No abstract available.
Aneurysm* ; Hydrocephalus*

No abstract available.
Histiocytosis, Sinus* ; Lip*

The authors report a very unusual case of ruptured aneurysm by direct vessel invasion of anaplastic oligodendroglioma (WHO grade III) confirmed by histopathological examinations. As local invasion is the hallmark of malignant gliomas, malignant glial tumors invade neighboring structure and often cause microscopic endothelial proliferation, telangiectasias in small arteriols, but direct arterial invasion by glioma is very rare. Possible mechanisms of intracranial aneurysm development by glioma are thought to be related to the close proximity to the tumor, perivascular basement membrane breakage due to high tumor pressure and increased regional blood flow through the feeding artery of tumor. The aneurysm and tumor were treated in a single operation simultaneously.
Aneurysm ; Aneurysm, Ruptured ; Anterior Cerebral Artery* ; Arteries ; Basement Membrane ; Glioma ; Intracranial Aneurysm* ; Oligodendroglioma* ; Regional Blood Flow ; Rupture* ; Telangiectasis

The purpose of this study was to evaluate the role of anterior cervical plate after discectomy and autologous iliac bone graft in the treatment of cervical spondylosis. One hundred and seven cervical spondylotic patients from Jan. 1995 to Mar. 1998 were separated into two groups: Group 1. consisted of 58 patients treated with anterior discectomy, bone fusion, and anterior cervical plate fixations(54 cases of Caspar nonlocking plate and 4 cases of Orion locking plate system), Group 2. consisted of 49 patients treated with anterior discectomy and bone fusion. The mean follow-up duration was 26.5 months(from 6 to 45 months). The overall fusion rate did not showed any difference between the two groups, but in multi-level patients, graft materials related complications(extrusion or collapse of graft) were significantly high in group 2.(p<0.01). Group 1. patients ambulated on POD 1 with Philadelphia collar. The average admission period was 8.4 days following operation. Group 2. patients ambulated on POD 5-7 with Philadelphia collar. The average admission period was 11.9 days after surgery. In conclusion, bony fusion was successfully achieved in both groups and graft materials related complication rate showed no difference in the single level, but was significantly low in group 1 in the multilevel.
Diskectomy* ; Follow-Up Studies ; Humans ; Spondylosis* ; Transplants

A most common site for the isthmic spondylolisthesis is at fifth lumbar vertebra(L5) and far less at fourth(L4). The pathogenic lesion in the pars interarticularis is essentially the same in LA and L5 isthmic spondylolisthesis, but the clinical characteristics may differ each other according to their anatomical and biomechanical differences. A retrospective review of 24 patients of LA(study group) and 27 patients of L5(control group) isthmic spondylolisthesis was undertaken for their medical records and radiographs to compare the clinical characteristics in each groups. Included in each groups were all patients who were surgically treated during the same period and followed for more than two years after surgery. In the study group, 18 of 24 patients were females having an average age of 42.5 years(ranging 34-65), while in the control group, 17 of 27 patients were males having an average age of 38,1 years (ranging 13-59). The symptoms were severe leg pain in most of the study group, but in the control group, the leg pain and back pain were equally complained. The degrees of slip were similar in two groups, but a narrowing of dise space at slip segment was more prominent in study group. The lateral radiographs taken in flexion and extension revealed more changes of slip in study group (4.7mm in study group vs 2.8mm in control group in averages), and more angular motion at slip segment in study group unless the dise space is not severely narrowed. A spinal stenosis in CT findings was disclosed in almost all patients of study group and in 18 patients of control group. The sizes of L5 transeverse process were bigger than twice as those of L4 in 17(70.8%) patients including 9(37.5%) sacralizations of L5 in suty group, while in control group they were only 8(29.6%) patients with no sacralization. The heights of intercreastal line revealed no difference in two groups. The surgical procedures in study group were fusion only in two and decompression with fusion in 22(91.7%) patients and those in control group were fusion only in 11 and decompression with fusion in 16(59.3%) paticnts. The satisfactory results of treatment were in 21(87.5%) patients of study group and 25(92.6%) patients of control group without significant difference between two groups. In conclusion, the L4 spondylolytic spondylolisthesis compared to L5 lesion was more unstable and developed spinal stenosis more often. The surgical treatment and decompression procedure were also more needed in L4 lesions particularly in agend women.
Back Pain ; Decompression ; Female ; Humans ; Leg ; Male ; Medical Records ; Retrospective Studies ; Spinal Stenosis ; Spondylolisthesis

An isolated unilocular renal hydatid cyst is very rare and to the best of our knowledge, no such case has been reported in the Korean literature. A 56 year old woman, who liked eating raw vegetables fertilized by dog feces, visited our department because of an incidentally found renal cyst. Ultrasonography and the computed tomography (CT) scan showed a typical daughter cyst within the 6cm sized mother cyst. We performed retroperitoneal laparoscopic cyst marsupilaization after aspiration of the cystic contents and injection of a scolecidal agent. No dissemination and no recurrence have occurred to date.
Animals ; Dogs ; Eating ; Echinococcosis* ; Feces ; Female ; Humans ; Kidney ; Laparoscopy ; Middle Aged ; Mothers ; Nuclear Family ; Recurrence ; Ultrasonography ; Vegetables

Urethral diverticulum is a relatively uncommon abnormality for a man. We report here on a case of acquired anterior urethral diverticulum with giant calculi and cutaneous fistula in a 64-years old male patient who had suffered from urethritis 10 years previously. Retrograde urethrography and urethroscopy confirmed the anterior urethral diverticulum with giant calculi, and these procedures ruled out the presence of any associated obstructive urethral anomalies. We performed urethral diverticulectomy, with removal of the calculi, and then we performed urethroplasty.
Calculi* ; Cutaneous Fistula* ; Diverticulum* ; Humans ; Male* ; Middle Aged ; Urethra ; Urethritis

Herein, a rare case of port site metastasis, following a laparoscopic radical nephrectomy in a 62-years old male patient with a stage pT2N0M0 and Fuhrman grade III renal cell carcinoma, is reported. The patient suffered port site metastasis, with local recurrence. The port site metastasis was incidentally found in the patient during the laparoscopic examination for a laparoscopic mass resection of a local recurrent tumor. The most important appropriate surgical techniques are those where the port site metastasis can be controlled.
Carcinoma, Renal Cell* ; Humans ; Laparoscopy ; Male ; Middle Aged ; Neoplasm Metastasis* ; Nephrectomy* ; Recurrence

BACKGROUND AND OBJECTIVES: Tonsillar and adenoid hypertrophy is one of the common causes of nasal obstruction, mouth breathing, snoring and sleep apnea in children. Tonsillectomy and adenoidectomy (T & A) could relieve these symptoms but may also cause voice changes after the operation. The aim of this study was to evaluate the voice changes objectively by nasometric and acoustic rhinometric analyses. MATERIALS AND METHODS: Thirty-eight patients who underwent T & A and twenty-two control children who had no sinonasal or tonsillar hypertrophy problems were selected. A visual analogue scale was used for determining the subjective nasality changes and nasometric analyses were used to determine the objective nasalance differences. Acoustic rhinometry was used to measure the nasopharyngeal volume changes and the removed adenoid tissue were directly measured. Data were collected prior to the operation, and on the second, 7th and 14th days after the operation. Data were compared and analyzed statistically. RESULTS: The volume of removed adenoid tissue was not statistically related with the subjective nasality changes which increased significantly after T R. A. Nasalance in the patient group increased significantly after the operation compared to that in the control group. The voiume of nasopharynx increased significantly after adenoidectomy, but it had a minimal statistical correlation with the volume of the removed adenoid tissue. CONCLUSION: Nasometric and acoustic rhinometric tests can serve as objective tools for evaluating the subjective nasality changes after T 5z A.
Acoustics ; Adenoidectomy* ; Adenoids ; Child* ; Humans ; Hypertrophy ; Mouth Breathing ; Nasal Obstruction ; Nasopharynx ; Rhinometry, Acoustic ; Sleep Apnea Syndromes ; Snoring ; Tonsillectomy* ; Voice

BACKGROUND: Although degree of motor blockade during high thoracic spinal anesthesia is difficult to determine, pulmonary function may reflect the level of motor blockade. So we checked pulmonary function during spinal anesthesia with two different local anesthetic agents. METHODS: 50 patients, ASA PS 1-2, were randomly divided into two groups. After basal pulmonary function test (FVC: forced vital capacity, FEV1: forced expiratory volume in one second, PEFR: peak expiratory flow rate, PEP: peak expiratory pressure, PIP: peak inspiratory pressure.), the patients received spinal anesthesia with either 0.5% hyperbaric bupivacaine or 0.5% hyperbaric tetracaine. Thirty minutes after injection, level of sensory blockade was checked by pinprick test and pulmonary function test was performed. RESULTS: Almost all the values of pulmonary function reduced after spinal anesthesia, but the degrees of reduction were not differ in two groups except PEP, which reduced more profoundly in tetracaine group than bupivacaine group. CONCLUSIONS: It is more desirable that we use bupivacaine rather than tetracaine as spinal anesthetic agent in the patient with poor pulmonary function.
Anesthesia, Spinal* ; Anesthetics ; Bupivacaine* ; Forced Expiratory Volume ; Humans ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Tetracaine* ; Vital Capacity