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A 22 years old man was admitted to the= Department of Neurosurgery, Capital Armed General Hospital, Seoul, Korea. complaining of a sudden visual disturbance 8 months before admission. Fifteen days later itis vision became diploic and was followed by general weakness and progressive loss of libido. On neurological examination he was fully conscious. Both optic fundi were normal. But his visual fields were bilaterally constricted, more in the temporal ones. His visual acuity was; OS, 20/40 and OD; 20/200. No other neurological abnormality was noted. Cerebrospinal fluid was normal. Skull X-ray showed a slightly enlarged pituitary fossa. PEG showed air-filling in the postchiasmatic cistern but no air shadow was seen in the sella. Right frontotemporal approach was done and a large empty sella was found, in which optic chiasma was sunken. Gelfoam tagged with a silver clip was placed in the empty sella for the elevation of the sunken optic chiasm. Postoperatively his vision was much improved.
A 26-year-old male patient was admitted to the Department of Neurosurgery, Capital Armed Forces General Hospital on July 4, 1974. He complained of severe headache, dizziness, vomiting and weakness of both lower extremities. Initially, 5 days previous to admission, weakness of right lower extremity was occurred and then it was aggravated progressively to result in paraplegia and urinary and fecal difficulty. On examination, he was mentally clear, well-oriented and speech was good. But his appearance was acutely illed and irritable. There was severe degree of stiffness of the neck and Kernig's sign. Paraplegia was more on the right side with sensory loss below T10 level bilaterally in all sensory modalities. There was severe tenderness around T7 area on the back. Flaccid neurogenic bladder was present. DTRs were abolished in all part and Babinski and ankle clonus persisted. Blood count revealed moderate leucocytosis and mild degree of anemia which was aggravated progressively until the time of death. Urine was bloody and albuminuric. CSF study showed markedly elevated protein and pleocytosis. Blood culture gave gram-positive, straight rod arranged in long chain bearing spores in nearer one pole. Lumbar and cisternal myelography showed complete block of dye column Ll and C6 respectively. Total laminectomy was done under the diagnosis of the thoracic spinal epidural abscess, T7 area. We found severe arachnoid adhesions from Ll to T3. Postoperatively neurological condition was much improved but systemic symptoms and signs were not calmed down in spite of massive antibiotic therapy. Patient died of fulminating bacteremia on August 11, 1974.
In order to examine the validity of mathematics course for elementary pre-service teacher, we surveyed the perception of student on the introduction class of mathematics who are going to be elementary school teacher. 218 junior students in Cheongju National University of Education who took a introduction class of mathematics when they were freshman were asked of what did they remember on mathematics, what mathematics did they experience and what teaching method was used in a introduction class of mathematics, and their suggestion on improvement of this class.
Authors report the clinical study on the usefulness of thyrotropin-releasing hormone tartrate(TRH-T) in the treatment of mild disturbance of consciousness. 20 patients suffering head trauma, subarachnoid hemorrhage, and intracerebral hemorrhage were given TRH-T intravenously for ten days. TRH-T was effective for the patients in whom the consciousness disturbance was mild, the duration in fixed consciousness level was short, and the brain was not distorted on CT scan. These features were most prominent in patients with subarachnoid hemorrhage. There was no significant side effect, and TRH-T turned out to be safe.
In order to study about the causes of deleterious effects of mannitol, which is frequently used in severe neurosurgical patients, author had performed a clinical experimental study after infusion of 15% mannitol intravenously. The amount of injection was 1.5 gm to 2.0 gm per kilogram, body weight. Twenty patients who were admitted to the Department of Neurosurgery, Seoul National University Hospital from April, 1976 to August, 1976, were studied. Author had observed changes of pulse rate and blood pressure, urine output and uring specific gravity at 15 minutes, 30 minutes, 45 minutes, 60 minutes, 120 minutes ISO minutes, 240 minutes, 300 minutes and 360 minutes after completion of mannitol infusion. And author had studied those changes of CBC, electrolyte, serum and urine osmolalities. The results are as following: 1. Blood pressure was decreased 10㎜Hg in systolic pressure during 30 minutes to one hour after mannitol infusion but pulse rate was not significantly changed. 2. Urine output in 6 hours was 1368cc in average, of which 70 percent was excreted within three hours. 3. Changes of urine specific gravity were raising from one hour and peak value was at 5 hours after mannitol infusion. 4. Serum Na and urine osmolalities were significantly changed after mannitol infusion.