We studied two intraabdominal desmoplastic small cell tumors. The patients were two men, 37 and 23 years old, with jaundice and palpable abdominal masses. On exploratory laparotomy, each patient revealed a huge mass in the greater omentum with disseminated peritoneal seeding, measuring 32 cm and 11 cm in its greatest dimension, respectively. The tumor involved the diaphragm, rectal shelf, and cul de sac in case 1, and it involved the porta hepatis, retroperitoneum, and serosal surface of the ascending and transverse colon in case 2. Omentectomy of the huge mass and satellite masses was performed in each patient. Both tumors showed nearly the same histopathologic features. The histologic pattern was suggestive of a metastatic small cell carcinoma, but there was no specific, single primary site. The tumors consisted of variably sized, discrete islands of epithelial-like small cells in dense desmoplastic stroma. The tumor cells revealed divergent epithelial, mesenchymal, and neural differentiation by histologic, immunohistochemical, and electron microscopic observations. Only one cycle of chemotherapy including cisplatin and VP-16 was given in case 1 because of a subsequent hepatic problem, who, thereafter, showed massive intraabdominal recurrent tumors 6 months after diagnosis. In case 2, the poor condition of the patient had made chemotherapy and radiotherapy impossible. Case 2 died of disseminated intravascular coagulation following progressive cachexia 7 months after diagnosis.
Neoplasm Metastasis

No abstract available.
Intracranial Arteriovenous Malformations* ; Risk Factors*

BACKGROUND:We have often observed arm withdrawal on administering rocuronium. This study was performed to determine the cause and to prevent this movement by mixing rocuronium with lidocaine or sodium bicarbonate. METHODS: Sixty-two patients, ASA I-II, were randomized into three groups for this blind, prospective study. After induction of anesthesia by thiopental sodium 0.5 mg/kg, each group received rocuronium 0.6 mg/kg alone (group R), with 2% (2 ml) lidocaine (group L), or rocuronium with an equivalent volume of 8.4% sodium bicarbonate (group S). Patients' responses to the injection were graded using a 4-point scale and the pHs of the mixtures were measured. RESULTS: The incidence rate of arm withdrawal was more reduced in groups L (47%) and S (45%) than in group R (80%) (P < 0.05). Severe withdrawal movement (grade 3) did not occur in group S (0%). CONCLUSIONS: The incidence and the degree of withdrawal movement in response to the injection of rocuronium were significantly reduced by mixing an equivalent volume of 8.4% sodium bicarbonate with rocuronium.
Anesthesia ; Arm ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Lidocaine* ; Prospective Studies ; Sodium Bicarbonate* ; Sodium* ; Thiopental

Meningioma is one of the most common tumors of the spinal canal. Spinal meningiomas are usually found in the thoracic spine and intradural extramedullary space. Intraspinal clear cell meningiomas are a rare histological variant. Fewer than 20 intraspinal cases have been reported in the literature and only two cases have been reported in the Korean literature, but there is no report available in the Korean orthopedic literature. We report here on a case of an intraspinal clear cell meningioma that was found in the thoracic region and it was completely resected. The nonspecific MR imaging characteristics make the diagnosis of this tumor difficult. Histological examination must be used to differentiate clear cell meningiomas from other tumors. Clear cell meningioma represents an aggressive variant of meningiomas, and surgical reatment and adjuvant radiotherapy are though to be essential. Further more, long term follow-up observation will be needed for detecting recurrence of clear cell meningioma.
Follow-Up Studies ; Meningioma ; Orthopedics ; Radiotherapy, Adjuvant ; Recurrence ; Spinal Canal ; Spine

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the effect of intraoperative wound application of vancomycin on preventing surgical wound contamination during instrumented lumbar spinal surgery. OVERVIEW OF LITERATURE: Postoperative infection is the one of the most devastating complications of lumbar surgery. There are a few reports showing the benefits of intraoperative wound application of vancomycin during spinal surgery. However, there is no report about the effectiveness of local vancomycin instillation in prevention of surgical wound contamination. METHODS: Eighty-six patients underwent instrumented lumbar spinal surgery. Mean patient age was 65.19 years (range, 23-83 years). There were 67 females and 19 males. During surgery, vancomycin powder was applied into the surgical site before closure in 43 patients (antibiotic group) and vancomycin powder was not applied into the surgical site before closure in 43 patients (control group). The tip of the surgical drain was cultured to evaluate surgical wound contamination. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured on the first, third, seventh, and fourteenth day after the operation. RESULTS: We found two patients with a positive culture from the tip of surgical drains in the antibiotic group, and one patient with a positive culture from the tip of the surgical drain in the control group. Postoperative ESR and CRP levels did not show significant differences between the two groups. On the third postoperative day, ESR in patients of the antibiotic group was more significantly decreased than that in patients of the control group, while CRP level did not show a significant difference between the two groups. CONCLUSIONS: There was no evidence to suggest that intraoperative vancomycin application is effective in decreasing the risk of postoperative wound infection after instrumented posterior lumbar fusion surgery.
Anti-Bacterial Agents* ; Blood Sedimentation ; C-Reactive Protein ; Female ; Humans ; Male ; Retrospective Studies ; Surgical Wound Infection ; Vancomycin ; Wounds and Injuries

Abscess ; Anti-Bacterial Agents ; Cavernous Sinus Thrombosis ; Disseminated Intravascular Coagulation ; Drainage ; Humans ; Mediastinitis ; Middle Aged ; Multiple Organ Failure ; Resuscitation ; Sepsis

Two Years Reports of "Journal of Korean Neuropychiatric Association" during 2001 to 2003 were evaluated by 17 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropychiatric Association" will develope a good journal.
Evaluation Studies as Topic*

Four Years Reports of "Journal of Korean Neuropsychiatric Association" during 2001 to 2005 were evaluated by 18 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropsychiatric Association" will develop a good journal.
Evaluation Studies as Topic*

Four Years Reports of "Journal of Korean Neuropsychiatric Association" during 2001 to 2005 were evaluated by 18 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropsychiatric Association" will develop a good journal.
Evaluation Studies as Topic*

Intracranial dural arteriovenous malformation(AVM) is an uncommon neurosurgical condition; in particular, it has been infrequently reported in Korea. To understand the general clinical characteristics of dural AVMs, the authors reviewed 41 cases and analysed the factors affecting hemorrhage of dural AVMs. Since 1980 we have encountered 320 pial and 41 dural AVM, a ratio of 7.8 to 1. The age of these patients ranged from 3 months to 70 years, the most common being the 6th decade, and female exceeded males by a ratio of 1.56 to 1. All lesions except one was single, and symptoms were related to it's location and the venous drainage pattern. The most common location was the cavernous sinus, accounting for about 70% of cases, so the most common clinical symptoms of dural AVMs were ocular, namely-proptosis and chemosis. The next was tinnitus found in transverse/sigmoid sinus dural AVMs. Intracranial hemorrhage was seen in six cases(14.6%), the primary cause of hemorrhage was retrograde intracranial venous drainage(p=0.001), and no hemorrhage was observed in cases with no intracranial venous drainage. And intracranial hemorrhage was more frequent in transverse/sigmoid than cavernous sinus dural AVMs, and this was so even where there was intracranial venous drainage(p<0.001). However two of 28 patients with cavernous dural AVMs became blind in one eye, demonstrating that in such patients, the clinical course could be aggressvie. The majority of cases were treated by endovascular therapy: surgical excision was performed in only one patient with tentorial dural AVM. Eight patients were treated conservatively. Three died of hemorrhage, 3 who had had fixed deficit had neurologic deficits even after a definite treatment, and 35(85%) showed clinical improvement. During intervention, there was one hemorrhagic complication, due to obstruction of venous outflow with embolic materials.
Arteriovenous Malformations* ; Cavernous Sinus ; Drainage ; Female ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Korea ; Male ; Neurologic Manifestations ; Tinnitus