A rare case of mixd pial and dural arteriovenovs malformation in the left frontal convexity is reported. This arteriovenous malformation is supplied from the left middle meningeal artery and small pial vessels and drained into the superior sagittal sinus. This arteriovenous malformation was totally excised without artificial emoblization of the left middle meningeal artery.
Arteriovenous Malformations* ; Meningeal Arteries ; Superior Sagittal Sinus

No abstract available.

Jehovah's Witness patients who require an operation represent a challenge to the physician because of the patients' refusal to accept a blood transfusion. We report 5 years experience with a consecutive series of 12 Jehovah's Witness patients in the Obstetric & Gynecological department who underwent operation. In 12 cases, death ensued in one patient who underwent subtotal hysterectomy for ectopic pregnancy. The cause of death was severe anemia & complicated respiratory problems. We discussed the problem of elective & emergency operations on Jehovah's Witness patients. Anesthesiologists must understand legal aspects, as well as and ethical, if they are to conduct their practice as an art as well as science.
Anemia ; Blood Transfusion* ; Cause of Death ; Disulfiram* ; Emergencies ; Female ; Humans ; Hysterectomy ; Jurisprudence ; Pregnancy ; Pregnancy, Ectopic

We have experienced the anesthetic management of bilateral adrenalectomy in a 17 years old male, who was diagnosed as Cushing's syndrome. Anesthetic problems in Cushing`s Syndrome are hypertension, tachrcardia, hyperglycemia, hypokalemia and acute adrenal insufficiency. Therefore anesthetic management of this disease should focus on the through understanding of pathophysiology and adequate control of preoperative condition. Careful monitoring of the patient and frequent measurement of electrolytes and acid base balance status during the operation are also needed. We report the case of anesthetic experience of Cushing`s Syndrome and review anesthetic choice and management for better outcome of the patient.
Acid-Base Equilibrium ; Adolescent ; Adrenal Insufficiency ; Adrenalectomy ; Cushing Syndrome ; Electrolytes ; Humans ; Hyperglycemia ; Hypertension ; Hypokalemia ; Male

An analytical observation was carried out on clinical features manifested by 435 patients admitted to Sacred Heart Hospital under a diagnosis of hypertension for a period of June 1968 to August 1972. The following results were obtained: 1. The occurence rate of hypertension was like to be higher in males than in females, showing a ratio of 3:2. The group of the 6th decade of age showed the densest distribution followed the groups in the 5th and the 7th decades, in either sex. 2. The average measurement of blood pressure in patients with hypertension for less than 2 years of duration was 174.8+/-25.14/114.0+/-18.72 mmHg. One who had suffered for over 10 years showed 189.7+/-32.02/126.6+/-23.95mmHg. The value had a tendency to increase as the ailment duration prolonged. 3. In eye fundus findings,hypertensive retinopathy of K-W stage II was the most frequent, observed in 39.0% of all. The appearing rate of hypertensive retinopathy increased and the change in the eye ground was accentuated as the ailment lingered longer. There was no noticeable correlative evidence between serum cholesterol and retinopathy by K-W classification, while the appearing rate of arteriosclerosis in the eye ground by Scheie's classification somewhat increased as serum cholesterol elevated. 4. Albuminuria was observed in 62.9% of all cases, a tendency of a higher appearing rate in parallel with the protraction of illness and a higher measurement of blood pressure. 5. The appearing rate of albuminuria increased as the change of eye fundus deepened. 6. The mean value of serum cholesterol was 192.0mg%, and there was no difference in cholesterol determination by age. 7. The ECG revealed an abnormal tracing in 78.0% of all cases, of which LVH was the most common abnormality appearing in 62.3%. The abnormalities in ECG were found more frequently as the illness protracted longer and blood pressure measured higher. 8. The chest X-ray showed abnormal findings in 55.6% of all cases, of which cardiomegaly was the most common change evidenced in 43.9%. 9. The cerebrovascular accident(22.9%), cardiac failure(8.6%) and renal insufficiency(7.9%) were the major complications of hypertension. The cerebrovascular accident was also found in higher occurence in the cases of longer duration of ailment with hypertension.
Albuminuria ; Arteriosclerosis ; Blood Pressure ; Cardiomegaly ; Cholesterol ; Classification ; Diagnosis ; Electrocardiography ; Female ; Heart ; Humans ; Hypertension* ; Hypertensive Retinopathy ; Korea* ; Male ; Stroke ; Thorax

PURPOSE: To evaluate the effectiveness of the compression hip screw, we reviewed the clinical results of cases of femoral subtrochanteric fracture which were treated with compression hip screw. MATERIALS AND METHODS: From May 1997 to June 2004, 20 cases of femoral subtrochanteric fracture, which were treated with compression hip screw and followed up more than 12 months, were reviewed. By the Seinsheimer's classification, there were 1 case of type IIa, 4 cases of type IIb, 2 cases of type IIIa and IIIb, 4 cases of type IV and 7 cases of V. We analyzed the treatment results by bony union time, range of motion, ambulation status and complications. RESULTS: All 20 cases were gained bony union without serious complications and secondary operation. The average bony union time was 19.8 weeks. 17 of 20 cases were recovered pre-injury ambulatory status level. CONCLUSION: The compression hip screw may be effective in treatment of the femoral subtrochanteric fracture with very narrow intramedullary canal, proximal femoral deformity, comminuted fracture with large butterfly fragment, long spiral fracture with medial cortical comminution and combined intertrochanteric fracture.
Butterflies ; Classification ; Congenital Abnormalities ; Femur ; Fractures, Comminuted ; Hip Fractures* ; Hip* ; Range of Motion, Articular ; Walking

PURPOSE: We evaluated clinical outcomes after drainage for malignant pericardial effusion with imminent or overt tamponade. MATERIALS AND METHODS: Between August 2001 and June 2007, 100 patients underwent pericardiocentesis for malignant pericardial effusion. Adequate follow-up information on the recurrence of pericardial effusion and survival status was available for 98 patients. RESULTS: Recurrence of effusion occurred in 30 patients (31%), all of whom were diagnosed with adenocarcinoma. Multivariate analysis indicated that adenocarcinoma of the lung (hazard ratio [HR], 6.6; 95% confidence interval [CI], 1.9 to 22.3; p=0.003) and progressive disease despite chemotherapy (HR, 4.3; 95% CI, 1.6 to 12.0; p=0.005) were independent predictors of recurrence. Survival rates three months after pericardiocentesis differed significantly with the type of primary cancer; the rates were 73%, 18%, 90% and 30% in patients with adenocarcinoma of the lung, squamous cell carcinoma of the lung, breast cancer and other cancers, respectively. CONCLUSION: Recurrence and survival of patients with malignant pericardial effusion are dependent on the type of primary cancer and response to chemotherapy. Patients with adenocarcinoma of the lung may be good candidates for surgical drainage to avoid repeated pericardiocentesis, but pericardiocentesis is considered effective as palliative management in patients with other cancers.
Adenocarcinoma ; Breast Neoplasms ; Carcinoma, Squamous Cell ; Drainage ; Follow-Up Studies ; Humans ; Lung ; Multivariate Analysis ; Pericardial Effusion ; Pericardiocentesis ; Prognosis ; Recurrence ; Survival Rate

To report cases of metastasectomy for metastatic gynecologic malignancies, we reviewed the medical records of all patients who have undergone metastasectomy for metastatic gynecologic malignancies in Center for Uterine Cancer from June 2001 to October 2002. Six patients were identified with median age of 55 years (range 52-66 years). The metastatic sites and primary sites were as follows: 3 liver metastasis from ovary; 1 abdominal wall metastasis from uterus (endometrial cancer), 1 brain metastasis from ovary, 1 lung metastasis from uterus (sarcoma). The median disease free interval was 48 months (range 10 months-13 years). There was no perioperative mortality. Postoperative morbidity was tolerable with 1 case of bile leakage. In three patients with hepatectomy, one patient was dead of disease after 15 months, one patient is alive with disease at 20 months of follow up, one patient have no evidence of recurrence at 7 months follow up. The patient with brain metastasis was dead due to lung metastsis after 9 months later postoperatively. Remaining two patients with abdominal wall and lung metastasis have no evidence of tumor recurrence at 4, 7 months follow up respectively. Metastasectomy for metastatic gynecologic malignancies can be performed safely and may help prolong survival in carefully selected patients.
Abdominal Wall ; Bile ; Brain ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver ; Lung ; Medical Records ; Metastasectomy ; Mortality ; Neoplasm Metastasis ; Ovary ; Recurrence ; Uterine Neoplasms ; Uterus

The purpose of this study was to provide a basis for studying the molecular mechanism of pharmacological action of chlorhexidine digluconate. Large unilamellar vesicles (OPGTL) were prepared with total lipids extracted from cultured Porphyromonas gingivalis outer membranes (OPG). The anthroyloxy probes were located at a graded series of depths inside a membrane, depending on its substitution position (n) in the aliphatic chain. Fluorescence polarization of n- (9-anthroyloxy)stearic acid was used to examine effects of chlorhexidine digluconate on differential rotational mobility, while changing the probes' substitution position (n) in the membrane phospholipids aliphatic chain. Magnitude of the rotational mobility of the intact six membrane components differed depending on the substitution position in the descending order of 16- (9-anthroyloxy)palmitic acid (16-AP), 12, 9, 6, 3 and 2- (9-anthroyloxy)stearic acid (12-AS, 9-AS, 6-AS, 3-AS and 2-AS). Chlorhexidine digluconate increased in a dose-dependent manner the rate of rotational mobility of hydrocarbon interior of the OPGTL prepared with total lipids extracted from cultured OPG, but decreased the mobility of membrane interface of the OPGTL. Disordering or ordering effects of chlorhexidine digluconate on membrane lipids may be responsible for some, but not all of its bacteriostatic and bactericidal actions.
Chlorhexidine* ; Fluorescence Polarization ; Liposomes ; Membrane Lipids ; Membranes* ; Phospholipids ; Porphyromonas gingivalis* ; Porphyromonas* ; Thiram ; Unilamellar Liposomes

PURPOSE: Anterior cruciate ligament (ACL) injury is one of the most common injuries that occur in the knee, and ACL reconstruction (ACLR) is commonly performed for preventing aggravation of degenerative changes and restoring of knee stability in young, athletic patients. This metaanalysis has a purpose of evaluating the clinical and arthrometrical outcomes of ACLR in a group of middle age patients (40 years and older) and comparing with patients under 40 years of age. METHODS: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and SCOPUS electronic databases were searched for relevant articles comparing the outcomes of ACLR between younger and older than 40 years of age until December 2016. Data searching, extraction, analysis, and quality assessment were performed based on the Cochrane Collaboration guidelines. Clinical outcomes were evaluated and compared between groups. The results were presented as mean difference for continuous outcomes with 95% confidence intervals whereas risk ratio for binary outcomes. RESULTS: Seven studies were included in the meta-analysis. Based on International Knee Documentation Committee classification, side-to-side difference, Tegner activity score, Lysholm knee score, there were no significant clinical and mechanical differences between the groups. CONCLUSIONS: This meta-analysis confirmed that after ACLR, middle age (>40 years) and young age (<40 years) patients did not present with significant difference in clinical and arthrometric results.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Classification ; Cooperative Behavior ; Humans ; Knee ; Lysholm Knee Score ; Middle Aged ; Odds Ratio ; Sports