No abstract available.
Granular Cell Tumor*

We report a case of cutaneous sarcoidosis which occurred in a 32-year-old female who had, in addition to some cutaneous nodules, recently developed an acute spontaneous erythematous area of induration in old scars on her forehead and lower lip. Histopathologic findings revealed well-demarcated islands of epitheloid cells with a few giant, cells. In addition, slight admixture of lyrnphoid cells with present. at the margins of the epitheloid cell granulomas. Complete regression of the skin lesions was obtained with systemic steroid therapy without recurrence for some 8 months.
Adult ; Cicatrix ; Female ; Forehead ; Granuloma ; Humans ; Islands ; Lip ; Recurrence ; Sarcoidosis* ; Skin

A 52-year-old man was admitted with an incidentally detected right renal artery aneurysm (RAA). Computed tomographic angiography with three-dimensional reconstruction revealed that the aneurysm was 2.2 cm in diameter and located at the renal hilum. We performed hand-assisted laparoscopic nephrectomy with ex vivo repair of the RAA and auto-transplantation with minimal elongation of Gibson incision. The operation and postoperative course were uneventful. At last follow-up, the patient was alive with a well-functioning auto-transplant. Hand-assisted laparoscopic nephrectomy and auto-transplantation is a useful treatment option for hilar RAA.
Aneurysm* ; Angiography ; Follow-Up Studies ; Hand-Assisted Laparoscopy ; Humans ; Middle Aged ; Nephrectomy* ; Renal Artery*

Activation of the sympathetic nervous system in mediating the stress response attends traumatic brain injury. Plasma dopamine(DA), epinephrine(E), norepinephrine(NE) levels were measured in 26 severe traumatically brain injured patients to determine whether catecholamine levels obtained within 24 hours after injury provide reliable prognostic endogenous markers of outcome. Patient outcome was determine at 1 week using the Glasgow Coma Scale(GCS) and at the time of discharge the Glasgow Outcome Scale(GOS), 7 patients with diseases except those with a severe traumatic brain injury were selected as a control group. Firstly, we analyzed the difference of the average DA, E, and NE between the control group and severe traumatic brain injury patients. Secondly, we analyzed the difference of the average catecholamine levels in the 3 groups according to admission GCS scores(respectively 3~4, 5~7, 8~9). Third, we analyzed the difference of the average catecholamine levels in the 5 groups according to GOS scores at 1 week(respectively dead, 3~4, 5~7, 8~11, >11). Finally, we analyzed the difference of the average catecholamine levels in the 5 groups according to GOS at the time of discharge. As a result, there was no statical difference between the level of DA in the control group and those of the severe brain injury patients. But the level of E an NE in the experimental group were higher than the control group(respectively p<0.03, p<0.04). The admission GCS score correlated highly with the catecholamine levels(NE : r=0.69, p<0.001 ; E ; r=0.42, p<0.03 ; DA ; r=0.42, p<0.03). In patients with admission GCS of 3 to 4, NE levels increaed fourfold above other group(p<0.005). In the 13 patients with GCS scores of 3 or 4 on admission. NE levels predicted outcome at 1 week. All two patients with NE levels less then 750 pg/ml were survived, while 10 of 11 with NE levels greater than 750 pg/ml were died(p<0.02). The levels of NE was significantly higher in patients who died than in those with better outcome(p<0.02). Therefore, these findings indicated that the level of circulating NE is an excellent endogenous marker that appear to reflect the extent of brain injury and that may predict the likelihood of recovery.
Brain ; Brain Injuries* ; Coma ; Dopamine ; Epinephrine ; Humans ; Negotiating ; Norepinephrine ; Plasma* ; Prognosis* ; Sympathetic Nervous System

During the eleven months from September, 1989 to July, 1990, a total of 118 subarachnoid hemorrhage(SAH) patients were admitted. Among these, in 2 cases, the etiology was unknown and another 8 cases of Hunt & Hess clinical grade V patients died in the emergency room or intensive care unit within 24 hours after admission. The remaning 108 cases were managed with protocol as follows. 1) Surgery was done within 9 days after the SAH(total 67 cases) : Extraventricular drainage(EVD) was performed and a cisternal drainage(CD) catheter was positioned during surgery. EVD, CD nimodipine irrigation(0.4mg) through the CD catheter, and intravenous injection(IV) of nimodipine(1~2mg/hr)continued for 13days after the SAH. 2) Surgery was done after the 9th SAH day due to late transfer neurology or other hospitals or posterior circulation aneurysms(32 cases), and 9 cases refused surgery : Nimodipine was used orally(240mg/day) in 35 cases and an IV route(1~2mg/hr) in 6 cases. Total management outcome and results were obtained as follows. 1) A total unsatisfactory management outcome was 18.52%(serve disabled : 4.63%, vegetative : 0.93%, death : 12.96%. In the surgical cases only, 40.8%, 1.02%, 9.19%, respectively). 2) An unsatisfactory surgical outcome in cases following surgery after the 9th SAH day was 6.24%(severe disabled : 3.12%, death : 3.12%). 3) An unsatisfactory management outcome in cases of admission grades I & II following surgery within the 9th SAH day or those non-surgical patients was 19.15%(severe disabled : 4.25%, death : 14.89%. In surgical cases only 2.33%, 9.30%, respectively). 4) An unsatisfactory management outcome in cases of admission grades III & IV with surgery within the 9th SAH day or non-surgical patients was 29.63%(severe disabled : 7.41%, vegetative : 3.70%. death : 18.52%. In surgical cases only 9.09%, 4.55%, 13.64%, respectively). One case of admission grade V died. 5) Causes of unsatisfactory outcome were vasospasm : 9 cases(8.33%), SAH itself : 4 cases, rebleeding : 3 cases, surgical complication : 1 case, medical complication : 1 case, anesthesia : 1 case, and head trauma : 1 case. 6) Complications in management protocol with EVD, CD, CD nimodipine irrigation, and IV of nimodipine were transient hypotension(1 case) and meningitis(5 cases). These complications were improved without sequelae with discontinuing the IV of nimodipine and using antibiotics. We concluded that this protocol may improved the total management outcome of aneurysmal SAH patients, especially poor grade patients(Hunt & Hess grade III & IV) without significant complications. However, in spite of this protocol, the leading cause of an unsatisfactory outcome is vasospasm.
Anesthesia ; Aneurysm ; Anti-Bacterial Agents ; Catheters ; Craniocerebral Trauma ; Drainage* ; Emergency Service, Hospital ; Humans ; Intensive Care Units ; Intracranial Aneurysm* ; Neurology ; Nimodipine*

The purpose of the present study is to assess the effect of aging on left ventricular filling function and the relation between Doppler parameters of LV filling and radius/thickness ratio in an normal population and in hypertensive patients with left ventricular hypertrophy. We underwent M-mode echocardiography and pulsed Doppler measurement of the LV inflow in 123 normal controls and 78 hypertensive patinets with LVH. The results were as follows; 1) In hypertensive patients with LVH, the peak early velocity(60.9+/-13.5cm/sec)was significantly decreased, and the peak atrial velocity(78.9+/-19.6cm/sec)was significantly increased than that in normal controls(78.1+/-15.7cm/sec, 60.2+/-13.1cm/sec, P<0.005, respectively). 2) In the normal controls, peak early velocity correlated well with age(r=-0.388, -0.595, P<0.005, respectively), but not with radius/thickness ratio. 3) In the hypertensive patients with LVH, peak early velocity and the ratio of early to atrial velocity correlated with redius/thickness ratio (r=0.274 P<0.05, r=0.367 P<0.005, respectively), but not with age. In conclusion early LV diastolic filling is reduced and systolic is augmented, probably reflecting alteration in myocardial siffness with normal aging, whereas in chronic LVH, changes in radius/thickness ratio is more important determinants of ventricular compliance, overriding the effects of age.
Aging ; Compliance ; Echocardiography ; Humans ; Hypertrophy, Left Ventricular*

In humans, echinococcal species produce cystic lesions primarily involving the liver and lung. Echinococcal infection is caused far more commonly by Echinococcus granulosa than by E. multilocularis, which accounts for less than 5 percent of all cases of hydatid liver disease. Hydatid disease occurs principally in sheep grazing areas, particularly in the Australia, New Zealand, Greece, Yugoslavia, Middle East, and South American countries, but with increasing migration and traveling, this disease now has a worldwide distribution. This disease is rare in Korea and only few cases have been reported. This is a clinical case report of hydatid cyst of liver caused by Echinococcus granulosus in a 52-year-old man who had been dispatched in the Vietnam from 1966 to 1968.
Australia ; Echinococcosis* ; Echinococcus ; Echinococcus granulosus ; Greece ; Humans ; Korea ; Liver Diseases ; Liver* ; Lung ; Middle Aged ; Middle East ; New Zealand ; Sheep ; Vietnam ; Yugoslavia

To estimate the possibility of clinical application of TiN ion-plated Elgiloy(Co-Cr wire), measurements of tensile strength and hardness were made on the four tempers on each of the manufactured Elgiloy, the (heat-treated) Elgiloy for 30 minutes at 250degrees C and the TiN ion-plated Elgiloy. For comparison, the tensile strength and hardness of Stainless Steel wires were also measured. The following are the results of the study: · In the 4 tempers, tensile strength was the greatest in the TiN ion-plated group, followed by the heat-treated Elgiloy group and the manufactured Elgiloy group, but no statistical difference was noticed between heat-treated and manufactured Elgiloy groups(P<0.05). · In each temper, tensile strength- of ion-plated Elgiloy increased- about l0kgf/mm` in comparison with the values of the manufactured Elgiloy. · In yellow, green and red tempers except the blue, hardness was the greatest in ion-plated group. In the blue temper, there was no statistical difference between heat: treated and manufactured Elgiloy groups(P<0.05). · In each temper, hardness of ion-plated Elgiloy increased about 50-90VHN in comparison with the values of the manufactured Elgiloy. · The tensile strength of Stainless Steel wire was similar to that of the red temper of manufactured Elgiloy and the green temper of ion-plated Elgiloy.
Hardness ; Hot Temperature ; Orthodontic Wires* ; Stainless Steel ; Tensile Strength ; Tin*

We investigated normal response of bithermal caloric stimulation after repeated monothermal caloric stimulation. 12 subjects were selected for cold(30degreesC) water stimulation. 8 subjects were stimulated by warm(44degreesC) water. After the bithermal caloric test, caloric stimuli(cold or warm) was repeated 5 times on both ear with a 10 minute time interval and the next bithermal caloric test was performed. Monothermal caloric stimuli was done at the same temperature as the previous test a day later. The bithermal caloric test was repeated after 4 days. We checked the maximum slow phase eye velocity(SPEV) and calculated the canal paresis and directional preponderance. The SEPV was changed from 26.4(+/-10.9) degrees/sec to 26.7(+/-20.5) degrees/sec in repeated warm stimulation; from 25.0(+/-11.4) degrees/sec to 27.3(+/-11.1) degrees/sec in cold stimulation. Canal paresis was changed from 12.4(+/-8.7)% to 6.3(+/-5.1)% in repeated warm water stimulation; from 9.6(+/-9.9)% to 6.9(+/-3.1)% in cold stimuli. Directional preponderance was changed from 11.9(+/-6.9)% to 8.7(+/-9.9)% in warm stimuli; from 11.5(+/-7.6)% to 10.6(+/-5.5)% in cold stimuli. There was no significant change of caloric response after repeated monothermal caloric stimulation.
Caloric Tests ; Ear ; Paresis ; Water

Purpose: To report a case with corneal decompensation in a patient of pseudoexfoliation syndrome.Case summary: A 70-year-old woman was referred to our clinic to evaluate decreased visual acuity in the right eye. She had no history of previous ocular surgery or laser treatment. The best corrected visual acuity was 0.5 in both eyes. The patient had diffuse corneal edema in the epithelium and stroma in the right eye. The left eye showed diffuse endothelial pigment deposits. Deposition of pseudoexfoliation material on the iris and anterior lens capsule was observed in both eyes. The intraocular pressure was 15 mmHg in both eyes without treatment. Specular microscopy was limited in the right eye due to the corneal edema and the left eye showed endothelial cell loss, increased pleomorphism, and atypical guttata. Anterior segment optical coherence tomography revealed irregular thickening of the corneal stroma and protrusion of Descemet’s membrane in the right eye. Conclusions In patients with pseudoexfoliation syndrome, corneal decompensation can occur without intraocular pressure elevation and glaucomatous damage.