No abstract available.
Neurilemmoma* ; Neurofibromatoses* ; Neurofibromatosis 2*

The incidence of the distal anterior cerebral artery(DACA) aneurysm comprises about 2-6% of all intracerebral aneurysms. Because of the low incidence, unique anatomies of the distal anterior cerebral arteries and some technical difficulties in surgery, these aneurysms present such challenge to neurosurgeons. Presently, early surgery using interhemispheric approach is preferred. The auhtors experienced six patients with DACA aneurysms in 130 consecutive intracerebral aneurysms surgically treated between May. 1994 and Dec. 1997. The patients received operations within five days from the ictus, except one patient because of symptomatic vasospasm. The surgical approaches were all unilateral interhemispheric approaches. During the operations, infusion of large amount of mannitol and CSF volume removal were applied, although there were few difficulties in the interhemispheric dissections, the outcomes of the patients were excellent in three, good in three. The authors suggest that early operative interventions using unilateral interhemispheric approach without generous craniotomy can improve the outcomes of the patients with ruptured DACA aneurysm.
Aneurysm ; Anterior Cerebral Artery* ; Craniotomy ; Humans ; Incidence ; Intracranial Aneurysm* ; Mannitol

Pulmonary endomertiosis is a rare disorder with the typical symptom of hemoptysis during menstruation (catamenial hemoptysis). We report a case of a 19-year-old woman, gravida 0, with 3-month history of catamenial hemoptysis which was confirmed with chest computed tomography. She was treated by means of thoracoscopic wedge resection for the right lesion and fuperior segmental resection through the left thoracotomy, successively. Preoperative fluoroscopy-guided hooking for thoracosopic target lwsion was helpful in circumstances with one lung anesthesia. Four months of follow-up after an uneventful discharge revealed out no recurrence of catamenial hemoptysis in symptoms and images.
Anesthesia ; Female ; Follow-Up Studies ; Hemoptysis* ; Humans ; Lung ; Menstruation ; Recurrence ; Thoracotomy ; Thorax ; Young Adult

OBJECTIVE: The safety and effectiveness of Guglielmi Detachable Coil(GDC) embolization for cerebral aneurysm has been well documented. However, domestically there are few reports. The purpose of this study is to analyze procedural complications that occurred during endovascular coilling performed for cerebral aneurysms retrospectively. METHODS: From January 1996 to December 2003, a total of 453 patients (484 aneurysms) who had undergone GDC embolization for cerebral aneurysm were selected. The aneurysms were classified according to rupture history, location, dome and neck size. Procedural complications such as aneurysmal rupture, thrombosis and occlusion of patent vessels due to coil escape were noted. RESULTS: Procedural complications occurred 49 cases (10.1%). Among these, there were 27 of procedure-related aneurysmal rupture (5.6%), 14 of thrombosis (2.9%), 8 of occlusion of patent vessels due to coil escape (1.7%). Death or severe neurological deficit were seen in 18 cases of procedure-related rupture, 9 cases of thrombosis and 4 cases of coil escape. Procedure-related mortality and morbidity rates for endovascular coiling were calculated to be 2.9% and 3.6% respectively. CONCLUSION: The potential complications associated with shape, size and relationship to parent vessels of each specific cerebral aneurysm must be considered carefully before treatment. In order to reduce complications, proper equipment, knowledge on the hemodynamics and vascular anatomy, and operator's expertise are desired.
Aneurysm* ; Hemodynamics ; Humans ; Intracranial Aneurysm ; Mortality ; Neck ; Parents ; Retrospective Studies ; Rupture ; Thrombosis ; United Nations

BACKGROUND: Chlamydia pneumoniae is an important pathogen to cause approximately 5-10% of community-acquired respiratory infections and has been recently reported as a tentative causative agent of atherosclerosis in western countries. Considering that the most common cause of death is cerebral artery disease and coronary heart disease in Korea, we attempted to elucidate C. pneumoniae in atheromatous plaques. METHODS: Twenty-eight cases of atherectomy from 1996 to 1998, which included 20 patients with cerebral artery stenosis, two patients with carotid artery stenosis and six patients with coronary artery stenosis were prepared for immunohistochemistry to demonstrate C. pneumoniae. The Coronary arteries from 35 cadavers obtained were also stained with chlamydia genus-specific and C. pneumoniae-specific monoclonal antibodies. RESULTS: Eighteen of 20(90%) of cerebral artery stenosis, one of two of carotid artery stenosis and all six cases of coronary artery stenosis were positive for C. pneumoniae. Thirteen over 35(37.1%) cadavers presented arterial stenosis, while eight cases(61.5%) were positive for C. pneumoniae. CONCLUSIONS: This is the first report demonstrating C. pneumoniae in atheroma in Korea. In regard of the high positive rate of C. pneumoniae(89.3%) in cases of atherosclerosis, C. pneumoniae might be closely associated with atherosclerosis in Korea.
Antibodies, Monoclonal ; Atherectomy ; Atherosclerosis ; Cadaver ; Carotid Stenosis ; Cause of Death ; Cerebral Arterial Diseases ; Cerebral Arteries ; Chlamydia* ; Chlamydophila pneumoniae* ; Constriction, Pathologic ; Coronary Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Immunohistochemistry* ; Korea ; Plaque, Atherosclerotic ; Pneumonia ; Respiratory Tract Infections

A 60 year old male patient with a medical history of pulmonary tuberculosis presented with severe headaches and general weakness. Radiological studies revealed mass lesions both in the right using and the right cerebellar hemisphere. Clinically metastatic brain tumor and tuberculoma were highly suspected. The cerebella mass was totally excised and an unusual pathologic result was reported as botryomycosis. According to literatures reviewed, botryomycosis is a chronic bacterial infectious lesion resembling actinomycosis and mycotic abscess and it has been frequently reported in the skin, subcutaneous lesions and other visceral organs, but the cases of brain involvement were extremely rare. This article is a case report of a cerebellar botryomycosis. The pathologic characteristics and the differential diagnosis of botryomycosis are discussed.
Abscess ; Actinomycosis ; Brain ; Brain Neoplasms ; Diagnosis, Differential ; Headache ; Humans ; Male ; Middle Aged ; Skin ; Tuberculoma ; Tuberculosis, Pulmonary

Pulmonary embolism is one of the most common acute pulmonary disease in the adult general hospital populalion. However, the disease is still frequenfly unsuspected and underdiagnosed due to the nonspecifieity of both clinical findings and laboratory tests. The chest radiography in a patient suspected acute pulmonary embolism do not provide adequate information to establish or exclude the diagnosis of pulmonary embolism. Even in the case of infarction, there is no pathognomonic clues on the chest film. Rarely infarction presents unusual roentgenologic manifestation such as lobar consolidation, coin lesion, multinodular opacity, or massive pleural effusion. Especially, lobar consolidation in pulmonary embolism might mislead into the diagnosis of pneumonia. We experienced a case of pulmonary embolism presenting lobar consolidation in a 62 years old woman, originated from deep vein thrombosis. She took a compression stocking and underwent anticoagulant therapy with excellent outcome.
Adult ; Diagnosis ; Female ; Hospitals, General ; Humans ; Infarction ; Lung Diseases ; Middle Aged ; Numismatics ; Pleural Effusion ; Pneumonia ; Pulmonary Embolism ; Radiography ; Respiratory Insufficiency* ; Stockings, Compression ; Thorax ; Venous Thrombosis

PURPOSE: To investigate the error tendency between preoperative expected refraction and postoperative manifest refraction based on anterior chamber depth (ACD) and axial length (AXL) in cataract surgery cases and to report how ACD and AXL affect determination of intraocular lens (IOL) power. METHODS: We retrospectively studied 82 eyes of 62 patients who underwent cataract surgery in our hospital between August 2008 and January 2009. Anterior chamber depth and AXL were measured using IOL Master(R), and IOL power was calculated using the SRK II and SRK/T formulae. Patients were divided into three groups based on ACD and into another three based on AXL. Refractive error (RE) was analyzed one month after surgery. RESULTS: Though the RE of each group showed a tendency for hyperopic shifts, only those obtained with the SRK/T formula showed statistically significant differences between groups (p<0.05). Using the SRK/T formula, we found that an increasing AXL was associated with an increased hyperopic shift. This was more pronounced in those with shallow ACD (<2.5 mm), though the difference was not statistically significant. Similarly, an increase in ACD was associated with an increased hyperopic shift, and this difference was more pronounced in those with short AXL (<22.5 mm), and this time the difference was statistically significant. CONCLUSIONS: As ACD and AXL significantly affect RE, both should be considered when investigating postoperative RE tendency and when determining IOL power. Postoperative RE will be greatly affected by a short AXL or a shallow ACD, and therefore these factors should be considered in IOL power determination.
Anterior Chamber ; Cataract ; Eye ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Refractive Errors ; Retrospective Studies

Aggressive angiomyxoma is an uncommon soft-tissue neoplasm which affects the pelvis and genital organs of the young female predominantly. This tumor has a high tendency of local recurrence, but it usually does not develop metastasis. Although surgical excision with wide tumor-free margins may be necessary to obtain a complete cure, some of patients experience local recurrences. Many of the tumors are estrogen receptor (ER) and progesterone receptor (PR) positive and medical therapy with gonadotropin-releasing hormone (GnRH) agonists showed to be effective in a few cases. We present a case of 29-years-old women who has aggressive angiomyxoma which was misdiagnosed as bartholin duct cyst. She was treated by wide local excision with postoperative adjuvant GnRH agonist therapy for 3 months. She is now free of disease during 9 months of follow up. We have described this case with the brief of literature.
Estrogens ; Female ; Follow-Up Studies ; Genitalia ; Gonadotropin-Releasing Hormone ; Humans ; Myxoma ; Neoplasm Metastasis ; Pelvis ; Receptors, Progesterone ; Recurrence ; Vulva

For the treatment of carotid-cavernous fistula, detachable balloon occlusion(DBO) is the method of choice. When it fails, or when the fistula is incompletely occluded, alternative treatment methods include direct surgery and internal carotid artery occlusion at the proximal and distal portion of the fistula. Before ligation or occlusion of the internal carotid artery, however, coil embolization should be considered, as this preserves patent internal carotid artery. The authors used DBO in a 22-year-old male patient with carotid-cavernous fistula which developed after head injury. During the procedures the fistula was partially obstructed by one detachable balloon. In spite of several attempted occlusions with a second balloon, this could not be introduced into the small remnant fistula hole. The second stage of intervention involved embolization with a Guglielmi detachable coil(GDC) ; this was successfully introduced into the partially obstructed fistula, which was thus completely occluded, and the patient's clinical symptoms improved. In this case, GDC emboization was an effective tool for the treatment of carotid-cavernous fistula incompletely occluded by a detachable balloon.
Carotid Artery, Internal ; Craniocerebral Trauma ; Embolization, Therapeutic ; Fistula* ; Humans ; Ligation ; Male ; Young Adult