and shoulder adhesive capsulitis (AC) using a large-scale, nationwide, population-based cohort in the Republic of Korea. Methods: A total of 3,471,745 subjects aged over 20 years who underwent a National Health Insurance Service medical checkup between 2009 and 2010 were included in this study, and followed from the date of their medical checkup to the end of 2018. Subjects were classified into the following four groups based on the presence of dysglycemia and history of diabetes medication: normal, prediabetes, newly diagnosed T2DM (new-T2DM), and T2DM (claim history for antidiabetic medication). The endpoint was new-onset AC during follow-up. The incidence rates (IRs) in 1,000 person-years and hazard ratios (HRs) of AC for each group were analyzed using Cox proportional hazard regression models. Results: The IRs of AC were 9.453 (normal), 11.912 (prediabetes), 14.933 (new-T2DM), and 24.3761 (T2DM). The adjusted HRs of AC in the prediabetes, new-T2DM, and T2DM groups were 1.084 (95% confidence interval [CI], 1.075 to 1.094), 1.312 (95% CI, 1.287 to 1.337), and 1.473 (95% CI, 1.452 to 1.494) compared to the normal group, respectively. This secular trend of the HRs of AC according to T2DM status was statistically significant (P<0.0001). Conclusion This large-scale, longitudinal, nationwide, population-based cohort study of 3,471,745 subjects confirmed that the risk of AC increases in prediabetic subjects and is associated with T2DM status.

PURPOSE: The increased expression of cyclooxygenase (COX)-2 has been implicated in the development and progression of human cancer. This study investigated the COX-2 expression in colorectal cancer, and its relationships with tumor angiogenesis and the clinicopathological factors. MATERIALS AND METHODS: The expression of the COX-2 protein and microvessel density were evaluated, using immunohistochemical methods, in 21 normal colonic mucosa and 190 human colorectal carcinomas. Correlations between COX-2 expression and microvessel density, as well as various clinicopathological factors, were studied in colorectal carcinomas. RESULTS: The COX-2 protein expression in epithelial cells was increased in 169 of the 190 adenocarcinoma cases (88.9%), but in only 1 of the 21 (4.8%) normal mucosa cases. The COX-2 expression was significantly increased in the differentiated compared with the undifferentiated colorectal carcinomas (p<0.05), and significantly correlated with the depth of invasion and microvessel density (p<0.05). Rectal cancers had more COX-2 positive cases than the colon cancers (p<0.05). However, there were no significant differences in the tumor size and the presence of lymphatic or vascular invasion. CONCLUSION: The overexpression of cyclooxygenase-2 in colorectal carcinomas seems to play a role in the invasion and angiogenesis of the tumors, so may be a useful marker of the prognosis. The prominent expression was also demonstrated in differentiated colorectal cancers.
Adenocarcinoma ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Cyclooxygenase 2* ; Epithelial Cells ; Humans ; Microvessels* ; Mucous Membrane ; Prognosis ; Prostaglandin-Endoperoxide Synthases ; Rectal Neoplasms

BACKGROUNDS: The education by the family physician. is important for more practical primary care medicine education. In this study, we try to know the presnent state of education and the future and the number of education resource and how to multiply this resource. METHODS: we have got the list of family physicians who have their clinic in Seoul by the help of the Korean Academy of Family Medicine. And we performed telephone questionary. We also asked the demographic factors RESULTS: 134 persons were asked questionary by the telephone. 17persons were joining in education. Trainee by the 3rd grade hospitals was the major, the next was by 2nd grade hospital, and doctors who did not have the training. 14 persons have begun education by asking of the training hospital, 3 persons wanted it, but none thought it beneficial to them. 44 persons wanted to join education in the future, and there was no difference between the 3rd and the 2nd grade hospital trainee. CONCLUSION: There was no difference between the 3rd and 2nd grade hospital trainee but 2nd grade hospital trainee was less joining than the 3rd. This shows that the 2nd grade hospital trainee can be the good pool of the future education if there are adequate supply. So many adequate supply is necessary.
Demography ; Education* ; Humans ; Physicians, Family* ; Primary Health Care ; Seoul* ; Telephone

PURPOSE: Using proteomic analysis, this study was performed to see the characteristics of proteins expression in the muscles of spastic cerebral palsy patients. MATERIALS AND METHODS: We studied twelve specimens from six patients with spastic cerebral palsy, three patients with myelomeningocele, and three normal people who underwent orthopaedic surgeries due to trauma. We studied the extracted proteins showing differences in the two-dimensional electrophoresis, and the prominent thirteen proteins were re-evaluated by proteomics and the reverse transcriptional polymerase chain reaction, which was to clarify the relationship between gene and protein expression. RESULTS: Among fifteen proteins, six proteins were found to be higher in normal people, and nine were found to be higher in the groups of patients by spot histogram. The results of proteomic analysis with MALDI-TOF for fifteen proteins showed that the expression of DJ-1 was related to cerebral palsy. CONCLUSION: This study shows that strong expression of DJ-1 is related to spasticity and cerebral palsy. We showed for the first time the possibility of any relationship between spastic condition and DJ-1 expression.
Cerebral Palsy ; Electrophoresis ; Humans ; Meningomyelocele ; Muscle Spasticity ; Muscles ; Polymerase Chain Reaction ; Proteins ; Proteomics

The effects of Equiseti Herba Water-heating extract on the kidey & liver of rats were studied in 25 male Sprague-Dawley rats evenly divided into five groups, i.e., 5 rats each. The group I, which served as control and the group II, III, IV, were fed 300 mg/kg, 1000 mg/kg of Eqiseti Herba water-heating extract daily for one week, respectively. The group V was fed 1000 mg/kg of Equiseti Herba extract daily for two weeks. The effect of Equiseti Herba on the kidney and liver were determined by the measurements of the serum levels of BUN, creatinine, calcium, phosporus, sodium and potassium, total protein, albumin, transaminase (GOT & GPT) and cholesterol and 24hrs urine volume and GFR(ml/min), as well as by light microscopic and ultrastructural examinations of kidney and light microscopic examinations of liver in rats. The results were as follows; The groups II, III, IV were slightly higher than the control group on serum creatinine and potassium levels, but the group V was declined on serum creatinine and potassium levels, and 24hrs urine volume in spite of increased GFR. Histologically there was no remarkable changes in groups compared with the group I, except mild vacuolization of proximal convoluted tubule in group IV and V. These results suggested that equiseti Herba water-heating extract in rats induced reversible tubular changes on the kidney of rats. But the groups administrated by Equiseti Herba water-heating extract were not significantly higher than the control group on liver function test. Histologically there was no remarkable changes in groups II, III, IV & V compared with the group I.
Animals ; Calcium ; Cholesterol ; Creatinine ; Humans ; Kidney* ; Liver Function Tests ; Liver* ; Male ; Potassium ; Rats* ; Rats, Sprague-Dawley ; Sodium

A 42-year-old male was hospitalized with abdominal pain, dyspnea, and turbid peritoneal fluid. He was diagnosed with hypertension, diabetes and started continuous ambulatory peritoneal dialysis (CAPD) 11 months ago. He was treated with intraperitoneal cefazolin and ceftazidime, and then white blood cell counts of dialysate decreased. Incidentally, liver abscess was found in chest CT performed for the evaluation of dyspnea, and patient was febrile persistently. So percutaneous abscess drainage was done by pigtail catheter. We changed the antibiotics to ceftriaxone and metronidazole, and hemodialysis was started. Klebsiella pneumoniae was cultured from peritoneal fluid and blood simultaneously. We concluded that liver abscess is a primary cause of CAPD peritonitis.
Abdominal Pain ; Abscess ; Adult ; Anti-Bacterial Agents ; Ascitic Fluid ; Catheters ; Cefazolin ; Ceftazidime ; Ceftriaxone ; Drainage ; Dyspnea ; Humans ; Hypertension ; Klebsiella ; Klebsiella pneumoniae ; Leukocyte Count ; Liver ; Liver Abscess ; Male ; Metronidazole ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Renal Dialysis ; Thorax

BACKGROUND: The purpose of this study was to investigate the clinical and electro physiologic characteristics of patients with multiple accessory pathways. Recently as endocardial mapping has become more and more accurate, multiple accessory pathways which were considered to be rare in the past, have become more commonly reported in patients with Wolff-Parkinson-White syndrome. METHODS: From February 1993 to June 2000, there were a total of 452 patients, who were confirmed to have accessary pathway mediated-tachyarrhythmias diagnosed by electrophysiologic study. Among those, 19 patients had multiple accessory pathways, and were enrolled in this study. RESULTS: Among the 19 patients, thirteen patients were male and six were female, and their mean age was 36.5+/-16.17 years. All patients had 2 accessory pathways. The distribution of the location of the accessory pathways was at the left free wall (71.1%), right free wall (18.4%) and posteroseptal wall (10.5%). The most common combination pattern was the left free wall and left free wall (57.9%) and the most common anatomical areas were the left lateral wall and left posterior wall (36.8%). The success rate of the catheter ablation was 84.2% (16/19). The recurrence rate after the radiofrequency catheter ablation was 31.3% (5/16) and the most common recurrence site was left free wall (60.0%, 3/5). CONCLUSION: These results indicated that the clinical and electrophysiologic characteristics of the multiple accessory pathway patients with WPW syndrome in our study were similar to those of western countries.
Catheter Ablation ; Female ; Humans ; Male ; Recurrence ; Wolff-Parkinson-White Syndrome

Mulitiple intracranial aneurysms occur in range of 15% to 30% of all patients with intracranial aneurysms. The treatment of such patients offers a particular challenge for the neurosurgeon. Early reports dealing with multiple aneurysms recommended treatment of only the ruptured aneurysm, but recently, authors have advised treatment of all significant aneurysms. We performed a retrospective review for 63 patients with multiple intracranial aneurysms, admitted to Department of Neurosurgery, Kyung-Hee University Hospital between Jun. 1982 and Dec. 1989. The present study includes the incidence of multiple aneurysms, its age and sex distribution, aneurysm locations, probability of rupture, relationship of aneurysmal size and rupture, and operative results. The results were as follows ; 1) Multiple intracranial aneurysms occurred in about 12.2% of all patient with aneurysms. 2) The female to male ratio was about 2.3:1 for patients with two aneurysms and 5:1 for patients with three or more aneurysms. 3) Common location for multiple aneurysms were the PCoA, ICA, ACoA, and MCA. 4) On the distribution of multiple aneurysms according to location, unilateral and midline located mutliple aneurysms were 61.9%. 5) Probability of aneurysmal rupture according to site was(in decreasing order) ACoA, PCoA, AChoA, MCA, and ICA bifurcation. 6) Irregularity of shape was more inportant than size in identifying the site of rupture. 7) Most unruptured aneurysms were 5mm or smaller in size ; however, most ruptured aneurysms were 6mm or larger. 8) About 70% of surgical management showed good and fair result.
Aneurysm ; Aneurysm, Ruptured ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Neurosurgery ; Retrospective Studies ; Rupture ; Sex Distribution