No abstract available.
Asthma, Occupational* ; Paint* ; Urethane*

We present a series of 10 Patients(Seven men and three women with an average age of 53 years) who underwent decompressive craniectomy for treatment to massive brain swelling following acute cerebral infarction. Clinical signs of cerebral herniation(anisocoria or fixed and dilated pupil, and/or hemiplegia with decerebrate righidity) were present in all patients. Computed tomography and magnetic resonance imaging showed the mass effect by cerebral edema through midline shift. All patients were treated with an extensive craniectomy and duroplasty. Among them, one recovered without neurological deficit, three were moderately disabled but functionally dependent, three remained in a persistent vegetative state and three died within 9 days after surgery(good recovery=1, moderate disability=3, persistent vegetative state=3, death=3). The results suggest that decompressive craniectomy can be an useful lifesaving procedure for massive cerebral edema following widespread hemispheric infarction.
Brain Edema ; Cerebral Infarction* ; Decompressive Craniectomy* ; Female ; Hemiplegia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Persistent Vegetative State ; Prognosis ; Pupil

Ninety-three patients who had evidence of intraventricular hemorrhage(IVH) were reviewed. Primary and secondary IVH could be well distinguished by computerized tomographic(CT) brain scan. 11 patients had primary pure IVH and remaining 82 patients were secondary IVH from mainly hypertensive intracerebral hemorrhage. Four patients died and 7 survived in the pure IVH. Three of the 4 who died were aneurysmal rupture. Remaining one was unknown etiology. In CT scan hemorrhage was most frequently found in the occipital horns according to the supine position of the patient during the examination and least found in the temporal horns probably due to narrow crescentic shape. In the secondary IVH the distribution of the blood within the lateral ventricle was mainly ipslateral to the intracerebral hematoma. The point of penetration of the intracerebral hematoma into the lateral ventricle was the posterior body in the basal ganglia or thalamic hemorrhage, the frontal horn in the aneurysmal rupture and the trigone in the arteriovenous malformation. Although the level of consciousness on admission related to the size and location of primary intracerebral hemorrhage or IVH, the ventricular dilatation itself also seemed to contribute to the consciousness state. The degree of temporal horn dilatation correlated more with the clinical grade than the frontal horn dilatation.
Aneurysm ; Animals ; Arteriovenous Malformations ; Basal Ganglia ; Brain ; Cerebral Hemorrhage ; Consciousness ; Dilatation ; Hematoma ; Hemorrhage* ; Horns ; Humans ; Intracranial Hemorrhage, Hypertensive ; Lateral Ventricles ; Rupture ; Supine Position ; Tomography, X-Ray Computed

For the reduction of morbidity, such as an acute hydrocephalus, following intraventricular hemorrhage, we attempted to produce a lysis of the experimental intraventricular hemorrhage by a direct intraventricular injection of fibrinolytic agent. Urokinase was used as the fibrinolytic activator. Sixty-four adult rabbits were used in this study. The animals were divided into 5 groups to investigate the effect of urokinase in different time interval of urokinase injection. Intraventricular hemorrhage was made by an injection of 0.3cc of autogenous venous blood. Group I was the control group in which intraventricular injection of blood or urokinase was only done. In Group II and III urokinase was injected into the ventricule 30 minutes and 2 hours after the blood injection. In Group IV urokinase was injected into the ventricle at the same time of the blood injection. In Group V urokinase was injected into the ventricle at the same time of the blood injection, and then the urokinase injection was repeated 24 hours later. The animals of each group were sacrificed on the 1st, 2nd, 3rd and 7th day successively after the experimental procedures. The brains were examined to observe the outcome of intraventricular hematoma with urokinase injection and the consequent changes of the ventricular system grossly and microscopically. The results were as follows : The duration of the remaining hematoma in the ventricles and basal cisterns was 7 days in both the control and the urokinase injection groups equally. In the group of repeated urokinase injection the duration of remaining hematoma in the ventricular system was shortened to 5 days after the blood injection. Upon the ventricular dilatation, the blood injection control group showed moderate dilatation persistently for 1 week ; from minimal to moderate dilatations were found in the urokinase injection groups. In the microscopic examination there were no definite abnormal changes on the ventricular walls and leptomeninges throughout 1 week in the urokinase injection control group. The group of repeated urokinase injection revealed mild flattening and denudation of the ependyma of the ventricular system than the group of single urokinase injection.
Adult ; Animals ; Brain ; Dilatation ; Ependyma ; Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Injections, Intraventricular ; Rabbits ; Urokinase-Type Plasminogen Activator*

The measurement of gastric emptying time is useful in differentiation of the hypochondriacal neurosis from the functional gastrointestinal disturbance, and also useful in searching the hidden gastro-intestinal disease in patients who are believed as the functional gastrointestinal disturbance. We confirmed in this study that the more delayed gastric emptying time was measured in functional gastrointestinal disturbance compared to normal group, and more shortened gastric emptying time was found after treatment with dopamine antagonist (cleboril) in this group.
Dopamine ; Gastric Emptying* ; Gastrointestinal Diseases* ; Humans ; Hypochondriasis

To our knowledge, MR findings of neuroshistosomiasis has not been reported in Korea. A case of neuroshistosomiasis involving cerebellum and presumably spinal cord is reported. A 40 year old man who had lived in Middle East complained of low back pain and progressive paraparesis for 6 months, and subsequently developed headache, dizziness and diplopia. On cervical spine MRI, there was diffuse enlargement of cervical cord with increased signal intensity on T2 weighted image and nodular heterogenous enhancement after Gd-DTP^ administration. Brain MR imaging obtained 4 months later showed ill-defined, irregularly enhancing heterogenous mass in cerebellar vermis which was proved to be a granulomatous lesion containing shistosomiasis mansoni ova.
Adult ; Brain ; Cerebellum ; Diplopia ; Dizziness ; Granuloma* ; Headache ; Humans ; Korea ; Low Back Pain ; Magnetic Resonance Imaging* ; Middle East ; Myelitis, Transverse* ; Neuroschistosomiasis* ; Ovum ; Paraparesis ; Spinal Cord ; Spine

A case of puerperal cerebral hemorrhagic infarction with venous thrombosis in a 36-year-old female is reported. Brain CT scan showed an isodensity area surrounded by ill-defind low density medially in the right frontal lobe, and the most anterior portion of superior sagittal sinus and its draining veins were prominent, but draining veins in the frontal high convexity were not filled in the venous phase of the right carotid angiogram. Osteoplastic craniotomy on the right frontal area was performed to remove the lesion which was mistakenly understood as a mass. Abnormal brain parenchyma was excised from the right frontal subcortical region. Microscopic and pathological evaluation confirmed the diagnosis of hemorrhagic infarction due to venous thrombosis.
Adult ; Brain ; Craniotomy ; Diagnosis ; Female ; Frontal Lobe ; Humans ; Infarction* ; Superior Sagittal Sinus ; Thrombosis* ; Tomography, X-Ray Computed ; Veins ; Venous Thrombosis

Hemostatic effect is achieved most efficiently by bipolar electrocoagulation in the neurosurgical operation. As far as function is concerned, the laser surgical unit closely resembles the electrosurgical unit. It has been possible to unite arterial vessel ends in a very fast procedure by means of heat application with the laser or bipolar electrocautery. The authors studied the difference between the CO2 Laser and Bipolar Electrocautery Effects on coagulation and anastomosis of vessels experimentally. 46 rats weighing 200gm to 250gm, were used in this study. We divided the experimental animals into 4 groups : 1) arterial coagulation with the CO2 laser, 2) vessel coagulation with the bipolar electrocautery, 3) arterial anastomosis with the CO2 laser, 4) arterial anastomosis with the bipolar electrocautery. The CO2 laser was operated at 10 watts(W) to 50W for vessel coagulation, and 2W for arterial anastomosis. The output of bipolar generation(Malis type) varied from 10 to 80 dial setting (DS) for vessel coagulation or arterial anastomosis. The results obtained were as follows : 1) The lower limit of proper arterial coagulation by the CO2 laser was 20W, 3 seconds(sec) of exposure time with defocused beam. 2) The arteries were properly coagulated with the bipolar coagulator under the DS 30~40, coagulation time 2~4 sec. Over DS 50, the artery perforated to active bleeding. 3) The veins were coagulated satisfactorily under DS 20~30 with 1~5sec. of coagulation time. 4) Both temporary cease of blood flow and using blunt bipolar forceps reduced the coagulation time, and the arteries were not performed over DS 50. 5) Arterial anastomosis was accomplished with 2W, 0.05sec of exposure with 0.2mm of focused CO2 laser beam. With the bipolar coagulator, the arteries could be anastomosed under DS 5~10, 2~3sec. of coagulation time. 6) The patency rate after arterial anastomosis was 71% with the CO2 laser and was 22% with the bipolar coagulator. 7) In the histological examination of coagulated arteries, the entire layers of laser irradiated side revealed destruction and constriction of adventitia and media sparing intima on all around the vessel wall. Anastomosed site revealed coaptation of adventitia and media.
Adventitia ; Animals ; Arteries ; Constriction ; Electrocoagulation* ; Hemorrhage ; Hot Temperature ; Lasers, Gas* ; Rats ; Surgical Instruments ; Veins

PURPOSE: The recurrence of Kawasaki disease has not been considered significant and has not been reported on literatures in Korea. Authors reviewed cases with recurrent Kawasaki disease to get informations about recurrent Kawasaki disease and to know whether there is any factor, if present, that can predict recurrence. METHODS: We reviewed and analyzed the hospital records of patients with recurrent Kawasaki disease who had been admitted to Inha University Hospital from January 1986 through December 1994. RESULTS: The total number of cases with Kawasaki disease was 266 during that period in Inha University Hospital. Seven patients were diagnosed as having recurrent Kawasaki disease, but four of them fulfilled five or more items of the diagnostic criteria for Kawasaki disease. So the proportion of recurrent cases was 1.5%(4/259)(or 2.7% (7/259) ?). Sex ratio was M:F=3:1. The ages at the first episodes of illness were from 7 months to 3 years 2 months (median=24 months), and those of the second episodes were from 11 months to 6 years 3 months (median=4 years 3 months). The intervals between two episodes were from 4 months to 4 years 2 months (median=1 year 9 months). No special aspect could be found in the clinical and laboratory findings of primary cases, compared with other cases with kawasaki disease. The clinical manifestations and courses of recurred cases were not significantly different from those of primary cases, except one recurred case who developed coronary aneurysm. CONCLUSIONS: The recurrence rate of Kawasaki disease seems to be higher than 1.5%(or 2.7%) at least. The risk factors for recurrence could not be found, and there was no specific aspect in the clinical manifestations and courses of recurrent Kawasaki disease.
Coronary Aneurysm ; Hospital Records ; Humans ; Korea ; Mucocutaneous Lymph Node Syndrome* ; Recurrence ; Risk Factors ; Sex Ratio

Castleman's disease(Giant lymph node hyperplasia) is a pathologic entity of unknown etilogy, as attested to bythe number of names it has received, lymphoid hamartoma, angiomatous hamartoma, and giant lymph node, etc.Although the mediastinum is its most common location, it also occures in other areas of the body, usually wherelymph nodes are normally found. Authors have been experienced 2 cases of histologically porven Castleman's diseaseduring recent 3 years in Kyung Hee University Hospital, and present its radiological and pathological findings asmediastinal mass.
Hamartoma ; Lymph Nodes ; Mediastinum