OBJECTIVE: The operative indications on cerebellar hemorrhage have been controversial especially when the patient condition is grave. Therefore we investigated whether it can be justifiable if we perform the surgery in poor clinical grade. METHODS: Clinical records and computerized tomography(CT) films of the 89 patients, who were undergone hospital treatment due to spontaneous cerebellar hemorrhage between May 1997 and May 2004, were retrospectively researched. RESULTS: The study population consisted of 36 males and 53 female patients. The mean age was 65years (range 23~89). As a result of treatment, the patients, whose Glasgow coma scale(GCS) score were higher, showed better outcomes (p=0.001). 13 patients (14.6%) were below 5 in GCS score and 10 patients of these were operated. Among 10 patients, 4 patients (40%) showed good outcome and 5 patients (50%) had been dead. 3 patients (60%) of these dead patients had the findings of intraventricular hemorrhage, fourth ventricular obliteration and hydrocephalus in CT scan. CONCLUSION: This study suggests that operation may be justifiable in clinically poor grade patient with spontaneous intra cerebellar hemorrhage.
Coma ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hemorrhage* ; Humans ; Hydrocephalus ; Male ; Retrospective Studies ; Tomography, X-Ray Computed

Typhlitis is one of the most ominous complications in immunocompromised patients. Neutropenic enterocolitis or typhlitis is a clinical syndrome characterized by fever, diarrhea and abdominal pain that occurs in neutropenic patients. It has been reported as a complication of childhood leukemia, but is now known to occur in adults with solid malignancies, acquired immunodeficiency syndrome (AIDS) or bone marrow transplantation (BMT). The association of typhlitis and propylthiouracil has not been previously reported. We report a case of a 42-year-old female patient with typhlitis due to propylthiouracil patient with hyperthyroidism.
Abdominal Pain ; Acquired Immunodeficiency Syndrome ; Adult ; Bone Marrow Transplantation ; Diarrhea ; Enterocolitis, Neutropenic ; Female ; Fever ; Humans ; Hyperthyroidism* ; Immunocompromised Host ; Leukemia ; Propylthiouracil* ; Typhlitis*

No abstract available.
Prognosis* ; Subarachnoid Hemorrhage, Traumatic*

BACKGROUND: Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. METHODS: The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. RESULTS: Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. CONCLUSIONS: The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room.
Automation, Laboratory ; Efficiency, Organizational/*standards ; Phlebotomy/*statistics & numerical data ; Republic of Korea ; Time Factors ; Workflow

BACKGROUND: Iron deficiency still remains the most common single nutrient deficiency disorder in the world, especially among young children and adolescent girls. As little is recently known about iron deficiency in infants and preschool children in Korea, this study is aimed to determine the prevalence of iron deficiency in healthy population and to determine the proportion of children in whom iron deficiency goes undetected using the current screening technique. METHODS: We collected venous samples from 410 apparently healthy preschool children during March to June, 1997, as a part of a regular health check-up program. We measured hemoglobin, hematocrit, mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), serum ferritin, serum iron, and total iron binding capacity(TIBC). RESULTS: A total of 410 infants and preschool children aged 1~6 years were included in this study. The prevalence of anemia was 7.9%(3/38) in infants and children aged 1~2 years, 6.3%(12/190) in 3~4 years and 1.6%(3/182) in 5~6 years. The prevalence of iron deficiency(ferritin <10 ng/mL or transferrin saturation <10%) was 31.6%(12/38) in 1~2 years, 23.7%(45/190) in 3~4 years and 14.3%(26/182) in 5~6 years. The prevalence of IDA was 5.3% (2/38) in 1~2 years, 1.1% (2/190) in 3~4 years and 0.5%(1/182) in 5~6 years. Microcytic anemia was found in only 2 cases, both of which is included in 1~2 years of age. CONCLUSION: The prevalence of iron deficiency and IDA was relatively high in 1~2 years of age, critical period for neurologic development. Nutritional education including iron fortification for mothers having caring babies especially of this age group should be warranted.
Adolescent ; Anemia ; Anemia, Iron-Deficiency ; Child ; Child, Preschool* ; Critical Period (Psychology) ; Education ; Female ; Ferritins ; Hematocrit ; Humans ; Infant ; Iron* ; Korea ; Mass Screening ; Mothers ; Prevalence* ; Transferrin

Intracerebral sparaganosis, caused by the Plerocercoid of Spirometa mansoni, is very rare. A 54-yeas-old man, who has a history of having eaten raw frogs and snakes 20 years ago, was admitted with 2 years duration of focal seizure and monoparesis on right upper extremity. The brain CT scan and MRI demonstrated extensive and irregular hypodense lesion with punctate calcification in subcortical region of left parietal lobe. A whitish ribbon-like moving parasite could be picked up using CRW stereotactic frame under local anesthesia. On pathological examination was disclosed a sparganum with characteristic calcospherule. Also, preoperative ELISA test for sparganum-specific antibody(IgG) showed positive reaction to sparganum absorbance 1.04 in serum and 0.61 in CSF, respectively(normal abs. : below 0.22). Immediately after removal of parasite, the seizure and motor weakness disappeared. Stereotactic removal of cerebral sparganum can be considered a useful method in selected patients.
Anesthesia, Local ; Brain ; Enzyme-Linked Immunosorbent Assay ; Humans ; Magnetic Resonance Imaging ; Parasites ; Paresis ; Parietal Lobe ; Seizures ; Snakes ; Sparganum* ; Tomography, X-Ray Computed ; Upper Extremity

OBJECTIVE: Using the standardization of disease diagnosis of disease, and surgical procedures, the authors have made a clinical application for the analysis of inpatient data with the ability to search for information pertinent for writing of clinical articles. METHODS: A client-server system and database software was developed for networking. For clinical application, a computerized daily report has been developed. Data from Neurosurgical patients admitted at Soonchunyang University Hospital from January to December 1998 were analyzed with this system. Data for clinical articles was obtained using the search mode, information such as orbital infarction syndrome following intracranial aneurysm surgery and epidemiological analysis or geriatric neurosurgical patients. RESULTS: For the daily report it takes approximately 10 minutes to input the patients demographic information, name of disease, diagnosis and surgical procedure. The daily report also numbers and sorts the inpatients according to large categories of diagnosis, reports the ratio between inpatients and operative patients. The annual report that was obtained was very accurate and gave rapid statistics for the one year. By retrospective study for the past 18 years, we calculated the incidence of orbital infarction syndrome following intracranial aneurysm surgery as 1.4%, and also estimated the population of geriatric inpatients as 18.3% by retrospective study. CONCLUSIONS: It has been found to be most useful to make a daily and annual report for tracking and research purposes. For use in clinical articles, it can be possible to do a search of the patients using the standardized disease, diagnosis and neurosurgical procedures application and obtain pertinent information in a timely manner.
Diagnosis ; Epidemiology* ; Humans ; Incidence ; Infarction ; Inpatients ; Intracranial Aneurysm ; Neurosurgical Procedures* ; Orbit ; Retrospective Studies ; Writing

OBJECTIVE: The the international classification of disease and surgical procedure has been found to be a lengthy and time-consuming text for use by neurosurgeons. A more subject matter related classification system is needed for use by this specialty. The author has developed a more comprehensive and standardized classification system specified for diagnosis of neurological disease and neurosurgical procedures. METHODS: Standardization of disease was completed by modifying the name of disease according to that which was used for daily report past 10 years, and from textbook of neurosurgery. The fields of international coding are continued in each. Neurosurgical procedures were designated and modified according to Current Procedure Terminology 96. Client-server system will be used for networking and database software applications have been developed. RESULTS: Disease was classified in 14 large categories and 379 subcategories. Diagnosis was classified in 12 large categories and 43 subcategories. Neurosurgical procedure has 20 large and 202 subcategories. The international coding system such as ICD-10 and ICD-9CM is maintained for the diagnosis and procedures to each category. CONCLUSIONS: It could be possible to make and use a standardized database model of disease, diagnosis and neurosurgical procedures to be used by physician.
Classification ; Clinical Coding ; Diagnosis ; Epidemiology* ; International Classification of Diseases ; Neurosurgery ; Neurosurgical Procedures*

OBJECTIVE: Although posterior wiring techniques have been commonly used with good results in treating the traumatic atlantoaxial instabilities, screw fixation technique has been gaining popularity to secure atlantoaxial arthrodesis in recent years. The purpose of this study is to compare the surgical results of posterior arthrodesis for the traumatic atlantoaxial instability between these two methods. METHODS: Twenty patients underwent 21 procedures over a 6-year period with a mean follow-up of 23 months. The most common condition of traumatic atlantoaxial instability was dens fracture(15 patients) followed by transverse atlantal ligament injury(4 patients), and traumatic os odontoideum(2 patients). Thirteen posterior wiring and eight posterior screw fixations were performed. Among 13 wiring methods, nine Galli fusions, two occipito-cervical fusions, one Brooks fusion, and one C1-C3 fusion were done. RESULTS: No patient developed neurological worsening after surgery. Compared to wire method, all patients of screw group had significant pain reduction when the patients was younger than 50 years old(p=0.01). The postoperative changes in distances of space available for cord(SAC) was not statistically significant between wire and screw methods(p=0.7). The rate of complication(23% in wire vs 25% in screw) was comparable to two methods. Although two screw malposition(25%) among screw fixations were developed, all revealed solid fusion without additional surgeries. The rate of fusion(85% in wire vs 100% in screw) was excellent in screw group. Postoperative loss of reduction, including redisplacement and kyphosis, was present only in wire group(31%). Two(15%) of wire fusions had redisplacement; both of these patients were type 2 dens fracture. Three procedures(23%) of wire fusions resulted in kyphotic change which occurred when delayed surgeries were done between 40 days and 90 days(mean: 63 days) after trauma. CONCLUSION: Considering both reduction loss and fusion rate, wire method caused more spinal deformity than screw method(38% vs 0%). This study demonstrates that screw method is a better surgical option for management of traumatic atlantoaxial instability.
Arthrodesis* ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Ligaments

Malignant fibrous histiocytoma(MFH) is well known as a soft tissue tumor of the extremities and retroperitoneum, but MFH of the skull is very rare. We report a case of MFH arising from the temporal bone in a 27-year-old male. This tumor presented as an osteolytic lesion and soft tissue mass on the left temporal bone without obvious invasion of the underlying brain parenchyma. The patient underwent tumor and bone removal, follwed by radiation therapy. Hostologic examination disclosed pleomorphic spindle cells in a storiform pattern and tumor cells showed positive reaction for vimentin, lysozyme, alpha 1-antitrypsin and (1-antichymotrypsin in immunohistochemical stain.
Adult ; alpha 1-Antitrypsin ; Brain ; Extremities ; Histiocytoma, Malignant Fibrous* ; Humans ; Male ; Muramidase ; Skull ; Temporal Bone* ; Vimentin