Intracranial lipomas are rare tumor which are usually found along the midline cerebral cisterns. A case of sylvian lipoma located usually at sylvian fissure was diagnosed by CT scanning and was confirmed with operation. Only partial resection could be done. The literature was reviewed and therapeutic options are proposed.
Corpus Callosum ; Lipoma* ; Tomography, X-Ray Computed

A clinical analysis and follow-up study were performed with 35 cases of subarachnoid hemorrhage of unknown etiology among 217 cases of spontaneous subarachnoid hemorrhage who were diagnosed by cerebral pan-angiohraphy and brain C-T scan and treated at department of neurosurgery, Chonju Presbyterian Medical Center from 1977 to 1982. The duration of follow-up study was 6 months to 8 years(mean 4.4years). The author obtained the following results. 1) Subarachnoid hemorrhage of unknown etiology was 16% of 217 cases of spontaneous hemorrhage. 2) The incidence of subarachnoid hemorrhage of unknown etiology was high in 5th decade and higher in women. 3) Manifestations of subarachnoid hemorrhage of unknown etiology were similar to those of ruptured aneurysm. 4) When primary cerebral pan-angiography was normal, the secondary cerebral pan-angiography was not so meaningful. 5) The overall prognosis of the cases of unknown etiology was good in 30 among 35 cases(86%) who were able to return to their previous occupation. 6) Age and blood pressure were probably major prognostic factor.
Aneurysm, Ruptured ; Blood Pressure ; Brain ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Jeollabuk-do ; Neurosurgery ; Occupations ; Prognosis* ; Protestantism ; Subarachnoid Hemorrhage*

No abstract available.
Hyperthyroidism* ; Purpura, Thrombocytopenic, Idiopathic*

PURPOSE: To evaluate the clinical and radiological results of patients that underwent total knee replacement arthroplasty (TKRA) using a NexGen(R). implant, and who were followed up for at least 2 years. MATERIALS AND METHODS: Between July 1996 and June 2002, 100 knees in 67 patients, and followed up for at least 2 years following TKRA using a NexGen(R). implant were retrospectively assessed for clinical and radiological results using the assessment standards of the Knee and Functional Score of the American Knee Society. RESULTS: The average preoperative range of motion in patients with osteoarthritis and rheumatoid arthritis were 107.4degrees (50-140degrees) and 105.8degrees (70-120degrees), respectively, which had improved to 127.2degrees (85-140degrees) and 125.6degrees (90-140degrees), respectively, at the final follow up. In addition, the preoperative flexion contracture improved from 11.3degrees (0-30degrees) and 10.6degrees (0-30degrees) to 1.3degrees (0-15degrees) and 3degrees (0-15degrees) postoperatively. The results using the assessment standards of the Knee and Functional Score of the American Knee Society were improved from 62 (35-82) and 40 (0-70) to 95.8 (87-100) and 97 (70-100) in patients with osteoarthritis, whereas the patients with rheumatoid arthritis were improved from 53.8 (32-73) and 36 (0-50) to 95.1 (89-98) and 79 (55-95). As a complication, infection occurred in 2 cases; they were given a reimplantation. CONCLUSION: TKRA using a NexGen(R). implant showed satisfactory improvement in pain relief and function, such as range of motion, as well as a lower occurrence rate of complications.
Arthritis, Rheumatoid ; Arthroplasty* ; Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies* ; Humans ; Knee* ; Osteoarthritis ; Range of Motion, Articular ; Replantation ; Retrospective Studies

Median raphe canal is a uncommon disease and represents a defect in the embryologic development of male genitalia. It occurs most commonly near the glans penis, but may occur anywhere from the urethral meatus to the anus, and is lined by endodermal or ectodermal epithelium. Surgical excision is the treatment of choice. we report a median raphe canal on the ventral aspect of the penis and the scrotum with review of literatures.
Anal Canal ; Ectoderm ; Endoderm ; Epithelium ; Genitalia, Male ; Male ; Penis* ; Scrotum*

Several cases of pulmonary air embolisms during surgery have been reported. However, such incidences are very rare during endoscopic surgeries. A 5-year-old boy with third ventricular arachnoid cyst and hydrocephalus underwent endoscopic third ventriculostomy under the general anesthesia, during which continuous intraventricular irrigation was maintained with normal saline. During the procedure, arterial and transcutaneous oxygen tension and end-tidal carbon dioxide tension became suddenly decreased while arterial carbon dioxide tension increased. Within 3 minutes after the inspired gas mixture was changed to 100% oxygen, the patient's respiratory variables returned to near base line. The second attack occured about 10 minutes later and decreased arterial oxygen tension with increased arterial carbon dioxide tension continued for about 5 minutes. After waking up from anesthesia, the patient suffered a generalized seizure attacks that was managed with anticonvusant therapy. We believe that we are the first to report an attack of pulmonary air emblism during brain endoscopic procedure. It was reported with the review of literatures.
Anesthesia ; Anesthesia, General ; Arachnoid ; Brain ; Carbon Dioxide ; Child, Preschool ; Embolism, Air* ; Humans ; Hydrocephalus ; Incidence ; Male ; Oxygen ; Pulmonary Embolism ; Seizures ; Ventriculostomy*

Lipid cell tumors of the ovary are the rarest functional ovarian neoplasm, and malignant variants are unusual. Although rare, due to endocrinological activity, these tumors are of great clinical interest. Recently we experienced a case of lipid cell tumor of the right ovary in 21 years old female, who presented with menometrorrhagia and menorrhagia, and reported it with a brief review of literatures.
Female ; Humans ; Menorrhagia ; Ovarian Neoplasms ; Ovary* ; Young Adult

PURPOSE: To determine the MR imaging findings of synovial sarcoma, with emphasis on the signal characteristicsof pathologically correlated T2-weighted images. MATERIALS AND METHODS: MR images of 14 cases ofpathologically-proven synovial sarcomas were retrospectively reviewed and correlated with the histopathologicfindings. We analyzed the signal intensity of T1- and T2-weighted images and the incidence of triple signalintensity, and evaluated the frequency of fluid-fluid levels, internal fibrous septa, calcification, the invasionof bone or neurovascular bundles and the involvement of joint capsules, as well as the size, location and marginof the tumors and pattern of contrast enhancement. RESULTS: Necrosis, cystic change or hemorrhage was suggested in11 cases, ten of which showed triple signal intensity, and in all cases, was pathologically confirmed. Fluid-fluidlevels were found in three cases and internal septa in ten. In four cases, maximum diameter was less than 5cm, andin nine, was greater than this. No mass was detected in one case. The tumor was located in the low extremity(n=9),pelvic girdle and hip joint area(n=2), scapular(n=1), shoulder joint area(n=1), and scalp(n=1). Eleven casesshowed a relatively well-defined margin and nine showed lobulation. Except in the area of necrosis and cysticchange, the pattern of contrast enhancement was diffuse and inhomogenous. Bony invasion was detected in two cases,neurovascular encasement in four, calcification in four, and joint capsule invasion in four. CONCLUSION: OnT2-weighted images, synovial sarcoma frequently showed triple signal intensity and internal septa with fluid-fluidlevels ; this was induced by cystic changes due to necrosis and hemorrhage.
Hemorrhage ; Hip Joint ; Incidence ; Joint Capsule ; Magnetic Resonance Imaging* ; Necrosis ; Retrospective Studies ; Sarcoma, Synovial* ; Shoulder Joint

To evaluate the nutritional status according to the degree of metabolic acidosis(MA) and determine that MA is a risk factor for malnutrition, we screened the laboratory data of 37 hemodialysis(HD) patients who were clinically stable for more than 6 months and taken bioelectrical impedence analysis(BIA) twice 6 months apart to check lean body mass (LBM). Mean age of patients was 49.1+/-15.0 years and sex ratio 1:2.4. Mean serum albumin level was 3.97+/-0.36g/dl and weekly Kt/V and normalized protein catabolic rate(nPCR) were 3.04+/-0.85 and 0.99+/-0.21g/kg/day. According to mean total CO2 content during the periods between BIA, the patients were divided to three groups[group 1(n=16):&18mEq/L, group 2(n=9):18< or =tCO2&21mEq/L, group 3(n=12):> or =21mEq/L). Group 1 had significantly higher body weight gain than group 2 and 3(1.82+/-1.62 vs. 0.77+/-3.13 and 1.35+/-3.85kg, P<0.05), and higher LBM gain(1.99+/-4.38 vs. 3.35+/-7.99kg, P<0.05), nPCR(1.05+/-0.20 vs. 0.91+/-0.13g/kg/day, P<0.05), intact parathyroid hormone(88.4+/-78.7 vs. 32.0+/-26.5pg/ml, P< 0.05), and phosphate(5.4+/-1.3 vs. 3.9+/-1.3mg/dl, P< 0.05) than group 3. There were no differences in age, serum albumin, BUN, creatinine and weekly Kt/V among three groups. Mean total CO2 level was inversely correlated with body weight gain and LBM gain. In conclusion, metabolic acidosis in stable HD patients may be the result of high protein intake and not related to decrease of body weight by protein catabolism.
Acidosis* ; Body Weight ; Creatinine ; Humans ; Malnutrition ; Metabolism ; Nutritional Status ; Renal Dialysis* ; Risk Factors ; Serum Albumin ; Sex Ratio

We investigated the frequency of sleep disturbances and the association between sleep disturbances and glucoregulation in type 2 diabetic patients. The frequency of sleep disturbances in 614 type 2 diabetic patients was investigated using validated sleep questionnaires. There were 381 male and 233 female patients. The mean age was 59.7 +/- 11.1 yr; the mean body mass index was 24.9 +/- 4.4 kg/m2; the mean HbA1c was 7.8% +/- 1.5%; and the mean duration of diabetes was 10.3 +/- 8.4 yr. The questionnaires revealed insomnia in 48.2% of the patients while 8.5% reported excessive daytime sleepiness. A total of 49% of the patients was poor sleepers, while 28.5% had depression. Multivariate logistic regression analysis showed that there was no significant association between HbA1c and other sleep disturbances, such as poor sleep, insomnia, and short duration of sleep. Sleep disturbances were very common in patients with type 2 diabetes mellitus, whereas there was no association between poor or short sleep and glucoregulation. Awareness and identifying sleep complaints in such patients are necessary to improve their quality of daily life.
Adult ; Aged ; Body Mass Index ; Depression/epidemiology ; Diabetes Mellitus, Type 2/complications/*diagnosis/drug therapy ; Female ; Hemoglobin A, Glycosylated/analysis ; Humans ; Hypoglycemic Agents/therapeutic use ; Logistic Models ; Male ; Middle Aged ; Quality of Life ; Questionnaires ; Sleep Disorders/*complications ; Sleep Initiation and Maintenance Disorders/epidemiology