No abstract available.
Drug Therapy* ; Humans ; Retreatment*

Autotransfusion has been known to have many benefits in patients who might have anticipated or unanticipated hemorrhage during elective or emergency surgical procedures. Twenty-nine patients with intracranial aneurysms with subarachnoid hemorrhage were enrolled in this study. Sixteen aneurismal patients were randomly selected for autotransfusion group, whose hematocrit value ranged between 21 to 39% after aspiration of mean arterial blood volume of 850 ml. For auto-transfusion, and 13 patients were given only homologous banked glood during surgical operation as control group. During surgical operation for direct clipping on aneurysmal neck in autotransfusion group, autotransfusion was applied by the method of perioperative blood collection and acute hemodilution of 30% hematocrit value. In 13 control aneurysmal patients who needed homologous banked blood during surgical operation to maintain normal blood pressure and intravascular blood volume, average mean volume of banked blood reguired was 1104 ml. In 16 aneurysmal autotransfusion group, it was only 438 ml of banked blood, and furthermore in 4 patients among them, homologous banked blood was not needed at all.
Aneurysm ; Blood Pressure ; Blood Transfusion, Autologous* ; Blood Volume ; Emergencies ; Hematocrit ; Hemodilution* ; Hemorrhage ; Humans ; Intracranial Aneurysm* ; Neck ; Subarachnoid Hemorrhage

The authors studied and analyzed microscopically the structure, length and diameter of each part of Willis circle in 264 cerebral hemispheres of 182 autopsied patients in the Taegu area from 1984 to 1990. The mean length of each A1 was 14.1mm and diameter at distal A1 was 2.25mm. The most common anatomical anomaly of the ACA part was A1 that of hypoplasia which appeared in 7.5% of the cases. The origin of the Heuner a. was accounted for the highest incidence of AcoA(82.5%). The length of AcoA. Noted 3.5mm with the incidence of duplication and triplication in 38.6%. The inner diameter of ICA noted 3.9mm at the communicating segment in ICA, and the average length of C4 was 12.5m. Except 5 hemispheres of undetectable origin at ICA, all the anterior choroidal a. originated from ICA, and the double stump of which noted 15.5%. Fetal type PcoA. Showed 6.6% of all and average length of the a. was 13.5mm. The inner diameter of MCA was 3.1mm and the mean length of M1 noted 15.5mm. The length of each P1 noted 6.95mm and the inner diameter of basilar a. at 1cm below the bifurcation was 3.3mm. The mean circumference of willis circle including both side of A1, P1, PcoA. AcoA. And choroidal and communicating segment of ICA was 88.6mm. Incidental finding of unruptured aneurysm noted 5.3% and junctional dilatation of PcoA. Showed 11.4% of all the cases.
Aneurysm ; Cerebrum ; Choroid ; Circle of Willis* ; Daegu ; Dilatation ; Humans ; Incidence ; Incidental Findings

A clinical studies were conducted on 71 patients with subarachnoid hemorrhage by ruptured intracranial aneurysms, to evaluate the significance of fundal hemorrhage. Fundal hemorrhage was found in 20 patients(28%), mainly preretinal in location, and it occurred more frequently in patients with aneurysms of internal carotid artery, and in ipsilateral or bilateral, rather than contralateral side. Significant relationship was noted between fundal hemorrhage and increased intracranial pressure. However, there was no such relationship with frequency of aneurismal rupture and hypertension. Intracranial complications by ruptured aneurysms were significantly higher(50%) in patients with fundal hemorrhage, compared to patients without it. Also, there were more severe neurological abnormalities as grade III-V according to Botterell's classification in patients with fundal hemorrhage. After surgical and/or nonsurgical treatment, 20% of patients with and 11.7% of patients without fundal hemorrhage could not lead their normal lives. Mortality rate in patients with fundal hemorrhage was higher by 30%, compared to that in patients without fundal hemorrhage(19.6%).
Aneurysm ; Aneurysm, Ruptured ; Carotid Artery, Internal ; Classification ; Hemorrhage* ; Humans ; Hypertension ; Intracranial Aneurysm* ; Intracranial Pressure ; Mortality ; Rupture ; Subarachnoid Hemorrhage*

Caffey's disease(infantile cortical hyperostosis) is an uncommon benign and self limited disorder of unknown etiology, affecting the skeleton and its contiguous fasciae and muscles. Its occurrence in isolated cases or in multiple members in families suggests the existence of two different forms, namely a sporadic form and a familial form. The tibia is the predominant bone known to be affected in the familial form, while the mandible is mostly affected in the sporadic form. This benign and self-limited disorder has rarely late recurrence or persistence of symptoms with deformity. The patient in this case had immediate and complete resolution of her symptoms while receiving acetaminophen with no recurrent bone formation during treatment with antiinflammatory drugs. We describe sporadic, nonfamilial Caffey's disease, affecting both radii and tibiae, but not involving the mandibular in a 4-month-old female infant.
Acetaminophen ; Congenital Abnormalities ; Fascia ; Female ; Humans ; Hyperostosis, Cortical, Congenital ; Infant ; Mandible ; Muscles ; Osteogenesis ; Recurrence ; Skeleton ; Tibia

Author report two cases of broad neck aneurysms situated on the bifurcation site of middle cerebral artery, which can not be treated by simple clipping method. It was treated successfully using two clips;one clipping the aneurysmal sac together with the posterior trunk of middle cerebral artery and the other clipping the posterior trunk just behind the aneurysmal sac. Normal blood flow was kept maintained in frontal ascending trunk of middle cerebral artery.
Aneurysm* ; Middle Cerebral Artery* ; Neck*

Authors have clinically analyzed 37 patients(33%) with intracranial aneurysms, detected among 112 patients with spontaneous subarachnoid hemorrhage confirmed by history, neurological examinations and neuroradiological findings, who were admitted to the department of neurosurgery, Kyungpook National University Hospital from Sept. 1977 through Aug. 1978. Twenty-two of 37 ruptured intracranial aneurysms were treated by direct surgical clipping applied on aneurysmal neck. Excellent and good results were obtained in 18 cases(818%) and all of them were after discharge leading their normal lives and/or working in their previous jobs. Two deaths were noted in patients with grade 3 and 4, resulting in overall mortality rate of 9.1%. There was no death in either grade 1 or 2.
Aneurysm ; Gyeongsangbuk-do ; Humans ; Intracranial Aneurysm* ; Mortality ; Neck ; Neurologic Examination ; Neurosurgery ; Subarachnoid Hemorrhage* ; Surgical Instruments

No abstract available.
Hematuria* ; Humans ; Mass Screening* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

The decision of proper time for operation on ruptured aneurysm is a very important tactic of treatment, because of the following major complications after subarachnoid hemorrhage. Recently it is widely accepted opinion that the ruptured aneurysm should receive an early operation for lower mortality and morbidity by preventing possible complications after subarachnoid hemorrhage such as rebleeding, symptomatic vasospasm and even hydrocephalus. Since 1985, we applied early to emergency surgery to the clinically deteriorating or non improving patients after aneurysm rupture and delayed surgery to the ameliorating patients who were placed under close observation. The early to emergency surgery on poor risk patient was performed within 48 hours after recent subarachnoid hemorrhage and delayed surgery was done after 2 weeks. Of the selective 95 poor-condition patients admitted to Kyungpook National University Hospital over the past 4 years from 1984, 60 got early surgeries and 35 delayed surgeries. Among the 60 patients in the early group, 22 patients with considerable intracranial hemorrhage were exempted from this comparative study. A few cases of vertebrobasilar aneurysms were not included in this paper for a little value in significance. In this prospective study, we evaluated the results of early and delayed surgeries of poor risk patients through clinical analyses and comparison, and we could gain better results from early surgeries.
Aneurysm* ; Aneurysm, Ruptured ; Emergencies* ; Gyeongsangbuk-do ; Humans ; Hydrocephalus ; Intracranial Hemorrhages ; Mortality ; Prospective Studies ; Rupture ; Subarachnoid Hemorrhage

No abstract available.
Humans* ; Ovarian Neoplasms* ; Tamoxifen*