Motor weakness is one of the neurological complication that can occur after aneurysmal subarachnoid hemorrhage (SAH); incidence of motor weakness of 14~29% has been reported. Detailed information on the pathogenic mechanism of motor weakness is essential for brain rehabilitation because it enables estimation of the severity of injury, establishment of scientific rehabilitative strategies, and prediction of motor outcomes by clinicians. However, the exact pathogenic mechanisms of motor weakness following aneurysmal SAH have not been clearly elucidated. In this article, 14 previous studies on pathogenic mechanisms in patients with aneurysmal SAH were reviewed according to the location of the lesion (cerebral cortex, brainstem, spinal cord, and peripheral nerve). The following pathogenic mechanisms have been suggested: vasospasm, cerebral ischemia, hydrocephalus, compression of cerebral cortex, neural injury, spinal cord infarction, and radiculo-neuropathy. Considering the high incidence of aneurysmal SAH and motor weakness following aneurysmal SAH, we believe that the pathogenic mechanisms of motor weakness have been relatively understudied. More effort should be taken to investigate this important topic.
Subarachnoid Hemorrhage

It is socially fortunate that there is little chance in the civil hospital to experience the victims of high velocity missiles. However it is reasonable thought to educate doctors about the gunshot and explosive injuries who might be mobilized in emergency condition. Authors have experiences to treat the high velocity missile wounds. In order to provide valid data to be an educational material, we clinically analyzed 41cases of those injuries who were treated at the Capital Armed Forces General Hospital from 19xx to 19xx. The results obtained were as follows: 1. In 15 cases there were only soft tissue injuries, The remaining 26 cases had the bone injuries and six of them had two injury sites. 2. In 28 cases the lower extremities were injuried, and they out-numbered the injury of upper extremities. The most frequent site of injuries was the thigh (31.7%). 3. Most common associated injuries were the periphenal nerve injuries, which numbered 10 cases. 4. The early operative treatments were given in 5 out of 32 cases having bone injuries. And the secondary operations, including bone graft and intemal fixation, had to be done in 10 out of the remaining 27 cases due to delayed union or nonunion. 5. There was no infection in cases having only the soft tissue injuries. But the localized osteomyelitis occurred in 4 cases among the cases having bony injuries. 6. Factors affecting the result of high velocity missile wounds were presence of bony involvement, site and extent of injuries, associated thoracoabdominal injuries and presence of peripheral nerve injuries and infection. 7. The evacuation time, chance of early adequate wound management, site of injury and extent of injury were the important factors in deciding the method of treatment. We suggest that the more selective and aggressive measures should be taken in the management of bony injuries.
Arm ; Emergencies ; Extremities ; Hospitals, General ; Lower Extremity ; Methods ; Osteomyelitis ; Peripheral Nerve Injuries ; Soft Tissue Injuries ; Thigh ; Transplants ; Upper Extremity ; Wounds and Injuries

PURPOSE: The purpose of this study was to evaluate the safety, feasibility and effectiveness of an endoluminally-placed bifurcated stent-graft (Vanguard) for the treatment of infrarenal abdominal aortic aneurysm (AAA). METHODS: Transluminal endovascular stent-graft placements were attempted in 29 patients (28 male, mean age 69+/-7 years) with AAAs involving the common iliac arteries from Aug. 1997 to Jan. 1999. Endovascular therapy was performed in the cardiac catheterization laboratory with epidural anesthesia. One side of the femoral artery was opened by surgical cutdown for the bifurcated stent-graft entry and the other side was punctured percutaneously for the straight stent-graft. Computed tomography and/or intraarterial angiography were performed during an average follow-up of 10 months (2-18 months). RESULTS: Primary success rate was 75.9% (22 of 29 patients) and the overall success rate was 79.3% with successful correction of one perigraft leak. Twenty patients (69.0%) had significant coronary artery disease. There were two technical failure cases, the one was tortuous iliac vessel with spasm, the other was disconnection of the stent-graft connecting portion. Complications related to procedure occurred in 13.8% of patients (4 of 29 patients) and two of these four patients had procedure-related mortality because of acute renal failure following contrast overdose and sepsis after operation. CONCLUSIONS: Endovascular treatment of infrarenal AAA with bifurcated stent-graft (Vanguard<0A397>) is effective, feasible and relatively safe. However, further investigation for the outcome, complication and long-term follow-up are needed.
Acute Kidney Injury ; Anesthesia, Epidural ; Angiography ; Aortic Aneurysm, Abdominal* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease ; Endoleak ; Femoral Artery ; Follow-Up Studies ; Humans ; Iliac Artery ; Male ; Mortality ; Sepsis ; Spasm

Myocarditis is defined as the myocardial inflammation caused by various infectious agents (such as virus, rickettsia , bacteria, protozoa, fungus and parasites). The clinical manifestations of myocarditis ranges from the asymptomatic state due to focal inflammation to fulminant fatal congestive heart failure secondary to diffuse myocardial involvement. Clinically, in some cases, it may simulate an acute myocardial infarction. We experienced a case of acute fulminant myocarditis that presented as acute myocardial infarction initially, and then progressed into and recovered from congestive heart failure and multiorgan failure.
Asymptomatic Diseases ; Bacteria ; Estrogens, Conjugated (USP)* ; Fungi ; Heart Failure* ; Inflammation ; Myocardial Infarction ; Myocarditis* ; Rickettsia

No abstract available.
Adenomyosis* ; Humans ; Uterus*

No abstract available.
Adenomyosis* ; Humans ; Uterus*

Dermoid cysts develop from sequestration of epithelium along lines of embryonic fusion.The most common locations are the lateral third of the eyebrows, nose, and scalp. These cysts are located in the subcutis; they are often adherent to periosteum, and may invade or erode underlying bane. A 34-year-old female presented with a solitary, skin colored, dome-shaped, child fistsized, subcutaneous mass on her right occiput. At operation, keratinous material was discharged and tufts of hair projected from opening of the cyst wall.The base of the cyst was firmly adherent to periosteum and diffuse depression with focal deep erosions of the outer table of skull was found.
Adult ; Child ; Cytochrome P-450 CYP1A1 ; Depression ; Dermoid Cyst* ; Epithelium ; Eyebrows ; Female ; Hair ; Humans ; Nose ; Periosteum ; Scalp ; Skin ; Skull*

A 46 year-old male with drowsy mentality and left hemiparesis had been treated. Right carotid angiogram showed a mass effect on the posterior temporal region. Preoperative CT brain scan revealed two separated hypodense masses with ring enhancement on the each hemisphere. The right-sided mass was totally removed and there was no invasion into the ventricle and meninges. The histological diagnosis was a glioblastoma multiforme. The left-sided mass was followed with the repeated CT scan, which showed the similar CT findings of a glioblastoma multiforme, and there was no evidence of commiccural extension. The above findings were consistent with the criteria of multicentric tumor.
Brain ; Diagnosis ; Glioblastoma* ; Humans ; Male ; Meninges ; Middle Aged ; Paresis ; Tomography, X-Ray Computed

Peripheral cementifying fibroma is histomorphologically similar to the central cementifying fibroma, but this lesion is unique to the gingival mucosa and is only rarely seen in edentulous area. In most instances, it arise from interdental papilla, with 80% occurring anterior to molar region. This lesion appears to involve the maxilla and mandible equally, demonstrates the highest occurrence rate during the second decade of life, and affects female more frequently than male, with 4.3:1 to 3:2. Peripheral cementifying fibroma presents as firm, pedunculated or sessile mass with an intact or ulcerated surface depending on the presence of trauma. Microscopically, it reveals a highly cellular mass of connective tissue containing numerous plump, proliferating fibrolasts and several forms of calcification. Effective treatment requires deep excision, which includes the ligament and periosteum, followed by a thorough root scaling of the adjacent teeth. A reveiw of the literature and a report of a case of peripheral cementifying fibroma are presented.
Connective Tissue ; Dental Scaling ; Female ; Fibroma* ; Gingiva ; Humans ; Ligaments ; Male ; Mandible ; Maxilla ; Molar ; Mucous Membrane ; Periodontal Ligament* ; Periosteum ; Tooth* ; Ulcer

We observed the effect of application of n-PTFE on mandibular bone defects in the rabbit. GTR is based on the hypothesis that during wound healing, non-osteogenic cells are mechanically blocked from entering a bone defect. This allows the slower-migrating mesenchymal cells from the surrounding bone and marrow, having osteogenic potential, to move the defect site. Bilateral through & through defects, 8mmx4mm in size, involving the inferior border of mandible, were created in the mandible angle of 15 rats. The experimental side was applied with high-density n-PTFE membrane, with the opposite side serving as a control. In the first week of the early experimental period, the bone defects of experimental groups were filled with highly vascularized fibrous connective tissue showing prominent osteoblastic activity with osteoid formation, whereas the defects of control were replaced by dense fibro-muscular tissue without osteoblastlf activity. After 3 weeks, the experimental group revealed well formed bone trabeculae and fibro-vascular marrow within surrounding membrane. With time the amount of new bone was decreased with increase of hematopoietic marrow, and the cortical plate composed of dense mature bone was more thicker. In the whole experimental periods, the inflammation and foreign body reaction were not found around the inserted n-PTFE membrane. After removal of membrane there was marked remodeling of newly formed bone by active osteoclasts in periosteal soft tissue, which decreased the bone volume apparently. These findings suggest that n-PTFE has biocompatibility, flexibility, and rigidity and offer rapid bone regeneration within limited area by the membrane. On the other hand, the early removal of membrane caused reduction of bone volume by the osteoclastic resorption. Thus, the time of removal may be more important factor for maintenance of regenerated bone volume.
Animals ; Bone Marrow ; Bone Regeneration ; Connective Tissue ; Foreign-Body Reaction ; Hand ; Inflammation ; Mandible ; Membranes ; Osteoblasts ; Osteoclasts ; Pliability ; Rabbits* ; Rats ; Wound Healing