OBJECTIVE: The goal of this study was to review the etiologies, phathophysiology, clinical presentations and to compare the results of the surgical methods of subdural empyema especially in infants. PATIENTS AND METHODS: We reviewed the clinical data of five infantile subdural empyemas experienced in our hospital from 1993 to 1998 which were all surgically treated by craniotomy or burr hole trephination. We experienced five cases of infantile subdural empyema: two males and three females. The ages ranged from 40 days to 11 months. RESULTS: The etiologies of all five cases were unproven but all five cases had meningitis before the subdural empyemas were diagnosed. The causative organism in one was streptococcus pneumoniae, and the other were unknown. Two were treated with craniotomy(one with a good outcome and the other died) and three were treated with burr hole trephination(all three had a good outcome). CONCLUSION: Subdural empyema is a rapid progressing disease and it is important to detect and treat in the early stages of disease. The choice of surgical method must be based on the stage of the disease and its location in the cranial cavity.
Craniotomy ; Empyema, Subdural* ; Female ; Humans ; Infant* ; Male ; Meningitis ; Streptococcus pneumoniae ; Trephining

OBJECT: Object of this study is to study which factors affect the prognosis in spontaneous thalamic hemorrhage treated with conservative method, stereotactic surgery and extraventricular drainage. MATERIAL AND METHODS: We analyzed 127 patients with spontaneous thalamic hemorrhage for evaluating the factors affecting prognosis. Various factors such as age, sex, location of hematoma, Glasgow coma scale(GCS) on admission, intraventricular hemorrhage(IVH), ventricular dilatation, CT classification, hematoma diameter, 4th ventricle dilatation, and treatment modality. RESULTS: The results were as follows: 1) Of the 40 patients with GCS of 3 to 8, 15 patients(37.5%) died. Of the 34 patients with GCS of 13-15, 33 patients(97%) survived 2) The 99 patients had intraventricular hemorrhage and 25 patients(25.2%) died. The 28 patients had no intraventricular hemorrhage and they all survived. 3) Of the 24 patients in whom the cerebrocaudate index(CCI) was more than 0.25, 10 patients(41.6%) died and only 2 patients had good prognosis. The 35 patients had no ventricular dilatation and all 35 patients survived 4) Of the 23 patients extending to hypothalamus or midbrain with ventricular hemorrhage, 11 patients(47.8%) died and 12 patients(52.1%) survived. 5) Of the 10 patients in whom hematoma diameter was more than 45mm, 4 patients(40%) died and 6 patients(60%) had a poor prognosis. 6) The 31 patients had hemorrhagic dilatation of the fourth ventricle and 16 patients(51.6%) died. Of the 29 patients with ventricular hemorrhage and no dilatation, 6 patients(20.6%) died. CONCLUSION: Multiple logistic regression analysis showed prognostic factors: GCS score(p<1/20.0001), extending to hypotahalamus or midbrain with ventricular hemorrhage(p<1/20.0001), thalamic hematoma with IVH(p<1/20.0001), dilated 4th ventricle hemorrhage(p<1/20.0012), hematoma diameter(p<1/20.0001), CCI(p<1/20.0001).
Classification ; Coma ; Dilatation ; Drainage ; Fourth Ventricle ; Hematoma ; Hemorrhage* ; Humans ; Hypothalamus ; Logistic Models ; Mesencephalon ; Prognosis

Two cases of post-traumatic arterial priapism diagnosed with duplex and color Doppler ultrasonography showed pseudoaneurysm and increased peak systolic and diastolic velocity of the inflowing cavernosal artery(low resistance index). An autologous blood clot successfully controlled tumescence and was comfortable and secure in preventing necrosis and impotence.
Aneurysm, False ; Embolization, Therapeutic* ; Erectile Dysfunction ; Male ; Necrosis ; Priapism* ; Ultrasonography, Doppler, Color

Melanosis ilei is a condition that's characterized by gross greyish-black or brownish-black pigmentation of the mucosa of the terminal ileum. There were several substances that produce gastrointestinal tract pigmentation such as lipofuscin, iron sulphide (FeS), Hemosiderin and exogenous material such as silicates and titanium. We report here on a case of a 58-year-old female who ingested charcoal for a long time, and she was diagnosed with melanosis ilei by colonoscopy. Her condition improved after she stopped ingesting the charcoal.
Charcoal ; Colonoscopy ; Female ; Gastrointestinal Tract ; Hemosiderin ; Humans ; Ileum ; Iron ; Lipofuscin ; Melanosis* ; Middle Aged ; Mucous Membrane ; Pigmentation ; Silicates ; Titanium

INTRODUCTION: Protamine reversal of heparin anticoagulation in patients often produces profound hypotension. The present study was aimed to investigate the effectiveness of pretreatment with a small dose (0.5 mg.kg (-1)) of protamine in attenuating protamine-induced systemic hypotension in heparinized dogs. METHODS: Forty mongrel dogs were pretreated with either intravenous saline (control group, n=19) or protamine 0.5 mg.kg (-1) (protamine group, n=11) 5 minutes after heparin (300 IU.kg (-1), iv) during 1.5% halothane anesthesia. All dogs were then given protamine 3 mg.kg (-1) over a period of 30 s through right atrium 10 minutes after the pretreatment. Mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), left ventricular end-diastolic pressure (LVEDP), heart rate (HR), and cardiac output and left circumflex coronary flow (LCX flow) via Doppler flowmeter were continuously recorded in baseline conditions and up to 20 minutes. Calculated parameters included cardiac index (CI), systemic and pulmonary vascular resistance indices (SVRI and PVRI), and LV dp/dt. RESULTS: In the control group, protamine infusion caused immediate but transient decreases of MAP (-42%), CI (-58%), LVEDP (-53%) and dP/dt (-25%), and increases of MPAP (39%), SVRI (38%) and PVRI (4.0 fold). Protamine pretreatment significantly attenuated but not completely blocked the hemodynamic responses to protamine. LCX flow increased significantly (213~258%) immediately after protamine infusion in both groups. CONCLUSIONS: These results suggest that, in the heparinized dog, pretreatment with a small dose of protamine attenuates the degree of hypotension that may follow the rapid administration of protamine.
Anesthesia ; Animals ; Arterial Pressure ; Cardiac Output ; Dogs* ; Flowmeters ; Halothane ; Heart Atria ; Heart Rate ; Hemodynamics ; Heparin* ; Humans ; Hypotension* ; Vascular Resistance

OBJECTIVES: Gallium 67(Ga-67) scintigraphy has been used to diagnose inflammatory and neoplastic diseases. We undertook a study to determine the clinical value of Ga- 67 renal scan in patients with various glomerular diseases. METHODS: Ga-67 scintigraphy was performed in 48 patients with various biopsy proven forms of renal diseases. Renal uptake in 48 patients images was graded as follow: Grade 0 = not visualization at 48 hours: 1 = faintly visualize: 2 = equal to uptake in spine: 3 = greater than over the spine: 4 = greater than activity over the liver. RESULTS: 1) Of the 48 patients, 31 were male, and mean age was 32 years. 11 patients had hypertension and 29 patients had hematuria. 2) Positive scintigram were seen in 40 of 48(83%) cases. In results of renal biopsy, IgA nephropathy(IgAN) was 15 patients, minimal change disease(MCD) was 14, focal segmental glomerulosclerosis (FSGS) was 8, membranoproliferative glomerulonephritis (MPGN) was 3, lupus nephritis(LN) was 3, poststreptococcal glomerulonephritis(PSGN) was 3 and membranous glomerulonephritis(MGN) was 2. 3) In 26 patients (54%) with nephrotic-range proteinuria, Grade 2 or higher renal uptake was observed in 9 (75%) of MCD, 5(100%) of FSGS, 2(100%) of LN and 3(75%) of IgAN. 4) In comparision nephrotics with non-nephrotics at biopsy, renal Ga-67 uptake in who patients had nephrotic-range proteinuria was correlated with clinical severity determined by serum albumin, serum total cholesterol and 24 hours urine protein excretion. CONCLUSIONS: Renal Ga-67 scintigraphy may be able to be a predictor in the assessment for severity of nephrotic syndrome.
Biopsy ; Cholesterol ; Gallium ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Hematuria ; Humans ; Hypertension ; Immunoglobulin A ; Liver ; Male ; Nephrotic Syndrome ; Proteinuria ; Radionuclide Imaging* ; Serum Albumin ; Spine

BACKGROUND: Protamine sulfate has been found to produce systemic hypotension secondary to acute pulmonary vasoconstriction and subsequent right heart failure in pigs and sheep. Nitric oxide (NO) is a potent pulmonary vasodilator. The present study was aimed to determine whether NO inhalation prevents hypotension in an open-chest canine model. METHODS: With IRB approval, 29 mongrel dogs were acutely instrumented during 1.5% enflurane anesthesia. All animals then received protamine 3 mg/kg over 30 s given through right atrium, 5 min after heparin (300 IU/kg, iv). NO inhalation was done for 20 min beginning 10 min before protamine infusion (NO group, n = 10). Control group was without NO inhalation (n = 19), which was retrospectively divided into two groups according to the magnitude of pulmonary arterial pressure (PAP) increase: normal PAP group (increase in PAP less than 6 mmHg, n = 9) and pulmonary hypertensive group (increase in PAP more than 6 mmHg, n = 10). Mean arterial pressure (MAP), PAP, left ventricular end-diastolic pressure (LVEDP), heart rate (HR), and cardiac output and left circumflex (LCX) coronary flow via a Doppler flowmeter were continuously monitored. Calculated parameters included cardiac index (CI), and systemic and pulmonary vascular resistance indices (SVRI and PVRI). RESULTS: Protamine increased PAP (66 vs 7%) and PVRI (5.1- vs 3.0- fold) more pronouncedly in pulmonary hypertensive than in normal group. However, protamine caused similar reductions of MAP (-40 vs -46%), CI (-60 vs -59%), and LVEDP (-47 vs -53%) in pulmonary hypertensive and normal groups. SVRI showed a biphasic response in both groups, an initial decrease (-15 vs -14%), followed by an increase (48 vs 25%, P<0.05). Continuous inhalation of NO at 80 ppm did not affect the protamine-induced reductions in MAP (-40%), CI (-55%), and LVEDP (-46%) and increases in PAP (45%) and PVRI (4.1-fold). LCX flow increased immediately after the protamine treatment in all groups to a similar magnitude (83-130%), indicating a rapid release of potent vasodilators. CONCLUSIONS: Protamine produces profound hypotension, which may not be causally related to an acute pulmonary vasoconstriction in the dog. It is unlikely that exogenous NO treatment affects hypotension.
Anesthesia ; Animals ; Arterial Pressure ; Cardiac Output ; Dogs* ; Enflurane ; Ethics Committees, Research ; Flowmeters ; Heart Atria ; Heart Failure ; Heart Rate ; Heparin ; Hypotension* ; Inhalation ; Nitric Oxide* ; Protamines ; Retrospective Studies ; Sheep ; Swine ; Vascular Resistance ; Vasoconstriction ; Vasodilator Agents

OBJECTIVES: This study was conducted to examine the preferences and needs of typical Korean females adults for food and nutrition information provided by the mass media. METHODS: A total of 343 females (77 in their 20s, 85 in their 30s, 88 in their 40s and 93 in their 50s) residing in the Seoul/Gyeonggido area was surveyed on general characteristics, main sources of food and nutrition information and needs for sources and contents of nutrition information. RESULTS: The survey showed that typical Korean females obtained knowledge of food and nutrition mainly through the Internet (30.4%) and broadcasting (29.0%). Typical Korean females were interested in 'dietary management for weight control' (21.9%), 'the prevention and treatment of disease' (20.0%), 'food safety' (16.8%), 'proper dietary habits' (14.6%), 'cookery' (11.8%), 'functional foods' (9.6%), 'restaurant details' (3.5%) and 'life-cycle-specific dietary guideline' (1.6%). Needs for food and nutrition program forms on TV were 'educational programs' (34.3%), 'documentaries' (20.8), 'expert lecture-style' (13.0%), 'entertainment programs' (11.9%), 'expert conversation' (11.4%), 'news-style' (4.6%) and 'public campaign advertisements' (4.0%). On the Internet, 38.6% of the respondents preferred to get information provided by food and nutrition-related institutions (38.6%) while 26.1% preferred webtoons for nutritional information. The favored forms in mobile applications were 'monitoring their diets' (29.5%), 'data-based texts information' (21.4%), 'experts feedback' (20.6%), 'communities' (15.1%) and 'games' (13.1%). The rates of the preference to obtain information from experts such as nutritionists and dietitians and doctors - or dietitian turned reporters increased markedly with older ages. CONCLUSIONS: Since the mass media is a main source of food and nutrition information for the general public, the effectiveness and accuracy of the information provided should be enhanced by taking the needs of the public into account. The quality of information should be improved by involving more nutrition experts.
Adult* ; Surveys and Questionnaires ; Female ; Humans ; Internet ; Mass Media* ; Mobile Applications ; Nutritionists

The clinical manifestations related to iliopsoas bursitis can vary due to compression of the adjacent structure such as the common femoral vein, nerve and bladder. We report here on a rare case of iliopsoas bursitis with compression of the common femoral vein that resulted in acute lower leg edema.
Bursitis* ; Edema* ; Femoral Vein* ; Leg* ; Urinary Bladder

BACKGROUND: Effects of fentanyl, sufentanil, meperidine, and morphine on the spontaneous contractility of isolated human pregnant uterine muscle strips were determined. METHODS: Uterine specimens were obtained from normal full-term parturients undergoing elective lower-segment cesarean section. Longitudinal muscle strips were made and mounted individually and vertically in tissue chambers to record their isometric tension. After establishment of rhythmic contractions in the buffer solution, opioid concentration-response curves were constructed. The responses to opioids were repeated in the presence of opioid receptor blocker, nitric oxide synthase inhibitor, beta-adrenoceptor blocker, or cyclo-oxygenase inhibitor. RESULTS: Fentanyl and meperidine caused concentration-dependent decreases of the uterine contractility, their IC50 (concentration which causes 50% inhibition of the amplitude of spontaneous contractions) being 6.8 x 10(-6) M and 2.2 x 10(-3) M, respectively. On the contrary, sufentanil and morphine were without significant effects on the contractility. Pretreatment with either naloxone, N(G)-nitro-L-arginine methyl ester, atenolol, or indomethacin did not affect the uterine responses to opioids. CONCLUSIONS: These results demonstrate that fentanyl and meperidine may have direct inhibitory effects on the contractility of the human uterus. However, the opioid concentrations needed to significantly reduce the uterine contractility were at a supraclinical range.
Analgesics, Opioid* ; Animals ; Atenolol ; Cesarean Section ; Female ; Fentanyl ; Humans* ; Indomethacin ; Inhibitory Concentration 50 ; Meperidine ; Mice ; Morphine ; Myometrium* ; Naloxone ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Pregnancy ; Prostaglandin-Endoperoxide Synthases ; Receptors, Opioid ; Sufentanil ; Uterus