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

No abstract available.
Anoxia* ; Neurons*

Permeability of membrane of chronic SDH is a unique characteristic. And various types of attenuation of chronic subdural hematoma(SDH) appearing on computerized tomography(CT) scans are related to the changes occurring as the result of recurrent bleeding. The authors have investigated the membrane permeability of SDH according to the histological changes of the outer membrane of chronic SDH. A consecutive series of 19 adult patients with chronic subdural hematoma has been studied in respect to the post-operative subdural drainage after burr-hole craniostomy and closed system drainage. The subdural drain was kept for 5 days. The amount and the pattern of daily drainage were correlated with histological findings of the outer membrane. The outer membrane of chronic SDH was very rich in blood vessels and contains giant capillaries. One electron microscopic finding of giant capillaries was the frequent formation of gap junctions between adjacent endothelial cells. Numerous red or white blood cells was spilling into the interstitial space of the outer membrane. In positive cases to both membrane hemorrhage and surface clot, total amount of drainage was significantly different from the cases without these findings(p=0.0263). In cases without membrane hemorrhage, the presence of migrating inflammatory cell was well correlated with total drainage amount(p=0.028). From these findings it is suggested that endothelial gap junction of macrocapillaies might play an important role in permeability of the outer membrane. But the recent episode of bleeding could act as a barrier and decrease the permeability actually. After resolution of fibrin clot infiltrated inflammatory cells which contribute to fibrinolysis would decrease and then the permeability would increase.
Adult ; Blood Vessels ; Capillaries ; Drainage ; Endothelial Cells ; Fibrin ; Fibrinolysis ; Gap Junctions ; Hematoma, Subdural, Chronic* ; Hemorrhage ; Humans ; Leukocytes ; Membranes* ; Permeability*

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

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*