Subfalcial herniation secondary to a unilateral supratentorial space occupying lesion is frequently seen on the brain CT scan, however, the development of distal anterior cerebral artery infarction following compression of the terminal branches of the pericallosal artery against the falx during the period of subfalcial herniation is uncommon. For the last three years, we have experienced three cases of distal anterior cerebral artery infarction caused by subfalcial herniation on the brain CT scan. All patitnts had acute subdural hematomas resulting in subfalcial herniation on the first CT scan and subsequently developed focal infarctions in the ipsilateral paracentral lobule. The patients did not improve clinically and died several days after operation. The development of such infarction may reflect severe cerebral injury and portend a poor clinical outcome.
Anterior Cerebral Artery* ; Arteries ; Brain ; Hematoma, Subdural, Acute ; Humans ; Infarction* ; Infarction, Anterior Cerebral Artery ; Tomography, X-Ray Computed

No abstract available.
Meniere Disease*

PURPOSE: We wanted to investigate the efficacy of percutaneous radiofrequency (RF) neurotomy of the medial branch for the management of chronic low back pain due to lumbar zygapophysial joint dysfunction. MATERIALS AND METHODS: Thirteen patients who had unremitting chronic low back pain for more than 6 months and whose VAS scores were over 7 were selected on the basis of double comparative nerve blocks. The patients consist of three males and 10 females, and their nean age was 67 years. Sensory stimulation was performed to detect the "pathologic branches" that were responsible for pain generation. RF neurotomy was performed using a lesion generator at 80 C for 90 seconds. The postoperative outcome was classified, depending on the degree of pain reduction, as excellent (> or = 75%), good (50-75%), and poor (<50%). Follow-up evaluation was performed at 6 weeks, 3 months and 6 months after surgery. RESULTS: The mean number of medial branches was 6.2. Eleven patients had bilateral disease and two had unilateral disease. Sensory stimulation was positive in all patients with a mean amplitude of 4.5V (range: 0.15-6 V). The L5 dorsal ramus was the most frequently involved segment, and this was followed by L4, L3 and L2. The number of lesionings for each medial branch was 3.7. The surgical outcome was graded as excellent (53%), good (23%), and poor (24%) after 6 months of follow-up. Transient backaches were noticed in two patients; however, complications were not observed. Recurrences were not demonstrated during the follow-up period CONCLUSION: We conclude that RF neurotomy of the medial branches is an efficient method to substantially alleviate the chronic low back pain caused by zygapophysial joint dysfunction.
Arthralgia* ; Back Pain ; Female ; Follow-Up Studies ; Humans ; Joints* ; Low Back Pain ; Male ; Nerve Block ; Recurrence ; Spine

BACKGROUND: The purpose of this study is to evaluate and analyze the surgical results in patients undergoing operations for multiple for multiple valvular heart diseases. MATERIAL AND METHOD: From April 1982 to June 1997 multiple valve replacement was performed in 150 patients mitral and aortic valve replacement were done in 135 patients mitral and tricuspid valve replacements in 10 patients triple replacements in 4 patients and aortic and tricuspid valve replacement in 1 patient. Of the valves implanted 157 were St. Jude 104 Duromedics 20 Carpenter-Edwards 6 Bjork-Shiley 6 Ionescu-Shiley and 2 Medtronics. RESULT: The hospital mortality rate was 10.7% (16/150) and the late mortality rate was 7.2% (8/134) The mortality rate was high in early operative period but decreased with time. The causes of death were low cardiac output in 9 sudden death in 3 congestive heart failure in 3 bleeding in 2 cerebral thrombosis in 1 leukemia in 1 multiorgan failure in 1 and so on . The actuarial survival rate excluding operative death was 83.1% at 15 years. CONCLUSIONS: With a follow-up now extending to 15 years the multiple valve replacement continues to be reliable procedure with relatively low mortality and morbidity.
Aortic Valve ; Cardiac Output, Low ; Cause of Death ; Death, Sudden ; Follow-Up Studies ; Heart Failure ; Heart Valve Diseases ; Hemorrhage ; Hospital Mortality ; Humans ; Intracranial Thrombosis ; Leukemia ; Mortality ; Survival Rate ; Tricuspid Valve

No abstract available.

No abstract available.
Leukemia* ; Skin*

Cutaneous horn is the clinical term for a circumscribed, conical, markedly hyperkeratotic lesion. We report a case of cutaneous horn occuring on the face in a 81 year old women. An about 1.2 X1.3 cm sized dark brownish conical horn was developed on her face 1 year before. Histopathologic findings showed marked hyperkeratosis, parakeratosis, and papillornatosis of the epidermis, and some cells of straturn mslpighii showed pleornorphism and nuclesr atypis. This case was considered to be cutaneous horn arising from actinic keratosis, and we performed minimal local excision.
Actins* ; Aged, 80 and over ; Animals ; Epidermis ; Female ; Horns* ; Humans ; Keratosis, Actinic* ; Parakeratosis

No abstract available.

Since it had not been possible to find any formal report on this disease in Korea, we had chance to examine and to make accurate diagnosis, so that we would like to report 10 calles among 3 families. Throughout the literature, the age of onset, the incidence, the mode of heredity, the etiology, the clinical picture, the prognosis, and the treatment were discussed. The results of this survey are as followings. 1. There were 5 males and 5 females in this material. This sex incidence showed rather similar with Japanese's than European's and American's. 2. As to the incidence of age of onset, Case I and III were between 15-22 years old, but Case II were between 6-8 years old. 3. As to the visual acuity, most patients had from H.M. to 0.1 (20/200), and most patients were who associated with the color disturbance. 4. The ophthalmoscopic finding revealed only total or temporal pallor on the disc, otherwise normal macula and retinal vessels. 5. Visual field changes showed central scotoma in all cases which were examined. 6. Various laboratory examinations, X-ray examinations for skull and orbit, neurological examination, etc., showed no significant pathological finding in cases which were examined. 7. As to the mode of heredity, those three families revealed not a typical sex-linked recessive form, as far as we could observe in two generations of the pedigree.
Age of Onset ; Diagnosis ; Family Characteristics ; Female ; Heredity ; Humans ; Incidence ; Korea ; Male ; Neurologic Examination ; Orbit ; Pallor ; Pedigree ; Prognosis ; Retinal Vessels ; Scotoma ; Skull ; Visual Acuity ; Visual Fields

We report a case of multiple xanthogranuloma occurring ori the scalp in a 33 years old wornan. Multiple yellowish papules were developed on her scalp 3 months ago. Histopathologic findings showed massive granulomatous infiltrations of foamy histiocytes Touton giant cells in the dermis, and these cells were positive for lipid stain. This case was considered to be multiple xanthogranuloma in an adult, and treated by sur- gical excision.
Adult* ; Dermis ; Giant Cells ; Histiocytes ; Humans ; Scalp