BACKGROUND AND OBJECTIVES: Body lateropulsion with falling to one side is a well-known clinical feature of stroke in the posterior circulation. Body lateropulsion as an isolated or predominant manifestation of a pontine stroke has not previously been reported. To elucidate the possible mechanisms of patients presenting with body lateropulsion as an isolated or predominant symptom of isolated pontine infarction. MATERIALS AND METHOD: Between May 2004 and February 2006, out of 134 admitted patients with an isolated pontine stroke we identified 8 consecutive patients (6.0%) in the Keimyung University Stroke Registry who had body lateropulsion as the main presenting symptom. RESULTS: All lesions were localized to the paramedian tegmentum just ventral to the 4th ventricle. All except 1showed a uniform pattern of body lateropulsion, in which the direction of falling was away from the side of infarct. In 2 patients, body lateropulsion was the sole clinical manifestation, whereas the other patients had other neurological signs. All but 1 had contraversive tilting of the subjective visual vertical (SVV). In all cases, the direction of SVV tilt corresponded to the direction of body lateropulsion. The mean net tilt angle was 6.1 CONCLUSION: Based on the known anatomy of ascending vestibular pathways, the SVV tilting, and MRI findings, body lateropulsion probably results from damage to the graviceptive pathway ascending through paramedian pontine tegmentum.
Humans ; Infarction* ; Magnetic Resonance Imaging ; Pons ; Stroke

The clinical studies were performen on 304 patients with heart disease who had been received corrective heart surgery at Kosin Medical Center from July, 1984 to December, 1991. The results were as follows: 1) Out of 304 patients, 162 cases (53.3%) were male and 142 cases (46.7%) were female and sex ratio was 1.15:1. 35 cases (11.5%) had clinical cyanosis and 269 cases (88.5%) had no evidence of cyanosis. 2) As age distribution of patients, under 2 years, 3~5 years, 6~10 years, 11~15 years, 16~18 years consist of 22.0%, 26.0%, 29.0%, 16.1% and 6.9%, respectively. 3) As disease distribution, out 304 patients, ventricular septal defect (57.9% of all) was the most common disease, and then atrial septal defect (13.2%), tetralogy of Fallot (11.2%), patent ductus arteriosus (9.9%) and pulmonic stenosis (5.3%), in their order. 4) As sex distribution of each disease, ventricular septal defect, atrial septal defect and tetralogy of Fallot were more common in male and patent ductus arteriosus and pulmonic stenosis were more common in female. 5) The most frequent cardiac anomaly associated with ventricular septal defect and atrial septal defect was pulmonic stenosis. In the case of subarterial ventricular septal defect, aortic insufficiency was associated in 13.3%. 6) Respiratory problems (11.3%), tricuspid regurgitation (9.5%), arrhythmia (6.2%) and congestive heart failure (5.8%) were the major complications after surgery. 7) Case fatality reat was 4.4%. Mortality rate in ventricular septal defect, tetralogy of Fallot and tricuspid atresia were 1.7%, 20.6% and 100%, respectively, Majority (75.0%) of expired patients were died within 24 hours after sugery and the cause of death was hypoxia due to low cardiac output syndrome.
Age Distribution ; Anoxia ; Arrhythmias, Cardiac ; Cardiac Output, Low ; Cause of Death ; Cyanosis ; Ductus Arteriosus, Patent ; Female ; Heart Diseases* ; Heart Failure ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Male ; Mortality ; Pulmonary Valve Stenosis ; Sex Distribution ; Sex Ratio ; Tetralogy of Fallot ; Thoracic Surgery ; Tricuspid Atresia ; Tricuspid Valve Insufficiency

Cerebral venous infarction is associated with a wide variety of clinical symptoms and signs, which may often delay appropriate diagnosis. Unilateral vestibular deficit as a presenting sign of cerebral venous infarction has rarely been reported. We report a patient with cerebral venous infarction who had severe prolonged vertigo, vomiting, occipital headache, positive head thrust testing, and unilateral caloric weakness as main clinical features. Although the patient had occipital headache, overall symptoms and signs closely mimicked those of acute peripheral vestibulopathy.
Diagnosis ; Head Impulse Test ; Headache ; Humans ; Infarction* ; Vertigo ; Vestibular Neuronitis ; Vomiting

Vestibular neuritis (VN) is an idiopathic peripheral vestibular syndrome characterized by acute isolated prolonged vertigo. In most cases, it results from inflammation of the vestibular nerve presumably of viral origin. There has been no previous report of VN associated with a vascular cause. We here report a patient with VN of vascular origin who presented with acute onset of prolonged isolated vertigo, a unilateral decreased caloric response, and simultaneously with acute infarcts on brain MRI that were unrelated to patient's vertigo.
Brain ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Vertigo ; Vestibular Nerve ; Vestibular Neuronitis*

No abstract available.
Bronchopulmonary Sequestration* ; Lung* ; Ultrasonography, Prenatal*

No abstract available.
Arthritis, Rheumatoid* ; Humans ; Neuroma*

The authors reviewed 3145 pediatric patients who visited the emergecy room in this hospital during 3yrs period from Jan. 1989 to Dec. 1991. 1) Among the patients visiting the emergency room, the patients under 15 years of age were 26.4% (3145) of total emergency patients (11930). 2) yearly distribution of patients were decreased 17% between 1989 and 1991. 3) Monthly distribution of visits showed higher incidence in June and July. The male to female ratio was 1.5:1. 4) Weekly distribution of visits showed higher incidence on Sunday and Saturday, relatively. 5) Most popular time of visiting the emergency room was between 8:00 PM to 12:00 PM during which time 29.5% of all pediatric patient were seen. 6) Distribution of age showed peak incidence between 6 and 12 years of age (30.9%). 7) 65.18% of total emergency room isits were pediatric patients. 8) Distribution of cases was as follows: Respiratory disease 37%, accident, GI disease in turn listed respectively in ecreasing order of freqency. 9) The admission rate through emergency was 8.5% of total pediatric emergency patients. 10) 82.3% of total emergency visits had medical insurance coverage, 7% had no insurance and 10.7% were on medical aid program.
Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Incidence ; Insurance ; Insurance Coverage ; Male

Background: To investigate the patterns of blood pressure (BP) decrement during the tilt, to compare the pattern of orthostatic hypotension (OH) and sympathetic index (SI) from the Valsalva maneuver (VM), and to identify whether the pattern of OH can predict the severity of autonomic failure. Methods: From January 2015 to July 2017, 551 consecutive patients with neurogenic OH were enrolled. All patients performed a standardized battery of autonomic tests, including the head-up tilt (HUT) test and VM using Finometer devices for recording beat-to-beat BP. SIs were calculated from the VM. The composite autonomic severity score (CASS) adrenergic subscore was also obtained to evaluate the severity of sympathetic adrenergic failure. Results: We classified OH into nine groups according to the patterns of orthostatic BP decrement during HUT. The two most common patterns of OH were classic stable OH (n=193) and classic OH with delayed normalization (n=102). Patients with classic stable OH and classic OH with delayed worsening had a more severe degree of sympathetic adrenergic failure as assessed with SI 5 and SI 4 from the VM, and a higher CASS adrenergic subscore than patients with other patterns of OH. There were no differences of autonomic parameters between the two delayed OH groups. Conclusions The different patterns of orthostatic BP decrement may reflect underlying different pathophysiologic mechanisms causing OH. The pattern of orthostatic BP decrement can help to predict the degree of sympathetic adrenergic autonomic failure.

Pelvic actinomycosis is a rare disease, and has variable clinical manifestations and courses, which make it difficult to diagnose the disease initially. We experienced a pelvic actinomycosis in a woman who complained vaginal discharge and lower abdominal pain, and had not been carring a intrauterine contraceptive device. This infection results in tissue destruction, fibrosis, and the formation of draining sinuses. We describe the case with brief review of clinical diagnosis and management.
Abdominal Pain ; Actinomycosis* ; Diagnosis ; Female ; Fibrosis ; Humans ; Intrauterine Devices ; Rare Diseases ; Vaginal Discharge

PURPOSE: This study was designed to determine the outcome and safety of intravenous gamma-globulin(IVGG) retreatment in Kawasaki disease. METHODS: A clinical observation of the therapeutic effects, laboratory findings and echocardiograms was carried out on 72 patients with Kawasaki disease in Kosin University Hospital from 1991 to 1999. 27 patients were treated with 1g/kg/day IVGG for 2 days, 45 patients were treated with 2 g/kg for 10hours. The clinical indication for retreatment was fever. Persistent fever was defined as a temperature> or =38.3degrees C persisting beyond 48hrs after the completion of the infusion. Recrudescent fever was defined as a temperature> or =38.3degrees C for 48hrs after the completion of the infusion, followed by a temperature< or =38.3degrees C. Treatment failure was defined as the development of new coronary artery abnormalities after IVCG treatment in a child with normal baseline echocardiogram. RESULTS: The 5 patients(6.94%) were retreated with IVC.G. Two were retreated due to persistent fever and three due to recrudescent fever. Among retreated patients, one was retreated with 1 g/kg and the others with 2g/kg. Nobody had serious complications, and there was no significantly different clinical charicteristics except for CRP between one course IVGG infusion and retreatment group(P=0.003). Treatment failure was not found in either gr<>up. CONCLUSION: We concluded that the IVGG retreatment of Kwasaki disease may improve the clinical course and coronary artery outcome.
Child ; Coronary Vessels ; Fever ; gamma-Globulins* ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Retreatment* ; Treatment Failure