No abstract available in English.
Child ; Humans ; Osteomyelitis

We have employed the external akeletal fixation devices, that is Hoffmann apparatus and Pin and Resin fixation method, for the treatment of 44 cases of long bone fractures from Dec. 1978 to Dec. 1981. The following are our impressins. 1. Hoffmann apparatus and Pin and Resin fixation method proved to be effective and useful measure for the management of fractures of long bones, particulary in cases of the open tibial fractures. 2. Employing the Hoffmann apparatus to the tibial model, the possible limit of correction of the fracture alignment was calculated. It was found that the average angle of correction of deformity can be managed up to 20 degrees in varus and valgus deformity, 70 degrees in anterior angulation, 40 degrees in posterior angulation and 70 degrees in rotation. 3. Pin and Resin fixation method is one of effective means in immobilization of long bones. It is simple to apply, easy to manipulate and inexpensive while offering fair fixation without much complications and therefore we recommend the method as the best alternative to expensive Hoffmann apparatus. 4. The complications of Hoffmann apparatus and Pin and Resin fixation method were pin tract infections and ankle stiffness which were generally minor and prevented by more careful aseptic technique and encouraging early joint motion.
Ankle ; Congenital Abnormalities ; Fracture Fixation ; Fractures, Bone ; Immobilization ; Joints ; Methods ; Tibial Fractures

Using Xenon inhalation method, the authers measured the rCBF's within 24 hours before and after the operation of 4 AVM patients. We found the obliteration of the cerebral steal syndrome in all cases and the loss of initial shunt peak in 2 cases after excision of AVM. We discussed these hemodynamic changes in AVM and reviewed the literatures.
Hemodynamics ; Humans ; Inhalation ; Intracranial Arteriovenous Malformations* ; Xenon

With Xenon gas inhalation method, the authors measured the rCBF from 14 AVM patients who were checked into the Neurosurgical Department of Kyung Hee Medical College. In nine of them, we detected the rCBF within 24 hours after operation ; in comparison with the clinical progress, we got the results as follows; 1) The amount of rCBF before operation was 62.9+/-12.7 in adjacent regions around the AVM, and 67.8+/-14.7 in the contralateral hemisphere. These values were lower than normal rCBF, undoubtedly demonstrating the development of cerebral steal phenomenon. 2) After total excision of AVM, the amount of rCBF was 77.5+/-20.7(11.6+/-21.5% increase) in adjacent regions around AVM, and 79.6+/-16.3(8.9+/-17.0% increase) in the contralateral hemisphere. As the cerebral steal phenomenon was disappeared, 80% of clinical symptoms and signs were restored, which showed the interrelation between the rCBF and clinical progress. 3) The measurement of rCBF by Xenon gas inhalation method does no harm to human body, and can be carried out with ease and safety. 4) It is thought that in the case if AVM patient, the measurement of rCBF by Xenon gas inhalation method is a good parameter for diagnosis and follow up of AVM's patients.
Arteriovenous Malformations* ; Diagnosis ; Hemodynamics* ; Human Body ; Humans ; Inhalation ; Xenon

A series of 70 patients with chronic subdural hematoma, admitted to the Department of Neurosurgery of Kyung Hee University Hospital from Aug. 1, 1977 to July 31, 1982 is presented. The following results were obtained. 1) Males were more frequently involved than female with the ratio of 4.8 : 1. Peak age incidence was 6th and 7th decade. Bilateral subdural collections were only 4 cases and others were unilateral. 2) Older age(more than 50) had more frequently focal neurologic deficit such as hemiplegia, however younger age(less than 50) presented as increased intracranial pressure signs such as headache and vomiting. 3) The hematoma density of CT-scan on admission was hypertense, 3 cases(4.9%); mixed density, 20 cases(32.8%); isodense, 18 cases(29.8%); and hypodense, 20 cases(32.8%) respectively. 4) The operative method between simple burr hole drainage and craniotomy with membranectomy didn't affect the postoperative results. The operative mortality was 2.9%. 5) Follow-up CT scanning was performed in 32 patients, only 8 of them showed normal CT findings within one month after operation. One patient still showed remnant of hematoma on 50th postoperative day. 6) Osmolarities of the hematoma and systemic venous blood were measured simultaneously 10 times in 8 cases. Hematoma osmolarities were isosmolar 1, hyperosmolar 6 and hyposmolar 3 compared with systemic venous blood.
Craniotomy ; Drainage ; Female ; Follow-Up Studies* ; Headache ; Hematoma* ; Hematoma, Subdural, Chronic* ; Hemiplegia ; Humans ; Incidence ; Intracranial Pressure ; Male ; Mortality ; Neurologic Manifestations ; Neurosurgery ; Osmolar Concentration* ; Tomography, X-Ray Computed ; Vomiting

Carotid cavernous sinus fistula is abnormal communication between the carotid artery and the cavernous sinus. It can be classified according to three criteria : 1) pathologically into spontaneous or traumatic ; 2) hemodynamically into high flow or low flow fistula ; 3) angiographically into direct or dural fistula. We studied the regional cerebral blood flow changes in traumatic carotid cavernous sinus fistula. Regional cerebral blood flow checked 7 times during trapping procedure. The results are as follows ; 1) regional cerebral blood flow decreased in normal side than in lesion side hemisphere in the state of carotid cavernous fistula. 2) After compression of lesion side common carotid artery over 10 minutes, cerebral blood flow increased in both side. 3) Cerebral blood flow decreased temporary after operation on both side but normalized 2 or 3 weeks later.
Carotid Arteries ; Carotid Artery, Common ; Carotid-Cavernous Sinus Fistula ; Cavernous Sinus ; Fistula*

Spontaneous hematomyelia is an acute expanding lesion by the hemorrhage within the substance of the located primarily in the gray matter. It is necessary to have urgent operation to preserve the remainding cord function. We are reporting a rare case of spontaneous hematomyelia extending from T-8 to T-10 of unknown cause of which transverse symptoms have largely subsided after surgical evacuation of the liquefied hematoma.
Hematoma ; Hemorrhage ; Spinal Cord Vascular Diseases*

1210 patients with adult head injury who were admitted to the Department of Neurosurgery, Kyung Hee University Hospital during the period of 5 years from January, 1980 were analyzed clinicostatistically. The results were as follows : 1) There were 842 male and 368 females with the ratio of 2.3 : 1. 2) Higher incidence was observed on May and September of the year, and between 6:00 P.M. and 8:00 P.M. of the day. 3) The most common cause of head injury was traffic accident(58.3% of the total cases), especially pedestrian accident and the next causes were fall-down and assaults. 4) Loss of consciousness was observed in 862 cases(71% of the total cases) and the duration of unconsciousness seemed to be related with severity of clinical course. 5) Lucid interval was observed in 21.4% of the cases of intracranial mass lesion and the highest manifestated lesion was epidural hematoma. There was vomiting in 31.2% of the total cases and early posttraumatic epilepsy in 2.1%. 6) Skull fractures were identified in 375 cases ; 273 cases of linear, 50 cases of depressed, 41 cases of basal and 11 cases of diastic fractures. The most common site of linear skull fracture was temporoparietal bone. 7) 79.8% of epidural hematomas were associated with skull fractures and the most common site of hematoma was temporal area. 8) Of all cases of subdural hematoma, acute type was prevalent(59.7%) and in main involved site was frontotemporoparietal area. 9) The frequent associated injuries were mandible fracture and other facial bone fracture, chest injury and lower extrimities fracture in order. 10) The minor head injury of Glasgow Coma scale score(GCS) of 13 to 15 was 864 cases(71.4%), the moderate head injury of 9 to 12, 139 cases(11.5%), and the severe head injury of 3 to 8, 207 cases(17.1%). 11) Of 270 cases of severe head injury, the mortality was 43% and 21% had good recovery. But outcome was different according not only to GCS but also to the type of lesion. 12) Acute subdural hematoma with GCS of 3 to 5 was uniformly the worst problem(88% mortality), whereas subacute and chronic subdural hematoma had good outcome. 13) The overall mortality was 8.0% and the operation mortality in 283 cases was 19.8%. Among the 1,210 cases of head injury in adults, 80.8% showed good recovery and 11.2% remained in disabled or vegetative state.
Adult* ; Craniocerebral Trauma* ; Epilepsy ; Facial Bones ; Female ; Glasgow Coma Scale* ; Head* ; Hematoma ; Hematoma, Subdural, Acute ; Hematoma, Subdural, Chronic ; Humans ; Incidence ; Male ; Mandible ; Mortality ; Neurosurgery ; Persistent Vegetative State ; Skull Fractures ; Thoracic Injuries ; Unconsciousness ; Vomiting

Authors experienced fifteen cases of the pineal tumors during about 5 years from October, 1977 to September, 1982, which were diagnosed with brain C-T scanning. The details of clinical evaluation and follow up of 15 cases of the pineal tumors are presented. The following results were obtained. 1) The age group below age of 20 years in predominant and include 11 cases(73%) of 15 cases, and male is predominantly much than female. 2) On the neurological examination at admission, the RICP signs were showed in 15 cases, Parinaud's syndrome showed in 6 cases, cranial nerve palsy in 8 cases and DI symptom in 5 cases of all 15 cases. 3) In the follow up study, brain CT was more effective than any other conventional neuroradiologic technique. 4) 8 cases of all 15 cases have had normal life in follow up period with minium of 6 months and maximum of 6 months and maximum of 5 years, and one case with mild neurological deficit has been spent life for about 12 months. 5) Of 6 cases died within 2 years, 3 cases had insufficient treatment and 3 cases had sufficient treatment, of whom ond had tumor recurrence at primary site and dissemination to spinal epidural space and other two cases were suspected to have clinical dissemination to spinal cord. 6) On the basis of high survival rate in 9 cases of 12 cases who were treated completely, we thought that good survival rate in the patient with pinealoma will be resulted from a series of planed treatment, including early diagnosis, correction of hydrocepalus, surgical intervention and irradiation.
Brain ; Cranial Nerve Diseases ; Early Diagnosis ; Epidural Space ; Female ; Follow-Up Studies* ; Germinoma ; Humans ; Immunotherapy ; Male ; Neurologic Examination ; Ocular Motility Disorders ; Pinealoma* ; Recurrence ; Spinal Cord ; Survival Rate

Three cases of cerebral rete mirabile associated with aneurysms are presented. In two cases the aneurysms were located at the anterior communicating arteries, and in one at the peripheral portion of the middle cerebral artery. For the anterior communicating artery aneurysms, operations were performed. Based on these experiences, the difficulties and necessities of operations for the aneurysms associated with cerebral rete mirabilies are briefly discussed.
Aneurysm* ; Arteries ; Intracranial Aneurysm ; Middle Cerebral Artery ; Mirabilis ; Moyamoya Disease*