Recently advanced treatment of head injury has substantially improved result. Aggressive and intensive treatment has not only saved lives but has also reduced morbidity. This article elucidates the problems that must be dealt with in the management of severe head injury patients and develops guidelines in basic principles of modern treatment of head injury in making surgical decision. The rapid establishment of adequate ventilation and circulation is the first step. Next is followed by rapid evacuation of space-occupying mass lesions. Intensive monitoring of intracranial pressure and cerebral perfusion pressure is important. Finally deteriorating secondary injuries should be avoided. Many drugs have been claimed to be beneficial in animal studies, including lipid peroxidation inhibitors, free radical scavengers, NMDA receptor blockers, calcium channel blockers, monosialic gangliosides, and polyamine. New agents with efficacy either in lowering raised ICP or protecting the nervous system are introduced, and the results of their application are to be included.
Animals ; Calcium Channel Blockers ; Craniocerebral Trauma* ; Free Radical Scavengers ; Gangliosides ; Head* ; Humans ; Intracranial Pressure ; Lipid Peroxidation ; N-Methylaspartate ; Nervous System ; Perfusion ; Ventilation

Sertoli-Leydig cell tumor or Brenner tumor is a relatively rare ovarian tumor. Other associated elements in the form of epithelial, mesenchymal, and tumor components of each tumor have been reported. The Sertoli-Leydig cell tumor with a Brenner tumor element has not been documented in the literature, so we are reporting on a case of Sertoli-Leydig cell tumor coexisting with a Brenner tumor. This 62-year-old woman presented with a 4 year history of lower abdominal mass and vaginal bleeding. Exploratory laparotomy was done. The left ovary showed a multiseptated, cystic, yellow-white solid mass, measuring 17.0x13.0x5.0 cm and weighing 985.0 gm. Microscopic examination revealed a tubular or trabecular arrangement of the Sertoli cells and variable numbers of Leydig cells. There were several tumor nests with cystic spaces composed of ovoid cells showing longitudinal nuclear grooving. Sarcomatoid or heterologous elements were not found.
Female ; Humans

No abstract available.
6-Cyano-7-nitroquinoxaline-2,3-dione* ; Cycloheximide* ; Dizocilpine Maleate*

No abstract available.
Contrast Media* ; Endothelium*

No abstract available.
Child* ; Humans ; Hydrocephalus*

The clinical triad of relapsing iritis, ulcers of the mouth and genitalia was first described in 1939 by Hulusi Behcet. This entity, originally confined to the above triad of symptoms appears to be systemic disease manifested by skin lesion, thrombophlebitis, neurologic, cardiovascular or visceral symptoms. The vascular involvement in Behcet's syndrome has been reported since Mischima first described a case in 1961, four types of vascular lesion are freuqnetly observed most commonly on the inferior or superior vena cava. Treatments consist of anticoagulation and administering oral steroids. We report a case of SVC obstruction in 36 years old female patient with Behcet's syndrome.
Adult ; Behcet Syndrome* ; Female ; Genitalia ; Humans ; Iritis ; Mouth ; Skin ; Steroids ; Thrombophlebitis ; Ulcer ; Vena Cava, Superior

A normal-weight full-term newborn infant with a posterior fossa subdural hematoma is described. This potentially trea table condition has been previously diagnosed in only 13 reported cases. The clinical characteristics in this case were the lack of specific symptoms and signs indicating the nature and location of the lesion and the presence of signs of intracranial hypertension. Computed tomography allowed for earlier confirmation of the diagnosis and early surgical treatment resulted in excellent recovery.
Diagnosis ; Hematoma, Subdural* ; Humans ; Infant, Newborn* ; Intracranial Hypertension

No abstract available.
Emergencies* ; Hematoma, Subdural, Acute* ; Trephining*

PURPOSE: Relaxation of the penile cavernosum smooth muscle is a critical event in erection. Artemisia iwaymogi(AI) is a perennial herb growing in Korea. The aerial parts have been used in folk medicine. Bioassay-guided fractionation of an H2O extract of AI has furnished an inhibitory substance (PCLS-2). We investigated compound extracted in the rabbit corporal cavernosum smooth muscle. MATERIALS AND METHODS: Bioassay-guided fractionation of an H2O extract was used. A strip of rabbit corpus cavernosum was mounted in an organ chamber to measure the isometric tension. PCLS-2 compound induced relaxations were evaluated by in vitro study using muscarinic receptor blocker atropine (ATR), cyclo-oxygenase inhibitor indomethacin, nitric oxide synthase (NOS) ihibitor Nitro-L Arginine-Methyl Ester (NAME), guanylate cyclase inhibitor 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin 1-one (ODQ), intrinsic neurotransmission inhibitor tetrodotoxin (TTX), or/and potassium channel blockers. RESULTS: PCLS-2 showed relaxation in a dose-dependent manner. Atropine, Indomethacin, NAME, ODQ, TTX, glibenclamide, tetraethylammonium, 4-aminopyridine, charybdotoxin, or apamin did not inhibit the relaxation induced by PCLS-2 compound. CONCLUSIONS: The present results suggest that the PCL-2 compound has effect of relaxation of corpus cavernosum smooth muscle and the relaxation was not involved muscarinic receptor, nitric oxide, prostaglandin, potassium channels and intrinsic neurotransmission. Other mechanisms may by involved in the PCLS-2 induced relaxation in the rabbit corpus cavernosum smooth muscle.
4-Aminopyridine ; Apamin ; Artemisia ; Atropine ; Charybdotoxin ; Glyburide ; Guanylate Cyclase ; Indomethacin ; Korea ; Medicine, Traditional ; Muscle, Smooth* ; Nitric Oxide ; Nitric Oxide Synthase ; Potassium Channel Blockers ; Potassium Channels ; Prostaglandin-Endoperoxide Synthases ; Receptors, Muscarinic ; Relaxation ; Synaptic Transmission ; Tetraethylammonium ; Tetrodotoxin

In recent years there has been a tendency to abandon repeat cerebral angiography in patients with subarachnoid hemorrhage(SAH) if the initial angiogram is normal because prognosis is said to be excellent. Our experiences does not support such a conclusion. In 291 cases with subarachnoid hemorrhage(SAH), four vessel cerebral angiography was performed to investigate a source of the hemorrhage. The first four vessel study on admission revealed 234 cases(80.4%) of ruptured cerebral aneurysms. Fifty-five of 291 patients with primary subarachnoid hemorrhage(SAH) did not show vascular lesion in initial pan-angiography studies. In order to define the benefit of control angiography these patients were reviewed. Among 41 patients who underwent repeat angiography, a second angiography showed an aneurysm in 24(58.5%). Twelve of the twenty-four cases had aneurysms in the anterior communicating artery. But the age, sex, initial clinical grade and CT grade of patients with aneurysm in repeat angiography were indistinguishable from thoses of patients without aneurysm. Even in the patients who showed angiographic vasospasm in intial angiography, probability of revealing an aneurysm was not different from those without spasm. We conclude that repeat angiography is necessary in the cases of SAH with normal initial angiogram regardless of the CT findings and the presence of vasospasm.
Aneurysm ; Angiography* ; Arteries ; Cerebral Angiography ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Prognosis ; Spasm ; Subarachnoid Hemorrhage*