We experienced nutiple brain abscess in two neonates. Diagnosis was made CT scan, Which revealed multiple ring-like enhancing leason in both frontoparietal and left posterior parietal cerebral parenchyme. Therapy was consisted of systemic antibiotic treatment and CSF V-P shunt operation due to complicated hydrocephalus. One neonate was died and the other neonate has been followed up due to convulsion and neurological sequale.
Brain Abscess* ; Diagnosis ; Humans ; Hydrocephalus ; Infant, Newborn* ; Rabeprazole ; Seizures ; Tomography, X-Ray Computed

We already achieved the goal of the elimination of leprosy that was recommended by WHO. But the amazing change of our country's situation of the economical & social conditions makes the need of the migrant worker. Especially, the portion of migrant workers form India, Nepal, Indonesia, Philippines, Bangladesh, & Vietnam, the countries of relatively high prevalence rate of Hansen's disease are increasing among them recently. It means the attention about the influx of Hansen's disease form the foreign countries. We perform the survey for Hansen's disease of the migrant worker. Total 603 workers were surveyed. We found only 4 persons, that had the high titer(above 500) of the result of PGL-1 ELISA, and only 3 persons, that had some findings, the suggestive finding of Hansen's disease, of cutaneous & neurological symptoms. In spite of the special study, we did not conform the diagnosis of Hansen's disease among them. During this survey, we did not find the conformed patients of Hansen's disease. But we think that we will be concerned about the influx of Hansen's disease from foreign countries, because of the recently significance change of the epidemiological situations of Hansen's disease in Korea.
Bangladesh ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; India ; Indonesia ; Korea ; Leprosy* ; Nepal ; Philippines ; Prevalence ; Social Conditions ; Transients and Migrants* ; Vietnam

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*

PURPOSE: Authors pursuit the meaningful guide for doing arthroscopic meniscetomy in the treatment of symptomatic discoid meniseus of the knee by determining the needed resection margin(partial or total) from the schematic diagram of degeneration and tear which is based on pre-operative MRI. MATERIALS AND METHODS: We analyzed the findings of MRI and operation retrospectively for 32 knees. At first, we designed authors own schematic diagram of discoid meniscus and divided it into 6 x 6 block. The radiologists draw the pattern of degeneration and tear on diagram from pre-operative MRI and the orthopedic surgeons draw the status of degeneration, tear and remaining meniscus after meniscetomy by retrospective analysis of video documentation. Two diagrams were compared for analysis. RESULTS: We had used morselization technique to save meniscus as much as possible on doing meniscetomy. The resected margin of cases were as follows; 9 cases were partial, 21 cases were subtotal and 2 cases were total meniscetomy. But in this study, 19 cases were requested total resection margin on pre-op MRI evaluation. Among these 19 cases, 17 cases of partial or subtotal meniscetomized were reviewed again on video documentation to determine the remained meniscus would be removed completely or not. In 13 of 17 cases, remaining menisci have advanced horizontal tear and rims were not stable that would be rather cases of total meniscetomy. CONCLUSION: Use of diagram of degeneration and tear on the basis of pre-op MRI would be valuable guide to determine appropriate resection margin and moreover the technique of the meniscetomy in the treatment of symptomatic discoid meniscus.
Knee ; Magnetic Resonance Imaging* ; Orthopedics ; Retrospective Studies

Aneurysms located on the proximal(A1) segment of the anterior cerebral artery are known for their rarity. In this study, eight patients, all with aneurysms arising from the proximal(A1) segment of the anterior cerebral artery, were selected from 625 patients who underwent surgical treatment under the diagnosis of cerebral aneurysm. Each cases were reviewed as an attempt to investigate the demographic and clinical features of these patients. The incidence of A1 aneurysm was 1.3%. Multiple aneurysms occurred in one(12.5%) out of the 8 cases and the bleeding was from the A1 aneurysm. The mean age of the eight patients was 56.8 years: there were six women and two men. The aneurysms were classified according to the mode of origin of the aneurysm in relation to the A1 segment: in 4 of the 8 cases, the aneurysms were found to be originated from the junction of the A1 segment and a perforating artery: in which the remaining 4 cases, they are from the A1 segment directly. Computerized tomography(CT) of these aneurysms revealed subarachnoid hemorrhage extending to the surprasellar and sylvian cisterns similar to that of the posterior communicating artery aneurysm or the internal carotid artery bifurcation aneurysm. Bleeding which extends to the interhemispheric cisterns or septum pellucidum, while frequently occurrs during the rupture of anterior communicating artery aneurysm, are rare in these cases. Because there are many differences between the findings in author's series and these in the literature, coordinated studies are necessary to define the demographic and clinical features of A1 aneurysm in Korea.
Aneurysm* ; Angiography ; Anterior Cerebral Artery* ; Arteries ; Carotid Artery, Internal ; Diagnosis ; Female ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm ; Korea ; Male ; Rupture ; Septum Pellucidum ; Subarachnoid Hemorrhage

Stereotactic ventrolateral thalamotomy has been successful in treating a wide spectrum of involuntary movement disorders. But very little has been reported concerning their application in essential tremor. Twenty three patients with medically refractory disabling essential tremor underwent ventralis(VL) thalamotomies. The procedure was unilateral in twenty three cases. Contralateral tremor remained abscent or markedly reduced in 22 patients at the time of the most recent follow-up examinations at a mean of 2.9 months after surgery. Disability was determined by a modified form of an estabilished rating scale for termor reported by Fahn and was reduced from a mean score of 11 to 3(p<0.0001) after the operation. Persistent surgical morbidity was limited to three patients with mild dysarthria and two with a mild cognitive impairment. There were no surgically related deaths. It is concluded that stereotactic VL thalamotomy is a treatment option for medically intractable disabling essential tremor.
Dysarthria ; Dyskinesias ; Essential Tremor* ; Follow-Up Studies ; Humans ; Mild Cognitive Impairment ; Movement Disorders ; Tremor

We evaluated the clinical effects of amlodipine in 10 patients(7 male and 3 female) with angina pectoris in terms of the effect on the anginal pain, hemodynamic changes and side effects. The results obtained were as follows; 1) The clinical improvement was obsebed in 8(80.8%) of 10 and 9(88.9%) of 9 patients at 2 and 10 weeks after oral amlodipine. 2) The systolic and diastolic blood pressure was decreased significantly(136.0+/-16.5mmHg vs 117.0+/-10.6mmHg, p<0.01 and 85.0+/-9.7mmHg vs 75.0+/-5.3mmHg, p<0.01 respectively) but the heart rate was indepentent of amlodipine administration. 3) The adverse effects of amlodipine were as headache in 3, facial flushing in 3, palpitation, dizziness, urinary difficulty in 1 respectively and one of them discontinued amlodipine due to severe palpitation and facial flushing.
Amlodipine* ; Angina Pectoris* ; Blood Pressure ; Dizziness ; Flushing ; Headache ; Heart Rate ; Hemodynamics ; Humans ; Male

PURPOSE: To evaluate a role as over 35 years, maternal serum markers, and a false positive screen for Down syndrome were the predictor of adverse pregnancy outcome. Materials and METHODS: From Mar.1994, through Feb.1996, 5284 women were screened triple test to detect Down syndrome in the second trimester and were delivered Samsung Cheil hospital. The values of each maternal serum markers were measured with radioimmunoassay. And then, the screen positive of Down syndrome was calculated using alpha-software Version 4.0. The adverse outcome of the fetus and the mother included low birth weight(LBW) ( <2500gm), prematurity( <37 gestational weeks), placenta previa, preterm premature rupture of membranes(PPROM), pregnancy induced hypertension(PIH),abruptio placenta, and intrauterine fetal death(IUFD). The predictor markers included over 35years, elevated alpha-fetoprotein (AFP), elevated human chorionic gonadotropin(hCG), lowered unconjugated estriol (uE3), and a false positive screen for Down syndrome. RESULTS: Mean age and mean gestational weeks in the study were 30+/-4.8 years and 17.1 weeks respectively. The adverse pregnancy outcomes were 357 LBW(6.8%), 253 prematurity(4.8%), 108 placenta previa(2.0%), 68 PPROM(1.3%), 66 PIH(1.3%), 24 abruptio placenta(0.5%), and 20 IUFD(0.4%). In univariate analysis, over 35 years was significantly associated with abruptio placenta, prematurity, and placenta previa, elevated MS-AFP( >2.0 MoM) associated with IUFD, LBW, PIH, prematurity, and PPROM , elevated MS-hCG (>3.0 MoM) associated with IUFD, LBW, PIH, prematurity, and placenta previa, lowered uE3 (<0.75) associated with IUFD, abruptio placenta, LBW, and prematurity.(P <0.05). In multivariate logistic regression analysis, IUFD was significantly associated with only elevated MS-AFP, LBW associated with elevated MS-AFP, elevated MS-hCG, and lowered uE3, PIH associated with only elevated MS-AFP, PPROM only elevated MS-AFP, prematurity only elevated MS-AFP, and placenta previa over 35 years, elevated MS-hCG.(P <0.05). However, abruptio placenta was not significantly associated with predictor markers.(P >0.05) CONCLUSIONS: Some predictors such as over 35 year, elevated hCG, lowered uE3, a false positive screen for Down syndrome were significantly associated with adverse pregnancy outcome. Also in multivariate analysis, we identified especially elevated AFP to be the most reliable predictor for adverse pregnancy outcome.
alpha-Fetoproteins ; Biomarkers ; Chorion ; Down Syndrome ; Estriol ; Female ; Fetus ; Humans ; Logistic Models ; Mothers ; Multivariate Analysis* ; Parturition ; Placenta ; Placenta Previa ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, Second ; Pregnancy* ; Radioimmunoassay ; Rupture

Most of dural arteriovenous malformations(D-AVM's) are known to be an acquired lesion developed by a previously thrombosed dural sinus. They are usually no greater than 1 or 2 cm in size and most often present as spontaneous intracranial hematoma in fifth and sixth decades of life. We had surgical experiences of an unusual case of a 8 cm sized dural AVM in an infancy presented with a large scalp mass and two other cases presented with spontaneous intracerebral hemorrhage and subdural hematoma.
Cerebral Hemorrhage ; Hematoma ; Hematoma, Subdural ; Scalp