The authors anaylzed 244 cases of good grade(Hunt-Hess I or II) intracranial aneurysm patients who underwent surgery between January 1984 to May 1995. Unfavorable outcome according to the Sundt scale, included surgical results which were fair or poor, and also patients who died, and was more prevalent in patients aged over 60, those with a history of hypertension, or in whom a basal blood clot thicker than 3mm, as seen on brain CT scan, or intraventricular hemorrhage was present. The main cause of unfavorable surgical outcome was technical failure(47%), and the other causes were delayed vasospasm, cerebrovascular accident(CVA) and hydrocephalus. The results suggest that in good-grade aneurysm(grade I or II), prudent surgical techniques, aggressive early treatment for vasospasm, the prevention of perioperative CVA, and proper management of hydrocephalus lead to a better outcome.
Aneurysm* ; Brain ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Intracranial Aneurysm ; Tomography, X-Ray Computed

Three hundred and fourty two patients with a fracture of tibial shaft were treated and managed in the Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital from January 1981 to December 1985. In 147 cases, 62 cases had only tibial shaft fracture and 85 tibial and fibular shaft fracture. All of these were treated conservatively by manipulation and cast immibilization. We analyzed the initial fracture characteristics, the treatment employed, and the subsequent complications in fracture healing in a series of patients who had sustained a tibial shaft fracture with and without a fibular fracture. The results were as follows; 1. Duration of average bone healing was more slowly in the patients more than twenty years old who were treated for a tibial shaft fracture with and without a concomitant fibular fracture than in the patients less than twenty years old. 2. Duration of average bone healing was more slowly by one or two weeks in the the group of tibial shaft fracture without fibular fracture than in than in those with fibular fracture. 3. The frequency of delayed union, nonunion, varus malunion and pain in the ipsilateral ankle joint were more increased in the group of the tibial shaft fractures without fibular fracture in than those with fibular fracture. 4. The frequency of valgus malunion was more increased in the group of the tibial shaft fractures with fibular fracture than in those without fibular fracture.
Ankle Joint ; Fracture Healing ; Humans ; Tibia

Cysticercosis is due to a larva of Taenia Solium. It is frequently reported in developing countries. It usually affects subcutaneous tissue, muscles and brain. But, spinal cysticercosis is rare and is usually diagnosed at surgery. Authors experienced a case of spinal cysticercosis accompanied with spondylolistheses at the same level. Space occupying lesion and arachnoiditis, confirmed by MMCT and MRI, were noted at the same level of spondylolistheses. So, it was very hard to make dicision whether we should open up the dura or not.
Arachnoid ; Arachnoiditis ; Brain ; Cysticercosis ; Developing Countries ; Larva ; Magnetic Resonance Imaging ; Muscles ; Spondylolisthesis ; Subcutaneous Tissue ; Taenia solium

No abstract available.
Animals ; Rats*

This study evaluates the pathogenesis of rheumatoid arthritis by producing immune complex induced arthritis with an intra-articular injection of BSA in immunized rabbits, and the effect of systemic administration of cyclophosphamide and local administration of anti-macrophage serum. The reduction of inflammatory reaction by cyclophosphamide administration appears to be caused mainly by selective depletion of the neutrophils, and partly by immune suppression. It appears that the rabbit abdominal macrophage has the common morphologic, functional and antigenic patterns with the M-type synovial lining cells. There is another possibility that the cross-reacting antigens between macrophage and the M-type cell of the synovial lining may exist. It is concluded that in this experimental immune complex arthritis, the site of localization of immune complexes seems to be the synovial, M-type cell, and the tissue injury of synovium is largely mediated not only by neutrophils and complement, but also by macrophages.
Animal ; Antigen-Antibody Complex* ; Arthritis, Rheumatoid/etiology* ; Cyclophosphamide/pharmacology ; Immune Complex Diseases/etiology* ; Immune Sera/pharmacology ; Macrophages ; Rabbits ; Serum Albumin, Bovine/administration & dosage ; Synovial Membrane/pathology

No abstract available.
Animals ; Rats* ; Reperfusion*

Epidural hemangioma is a rare neoplasm which consists of 4% of epidural tumors and 12% of hemangiomas of vertebral column. But most of them are secondary involvement of epidural space by vertebral hemangioma and pure epidural hemangioma is very rare. Reported cases involve thoracic & lumbar level. Neural foramen & paraspinal region are usually invaded by the tumor mass. Clinical symptoms are similar to simple low back pain or disc herniation. Myelography, CT & MRI are helpful to make diagnosis but pathologic finding is important for final diagnosis. Authors are reporting a case of epidural hemangioma which was difficult to differentiate from HIVD by symptomatology & radiologic findings alone.
Diagnosis ; Epidural Neoplasms ; Epidural Space ; Hemangioma ; Low Back Pain ; Magnetic Resonance Imaging ; Myelography ; Spine

In 1971, for purpose of reduction of peak stress occuring in cement and trabecular bone of the acetabulum, Harris reported a series of metal-backed acetabular components with removable polyethylene liners that could be replaced if excessive wear occured. Modular designs of hip prostheses have become popular recently, but they introduce the risk of disassembly of the components postoperatively. And introduce of loosening and infection of femoral or acetabular components by debris of polyethylene liner. We report a case of mechanical disassembly of polyethylene liner in cementless metal backed cup, and review previously reported articles.
Acetabulum ; Hip Prosthesis ; Polyethylene

Early and delayed 201Tl SPECT studies were performed on 20 patients with intracranial meningioma who were classified into 4 groups according to Helsinki Grading System: Grade I: benign(n=15), Grade II: atypical(n=5), Grade III: anaplastic(n=0) and Grade IV: sarcomatous(n=0). The early uptake indices(eTl, ratios of average counts/pixel in the lesion to those of contralateral area on early image) were relatively high in all types: Grade I, 3.05+/-1.44(mean+/-standard deviation): Grade II, 2.66+/-1.29. There was no statistical difference in relation to pathological grade. The delay uptake indices were 2.64+/-1.34 and 2.67+/-1.31 respectively, there was no statistical difference in relation to pathological grade. The retention indices(RI, ratios of delay to early uptake indices) were 0.92+/-0.35, 1.04+/-0.36 respectively. there was no statistical differences in relation to pathological grade. In ten cases presenting mitosis, RI was 1.11+/-0.30. But other cases not presenting mitosis RI was 0.80+/-0.34. There was significant difference between two groups p<0.05. The 99mTc-MIBI SPECT study was performed in 14 patients who classified into 4 group: Grade I(n=10) and Grade II(n=4). The uptake ratios were high in all types: Grade I, 6.70+/-3.63 and Grade II, 5.40+/-0.92. There were no statistical difference. In this study, there was no malignant case(Grade III, IV). In summary, if the further study including malignant cases, this study would aid in overcoming to overcome the limitation of CT, MRI about tumor differentiation, with regards to possible detection of presence of residual tumor and viability of tumor after treatment.
Humans ; Magnetic Resonance Imaging ; Meningioma* ; Mitosis ; Neoplasm, Residual ; Tomography, Emission-Computed, Single-Photon*

Authors analyzed the post-operative subdural hygroma using radioisotope(RI) cisternography in 30 cases following aneurysmal surgery with pterional approach from October, 1995 to March, 1996. Age, CSF flow from basal cisterns, and etent of opening of Liliequist's membrane during operation were significantly related to the development of post-operative subdural hygroma. Computed tomography(CT) scan of brain and RI cisternography were performed in all patients at three weeks following operations. RI diffusion time from the interpeduncular cistern to the cerebral convexity of ipsilateral side with surgically opened Liliequist's membrane was compared with contralateral nonoperated normal side. Diffusion time of ipsilateral side(mean 5.2+/-8.4hr) was faster than that of contralateral one. Age, cerebrospinal fluid(CSF) from basal cistern, and extent of opening of Liliequist's membrane during operation were significantly related to development of post-operative subdural hygroma. Development of subdural hygroma after pterional approach for aneurysmal operations in our series is believed to be caused by stagnation of CSF in the convexity until its absorption into the arachnoid villi. Increased CSF flow from the infratentorial space to the supratentorial space through extensively opened Liliequist's membrane is considered to contribute development of its formation.
Absorption ; Aneurysm* ; Arachnoid ; Brain ; Diffusion ; Humans ; Membranes ; Subdural Effusion*