Fifty-one consecutive 186 patients with aneurysmal subarachnoid hemorrhage were treated from the day of admission with nimodipine which was given first as an IV infusion at 30ug/kg/hr for 1 week and then orally in a dose of 360mg/day for 2 weeks and compared with 135 patients which were treated without nimodipine for the past 2 years. A comparision based on clinical and radiological variables influencing both the coruse and the outcome of the disease showed no significant difference between the nimodipine treated group and the control group except the delayed timing of surgery in the control group. There was no significant difference in the outcome between the nimodipine treated patients and the patients treated without nimodipine, however in Hung & Hess grade IV patients nimodipine treatment was associated with a significantly better outcome. Nimodipine treatment reduced the occurrence of delayed ischemic deficts(DID) in grade III, IV patients. Significant improvement in the outcome occurred in the nimodipine treated patients with subarachnoid hemorrhage of large amount(Fisher classification III).
Aneurysm* ; Classification ; Humans ; Intracranial Aneurysm ; Nimodipine* ; Subarachnoid Hemorrhage*

The computed tomography (CT) number is closely related to hematocrit level according to many of the previous reports. We measured the CT number in various organs, such as the frontal white matter, basal ganglia, occipital white matter, cerebrospinal fluid, liver, abdominal aorta, spleen, kidney, and psoas muscle. We correlated the CT numbers of the organs with hematocrit levels which were graded into 10% increments (20.0-29.9%, 30.0-39.9%, 40.0-49.9%). Thus the change of CT numbers in various organs according to the hematocrit level was analyzed. The increased CT numbers according to the 10% increment of hematocrit in the frontal white matter, basal ganglia, occipital white matter, liver, abdominal aorta, spleen, and psoas muscle were 1.3, 1.5, 1.6, 3.3, 5.3, 3.8, 2.4 respectively. Even though the CT numbers of the cerebrospinal fluid and kidney were not influenced by hematocrit level the CT numbers in most of the there organs postitively correlated with hematocrit level. Therefore, it was concluded that in the differential diagnosis using CT numbers, the hematocrit level of patient must be taken into consideration.
Aorta, Abdominal ; Basal Ganglia ; Cerebrospinal Fluid ; Diagnosis, Differential ; Hematocrit* ; Humans ; Kidney ; Liver ; Psoas Muscles ; Spleen ; White Matter

No abstract available.
Asthma* ; Child* ; Dermatitis, Atopic* ; Humans ; Immunoglobulin E* ; Rhinitis*

No abstract available.
Carcinoma, Renal Cell*

No abstract available.
Carbamazepine* ; Haloperidol*

The authors reviewed forty cases of acoustic neurinomas operated on from July 1974 to June 1984, analyzing our data obtained during 10 years in the following three periods: 1974 to 1978, 1978 to 1981, 1981 to 1984. A suboccipital approach was used for the removal of acoustic neurinomas in all cases. 1) A peak in the age distribution was seen at 40-50 years of age and no sexual difference was present. 2) The earliest symptoms were hearing loss(50%), headaches(25%), tinnitus(15%) in order of frequency. The time between onset of complaints and admission was mostly within 5 years(83%). 3) Most of the patients had large tumors(78%), greater than 3cm, of whom 4 patients were free of cerebellar and brain stem dysfunction. 4) Total removal was carried out in 27 out of 40 patients(67%) and particularly in 8 out of 14 patients(57%) with large tumors greater than 5cm. The total mortality was 7.5%. 5) In the last 3 years with the advance of microsurgical technique and CT scan, 25 patients were operated on only with a single death and total removal was carried out in 20 out of 25 patients. 6) In total removal, the total mortality was 7.4% and the mortality was 8% in patients with 3-5cm sized tumors and 13% in patients with tumors greater than 5cm, particularly 5% in the recent 3 years. 7) Preservation of the facial nerve following total removal was achieved in 59%. In the recent 3 years, the facial nerve was preserved in 65%. In the large tumors, 3-5cm sized and greater than 5cm, the rates of 75% and 37% were obtained.
Acoustics* ; Age Distribution ; Brain Stem ; Facial Nerve ; Hearing ; Humans ; Mortality ; Neuroma, Acoustic* ; Tomography, X-Ray Computed

The VATER syndrome is a group of congenital anomalies with a nonrandom tendency for concurrence. Defects include vertebral, anorectal malformation, tracheoesophageal fisutla with esophageal atresia, radial-limb, vascular, and renal abnormalities. The critical period of organogenesis is at or before the sixth or seventh week of gestation. We experienced one case of VATER syndrome in a 1 day old male neonate having vertebral anomalies, esophageal atresia with tracheoesophageal fistula to the distal esophageal segment, imperforated anus, left renal dysplasia with hydronephrosis of the right kidney and both hydroureter, patent ductus arteriosus. We report a case of VATER syndrome with brief review of related literature.
Anal Canal ; Critical Period (Psychology) ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Humans ; Hydronephrosis ; Infant, Newborn ; Kidney ; Male ; Organogenesis ; Pregnancy ; Tracheoesophageal Fistula

Although many experiments of renal infection in animals have been studied, its pathway, regional pathogenesis and the healing process are yet to be cleared exactly. Especially in human. we have infrequent opportunities to study the pathologic changes of the acute pyelonephritis by renal biopsy, because ot accompanying general symptoms such as fever and bacteremia. This study underwent to define these changes exactly. A strain of Escherichia coli No.018 :K77 was inoculated to rabbit bladder to produce retrograde pyelonephritis. The histopalho1ogical changes at the early stage of acute pyelonephritis, the pathways of bacterial invasion, distribution in the infected kidneys and healing process were studied by using light and electron microscope. The histopathological changes were characterized by degeneration and destruction of renal pelvis and tubular epithelial cells, and a massive infiltration of polymorphonuclear leukocytes. The inflammatory changes were initially found at renal fornix and progressed to medullar after 7 hours of bacterial inoculation. These changes extended to basement membrane accompanying with discrete chronic inflammatory changes after 9 hours. The inflammatory changes extended to cortex with bacilli within blood vessels after 12 hours and sustained until the end of first week. The chronic inflammatory. changes subsided as a whole of renal parenchyma until eighth weeks. Therefore we concluded that the retrograde pyelonephritis in rabbit extends rapidly from forniceal mucosa to capsule through tubule, interstitium and blood vessels, and the natural healing process occurs diffusery for longer period.
Animals ; Bacteremia ; Basement Membrane ; Biopsy ; Blood Vessels ; Epithelial Cells ; Escherichia coli ; Fever ; Humans ; Kidney ; Kidney Pelvis ; Mucous Membrane ; Neutrophils ; Pyelonephritis* ; Urinary Bladder

Previous successful results of neocartilage formation using tissue engineering technique in immunocompromised nude mouse xenograft model were reported. For clinical application, autogenous cell is preferrable to allogenic or xenogenic cell for circumvention of immune rejection. This study evaluates the feasibility of producing a engineered cartilage using autogenous chondrocytes. Chondrocytes were isolated from the auricular cartilage of New Zealand White rabbit and seeded onto PGA polymer coated with polylactic acid in round pattern(diameter 0.7 cm, thickness 0.1 cm) at a concentration 7 x 10(7) chondrocytes per cm3. Each Autogenous Cell-polymer constructs were implanted subcutaneously into the left side of dorsum of twelve rabbits. Polymer templates not containg cells were implanted into the right side as a control. Twelve rabbits were sacrificed at the following intervals: 5 rabbits at nine weeks, 7 rabbits at twelve weeks New autogenous cartilage formation which retained the approximate dimensions of original round polymer template in 11 of 12 cell seeded implants. Histological examination using hematoxyline and eosin stain revealed vast majority of implants developed into mature cartilage. This study opens up the possibility of autologus cell transplant to construct autogenous cartilge.
Animals ; Cartilage* ; Chondrocytes* ; Ear Cartilage ; Eosine Yellowish-(YS) ; Hematoxylin ; Heterografts ; Mice ; Mice, Nude ; New Zealand ; Polymers ; Rabbits ; Tissue Engineering ; Transplants

Studer's pouch was evaluated clinically and urodynamically. The pouch was constructed for bladder substitution in 18 and for bladder augmentation in 2 from July 1990 to November l995. Three patients of substitution were not included in this review because of operation related death in 1 case and short period(<6 months) of follow-up in 2 cases. Mean age is 53.2(range: 22-69) years. Mean follow-up period is 22.2(range: 2-64) months. Mean cystometric capacity was 445 ml, mean intraluminal pressure at 200 ml and 400 ml filled was 12.8(range: 5-30) and 23.7(range: 5-45) cmH2O, respectively. Maximal urethral closure pressure was 54.3(range: 18-112) cmH2O in bladder substitution cases. Maximal flow rate was 19.1(range: 12.9-26.0) ml/sec. Mean residual urine was 37.8(range: 0-80) ml. Reflux into ileal limb occurred in all patient at mean volume of 227(range : 30-400) ml. Reflux into kidney occurred in 20 of 24 renal units at mean volume of 291(range : 50-450) ml, but it drained completely and rapidly in all cases. No pelvocalyceal ectatic changes were seen. Urine was sterilized in 9 patients. Recurrent bacteriuria occurred in 6 patients. All of them had been controlled by parenteral antibiotic therapy. All of 15 substitution patients were completely continent during daytime. Two had mild daytime stress incontinence in early postoperative period, but which is improved as time passing. Three of them have nighttime incontinence. One of three has intermittent incontinence and is using a diaper for prevention from bed wetting. Two have total nighttime incontinence using a kismo every night. Though longer follow-up should be needed to confirm the safety of upper tract, we think that Studer's pouch seems not only to guarantee the continence but to be rather simple and easy to perform.
Bacteriuria ; Extremities ; Follow-Up Studies ; Humans ; Kidney ; Postoperative Period ; Urinary Bladder