Many synthetic coating materials had been reported in the literature. One of them, ethyl, 2-cyanocrylate is known to the most avaliable material in coating aneurysms. We have recently used it in the treatment of 5 cases of intracranial aneurysms at various sites with successful results, and in following situations much advantages and need seem to be there. First, reinforcement of incomplete simple aneurysmal clipping because of each shape, configuration, site, broad neck and surrounding vital vessels which enter and leave the aneurysmal sac. Second, under surgical microscopic field, to reinforce the incidental microaneurysm, the local thining and dilation of regional arterial well. And last, for preventing of the possible slipping of clip in itself.
Aneurysm ; Intracranial Aneurysm* ; Neck

It is well known that many investigators have devised the methods for the localization of foramen of Monro, considering it as an essential one in stereotactic brain surgery. They have made use of calcified pineal gland, pneumoencephalogram or calculation of the coordinates of the foramen of Monro by bone structures etc. But the complications brought about by the above mentioned methods and nonvisualization of the pineal gland have made them in complex to make exact localization of foramen of Monro. The author devised a new, simple method for the localization of foramen of Monro, using 20 cases of lateral view of pneumoencephalogram whose diagnoses were confirmed as idiopathic epilepsy. The results obtained are as follow : 1. The anterior margin of foramen of Monro is located on the line interconnecting the central point of sella turcica and inner table of the cranial vault with the angle of 86.2?.3? provided that the base line is supposed as the line interconnecting the central point of sella turcica and the internal occipital protuberance. 2. The length from the central point of sella turcica to the anterior margin of foramen of Monro is measured to be 3.5 not equal 0.2cm. 3. Approximately 0.3 is calculated from the ratio between the segment interconnecting the central point of sella turcica and the anterior margin of foramen of Monro, and the segment interconnecting the central point of sella turcica and inner table of skull through anterior margin of foramen of Monro.
Brain ; Cerebral Ventricles* ; Diagnosis ; Epilepsy ; Humans ; Pineal Gland ; Research Personnel ; Sella Turcica ; Skull

BACKGROUND: Conventional visual assessment of coronary arteriogram is fraught with large interobserver variance and disagreement with pathologic findings. Thus quantitative coronary angiography had been recently developed to meet the requirement of more reproducible measurement of severity of coronary artery disease. This study was designed to evaluate the interobserver variability of quantitative coronary angiography and its usefulness in clinical application. METHODS: Three independent observers analysed coronary angiogram of 31 consecutive patients by visual assessment and quantitative measurement using computer based algorithm. RESULTS: 1) There was considerable disagreement between 3 observers in the identification of significant coronary stenosis. Complete agreement was achieved in only 29/61 (47%) coronary lesion and agreement of more than 2 observers in 41/61(67%) lesion. 2) In visual assessment, the largest interobserver variance was found in acute marginal artery and distal circumflex artery, whereas the least variance was observed in proximal right coronary artery. 3) The average interobserver variance was 13.1% in visual assessment, 14.9% in geometric analysis, and 10.5% in video densitometric analysis. There was no significant difference between these values. 4) Visual assessment was noted to overestimate the severity of stenotic lesion, by 5.6% compared to geometric analysis and by 11.8% compared to video-densitometric analysis. CONCLUSION: These findings suggest that identifying significant lesion is major source of interobserve variability in both visual and quantitative analysis of coronary arteriogram. In addition, suboptimal image quality was responsible for the inability of quantitative analysis to reduce the variance. These factors seem to be major limitation of quantitative coronary arterirogam.
Arteries ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Observer Variation*

BACKGROUND: Fosinopril is a new phosphorous containing angiotensin converting enzyme inhibitor. To assess the antihypertensive efficacy and safety of fosinopril, the clinical trial was done in patients with mild to moderate hypertension. METHODS: In 30 patients with mild to moderate essential hypertension, we administered fosinopril 10-20mg once daily for 10 weeks and checked their blood pressure every 2 weeks. RESULTS: The blood pressure decreased from 158+/-12.3/103.4+/-4.2mmHg to 139+/-7.5/88.4+/-5.9mmHg at the end of treatment(p<0.05). Heart rate did not change significantly during therapeutic period. Of 30 patients, the efficacy of fosinopril therapy disclosed 25 patients(83.7%) with normal diastolic pressure of more than 10mmHg decline of diastolic blood pressure. But two patients had no effects and three patients were not followed up. The adverse reactions due to fosinopril were reported in 3 patients(10%) with dry cough, 2 patients with palpitation(6.7%) and 1 patient with weakness(3.3%), but there were no patients who discontinued fosinopril due to adverse effect. CONCLUSION: Fosinopril has an excellent antihypertensive effect at low dosage as a first line antihypertensive agent or as a substituting agent for other antihypertensives in patients with mild to moderate essential hypertension.
Antihypertensive Agents ; Blood Pressure ; Cough ; Fosinopril* ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A

Chondrosarcoma is an uncommon neoplasm originated from cartilage cells. This occurs less than 10% in the head and neck region. Chondrosarcoma of the condyle affects mainly women. The most common symptom is swelling in the preaucricular region, limited mouth opening and pain on chewing. This report describes a case of chondrosarcoma, which occurred in the mandibular condyle.
Cartilage ; Chondrosarcoma ; Female ; Head ; Humans ; Mandibular Condyle ; Mastication ; Mouth ; Neck

A 38-year-old Korean man was diagnosed with hereditary sensory and autonomic neuropathy (HSAN) type 2 because of his chronic sensory neuropathy and progressive acro-mutilation. Genetic analysis revealed that he was a compound heterozygous for two novel mutations in the HSN2 gene including a nonsense mutation (Gln73X) and a 1-bp insertion mutation (Asp379fsX1). To our knowledge, this is the first report of a genetically confirmed case of HSAN type 2 in the Asian population and supports the genetic homogeneity of this rare disease.
Adult ; Asian Continental Ancestry Group ; Codon, Nonsense ; Hereditary Sensory and Autonomic Neuropathies ; Humans ; Mutagenesis, Insertional ; Rare Diseases

BACKGROUND: Thyrotoxic periodic paralysis is an uncommon illness characterized by intermittent flaccid paralysis of skeletal muscle, usually accompanied by hypokalemia, in patient with hyperthyroidism. However. the pathophysiology of thyrotoxic periodic paralysis remains largely unexplained and controversial. This report describes the clnical and biochemical findings in 19 patients with thyrotoxic periodic paralysis who were examined at the Yeungnam University Medical Center (YUMC) during the past decade. METHODS: The medical records of 997 YUMC patients, seen between 1986 and 1996, with dignosis of hyperthyroidism were reviewed. Nineteen patients out of 997 hyperthyrodism patients were diagnosed, and examined by history, physical examination, serum electrolyte value, and thyroid function test during paralysis. On the basis of these results, compasons were made on age. sex, precipitating factors, timing, affected limbs, prognosis, serum potassium and serum phosphate and thyroid hormone levels. RESULTS: the prevalence of periodic paralysis in hyperthyroidism was 1.9 percent and the male to female prevalence ratio was 30:1 and in all patients, the development of perodic paralysis was correlated with hyperfuntional state of the throid gland. Eleven cases of periodic paralysis were associated with hypokalemia and their throid hormon levels were significantly more increased than those of the patients without hypokalemia. interestingly, our study shows the recurrence of paralysis after treatment. CONCLUSION: Although the precise pathophysiology of the disease is as yet undefined and controversial, it occurs primarily in Asians with an overwhelming male preponderance and prevalence of 2 percent in hyperthyrodism. The interactive roles of thyroid hormon. Na-K pump. and genetically inherited defect in the celluar membrance potential of the skeletal muscle can be speculated. Further investigation will be neede to firmly establish the mechanism of thyrotoxic periodic paraysis.
Academic Medical Centers ; Asian Continental Ancestry Group ; Extremities ; Female ; Humans ; Hyperthyroidism ; Hypokalemia ; Hypophosphatemia ; Male ; Medical Records ; Muscle, Skeletal ; Paralysis* ; Physical Examination ; Potassium ; Precipitating Factors ; Prevalence ; Prognosis ; Recurrence ; Thyroid Function Tests ; Thyroid Gland

PURPOSE: Lymphedemas are tissue fluid swellings, usually on the arms or legs, and occur as a result of impaired lymphatic drainage. Presently, the most effective treatment available is complete decongestive physiotherapy (CDP). However, this therapy is ineffective in some patients and surgery may be indicated. Herein, we examined the efficacy of minimally invasive needle aspiration of the most enlarged areas in hypodermic adipose tissues, of patients who had failed CDP. METHODS: We included 21 patients who were diagnosed with lymphedema stage II-III in the upper or lower extremities and visited the lymphedema clinic at a university hospital from September 1, 2003 to February 28, 2004. All patients had been treated with CDP at least once, but had failed to respond to the therapy for more than one year. Nine patients had breast cancer and 12 had cervical cancer. We identified the area with the most severe edema by using MRI and performed a 16-gauge angio-needle aspiration on the area. The patients were followed up for 3 months. Effectiveness of the treatment was evaluated by comparing the volume of edema before and after the treatment using Wilcoxon signed rank-test. RESULTS: The mean reduction ratio of the volume of edema comparison normal volume was 41.1+/-35.3% (P=0.001). There were no major or minor operative complications except localized hemorrhage. CONCLUSION: We conclude that a needle aspiration prior to other surgical treatments is relatively safe and effective for those patients who are unresponsive to CDP.
Arm ; Breast Neoplasms ; Cytidine Diphosphate ; Drainage ; Edema ; Hemorrhage ; Humans ; Leg ; Lower Extremity ; Lymphedema ; Needles ; Uterine Cervical Neoplasms