We report a 17-year-old woman presented with a one-month history of lower back pain and radiating pain in the left leg. Examination revealed Lasegues sign in left leg with mild weakness of the plantar flexion of the left big toe. Magnetic resonance image revealed a well enhanced intradural lesion at the S1-2 level. Following a subtotal laminectomy of S1 and an intradural exposure, the roots of the cauda equina draped the tumor loosely without any attachment to the dura or cauda equina. The tumor was removed en bloc. The patient's recovery was uneventful. Histological examination confirmed a clear cell meningioma.
Adolescent ; Cauda Equina* ; Female ; Humans ; Laminectomy ; Leg ; Low Back Pain ; Meningioma* ; Spinal Cord Neoplasms ; Toes

OBJECTIVE: Massive intracerebral hemorrhage (ICH) is devastating neurosurgical disease. Decompression surgery has been performed to manage the uncontrolled increased intracranial pressure and good clinical result has been reported. Authors analyze the ICP trend after the decompression surgery and report the clinical usefulness. METHODS: Thirty patients data with massive ICH were analyzed retrospectively. Surgical indication was constantly followed in these patient ; Glasgowcoma scale score less than 8, midline shift more than 6 mm on brain CT. In all patients ventricular puncture was done before the decompression and monitored the ventricular pressure changes during and after the surgery. RESULTS: In massive ICH patients, the ICP was maintained in physiological range if the hematoma was removed more than 80%. And when we tried additional therapies like hypothermia or coma therapies in another group, the ICP was elevated at the time of the additional therapy. CONCLUSION: From this study, if the ICH removed more than 80% and The ICP was not exceed 20 mmHg during the first post-operation day, the ICP hardly exceed 20 mmHg after than. Authors thought that decompression surgery is not an essential treatment for the massive ICH patient if their hematoma removed enough.
Brain ; Cerebral Hemorrhage ; Coma ; Decompression ; Decompressive Craniectomy ; Hematoma ; Humans ; Hypothermia ; Intracranial Pressure ; Punctures ; Retrospective Studies ; Ventricular Pressure

Approximately 1% of all the meningiomas arise from the extradural space. Intradiploic meningiomas constitutes only a very small percentage of this figure. Because of its rarity, it is often confused preoperatively with primary bone tumors of the skull. The intradiploic meningioma of the orbital wall may be considered as a subgroup of intradiploic ectopic meningioma. The following is our report of a recently observed case of intradiploic meningioma of the orbital wall without intracranial or intraorbital involvement. The preoperative tentative diagnosis was osteoma of the orbital wall. Nomenclature and histogenesis of this type of meningioma are discussed.
Diagnosis ; Meningioma* ; Orbit* ; Osteoma* ; Skull

Approximately 1% of all the meningiomas arise from the extradural space. Intradiploic meningiomas constitutes only a very small percentage of this figure. Because of its rarity, it is often confused preoperatively with primary bone tumors of the skull. The intradiploic meningioma of the orbital wall may be considered as a subgroup of intradiploic ectopic meningioma. The following is our report of a recently observed case of intradiploic meningioma of the orbital wall without intracranial or intraorbital involvement. The preoperative tentative diagnosis was osteoma of the orbital wall. Nomenclature and histogenesis of this type of meningioma are discussed.
Diagnosis ; Meningioma* ; Orbit* ; Osteoma* ; Skull

PURPOSE: To demonstrate the incidence and variation of the meniscofemoral ligament in Koreans. MATERIALS AND METHODS: A total of 100 MR studies of 95 patients were reviewed with special attention to the appearance and incidence of the meniscofemoral ligaments. The ligament of Wrisberg was classified according to proximal insertion: type I, insertion at the posterofemoral condyle ; type II, insertion at the distal portion of the posteriorcruciate ligament ; type III, insertion at the distal portion of the posterior cruciate ligament. On T2-weighted images, the high signal at the meniscal insertion of the meniscofemoral ligament was classified according to itsshape. RESULTS: The ligament o Humprey was observed in 17 cases and the ligament of Wrisberg was in 90:type I in41 cases;type II, 19 cases;type III, in 28 cases; unclassified, in 2 cases. In 77 cases, the cleft with high signal intensity was seen between the meniscofemoral ligament and the posterior cruciate ligament. CONCLUSION: From our results, the incidence of the ligament of Wrisberg on MRI was moe prevelant than the ligament of Humprey. An exact knowledge of the meniscofemoral ligament could be helpful in distinguishing it from pathologic lesions.
Classification* ; Humans ; Incidence* ; Knee ; Ligaments* ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament

A case of dissecting aneurysm of the intracranial vertebral artery in 46-year-old man is reported. Dissecting aneurysm of the vertebral artery associated with SAH is very rare. The characteristic angiographic findings of dissecting aneurysm were: 1) retention of contrast medium in the aneurysm; 2) the presence of double lumina; 3) "String" or "Pearl-string" sign. The therapeutic occlusion of the intracranial vertebral artery was performed successfully.
Aneurysm ; Aneurysm, Dissecting* ; Angiography ; Arteries* ; Humans ; Middle Aged ; Therapeutic Occlusion ; Vertebral Artery

The development of postischemic irreversible brain damage depends upon the length of ischemia and its severity during arterial occlusion, although release of the occlusion always leads to restoration of normal or above noraml cerebral blood flow. The experiment was planned to determine the effects of mannitol on cerebral ischemia on subsequential regional cerebral blood flow(rCBF) and somatosensory evoked potential(SEP) following reperfusion after ischemia and also define the proper time of vascular occlusion without irreversible brain damage. Cerebral ischemia was induced in cat by transorbital occlusion of the left MCA with a Sugita clip for period of 30 minutes and the ischemic brain was reperfused for 180 minutes by removing the clip. Forty adult cats, weighing 2.5 to 4.0 Kg were divided into 5 group ; control(Group I, n=8), permanent MCA occlusion(Group II, n=8), permanent MCA occlusion with mannitol infusion(Group III, n=8), permanent MCA occlusion with mannitol infusion(Group III, n=8), 30 minutes MCA clipping followed by reperfusion(Group IV, n=8) and 30 minutes MCA clipping with mannitol infusion followed by reperfusion groups(Group V, n=8) respectively. The rCBF and SEP measurents were carried out in each animal immediately, after MCA occlusion, at 30 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes and 180 minutes followed by perfusion. The rCBF was measured by the hydrogen clearance technique. Mannitol was given in bolus of lg/kg body weight as a 25% solution delivered via the femoral vein. The results were as follows : 1) Gradual elevation of intracranial pressure(ICP) and systolic blood pressure were observed after MCA occlusion. Treatment with mannitol in MCA occlusion animals(Group III & V) decreased ICP immediately after infusion of mannitol. 2) Normal control rCBF(ml/100 g/min) were 51.94+/-5.05 in the left temporal(LT) and 50.80+/-4.87 in the left perietal lobes(LP). 3) The MCA occlusion resulted in a reduction of the blood flows to 72% of the normal control ones(LT : 14.29+/-4.81 ml/100 g/min) at the left temporal area immediately after occlusion and also a reduction of flows to 80.4% of the normal control ones(LT : 10.24+/-3.69 ml/100 g/min) at 180 minutes after occlusion in Group II. 4) In the mannitol-treated group(group IV), reperfused animals, with removal of the clip on MCA had an improved postischemic recovery of blood flow and ipsilateral cerebral blood flows were restored to 42.5% of the normal control ones(LP : 21.2+/-4.13 ml/100 g/min) at 180 minutes after occlusion in Lt. parietal CBF. 5) In the reperfusion group(group IV), reperfused animals, with removal of the clip on MCA had an increase in rCBF to the level of 83.3% of the control value(LT : 45.78+/-6.80 ml/100 g/min) at 180 minutes after reperfusion and also reperfused animals, with treated mannitol had further increase the blood flow up to the level of 92.5% of the control value(LT : 49.04+/-43.6 ml/100 g/min) at 180 minutes after reperfusion. 6) After the MCA occlusion, the SEP was present but markedly altered in shape and particularly the early components of the SEP were suppressed in the ipsilateral occlusion hemisphere. 7) In the mannitol-treated reperfusion group(Group V) the amplitude of the SEP was restored to 80% of control value. The SEP was significantly suppressed if the rCBF fell below 10-14 ml/100 g/min. These result suggest that provided CBF can be restored to above the 40% threshold well within 30 minutes, prevention of ischemic brain damage can be expected and also the mannitol may of benefit in prolongation of the time threshold for the formation of the cerebral ischmia after vessel occlusion.
Adult ; Animals ; Blood Pressure ; Body Weight ; Brain ; Brain Ischemia* ; Cats ; Evoked Potentials ; Femoral Vein ; Humans ; Hydrogen ; Ischemia ; Mannitol* ; Perfusion ; Rabeprazole ; Reperfusion

As internet technology rapidly improves, clinical services are increasingly computerized in most hosptials. In order to effectively support patient care and clinical researches, information technologies are widely utilized to integrate clinical databases and disseminate information. However, most hospital information systems in Korea are still independently implemented and not fully integrated due to lack of standardization and security measure. In order to meet increasing demand for better patient care and upgrading clinical research, there is a need for a development and sharing of integrated clinical information system with a common database including clinical data collected from various hospitals. The purpose of this study was to develop a web-based clinical information system for management of Behcet's disease by constructing an integrated database with treatment data, test results, and patient demographic data in collaboration with several hospitals. Specifically, current treatment procedure for Behcet's disease was analyzed first and enhanced treatment procedure as well as a web-based clinical information system for management of Behcet's disease was proposed using a structured systems analysis and literature review on the shared clinical information systems. Expected benefits of the system include an improvement of consistency in patient management and reduction of duplicate prescriptions and test orders. In addition, this system can help improve communication among clinics and tertiary hospitals by sharing common clinical database. In a long run, the share system can also help reducing hospital expenditures by reducing duplicate investment on high cost equipments by sharing them among hospitals.
Cooperative Behavior ; Health Expenditures ; Hospital Information Systems ; Humans ; Information Systems* ; Internet ; Investments ; Korea ; Patient Care ; Prescriptions ; Security Measures ; Systems Analysis ; Tertiary Care Centers

Although encounters with poisonous marine organisms occur predominantly in warm temperatures and tropical seas, dangerous marine animals are found as far north as 50degrees latitude. There are some 1000 catfish species inhabiting both fresh and salt waters; many of these fishes are capable of inflicting serious stings. The oriental catfish (Plotosus lineatus) possesses one of the most potent known marine toxins, and it is potentially lethal. We report a case of moderate envenomation by an oriental catfish. A 42-year-old male was stung by an oriental catfish. A puncture wound was noted on his left swollen thumb. He complained of severe pain in the hand and forearm, especially in the punctured finger. Initial management included hotwater immersion, tetanus prophylaxis, antibiotics, analgesics and digital nerve block. He was discharged after observation in the emergency department.
Adult ; Analgesics ; Animals ; Anti-Bacterial Agents ; Aquatic Organisms ; Bites and Stings ; Catfishes* ; Emergency Service, Hospital ; Fingers ; Fishes ; Forearm ; Hand ; Humans ; Immersion ; Male ; Marine Toxins ; Nerve Block ; Oceans and Seas ; Punctures ; Spine* ; Tetanus ; Thumb ; Wounds and Injuries

BACKGROUND: The past. studies on prediction formulas of pulmonary function parameters in healthy nonsmoking Korean adults have been performed in relatively small number of subjects and the reported results were restricted on a few parameters. Also there was no systematic investigation into the effect of smoking on pulmonary function parameters in smokers who have no respiratory symptoms. Therefore we attempted to establish prediction formulas of pulmonary function parameters and examined the effect of smoking on pulmonary function parameters. METHODS: We analyzed the result of parameters derived from the forced expiratory spirogram in 1,067 nonsmoking subjects from June in 1990 to December in 1991. They consisted of 306 males and 761 females and had neither respiratory symptoms nor history of respiratory disease. We derived prediction formulas by multiple linear regression method from their age, heights, and weights in each sex. To examine the effect of smoking on pulmonary function parameters, we classified 383 smoking men into three groups according to the past amount of smoking as follows : i.e. group of smokers who have smoked below 10 pack-years, 10-20 pack-years and above 20 pack-years. Regarding each group of past smoking as an independent dummy variable, we analyzed pulmonary function parameters including nonsmoking men as a baseline by multiple linear regression. We evaluated the smoking effect on pulmonary function parameters according to estimated p-value. RESULT: 1) Prediction formulas for pulmonary function parameters in each sex were derived. 2) The past smoking less than 10 pack-years does not give any effect on pulmonary function parameters. The past smoking of 10~20 pack-years showed significant negative correlation with FEV1/FVC and FEF 25~75%, and the smoking above 20 pack years showed negative correlation with FEV1 and FEV1/FVC. CONCLUSION: We have got prediction formulas of pulmonary function parameters which is driven from forced expiratory spirogram in nonsmoking Korean adults by multiple linear regression from age, heights and weights of subjects. The past smoking more than 10 pack-years showed negative correlation with some pulmonary function parameters of airflow obstruction.
Adult* ; Female ; Humans ; Linear Models ; Male ; Smoke* ; Smoking* ; Weights and Measures