A prospective analysis of 80 consecutive operated cases of aneurysm were carried out to know the prognostic factors in intracranial aneurysmal surgery. Analysis of end-results with respect to aneurysmal locations and timing of operation showed that the internal carotid artery aneurysm did not make difference in outcome regardless of the timing of surgical intervention, but anterior cerebral artery, middle cerebral artery, and multiple aneurysm were more poor outcomes in the early surgical group(p<0.05). The more grave initial neurological state showed the worse surgical end-results. The poor results were shown in cases of above 3 mm in thickness of the basal cisternal hemorrhage and/or above 30 ml in volume of the intracerebral hematoma on the brain CT scan. During the operation, no sunkened brain, a spasm of offending artery, premature rupture of aneurysm, and post-operative residual intracerebral hematoma were also adverse effects to the post-operative outcomes.
Aneurysm ; Anterior Cerebral Artery ; Arteries ; Brain ; Carotid Artery, Internal ; Hematoma ; Hemorrhage ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Prospective Studies ; Rupture ; Spasm ; Tomography, X-Ray Computed

Neurilemmoma, also called schwanomma, neurinoma, and perineural fibroblastoma is a rare benign tumor originated from the schwann cell of nerve sheath. They occur commonly at 20-50 aged person and involved the head and neck and flexor surface of the extremity. Histologically, they are characterized by Antoni A and Antoni B tissue composed of high and low cellularity. Primary neurilemmoma involved in the bronchial wall is extremely rare and few cases have been reported previously. We experienced neurilemmoma of the bronchial wall in a 72 year old woman The pulmonary radiology showed the right middle lobe collapse with single lymphadenopathy, and bronchoscopic biopsy was performed to confirm the neurilemmoma.
Aged ; Biopsy ; Extremities ; Female ; Head ; Humans ; Lymphatic Diseases ; Neck ; Neurilemmoma*

BACKGROUND: Angiocentric T-cell lymphomas are rare T-cell malignancies which involve extranodal sites, such as the skin, nasal cavity, soft tissue and gastrointestinal tract. They have been reported with significant frequency in Asia. OBJECTIVES: The main objective of this study is to characterize the clinical, pathological, and immunohistochemical featnres of cutaneous angiocentric T-cell lymphoma. Another objective is to search for the Epstein-Barr virus (EBV) in the tissues of cutaneous angiocentiric T cell lymphoma. METHODS: Clinical records, laboratory data, and histopathologic sections of 12 patients with cutaneous angiocentric T-cell lymphoma were reviewed. Paraffin tumor tissues were immunophenotyped. In situ hybridizaion studies were performed to detect the EBV genomes. RESULTS: The ages of the 12 patients ranged from 34 to 64 years(mean 45.8 years). The cutaneous lesions were nodules or plaqes, and were with ulcerated or had intact skin. Eight patients had evidence of extracutaneous involvement, usually involving lymph nodes, liver, and spleen. Eleven patients showed the abnormal laboratory findings including anemia, leukopenia, and elevated level of LDH. The disease pursued an aggressive course and was not uncommonly resistant to treatment. Histologically, the lymphomatous infiltrate occurred predominantly in the subcutaneous layer with involvement of the dermis. The pattern was mainly perivascular and periadnexal. A prominent feature was invasion of small or medium vesselsby lymphoma cells. The infiltrating lymphrcytes expressed CD45RO in all cases; variable expression of CD3 and CD56 was detected in piaffin sections. Among the 11 cases where in situ hybridization was performed, EBV genome could be detected in 9 cases. CONCLUSION: Angiocentric T-cell lymphoma of the skin is an aggressive lymphoma distinct from classic cutaneous T-cell lymphoma. However, further studies are needed to regard them as a homogeneous entity of T-cell lymphoma involving the skin.
Anemia ; Asia ; Dermis ; Gastrointestinal Tract ; Genome ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leukopenia ; Liver ; Lymph Nodes ; Lymphoma* ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous ; Nasal Cavity ; Paraffin ; Skin* ; Spleen ; T-Lymphocytes ; Ulcer

OBJECTIVE: Unilateral percutaneous vertebroplasty is a widely accepted treatment for osteoporotic vertebral compression fractures (VCFs). However, bone cement may fail to fill both hemivertebra from the single needle. We assessed the radiographic and clinical outcome of hemivertebroplasty (HVP) and evaluated the factors that affect subsequent VCFs after HVP. METHODS: Fifty two patients who underwent HVP were reviewed. VCFs were identified based on clinical and radiological findings. The patients were grouped into two groups: 1) no subsequent VCFs, 2) subsequent VCFs. We evaluated the association between age, sex, body mass index (BMI) and bone mineral density (BMD) and subsequent VCFs. We also assessed the impact of location, type and grade of fracture, endplate fracture, burst fracture, bone cement volume on subsequent VCFs. We analyzed the compression ratio, wedge angle, kyphotic angle, and visual analogue scale (VAS) score in both groups. RESULTS: There were no significant differences in age, gender, BMI, and BMD between two groups. No significant difference was also found in pre-existing VCF, location, type and grading of fracture, endplate fracture, burst fracture, amount of bone cement, and radiological findings such as compression ratio, wedge angle, and kyphotic angle between two groups. The final mean VAS scores of patients with or without subsequent VCFs were 3.11 and 4.02, respectively. CONCLUSION: No major risk factors for the subsequent VCFs after HVP were found. However, we identified adjacent fractures, refractures, and remote fractures after HVP in chronological order. Therefore, long-term follow-up is necessary to evaluate the effectiveness of HVP to osteoporotic VCFs.
Body Mass Index ; Bone Density ; Follow-Up Studies ; Fractures, Bone ; Fractures, Compression ; Humans ; Needles ; Osteoporotic Fractures ; Risk Factors ; Vertebroplasty

The effect of fermentation parameters and medium composition on the simultaneous mycelial growth and exo-polymer production from submerged cultures of Ganoderma applanatum was investigated in shake-flask cultures. The optimum initial pH for mycelial growth and exo-polymer production was 5.0 and 6.0, respectively. The optimum temperature was 25degrees C and the optimum inoculum content was 3.0% (v/v). The optimal carbon and nitrogen sources were glucose and corn steep powder, respectively. After 12 days fermentation under these conditions, the highest mycelial growth was 18.0 g/l and the highest exo-polymer production was 3.9 g/l.
Carbon ; Fermentation ; Ganoderma ; Glucose ; Hydrogen-Ion Concentration ; Nitrogen ; Zea mays

We experienced 3 cases of early stage tubal cancer incidentally recognized during the operation and diagnosed pathologically after surgery of the tubo-ovarian abscess, the symptomatic adenomyosis, the myoma with adnexal cyst patients, so we report our cases with a review of the literature.
Abscess ; Adenomyosis ; Humans ; Myoma

OBJECTIVE: The purpose of this study was to evaluate the risk of cesarean section in nulliparous women who undergone induction at postterm pregnancy. METHODS: The retrospective study was conducted from March, 1997 to March, 2005 by reviewing 331 nulliparous patients more than 41 weeks' gestation delivered after induction at our Hospital. The evaluated variables to assess the risk of cesarean section were maternal age, body mass index (BMI), gestational age (GA), Bishop scores (BS), fetal body weight (FBW), fetal head circumference (FHC) and fetal sex. t-test and x2-test were used to compare these categorical variables. RESULTS: The study included 331 nulliparous singleton pregnant women undergoing elective induction for postterm pregnancy: 127 (38.4%) delivered babies by cesarean section due to induction failure, progression failure and fetal distress, whereas 204 (61.6%) delivered vaginally. The mean maternal ages were 27.59+/-2.57 in cesarean delivery group and 26.99+/-2.61 in vaginal delivery group. The average values of BMI at postterm in cesarean and vaginal delivery groups were 26.70+/-2.82 and 25.75+/-2.67 kg/m2. GA was 41.36+/-0.27 weeks in cesarean delivery group, whereas 41.20+/-0.19 weeks in vaginal delivery group. The average FBW and FHC were 3460.31+/-358.22 g and 34.59+/-1.18 cm in cesarean delivery group, compared to 3363.95+/-361.22 g and 34.03+/-1.34 cm in vaginal delivery group. CONCLUSION: The BMI, FBW and FHC have linked to the risk of cesarean delivery in nulliparous women who underwent elective induction. Thus, these information would provide the useful tools to assess the risk of cesarean section in postterm nulliparous patients for planning an induction.
Body Mass Index ; Cesarean Section* ; Female ; Fetal Distress ; Fetal Weight ; Gestational Age ; Head ; Humans ; Maternal Age ; Pregnancy ; Pregnancy* ; Pregnant Women ; Retrospective Studies

This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the PHQ-15. The primary endpoint was a responder rate defined by the total score of IPSS (< or = 7) at the end of treatment. The LUTS/BPH severity was significantly higher in patients with depression (whole symptoms P = 0.024; storage sub-symptom P = 0.021) or somatization (P = 0.024) than in those without, while the quality of life (QOL) was significantly higher in patients with anxiety (P = 0.038) than in those without. Anxious patients showed significantly higher proportion of non-response (odds ratio [OR], 3.294, P = 0.022) than those without, while somatic patients had a trend toward having more non-responders (OR, 2.552, P = 0.067). Our exploratory results suggest that depression, anxiety and somatization may have some influences on the clinical manifestation of LUTS/BPH. Further, anxious patients had a lower response to treatment in patients with LUTS/BPH. Despite of limitations, the present study demonstrates that clinicians may need careful evaluation of psychiatric symptoms for proper management of patients with LUTS/BPH.
Anxiety/epidemiology/*psychology ; Causality ; Comorbidity ; Depression/epidemiology/*psychology ; Humans ; Lower Urinary Tract Symptoms/epidemiology/prevention & control/*psychology ; Male ; Middle Aged ; Outcome Assessment (Health Care)/methods ; Prostatic Hyperplasia/epidemiology/*psychology/*therapy ; Psychometrics/methods ; Republic of Korea/epidemiology ; Risk Factors ; Severity of Illness Index ; Somatoform Disorders/epidemiology/*psychology ; Treatment Outcome

This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the PHQ-15. The primary endpoint was a responder rate defined by the total score of IPSS (< or = 7) at the end of treatment. The LUTS/BPH severity was significantly higher in patients with depression (whole symptoms P = 0.024; storage sub-symptom P = 0.021) or somatization (P = 0.024) than in those without, while the quality of life (QOL) was significantly higher in patients with anxiety (P = 0.038) than in those without. Anxious patients showed significantly higher proportion of non-response (odds ratio [OR], 3.294, P = 0.022) than those without, while somatic patients had a trend toward having more non-responders (OR, 2.552, P = 0.067). Our exploratory results suggest that depression, anxiety and somatization may have some influences on the clinical manifestation of LUTS/BPH. Further, anxious patients had a lower response to treatment in patients with LUTS/BPH. Despite of limitations, the present study demonstrates that clinicians may need careful evaluation of psychiatric symptoms for proper management of patients with LUTS/BPH.
Anxiety/epidemiology/*psychology ; Causality ; Comorbidity ; Depression/epidemiology/*psychology ; Humans ; Lower Urinary Tract Symptoms/epidemiology/prevention & control/*psychology ; Male ; Middle Aged ; Outcome Assessment (Health Care)/methods ; Prostatic Hyperplasia/epidemiology/*psychology/*therapy ; Psychometrics/methods ; Republic of Korea/epidemiology ; Risk Factors ; Severity of Illness Index ; Somatoform Disorders/epidemiology/*psychology ; Treatment Outcome

Intracranial pressure was monitored in 23 patients, either who exhibited an increase in pressure or who were considered at risk for the developement of intracranial hypertention. The intracranial pressure was measured while the patient was in the position from supine to 50 degree of head elevation. The intracranial pressure was decreased during head elevation, but 8 cases(34.8%) were not changed. The maximal cerebral perfusion pressure was seen at 50 degree of head elevation(52.2%), next 30 degree(21.7%) and 40 degree(7.4%) in orders. The changes of vital sign were not significant during head elevation. To control the intracranial pressure, the patient who were managed in the position of 30degrees and 50degrees head elevation showed most effective cerebral perfusion pressure without any significant changes of the vital sign and central venous pressure.
Central Venous Pressure ; Head* ; Humans ; Intracranial Pressure* ; Perfusion* ; Vital Signs*