No abstract available.
Cleft Lip* ; Congenital Abnormalities*

PURPOSE: The aim of this study was to assess the accuracy and timeliness of using tracheal ultrasound for examination of endotracheal tube placement in cardiac arrest patients. METHODS: This was a prospective, observational study, conducted at the emergency department of a university teaching hospital. Patients underwent emergency intubation due to cardiac arrest. Airway ultrasonography was performed during emergency intubation with the transducer placed transversely at the trachea over the suprasternal notch. Quantitative waveform capnography was used as the criterion standard for confirmation of tracheal intubation. The main outcome was the timeliness between airway ultrasonography and capnography. RESULTS: A total of 16 patients and 19 intubations were included in the analysis. The endotracheal tube was placed in the trachea in 16 intubations and in the esophagus in three intubations. The overall sensitivity and specificity of ultrasound for confirmation of tracheal intubation was 100%, respectively. The capnography application time after intubation was 17.5(10.0~32.5) seconds. The capnograpny confirmation time after application was 30(10~120) seconds. The ultrasound confirmation time for endotracheal tube placement after application was 5(4~5) seconds. CONCLUSION: When patients were in a low pulmonary blood flow state, such as cardiac arrest, capnography confirmation of endotracheal tube placement was not rapid and needed a lot of times. Ultrasound confirmation was very rapid and accurate, and was not affected by pulmonary blood flow. Ultrasound confirmation of endotracheal tube placement is more useful in the emergency department.
Capnography ; Emergencies ; Esophagus ; Heart Arrest ; Hospitals, Teaching ; Humans ; Intubation ; Prospective Studies ; Sensitivity and Specificity ; Trachea ; Transducers

An unusual case of glroependymal cyst involving the lateral ventricle, 3rd ventricle, cerebellopontine angle cistern and prepontine cistern, simultaneously, is reported. The glroependymal cyst is benign developmental cyst that mainly occurs in the cerebrospinal axis in relation to ventricle, but occasionally occurs in relation to extraventricular system, such as subarachnoid space, brain stem and cerebral parenchyme. The histological characteristics of ependymal cyst wall are ependyma-like epithelium and neuroglial tissue.
Axis, Cervical Vertebra ; Brain Stem ; Cerebellopontine Angle ; Epithelium ; Lateral Ventricles ; Subarachnoid Space

OBJECTIVES: We investigated impulsivity and sensation seeking of pathological gambling, comparing with alcoholism and normal group. METHODS: 36 pathological gamblers, who were diagnosed by DSM-IV criteria, were compared with 31 alcoholism group and 26 healthy normal group with Barratt impulsivity scale and Zuckerman sensation seeking scale. RESULTS: 1) Pathological gamblers appeared to have much more impulsivity than alcoholism group or normal group. In respect to sensation seeking, no significant differences were founded among three groups. 2) Pathological gamblers tend to have more non-planning impulsivity, cognitive impulsivity, and motor impulsivity than alcoholic group. Comparing with normal group, pathological gamblers tend to have more non-planning impulsivity and motor impulsivity, but not in cognitive impulsivity. 3) There were no differences in three sub-scales including of thrill seeking, experience seeking and disinhibition out of four sub-scales of sensation seeking scale, among three groups. However, Boredom susceptibility was higher in pathological gamblers than alcoholics and normal group. CONCLUSIONS: These results suggested that personality of pathological gambler is most impulsive and boredom susceptible, which indicates that pathological gamblers is more serious pathological clinical disorder than alcoholism.
Alcoholics ; Alcoholism* ; Boredom ; Diagnostic and Statistical Manual of Mental Disorders ; Gambling* ; Humans ; Impulsive Behavior* ; Sensation

The patients with degenerative lumbar spine disease were treated using TSRH(Texas Scottish Rite Hospital) universal instrumentation system. The patient population consisted of 6 men and 4 women with a mean age of 56 years(43 to 65 years). All patients suffered chronic back pain with other neurological symptoms and signs. Neurological improvement was obtained in all cases postoperatively. Complication include pneumonia in 1 case, deep vein thrombosis in 1 case, flaccid neurogenic bladder in 1 case. Autogenous bone graft, obtained from iliac bone, between transverse process provided excellent bony fusion in 7 cases on radiologic evaluation between 9 months to 12 months after operation. TSRH universal instrumentation system have several advantages compared with other pedicle screw rod systems ; easy to handle, low morbidity, shorter operative time and easier relieval of root compression.
Back Pain ; Female ; Humans ; Male ; Operative Time ; Pneumonia ; Spine ; Transplants ; Urinary Bladder, Neurogenic ; Venous Thrombosis

No abstract available.

Cerebral herniations were successfully produced in experimental animals during the expansion of intracranial balloon or laminaria. Visualizing structures deep in the brain, cat's heads were instantaneously frozen with liquid nitrogen and were sectioned in the midline longitudinally. The cerebral herniations were assessed by measureing the distance between parts of various anatomical structures on the brain in mid-sagittal sectional plane. Transtentorial rostrocaudal herniation of the brain stem was evident and more marked in the group of bilateral lesions than in the groups of frontal and temporal lesions. Infratentorial lesions produced transtentorial upward herniation of a part of anterior cerebellar vermis and downward herniation of the cerebellar tonsil through the foramen magnum. The risk of brain herniation was noted to be greater in rapid expanding lesions with balloon than the more slowly developing lesions with laminaria.
Animals ; Brain Stem ; Brain* ; Foramen Magnum ; Head ; Laminaria ; Nitrogen ; Palatine Tonsil

Hyperglycemia during either global or regional ischemia is widely known to be detrimental, and ischemia induced release of diverse neurotransmitters and the ensuing activation of specific postsynaptic receptors have been suggested to play a important role in the development of ischemic selective vulunerability. This study was undertaken to investigate the influence of blood glucose change on tissue concentration of some catecholamines ; dopamine, norepinephrine, serotonin, of the transient ischemic rat's brain, estimated by high performance liquid chromatography(HPLC) assay system, following transient bilateral forebrain ischemia in the rat's model subjected to 20 minutes of normothermic ischemia by two vesseles occulusion plus profound cortex, hippocampus and striatum respectively by HLPC. The concentrations of catecholamines were significantly decreased in all sampled areas in experimental groups compared with the control group(p<0.05), respectively(average decrease rate : norepinephrine 71%, dopamine 89%, serotonin 80% in frontal cortex ; norepinephrine 71%, dopamine 93%, serotonin 81% in hippocampus ; norepinephrine 33%, dopamine 35%, serotonin 78% in striatum). Dopamine was relatively decreased in concentration in frontal cortex and hippocampus, and serotonin was relatively decreased in striatum. But no statistic significancy(p>0.05) of catecholamines level between each experimental group(hyper-, hypo- and normoglycemic group) according to the change of blood sugar. The results suggested that blood glucose level did not influence the tissue concentration of dopamine, norepinephrine and serotonin in frontl cortex, hippocampus and striatum of transient ischemic rat's brain.
Blood Glucose* ; Brain* ; Catecholamines ; Dopamine* ; Frontal Lobe* ; Hippocampus* ; Hyperglycemia ; Ischemia ; Neurotransmitter Agents ; Norepinephrine* ; Prosencephalon ; Serotonin*

PURPOSE: To determine whether CT angiography can predict the parent artery of an anterior communicating aneurysm on the basis of characteristics of the aneurysm and precommunicating anterior cerebral artery. MATERIALS AND METHODS: Eighteen patients with anterior communicating aneurysm were studied prospectively using CT angiography and conventional angiography. The parent artery of an aneurysm was predicted by evaluating aneurysm neck location, direction of aneurysm projection, and size of the precommunicating anterior cerebral artery, as seen on CT angiography. A somatom Plus-4 spiral CT scanner was used and shaded-surface display three-dimensional images were constructed. RESULTS: Aneurysm neck was located near the parent artery in 12 cases(66.7%), and aneurysm projection was against the parent artery in 11 cases(61.1 %). The parent artery of the anterior cerebral artery was larger in 15 cases (8 3 .3 %), including ten cases of hypoplasia or agenesis of the contralateral anterior cerebral artery. In 17 of 18 aneurysms(94.4%) the parent artery seen on DSA was correctly predicted by CT angiography. CONCLUSION: Teh parent artery of an anterior communicating aneurysm can be predicted by evaluating a-neurysm neck location, direction of aneurysm projection, and precommunicating anterior cerebral artery, as seen on CT angiography.
Aneurysm ; Angiography* ; Anterior Cerebral Artery ; Arteries* ; Humans ; Imaging, Three-Dimensional ; Intracranial Aneurysm* ; Neck ; Parents* ; Prospective Studies ; Tomography, Spiral Computed

The authors present a statistical survey of the general incidence, age distribution, and preferential site of 631 tumors of the brain which have been surgically treated at Korea university medical center, department of neurosurgery over the last period of 10 years from 1985 to 1994. Among them 269 cases were males and 362 were females. Of the 631 intracranial neoplasms verified histologically, tumors of neuroepithelial tissue comprised 34%(212 cases), tumors of meninges 23%(148 cases), pituitary adenoma 18%(114 cases), metastatic tumors 8%(50 cases), neurilemmomas 8%(49 cases), germ cell tumors 3%(13 cases), cyst and tumor like lesions 3%(16 cases), and lymphomas 1%(5 cases). Of the 178 gliomas, astrocytic tumors comprised 83%(148 cases), oligodendroglial tumors 11%(20 cases), ependymal tumors 3%(6 cases) and mixed gliomas 1.7%(3 cases). Brain tumors occurred most frequently in the age group of 45-50 years, as seen by an incidence of 63 cases(10%). The male to female ratio was 0.74: 1. Tumors that showed a definitive preponderance of females over males were meningiomas, neurilemmomas, and pituitary adenomas. Supratentoral and infratenorial cases were 73%(461 cases) and 26%(162 cases), respectively and the remaining cases involved both sites. Of the 114 cases of childhood and adolescent tumors, 60 were male and 54 were female. Supratentorial tumors were 56% and infratentorial were 44%. The tumors in order of frequency were astrocytomas(28%), primitive neuroectodermal tumors(21%), craniopharyngioma(10%) and so on. Meningiomas occurred most frequently in parasagittal/falx area(25%), followed by cerebral convexity 23%, sphenoid 14%, posterior fossa 13%. Among pituitary adenomas, prolactinomas(32%) were the most common and followed by null cell adenomas 31%, growth hormone cell adenomas 15%, mixed GH-PRL cell adenomas 11%.
Academic Medical Centers ; Adenoma ; Adolescent ; Age Distribution ; Astrocytoma ; Brain Neoplasms* ; Brain* ; Female ; Glioma ; Growth Hormone ; Humans ; Incidence ; Korea* ; Lymphocytes, Null ; Lymphoma ; Male ; Meninges ; Meningioma ; Neoplasms, Germ Cell and Embryonal ; Neural Plate ; Neurilemmoma ; Neurosurgery ; Pituitary Neoplasms ; Supratentorial Neoplasms