We present a series of 10 Patients(Seven men and three women with an average age of 53 years) who underwent decompressive craniectomy for treatment to massive brain swelling following acute cerebral infarction. Clinical signs of cerebral herniation(anisocoria or fixed and dilated pupil, and/or hemiplegia with decerebrate righidity) were present in all patients. Computed tomography and magnetic resonance imaging showed the mass effect by cerebral edema through midline shift. All patients were treated with an extensive craniectomy and duroplasty. Among them, one recovered without neurological deficit, three were moderately disabled but functionally dependent, three remained in a persistent vegetative state and three died within 9 days after surgery(good recovery=1, moderate disability=3, persistent vegetative state=3, death=3). The results suggest that decompressive craniectomy can be an useful lifesaving procedure for massive cerebral edema following widespread hemispheric infarction.
Brain Edema ; Cerebral Infarction* ; Decompressive Craniectomy* ; Female ; Hemiplegia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Persistent Vegetative State ; Prognosis ; Pupil

No abstract available.
Magnetic Resonance Imaging*

Ultrasonograhy, it's excellent ability of differentiating cystic from solid lesion and depicting detailedarchitecture, proved itself useful in the diagnosis of thyroid pathologies. Adanced high resolution equipmentsmade hidden small lesion detected and finer structure clearly seen. They seemed to throw light on the histologicaldiagnosis of thyroid diseases, especially differentiation of benignancy and malignancy. Author reviewed picturesof high-resolution ultrasonography of thyroid disease(24 ases0 and correlated them witn proven pathologicalfindings. The results were as follows: 1. Multiplicity of lesion favors benignancy(4 cases). 2. Well definedmargin favors benignancy(14/17), while ill defined margin favors malignancy(3/4), and lesion of no margin favorsthyroiditis(3/3). 3. Surrounding halo favors benignancy(7 cases). 4. Hypoechogenicity were found in most ofmalignancy and thyroiditis. Cystic components in solid nodule were common findings in bening and malignantlesions. Calcification was not found in malignancy.
Diagnosis ; Pathology ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Ultrasonography

Examining the eye with high resolution ultrasonography, authors encountered 34 cases(41 eyeballs) of cataractand found out its characteristic ultrasonographic findings, though cataract is easily recognized by physician oninspection. Ultrasonographic findings of cataract were as follows; 1. Thickening of lens due to edema. 2.Demonstration of lens echo in whole circumference. 3. Multiple internal lens echo.
Cataract ; Edema ; Ultrasonography

OBJECTIVES: The aim of this study was to investigate the characteristics of acute poisoning cases admitted to a local emergency department in an urban-rural area. METHODS: This retrospective study included all patients with acute poisoning who admitted the emergency department between June 2004 and May 2005. We analyzed the medical records for etiological and demographical characteristics of the acutely poisoned patients. RESULTS: There were 155(1.0%) poisoning cases among 15,457 admitted to the emergency department. Of the admitted cases, 51.0% were female and 49.0% male. The poisoning made a peak in the age range of 30-39 and over 60. The seasonal distribution in poisoning patients suggested a peak in spring(38.1%) and summer(24.5%). The majority of exposures(95.5%) occurred in patient's home, 81.8% were deliberate. The most common agents of acute poisoning in deliberate causes were drugs(p<0.01). All of deliberate cases were suicidal attempts. The most common poisoning cases were pesticides in male, but in female were medications(p<0.01). Overall mortality rate of total cases were 12.9%. The overall mortality rate was higher in male(p<0.05), increasing age(p<0.05) and intentional ingestion(p<0.05), pesticides poisoning(p<0.05). CONCLUSIONS: The study forms a foundation for future work on poisoning epidemiology which hopefully will facilitate the allocation of preventive services in order to reduce the incidence as well as morbidity and mortality of toxic exposures.
Emergencies ; Female ; Humans ; Incidence ; Male ; Medical Records ; Pesticides ; Retrospective Studies ; Seasons ; Suicide

No abstract available.
Diagnosis* ; Female ; Pregnancy ; Pregnancy, Ectopic* ; Ultrasonography*

Forty-four patients were operated on functioning pituitary adenomas during 5 years since Jun. 1977 at the Department of Neurosurgery, Seoul National University Hospital. Clinical and laboratory findings were analyzed and the following results were obtained. 1) The peak incidence was in the 3rd and 4th decade 21 cases were male and 23 cases were female. 2) Endocrinologic study revealed prolactinoma in 28 cases(37%), somatotropic adenoma in 13 cases(17%), corticotropic adenoma in 3 cases(4%), endocrine-inactive adenoma in 32 cases(42%). 3) MAin symptoms were endocrine symptoms(86%), headache(75%) and visual field defect(59%). 4) Seven(16%) were in the stage I(micro-adenoma), 27(61%) in the stage II, 6(14%) in the stage III, 4(9%) in the stage IV. 5) The rate of endocrinologic cure or improvement was 65% in prolactinoma and 75% in somatotropic adenoma. This result was less favorable less favorable than the result of other recent studies, but it seemed to be due to large proportion of large or invasive adenoma instead of micro-adenoma in this series. 6) In prolactinoma, 7 out of 12 patients with amenorrhea resumed menstrual cycle and 2 patients had pregnancies postoperatively. 7) The visual field defect was improved in 16 of 21 cases(76%) postoperatively.
Acromegaly ; Adenoma ; Amenorrhea ; Female ; Humans ; Incidence ; Male ; Menstrual Cycle ; Neurosurgery ; Pituitary Neoplasms* ; Pregnancy ; Prolactinoma ; Seoul ; Visual Fields

Spinal stenosis denoting a critical reduction of the A-P diameter of spinal canal, foramina and lateral recesses can be existed in both cervical and lumbar regions. But it is relatively rare that cervical and lumbar spinal stenosis are coexisted simulataneously. The authors report a case of coexisting cervical and lumbar spinal stenosis with historical background and discussion. The patient was 49 years old male who complained intermittent neurogenic claudication, paraparesis and voiding disturbance. A successful result was obtained through one stage decompressive laminectomies in cervical and lumbar reaions.
Humans ; Laminectomy ; Lumbosacral Region ; Male ; Middle Aged ; Paraparesis ; Spinal Canal ; Spinal Stenosis*

BACKGROUND AND OBJECTIVES: Failure of vascular smooth muscle apoptosis and inflammatory response in pulmonary arterial hypertension (PAH) is a current research focus. The goals of this study were to determine changes in select gene expressions in monocrotaline (MCT)-induced PAH rat models after human umbilical cord blood derived mesenchymal stem cells (hUCB-MSCs) transfusion. MATERIALS AND METHODS: The rats were separated into 3 groups i.e., control group (C group), M group (MCT 60 mg/kg), and U group (hUCB-MSCs transfusion) a week after MCT injection. RESULTS: TUNEL assay showed that the U group had significantly lowered positive apoptotic cells in the lung tissues, as compared with the M group. mRNA of caspase-3, B cell leukemia/lymphoma (Bcl)-2, interleukin (IL)-6, tumor necrosis factor (TNF)-alpha and vascular endothelial growth factor (VEGF) in the lung tissues were greatly reduced at week 4 in the U group. Immunohistochemical staining of the lung tissues also demonstrated a similar pattern, with the exception of IL-6. The protein expression of caspase-3, Bcl-2 VEGF, IL-6, TNF-alpha and brain natriuretic peptide in the heart tissues were significantly lower in the U group, as compared with the M group at week 2. Furthermore, the protein expression of VEGF, IL-6 and BNP in the heart tissues were significantly lower in the U group at week 4. Collagen content in the heart tissues was significantly lower in the U group, as compared with M group at weeks 2 and 4, respectively. CONCLUSION: hUCB-MSCs could prevent inflammation, apoptosis and remodeling in MCT-induced PAH rat models.
Animals ; Apoptosis ; Caspase 3* ; Collagen ; Fetal Blood* ; Gene Expression* ; Heart ; Humans* ; Hypertension ; Hypertension, Pulmonary* ; In Situ Nick-End Labeling ; Inflammation ; Interleukin-6* ; Interleukins ; Lung ; Mesenchymal Stromal Cells* ; Models, Animal* ; Monocrotaline ; Muscle, Smooth, Vascular ; Natriuretic Peptide, Brain ; Rats* ; RNA, Messenger ; Stem Cells ; Tumor Necrosis Factor-alpha* ; Umbilical Cord* ; Vascular Endothelial Growth Factor A*

Intracranial germinoma usually occurs in the pineal and suprasellar regions. It is relatively rare that germinoma occurs in the thalamus and basal ganglia. The authors report a case of germinoma involving the posterior part of thalamus and basal ganglia involving the posterior part of thalamus and basal ganglia. The patient was 20 years old male who complained left side hemiparesis for 2 months. A successful result was obtained through radiation therapy after partial removal of tumor mass.
Basal Ganglia* ; Germinoma* ; Humans ; Male ; Paresis ; Thalamus* ; Young Adult