Encapsulated and free pus in the substance of the brain tissue following an acute purulent infection is known as brain abscess, and which is uncommon. The brain abscess arise either as direct extention from infections within the cranial cavity or as hematogenous metastasis from infections elsewhere in the body. Since 1945, the antibiotics associated use of steroid and mannitol have been available for the treatment of brain abscess, and the result are very hopeful. The common method of surgical treatment are consist of excision and drainage and the problem of the best operative procedure has been disputed on the many neurosurgical literatures for many years. Recently we had treated 2 cases of severe otogenic brain abscesses with semicomatose patient by drainage, and good was the result compared with the other literatures. Result; 1. One case with semicoma recovered completely without any neurologic sequelae, and the other case recovered with visual disturbance. 2. The best operative procedure for the severe brain abscess considered a drainage.
Anti-Bacterial Agents ; Brain Abscess ; Brain* ; Drainage* ; Hope ; Humans ; Mannitol ; Neoplasm Metastasis ; Suppuration ; Surgical Procedures, Operative

PURPOSE: This study was to identify behaviors preventing the recurrence of breast cancer and the level of quality of life. METHODS: This descriptive study was conducted using a structured questionnaire from November 1, 2006 to December 25, 2006 . One hundred and twenty two women breast cancer survivors were recruited by convenience sampling. RESULTS: The most frequent behavior for preventing recurrence of the breast cancer was dietary treatment (90.9%) and exercise (86.8%) was the second behavior. In addition, most of them perceived these behaviors as 'very effective' (82.8%). The degree of the quality of life of a breast cancer survivor was 5.34 point indicating a 'medium level'. CONCLUSION: Breast cancer survivors pursued various behaviors for preventing recurrence of breast cancer. Therefore, the nursing interventions should be focused on a systematic educational approach considering healthy behaviors to prevent breast cancer recurrence for breast cancer survivors.
Adaptation, Psychological ; Adult ; Aged ; Breast Neoplasms/prevention & control/*psychology/therapy ; Data Interpretation, Statistical ; Demography ; Dietary Supplements ; Exercise Therapy ; Female ; *Health Behavior ; Humans ; Life Style ; Middle Aged ; Neoplasm Recurrence, Local/*prevention & control ; *Quality of Life ; Questionnaires ; Recurrence ; Survivors/*psychology

Acute subdural hematoma is commonly occurred by severe or minor head injury, which is encountered to neurosurgeons and needed the emergency operation. But the mortality rate of the acute subdural hematoma is still very high(60-90%) in spite of the recently advanced neuroradiology. Neurosurgery and anesthesiology the authors had managed 50 cases of acute subdural hematomas, confirmed surgically, during 24 months from march 1971 to march 1973 and observed clinically. Followings are the results. 1. The male sex was predominantly high in incidence, 6 to 1. the age incidence was high in the 3 rd decade to 5 th decade which is in vigorous social activity. 2. The most common mode of the head injury was the traffic accident in 35 of 50 cases. 15 cases were from other injuries. 3. The level of consciousness of the acute subdural hematoma was various from drowsy consciousness to coma. The lucid interval was developed in 18% of those. 44 cases showed papillary change. 39(88.6%) of these were ipsilateral mydriasis. In 23 of 50 cases had motor disturbance and 78.2% of 23 cases showed contralateral hemiplegia or hemiparesis. The papillary change and hemiplegia were valuable to know the side of hematoma. 4. One of the best diagnostic procedure for the acute subdural hematoma was the angiography. The authors performed the carotid angiography before surgery in all cases. The avascular zone of the angiographic finding was crescentic form in 71.4% of all and the most common site was the parietotemporal region, but rare in the posterior fossa in one case. 5. The mortality rate was 46%. the high mortality was observed in the condition of the old age, persistant coma after surgery, bilateral mydriatic fixed pupil, concomitant profound brain damage and brain swelling. 3 cases of non survival which were in the persistant coma after surgery were died of the complication of severe decubital ulcer, septicemia, pneumonia and cachexia. 6. In 27 survival cases, the hemiplegia, oculomotor palsy, organic dementia and epilepsy were observed as sequelae, which were progressively recovered. 9 of 27 cases were completely recovered to normal social life. But the epilepsy and organic dementia were falt to be the worst sequelae remaining the problem.
Accidents, Traffic ; Anesthesiology ; Angiography ; Brain ; Brain Edema ; Cachexia ; Coma ; Consciousness ; Craniocerebral Trauma ; Dementia ; Emergencies ; Epilepsy ; Hematoma ; Hematoma, Subdural, Acute* ; Hemiplegia ; Humans ; Incidence ; Male ; Mortality ; Mydriasis ; Neurosurgery ; Paralysis ; Paresis ; Pneumonia ; Pupil Disorders ; Sepsis ; Ulcer

The intracranial epidural abscess is a not indenpendent disease which is practically always secondary to osteitis or osteomyelitis of overlying bone. Also it was developed from complication of frontal sinusitis, middle ear or mastoiditis, incomplete debridement of compound comminuted depressed fracture and post-operative complications. Occasionally it was derived from dural sinus thrombophlebitis especially cavernous sinus. It was frequently developed frontal and temporal region. We have experienced 5 cases of intracranial epidural abscesses for this one year. Followings are the results ; 1. The causes were complication of compound depressed fracture, chronic osteomyelitis and post-operative complications. 2. The usual symptom was headache, fever and increased lethargy. 3. The laboratory findings of CBC were the increased WBC count and ESR. The CSF findings revealed occasionally increased the cell count and sugar. 4. The pus culture revealed proteus, coliform bacilli and paracolon bacili. 5. Treatment was surgical removal of overlying diseased bone, drainage of the purulent materials and instillation of antibotics irrigation. 6. The prognosis of the 5 cases of the intracranial epidural abscess was good. There was not appeared any complication or sequelae.
Cavernous Sinus ; Cell Count ; Debridement ; Drainage ; Ear, Middle ; Enterobacteriaceae ; Epidural Abscess* ; Fever ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Lethargy ; Mastoid ; Mastoiditis ; Osteitis ; Osteomyelitis ; Prognosis ; Proteus ; Suppuration ; Thrombophlebitis

Pheochromocytoma is derived from the chromaffin cells and patients with pheochromocytoma present with several signs and symptoms by producing, storing and secreting catecholamine. Spontaneous rupture or necrosis of pheochromocytoma is extremely rare, but it can be lethal because of the dramatic change in the circulation such as an acute abdominal emergency or shock. Spontaneous remission of the clinical symptoms due to necrosis of the pheochromocytoma is rare. We describe such a case that presented with cardiogenic shock due to extensive necrosis of the pheochromocytoma and this was followed by spontaneous remission of the clinical symptoms without removal of the pheochromocytoma.
Chromaffin Cells ; Emergencies ; Humans ; Necrosis ; Pheochromocytoma ; Remission, Spontaneous ; Rupture, Spontaneous ; Shock ; Shock, Cardiogenic

No abstract available.
Humans

BACKGROUND: The goal of antihypertensive therapy will be to extended the life expectancy of hypertensive patients to that of subjects without high blood pressure. Hypertension treatment in the 1990s will focus on the mechanisms by which blood pressure is lowered by various antihypertensive agents, as will as individualization of drug therapy. In recognition of their lack of adverse lipid effects and their tolerability, first line therapy with alpha blocker, angiotensin converting enzyme inhibitors and calcium antagonists will become increasingly commom. We studied a new dihydropyridine calcium antagonist barnidipine to evaluate the efficacy and safety in patients with essential hypertension. METHODS: The rabit aortic rings were cut and mounted on the force transducer to record an isometric tension on polygraph. To elucidate the mechanism of saponin effect on vascular smooth muscle, the contractility of the vascular smooth muscle were measured under vatying experimental condition. RESULTS: 1) The baseline sitting systolic and diastolic blood pressure after 4 weeks washout period were 154.+/-15.9mmHg and 1.0+/-8.2mmHg. At the end of 8 weeks of therapy sitting systolic and diastolic blood pressure were 126+/-9.5mmHg and 84.5+/-4.6mmHg which declined statistically significant(p<0.05). 2) The pulse rates did not change significantly during treatment period(70.0+/-6.6 beats / min at baseline, 70.9+/-7.2 beats / min at 2 weeks, 71.2+/-5.0 beats / min at 4 weeks, 72.8+/-8.5 beats / min at 6 weeks, and 71.9+/-6.8 beats / min). 3) The adverse reactions due to branidipine were reported in 2 patients(6.5%) with headache, 2 patients(6.5%) with facial flushing, 1 patient(3.4%) with dizziness and 1 patients(3.4%) with nausea and vomiting). 4) The abnormal laboratory findings due to barnidipine were reported in 1 patient with increased total bilirubin and GPT, 1 patient with increased transaminase and 1 patient with CK but another findings were normal. CONCLUSION: These results indicate that barnidipine is effective and safe antihypertensive agent in the treatment of essential hypertension.
Angiotensin-Converting Enzyme Inhibitors ; Antihypertensive Agents ; Bilirubin ; Blood Pressure ; Calcium ; Dizziness ; Drug Therapy ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension* ; Life Expectancy ; Muscle, Smooth, Vascular ; Nausea ; Saponins ; Transducers

BACKGROUND: Although cross-sectional studies have suggested a relationship between proton pump inhibitor (PPI) use and hypomagnesemia, no large-scale cohort study has been conducted to date. Here, we examined the changes in serum magnesium levels in response to PPI use. We hypothesized that PPI use might change the serum magnesium concentration. METHODS: Of the 2,892 patients hospitalized for percutaneous coronary intervention between January 2007 and May 2012, 1,076 patients with normal baseline (1.6-2.5 mg/dL) and follow-up serum magnesium concentrations were enrolled. These patients were divided into two groups: the PPI group and the control group. RESULTS: The mean follow-up period was 9.51+/-2.94 months. The incidence of hypomagnesemia (<1.6 mg/dL) was 0.4% (3/834) in the PPI group and 0.4% (1/242) in the control group (P = 0.904). The change in magnesium levels did not differ between the two groups, and this result was maintained in the analysis of covariance after adjusting for confounding factors (P = 0.381). Moreover, magnesium levels did not significantly differ between the long-term (duration of use > or =12 months, n = 71) and short-term PPI groups (duration of use <12 months, n = 763), and the control group (n = 242; P = 0.620). The effect of PPI use on change in serum magnesium concentration was affected by the use of multiple diuretics (-0.01+/-0.25 mg/dL; P = 0.025), although a single diuretic use with PPI did not alter the change in magnesium level (0.12+/-0.27 mg/dL). CONCLUSION: Changes in magnesium levels might be subtle after PPI use in patients with normal baseline magnesium values.
Cohort Studies ; Diuretics ; Follow-Up Studies ; Humans ; Incidence ; Magnesium* ; Percutaneous Coronary Intervention* ; Proton Pumps*

PURPOSE: To transmit DICOM data to a personal computer in the hospital without PACS, and estimate theusefulness of digital image management and its convenience for physicians through transmitted file size,transmission time and quality of transmitted images. MATERIALS AND METHODS: The raw data of three brain MRI andlumbar spine MRI were transmitted from an MR system to a personal computer via Ethernet TCP/IP connection. Thefile size and transmission time of transmitted images were measured according to the matrix number. Threeboard-certified radiologists compared the image quality of the transmitted and scanned images. RESULTS: Thetransmission of DICOM data to the personal computer was successful and the transmitted images and their headerinformation were displayed by various personal computer-based DICOM viewing programs. The file size andtransmission time of the 256 and 512 matrix images were 136 Kbyte, 2.17 seconds/slice and 520 Kbyte, 4.37seconds/slice, respectively. All radiologists regarded the transmitted brain MRI images as superior. Oneradiologist considered the transmitted lumbar spine MRI images superior, while others decided that the quality oftransmitted and scanned images was the same. CONCLUSION: The transmission of DICOM format image data to apersonal computer through an appropriate DICOM receiving program is useful for managing digital images andconvenient for physicians in the hospital without PACS.
Brain ; Humans ; Magnetic Resonance Imaging ; Microcomputers* ; Spine

XX male has a male phenotype with testes or gonads of testicular type and a female chromosomal constitution of 46, XX with no evidence of either ovarian tissue or female genital organs. Generally, they have normal male genitalia and all are infertile. We experienced a neonate with anophthalmia, hypospadia, small penis, and normal testes, whose chromosomal analysis demonstrated 46, XX. Polymerase chain reaction revealed the existence of a sex-determining region of Y (SRY). These findings suggest that the translation of an SRY on the X chromosome led to the development of a male phenotype. We report the case with a review of the related literature.
46, XX Testicular Disorders of Sex Development* ; Anophthalmos ; Constitution and Bylaws ; Female ; Genitalia, Female ; Genitalia, Male ; Gonads ; Humans ; Hypospadias ; Infant, Newborn ; Male ; Penis ; Phenotype ; Polymerase Chain Reaction ; Testis ; X Chromosome