Is superselective embolization of the brain AVMs, the possibilities of adjacent normal brain tissue damage necessitates preembolic evaluation. The authors performed the Sodium Amytal test on 15 patients with brain AVMs. In the AVM patients with negative Amytal test(30 cases), all patients showed normal pattern on EEG and neurologic examinations after embolization Among the five patients with positive Amytal test, three cases showed neurologic deficit and the others two didn't. In eleven patients. Repeated embolization without the Amytal test were done. Among them, 5 cases showed neurlogic deficit and the others were quite normal. In conclusion, the Amytal test is a useful method of evaluation of the risk to damage normal brain tissue which are supplied by superselected feeding vessels. Combining the EEG with this test is a sensitive and objective method in evaluating patients following the Amytal test. And it is essential to performed the Amytal test for repeat embolization procedures.
Amobarbital* ; Arteriovenous Malformations* ; Brain* ; Electroencephalography ; Humans ; Methods ; Neurologic Examination ; Neurologic Manifestations

No abstract available.
Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Hot Temperature* ; Humans ; Intellectual Disability*

No abstract available.
Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Hot Temperature* ; Humans ; Intellectual Disability*

No abstract available.
Macrophages, Alveolar* ; Mycobacterium tuberculosis* ; Mycobacterium*

Thirty cases of lacerated canaliculi were repaired by bicanalicular silicone intubation(Pilling(R) Intubation Set)with use of a silicone sponge for nasal fixation. The results were as follows: Canalicular laceration occurred mainly in males(25 cases), and in young age group(10-39yrs). An isolated inferior canalicular laceration was the most common and occurred in 23 cases. There was no significant difference in laterality between right and left. The average follow up period was 13.8 months and final results were better in patients who were repaired earlier and had a longer intubation time. Postoperative complications occurred in 7 cases and all of them were canalicular slits. Canalicular slits were not related to the duration of intubation and did not affect the final results significantly. The advantages of this operation were good cosmetic results, minimal irritation by tube, and easy removal of tube.
Follow-Up Studies ; Humans ; Intubation* ; Lacerations* ; Porifera ; Postoperative Complications ; Silicones*

Castleman disease rarely presents as an isolated retroperitoneal mass. We report two cases of retroperitoneal Castleman disease. Sonography showed hypoechoic mass. in two CT demonstrated homogeneously enhancing mass in two cases and calcifications in one case.
Giant Lymph Node Hyperplasia*

Congenital diverticulum of the left ventricle is a very rare disease. Ventricular diverticulum is usually associated with other anomalies including intracardiac and midline thoracoabdominal defect. We describe a case with congenital left ventricular diverticulum presenting as an isolated lesion. A 37-year-old man presented with 4-year history of chest pain. Diverticulum was diagnosed by echocardiography and left ventriculogram.
Adult* ; Chest Pain ; Diverticulum* ; Echocardiography ; Heart Ventricles ; Humans ; Rare Diseases

OBJECTIVE: To evaluate the relative benefits and the costs associated with the introduction of the new pharmaceutical provision called 'Mandatory Prescription Syste m' which separates the role of physicians from that of pharmacists with respect to the prescription and dispensation of from the perspective of consumers (i.e., patients). METHODS: The costs of the system were measured by considering both direct and indirect costs. Direct costs included additional payments for ambulatory care and dispensing fees that occurred under the new system. Indirect costs consisted of transportation expenses and costs related to time spent for physician consultation, waiting for the prescriptions to be filled, and extra traveling. Benefits identified in this study were the reduction of drug misuse and overuse, and the overall decrease in drug consumption among the Korean population. Sensitivity analysis was performed for the inclusion of benefits for outpatients of hospitals, price elasticity, and increased fees for established patients. RESULTS: The net benefit was estimated to be about minus 1,862 billion won and the benefit-cost ratio was 0.478. This indicates that the costs of 'Mandatory Prescription' outweigh its benefits, relative to the previous system. The sensitivity analysis results for all the variables considered in this study consistently showed the benefit-cost ratio to be less than 1. CONCLUSION: The results of this study suggest that implementing Mandatory Prescription System in Korea might be inefficient from the consumer's perspective. The results of this study do not coincide with the results of previous studies, presumably because of the differences in study design and in which items of costs and benefits were considered.
Ambulatory Care ; Cost-Benefit Analysis* ; Elasticity ; Fees and Charges ; Humans ; Korea* ; Outpatients ; Pharmacists ; Prescription Fees ; Prescriptions* ; Transportation

Traumatic hemoperitoneum can still induce high mortality and morbidity rates, despite current method of intensive management. This study was performed to identify the independent prognostic factors in patients with traumatic hemoperitoneum. Two hundred thirty-six patients who underwent emergency operations because of traumatic hemoperitoneum at the Department of Surgery, Dong Kang General Hospital, Ulsan, from January 1986 to June 1994, were entered into this retrospective study. One hundred eighty-six patients were male, and fifty were female. The median age of the patients was 34 years (2 to 77 years). The modes of trauma were 131 motor-vehicle accidents, 43 fall down injuries, 30 stab injuries, 23 assaults, and 9 others . The common sites of injury were lthe iver and the spleen, followed by the mesentery, the stomach, the small bowels, the large bowels, the pancreas, the kidney, the diaphragm, and the retroperitoneum in order of frequency. Prognostic variables were identified from the perioperative parameters by using a univariate analysis(student t- test, chi-square test), and independent prognostic factors were determined by a multivariate stepwise logistic regression analysis, using the SPSS Win. Ver.5.0 PC package program. Statistical significance was present for p < 0.05. The overall postoperative morbidity and mortality rates were 34.3% and 19%, respectively. By using univariate analysis, the amount of bleeding, transfusion, and the immediate post-operative blood pressure were identified as significant prognostic factors for morbidity. Also age over 50, accompanying brain injury, time interval (less than 3 hrs), the systolic blood pressure on arrival (less than 100 mmHg), trauma score (less than 10), grade of liver injury (greater than IV), great vascular injury, total amount of resuscitative fluid (more than 4,000cc), the total amount of transfusion (more than 10 units), and the immediate postoperative systolic blood pressure (less than 100 mmHg) were identified as significant factors for mortality. Multivariate analysis demonstrated the following important independent prognostic factors : the total amount of transfusion for morbidity and mortality, and the post-operative blood pressure and trauma score for mortality. Our results suggest that early massive resuscitation, early operation to minimize the total amount of blood loss, and intensive immediate postoperative care to maintain blood pressure, are of utmost importance in multiple trauma patients with hemoperitoneum.
Blood Pressure ; Brain Injuries ; Diaphragm ; Emergencies ; Female ; Hemoperitoneum* ; Hemorrhage ; Hospitals, General ; Humans ; Kidney ; Liver ; Logistic Models ; Male ; Mesentery ; Mortality ; Multiple Trauma ; Multivariate Analysis ; Pancreas ; Postoperative Care ; Resuscitation ; Retrospective Studies ; Spleen ; Stomach ; Ulsan ; Vascular System Injuries

BACKGROUND: A long-term objective is to understand the pathogenesis of neurologic injuries associated with cardiac surgery, cardiopulmonary bypass, and circulatory arrest. Our specific aims are to establish a dose of air which results in moderate to severe neurologic defects in normothermic (37degrees C) rabbits. METHODS: To first establish a dose of air which would cause unequivocal neurologic impairment, anesthetized rabbits received either 0, 50, 100 or 150 microgram l/kg of air into the internal carotid artery(n=5 in each group). One hour later, anesthesia was discontinued and animals were recovered. Animal were neurologically evaluated at 24 hours using a zero(normal) to 97(coma) point scale. RESULTS: There was a clear relationship between the dose of air injected and the severity of neurologic impairment at 24 hours, p=1.1x10(-7). Rabbits receiving 50 micrograml/kg of air were minimally affected and were difficult to distinguish from controls. In contrast, rabbits receiving 150 micrograml/kg of air were uniformly and unequivocally impaired. CONCLUSION: we recommend for future cerebral air embolism studies, 150 microgram l/kg as the optimal dose of air which would reliably produce viable subjects for 24 hours with marked unequivocal, neurologic impairment.
Anesthesia ; Animals ; Brain ; Cardiopulmonary Bypass ; Embolism ; Embolism, Air* ; Rabbits ; Thoracic Surgery