No abstract available.
Electrodes* ; Neural Conduction* ; Suction*

A case of 10 months old Korean female infant with congenital binocular cataracts, posterior fossa cyst, and macrodactyly simulating Marinesco-Sjogren Syndrome is presented. The diagnosis of the posterior fossa cyst was added by brain computerized tomogram, conray ventriculogram and vertebral angiogram. The studies demonstrated marked hydrocephalus with a huge posterior fossa cyst displacing 4 th ventricle and cerebellum anteriorly. The cyst was also extending upward displacing the tentorium superiorly. Following ventriculoperioneal shunt an exploration of the cyst was performed. The cerebellar hemispheres and vermis were appeared to be atrophic and displaced anteriorly due to the cyst. The histologic study of the biopsied cyst wall was normal arachnoid membrane. The authors assume that some of the reported cases of Marinesco- sjogren Syndrome could have similar cystic lesion which was found in this case to cause cerebellar ataxia and mental retardation.
Arachnoid ; Brain ; Cataract* ; Cerebellar Ataxia ; Cerebellum ; Diagnosis ; Female ; Humans ; Hydrocephalus ; Infant ; Intellectual Disability ; Membranes ; Sjogren's Syndrome ; Spinocerebellar Degenerations* ; Telescopes*

No abstract available.
Nephrotic Syndrome*

No abstract available.
Purpura, Schoenlein-Henoch*

Pontine hematomas are very rare lesions that in the past found at postmortem examination rather than diagnosed from the clinical presentations. Computed tomography has particularly stimulated further neurosurgical interest in this relatively rare condition, making surgical evacuation possible in some cases. Four patients suffering from pontine hemorrhages, revealed by computed tomography, are discussed. The classification regard to the site, clinical features and outcomes of this lesion are discussed in an attempt to establish general criteria for adequate management. With regard to the site, three types of hemorrhage are to be considered the tegmentotectal(type I), the tegmentolateral(type II) and the tegmentobasilar(type III), 2 patients(type I II, treated conservatively) had a fair outcome, and 2 patients(one of type III, treated conservatively, and one of type I, by surgical evacuation) had a death. Surgical management for the pontine hemorrhages should be reserved for the type I(tegmontotectal) and type II(tegmentolateral), whenever the neurological conditions deteriorate progressively.
Autopsy ; Classification ; Hematoma ; Hemorrhage* ; Humans ; Prognosis*

A series of 41 patients with chronic subdural hematoma, admitted to the Department of Neurosurgery of Catholic Medical College Hospital from May 1, 1980 to May 1, 1984 is presented. The following results were obtained : 1) Male were more frequently involved than female with the ratio of 4.9:1. The over 50 years old age group were predominately 75.6%. 2) The etiologic factors reveal younger group(under 50) has mainly unidentified factors, but older group(over 50) has mainly head trauma history and alcoholism. 3) Older group had more frequently focal neurologic deficit such as hemiplegia, however younger group presented as increased intracranial pressure signs such as headache and vomiting. 4) The hematoma density of C-T scan on admission was hypodense 50%, isodense 30%, mixed 28%, hyperdense 2% and no correlation to age. 5) Younger group performed burr hole with drainage, and older group performed craniotomy with removal of hematoma, but post-operative results were significantly good in older group with craniotomy.
Alcoholism ; Craniocerebral Trauma ; Craniotomy ; Drainage ; Female ; Headache ; Hematoma ; Hematoma, Subdural, Chronic* ; Hemiplegia ; Humans ; Intracranial Pressure ; Male ; Middle Aged ; Neurologic Manifestations ; Neurosurgery ; Vomiting

The effect of Atenolol on the blood pressure were studied in 31 cases of essential hypertension and on the effect of plasma renin activity in 8 cases. There were 8 cases of male with age 49.5(42-70) and 23 cases of female with age 49(35-71) years. 27 cases of 31 cases were untreated hypertensive patients and 4 cases were refractory to hypotensive drugs of diuretics and vasodilators. The Atenolol 50mg once-daily was given to all patients orally for 3 weeks. The blood pressure, heart rate, ECG and symptoms were checked in one week interval. In 8 cases, the plasma renin activity was measured by Dainabot Kit before and after one week medication. The results were as follows: 1. In 27 cases of untreated hypertension, the control blood pressure was 182.9/11.4mmHg in average. The blood pressure decreased in average by 18.3/11mmHg in one week, 23.7/15.9mmHg in two week and 21.5/10.5mmHg in three week. The heart rate also decreased by 7.4/min. in one week, 14.9/min. in two week and 7.8/min. in three week. These data showed considerable reduction of blood pressure and heart rate with 50mg Atenolol once-daily. 2. The basal plasma renin activity after one week medication was reduced by 46% in 8 cases and this data showed considerable reduction regardless control level of basal plasma renin activity. 3. There were considerable blood pressure reduction by adding Atenolol 50mg once-daily to diuretics and vasodilator to which patient's blood pressures were refractory. 4. There was no orthostatic hypotension or serious side effect by Atenolol medication.
Atenolol ; Blood Pressure* ; Diuretics ; Electrocardiography ; Female ; Heart Rate ; Humans ; Hypertension* ; Hypotension, Orthostatic ; Male ; Plasma* ; Renin* ; Vasodilator Agents

Spontaneous dissection of the vertebrobasilar arterial system is less common than that of the carotid system. These dissections are usually found extracranially or in a combination of intracranial and extracranial location. Pure intracrainl involvement is uncommon. Particularly in oriental country. This vascular anomaly is one of the important causes of posterior circulation stroke in young and middle-aged adults. Lf manifested as brainstem, ischernia, the usual symptoms and signs are typically neck or occipital pain followed later by particular features of the lateral medullary syndrome. Etiology remains obscure in most cases of spontaneous dissection and management is still controversial. We present three cases of dissecting aneurysm of the intracranial portion of unilateral vertebral artery. The two patients manifested as lateral medullary syndrome with sudden neck pain and digital substracted angiogram revealed proximal narrowed segments and distal fusiform dilatation of the unilateral vertebral arter.,v. The other patient manifested as subarachnoid hemmorrhage and angiographically dilatation at the junction of vertebral artery and posterior inferior cerebellar artery was noted. In operative field, two cases were confirmed as dissecting aneurysm.
Adult ; Aneurysm, Dissecting* ; Arteries ; Brain Stem ; Dilatation ; Humans ; Lateral Medullary Syndrome ; Neck ; Neck Pain ; Stroke ; Vertebral Artery*

Cerebral air embolism is an uncommon disorder, but it can result in significant morbidity and even mortality. Cerebral air embolism during esophago-gastro-duodenoscopy is also rare, but has in recent years been repeatedly reported. We report here a patient with cerebral infarction due to air embolism during endoscopic variceal ligation in liver cirrhosis. The patient was later confirmed to have patent foramen ovale. To our knowledge, this is the first report of such a complication with underlying patent foramen ovale and portal hypertension, who did no have underlying malignancy

BACKGROUND: For complicated appendicitis, in contrast to simple appendicitis, laparoscopic appendectomy (LA) is considered a relative or absolute contraindication because of the higher postoperative complication rate than that of open appendectomy (OA), especially, high incidence of intra-abdominal abscess. The purpose of this article is to assess the feasibility of LA for complicated appendicitis. METHODS: A retrospective review of 35 LA and 128 OA for the cases of gangrenous, perforated appendicitis, and periappendiceal abscess between May 1995 and June 1997 was performed. Patients were identified through the hospital pathology registry. We compared data from both groups with respect to operative times, postoperative pain, duration of ileus, length of hospital stay, and complication rate, with special attention to the incidence of intra-abdominal abscess. RESULTS: 1) The male:female ratio of LA (1:1.2) was significantly lower than that of OA (1:0.45) (p<0.05). There was no significant difference in the age distribution between both groups. 2) The mean operative time of LA (58.3 minutes) was significantly longer than that of OA (51.8 minutes) (p<0.05). 3) The mean number of injections of analgesics and the mean duration of ileus represented an advantage for LA (1.2 times and 1.8 days) than those of OA (1.6 times and 2.0 days). But these differences did not reach statistical significance. 4) The length of hospital stay of LA (6.5 days) was shorter than that of OA (7.8 dyas) (p<0.05). 5) Overall postoperative complication rate was lower in LA (11.4%) compared with OA (11.7) (p>0.05). But LA was associated with higher incidence of postoperative intra-abdominal abscess (3/35, 8.6%) than OA (3/128, 2.3%) (p=0.114). There was one serious intra-abdominal abscess in the LA, which required reoperation. The rest 2 cases in the LA and all 3 cases in the OA were treated conservatively. CONCLUSIONS: LA for complicated appendicitis could afford the merits of shorter hospital stay, reduced incidenceof wound infection, and comparable incidence of overall complication rate. To reduce the incidence of postoperative intra-abdominal abscess, copious irrigation and adequate drainage should be recommended.
Abdominal Abscess ; Abscess ; Age Distribution ; Analgesics ; Appendectomy ; Appendicitis* ; Drainage ; Humans ; Ileus ; Incidence ; Length of Stay ; Operative Time ; Pain, Postoperative ; Pathology ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Wound Infection