No abstract available.
Glioblastoma*

Myxoma is a rare nonepithelial neoplasm of the larynx frequently misdiagnosed as a large vocal polyp due to its slow-growing nature. Myxoma is a benign but often infiltrating neoplasm of uncertain mesenchymal cell origin, characterized by irregular round, spindle or stellate cells within a matrix containing abundant mucoid material, scant vascularity and a variable meshwork of reticulum and collagen. We report one case of myxoma with life-threatening dyspnea requiring tracheotomy.
Case Report ; Critical Illness ; Human ; Laryngeal Neoplasms/complications* ; Male ; Middle Age ; Myxoma/complications* ; Respiration Disorders/surgery ; Respiration Disorders/etiology* ; Tracheotomy

The mortality and morbidity of the intraventricular hemorrhage(IVH) has been decreased since the introduction of external ventricular drainage(EVD) and direct intraventricular infusion of urokinase as an effective therapeutic method. In 1989, we already reported a series of 54 cases of IVH treated with simple EVD or EVD with urokinase irrigation in a few cases. Authors analyzed again a series of 50 cases of IVH treated by EVD with direct intraventricular urokinase irrigation after the pervious report. The mortality rate was 55.5% in former occasion, however 18% in this study and the complications were considerably low. We experienced again that the EVD with urokinase irrigation is an effective method and convenient, simple technique in the management of IVH even though there is no ICP monitoring. So we prefer EVD with urokinase irrigation therapy in managing the IVH even if the patient is moribund state.
Drainage* ; Hemorrhage* ; Humans ; Infusions, Intraventricular ; Mortality ; Urokinase-Type Plasminogen Activator*

Primary oligodendroglioma of the spinal cord is very rare tumor. On searching through the literature from 1931, we could find only about 46 cases, and this tumor is almost absent in Korea on the review of the literature. The authors present a case of 8-year-old female patient with the symptoms of paraparesis, urination difficulty, diffuse back pain and hypesthesia in both lower extremities. Spine MRI revealed the mass at the level of T3-T12, with combined nature of cystic and solid portion. Decompressive laminectomy and partial mass removal was performed, and then adjunctive radiotherapy and chemotherapy was done. The patient was improved after operation with radiotherapy and chemotherapy, so she walks alone and has no voiding difficulty at present(postoperative about 20 months) .
Back Pain ; Child ; Drug Therapy ; Female ; Humans ; Hypesthesia ; Korea ; Laminectomy ; Lower Extremity ; Magnetic Resonance Imaging ; Oligodendroglioma* ; Paraparesis ; Radiotherapy ; Spinal Cord* ; Spine ; Urination

This study is a retrospective clinical analysis of 134 cases of anterior communicating artery aneurysms surgically treated in the Department of Neurosurgery, Chungnam National University Hospital from January 1990 to December 1996. The results of analysis were summarized as follows; 1) Peak age incidence was in the sixth decade and male to female ratio was 1: 1.2, showing female predominancy. 2) There was no statistically significant relationship between direction of aneurysm and Fisher's grade, and occurrence of hydrocephalus, and also between the direction, size and shape of aneurysm and preoperative Hunt-Hess grade. 3) There was statistically significant relationship between the shape of aneurysm and angiographic vasospasm; there was high incidence of vasospasm in lobulated and oval shape of aneurysm. But there was no statistically significant relationship between the direction, size of aneurysm and angiographic vasospasm. 4) The correlations between outcome and preoperative Hunt-Hess grade, and occurrence of angiographic vasospasm, and temporary clipping were statistically significant; the outcome was good in cases of no vasospasm, temporay clipping and better preoperative Hunt-Hess grade. 5) The direction, shape and size of aneurysm, existence or not of abnormality in circle of willis, timing of surgery and operative procedure had no statistically significant relationship with outcome. 6) Postoperative complications were vasospasm and infarction(18.7%), brain edema, hydrocephalus, in order of frequency, and the mortality rate was 3%.
Aneurysm ; Brain Edema ; Chungcheongnam-do ; Circle of Willis ; Female ; Humans ; Hydrocephalus ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Neurosurgery ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative

One hundreds eighty cases of traumatic intracerebral hematoma(TICH) among 1,633 head injury patients diagnosed with computerized tomography in neurosurgical department from Jan. 1990 to Jun. 1996. were classified into two TICH groups; TICH group associated with other traumatic intracranial lesions and TICH group without other traumatic intracranial lesions. The incidence of TICH was 11.0% and percentage of TICH with other traumatic intracranial lesions among 180 cases of TICH was 66.7%. TICH group with other traumatic intracranial lesions showed worse initial level of consciousness, more likely to have abnormal pupillary reflex, higher incidence of delayed traumatic intracerebral hematomas(DTICH), greater amount of hematoma, increased chance of surgery and worse outcome. In TICH group with other traumatic intracranial lesions, the factors affecting prognosis were initial Glasgow coma scale(GCS) score, pupillary reflex, amount of hematoma and treatment modality. In TICH only group, the factors affecting prognosis were initial GCS score, pupillary reflex, amount of hematoma and DTICH. The patients with 12-15 of GCS score, normal pupillary reflex, absence of DTICH, and amount of hematoma below 10cc, the presence of other traumatic intracranial lesions were found to be important prognostic factor. The overall mortality was 27.7% but in TICH group with other traumatic intracranial lesions, the mortality was 35.0% compared to 13.3% in TICH only group. It is concluded from this study that in the case with other traumatic intracranial lesions, TICH showed worse initial neurological status and prognosis compared to those without other lesions. Thus, these patients, although in conditions of good general clinical index at admission, should be considered to provide intensive care and treatment because these associated lesions will play as a bad prognostic factor.
Coma ; Consciousness ; Craniocerebral Trauma ; Hematoma* ; Humans ; Incidence ; Critical Care ; Mortality ; Prognosis ; Reflex, Pupillary

Among the four-hundred patients with cerebral aneurysms confirmed by cerebral angiography, we divided them into two age groups, one with ages 39 years or younger(young-aged group: 51 patients, 12.8%), and another with ages 65 years or older(old aged group: 45 patients, 11.3%). A comparison was undertaken in regard to clinical characteristics and overall outcome in two groups. In young-aged group, the female-to-male ratio was 2.2: 1 whereas, women was predominant by five times more in old aged group. Anterior communicating artery aneurysm was the most common site(43.1%) in young-aged group, unlike to old aged group where posterior communicating artery was the most common site(33.3%). The most common symptom was headache in both groups, and the hypertension was more frequent in young-aged group(45.5%) than old-aged group(33.3%). Surgery was performed in 43 patients(84%) in younger group, and 37 patients(82.2%) in elderly group. Young-aged group showed more favorable outcome(91%) than old-aged group(70%).
Aged ; Arteries ; Cerebral Angiography ; Female ; Headache ; Humans ; Hypertension ; Intracranial Aneurysm* ; Prognosis

Two cases of aneurysms in the P3 segment of the posterior cerebral artery are described. These were managed by the subtemporal approach. One giant aneurysm in a 47-year-old male was treated by clipping the afferent artery, and the other small saccular aneurysm in a 41-year-old female was treated by clipping the aneurysmal neck. There were no complications after surgery, and the patients were discharged without neurological deficit. The operative approaches and procedures are also discussed in relation to the anatomy of posterior cerebral artery aneurysms.
Adult ; Aneurysm ; Arteries ; Female ; Humans ; Intracranial Aneurysm* ; Male ; Middle Aged ; Neck ; Posterior Cerebral Artery*

PURPOSE: This study aimed to determine the exact characteristics of bacterial colonization after a ureteral stent indwelling. MATERIALS AND MTHODS: The natural history of bacterial colonization on the stent itself and urine samples after different periods of stent indwelling was examined. A total of 57 double-J stents from 52 patients (21 male; 31 female) with mean age of 52 (range 20-79) years were examined. In all patients, short-term (for 2-3 days) antimicrobial therapy was done at the time of stenting. Regular urinalysis and urine culture were performed until the stent was removed. The stents were removed under aseptic conditions and the proximal and distal tip segments were obtained. Three culture specimens were acquired from each stent segments (inner surface washing suspension, outer surface washing suspension and the stent tip itself). RESULTS: Bacterial colonies were found in 44% (25/57). Multiple pathogens were identified, and Enterococcus species (6/25) was the most common pathogen followed by E. coli (5/25). The bacteria did not colonize within the first 2 weeks of indwelling. However, the colonization rate increased, as the duration of the indwelling was further increased. Colonization in the stent was followed by the colonization in the urine. CONCLUSIONS: Bacterial colonization does not occur during the initial 2 weeks after stent indwelling. This suggests that antibiotics for short-term indwelling of ureteral stents are not necessary.
Anti-Bacterial Agents ; Bacteria ; Bacterial Adhesion ; Colon* ; Enterococcus ; Humans ; Male ; Natural History ; Stents* ; Ureter* ; Urinalysis ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: This study aimed to determine the exact characteristics of bacterial colonization after a ureteral stent indwelling. MATERIALS AND MTHODS: The natural history of bacterial colonization on the stent itself and urine samples after different periods of stent indwelling was examined. A total of 57 double-J stents from 52 patients (21 male; 31 female) with mean age of 52 (range 20-79) years were examined. In all patients, short-term (for 2-3 days) antimicrobial therapy was done at the time of stenting. Regular urinalysis and urine culture were performed until the stent was removed. The stents were removed under aseptic conditions and the proximal and distal tip segments were obtained. Three culture specimens were acquired from each stent segments (inner surface washing suspension, outer surface washing suspension and the stent tip itself). RESULTS: Bacterial colonies were found in 44% (25/57). Multiple pathogens were identified, and Enterococcus species (6/25) was the most common pathogen followed by E. coli (5/25). The bacteria did not colonize within the first 2 weeks of indwelling. However, the colonization rate increased, as the duration of the indwelling was further increased. Colonization in the stent was followed by the colonization in the urine. CONCLUSIONS: Bacterial colonization does not occur during the initial 2 weeks after stent indwelling. This suggests that antibiotics for short-term indwelling of ureteral stents are not necessary.
Anti-Bacterial Agents ; Bacteria ; Bacterial Adhesion ; Colon* ; Enterococcus ; Humans ; Male ; Natural History ; Stents* ; Ureter* ; Urinalysis ; Urinary Tract Infections* ; Urinary Tract*