No abstract available.
Brain Edema* ; Brain* ; Decompressive Craniectomy*

BACKGROUND: Vasopressin has recently been recognized to have greater effect on improving blood flow to myocardium and brain during cardiac resuscitation than epinephrine and also improves rates of ROSC(return of spontaneous circulation) and survival in pre-hospital and in-hospital prolonged refractory cardiac angst patients who did not respond to the standard epinephrine treatment. This study was designed to investigate the effects of vasopressin on ROSC rates and survival rates in rat asphyxia arrest model. METHOD AND MATERIAL: Thirty male Sprague-Dawley rats were used. Anesthesia was induced with halothane and nitrous oxide and ventilatory cairo was maintained. EtCO2 was adjusted to 30-40mmHg and halothane was maintained. Right infernal carotid artery and right femoral vein were cannulated and EKG electrodes were attached. After 10 minutes of asphyxia, group 1 was treated with 1ml of saline, group 2 with 1ml(0.001mg/100g) of epinephrine and group 3 with 1ml(0.16u/100g) of vasopressin for resuscitation. Statistical significance was an analysed by SPSS with ANOVA and chi-square tests. RESULTS: No significant differences were seen in baseline measurements. Three ROSC and eight 60 minutes survivals were found in group 1, whereas nine ROSC and eight 60 minutes survivals were obtained in group 2 and all of the subjects in group 3 showed ROSC and 60 minutes survival, but no statistical differences were seen between group 2 and 3. CONCLUSION: Vasopressin seems to have similar effect on improving ROSC and survival rates compared to epinephrine in rat asphyxia models.
Anesthesia ; Animals ; Asphyxia* ; Brain ; Carotid Arteries ; Electrocardiography ; Electrodes ; Epinephrine* ; Femoral Vein ; Halothane ; Humans ; Male ; Myocardium ; Nitrous Oxide ; Rats* ; Rats, Sprague-Dawley ; Resuscitation* ; Survival Rate ; Vasopressins*

OBJECTIVE: Chronic subdural hematoma(CSDH) is usually treated by burr hole trephination and hematoma evacuation with closed drainage and the surgical result is relatively good in most reported series. But, some patients experience the recurrence of CSDH. We study the clinical factors related to the recurrence of CSDH. METHODS: 213 consecutive patients with CSDH who were treated with burr hole trephination and hematoma evacuation with closed drainage. The medical records, radiologic findings were reviewed retrospectively and clinical factors associated with the recurrent CSDH were analysed statistically. RESULTS: 8.4%(18 cases) of the 213 patients who were treated due to CSDH were recurred. The demographic variables such as age, sex, coexisting diseases were not related to the recurrence. The preoperative hematoma thickness and postoperative hematoma thickness were not associated with the recurrence. The only factor related to the recurrence is postoperative hematoma density in this study. CONCLUSION: This study shows that postoperative hematoma density was strongly related to the recurrence of CSDH. However, several factors associated with the recurrent CSDH were reported in the liletrature. Thus, further study will be needed to uncover the factors related to the recurrence of CSDH. Chronic subdural hematoma(CSDH);Recurrence;Postoperative hematoma density.
Drainage ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Medical Records ; Recurrence ; Retrospective Studies ; Trephining

No abstract available.

PURPOSE: To construct new Korean reference curves for birth weight by sex and gestational age using contemporary Korean birth weight data and to compare them with the Lubchenco and the 2010 United States (US) intrauterine growth curves. METHODS: Data of 2,336,727 newborns by the Korean Statistical Information Service (2008-2012) were used. Smoothed percentile curves were created by the Lambda Mu Sigma method using subsample of singleton. The new Korean reference curves were compared with the Lubchenco and the 2010 US intrauterine growth curves. RESULTS: Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles birth weight by gestational age were made using 2,249,804 (male, 1,159,070) singleton newborns with gestational age 23-43 weeks. Separate birth weight curves were constructed for male and female. The Korean reference curves are similar to the 2010 US intrauterine growth curves. However, the cutoff values for small for gestational age (<10th percentile) of the new Korean curves differed from those of the Lubchenco curves for each gestational age. The Lubchenco curves underestimated the percentage of infants who were born small for gestational age. CONCLUSION: The new Korean reference curves for birth weight show a different pattern from the Lubchenco curves, which were made from white neonates more than 60 years ago. Further research on short-term and long-term health outcomes of small for gestational age babies based on the new Korean reference data is needed.
Asian Continental Ancestry Group ; Birth Weight* ; Female ; Gestational Age* ; Growth Charts ; Humans ; Infant ; Infant, Newborn ; Information Services* ; Male ; United States

OBJECTIVE: In severe head injury or postoperative patients with increased intracranial pressure(IICP) in spite of indroducing barbiturate coma therapy, mannitol, and diuretics infusion, we try hypertonic saline infusion therapy as a new treatment modality and observe its relating results and complications. METHODS: Eleven patients that were treated using hypertonic saline infusion were analyzed. They showed decreased Glasgow coma scale(GCS) or aggravated brain swelling on brain CT scan in spite of conventional therapy for IICP using barbiturate coma and mannitol infusion. We infused 3% hypertonic saline with the rate of 40~60cc/hour. Our goal in using 3% hypertonic saline is to increase the serum sodium level in the range of 150 to 155mEq/l. Serum electrolyte level were monitored every 6 hours and the rate of infusion was controlled according to the current serum sodium level. The therapy was continued until each patient demonstrated clinical improvement, complication of therapy, or lack of response. RESULTS: Six cases showed improvement of GCS. One case was expired due to lung problem even though GCS was improved. Two cases showed persistent vegetative state and other 2 cases never showed any response. All expired cases were head injury patients whose GCS score were lower than 5. There was no hypertonic saline infusion related complications. CONCLUSION: Hypertonic saline therapy are very easy and effective adjunctive therapeutic modality for the patient with severely IICP that is refractory to conventional method. To establish this method as standard therapeutic regimen for the intracranial hypertension, more cases analysis should be necessary to confirm the safety and effectiveness.
Brain ; Brain Edema ; Coma ; Craniocerebral Trauma ; Diuretics ; Humans ; Intracranial Hypertension ; Intracranial Pressure* ; Lung ; Mannitol ; Persistent Vegetative State ; Sodium ; Tomography, X-Ray Computed

No abstract available.
Echocardiography ; Myocardial Infarction*

Rathke's cleft cysts are believed to be derived from remnants of Rathke's pouch, a dorsal invagination of the stomodeum. Although these cysts are characteristically small, asymptomatic and intrasellar in location, they occasionally provoke symtoms with enlargement to compress surrounding structures. It is characteristically lined by stratified squamous epithelium with keratinization on a layer of connective tissue. The cells of the anterior pituitary lobe, from which pituitary adenomas develop, are also formed by the proliferation of the anterior wall of Rathke's pouch. Thus, Rathke's cleft cyst and pituitary adenomas are considered to have a common ancestry. We report a rare case in which the preoperative diagnosis was pituitary adenoma, but the pathologic diagnosis was a combination of a Rathke's cleft cyst and a coincidental pituitary adenoma.
Adenoma* ; Central Nervous System Cysts ; Connective Tissue ; Diagnosis ; Epithelium ; Pituitary Neoplasms*

The purpose of the present study was to investigate the relationship of dental crowding to tooth size and arch dimension in Korean subjects. Two groups of dental casts with Class I molar relationship, were selected on the basis of crowding. One group, consisting of 82 pairs of study cast (29 males and 53 females), exhibited at least 7 millimeters of crowding in each arch. A second group, consisting of 82 sets of study cast (37 males and 45 females), exhibited normal occlusion with little or no crowding. Mesiodistal tooth diameters, and buccal and lingual dental arch widths were measured and compared between the crowding and normal occlusion groups. Significant differences were observed between the two groups not only in arch widths but also in tooth sizes. The results of the present study suggest that both etraction and expansion can be used as a treatment approach for the crowding cases.
Dental Arch ; Humans ; Male ; Malocclusion ; Molar ; Tooth*

OBJECTIVE: The aim of this study was to analyze the treatment results and prognostic factors in patients with massive cerebral infarction who underwent decompressive craniectomy. METHODS: From January 2000 to December 2005, we performed decompressive craniectomy in 24 patients with massive cerebral infarction. We retrospectively reviewed the medical records, radiological findings, initial clinical assessment using the Glasgow Coma Scale, serial computerized tomography (CT) with measurement of midline and septum pellucidum shift, and cerebral infarction territories. Patients were evaluated based on the following factors : the pre- and post-operative midline shifting on CT scan, infarction area or its dominancy, consciousness level, pupillary light reflex and Glasgow Outcome Scale. RESULTS: All 24 patients (11 men, 13 women; mean age, 63 years; right middle cerebral artery (MCA) territory, 17 patients; left MCA territory, 7 patients) were treated with large decompressive craniectomy and duroplasty. The average time interval between the onset of symptoms and surgical decompression was 2.5 days. The mean Glasgow Coma Scale was 12.4 on admission and 8.3 preoperatively. Of the 24 surgically treated patients, the good outcome group (Group 2 : GOS 4-5) comprised 9 cases and the poor outcome group (Group1 : GOS 1-3) comprised 15 cases. CONCLUSION: We consider decompressive craniectomy for large hemispheric infarction as a life-saving procedure. Good preoperative GCS, late clinical deterioration, small size of the infarction area, absence of anisocoria, and preoperative midline shift less than 11mm were considered to be positive predictors of good outcome. Careful patient selection based on the above-mentioned factors and early operation may improve the functional outcome of surgical management for large hemispheric infarction.
Anisocoria ; Brain Edema ; Cerebral Infarction* ; Consciousness ; Decompression, Surgical ; Decompressive Craniectomy ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Humans ; Infarction ; Intracranial Pressure ; Male ; Medical Records ; Middle Cerebral Artery ; Patient Selection ; Reflex ; Retrospective Studies ; Septum Pellucidum ; Tomography, X-Ray Computed