No abstract available.
Crohn Disease*

No abstract available.
Scrub Typhus*

PURPOSE: The osmolar gap increases in proportion to the ethanol level. Some previous studies have shown that the correlation between the osmolar gap and the ethanol level is weak in trauma patient by using an indirect comparison with other patients. We conducted a direct comparison of the correlation of the osmolar gap to the ethanol level between trauma patients and non-trauma patients. We also analyzed the accuracy of the estimated ethanol level between the two groups. METHODS: The research candidates were adult patients who had visited the emergency department of our hospital from December 2003 to November 2008. By using a retrospective chart review, we classified them into three subgroups: non-trauma without shock, trauma without shock, and trauma with shock. In each group, we compared the correlation between the osmolar gap and the measured ethanol level, and we analyzed the accuracy of the estimated ethanol level by using Lin's concordance correlation coefficient. RESULTS: Four hundred forty-seven patients were enrolled in this study. For correlation of the osmolar gap and the measured ethanol level, Pearson's correlation coefficient was 0.916 in all patients, 0.939 in non-trauma without shock patients, 0.917 in trauma without shock patients, and 0.844 in trauma with shock patients. In the analysis of the accuracy of the estimated ethanol level by using Lin's concordance correlation coefficient, the accuracy in trauma with shock patients was lower than that in non-trauma without shock patients. CONCLUSION: We found that the correlation between the osmolar gap and the measured ethanol level in the patient group with trauma was lower than it was in the patient group without trauma. Moreover trauma patients with shock had a lower accuracy of the estimated ethanol level than non-trauma patients.
Adult ; Emergencies ; Ethanol ; Humans ; Osmolar Concentration ; Retrospective Studies ; Shock

OBJECTIVE: To investigate the morphometric characteristics of the pituitary gland and diaphragma sellae in Korean adults. METHODS: Using the 33 formaline fixed adult cadavers (23 male, 10 female), the measurements were taken at the diaphragma sellae and pituitary gland. The authors investigated the relationship between dura and structures surrounding pituitary gland, morphometric aspects of pituitary gland and stalk, and morphometric aspect of central opening of diaphragma sellae. RESULTS: The boundary between the lateral surface of pituitary gland and the medial wall of cavernous sinus was formed by the thin dural layer and pituitary capsule. The pituitary capsule adherent tightly to the pituitary gland was observed to continue from the diaphragma sellae. Mean width, length, and height of the pituitary gland were 14.3 +/- 2.1, 7.9 +/- 1.3, and 6.0 +/- 0.9 mm in anterior lobes, and 8.7 +/- 1.7, 2.9 +/- 1.1, and 5.8 +/- 1.0 mm in posterior lobes, respectively. Although all dimensions of anterior lobe in female were slightly larger than those in male, statistical significance was noted in only longitudinal dimension. The ratio of posterior lobe to the whole length of pituitary gland was about 27%. The mean thickness of pituitary stalk was 2 mm. The diaphragmal opening was 5 mm or more in 26 (78.8%) of 33 specimen. The opening was round in 60.6% of the specimen, and elliptical oriented in an anterior-posterior or transverse direction in 39.4%. CONCLUSION: These results provide the safe anatomical knowledge during the transsphenoidal surgery and may be helpful to access the possibility of the development of empty sella syndrome.
Adult ; Cadaver ; Cavernous Sinus ; Diaphragm ; Empty Sella Syndrome ; Female ; Formaldehyde ; Humans ; Male ; Pituitary Gland

No abstract available.

The arteriovenous fistula and cirsoid aneurysm, characterised by abnormal arterial and venous connections with grossly dilated and expansile mass of vessels, may predispose to dramatic complications. Cirsoid aneurysms of the scalp have been reported to be difficult to remove. Multiple treatment schemes have been described and, as yet, no standard form of therapy exists. Three cases of cirsoid aneurysms of the scalp are presented. Each of them was treated with embolization and total excision after ligation of the feeding arteries. All of them were well cured.
Aneurysm* ; Arteries ; Arteriovenous Fistula ; Ligation ; Scalp*

OBJECTIVE: Maternal anemia is one of the most common hematologic disorders of the child-bearingmothers. However the role of maternal anemia in the etiology of preterm delivery and adverse pregnancyoutcomes remains a source of controversy. The aim of this study was to determine the effects of maternalanemia on the preterm birth and the adverse pregnancy outcomes. STUDY DESIGN: A total of 1,010 women aged 19~44 years, who admitted to our hospitalfor the delivery between December 1994 and October 1995, were recruited into a hospitalbaed case-control study design. 259 women complicated by maternal anemia(cases) werecompared with 751 women without maternal anemia(controls). Multiple logistic regressionanalyses were performed to control for the effects of other potentially confounding factors,including maternal age, body mass index, previous term delivery, previous preterm deliveryand previous abortion. In all logistic regression analyses odds ratio and 95% confidenceintervals were calculated. RESULTS: The prevalence of maternal anemia(hemoglobin<10g/dl) was 25.6%. Therewas a positive linear relationship between the prepartum hemoglobin concentration and thepostpartum concentration. There was no significant differences of the incidence of pretermbirth and the neonatal morbidity, such as poor Apgar scores, fetal distress, congenitalanomaly, birth trauma, admission to neonatal intensive care unit, resuscitation and sepsisbetween case and control groups. Small for gestational age and low birth weight were associatedwith an somewhat decreased risk of maternal anemia and large for gestational age, notmacrosomia, was associated with an 70% increased risk of maternal anemia at the time ofdelivery. Maternal anemia was associated with 6.5 fold increases in the risks of postpartumbleeding, 8.5 fold increases in the postpartum transfusion and 80% increases in the puerperalfever respectively. CONCLUSIONS: Maternal anemia was not associated with increased risks of preterm birthand the neonatal morbidty. However there was a significant relationship between maternalanemia and postpartum maternal morbidity, such as postpartum bleeding, postpartum transfusionand puerperal fever.
Abortion, Induced ; Anemia* ; Body Mass Index ; Case-Control Studies* ; Female ; Fetal Distress ; Fever ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Logistic Models ; Maternal Age ; Odds Ratio ; Parturition ; Postpartum Period ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth* ; Prevalence ; Resuscitation

The authors reviewed one hundred and twenty cases of cerebellopontine angle(CPA) tumors that were operated upon at the department of neurosurgery of Seoul National University Hospital between 1977 and 1987. The pathologic diagnosis of the tumors were acoustic neurinoma(66%), meningioma(13%), epidermoid(5%) and trigeminal neurinoma(5%). The age incidence was most frequent in the 5th and the 6th decades and 6.7% of cases occurred at the pediatric ages. Acoustic neurinomas were frequent in the 5th decade and on admission more than half of patients were poor clinical grades with large tumors more than 3cm in diameter(78.5%). There was good correlation between the clinical grade and tumor size on admission. All of the acoustic tumors were operated through the suboccipital transmeatal approach and total removal was possible in 73% with 5% of motality rate. Facial nerve was preserved in 62% of total removal-cases and the size of tumor was the important factor for the total removal of tumor with preservation of facial nerve. Cerebellopontine angle meningioma comprised 13% of all CPA tumors and incidence of male to female ratio was 2:13. Operations were performed either through retromastoid suboccipital approach or combined supra-infratentorial approach. Total temoval was possible in 67% without mortality. Six trigeminal neurinomas were located:one in the middle fossa, one in the posterior fossa and the other four cases appearing as dumbbell shape. Total removal was possible in two cases and subtotal removal in four cases and the outcome was rather good in all cases. Pediatric CPA tumors were two each of medulloblastomas and ependymomas and one each of astrocytoma, primitive neuroectodermal tumor(PNET) and trigeminal neurinoma, Masson's hemagioendothelioma. Total removal was possible in four cases and the outcome was good in all cases.
Acoustics ; Astrocytoma ; Cerebellopontine Angle* ; Diagnosis ; Ependymoma ; Facial Nerve ; Female ; Humans ; Incidence ; Male ; Medulloblastoma ; Meningioma ; Mortality ; Neural Plate ; Neurilemmoma ; Neuroma, Acoustic* ; Neurosurgery ; Seoul

Benign metastasizing leiomyoma is a rare disease that histologically shows features of a benign tumor; however it can metastasize to the lung or other organs. We report here on a case of a 53-year-old woman with benign metastasizing leiomyoma, and she was admitted to the hospital with symptoms of coughing for 2 months; she showed multiple diffuse nodular opacities of both lungs on a chest radiograph. She had undergone hysterectomy for leiomyoma of the uterus 13 years previously. Thoracoscopic lung biopsy was performed to rule out metastatic lung cancer. The pulmonary nodules appeared benign with a very low mitotic rate and they consisted of smooth muscle cells. The pathologic findings of the pulmonary nodules were consistent with benign metastasizing leiomyoma. The patient has been followed up closely without any specific therapy.
Biopsy ; Cough ; Female ; Humans ; Hysterectomy ; Leiomyoma ; Lung ; Lung Neoplasms ; Middle Aged ; Myocytes, Smooth Muscle ; Neoplasm Metastasis ; Rare Diseases ; Thorax ; Uterus

919 consecutive brain tumor cases and 665 consecutive spontaneous intracranial hemorrhage cases were reviewed for the analysis of cases in which spontaneous intracranial hemorrhage caused by brain tumor was confirmed with gross operative findings. Authors analyzed their incidence, patients' demography, tumor histology, clinical symptoms and signs, predisposing factor, tumor vascularity, type of hemorrhage, relations between the clinical symptoms and signs and the type of hemorrhage, relations between the location of tumor and the type of hemorrhage and the outcome of treatment. The conclusions are as follow; 1) The proportion of the hemorrhage caused by brain tumor to the total spontaneous intracranial hemorrhage was 5.1%(34/665). 2) The proportion of the spontaneous intracranial hemorrhage caused by brain tumor to the total brain tumor was 3.7%(34/919) and the proportion of that excluding pituitary adenoma was 2.5%(18/729). 3) Compared with the other brain tumors, oligodendroglioma and pituitary adenoma had significant tendency of hemorrhage(p<0.05, p<0.01, respectively) and meningioma had a significantly low incidence of hemorrhage(p<0.05). 4) The hemorrhage brought about major symptoms in 13 cases(72%), minor symptoms in 2 cases(11%). These cases showed no symptoms related to the hemorrhage. 5) Among the 18 cases of spontaneous intracranial hemorrhage caused by brain tumor, one case with the major attack died of postoperative pneumonia. There were additional 2 motalities which were not related to the preoperative hemorrhage. And most of the symptoms associated with the preoperative hemorrhage stabilized or improved with operative treatment.
Brain Neoplasms* ; Brain* ; Causality ; Demography ; Hemorrhage ; Incidence ; Intracranial Hemorrhages* ; Meningioma ; Oligodendroglioma ; Pituitary Neoplasms ; Pneumonia