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

Cardiac myxoma is the most common benign cardiac tumor and it presents various clinical symptoms and signs. Although two-thirds of patients have abnormal electrocardiographic findings, atrial flutter or conduction abnormalities are known to be rare. We report on a case of a large left atrial myxoma which was diagnosed by trans-thoracic, trans-esophageal echocardiography, chest computerized tomography, and histological examination. The myxoma was presented as atrial flutter in a 41-year old man who was complaining palpitation and dyspnea on exertion. After surgical excision of the mass, atrial flutter converted to normal sinus rhythm. We report this case with review of literatures on left atrial myxoma associated with arrhythmia.
Arrhythmias, Cardiac ; Atrial Flutter ; Dyspnea ; Echocardiography ; Electrocardiography ; Heart Neoplasms ; Humans ; Myxoma ; Thorax

BACKGROUND: As lack of myocardial perfusion was demonstrated on myocardial contrast echocardiography(MCE) despite angiographic documentation of reflow, patency of infarct related artery (IRA) after acute myocardial infarction(AMI) does not guarantee myocardial tissue perfusion. Myocardial enhancement on MCE is associated with myocardial perfusion and microvascular integrity. We are to assess myocardial perfusion immediately after thrombolysis and to correlate myocardial enhancement with functional recovery of postischemic dysfunctional myocardium. METHODS: MCE was performed by intracoronary injection of hand-agitated Ioxaglate in 17 consecutive AMI patients immediately after thrombolysis. Myocardial enhancement of 37 infarct segment was quantified as corrected peak videointensity(PI) by videodensitometry and the PI ratio of infarct to normal segments was used to assess myocardial reperfusion. Viable myocardium was defined as the presence of functional recovery on follow-up echocardiography. RESULTS: 1) MCE was performed in 37 segments of 17 AMI patient and functional recovery was noted in 28 segments of 12 patients on follow-up echocardiography. 2) Six infarct segments with no reflow on MCE showed severe fixed perfusion defect in thallium scan and no functional recovery in follow-up echocardiography. 3) The peak cardiac enzyme level was significantly higher in patients without functional recovery(p<0.005), but mean PI ratio(p<0.005) and patency of IRA(p<0.05) were significantly higher in patient with functional recovery. Age, sex, time to thrombolysis and stenosis of IRA were not associated with functional recovery. 4) Apical segment(p<0.01), TIMI grade 2 patency(p<0.01) and LAD territory(p<0.05) were significantly associated with nonviable myocardium, and PI ratio(p<0.001) was significantly correlated to viable myocardium. The PI ratio was the most significant predictor of myocardial functional recovery on multiple logistic regression analysis. CONCLUSION: Myocardial contrast echocardiography immediately after thrombolysis can be used for assessment of myocardial reperfusion, decision of revascularization and prediction of functional recovery.
Arteries ; Constriction, Pathologic ; Echocardiography* ; Follow-Up Studies ; Humans ; Ioxaglic Acid ; Logistic Models ; Myocardial Reperfusion* ; Myocardium* ; Perfusion ; Thallium

BACKGROUND: As lack of myocardial perfusion was demonstrated on myocardial contrast echocardiography(MCE) despite angiographic documentation of reflow, patency of infarct related artery (IRA) after acute myocardial infarction(AMI) does not guarantee myocardial tissue perfusion. Myocardial enhancement on MCE is associated with myocardial perfusion and microvascular integrity. We are to assess myocardial perfusion immediately after thrombolysis and to correlate myocardial enhancement with functional recovery of postischemic dysfunctional myocardium. METHODS: MCE was performed by intracoronary injection of hand-agitated Ioxaglate in 17 consecutive AMI patients immediately after thrombolysis. Myocardial enhancement of 37 infarct segment was quantified as corrected peak videointensity(PI) by videodensitometry and the PI ratio of infarct to normal segments was used to assess myocardial reperfusion. Viable myocardium was defined as the presence of functional recovery on follow-up echocardiography. RESULTS: 1) MCE was performed in 37 segments of 17 AMI patient and functional recovery was noted in 28 segments of 12 patients on follow-up echocardiography. 2) Six infarct segments with no reflow on MCE showed severe fixed perfusion defect in thallium scan and no functional recovery in follow-up echocardiography. 3) The peak cardiac enzyme level was significantly higher in patients without functional recovery(p<0.005), but mean PI ratio(p<0.005) and patency of IRA(p<0.05) were significantly higher in patient with functional recovery. Age, sex, time to thrombolysis and stenosis of IRA were not associated with functional recovery. 4) Apical segment(p<0.01), TIMI grade 2 patency(p<0.01) and LAD territory(p<0.05) were significantly associated with nonviable myocardium, and PI ratio(p<0.001) was significantly correlated to viable myocardium. The PI ratio was the most significant predictor of myocardial functional recovery on multiple logistic regression analysis. CONCLUSION: Myocardial contrast echocardiography immediately after thrombolysis can be used for assessment of myocardial reperfusion, decision of revascularization and prediction of functional recovery.
Arteries ; Constriction, Pathologic ; Echocardiography* ; Follow-Up Studies ; Humans ; Ioxaglic Acid ; Logistic Models ; Myocardial Reperfusion* ; Myocardium* ; Perfusion ; Thallium

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

Respiratory bronchiolitis associated interstitial lung disease is a rare condition among current or ex-smokers, which has features consistent with interstitial lung disease. The presentations are non-specific, but symptoms generally include a cough and dyspnea on exertion, and its pathology is characterized by the accumulation of pigmented macrophages within the respiratory bronchioles and adjacent air spaces, and is associated with mild thickening of the peribronchiolar interstitium. Recently, the case of a 54-year-old woman passive smoker, diagnosed as having respiratory bronchiolitis associated interstitial lung disease, was experienced at our institution.
Bronchioles ; Bronchiolitis* ; Cough ; Dyspnea ; Female ; Humans ; Lung Diseases, Interstitial* ; Macrophages ; Middle Aged ; Pathology ; Tobacco Smoke Pollution*

PURPOSE: This study aims to determine the efficacy and safety of house dust mite (HDM)-sublingual immunotherapy (SLIT) in elderly patients with AR. METHODS: A total of 45 patients aged ≥ 60 years with HDM-induced AR who had ≥ 3 A/H ratio on skin prick test and/or ≥ 0.35 IU/L to both Dermatophagoides farinae and Dermatophagoides pteronyssinus by ImmunoCAP were enrolled in 4 university hospitals. To evaluate additional effects of HDM-SLIT, they were randomized to the SLIT-treated group (n = 30) or control group (n = 15). Rhinoconjunctivitis total symptom score (RTSS), rhinoscopy score, Korean rhinoconjunctivitis quality of life questionnaire, rhinitis control assessment test, asthma control test scores, and adverse reactions, were assessed at the first visit (V1) and after 1 year of treatment (V5); for immunological evaluation, serum levels of HDM-specific immunoglobulin A/IgE/IgG1/IgG4 antibodies and basophil response to HDMs were compared between V1 and V5 in both groups. RESULTS: There were no significant differences in demographics, RTSS, skin reactivity to HDMs, or serum total/specific IgE levels to HDMs (P < 0.05, respectively) between the 2 groups. Nasal symptom score and RTSS decreased significantly at year 1 in the 2 groups (P < 0.05). There were no significant differences in percent decrease in nasal symptom score and RTSS at year 1 between the 2 groups (P < 0.05); however, rhinoscopic nasal symptom score decreased significantly in the SLIT-treated group (P < 0.05). Immunological studies showed that serum specific IgA levels (not specific IgE/IgG) and CD203c expression on basophils decreased significantly at V5 in the SLIT-treated group (P = 0.011 and P = 0.001, respectively), not in the control group. The control group required more medications compared to the treatment group, but there were no differences in adverse reactions. CONCLUSIONS: It is suggested that HDM-SLIT for 1 year could induce symptom improvement and may induce immunomodulation in elderly rhinitis patients.
Aged* ; Antibodies ; Asthma ; Basophils ; Demography ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust* ; Hospitals, University ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulins ; Immunomodulation ; Immunotherapy ; Pyroglyphidae* ; Quality of Life ; Rhinitis* ; Rhinitis, Allergic ; Skin ; Sublingual Immunotherapy*

The dietary intake of whole grains is known to reduce the incidence of chronic diseases such as obesity, diabetes, cardiovascular disease, and cancer. To investigate whether there are anti-adipogenic activities in various Korean cereals, we assessed water extracts of nine cereals. The results showed that treatment of 3T3-L1 adipocytes with Sorghum bicolor L. Moench, Setaria italica Beauvois, or Panicum miliaceum L. extract significantly inhibited adipocyte differentiation, as determined by measuring oil red-O staining, triglyceride accumulation, and glycerol 3-phosphate dehydrogenase activity. Among the nine cereals, P. miliaceum L. showed the highest anti-adipogenic activity. The effects of P. miliaceum L. on mRNA expression of peroxisome proliferator-activated receptor-gamma, sterol regulatory element-binding protein 1, and the CCAAT/enhancer binding protein-alpha were evaluated, revealing that the extract significantly decreased the expression of these genes in a dose-dependent manner. Moreover, P. miliaceum L. extract changed the ratio of monounsaturated fatty acids to saturated fatty acids in adipocytes, which is related to biological activity and cell characteristics. These results suggest that some cereals efficiently suppress adipogenesis in 3T3-L1 adipocytes. In particular, the effect of P. miliaceum L. on adipocyte differentiation is associated with the downregulation of adipogenic genes and fatty acid accumulation in adipocytes.
3T3-L1 Cells ; Adipocytes ; Adipogenesis ; Cardiovascular Diseases ; Edible Grain ; Chronic Disease ; Down-Regulation ; Fatty Acids ; Fatty Acids, Monounsaturated ; Glycerol ; Glycerophosphates ; Incidence ; Obesity ; Oxidoreductases ; Panicum ; Peroxisomes ; RNA, Messenger ; Setaria Plant ; Sorghum ; Sterol Regulatory Element Binding Protein 1 ; Transcription Factors ; Water