In order to determine the survival rate and prognostic factors of patients with intracranial oligodendroglioma as predictors of survival, a retrospective analysis of a total of 68 cases treated between 1982 and 1992 at our institute was performed. The 5-year and 10-year survival rates were 84.5% and 55.1% respectively while the median survival time was 116+/-5.3 months. The significant factors identified by the univariate analysis included the presence of preoperative seizure, the pre- and postoperative status, the presence of signs of increased intracranial pressure before operation and pathologic grade of the tumors. Factors such as age, types of chief complaints, blood types, the preoperative neurologic deficit, the size of tumor, the enhancement of tumor, cysts in tumor, the extent of removal and the postoperative seizure had no correlations with survival rates. The only significant prognostic factor determined by the multivariate analysis was the pathological grade(p=0.04).
Humans ; Intracranial Pressure ; Multivariate Analysis* ; Neurologic Manifestations ; Oligodendroglioma* ; Retrospective Studies* ; Seizures ; Survival Rate*

Congenital anomalies occur in 2-3% of neonates and have unknown and variable causes. It's occurance rate is higher in twin gestations than in singleton gestations, especially in monozygotic twins. In most cases of twin anomalies, one fetus is normal and the other fetus is not. When an anomaly is found in one fetus, various tests, such as chorionic villus sampling, amniocentesis, and umbilical cord aspiration are strongly recommended in high risk groups of chromosmal anomaly for accurate diagnosis and proper treatments. A case of congenital anomalies in both twins diagnosed in a 35 year old multiparous woman is presented with brief review of literatures.
Adult ; Amniocentesis ; Anencephaly ; Chorionic Villi Sampling ; Diagnosis ; Down Syndrome ; Female ; Fetus ; Humans ; Infant, Newborn ; Pregnancy ; Twins* ; Twins, Monozygotic ; Umbilical Cord

Pressure volume index(PVI) is a variable reflecting the intracranial hydrodynamic properties and is applied to the management and the prediction of the prognosis in cases of hydrocephalus, head injury, subarachnoid hemorrhage and increased intracranial pressure of other causes. To understand the hydrodynamic properties in acute and chronic phases of the kaolin-injected hydrocephalus in cats, the PVI values were measured in the 6 groups (pre-injection, post-injection 3 days, 1 week. 2 weeks, 3 weeks, 4 weeks). The PVI values were 0.49+/-0.02 ml in control(pre-injection) group, 0.45+/-0.03 ml in 3day group, 0.46+/-0.01 ml in 1week group. 0.48+/-0.04 ml in 2 week group, 0.51+/-0.04 ml in 3 week group and 0.56+/-0.03 ml in 4 week group. Comparing with the values of the control group, the PVI's were decreased in the 3day group and the 1 week group(p<0.05, each) and were increased in the 4 week group(p<0.01).
Animals ; Cats ; Craniocerebral Trauma ; Hydrocephalus* ; Hydrodynamics ; Intracranial Pressure ; Prognosis ; Subarachnoid Hemorrhage

An encepholocele is defined as a herniation of cranial contents through a defect in the skull. Encephaloceles are classified accroding to their contents and location. Encephalocele is a useful general term to refer to common features of the various forms of anomaly, but considerable differences exist in the pathology, treatment and prognosis of encephaloceles at each anatomical location. Improved neuroimaging facilities, especially MRI, make it easy not only to detect the encephalocele including its contents and location, but also to get preoperative informations. We have reviewed a total of 22 patients with encephalocele whom we have experienced from 1986, July to 1990, June. Twelve were at occipital location, six at cranial vault, three at cranial base, one at frontoethmoidal location. The size of cranium bifidum and herniating sac of the cranial vault and occipital location is larger than that of frontobasal location. The incidence of associated hydrocephalus is in order of occipital, cranial vault, frontobasal form, and its prognosis is also better in frontobasal form than in occipital of cranial vault form.
Encephalocele* ; Humans ; Hydrocephalus ; Incidence ; Magnetic Resonance Imaging ; Neuroimaging ; Pathology ; Prognosis ; Skull ; Skull Base

For the experimental study of neural tube defect (NTD), a surgical model has advantages over other models in a few aspects. It causes less functional derangement of cells and the NTDs can be made selectively by surgery. The authors planned to use the surgical model for the experimental study of NTD. As the first step for the studies, the chronological changes of morphology during the early postoperative period were investigated using postincubation 3-day chick embryos. The objectives of this study are (1) the morphological evaluation of the surgical model as a method for studies of open NTD, and (2) the observation of morphological changes for the first 24 hours after surgery which include 'overgrowth' appearance and the continuity between the surface ectoderm and the neuroectoderm. The morphological changes were observed by light microscope and scanning electron microscope. Immediately after surgery, typical open NTDs were observed. Morphologically they were very similar to the appearance of spontaneous (non-surgical) open NTDs. The opened neural tubes were everted progressively and they looked rather flat at 24 hours after surgery. Cellular hyperplasia ('overgrowth' appearance) was noted within 24 hours after surgery and became more prominent during the 24 hours. There was increasing continuity between the surface ectoderm and the neural tissue until 24 hours after surgery when the continuity looked almost complete. In conclusion, surgically induced NTDs are morphologically very similar to spontaneous NTDs.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals ; Chick Embryo ; *Disease Models, Animal ; Evaluation Studies as Topic ; Neural Tube Defects/etiology/*pathology ; Postoperative Period

BACKGROUND: Waist circumference is one of the key components of metabolic syndrome. Recent studies demonstrated that the reproductive profile was associated with metabolic syndrome in postmenopausal women. This study focused on the association between central obesity and age at first childbirth. It also considered other factors associated with central obesity in postmenopausal women. METHODS: This study was based on the 2013–2015 Korean National Health and Nutrition Examination Survey and involved 3,143 naturally postmenopausal women. These women were divided into three groups according to their age at first childbirth: 19 years or younger (n=252), 20–29 years (n=2,695), and 30 years or older (n=196). Multivariate analysis using logistic regression was performed to evaluate the effects of various reproductive factors, including other confounding factors. RESULTS: During adjustment for confounding factors, in the early age at first childbirth group, odds ratios (95% confidence intervals) for central obesity decreased. In the final model, younger age at first childbirth was not significantly related to central obesity (waist circumference more than 85 cm) in naturally postmenopausal women after adjusting for other confounding factors. CONCLUSION: Younger age at first childbirth was not significantly associated with central obesity after adjustment for confounding factors.
Female ; Humans ; Logistic Models ; Menopause ; Multivariate Analysis ; Nutrition Surveys* ; Obesity, Abdominal* ; Odds Ratio ; Parturition* ; Waist Circumference

PURPOSE: This study conducted a comparative analysis on 49 hips treated with a core decompression procedure and 19 hips treated with a Sugioka's transtrochanteric rotational osteotomy for a osteonecrosis of the femoral head (ONFH). MATERIALS AND METHODS: This study evaluated the relationship between the Ficat and Arlet Stage and the extent of the necrotic lesion (using Shimizu's Grade Classification), and the clinical outcome of each procedure. The patient's outcomes were assessed after a mean follow-up of 46 months (range=36-82 months) after the core decompression and 53 months (range=37-108 months) after the Sugioka's transtrochanteric rotational osteotomy. The results were considered successful if the patients were asymptomatic with no disease progression, and unsuccessful if there was radiographic (progression of the stage or collapse) or clinical failure (the need for an arthroplasty or subsequent salvage operation). RESULTS: Twenty one out of 49 cases (43%) in the core decompression group and 14 out of 19 (74%) in the rotational osteotomy group showed successful outcomes. In the core decompression group, among the 22 F-A Stage I hips, 15 (68%) hips had survived according to radiological criteria. All four (100%) Shimizu's Grade A hips of the F-A Stage I had successful results, which is in contrast to the 11 hips out of 18 hips (61%) of the Shimizu's Grade B and C hips (p<0.01). Six (38%) out of 16 F-A Stage IIA hips and two (25%) out of eight IIB hips in the core decompression group had successful results, while 11 (85%) out of 13 IIA and two (50%) out of four stage IIB hips in the rotational osteotomy group had successful results. In the F-A Stage III hips, all 2 hips in the Sugioka transtrochanteric rotational osteotomy treatment group had survived, while none of the three Shimizu's Grade C hips in the core decompression group were successful. CONCLUSION: A core decompression is effective only in the earliest stages of osteonecrosis (F-A Stage I), which means that its success strongly depends on the location and extent of the femoral head necrosis. Sugioka's transtrochanteric rotational osteotomy is a more dependable procedure than a core decompression for treating large lesions of nonsteroidal ONFH, particularly for patients under the age of 50.
Arthroplasty ; Decompression* ; Disease Progression ; Follow-Up Studies ; Head* ; Hip ; Humans ; Necrosis ; Osteonecrosis* ; Osteotomy*

In order to analyze and evaluate the role of surgical treatment and clinical outcome in patients with intracranial cavernous angiomas, we retrospectively reviewed the medical records of 30 patients who underwent surgery between 1988 and 1995. Preoperative symptoms and signs were intracranial hemorrhage(ICH) in 16 cases(53%), seizure in 14(47%) and neurologic deterioration due to effect of the mass in seven(23%). Four of the 16 patients admitted because of ICH had a previous history of this condition. Intervals between hemorrhages varied from 5 days to 20 months, with a mean of 7.4 months. The mass was removed gross-totally in 27 patients, subtotally in two and partially in one; post-operative neurologic status was aggravated in only two patients. Lesions had recurred in five of the 27 patients from whom these were thought to have been totally removed; in one case, there was recurrent hemorrhage sixteen months after surgery. Four of the five recurrent cases had been operated on immediately after ICH, and in the other a lesion which contained calcification had been seen. Only one of the 12 patients who had shown preoperative seizures and was followed up for at least 12 months after surgery continued to suffer from seizures after removal of the lesion. In conclusion, our study demonstrated that after initial bleeding, hemorrhaging tends to recur in thses lesions, and that if they are removed immediately after ICH, there is a risk that the angioma may recur.
Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Medical Records ; Recurrence ; Retrospective Studies ; Seizures

Diphenylhydantoin(DPH) has been used intravenously as a drug of choice in conditions which seizure patients are incapable of oral feeding or in a state of status epilepticus. However, its clinical use has limitations because of its serious side effects of cardiac depression or systemic hypotension. In Western countries, the recently developed intravenous sodium valproate has been reported as safe and effective for seizure control in such patients. To assess the safety and effectiveness in seizure control, we investigated the serum levels of the drug at 24 hours, 48 hours, and 7 days after intravenous administration of sodium valproate(Depakine(R)), occurrence of seizures in the perioperative period, and the side effects of the drugs in 30 neurosurgical patients older than 3 years of age. The mean serum concentrations of valproic acid after bolus injection of 15mg/kg followed by continuous infusion with the rate of 0.5mg/kg/hour, were over 45.0 microgram/ml;45.0+/-16.3 microgram/ml at 24 hours, 50.4+/-21.0 microgram/ml at 48 hours, and 58.9+/-20.7 microgram/ml at 7 days after the start of the administration. All the patients whose serum valproic acid level was within the therapeutic range(40-100 microgram/ml), had never experienced an episode of seizure attack during the perioperative days. There was no evidence of elevated liver enzyme activity, but there were evidence of some tendency of decreased platelet count in the peripheral blood at 2 days after the administration of intravenous valproic acid. Four patients experienced episodes of mild nausea and/or vomiting. In conclusion, perioperative intravenous administration of valproic acids in neurosurgical patients was safe and effective in seizure control. However, it must be used precauciously in the patients with compromised coagulation system.
Administration, Intravenous ; Depression ; Humans ; Hypotension ; Liver ; Nausea ; Perioperative Period ; Platelet Count ; Seizures ; Sodium* ; Status Epilepticus ; Thrombocytopenia ; Valproic Acid ; Vomiting

The medical records of 30 patients with histologically confirmed and angiographically occult intracranial vascular malformations(AOVM), who underwent surgery between May 1988 and May 1993, were reviewed retrospectively to determine whether their radiological and clinical characteristics are helpful in differential diagnosis. Histological diagnoses were cavernous angioma(CA) in 17 cases, arteriovenous malformation(AVM) in nine, venous angioma in one and unclassified vascular malformation in three. The most common initial presenting mode was intracranial hemorrhage(ICH ; 18 cases, 60.0%), followed by seizure(11 cases, 33.3%) and headache(two cases, 6.6%). CA, once it had bled, tended to bleed repeatedly, and this occurred before surgery in seven of nine cases of CA presenting with ICH. On CT scan, calcification was observed only in CA(two cases). On MRI images obtained in 28 patients, a mottled density mass with or without adjacent ICH(ten of 16 CA's) and multiple lesions(three of 16 CA's) were pathognomonic for CA, while single stage ICH(two of eight AVM's) and signal void(three of eight AVM's) were observed only in cases of AVM. Findings of MRI such as multiple stage hemorrhage, low signal intensity rim or edema around the lesion were not helpful in differential diagnosis of the histological type of lesions. After enhancement with gadolinium, one case of AVM and another of venous angioma showed a serpentine pattern of enhancement. In 29 cases, the results of surgery were excellent ; there was no mortality and morbidity in only one case. In conclusion, CA, once it had bled, tended to rebleed and MRI was helpful in the differential diagnosis of AOVM's. MRI findings such as a mottled density mass or multiple lesions were pathognomonic for CA, while single stage hemorrhage or signal void were findings of AVM.
Arteriovenous Malformations ; Diagnosis ; Diagnosis, Differential ; Edema ; Gadolinium ; Hemangioma ; Hemangioma, Cavernous ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Mortality ; Retrospective Studies ; Tomography, X-Ray Computed ; Vascular Malformations*