Although various studies of effectiveness of mannitol and steroid for the brain swelling have been reported, there are still few reports on cerebral trauma. This study is based on electrolyte change after the infusion of hypertonic mannitol and steroid, and basedon evaluation of Prognostic effect followed mannitolization. Author studied 36 operative cases of brain stem dysfunction group, 70 operative cases of semicomatous group of cerebral traumas, who were admitted at Woo Suk Hospital, Korea University Medial College from Jan. 1968 to Sept. 1971. Author measured degree or reduction of C.S.F. pressure continuously under adequate mannitolization and checked electrolytes preoperatively and after mannitolization and C.B.C., Urinalysis, daily Urine out put and Urine S.G. were also checked. The results was summarized as follows. 1) The reduction of C.S.F. pressure started approximately one, one and half hours after mannitolization. 2) Better prognosis was obtained, in preoperative administration of mannitol and steroid infused case. a) loser mortality, b) rapid metal recovery, c) prolonged survival. 3) In electrolyte changes; No remarkable dilutional hyponatremia was seen.
Brain Edema ; Brain Stem ; Electrolytes ; Head* ; Humans ; Hyponatremia ; Korea ; Mannitol* ; Mortality ; Prognosis ; Urinalysis

A rate com;lication of hysterectomy is complete prolapse and inversion of vagina. This can occur whether the hysterectomy was abdominal or vaginal and cystocele and/or enterocele is often associated with this condition. Traditionally, prolapse has been treated by surgery, the types of operation for prolapse are generally but not always, carried out through the vaginal rather than through the abdominal surgical route. We experienced five cases who had repair of posthysterectomy vaginal vault prolapse by transabdominal sacral colpopexy and report with brief review of literatures.
Cystocele ; Hernia ; Hysterectomy* ; Pelvic Organ Prolapse* ; Prolapse ; Vagina

PURPOSE: To investigate the neuro-ophthalmic diagnosis and clinical manifestations of intracranial aneurysm. METHODS: A retrospective survey of 33 patients who were diagnosed with intracranial aneurysm and underwent neuro-ophthalmic examination from April 2008 to December 2016. Frequency of the first diagnosis of intracranial aneurysm in ophthalmology, neuro-ophthalmic diagnosis, location of intracranial aneurysm, examination of intracranial aneurysm rupture, and neurologic prognosis of Terson's syndrome patients were analyzed by image examination, neurosurgery, and ophthalmology chart review. RESULTS: Of the 33 patients, most patients (n = 31, 94%) were diagnosed with intracranial aneurysm at the neurosurgical department and only 2 patients were diagnosed initially at the ophthalmology department. Causes and association were: Terson's syndrome (n = 10, 30%), third cranial nerve palsy (n = 10, 30%), internclear ophthalmoplegia (n = 4, 12%), visual field defect (n = 3, 9%), optic atrophy (n = 3, 9%), sixth cranial nerve palsy (n = 2, 6%), and nystagmus (n = 1, 3%). The location of intracranial aneurysms were: anterior communicating artery (n = 13, 39%), medial communicating artery (n = 12, 36%), and posterior communicating artery (n = 5, 15%). Ten of 33 patients had Terson's syndrome, and 6 patients (60%) with Terson's syndrome had apermanent neurological disorder such as agnosia, gait disorder and conduct disorder. CONCLUSIONS: Third cranial nerve palsy was the most common neuro-ophthalmic disease in patients presenting with intracranial aneurysm. The neuro-ophthalmic prognoses for those diseases were relatively good, but, if Terson's syndrome was present, neurological disorders (agnosia, gait disorder, conduct disorder) were more likely to remain after treatment.
Abducens Nerve Diseases ; Agnosia ; Arteries ; Conduct Disorder ; Diagnosis ; Gait ; Humans ; Intracranial Aneurysm* ; Nervous System Diseases ; Neurosurgery ; Oculomotor Nerve ; Ophthalmology ; Ophthalmoplegia ; Optic Atrophy ; Paralysis ; Prognosis ; Retrospective Studies ; Rupture ; Visual Fields

The various special diagnostic procedures have been used for the cervical cord injuries. The author describes a new technique of pantopaque cervical myelography based on the lateral C1-2 puncture.
Iophendylate* ; Myelography* ; Punctures*

PURPOSE: We report a rare case of bilateral macular infarction as an ocular presenting sign of primary antiphospholipid syndrome. CASE SUMMARY: A 29-year-old woman who had undergone a cesarean section for chorioamnionitis in the department of Obsterics was referred to the department of ophthalmology for bilateral visual loss. At examination, best-corrected visual acuity (BCVA) of the right eye was counting fingers, and for the left was 0.05. Fundus examination revealed extensive macular edema and cotton-wool spots in both eyes. We performed hematologic tests including thrombophilia examination. Antinuclear antibody and rheumatoid factor were negative but lupus anticoagulant presented high titers on two occasions 12 weeks apart. She was administered sub-Tenon's injections of triamcinolone acetonide 50 mg/week in both eyes under the diagnosis of bilateral macular arteriolar occlusion in primary antiphospholipid syndrome. Her BCVA remained 0.025 in her right eye and improved to 0.125 in her left eye. CONCLUSIONS: Macular infarction is an uncommon but severe complication of antiphospholipid syndrome. Early and regular fundus exam in patients with antiphospholipid syndrome is necessary to avoid progression of severe ocular complications.
Adult ; Antibodies, Antinuclear ; Antiphospholipid Syndrome* ; Cesarean Section ; Chorioamnionitis ; Diagnosis ; Female ; Fingers ; Hematologic Tests ; Humans ; Infarction* ; Lupus Coagulation Inhibitor ; Macular Edema ; Ophthalmology ; Pregnancy ; Rheumatoid Factor ; Thrombophilia ; Triamcinolone Acetonide ; Visual Acuity

Numerous experimental and clinical studies of brain metabolism have reported since last two decades and many authors have concentrated their efforts on the metabolism of gas, glucose, electrolytes and enzymes. Oxygen and glucose that are utilized in the brain are two of the most important substances and play very important roles in the brain to form high energy bond(adenosine triphosphate) and nucleic acid. Authors have attempted to measure oxygen consumption in normal rabbit brains and diseased brains that are produced the expansion of stalk of laminaria in the right epidural space of the rabbit. In the normal rabbits, the average value of oxygen consumption of cerebral gray and white matters were 3.44+/-0.29---lO2/100 mg(dry weight)/30 min and 0.72+/-0.04---lO2/100 mg(dry weight)/30 min respectively. The value of oxygen consumption of cerebral gray and white matters in the compressed hemisphere showed high values than those in control group, and they revealed a tendency of rather rapid increase at an early experimental stage, and of gradual decrease thereafter.
Brain* ; Edema* ; Electrolytes ; Epidural Space ; Glucose ; Laminaria ; Metabolism ; Oxygen Consumption* ; Oxygen* ; Rabbits

The authors describe a new technique for the reduction and wiring of atlanto-axial dislocation. More strong supporting effect has been achieved by double wiring of the posterior arch of the cervical vertebrae. Various techniques for the fixation of the atlanto-axial dislocation have been discussed.olved.
Cervical Vertebrae ; Dislocations* ; Female ; Odontoid Process*

With the establishment of the anterior cervical approach as the procedure of choice for cervical fracture-dislocation, attention has now turned to refinements of Cloward technique. The purpose of application of the Cloward technique is to achieve early stabilization of the fracture-dislocation, to shorten the recumbency period, and to promote rehabilitation. Recently the authors have experienced with the Cloward technique in the treatment of cervical fracture-dislocation. Our results indicated that anterior interbody fusion has been a satisfactory method for stabilizing one or more segment of the cervical fracture-dislocation. The prevention of dowel fracture or extrusion following fusion has been a important factor in the success. Another advantage obtained is to use the operating microscope for decompression of nerve roots. The chronic locked facets have not been reduced by the application of Cloward technique, but have been managed to achieve stabilization with Smith-Robinson technique. The lateral cervical pucture technique(C1-C2) for pantopaque myelography has been shown to be a valuable adjunct of acute injuries of the cervical spinal cord. A new technique for wiring and fusion of atlanto-axial dislocation has been performed with satisfactory results.
Decompression ; Dislocations* ; Iophendylate ; Myelography ; Rehabilitation ; Spinal Cord

The authors report a case of malignant brain-stem glioma with typical clinical signs in which successful surgical decompression and biopsy were obtained under the surgical microscope, and factors favoring surgical removal of such lesion are discussed.
Biopsy* ; Decompression* ; Decompression, Surgical ; Glioma*

PURPOSE: To report a case of acute interstitial keratitis as the first clinical sign in a patient with latent syphilis. CASE SUMMARY: A 23-year-old female presented with visual impairment and discomfort in her right eye that developed 3 days earlier. The visual acuity in the right eye was 20/200 and corrected to 20/100, and slit lamp examination showed round sub-epithelial opacification in the central cornea with stromal edema and neovascularization on the cornea of the right eye. Whole body tests including serological tests were performed. Under the suspicion of acute interstitial keratitis, topical antibiotics and steroids were applied 4 times a day initially. Serological tests were reactive for venereal disease research laboratory test (VDRL). Under the suspicion of acute interstitial keratitis due to syphilis, fluorescent treponemal antibody absorption test IgM/IgG (FTA-ABS IgM/IgG) was performed; a positive result for FTA-ABS IgG led to diagnosis of acute interstitial keratitis with latent syphilis. During treatment, systemic doxycycline 200 mg for 4 weeks with topical antibiotics and steroids were administered, the opacity and edema of the cornea regressed after 2 weeks of treatment, and visual acuity in the patient's right eye improved to 20/20. CONCLUSIONS: We report an unusual case of acute interstitial keratitis as the first clinical manifestation of latent syphilis in an immunocompetent patient.
Anti-Bacterial Agents ; Cornea ; Diagnosis ; Doxycycline ; Edema ; Female ; Fluorescent Treponemal Antibody-Absorption Test ; Humans ; Immunoglobulin G ; Keratitis* ; Patient Rights ; Serologic Tests ; Sexually Transmitted Diseases ; Slit Lamp ; Steroids ; Syphilis* ; Syphilis, Latent ; Treponema pallidum ; Vision Disorders ; Visual Acuity ; Young Adult