Between Jan. 1983 and Dec. 1990, 17 Patients with distal anterior cerebral artery(DACA) aneurysms were admitted to our institute and underwent microsurgical neck clipping of their aneurysms. This group comprised 3.7% of the 437 aneurysms managed surgically during this period. There were 11 females and 6 males. The mean age was 48.5 years. Most of DACA aneurysms were located at the genu portion of the anterior cerebral artery. Three cases were at the proximal protion of A2 close to the anterior communicating artery. Two cases were at the dista pericallosal artery and distal callosomarginal artery. Eight patients had additional vascular anomalies documented by angiography such as multiple aneurysms, azygos DACA and duplication of DACA. Direct neck clipping was possible in all cases through the interhemispheric approach or the frontotemporal approach according to the location. For the interhemispheric apporach preoperative evaluation of the exact location and direction of the aneurysms on the angiogram was important for operative planning. The surgical outcome was good or excellent without any neurological deficits in 17 of the cases. Operative management, clinical features and incidence of vascular anomalies associated with DACA aneurysms are discussed.
Aneurysm ; Angiography ; Anterior Cerebral Artery* ; Arteries ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Neck

Total exchangeable sodium and plasma volume were measured to evaluate role of sodium in hypertension by radioisotope 24 Na and Evans blue in 25 patients with essential hypertension, 10 with malignant hypertension, 5 with renal hypertension and 15 normal controls. The results obtained are as follows. 1. The total exchangeable sodium content was 35.8+/-3.5mEq/kg in normal controls, 35.6+/-2.7mEq/kg in essential hypertension and 36.2+/-3.5mEq/kg in renal hypertension revealing no statistical significance in difference. In malignant hypertension, it was 44.9+/-2.0mEq/kg and it was markedly elevated than in normal controls. 2. Plasma volume in normal controls was 44.0+/-4.7ml/kg. In essential hypertension there was two groups, one (group II, 35.2+/-5.6ml/kg) was slightly lower than the other (group I, 43.2+/-4.8ml/kg). In malignant hypertension, it was 56.9+/-7.5ml/kg revealing significant increase than in normal controls. 3. Changes of the total exchangeable sodium content was observed after the administration of hydrochlorothiazide 50mg in normal controls and essential hypertension. In normal controls there was no statistical significance in reduction. In essential hypertension, initially low salt group (group II) showed no significant reduction and the other group (group I) showed significant reduction with depression on blood pressure. 4. Long term therapy with hydrochlorothiazide 50mg for 2~3 months in the group of hypertension who responded well with short term therapy (group I), the contents of exchangeable sodium reduced significantly than normal controls and the antihypertensive effect was sustained. 5. The reduction of plasma volume with hydrochlorothiazide in essential hypertension are similar as changes of total exchangeable sodium. 6. In cases of low salt diet 4gm of daily salt intake, there was similar results as diuretic therapy in exchangeable sodium. 7. In patients who responded well to antihypertensive effect of hydrochlorothiazide or low salt diet (group I), salt loading of 10gm daily showed an increase of total exchangeable sodium and an elevation of blood pressure with statistical significance.
Blood Pressure ; Depression ; Diet ; Evans Blue ; Humans ; Hydrochlorothiazide ; Hypertension* ; Hypertension, Malignant ; Hypertension, Renal ; Plasma Volume* ; Plasma* ; Sodium*

Total exchangeable sodium and plasma volume were measured to evaluate role of sodium in hypertension by radioisotope 24 Na and Evans blue in 25 patients with essential hypertension, 10 with malignant hypertension, 5 with renal hypertension and 15 normal controls. The results obtained are as follows. 1. The total exchangeable sodium content was 35.8+/-3.5mEq/kg in normal controls, 35.6+/-2.7mEq/kg in essential hypertension and 36.2+/-3.5mEq/kg in renal hypertension revealing no statistical significance in difference. In malignant hypertension, it was 44.9+/-2.0mEq/kg and it was markedly elevated than in normal controls. 2. Plasma volume in normal controls was 44.0+/-4.7ml/kg. In essential hypertension there was two groups, one (group II, 35.2+/-5.6ml/kg) was slightly lower than the other (group I, 43.2+/-4.8ml/kg). In malignant hypertension, it was 56.9+/-7.5ml/kg revealing significant increase than in normal controls. 3. Changes of the total exchangeable sodium content was observed after the administration of hydrochlorothiazide 50mg in normal controls and essential hypertension. In normal controls there was no statistical significance in reduction. In essential hypertension, initially low salt group (group II) showed no significant reduction and the other group (group I) showed significant reduction with depression on blood pressure. 4. Long term therapy with hydrochlorothiazide 50mg for 2~3 months in the group of hypertension who responded well with short term therapy (group I), the contents of exchangeable sodium reduced significantly than normal controls and the antihypertensive effect was sustained. 5. The reduction of plasma volume with hydrochlorothiazide in essential hypertension are similar as changes of total exchangeable sodium. 6. In cases of low salt diet 4gm of daily salt intake, there was similar results as diuretic therapy in exchangeable sodium. 7. In patients who responded well to antihypertensive effect of hydrochlorothiazide or low salt diet (group I), salt loading of 10gm daily showed an increase of total exchangeable sodium and an elevation of blood pressure with statistical significance.
Blood Pressure ; Depression ; Diet ; Evans Blue ; Humans ; Hydrochlorothiazide ; Hypertension* ; Hypertension, Malignant ; Hypertension, Renal ; Plasma Volume* ; Plasma* ; Sodium*

A case of neonatal diabetes mellitus is described. The child presented with low birth weight but was normal in appearance. She was acidotic and ketonuria was observed. The HLA typing was DR1 and 3, and insulin autoantibodies were negative. Genetic analysis with polymorphic DNA markers for chromosome 6 indicated biparental inheritance. She required insulin therapy for the control of hyperglycemia, and insulin dependence continues after 8 months of age.
Autoantibodies ; Child ; Chromosomes, Human, Pair 6 ; Diabetes Mellitus* ; Genetic Markers ; Histocompatibility Testing ; Humans ; Hyperglycemia ; Infant, Low Birth Weight ; Infant, Newborn ; Insulin ; Ketosis ; Wills

No abstract available.
Colonic Neoplasms* ; Rectum*

Diabetes insipidus(DI) of central origin is a clinical syndrome resulting from low blood levels of antidiuretic hormone secreted from the posterior lobe of the pituitary gland, which is usually caused by lesions involving the hypothalamus-neurohypophyseal axis. MR imaging can reveal absence of the posterior pituitary bright signal(PPBS)in DI. The authors reviewed four patients with intracranial germinomas who had DI due to hypothalamus involvement. All patients before radiotherapy revealed absence of PPBS on MRI. Three cases recovered from DI after radiotherapy and showed reappearance of PPBS. Another one patients who continued DI didn't show signal change of the posterior pituitary gland. Ws speculated that the reappearance of PPBS is related to clinical improvement of DI.
Diabetes Insipidus* ; Follow-Up Studies* ; Germinoma* ; Humans ; Hypothalamus ; Magnetic Resonance Imaging ; Pituitary Gland ; Pituitary Gland, Posterior ; Radiotherapy*

Various hantaviruses were isolated from HFRS patients and various rodent species, in many parts of the world. Bandicotas were captured at Yogyakarta, east region of Sumatura island, Indonesia; and 4 rodents species including Bandicotas were captured at Chiang Rai in Thailand during 1995. Sera were collected from captured andicotas and other rodent spicies were screened for antibody test against Hantaan (HTN), Seoul (SEO), Puumala (PUU) and Sin Hombre (SN) viruses by immunofluoresence antibody assay (IFA). Hantavirus antigen in lung tissues were tested by IFA. Among 55 captured Bandicota indica in Indonesia, 14 (25.5%) were antibody positive against HTN, SEO, PUU and SN virus. Hantavirus antigen were detected from 5 (9.0%) out of 55 lungs tested. Among 34 captured Bandicota indica in Thailand, 9 (26.5%) were antibody positive against HTN, SEO, PUU and SN virus. Among 34 lungs tissues of Bandicota indica examined, 3 (8.8%) were antigen positive. In other rodent species, antibody positive against Hantaviruses of Rattus rattus, Rattus losea and Mus cervicolor were 4/62(6.5%), 5/25(20%), 1/1(100%), respectively. But no one has antigen in their lung tissues. Antigen positive lungs suspension were inoculated into vero E6 cells for virus isolation and 4 viruses were isolated from Indonesian Badicota and 3 viruses from Thailand.
Animals ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Indonesia* ; Lung* ; Mice ; Murinae* ; Rats ; Rodentia ; Seoul ; Thailand*

No abstract available.
Follow-Up Studies* ; Intermittent Urethral Catheterization*

Fifty-one consecutive 186 patients with aneurysmal subarachnoid hemorrhage were treated from the day of admission with nimodipine which was given first as an IV infusion at 30ug/kg/hr for 1 week and then orally in a dose of 360mg/day for 2 weeks and compared with 135 patients which were treated without nimodipine for the past 2 years. A comparision based on clinical and radiological variables influencing both the coruse and the outcome of the disease showed no significant difference between the nimodipine treated group and the control group except the delayed timing of surgery in the control group. There was no significant difference in the outcome between the nimodipine treated patients and the patients treated without nimodipine, however in Hung & Hess grade IV patients nimodipine treatment was associated with a significantly better outcome. Nimodipine treatment reduced the occurrence of delayed ischemic deficts(DID) in grade III, IV patients. Significant improvement in the outcome occurred in the nimodipine treated patients with subarachnoid hemorrhage of large amount(Fisher classification III).
Aneurysm* ; Classification ; Humans ; Intracranial Aneurysm ; Nimodipine* ; Subarachnoid Hemorrhage*

No abstract available.
Hantaan virus* ; Hemorrhagic Fever with Renal Syndrome*