Cerebral paragonimiasis ad cerebral cysticercosis are two notorious parasitic infestations of the brain in Korea, of which diagnoses were not clarified yet clinically. The authors experienced 25 such parasitic brain diseases with their characteristic CT findings, and it was assumed that computed cosmography(CT scan) is the procedure of choice for the diagnosis of these parasitic brain diseases.
Brain Diseases ; Brain* ; Cysticercosis ; Diagnosis ; Korea* ; Paragonimiasis

Early attempts at determining the effects of experimental ablation of the hypophysis in the mammal resulted ambiguously, for the animals usually died from attendant injury to the brain or form infection, or , if they survived, some of the effects observed often were due to injury to the adjacent regions of the brain during the operation. In 1912, Aschner performed removal of the pituitary body by a transbuccal transsphenoidal route in the dog. Smith in 1927 and 1930 reported two methods of hypophysectomy in the rat; the first one was temporal approach, in this method he exposed the pituitary and destroyed with chromic acid injection; the second one was parapharyngeal route. In 1963, Falconi and Rossi described transauricular hypophysectomy in the rat and mice. It is well known that in studying the effects of hypophysectomy removal of the pituitary must be essentially complete without injury to the adjacent regions of the brain, especially in the hypothalamus. The present study was undertaken to device a method of total hypophysectomy and observe the effects on pancreatic structure and carbohydrate metabolism. In this study twenty adult mongrel dogs, weighting from 7 to 10 kg, were used. Twelve of them were male and eight were female. Operative procedure: Under pentobarbital sodium, 30 mg/kg body weight, intravenous anesthesia the dog was placed on the operating table in prone position, and a tube was inserted in the mouth to displace the mandibular angle anterodownwardly. A vertical incision from the midline to just behind the mandibular angle was made, the temporal muscles were also incised vertically and retracted to expose the temporal bone. Following wide craniectomy down to the base of middle cranial fossa and careful opening the dura, temporal lobe was elevated with about 1cm wide brain retractor at the tip of the middle cranial fossa. Since this approach was deep and narrow, a brilliant illumination was thrown from head lamp at neat the center of the binocular magnifier. As the third cranial nerve and intracranial portion of the internal carotid artery were exposed, arachnoid membrane was torn and aspirated cerebrospinal fluid slowly to obtain wider exposure, then elevated posterior communicating artery to expose the pituitary body and stalk. The stalk was clipped and sectioned then pituitary body was removed in a piece or sucked out under direct vision, and the would was closed in layers. In all experimental dogs, pre- and postoperative fasting blood sugar was measured, and the brain and pancreas were removed and fixed in 10 % neutral formalin solution following intracarotid artery infusion of 10% neutral formalin. The removed brain was examined and the pancreas was stained with hematoxylin-eosin, Maldonado, and Toluidine blue sating methods. The following results were obtained: 1. The average preoperative fasting venous blood sugar was 98.5+/-5.4mg% in 20 mongrel dogs. 2. In five hypophysectomized dogs, their preoperative average blood sugar was 99.2+/-5.2mg% and their postoperative blood sugar was decreased in the rage from 13.0 to 35.4mg% during the period from 56 to 77 days. 3. In ten dogs who received daily intramuscular injection of 2mg dexamethasone following hypophyseetomy, their average venous blood sugar was 99.5+/-6.12mg%, and their postoperative blood sugar was decreased in the range from 9.7 to 30.5mg%. 4. In five normal dogs, the number of cells per islet varied from 14 to 96 and the average number was 45, and the average ratio of alpha, beta to delta cells was 14.2 : 79.4 : 6.4; in hypophysectomized group the average number per islet was 53 and their ratio was 19.5 : 75.1: 5.4; in the group which received dexamethasone for a week following hypophysectomy, the average number per islet was 53 and the average ratio was 14.6 : 80.5: 4.9, and in the group which received dexamethasone for two weeks, the average number per islet was 37 and the ratio was 15.2 : 80.2 : 4.5. 5. The acini in the hypophysectomized dogs were rather atrophic and illustrated mild intracytoplasmic vacuolization, and the Langerhans islet demonstrated exhausted pattern with small and degranulated beta cells. However, the Langerhans islets of hypophysectomized dogs with dexamethasone administration showed regranulated beta cells in one dog. 6. In pancreas of hypophysectomized dogs increased number of mast cells along the interstitial tissue, periductal region, and peripancreatic fat tissue were observed. There were also one or two mast cells in the islet mainly along the capsule of islets. 7. In pancreas of hypophysectomized dog with dexamethasone administration a few mast cells were observed along the lobular margin and just beneath the capsule of the islets.
Adult ; Anesthesia, Intravenous ; Animals ; Arachnoid ; Arteries ; Blood Glucose* ; Body Weight ; Brain ; Carbohydrate Metabolism ; Carotid Artery, Internal ; Cerebrospinal Fluid ; Cranial Fossa, Middle ; Dexamethasone ; Dogs* ; Fasting ; Female ; Formaldehyde ; Head ; Humans ; Hypophysectomy ; Hypothalamus ; Injections, Intramuscular ; Islets of Langerhans ; Lighting ; Male ; Mammals ; Mast Cells ; Membranes ; Mice ; Mouth ; Oculomotor Nerve ; Operating Tables ; Pancreas* ; Pentobarbital ; Pituitary Gland ; Prone Position ; Rage ; Rats ; Somatostatin-Secreting Cells ; Surgical Procedures, Operative ; Telescopes ; Temporal Bone ; Temporal Lobe ; Temporal Muscle ; Tolonium Chloride

The authors present a case in which an organized chronic subdural hematoma(CSDH) was incidentally found in a 9-year-old boy with no significant medical history after a pedestrian traffic accident. Preoperative magnetic resonance(MR) imaging showed calcification on the inner membrane and an irregular heterogeneous structure in the hematoma cavity. The findings from the preoperative brain computed tomogram(CT) and MR image were very useful for making the preoperative diagnosis and surgical decision. In choosing the proper surgical strategy for removing the organized CSDH, it was thought that burr hole trephination would present unnecessary difficulties. Thus, craniotomy was selected and the organized CSDH was successfully removed with no complications.
Accidents, Traffic ; Brain ; Child* ; Craniotomy ; Diagnosis ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Magnetic Resonance Imaging ; Male ; Membranes ; Trephining

BACKGROUND: The studies on cryopreserved arterial allograft have been focused on cooling methods, pre-treatment, cryoprotectant agents, and preservation temperature. But recently, several studies have reported that thawing methods also play an important role in the occurrence of macroscopic and microscopic cracks. This study was designed to investigate the cell injury after thawing, using a rabbit model to clarify the effect of thawing methods on cryopreserved arteries. MATERIAL AND METHOD: Segments of the rabbit aorta were obtained and divided into 3 groups (n=60) according to whether the specimens were fresh (control, n=20), cryopreserved and rapidly thawed (RT) at 37oC (n=20), or cryopreserved and subjected to controlled, automated slow thawing (ST)(n=20). Cell damage was established using the TUNEL method and the morphological changes were also evaluated. RESULT: In the group that was rapidly thawed, the expression of TUNEL (+) cells increased significantly more than in the slowly thawed group. In addition, the endothelial denudation, microvesicles and edema were significant in the rapidly thawed group compared with those changes in the slowly thawed group. CONCLUSION: Our study suggests that the rapid thawing method may be one of the major causes of cellular damage and delayed rupture in cryopreserved arterial allografts. The expression of TUNEL (+) cells and structural changes were significantly low in the slowly thawed group, which might have contributed to the improvement of graft failure after transplantation.
Allografts ; Aorta* ; Arteries ; Cryopreservation ; Edema ; In Situ Nick-End Labeling ; Rupture ; Transplants

OBJECTIVE: This study was done to propose a new method of determining the cutoff frequency against measurement noise in fetal heart rate signal and to analyze the discriminating value for normal fetus (pH>7.15) and abnormal fetus (pH< or =7.15) by nonlinear method. METHODS: The patients were classified by umbilical artery pH (7.15) or base excess (-10 mEq/L). After removing the high frequency noise components at the cutoff frequency determined in this study, we calculated correlation dimension as a discriminating value for the normal and abnormal fetuses. RESULTS: After low pass filtering of fetal heart rate signal at the cutoff frequency, the numerical result of embedding dimension was 5.47+/-0.67 (normal), 4.43+/-0.60 (abnormal) (p<0.001), and correlation dimension was 2.51+/-0.43 (normal), 1.79+/-0.15 (abnormal). CONCLUSION: We could determine the cutoff frequency from the different fluctuation level between high frequency noise and principal signal according the cutoff frequency function. The detection of fetal distress was done objectively by this method. We could discriminate between normal fetus and abnormal fetus by correlation dimension as indicator for the nonlinear complexity.
Female ; Fetal Distress ; Fetal Heart* ; Fetus ; Heart Rate, Fetal* ; Humans ; Hydrogen-Ion Concentration ; Noise* ; Pregnancy ; Umbilical Arteries

OBJECTIVES: For estimating the antenatal fetal wellbeing to develop new analysis method of fetal heart rate(FHR) with electronic Fetal Heart Rate Monitoring(eFHRM) and computer. METHODS: Heart rate signal is received from distressed fetus using eFHRM. It is necessary to carry out low pass filtering as a preprocess for the nonlinear method. Nonlinear parameters are calculated and classified to investigate the relations between these parameters and values of umbilical cord blood gas. RESULTS: By dividing values of the umbilical cord blood gas into 5 fetuses of acidemic group and 17 fetuses of non-acidemic group after 22 neonates who presented fetal distress were born, the following results as compared with nonlinear chaotic analysis result were obtained. 1. Delay time through AMI for acidemic group was 16.80+/-3.11, and was higher than 15.41+/-2.27 for non-acidemic group, and is not significant in statistics. 2. Embedding Dimension calculated with FNN method was 5.60+/-2.07 for acidemic group, and 4.71+/-1.26 for non-acidemic group, and it was not significant statistically. 3. Correlation dimension for acidemic group was 1.41+/-0.20, and was higher than 1.10+/-0.38 for non-acidemic group, and is not significant in statistics. 4. Mean crossing value by isoangular return map was 28.80+/-11.34 for acidemic group, and 16.65+/-7.00 for non-acidemic group, and it was significant statistically(P=0.008). 5. In comparison of information entropy in 1-D ED, acidemic group was 6.32+/-0.38 and non-acidemic group was 6.20+/-0.28 and it was not significant statistically. Also, in comparison of value in 2-D ED, acidemic group was 10.20+/-0.34. It was higher than non-acidemic group of 9.51+/-0.43 significantly in statistics(P=0.004). But, in comparison of value in 2-D EP, acidemic group was 8.78+/-0.86 and non-acidemic group is of 9.22+/-0.74 and it wasn't significant statistically. And, 2-D ED(DI) value was 10.64+/-0.14 for acidemic group and 10.51+/-0.18 for non-acidemic group, and it wasn't significant statistically. CONCLUSIONS: By the above result, nonliner dynamics and chaotic analysis of heart rate data with computer can serve as a new diagnosis method which may estimate the fetal wellbeing with real time. Through further studies for establishment of diagnosis standard and computer programming, real time diagnosis method shall be applied to clinical practice.
Diagnosis ; Entropy ; Female ; Fetal Blood ; Fetal Distress* ; Fetal Heart* ; Fetus ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Infant, Newborn ; Nonlinear Dynamics* ; Pregnancy

BACKGROUND: At present, there are many instruments to diagnose anxiety and depression. However, most of the instruments have a number of questions. Therefore, we have many difficulties in applying them to the primary care. The purpose of this study was to measure the reliability and the validity of a Korean-translated Goldberg s short screening scale for anxiety and depression, which were developed for screening of anxiety and depression in primary care. METHODS: 178 asymtomatic subjects and 58 patients(anxiety 15, depression 43) aged from 18 to 64 years old were selected. The patients were diagnosed by psychiatrist according to DSM-IV criteria. This study was performed for 3 months, from May to August 1996. The reliability of this instrument was measured by internal consistency reliability. The validity of this instrument was measured by three methods. The first method was the comparison of the score between the patients and the control group. The second method was to measure the relationships of this instrument with the other instruments such as Self-rating Depression Scale and State-Trait Anxiety Inventory. The last method was to measure the relationship of this instrument with Comprehensive Global Assessment. In addition, we calculated the sensituvity and specificity at the cut off values. RESULTS: The Cronbach's a value was 0.736 for the anxiety and 0.749 for the depression. Goldberg anxiety scale was significantly associated with state in STAI(r=0.279, P<0.001), and trait in STAI(r=0.125, P=0.041). However, Goldberg depression scale was not sigficantly associated with SDS. Goldberg anxiety scale as well as Goldberg depression scale were significantly associated with CGA(r=0.433, P=0.001; r=0.695, P=0.001). The seore of Goldberg anxiety scale was significantly higher in the anxious patients than in the control group(P=0.047). The score of Goldberg depression scale was significantly higher in the depressive patients than in the control group(P<0.001). For anxiety scale of Goldberg scale, the sensitivity and the specificity was 60% and 68% at score 3. For depression scale of Goldberg scale, the sensitivity and the specificity was 80% and 68% at score 2. CONCLUSIONS: We concluded that the value of Cronbach's a in Goldberg scale was 0.736 for anxiety and 0.749 for depression. For the validity, the scores of Goldberg scale were higher in patient group than in asymptomatic group. However, the relationships of Goldberg scale with other screening instruments were variable. So further study for the validity of Goldberg scale is requested.
Anxiety* ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening* ; Middle Aged ; Primary Health Care ; Psychiatry ; Sensitivity and Specificity

Objective: To investigate the clinical factors associated with successful gastrostomy tube weaning in patients with prolonged dysphagia after stroke. Methods: This study involved a retrospective medical chart review of patients diagnosed with prolonged dysphagia after stroke who underwent gastrostomy tube insertion between May 2013 and January 2020. Forty-seven patients were enrolled and consequently divided into gastrostomy tube sustaining and weaning groups. The numbers of patients in the sustaining and weaning groups were 31 and 16, respectively. The patients’ demographic data, Korean version of Mini-Mental State Examination (K-MMSE) score, Korean version of the Modified Barthel Index (K-MBI), Functional Dysphagia Scale (FDS) score, and Penetration-Aspiration Scale (PAS) score were compared between the two groups. A videofluoroscopic swallowing study was performed before making the decision of gastrostomy tube weaning. The clinical factors associated with gastrostomy tube weaning were then investigated. Results: There were significant differences in age; history of aspiration pneumonia; K-MMSE, FDS, and PAS scores; and K-MBI between the groups. In the multiple logistic regression analysis, the FDS (odds ratio [OR]=0.791; 95% confidence interval [CI], 0.634–0.987) and PAS scores (OR=0.205; 95% CI, 0.059–0.718) were associated with successful gastrostomy tube weaning. In the receiver operating characteristic curve analysis, the FDS and PAS were useful screening tools for successful weaning, with areas under the curve of 0.911 and 0.918, respectively. Conclusion In patients with prolonged dysphagia, the FDS and PAS scores are the only factors associated with successful gastrostomy tube weaning. An evaluation of the swallowing function is necessary before deciding to initiate gastrostomy tube weaning.

Several cases of familial occurrence of gliomas have been reported, but little has been known on the importance of genetic factors, which indeed remains controversial. In establishing the genetic basis for cancer susceptibility, the evaluation of a single family is perhaps the most satisfactory and meaningful approach. We report a family in which the 47-year-old father had glioblastoma in cerebellar vermis and his 14-year-old daughter developed pilocytic astrocytoma in cerebellar hemisphere. Karyotypic analysis of this family showed no abnormal findings in chromosomes.
Adolescent ; Astrocytoma ; Fathers ; Glioblastoma ; Glioma* ; Humans ; Karyotype ; Middle Aged ; Nuclear Family

Meningeal tumor obstructing the foramen magnum is relatively rare, moreover occurrence of such a tumor in children has rarely been reported. This tumor shows various characteristic clinical manifestations, partly from anatomical standpoint and partly from unknown mechanism. In addition, not uncommon remitting and relapsing clinical course often presents diagnostic conflicts. We experienced a case of basilar groove meningioma presenting many difficult problems in the diagnosis and treatment, which was confirmed at operation and subsequent autopsy in a child.
Autopsy ; Child* ; Diagnosis ; Foramen Magnum ; Humans ; Meningeal Neoplasms ; Meningioma*