To elucidate the early sequential morphogenetic progress of exencephaly and myeloschisis, rat embryos whose mothers had been treated with hypervitaminosis A were studied at 1-day interval from gestation day 10.5 to 15.5. In exposed animals sequential change was found in both exencephaly and myeloschisis as the embryos grew up. The 10.5-day old exencephalic embryos had still widely open cephalic neural tubes. Exencephalic embryos older than 13.5 days of gestation showed strikingly severe eversion and overgrowth of the cephalic neuroepithelium, thus failed in forming normal primitive brain. The convex dorsal surface of the exencephaly was covered with ependyma, which was connected directly with surrounding surface eqithelium at the periphery. The earliest morphologically recognized myeloschisis was in the 13.5-day old embryos. In myeloschisis, divergence at the roof plate and eversion of the spinal neural tube, disorganized overgrowth of the neuroepithelium, malformed and misplaced spinal ganglia and nerve roots, and absence of the neural arch and dermal covering were characteristic. It is suggested that exencephaly results from failure of the cephalic neural tube closure which is followed by eversion and overgrowth of the neuroepithelium. And failure in closure of the posterior neuropore and disturbance in the development of the tail bud probably play major role in the morphogenesis of myeloschisis.
Animals ; *Embryonic and Fetal Development ; Female ; Hypervitaminosis A ; Neural Tube Defects/chemically induced/*pathology ; Pregnancy ; Rats ; Rats, Inbred Strains ; Spinal Cord/*abnormalities/embryology

CT has becom increasingly important diagnostic method as the inital examination in the diagnosis of subarachnoid hemorrhage with direct detection of extravasated blood inbasal cistern and cortical sulci. Furthermore, CT provides better and exact visualization of the presence, localization, extent and degree of intracerebral, intraventricular and subdural hemorrhage, infarction, hydrocephalus and rebleeding which may be associated wtih subarachnoid hemorrhage, and also could detect the causative lesions with contrast enhancement inmany cases. The purpose of the paper is to describe the CT findings of subarachonid hemorrhage due to various causes and to evalute the diagnostic accuracy of CT in subarachonoid hemorrhage. Authors analysed a total of 153 cases with subarachnoid hemorrhage confirmed by lumbar puncture at Seoul National University Hospital from March 1979 to April 1981, with special emphasis on CT findings.All of the cases took CT scan and 125 cases of the mangiography. The results are as follows; 1. Most prevalent age group was 4th to 6th decades (78%). The ratio ofmale to female was 1.1:1. 2. Of all 125 with angiography, aneurysm was a major cause (68%). Others were arterio-venous malformation (9.6%), Moya-moya disease(4%) and unknown (18.4%). 3. Of all 153 cases with CT scan,hemorrhage was demonstrated in 98 cases (64.1%); SAH in 72 cases (47.1%), ICH in 65 cases (42.5%), IVH in 34 cases(22.2%) and SDH in 1 case(0.7%). SAH combined with ICH was a major group (34.7%) in SAH. Detecton rate of SAH was68.3% within the first 7 days and 5.8% after 7 days. 4. In aneurysms, SAH was detected in 60 of 85 cases (70.6%);88.1% within the first 7 days and 5.6% after 7 days. Anterior communicating artery was the most common site of theaneurysms(40%), in which detection rate of SAH was 100% within the first 7 days. SAH was combined with ICH in38.3%. 5. On CT, SAH of unilateral Sylvian fissure was pathognomonic for ruptured MCA aneurysm and ICH of corpuscallosum for ACA aneurysm. 6. The detection rate of aneurysm itself on CT was 20%(17/85) and its size was variablefrom 5 to 25mm. 7. Infarction was demonstrated in 9 cases (6%) and there was no significant correlation between infarction and angiospasm, 8. Hydrocephalus was detected in 65% cases(42.5%), and 21 cases (32.3%) were demonstrated within the first 3 days.
Aneurysm ; Angiography ; Arteries ; Diagnosis ; Female ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hydrocephalus ; Infarction ; Methods ; Seoul ; Spinal Puncture ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed

BACKGROUND: Endotoxin is a complex lipopolysaccharide molecule situated within the outer membrane of Gram-negative bacteria. Sepsis and acute respiratory failure (ARDS) can be induced by endotoxin. In order to introduce and develop the experimental model of ARDS in sepsis, we induced sepsis with the endotoxin and investigated the change of respiratory pathophysiology during sepsis using a multiple inert gas elimination technique (MIGET). METHODS: Ten New Zealand white rabbits were anesthetized and ventilated with a Harvard apparatus. In 5 rabbits, 2 mg/kg of lipopolysaccaride from E. coli was infused intravenously for 30 min (Toxin group). At 1, 2, 3, and 4 hours after endotoxin infusion, arterial blood gas, and hemodynamic profiles were checked. To perform the MIGET, six inert gases (SF6, krypton, desflurane, enflurane, diethyl ether, acetone) of widely varying solubility were infused peripherally and the excretion and retention data was determined from measurements of inert gas tensions in pulmonary arterial, systemic arterial blood samples and mixd expiratory gas sampling of pre and post septicemia using gas chromatography. We transformed and analysed the data into a V/Q distribution curve to find out the change of V/Q distribution curve. After the experiments, the animals were dissected and the lungs were extracted for wet/dry weight ratio (WW/DW) and microscopic examination. RESULTS: In the Toxin group, the pulmonary arterial pressures were increased and arterial oxygen tensions were decreased after the endotoxin infusion. The lung WW/DW were increased and inflammatory findings were seen in microscopic examination. In the MIGET, shunt, deadspace and log SDQ were increased in the toxin group, though there were wide V/Q distributions in the control group. CONCLUSIONS: We developed a successful endotoxin induced septic animal model, V/Q distribution curve and data using MIGET. The accomplishment of the experiment will not only allow us to better understand pulmonary pathophysiology of endotoxin induced sepsis using MIGET, but it will also contribute to other pulmonary physiology experiments associated with sepsis.
Animals ; Arterial Pressure ; Chromatography, Gas ; Enflurane ; Ether ; Gram-Negative Bacteria ; Hemodynamics ; Krypton ; Lung ; Membranes ; Models, Animal ; Models, Theoretical ; Noble Gases ; Oxygen ; Physiology ; Rabbits ; Respiratory Insufficiency ; Sepsis ; Solubility ; Ventilation-Perfusion Ratio*

OBJECTIVE: This study was done to propose a new method of determining the cutoff frequency against measurement noise in fetal heart rate signal and to analyze the discriminating value for normal fetus (pH>7.15) and abnormal fetus (pH< or =7.15) by nonlinear method. METHODS: The patients were classified by umbilical artery pH (7.15) or base excess (-10 mEq/L). After removing the high frequency noise components at the cutoff frequency determined in this study, we calculated correlation dimension as a discriminating value for the normal and abnormal fetuses. RESULTS: After low pass filtering of fetal heart rate signal at the cutoff frequency, the numerical result of embedding dimension was 5.47+/-0.67 (normal), 4.43+/-0.60 (abnormal) (p<0.001), and correlation dimension was 2.51+/-0.43 (normal), 1.79+/-0.15 (abnormal). CONCLUSION: We could determine the cutoff frequency from the different fluctuation level between high frequency noise and principal signal according the cutoff frequency function. The detection of fetal distress was done objectively by this method. We could discriminate between normal fetus and abnormal fetus by correlation dimension as indicator for the nonlinear complexity.
Female ; Fetal Distress ; Fetal Heart* ; Fetus ; Heart Rate, Fetal* ; Humans ; Hydrogen-Ion Concentration ; Noise* ; Pregnancy ; Umbilical Arteries

Authors experienced one case of intrauterine depressed skull fracture which associated with skull capillary hemangioma. In reviewing literatures, there are two types of intrauterine skull depression, traumatic and spontaneous. Pressure of the fetal head against maternal bony structures accounts for most of the so-called spontaneous type. Authors case was spontaneous type and associated with "fetal factor", congenital capillary hemangioma of the skull.
Capillaries* ; Depression ; Head ; Hemangioma, Capillary* ; Humans ; Infant, Newborn* ; Skull Fracture, Depressed* ; Skull*

Authors experienced one case of intrauterine depressed skull fracture which associated with skull capillary hemangioma. In reviewing literatures, there are two types of intrauterine skull depression, traumatic and spontaneous. Pressure of the fetal head against maternal bony structures accounts for most of the so-called spontaneous type. Authors case was spontaneous type and associated with "fetal factor", congenital capillary hemangioma of the skull.
Capillaries* ; Depression ; Head ; Hemangioma, Capillary* ; Humans ; Infant, Newborn* ; Skull Fracture, Depressed* ; Skull*

Authors reviewed 92 cases of intracranial meningiomas which confirmed by operation at the Department of Neurosurgery, Seoul National University Hospital from September 1957 to July 1982. 45 cases out of 50 cases that had performed computerized tomographic(CT) scans preoperatively were analyzed. The results were as following ; 1) Meningiomas constituted 12.4% of all intracranial tumors. There were 51 women and 41 men(55.4%/44.6%). The average age at the time of diagnosis was 41.2 years. 2) The initial symptoms were headache(50.0%), visual disturbance(14.1%), and seizure(8.7%) in the order. 3) The most common location was parasagittal-falcial, and followed by convexity, sphenoid ridge, tuberculum sellae tentorial and olfactory groove. 4) 61 cases(76%) out of 80 cases showed abnormal findings in the plain skull X-ray examinations. The preenhanced CT scans(45 cases) showed hyperdense lesion in 57.8%(26 cases), isodense lesion in 35.6%(16 cases), and hypodense lesion in 6.6%(3 cases). The incidence of peritumoral low density was 68.9%. The detection rate of intratumoral calcification by CT scan was 22.2%, and by plain X-ray was 7.5%, 95.6%(43 cases) of meningiomas showed contrast enhancement. 5) The detection rate of tumors by CT scans was 98%, and 1 case(2%) couldn't be detected by CT scans because it was en plaque type. Preoperatively, 44 cases(88%) were diagnosed as meningiomas and other 6 cases were diagnosed as glioblastoma multiforme, cystic astrocytoma, glioma, and bone tumor by CT scans. 6) The postoperative pathological diagnosis were meningotheliomatous(55.4%), fibroblastic(13.0%), transitional(8.7%), angioblastic(3.3%), and sarcomatous(2.2%).
Astrocytoma ; Diagnosis ; Female ; Glioblastoma ; Glioma ; Humans ; Incidence ; Meningioma* ; Neurosurgery ; Seoul ; Skull ; Tomography, X-Ray Computed

Authors reviewed 92 cases of intracranial meningiomas which confirmed by operation at the Department of Neurosurgery, Seoul National University Hospital from September 1957 to July 1982. 45 cases out of 50 cases that had performed computerized tomographic(CT) scans preoperatively were analyzed. The results were as following ; 1) Meningiomas constituted 12.4% of all intracranial tumors. There were 51 women and 41 men(55.4%/44.6%). The average age at the time of diagnosis was 41.2 years. 2) The initial symptoms were headache(50.0%), visual disturbance(14.1%), and seizure(8.7%) in the order. 3) The most common location was parasagittal-falcial, and followed by convexity, sphenoid ridge, tuberculum sellae tentorial and olfactory groove. 4) 61 cases(76%) out of 80 cases showed abnormal findings in the plain skull X-ray examinations. The preenhanced CT scans(45 cases) showed hyperdense lesion in 57.8%(26 cases), isodense lesion in 35.6%(16 cases), and hypodense lesion in 6.6%(3 cases). The incidence of peritumoral low density was 68.9%. The detection rate of intratumoral calcification by CT scan was 22.2%, and by plain X-ray was 7.5%, 95.6%(43 cases) of meningiomas showed contrast enhancement. 5) The detection rate of tumors by CT scans was 98%, and 1 case(2%) couldn't be detected by CT scans because it was en plaque type. Preoperatively, 44 cases(88%) were diagnosed as meningiomas and other 6 cases were diagnosed as glioblastoma multiforme, cystic astrocytoma, glioma, and bone tumor by CT scans. 6) The postoperative pathological diagnosis were meningotheliomatous(55.4%), fibroblastic(13.0%), transitional(8.7%), angioblastic(3.3%), and sarcomatous(2.2%).
Astrocytoma ; Diagnosis ; Female ; Glioblastoma ; Glioma ; Humans ; Incidence ; Meningioma* ; Neurosurgery ; Seoul ; Skull ; Tomography, X-Ray Computed

One case of craniopharyngioma confined to the third ventricle is reported. His symptom was only headache without visual disturbance or endocrine dysfunction. The CT scan showed isodense round mass in the anterior portion of the third ventricle with strong homogeneous enhancement. There was no calcification.
Craniopharyngioma* ; Headache ; Third Ventricle ; Tomography, X-Ray Computed

Retrospective analysis of reoperation and complication was made for 186 patients with lumbar herniated disc. The results showed complication rate of 7%(13 cases) and reoperation rate of 10.2%(19 cases). The primary complications were infections(9 cases), technical errors(2 cases), and scores(2 cases). Rate of discitis was 1.6%(3 cases). The outcomes of reoperation resulted in excellent recovery of 16%(3 cases) and good recovery of 58%(11 cases). The most common intraoperative findings of reoperation were inadequate disectomy or missed disc fragments 31.6% or 6 cases;epidural fibrosis 26.3% or 5 cases;and new herniation at other level 15.8% or 3 cases. Excellent and good results could be achieved in patients operated within 1 month or more than 6 months after while the patients who underwent reoperation between 1 month and 6 months showed poor results. The delicate perioperative menagement and complete discectomy, adequate bleeding control and laminectomy were considered to be essential in reducing the chance of complication and reoperation.
Discitis ; Diskectomy ; Fibrosis ; Hemorrhage ; Humans ; Intervertebral Disc Displacement ; Laminectomy ; Reoperation* ; Retrospective Studies