Rapid administration of solution containing dextroae results in marked hyperglycemia and osmotic diuresis hut a balanced electrolyte solution containing maltese does not increase blood sugar. 30 patients were chosen at random and divided into 3 groups j.e, one group received 5% dextrose in water, the second group received Hartmann solution and the third group, 5% maltose in a balanced electrolyte solution. The Patient's blood was collected in the operating room prior to the start l.V. infusion, for the measurement of blood sugar, insulin, osmolarity and electrolrtes in various conditions of N.P.O. Intravenous fluid was administered at a rate of 10 m1/kg/hour while anesthesia was induced and maintained with an endotracheal tube in place. Blood samples were taken one hour. 2 hours and 3 7ours f:on the time 1,V. infusion started, In the of 5% dextrose in water groups, the value of blood sugar and insulin was 88.5+/-12.1 mg% and 14.60+/-7.67 un/ml at NPO, 257.7+/-60.8mg% and 70.75+/-37.55 un/m1 at 1 hour, 298.8+/-84.4mg%: and 143.19+/-50.32 un/ml at 2 hours and 228.6+/-75.8% and 127.71+/-56.98 un/m1 at 3 hours. Although the b1ood sugar and insulin values increased markedly. but potassium and chloride were 4.74+/-0.55 mEq/l and 101.1+/-2.9 mEq/l and 4.11+/-0.31 mEq/l, 107.4+/-2.3 mEq/l and 3.75+/-0.41 mEq/l, 176.4+/-2.7mEq/l and 3.89+/-0.50mEq/l, 106.3+/-2.2 mEq/l and shoewed mild decrease, by the way, osmolarity and serum sodium did not changed. In contrast to the 5% dextrose in water groups, there are no changes in the blood glucose. insulin levels, osmolarity or and electrolrtes in the either Hartmann or Elitol (Elitol=5% maltose contained in a balanced electrolyte solution) groups. There was a slight increase in osmolarity with maltose but it was not significant. Accordingly it is concluded that rapid infusion of harmann or 5% maltose contained ina balanced electrolyte solution affects the blood sugar and insulin levels insignificantly compared to the dextrose cont5aining solution which increase the blood sugar and indulin levels markedly.
Anesthesia ; Blood Glucose* ; Diuresis ; Electrolytes* ; Glucose ; Humans ; Hyperglycemia ; Insulin* ; Maltose ; Operating Rooms ; Osmolar Concentration* ; Potassium ; Sodium ; Water

A case of multiple hemangioendothelioma of the cauda equina nerve roots and conus medullaris is described. This case is the first report of intradural multiple hemangioendothelioma in Korea. A 74-year-old woman presented with a 4-month history of progressive bilateral leg weakness and lancinating leg pain especially at night. Magnetic resonance image revealed multiple enhancing nodular masses in the cauda equina nerve roots and pial surface of the conus medullaris. We performed total removal of conus medullaris mass and partial removal of two nerve rootlets masses. Two lesions were histologically examined and found to be hemangioendotheliomas
Aged ; Cauda Equina* ; Conus Snail ; Female ; Hemangioendothelioma* ; Humans ; Korea ; Leg ; Spinal Cord*

OBJECTIVE: The purpose of this study was to compare clinical findings and outcomes of Enterprise and Solitaire stent-assisted coiling (SAC). MATERIALS AND METHODS: Between January 2012 and March 2014, 86 patients (mean age, 60.3 years) harboring 89 aneurysms were treated with Enterprise (n = 57) or Solitaire (n = 32) SAC. The patients' demographics, angiographic results, and clinical outcomes were reviewed retrospectively. RESULTS: There were no cases of stent navigation, deployment failure, arterial dissection, or intraoperative aneurysmal rupture. Angiographic follow-up imaging was available for 86 (96.6%) aneurysms (Enterprise group, n = 55; Solitaire group, n = 31). Immediate postoperative and follow-up angiographic results showed no flow or only minimal flow into the neck in 83% (Enterprise group, 77.2%; Solitaire group, 93.8%) and 95.3% (Enterprise group, 92.7%; Solitaire group, 100%) of SAC-treated aneurysms, respectively. Both stent groups showed good immediate postoperative and follow-up clinical outcomes. Excepting 2 cases, all patients achieved modified Rankin Scale scores of 0. Coil loop or tail protrusion into the parent artery was observed in 17 (29.8%) and 7 (21.9%) cases in the Enterprise and Solitaire groups, respectively. No statistically significant difference in terms of angiographic results or clinical outcomes was observed between the groups. CONCLUSION: Excellent and comparable clinical and angiographic outcomes for wide-neck intracranial aneurysms were achieved using both stents. Because of its higher radial strength and better vessel wall apposition, we cautiously propose that the Solitaire stent may be more effective for SAC of aneurysms harboring a large or severe tortuous parent artery.
Aneurysm* ; Arteries ; Demography ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Neck ; Parents ; Retrospective Studies ; Rupture ; Stents* ; Tail

OBJECTIVE: The purpose of this study was to compare clinical findings and outcomes of Enterprise and Solitaire stent-assisted coiling (SAC). MATERIALS AND METHODS: Between January 2012 and March 2014, 86 patients (mean age, 60.3 years) harboring 89 aneurysms were treated with Enterprise (n = 57) or Solitaire (n = 32) SAC. The patients' demographics, angiographic results, and clinical outcomes were reviewed retrospectively. RESULTS: There were no cases of stent navigation, deployment failure, arterial dissection, or intraoperative aneurysmal rupture. Angiographic follow-up imaging was available for 86 (96.6%) aneurysms (Enterprise group, n = 55; Solitaire group, n = 31). Immediate postoperative and follow-up angiographic results showed no flow or only minimal flow into the neck in 83% (Enterprise group, 77.2%; Solitaire group, 93.8%) and 95.3% (Enterprise group, 92.7%; Solitaire group, 100%) of SAC-treated aneurysms, respectively. Both stent groups showed good immediate postoperative and follow-up clinical outcomes. Excepting 2 cases, all patients achieved modified Rankin Scale scores of 0. Coil loop or tail protrusion into the parent artery was observed in 17 (29.8%) and 7 (21.9%) cases in the Enterprise and Solitaire groups, respectively. No statistically significant difference in terms of angiographic results or clinical outcomes was observed between the groups. CONCLUSION: Excellent and comparable clinical and angiographic outcomes for wide-neck intracranial aneurysms were achieved using both stents. Because of its higher radial strength and better vessel wall apposition, we cautiously propose that the Solitaire stent may be more effective for SAC of aneurysms harboring a large or severe tortuous parent artery.
Aneurysm* ; Arteries ; Demography ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Neck ; Parents ; Retrospective Studies ; Rupture ; Stents* ; Tail

The familial occurrence of bilateral acoustic neuroma has rarely been reported in the literatures, and its inheritance is known to be an autosomal dominant trait in association with or without von Recklinghausen's disease. Recently, we experienced an unusual case of bilateral acoustic neuroma, which was familially occurred in mother and her son. A 18-year-old Korean boy was referred to us due to bilateral hearing disturbance and staggering gait of one year duration. There were no stigmata of von Recklinghausen's disease. Neurological examination, simple skull films and vertebral angiograms revealed various evidences of bilateral cerebellopontine angle tumors. At operation, a hen egg-sized firm mass was subtotally removed at the left cerebellopontine angle region and a peanut-sized mass was totally removed at the right cerebellopontine angle region via suboccipital craniectomy. The histological diagnosis was neurofibroma. In family history, 13 years ago his mother was operated on C6-7 neurofibroma at her age of 28 years, and again operated on bilateral acoustic tumors 2 years later. The histological diagnosis was also neurofibroma.
Acoustics* ; Adolescent ; Cerebellopontine Angle ; Christianity ; Diagnosis ; Gait ; Hearing ; Humans ; Male ; Mothers ; Neurofibroma ; Neurofibromatosis 1 ; Neurologic Examination ; Neuroma, Acoustic* ; Skull ; Wills

A 20-year-old male patient was admitted to this hospital because of headache and high fever on October 10, 1974. He has insidiously develope frontal headache and high fever for these 10 days, followed by vomiting, convulsions, aphasia and motor weakness on the left extremities and subsequently fell into semicomatose state. Hemogram showed marked leukocytosis, 22500/mm3, and cerebrospinal fluid cell count revealed increased leukocyte, 1210/mm3. Simple skull Roentgenograms showed no significant abnormalities except for suspicious haziness on the left frontal sinus. Carotid angiogram showed distal shift of the anterior cerebral artery, medial displacement of the middle cerebral artery and small avascular area on the left temporo-parietal area. Brain scan showed high activities on the entire left cereral hemisphere. On October 12, 1974 a large fronto-temporo-parietal osteoplastic craniotomy was done. Yellowith green, foul odored pus gushed out from the subdural space of the entire operating fields. Preteus mirabilis was isolated in pus culture. He was discharged with good recovery two months later.
Anterior Cerebral Artery ; Aphasia ; Brain ; Cell Count ; Cerebrospinal Fluid ; Craniotomy ; Empyema, Subdural* ; Extremities ; Fever ; Frontal Sinus ; Headache ; Humans ; Leukocytes ; Leukocytosis ; Male ; Middle Cerebral Artery ; Mirabilis ; Odors ; Seizures ; Skull ; Subdural Space ; Suppuration ; Vomiting ; Young Adult

After acute interruption of cerebral blood flow, various hemodynamic, morphologic and metabolic changes ensue in the occluded area. Such changes and subsequent brain damage are of great concern in the course of temporary arterial occlusion during aneurysmal surgery. Many experimental studies investigating the processes of cerebral infarction have been done through selective occlusion of intracranial vessels, and it has been known that 4 to 8 minutes interruption of cerebral blood flow results in irreversible brain damage. Cerebral resistance following vascular occlusion may be influenced by collateral circulation, hypothermia and hyperventilation. Recently we experienced two patients with right middle cerebral artery aneurysms, who were operated upon under normothermia, slight hypotension, and hyperventilation using microsurgical technique. The technique of temporary occlusion of middle cerebral artery was applied as an adjunctive method.
Aneurysm ; Brain ; Cerebral Infarction ; Collateral Circulation ; Hemodynamics ; Humans ; Hyperventilation ; Hypotension ; Hypothermia ; Intracranial Aneurysm* ; Middle Cerebral Artery*

Aspergillosis is an infection produced by Aspergillus, a group of fungi, of low pathogenesity for human beings unless resistance is overcome by an overwhelming inoculum or debilitating illness. The disease may become disseminated or remain localized to the lung, ear, orbit or paranasal sinuses, but rare in prostate. We present a case in which this disease process involved the prostate.
Aspergillosis* ; Aspergillus ; Ear ; Fungi ; Humans ; Lung ; Orbit ; Paranasal Sinuses ; Prostate

OBJECTIVES: This study investigated changes in the clinical characteristics of foreign patients receiving psychiatric treatment in a public mental hospital in Seoul over the last nine years. METHODS: We compared the sociodemographic and clinical characteristics of a multi-cultural mental health (MCMH) clinic group of 49 foreign psychiatric patients, who had attended the newly opened special clinic for foreigners during the period August 2009-2010, with those of a general group of 71 foreign psychiatric patients, who had been treated in conventional ways during the period 2002-July 2009. RESULTS: The MCMH clinic group was characterized by voluntary attendances with the assistance of family, friends or supporting organizations. The patients were more likely to have resided longer in Korea, to have Korean citizenship, to be young married immigrant women and to have children. They were also more able to communicate by themselves or with the support of bilingual interpreters and were more likely to receive outpatient-based treatment and to experience longer periods of treatment. In contrast, the general group was characterized by involuntary hospital attendances supported by the police or the embassies of their home countries, and patients received inpatient services. They were also discharged sooner to be sent back to their home countries. Depressive disorder, anxiety disorder, and adjustment disorder were more common in the MCMH clinic group, while schizophrenia, bipolar disorder and a past history of psychiatric disorders were more common in general group. In the MCMH clinic group, those patients with Korean citizenship or permanent residency seemed to maintain consistent and stable treatment with a good prognosis. CONCLUSION: The findings from the specialized multi-cultural mental health clinic suggest that specialized setting for foreigners is more efficient in helping them, particularly for married immigrant women. This means that specialized systematic evaluation and treatment approach needs to be developed to provide culturally relevant mental health services for foreigners living in Korea.
Adjustment Disorders ; Anxiety Disorders ; Bipolar Disorder ; Child ; Depressive Disorder ; Emigrants and Immigrants ; Female ; Friends ; Hospitals, Psychiatric ; Humans ; Inpatients ; Internship and Residency ; Korea ; Mental Health ; Mental Health Services ; Police ; Schizophrenia

Renal angiomyolipoma is a relatively uncommon benign tumor and may be associated with tuberous sclerosis, which is characterized by adenoma sebaceum, epilepsy and mental retardation. When a renalangiomyolipoma occurs with tuberous sclerosis, it can be easily diagnosed and the incidence of multiple and bilateral angiomyolipoma is high in patients with multiple sclerosis. Recently we experienced a case of unilateral renal angiomyolipoma associated with tuberous sclerosis which occurred in a 38 year-old housewife, who had right flank mass, adenoma sebaceum on the face, shagreen patches of the back and sublingual fibromas. So we report a case of unilateral renal angiomyolipoma associated with tuberous sclerosis with review of literatures.
Adult ; Angiomyolipoma* ; Epilepsy ; Fibroma ; Humans ; Incidence ; Intellectual Disability ; Multiple Sclerosis ; Tuberous Sclerosis*