Today, the exact causal relationship between prolapsed intervertebral disk and sciatica remains unclear. Murphy has proposed that inflammation rather than mechanical pressure is the basis of back pain and sciatica, and that causal irritant is likely to be a chemical product of disk degeneration. The administration of steroids into the epidural space reduces the inflammatory process of the neural structure is well known. We have studied the effect of injection of methylprednisolone acetate (Depomedrol) comparing with the effect of operative treatment. One hundred and eleven cases suffuring from diskogenic low back pain had been treated at Wallace Memorial Baptist Hospital during 2.5 years period from May 1979 to Nov. 1981. The results were as follows: 1. Sixteen patients (14%) stated that they had no relief from the injection, 24(22%) were moderately improved, 52(47%) were markedly improved and 19(17%) were completely relieved of symptoms. 2. The candidates for laminectomy which were confirmed by myelogram had complete improvement in 12%, marked improvement in 39%, moderate improvement in 21%, no relief in 28%.
Back Pain ; Epidural Space ; Humans ; Inflammation ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Laminectomy ; Low Back Pain ; Methylprednisolone ; Protestantism ; Sciatica ; Steroids

Clinical observation was done on 302 cases of cerebrovascular accidents admitted at Sung-Sim hospital, Chung-Ang University from January, 1968 to August, 1976. 1) Of 302 cases of cerebrovascular accidents, the incidence of cerebral hemorrhage was 28.8, cerebral thrombosis 47,7 Subarachnoid hemorrhage 20.2% and cerebral embolism 3.3%. 2) The peak age incidence was in the fifth decade in cerebral hemorrhage, subarachnoid hemorrhage, whereas in cerebral thrombosis, it was in the sixth decade. 3) The most frequent predisposing factor in cerebral hemorrhage and subarachnoid hemorrhage were physical activity and emotional stress, whereas in thrombosis and embolism, it was rest. 4) Among disease preceding the onset of cerebrovascular accidents, hypertension were presented 65.4% in cerebral hemorrhage, 63.6% in cerebral thrombosis, 56.6% in subarachnoid hemorrhage and valvular heart disease was presented 40.0% in cerebral embolism. 5) Serum cholesterol level over 200mg% was seen in 33.0% of cerebrovascular accidents. 6) Leukocytosis was seen 58.6% of cerebrovascular accidents which was predominantly found in the hemorrhagic group. 7) The pressure of cerebrospinal fluid was elevated in 61.7% of cerebrovascular accidents, predominantliny the hemorrhagic group. 8) The peak duration of admission was present in 51.7% of cerebrovascular accidents within 7 days and mortality rate during hospitalization was 38.0% in cerebral hemorrhage, 10.4% in cerebral thrombosis and 27.8% in subarachnoid hemorrhage. 9)The mortality rate during hospitalization was 35.3% in all cerebrlavascular accidents within 24 hours.
Causality ; Cerebral Hemorrhage ; Cerebrospinal Fluid ; Cholesterol ; Embolism and Thrombosis ; Heart Valve Diseases ; Hospitalization ; Hypertension ; Incidence ; Intracranial Embolism ; Intracranial Thrombosis ; Leukocytosis ; Mortality ; Motor Activity ; Stress, Psychological ; Stroke ; Subarachnoid Hemorrhage

Spontaneous cerebellar hemorrhage is classically considered a rare and fatal disease because the early diagnosis is very rarely made during the life, and there is scant mention of the problems of spontaneous hemorrhage into the cerebellar hemisphere. However our opinions indicate that its frequency is greater than is generally thought although it is considered a rare lesion. The purpose of this paper is to record our present opinions concerning the possible early diagnosis and surgical management of the spontaneous cerebellar hemorrhage. We believe that it is possible by clinical examination alone to make or strongly suspect the diagnosis in life during the early stage before irreversible damage occurs and that emergency surgical intervention is strongly indicated. The patients is a 38 year old man admitted to the Department of Neurosurgery, Catholic Medical Center on Nov 3, 1976 with severe headache, vomiting, dysarthria and mental confusion. On examination, he was disclosed mental confusion, repeated vomiting, constricred pupil, horizontal nystagmus, inability to stand, dysarthria and neck stiffness. We confirmed the diagnosis under the cerebellar hemorrhage involving the cerebellar vermis and both cerebellar hemispheres by means of vertebral and carotid angiography, conray ventriculography, and cerebrospinal fluid examination. We underwent suboccipital craniectomy with the evacuation of hematoma at the vermis and both cerebellar hemispheres after 48 hours of onset of illness and his postoperative course was good except for mild cerebellar dysfunction signs and he was discharged on 45th hospital days.
Adult ; Angiography ; Cerebellar Diseases ; Cerebrospinal Fluid ; Diagnosis ; Dysarthria ; Early Diagnosis ; Emergencies ; Headache ; Hematoma ; Hemorrhage* ; Humans ; Neck ; Neurosurgery ; Nystagmus, Pathologic ; Pupil ; Vomiting

No abstract available.
Child ; Coronary Vessels* ; Echocardiography ; Humans

We have experienced 109 cases of hypertensive intracerebral hemorrhage admitted to the Department of Neurosurgery of Catholic Medical Center from January 1973 to August 1976. We analized the result of treatment of hypertensive intracerebral hemorrhage and assessed prognostic factors affecting the results of surgical treatment of hypertensive intracerebral hemorrhage. 1. The age of the patients did not significantly influence on the mortality of operative or non-operative cases provided the age is below sixty. 2. The amount of hematoma did not directly related to the outcome of operated cases if the hematoma is less than 50ml, while the mortality was considerably increased if the clot was more than 50ml. 3. There was no specific difference in operative mortality between total evacuation and partial evacuation of hematoma in surgery of the hypertensive intracerebral hemorrhage, but total evacuation had better result than that of partial evacuation in the functional recovery. 4. The operative mortality of the hypertensive intracerebral hemorrhage was 43.6% and 55.7% in non-operative cases. Thalamic hemorrhage carried the highest mortality either operated or conservatively treated. 5. The surgical treatment carried better result than non-operative treatment in the case showing progressive change in consciousness following intracerebral hemorrhage. Conservative treatment obtained good result in the cases showed progressive improvement of conscious level following intracerebral hemorrhage. 6. The interval from the ictus to surgical intervention did not constantly influence on the result of surgery and it might be wise to decide the time of surgical intervention according to the progressive changes in conscious level and neurological status after bleeding. 7. The operative result was favorable in the patients who has shown progressive worsening of conscious level and neurologic status following clear conscious at hemorrhage (class II). We also noted that the patients were unconscious at ictus then became progressively stupor with increasing neurologic deficit showed better result with surgical treatment than non-operative care.
Cerebral Hemorrhage ; Consciousness ; Hematoma ; Hemorrhage ; Humans ; Intracranial Hemorrhage, Hypertensive* ; Mortality ; Neurologic Manifestations ; Neurosurgery ; Stupor

This study includes 48 patients with severe head injury and with Neurosurgical Coma Scale(N.C.S.) scores of < or =8, who were admitted during last 1 1/2 years in our neurosurgical department. One week interval Serial C.A.T. scan was performed for 3 times and reviewed with patient's outcome and coma score comparing with consequences of serial C.A.T. Scan. Mortality rate was 33% who's coma score of < or =5 and 14% of > or =6. C.A.T. scans are correlated with the level of consciousness and coma score. The most common abnormalities were small ventricle ad area of mixed density interpreted as diffuse contusion. Two cases are new formed post-traumatic intracerebral hematoma. The patients, who's coma score of < or =5 had severe clinical and C.A.T. abnormality.
Coma ; Consciousness ; Contusions ; Craniocerebral Trauma* ; Head* ; Hematoma ; Humans ; Mortality

148 male and 153 female college students attitude toward weight control, diet behaviors and food habits were investigated by self questionnaire. Among the students, underweight students were 11.0%, normal weight students were 63.5% and obese students were 25.6% by RBW standard, and underweight students were 16.0%, nromal weight students were 70.4% and obese students were 13.6% by BMI standard. However, more than 10% of male and 38% of female students thought they were obese even thought their body weight were normal. Female students tended to overeat when they were stressed or in a bad mood and generally all participants had poor scores on the dietary attitudes test, however, male students had significantly higher scores than female students. Female students tended to choose food more for its taste. Collegestudents are in early stage of adult life and their dietary attitudes, food behaviors and life style will continue to their later life. Therefore college students need more good nutrition knowledge, positive dietary attitudes, modified life styles to prevent and treat collegestudents obesity.
Adult ; Body Weight ; Diet* ; Female ; Food Habits* ; Humans ; Life Style ; Male ; Obesity ; Thinness ; Surveys and Questionnaires

There were 11 cases of pituitary tumors and 2 cases of craniopharyngiomas, who were admitted to the Department of Neurosurgery of the Catholic Medical Center from July 1976 to April 1977. The authors analyzed changes of the hormone related with the hypophyses before and after surgery, and radiation using the radioimmunoassay according to Schalch and Parker's double antibody method. The hormonal assays were performed as follows : 5 samplings of growth hormones were given at a fasting state, at 8 AM, 8:30 AM, 10 AM and 11 AM, also the oral glucose tolerance test simulataneously after the patients were given 100 gm of surgar, associated with the insulin tolerance test (0.15 unit/kg). Two specimens of blood for the prolactin were withdrawn at 8 AM and 4 PM on that day. A specimen for LH, FSH, TSH, T3, T4 and cortisol was taken at 8 AM. The 8 surgery cases of the pituitary tumors associated with post-operative radiation underwent 3 transsphenoidal approaches, 3 transfrontal and 2 transtemporal approaches, and all of the surgery cases were alive. The transtemporal approach was for all craniopharyngiomas, and all of them died following surgery. One patient in this chromophile adenoma group had radiation therapy only. Following the clinical improvement after the treatment, the endocrinological symptoms, i. e. diminished libido and amenorrhea, were improved in the acromegalic group. The visual disturbance in the chromophobe adenoma group was markedly improved and the menstruation had started in one case. In inoperative patients, the visual disturbance and the endocrinological disarrangements were aggravated. In the chromophile adenoma group accompanying the acromegaly, the mean value of the plasma growth hormone was markedly increased to 61.3 ng/ml and greatly decreased to 36.8 ng/ml after the surgery and radiation, but increased rather than before radiation in the one case of radiation only. The mean prolactine value was also increased to 60.6 ng/ml and not changed after the therapy. The gonadotropin was within normal limits and tended to decrease slightly after the treatment. The TSH, T3, T4 cortisol were within normal values. In the chromophobe adenoma group, the mean growth hormone values were within normal limits, 7.27 ng/ml, and not altered after the therapy. The mean prolactin value was increased to 57.8 ng/ml and not changed after the treatment. The gonadotropin, TSH, T4 and cortisol were within normal limits before and after the treatment, but the T3 value was slightly higher than normal. In the craniopharyngioma group, the mean growth hormone value was within normal limits, 7.4 ng/ml and not altered after the surgery. The mean prolactin gonadotropin, TSH, T3 and T4 were within normal limits but the cortisol value was increased to 13.7 ng/ml after the surgery.
Acromegaly ; Adenoma ; Adenoma, Chromophobe ; Amenorrhea ; Craniopharyngioma ; Fasting ; Female ; Glucose Tolerance Test ; Gonadotropins ; Growth Hormone ; Humans ; Hydrocortisone ; Insulin ; Libido ; Menstruation ; Neurosurgery ; Pituitary Gland ; Pituitary Neoplasms* ; Plasma ; Prolactin ; Radioimmunoassay* ; Reference Values

OBJECTIVE: The objective of this study is to evaluate the clinical presentation and outcomes of patients with an intracerebral hematoma (ICH) associated with a ruptured middle cerebral artery (MCA) aneurysm, and the correlation factors associated with the aneurysm and characteristics of the hematoma. METHODS: A retrospective evaluation of clinical and radiologic characteristics and outcomes was conducted for 24 patients (11 men and 13 women; mean age, 53 years) with ruptured MCA aneurysms associated with ICH between September 2008 and December 2011. RESULTS: Thirteen (54%) of the 24 patients had a favorable outcome, four (17%) suffered from severe disability, and seven (29%) died. Based on Hunt and Hess grade, one patient was classified as Grade II, three as Grade III, 12 as Grade IV, and eight as Grade V. Patients with an unfavorable outcome had significantly larger aneurysms (p = 0.047) and ICH volumes (p = 0.002), compared with patients in the group with a favorable outcome. The most frequent rupture point of aneurysms was the lateral aspect of the aneurysm (54.2%). When the rupture point is toward the lateral direction, the distribution of ICH tended to be located at the temporal lobe and intrasylvian. CONCLUSION: Results of the present study suggest an association of the initial clinical state, the size of the aneurysm, and ICH volume with outcome. Although no difference was observed between the location of the rupture point and patient outcomes, an accurate assessment of ICH patterns and the rupture point in angiography may help to ensure surgical exposure and a safe aneurysm clipping.
Aneurysm ; Angiography ; Dietary Sucrose ; Hematoma ; Humans ; Intracranial Aneurysm ; Male ; Middle Cerebral Artery ; Retrospective Studies ; Rupture ; Temporal Lobe

In 1957 Sament and Schwartz reported patient with profound coma and hyperglycemia but without ketonemia or acidosis. This syndrome in usually termed hyperosmolar hyperglycemic nonketotic coma(HHNC). Six critically ill patients while on the neurosurgical service were studied to establish the diagnosis of HHNC. Criteria for the diagnosis of HHNC included. 1) Serum glucose over than 220 mg/dl wigh glucosuria. 2) absence of significant acetonuria. 3) serum Na over than 150 mEq/l. 4) serum osmolarity over than 310 mOsM/kg. 5) neurological dysfunction. The production of the characteristic stupor and diminution of mental acuity appears to result from a decrease in intracellular water content within the brain due to the osmotic effects of those predominately extracellular substances. Factors documented to be significant in it's development include nonspecific stress to primary illness, hyperosmolar tube feeding. Dehydration, and mannitol, dilantin and steroid administration. The treatment of HHNC recommended the division of replacement into two stages: 1) rapid repair of water deficits which was calculated by described formula and correct the Na abnormality. 2) insulin replacement according to the degree of glucosuria. During the replacement therapy of water deficit and insulin, it should be necessary to repeat plasma electrolytes and blood glucose at 4 hour intervals until normal levels are approached. One among the 6 cases of HHNC became good recovery and 5 cases were expired on treatment, Fatal complications of this syndrome, such as acute renal failure, terminal arrhythmias and cardiopulmonary dysfunction, both cerebral and systemic, were common in these cases.
Acidosis ; Acute Kidney Injury ; Arrhythmias, Cardiac ; Blood Glucose ; Brain ; Coma ; Critical Illness ; Dehydration ; Diagnosis ; Electrolytes ; Enteral Nutrition ; Humans ; Hyperglycemia ; Hyperglycemic Hyperosmolar Nonketotic Coma* ; Insulin ; Ketosis ; Mannitol ; Osmolar Concentration ; Phenytoin ; Plasma ; Stupor ; Water