Neurilemmomas is benign tumor originating from all kinds of cranial nerve except optic nerve and olfactory nerve, spinal nerve root and peripheral nerve. It superficially resembles neoplasm of fibroblastic origin, but has distinctive histological pattern and arise from the neuroectodermal sheath of schwann. Approximately 25% to 40% of all neurilemmomas are found in the neural structure of the head and neck. The tumor mostly develops in the acoustic nerve and there are several reports of neurilemmonas originating form tongue, pharynx, lip, larynx and palate etc. However, reports of Neurilemmoma originating from cervical vagus nerve have been extremely rare. We experienced two cases neurilemmoma of cervical vagus nerve that were treated with different surgical methods. In the first case, the tumor was extirpated by sacrificing the nerve trunk and in second case, it was enucleated by preserving the neural pathway using the microsurgical technique.
Cochlear Nerve ; Cranial Nerves ; Fibroblasts ; Head ; Larynx ; Lip ; Neck ; Neural Pathways ; Neural Plate ; Neurilemmoma* ; Olfactory Nerve ; Optic Nerve ; Palate ; Peripheral Nerves ; Pharynx ; Spinal Nerve Roots ; Tongue ; Vagus Nerve*

This is a report of anesthesia for five cases of renal transplantation which was performed between February 1969 and August 1969 at St. Mary's Hospital, Catholic Medical College, Seoul, Korea. General of renal insufficiency of the operated cases were described. Operative technique were unilateral nephrectomy for three cases and bilateral nechprectomy with splenectomy for 2 cases ; Anesthesia was induced with epontol (propanidid) 250mgs i.v. and 4% halothane-oxygen and maintained with 1% halotbane-oxygen which was supplemented by nitrous oxide occasionally. 6% dextrose and lactated-Ringer's solution were infused. For transfusion, whole blood was given to replace the operative blood loss. Dextran was also used to maintain adequate blood volume. Shortly before anastomosis of renal and femoral vessels, patients were haparinized. Fluids and electrolytes balance were studied pre-and post-operatively. Preoperatively, uremia and hyperpotassemia was corrected by several hemodyalysis. Urinary output after surgery showed a marked degree of diuresis up to 1800 ml/hr until second post-operative day. The special concern of anesthesia for kidney transplantation were: 1. Patients were suffering from severe uremia and metabolic disterbances. 2. Acidosis and hyperpotassemia should be corrected before surgery by hemo-or peritoneal dialysis. 3. Immunosuppressive agents made the patient less resistant to infection. 4. Anemia and hydrops was difficult to be corrected before surgery. 5. Muscle relaxants of choice were depolarizing agents, because of impaired renal excretion.
Acidosis ; Anemia ; Anesthesia* ; Blood Volume ; Dextrans ; Diuresis ; Edema ; Electrolytes ; Glucose ; Humans ; Hyperkalemia ; Immunosuppressive Agents ; Kidney Transplantation* ; Kidney* ; Korea ; Nephrectomy ; Nitrous Oxide ; Peritoneal Dialysis ; Propanidid ; Renal Insufficiency ; Seoul ; Splenectomy ; Uremia

Laryngeal chondrosarcoma is an uncommon cartilaginous tumor very rarely encountered in the head and neck but most commonly in the sarcoma of the larynx. They occur most often in middle aged and older men. The prognosis of this tumor is potentially poor and surgical resection is generally recommended for the treatment. No benefit of chemotherapy or radiotherapy in chondrosarcoma has been documented in the literature. A 57 year-old male visited our clinic with history of dyspnea and hoarseness. Direct laryngoscopy showed a submucoid, intraluminal mass in subglottic space arising from posterolateral part of the cricoid cartilage. Neck computed tomography revealed a large calcified mass in the larynx. The perioperative frozen section showed it to be grade I chondrosarcoma of the cricoid cartilage. Conservative surgery with complete excision of tumor was performed through laryngofissure approach after tracheostomy. Follow up assesment was performed under close check up at 12 months after the surgery, but we found neither recurrence nor metastasis.
Chondrosarcoma* ; Cricoid Cartilage* ; Drug Therapy ; Dyspnea ; Equidae ; Follow-Up Studies ; Frozen Sections ; Head ; Hoarseness ; Humans ; Laryngoscopy ; Larynx ; Male ; Middle Aged ; Neck ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Recurrence ; Sarcoma ; Tracheostomy

Despite advances in imaging and antibiotic treatment, brain abscess is still encountered occasionally and is one of the most significant life-threatening complications of otologic disease. Nowadays, mortality rates of up to 10 percent have been reported. Brain abscesses are developed up to 0.5 percent of cases of acute otitis media and 3 percent of cases of chronic suppurative otitis media. In this case, underlying middle ear pathology showed chronic otitis media with cholesteatoma. Successful management of otogenic brain abscess still includes medical and surgical treatment. Initial surgical treatment of abscess is very controversial today. Some authors prefer the surgical excision of brain abscess prior to the management of temporal bone, yet other authors prefer the surgery of temporal bone prior to the management of brain abscess. Although an enterococcus is a significant cause of human infections outside of the central nervous system but, enterococcal infections involving the central nervous system are uncommon clinical entities. Because of the relatively small number of individuals who develop brain abscess or meningitis due to an enterococcus, an appropriate therapy has not been well defined. We report a case of enterococcal otogenic brain abscess which was treated successfully using antibiotics, immediate radical mastoidectomy and later stereotactic abscess drainage with a review of literatures.
Abscess ; Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Central Nervous System ; Cholesteatoma ; Drainage ; Ear Diseases ; Ear, Middle ; Enterococcus ; Humans ; Meningitis ; Mortality ; Otitis Media ; Otitis Media, Suppurative ; Pathology ; Temporal Bone

OBJECTIVE: To evaluate the effect of Korean Computer-Assisted Cognitive Rehabilitation Program (CogRehabK ) on cognitive function of the patients with brain injury. METHOD: Fifty subjects with brain injury were enrolled and classified into two groups, experimental (n=25) and control group (n=25). Control group received conventional rehabilitation therapy including physical and occupational therapy. Experimental group received additional computer-assisted cognitive training using CogRehabK software consisted of 10 level-completing programs, 3 times per week, 30 minutes per session, for 4 to 6 weeks. All patients were assessed their cognitive functions using Seoul Computerized Neuropsychological Test (SCNT , Maxmedica, 2001), minimental status examination (MMSE), digit span, and Wechslermemory scale before and after treatment. Functional independence measure and geriatric depression scale were also applied for evaluation of functional and mood status. RESULTS: Before the treatment, two groups showed no difference in their cognitive functions. After 4 to 6 weeks of treatment, the experimental group showed significantly higher performance in forward digit span, forward visual span, auditory continuous performance test, and visual continuous performance test in CNT and MMSE than control group (p<0.05). CONCLUSION: We conclude that the CogRehabK may be useful as an additional tool for the cognitive rehabilitation in patients with brain injury.
Brain Injuries* ; Brain* ; Depression ; Humans ; Neuropsychological Tests ; Occupational Therapy ; Rehabilitation* ; Seoul

OBJECTIVE: To find out the changes of the family structure and familial total income of Korean patients with the brain disorders and associated factors. METHOD: A total of 1,903 patients with brain disorders in Korea were enrolled and drew up the questionnaires about their socioeconomic state and family supports, including pre- and post-disorder family structure, compositions of their family income, and employment of caregivers. RESULTS: A 38.2% of subjects experienced the change in numbers of cohabiting family, decrement in 30.3% and increment in 7.9%. Prior to brain disorders, 48.6% of patients earned their living by themselves, but only 2.8% did after brain disorders. Separation and divorce increased, especially three times more in male patients than in females. A 16.6% of patients employed caregivers, and used them 6.2 days per week, 18 hours a day on average. CONCLUSION: This study reemphasized the worsening socioeconomic state of patients with brain disorders and their families. Increasing tendency of social isolation was also noted.
Brain ; Brain Diseases ; Caregivers ; Divorce ; Employment ; Female ; Humans ; Korea ; Male ; Surveys and Questionnaires ; Social Isolation ; Stroke