No abstract available.
Communicable Diseases* ; Zinc*

Three cases of giant pituitray adenoma are reported. Two cases were operated by transsphenoidal approach and a case by transcranial approach. Transsphenoidal approach showed satisfactory results despite of marked suprasellar extension of tumors. We report rare giant pituitary adenomas with review of relevant literatures.
Adenoma ; Pituitary Neoplasms*

No abstract available.
Carcinoma, Transitional Cell*

The use of steroids has long been reported many side effects. Steroid-induced mental disorder is one of many complications associated with corticosteroid therapy. Steroid psychosis is not common disease but it may be more popular due to high steroid therapy such as pulse therapy or high dose steroid therapy. Euphoria, irritability, insomnia, and hallucination are predominating symptoms. The dosage, duration of the treatment may not be correlated with the time of the onset, duration, severity, or type of mental disturbances, but the risk of developing psychosis is increased to the high dose of steroid. It is usually reversible on dose reduction or discontinuation of the drug.
Euphoria ; Hallucinations ; Mental Disorders ; Psychotic Disorders* ; Sleep Initiation and Maintenance Disorders ; Steroids

PURPOSE: The purpose of this study was to analyze the characteristic MR findings of childhood metachromatic leukodystrophy. MATERIALS AND METHODS: Five female patients (10--29 months old;mean age, 21.8 months) of biochemically confirmed metachromatic leukodystrophy were included in this study. We evaluated the extent of white matter degeneration, which was shown as high signal intensity on T2-weighted image, and the presence or absence of the enhancement. Result.' All 5 cases showed high signal intensity in periventricular deep white matter and centrum semiovale which were bilateral, symmetric and confluent. Posterior predominace, sparing of subcortical U fibers and immediate periventricular white matter, and the involvement of splenium of corpus callosum were also noted in all cases. There were other manifestations, such as 'tigroid pattern' in centrum semiovale (n=4), the involvement of genu of corpus callosum(n=4), posterior limb of internal capsule(n=4), descending pyramidal tracts (n=3), deep cerebellar white matter(n=1), claustrum(n=2), and diffuse brain atrophy(n=1). In three cases with Gd-infusion, contrast enhancement of the lesion was not seen. CONCLUSION: In childhood metachromatic leukodystrophy, MRI can clearly demonstrate the chracteristic extent of the white matter lesion and other associated findings, facilitating the differential diagnosis from other similar leukodystrophies.
Brain ; Corpus Callosum ; Diagnosis, Differential ; Extremities ; Female ; Humans ; Leukodystrophy, Metachromatic* ; Magnetic Resonance Imaging* ; Pyramidal Tracts

Lesions with coronary artery aneurysm (CAA) can become complicated during percutaneous coronary intervention. Here, we report a case of a 78-year-old man who developed a rupture, and spontaneous sealing of the CAA occurred after stent implantation, as shown by computed tomography coronary angiography.
Aged ; Aneurysm ; Congenital Abnormalities ; Coronary Aneurysm ; Coronary Angiography ; Coronary Vessels ; Drug-Eluting Stents ; Ear ; Humans ; Percutaneous Coronary Intervention ; Rupture ; Stents

The ocurrence of complications after brain tumor surgery often lead to death. To decrease the incidence of complications, it is desirable to identify patients at risk as early as possible prior to surgery. It can be achieved by determining preoperatively those factors known to be of prognostic relevance in the development of such postoperative complications. The prognostic factors may be differ considerably depending on the population studied but the homogeneous population studied in this analysis may help to contribute to the reference guide in identifying those factors. Authors have retrospectively analysed the major complications developed after performing on 150 brain tumor surgeries during last five years to identify the prognostic factors.
Brain Neoplasms* ; Brain* ; Humans ; Incidence ; Postoperative Complications ; Retrospective Studies

PURPOSE: To compare the intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness and central corneal thickness (CCT) in healthy individuals and patients with chronic renal failure (CRF) undergoing hemodialysis, and to evaluate the changes in each parameter before and after hemodialysis in patients with CRF. METHODS: Thirty-six eyes of 36 patients with CRF undergoing hemodialysis were included in the hemodialysis group and 54 eyes of 54 healthy subjects were recruited as the control group. All subjects underwent a complete eye examination, including best-corrected visual acuity (BCVA), slit lamp examination, dilated funduscopic examination, gonioscopy, automated perimetry, IOP measurement, corneal pachymetry, and evaluation of RNFL thickness. In the hemodialysis group, IOP, RNFL thickness, and CCT were measured again within 1 hour of hemodialysis. RESULTS: Age, sex, BCVA, cup-to-disc ratio, IOP, and CCT were not statistically different between the 2 groups. The RNFL of the hemodialysis group was statistically significantly thinner than the control group (p < 0.001). The IOP decreased from 16.52 +/- 2.95 mm Hg to 14.88 +/- 2.03 mm Hg after hemodialysis (1.63 +/- 3.27 mm Hg; p = 0.005). The changes in RNFL thickness and CCT were not statistically significant (p = 0.148, p = 0.352). CONCLUSIONS: In CRF patients with hemodialysis, RNFLs were thinner in the control group and hemodialysis induced significant IOP reduction. The results from the present study should be considered for the proper evaluation of ocular disorders in CRF patients with hemodialysis.
Corneal Pachymetry ; Eye ; Gonioscopy ; Humans ; Intraocular Pressure ; Kidney Failure, Chronic ; Nerve Fibers ; Renal Dialysis ; Retinaldehyde ; Visual Acuity ; Visual Field Tests

Among the series of 272 cases of surgically treated anterior circulation aneurysms, we experienced 6 cases of central infarctions involving caudate nucleus, globus pallidus, putamen and genu of internal capsule respectively or in combination. These surgery related complications were caused by the injury to the perforators going to the anterior perforated substance during manipulation of the large aneurysm or the aneurysms ruptured prematurely. The clinical courses of these patients, however, were not so severe. The morbidities were minimal or none after the average follow-up periods of 17 months. Thorough knowledge of the anatomy of the perforators may help to minimize the severe morbidity in the management of large or difficult aneurysms.
Aneurysm* ; Caudate Nucleus ; Follow-Up Studies ; Globus Pallidus ; Humans ; Infarction* ; Internal Capsule ; Olfactory Pathways ; Putamen

BACKGROUND: Herpes simplex virus encephalitis (HSVE) is a severe disease resulting in high mortality rates and residual sequelae; therefore, early diagnosis and treatment are very important. The purpose of this study was to evaluate the usefulness of polymerase chain reaction (PCR) assay of HSV DNA in cerebrospinal fluid (CSF) from patients with encephalitis for confirmatory diagnosis of herpes simplex virus encephalitis. MATERIALS AND METHODS: PCR analysis was done to detect DNA of HSV in 31 CSF samples obtained from 21 patients with encephalitis, admitted between November 1994 and June 1996, at the Seoul National University Children's Hospital. As controls, 15 samples from patients with proven diseases other than encephalitis were tested. Two different 22 bp- rimers, complementary to sequences within the DNA polymerase regions of HSV gene, were used. After amplification, PCR products were digested with DdeI to confirm the sequence. RESULTS: Three CSF specimens from 2 out of 21 patients with encephalitis were positive for HSV DNA, whereas all the control specimens were negative. PCR was positive in CSF samples obtained at 3 and 7 days after onset of symptoms from one patient and at 5 days from the other. PCR analysis yielded negative results in CSF samples collected at 10 and 14 days after acyclovir treatment. CONCLUSION: In this study, HSVE was diagnosed by PCR amplification of HSV genome from CSF obtained at early stage of the disease from patients with encephalitis. PCR assay of CSF samples could be used for early and confirmatory diagnosis of HSVE.
Acyclovir ; Cerebrospinal Fluid ; Diagnosis* ; DNA ; Early Diagnosis ; Encephalitis ; Genome ; Herpes Simplex* ; Humans ; Mortality ; Polymerase Chain Reaction* ; Seoul ; Simplexvirus*