No abstract available.
Bone and Bones* ; Dental Implants*

No abstract available.
Diagnostic Tests, Routine* ; Hantaan virus*

Spontaneous cerebellar hemorrhage is classically considered a rare and fatal disease because the early diagnosis is very rarely made during the life, and there is scant mention of the problems of spontaneous hemorrhage into the cerebellar hemisphere. However our opinions indicate that its frequency is greater than is generally thought although it is considered a rare lesion. The purpose of this paper is to record our present opinions concerning the possible early diagnosis and surgical management of the spontaneous cerebellar hemorrhage. We believe that it is possible by clinical examination alone to make or strongly suspect the diagnosis in life during the early stage before irreversible damage occurs and that emergency surgical intervention is strongly indicated. The patients is a 38 year old man admitted to the Department of Neurosurgery, Catholic Medical Center on Nov 3, 1976 with severe headache, vomiting, dysarthria and mental confusion. On examination, he was disclosed mental confusion, repeated vomiting, constricred pupil, horizontal nystagmus, inability to stand, dysarthria and neck stiffness. We confirmed the diagnosis under the cerebellar hemorrhage involving the cerebellar vermis and both cerebellar hemispheres by means of vertebral and carotid angiography, conray ventriculography, and cerebrospinal fluid examination. We underwent suboccipital craniectomy with the evacuation of hematoma at the vermis and both cerebellar hemispheres after 48 hours of onset of illness and his postoperative course was good except for mild cerebellar dysfunction signs and he was discharged on 45th hospital days.
Adult ; Angiography ; Cerebellar Diseases ; Cerebrospinal Fluid ; Diagnosis ; Dysarthria ; Early Diagnosis ; Emergencies ; Headache ; Hematoma ; Hemorrhage* ; Humans ; Neck ; Neurosurgery ; Nystagmus, Pathologic ; Pupil ; Vomiting

BACKGROUND: Group A streptococcus (Streptococcus pyogenes) is the most common cause of bacterial pharyngitis and an important cause of a variety of suppurative and nonsuppurative diseases. The molecular genetic analysis of group A streptococci in clinical isolates is rarely reported in Korea. In this study, molecular genetic analysis using serotyping and emm sequence analysis, testing the presence of the SpeA and SpeB gene, and the determination of an antimicrobial resistance pattern were investigated. METHODS: Sixty nine strains of S. pyogenes from clinical isolates in Korea during 1999-2002 were examined by T agglutination, serum opacity reaction, and emm sequence analysis. Also investigated were antimicrobial susceptibility and the frequency of SpeA and SpeB genes. RESULTS: The antibiotic resistance rates for S. pyogenes isolates were shown at 28.9% of erythromycin, 14.2% of ampicillin, 9.5% of chloramphenicol, and 6.3% of levofloxacin. However, all strains were susceptible to penicillin, vancomycin, and teicoplanin. By T agglutination typing, forty-one (59.4%) among sixty-nine isolates were identified as T28 (13%), T6 (13%), T1 (10%), T12 (8.7%), T4 (4%), T5/27/44 (4%), T3/B3264 (2.9%), T11/12 (1.4%), and TB3264 (1.4%). Thirty-five (50.7%) among sixty nine isolates were positive in serum opacity reaction. The SpeB gene showed positive in all strains but the SpeA gene in eleven (15.9%) strains. By emm gene sequence analysis, forty-seven (68.1%) CONCLUSIONS: Our data showed that antimicrobial resistance of clinical isolates to erythromycin were higher than those reported from the United States and Europe, and emm genotyping could be used for a reliable and efficient typing method.
Agglutination ; Ampicillin ; Chloramphenicol ; Drug Resistance, Microbial ; Erythromycin ; Europe ; Korea ; Levofloxacin ; Molecular Biology* ; Penicillins ; Pharyngitis ; Sequence Analysis ; Serotyping ; Streptococcus ; Streptococcus pyogenes* ; Teicoplanin ; United States ; Vancomycin

We have experienced a rare case of leukemic lesion(chloroma) in the lower spinal canal which was confirmed by the surgery and histologic examination of the tumor. A farmer, aged 39, was admitted to the Department of Neurosurgery, St. Paul Hospital in December 1974 with chief complaints of low back pain with radiating pain in the right lower extremity and voiding difficulty for one month. On admission, neurologically, the patient exhibited weakness of the right anterior tibialis, extensor hallucis longus and peroneus longus and brevis muscles and sensory involvement of the right third, fourth and fifth sacral dermatomes. He was disclosed the positive signs of the Naffziger's and Lasegue's and severe tenderness on the spinous process of the fifth lumbar and first sacral vertebrae. Lumbar myelogram demonstrated a total block at lower level of the fifth lumbar vertebra and a filling defect of the right fifth lumbar root area. Through the laminectomy of fourth lumbar to first sacral lamina, an extradural greenish soft mass located at the ventral aspect of the right fifth lumbar to upper sacral roots, and the mass was removed. The biopsy specimen disclosed chloroma with leukemic infiltration of the meninges.
Biopsy ; Humans ; Laminectomy ; Leukemic Infiltration ; Low Back Pain ; Lower Extremity ; Meninges ; Muscles ; Neurosurgery ; Sarcoma, Myeloid ; Spinal Canal* ; Spine

Hemorrhagic fever with renal syndrome (HIFRS), scrub typhus, murine typhus and leptospirosis have been the principal acute febrile diseases in Korea. To evaluate the seroepidemiologic patterns of acute febrile illness, sera collected from 2,423 patients in 1996 were examined for antibodies against Hantaan virus, Orientia tsutsugamushi, Rickettsia typhi, and Borrelia burgdorferi by indirect immunofluorescent antibody technique (IFA) and macroscopic agglutination test for Leptospira interogans. Seropositive cases against O. tsutsugamushi, Rickettsia typhi, Leptispira interogans and Hantaan virus were 192 (7.9%), 193 (8.0%), 12 (0.5%) and 324 (13.4%), respectively. Male was more affected in HFRS and murine typhus contrasting to scrub typhus and leptospirosis in female. Most positive cases occurred during October and November for scrub typhus, and during November and December for HFRS. These results showed similar patterns with previous epidemical data for recent couple of years, and possibly implied no significant changes occurred in ecologic situations for acute febrile diseases in Korea.
Agglutination Tests ; Antibodies ; Borrelia burgdorferi ; Female ; Hantaan virus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea* ; Leptospira ; Leptospirosis ; Male ; Orientia tsutsugamushi ; Rickettsia typhi ; Scrub Typhus ; Typhus, Endemic Flea-Borne

Mediastinal fibrosis is pathologically characterized by chronic inflammation and fibrosis of mediastinal soft tissue. Mediastinal fibrosis is local expression of a family of systemic fibrosing syndroms. This can result in compression of adjacent mediastinal structures. Idiopathic fibrosing syndromes include retroperitoneal fibrosis, sclerosing cholangitis of the orbit and fibrosis of the thyroid gland(Riedel's struma). The cause of these disorders is obscure, in some instance there is an underlying malignancy, infection, history of drug ingestion, or trauma with retoperitoneal bleeding. Treatment of mediastinal fibrosis depends on structures involved by the fibrotic process. The disease is self limited in most case or improved by steroids uses. We experienced a case of idopathic solerosing mediastinitis with orbital fibrous dysplasia of unknown cause, which was confirmed by open lung biopsy, so reported it with a review of literature.
Biopsy ; Cholangitis, Sclerosing ; Eating ; Fibrosis* ; Hemorrhage ; Humans ; Inflammation ; Lung ; Mediastinitis ; Orbit ; Retroperitoneal Fibrosis ; Steroids ; Thyroid Gland

We have experienced 109 cases of hypertensive intracerebral hemorrhage admitted to the Department of Neurosurgery of Catholic Medical Center from January 1973 to August 1976. We analized the result of treatment of hypertensive intracerebral hemorrhage and assessed prognostic factors affecting the results of surgical treatment of hypertensive intracerebral hemorrhage. 1. The age of the patients did not significantly influence on the mortality of operative or non-operative cases provided the age is below sixty. 2. The amount of hematoma did not directly related to the outcome of operated cases if the hematoma is less than 50ml, while the mortality was considerably increased if the clot was more than 50ml. 3. There was no specific difference in operative mortality between total evacuation and partial evacuation of hematoma in surgery of the hypertensive intracerebral hemorrhage, but total evacuation had better result than that of partial evacuation in the functional recovery. 4. The operative mortality of the hypertensive intracerebral hemorrhage was 43.6% and 55.7% in non-operative cases. Thalamic hemorrhage carried the highest mortality either operated or conservatively treated. 5. The surgical treatment carried better result than non-operative treatment in the case showing progressive change in consciousness following intracerebral hemorrhage. Conservative treatment obtained good result in the cases showed progressive improvement of conscious level following intracerebral hemorrhage. 6. The interval from the ictus to surgical intervention did not constantly influence on the result of surgery and it might be wise to decide the time of surgical intervention according to the progressive changes in conscious level and neurological status after bleeding. 7. The operative result was favorable in the patients who has shown progressive worsening of conscious level and neurologic status following clear conscious at hemorrhage (class II). We also noted that the patients were unconscious at ictus then became progressively stupor with increasing neurologic deficit showed better result with surgical treatment than non-operative care.
Cerebral Hemorrhage ; Consciousness ; Hematoma ; Hemorrhage ; Humans ; Intracranial Hemorrhage, Hypertensive* ; Mortality ; Neurologic Manifestations ; Neurosurgery ; Stupor

The term hydranencephaly designates the condition in which large protions of the cerebral hemispheres have been reduced to membranous sacs within a cranium of relatively normal size. Only basal ganglia and remnants of the mesencephalon are found at the base of the skull. We have experienced the 2 cases of infantile hydranencephaly. In surveying the pathogenesis of the hydranencephaly, it becomes apparent that the distribution of most of the lesions falls into certain distinct patterns, which is characterized by almost completely absent of both cerebral hemispheres and by relative gross preservation of the basal ganglia, a portion of lower temporal and occipital and contents of the posterior fossa in our experienced 2 cases. In our cases, the condition may present a defect in vascular ontogenesis or the outcome of vascular occlusion of both internal carotid arteries and their main branches on carotid angiogram and CT scan. This paper presents the essential features for the clinical diagnosis, suggesting pathogenesis in 2 cases of infantile hydranencephaly.
Basal Ganglia ; Carotid Artery, Internal ; Cerebrum ; Diagnosis ; Hydranencephaly* ; Mesencephalon ; Skull ; Tomography, X-Ray Computed

The introduction of the operating microscope improved not only the immediate operative management of cerebral aneurysms, but also the knowledge of their topography. The origin and projection of an aneurysm and its relation to the arteries concerned, identification and sparing of small functionally important arteries in the vicinity of the aneurysm, and the recognition of less known anomalies of the vascular system became as important as the dissection and clipping of the neck itself. We have presented 2 patients with aneurysms arising from the carotid artery in the origin of the ophthalmic artery. The origins and projections of aneurysms were analyzed with the aid of angiography, magnification technique, operative drawing and photographs. To facilitate the surgical procedures and results in lowered morbidity we have discussed the technical considerations for medialward directing aneurysm under the optic nerve in the view point of the surgical anatomy. We emphasized preoperatively defined plans concerning the origin, direction and size of the aneurysms, as well as, constant awareness of topographic relations.
Aneurysm* ; Angiography ; Arteries ; Carotid Arteries ; Humans ; Intracranial Aneurysm ; Neck ; Ophthalmic Artery ; Optic Nerve*