We experienced nutiple brain abscess in two neonates. Diagnosis was made CT scan, Which revealed multiple ring-like enhancing leason in both frontoparietal and left posterior parietal cerebral parenchyme. Therapy was consisted of systemic antibiotic treatment and CSF V-P shunt operation due to complicated hydrocephalus. One neonate was died and the other neonate has been followed up due to convulsion and neurological sequale.
Brain Abscess* ; Diagnosis ; Humans ; Hydrocephalus ; Infant, Newborn* ; Rabeprazole ; Seizures ; Tomography, X-Ray Computed

The authors analyzed 28 cases with hypertensive cerebellar hemorrhage, diagnosed by computerized tomography(CT), between 1987 and 1990, in Chonbuk National University Hospital. The authors assessed the relationship of outcome to the CT appearance of the quadrigeminal cistern, which in some cases was obliterated by rostral displacement of the vermis resulting from the cerebellar mass. Obliteration of the quadrigeminal cisterns was classified on the CT scans into three grades:Normal(Grade I), Compressed(Grade II), or Absent(Grade III). There were 7 cases with Grade I, 9 with Grade II, and 12 with Grade II cisterns. Of the 28 cases, 6(85%) of those with Grade I, 7(78%) of those with Grade II, and none of those with Grade III cisterns respectively returned to their previous activities at 6 months or more after onset. A Grade I cisterns predicted a good outcome whether the hematoma was evacuated or not, as long as obstructive hydrocephalus, if present, was relieved early. However, a Grade II cistern was not predictive of a good outcome unless the hematoma was evacuated within 48 hours after onset of the hemorrhage. A Grade III cisterns predicted an unfavorable outcome. Taken together, these results strongly suggest that the CT grade of quadrigeminal cistern obliteration may be an indicator of outcome and may be useful in selecting treatment for patients with cerebellar hemorrhage.
Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Jeollabuk-do ; Tomography, X-Ray Computed

The authors analyzed 28 cases with hypertensive cerebellar hemorrhage, diagnosed by computerized tomography(CT), between 1987 and 1990, in Chonbuk National University Hospital. The authors assessed the relationship of outcome to the CT appearance of the quadrigeminal cistern, which in some cases was obliterated by rostral displacement of the vermis resulting from the cerebellar mass. Obliteration of the quadrigeminal cisterns was classified on the CT scans into three grades:Normal(Grade I), Compressed(Grade II), or Absent(Grade III). There were 7 cases with Grade I, 9 with Grade II, and 12 with Grade II cisterns. Of the 28 cases, 6(85%) of those with Grade I, 7(78%) of those with Grade II, and none of those with Grade III cisterns respectively returned to their previous activities at 6 months or more after onset. A Grade I cisterns predicted a good outcome whether the hematoma was evacuated or not, as long as obstructive hydrocephalus, if present, was relieved early. However, a Grade II cistern was not predictive of a good outcome unless the hematoma was evacuated within 48 hours after onset of the hemorrhage. A Grade III cisterns predicted an unfavorable outcome. Taken together, these results strongly suggest that the CT grade of quadrigeminal cistern obliteration may be an indicator of outcome and may be useful in selecting treatment for patients with cerebellar hemorrhage.
Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Jeollabuk-do ; Tomography, X-Ray Computed

BACKGROUND: Hypertonic solutions are using in emergency patients including refractory shock. The effects of the hyperosmotic solutions for the cardiac contractile effect has remained unclear. To study the mechanism of increase in twitch force by hypertonic solution, memberane potential, intracellular sodium activities(aNia), and twitch force were measured simultaneously in 1 Hz-driven canine Purkinje fibers and guinea pig papillary muscles. METHODS: To increase osmolarity, 20, 40, and 80 mOsm glucose, NaCl or mannitol was added to normal Tyrode solution. We used the conventional and Na(+)-selective microelectrodes, to study the membrane potential and intracellular sodium activity. Changes in twitch force were evaluated also by tension tranducer. RESULTS: 1) Hyperosmolar glucose or NaCl added to normal Tyrode solution produced membrane pontential hyperpolarization, increase in aNia, and increase in twitch force in dog Purkinje fibers. Increase in twitch force was related to decrease in the ratio of aNia to extracellular sodium activity(aNoa). NaCl-inducedd aNia increase was not blocked by 10(-5)M tetrodotoxin, a fast sodium channel blocker. 2) Hyperosmolar glucose or mannitol added to normal Tyrode solution produced membrane potential hyperpolarization, increase in aNia, and increase in twitch force in guinea pig papillary muscles. However, the addition of hyperosmolar NaCl did not affect on membrane potential, but produced increase in aNia, and decrease in twitch force. 3) Prolonging effect of hyperosmolar glucose on duration of action potential was smaller than that of NaCl or mannitol in Purkinje fibers and papillary muscles. 4) Increase in twich force produced by ECF Na+reduction or by hyperosmotic solution was reated to decrase in the aNia ratio. 5) Relationship curve between increase in twitch force and aNoa/aNia ratio in hyperosmolr solution was less steeper than that in ECF Na(+)-reduced solution. CONCLUSION: The above results suggested that hyperosmolar solution-induced twitch force change was related to aNoa/aNia ratio change which influenced intracellular calcium activity via Na(+)-Ca(2+)exchange.
Action Potentials ; Animals ; Calcium ; Dogs ; Emergencies ; Glucose ; Guinea Pigs ; Humans ; Hypertonic Solutions ; Mannitol ; Membrane Potentials* ; Membranes* ; Microelectrodes ; Muscles* ; Osmolar Concentration ; Papillary Muscles ; Purkinje Fibers* ; Shock ; Sodium Channels ; Sodium* ; Tetrodotoxin

BACKGROUND: Recent randomized studies have shown a reduction of restenosis rate after denovo coronary stenting as compared to classical PTCA. The purpose of this study was to evaluate a new medication protocol using antiplatelet therapy(ticlodipine, aspirin) and heparin in conjunction with routine high pressure ballooning after stenting. METHODS AND RESULTS: Seventy two patients(47 males and 25 females, mean age : 58+/-11 years) underwent Palmaz-Schatz coronary stenting in 76 coronary lesions. Their clinical characeristice were ; 38 cases(63%) of unstable angina, 14 cases(19%) of stable angina and 20 cases(28%) of acute myocardial infarction(MI, Q : 16 cases, non-Q : 4 cases). In 15 out of 20 acute MI cases, stents were implanted in the infarct-related arteries. Primary elective stenting was indicated for 40 lesions(53%) ; 34 for de novo and 6 for restenosis after PTCA. Stents were implanted in 27 lesions(35%) with suboptimal result after PTCA and 9 lesions(12%) as a bailout procedure ; 8 threatened closures and 1 acute closure. All patients were treated with heparin for 48 hours and antiplatelet agents(aspirin 100-200mg/day and ticlopidine 200-500mg/day) after the procedure. All stents were greater than 3.0mm in size. Postdilatation was obtained with a max balloon diameter of 3.5+/-0.6mm(balloon-to-vessel ratio of 1.12+/-0.20) at a max inflation pressure of 14.4+/-2.8 atm. Percent diameter stenosis decreased from 70.4+/-15.5% to -1.2+/-4.8%(p<0.0001), and minimal luminal diameter increased from 0.94+/-0.57mm to 3.15+/-0.51mm(p<0.0001) after stenting. During mean follow-up duration of 5.1+/-3.0 months there were 3 cases(4.2%) of myocardial infarction, 2(2.7%) of repeat angioplasty, 1(1.4%) of CABG and 1(1.4%) of death. CONCLUSION: Palmaz-Schatz coronary stenting with poststenting routine high pressure ballooning appears to be safe and feasibile without anticoagulation and without use of intravascular ultrasound in selected patients.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Female ; Follow-Up Studies ; Heparin ; Humans ; Inflation, Economic ; Male ; Myocardial Infarction ; Phenobarbital ; Stents* ; Ticlopidine ; Ultrasonography

BACKGROUND: The previous reports have demonstrated that coronary artery flow profiles might change in patients with aortic valve disease. Our objective was to assess phasic coronary artery flow and velocity characteristics and coronary flow reserve in patients with severe aortic vale disease. METHOD: We studied six patients (4 men and 2 women, mean age 61.3+/-6.3 years) with aortic regurgitation and seven patients (3 men and 4 women, mean age 66.3+/-10.3 years) with aortic stenosis. Coronary flow velocity was measured at the proximal portion of left anterior descending artery with 0.014-inch Doppler tipped guide wire and intracoronary injection of adenosine. Nineteen patients (11 men and 8 women, mean age 52+/-9.8 years) with normal coronary artery were served as normal control. Result: The velocity-time integral of systolic coronary flow (SPVi) was significantly higher in patient with severe aortic regurgitation than control (21.1+/-5 vs 9.4+/-3.1, p<0.05, respectively) and ratio of diastlic to systolic the velocity-time integrals (DSiR) was significantly lower in patient with severe aortic regurgitation than control subject (1.5+/-0.5 vs 3.7+/- 0.8 p<0.05, respectively). Patients with severe aortic stenosis had significantly higher velocity-time integral of diastolic coronary flow (DPVi) than control subject (17+/-9.7 vs 8.8+/-3.0 p<0.05, respectively) and slighly higher DSiR than control subject (4.0+/- 2.5 vs 3.7+/-0.8 p<0.05, respectively). Coronary flow reserve was significantly decreased in patient with aortic valve disease compared with control subject (2.1+/-0.8 vs 3.2+/-0.4 p<0.05, respectively). CONCLUSION: Coronary flow reserve decreased significantly in patients with AR and with AS compared with normal control. Coronary blood flow profiles in patients with AR was characterized by systolic flow predominance and reduced diastolic flow whereas patients with AS was a tendency toward decreased systolic flow and increased diastolic flow.
Adenosine ; Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Aortic Valve* ; Arteries ; Coronary Vessels* ; Female ; Humans ; Male

No abstract available.
Adult* ; Humans ; Tibia*

PURPOSE: An adequate pain control is one of important factors for obtaining good outcomes in the ambulatory basis of hemorrhoidectomy. There have been many methods for pain control after hemorrhoidectomy such as narcotics, various kinds of analgesics, etc. The aim of this study is to compare intraoperative internal anal sphincter injection of Ketorolac tromethamine and other two conventional methods for pain control. METHODS: A total of 56 patients with hemorrhoid grade III or IV underwent surgery between May and October 1999, and prospectively assigned to three groups in the consecutive order. The group was divided in Group 1: [Ketorolac tromethamine (Tarasyn) 60 mg intrasphincteric injection intraoperatively and 30 mg IM/prn?10 mg po/6hrs], Group 2: [No intraoperative injection and maintain pain control with Tarasyn 30 mg IM/prn/10 mg po/6hrs], and Group 3: [No intraoperative injection and maintain pain control with Pethidine (Demerol) 50 mg IM/prn and Ibuprofen 400 mg/Paracetamol 500 mg/Codeine 20 mg (Myprodol) po/8hrs]. The post operative data and pain scoring was performed on the questionnaire with Point box scale (BS-11) and Behavioral rating scale (BRS-6) each 24 hours during 5 days after surgery. RESULTS: There are 22 patients in the Group 1, 16 in the Group 2 and 18 patients in the Group 3. The median age of the Group 1 is 42.5, Group 2, 44.5 and Group 3, 45 years. The pain score on the first day after surgery in group 1 was significantly lower than group 2 (p<0.05) in the both pain scoring scale but was no differences between group 1 and 3. On the fifth day after surgery group 3 was significantly lower than both group 1 and 2 in the point box scale (p<0.05). The urinary retention rate and the day of first bowel movement after surgery show no differences among three groups (p>0.05). CONCLUSIONS: Intraoperative internal anal sphincter injection of Ketorolac tromethamine shows a better pain control than conventional methods in early postoperative period. Therefore it might be helpful for patients to go home on the day after surgery, and strong pain killer to control pain after discharge will be needed.
Anal Canal* ; Analgesics ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Ibuprofen ; Ketorolac Tromethamine* ; Ketorolac* ; Meperidine ; Narcotics ; Postoperative Period ; Prospective Studies ; Surveys and Questionnaires ; Tromethamine ; Urinary Retention

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*