No abstract available.
Headache* ; Humans ; Physicians, Primary Care* ; Primary Health Care*

No abstract available.
Humans ; Neurologic Examination* ; Physicians, Primary Care* ; Primary Health Care*

BACKGROUND & OBJECTIVES: Subacute combined degeneration (SCD) is a disease of spinal cord involving the posterior and lateral column due to vitamin B12 deficiency. The clinical and electrophysiologic findings of SCD are various. METHODS: From 1989 to 1996, 7 patients were diagnosed with SCD in our hospitals. The diagnosis was made by the neurologic and laboratory findings and electrophysiolgic studies such as nerve conduction studies(NCS) and evoked potential(EP). RESULT: Four patients received gastrectomy. Two had chronic atrophic, gastritis; one of them was assumed to have food-cobalamin malabsorrtion. The remaining one was a heavy drinker. The mean duration of neurologic symptoms was 35.7 months. The most common initial complaint was paresthesia (in 4) and impairment of cutaneous sensation was the most common neurologic sign At the time of diagnosis, 5 patients had myelopathy with was supported by EP in 3(60%). There were abnormal NCS findings in 5 f 6 patients with peripheral neuropathy. In one patient, there was no symptom and sign compatible with myelopathy but median nerve SEP showed bilateral central conduction delay. No one had visual symptoms but prolongation of P 100 was detected in 2 patients. Sural nerve biopsy was done in 2 case, which revealed chronic nonspecific neuropatby in one and chronic axonopathy in the other. Megaloblastic anemia was found in 4 cases and improved by cobalamin therapy in all the parents, in which the follow up hematologic data were available. There as a tendency that nonanemic patients had more severe neurologic symptoms than anemic ones. We could not find any relationship between the duration and severity of neurologic menifestations was best in the patients with the shortest duration of neurologic manifestations and hematologic feature festations. CONCLUSIONS: The authors suggest that early detection and treatment is very important for the improvement of symptoms in SCD.
Anemia, Megaloblastic ; Biopsy ; Diagnosis ; Follow-Up Studies ; Gastrectomy ; Gastritis ; Humans ; Median Nerve ; Neural Conduction ; Neurologic Manifestations ; Parents ; Paresthesia ; Peripheral Nervous System Diseases ; Sensation ; Spinal Cord ; Spinal Cord Diseases ; Subacute Combined Degeneration* ; Sural Nerve ; Vitamin B 12 ; Vitamin B 12 Deficiency

The affiliations were published incorrectly.

No abstract available.
Classification* ; Humans ; Leukemia* ; Survival Rate*

No abstract available.
Brain Stem* ; Hepatolenticular Degeneration*

We have met 5 cases of cerebral sparganosis since 1984, including one which was reported by Hong et al. In 1985. We reviewed their medical records and clinical manifestations, possible etiologic histories, findings of brain CT and micro-ELISA done in all cases, and findings of brain biopsy done in 2 cases were discussed. 1. Initial manifestations were seizures (in 4 of 5) or limb weak-nesses (in 4 of 5), which were followed by symptoms and signs due to space occupying effects. 2. Raw snakes or raw frogs were ingested in 3 cases and estimated incubation periods in 2 cases were 2 and 5 years respectively. 3. Brain CT's showed widespread low density, usually in white matter area, ipsilateral ventricular dilatation and/or enhaneing nodules. 4. Micro-EILSA's showed that initial titers of sparganum-specific Ab were above criterion (0.22) except for serum of case 5, and F/U micro-ELISA'S done in 3 cases revealed negative conversion (decrease of Ab titer below criterion) only for CSF of case 5, in which surgical removal was successfully done, and otherwise variable changes of titers. 5. Brain biopsies done in 2 cases showed such findin-gs as degenerating worm, granuloma, tunnel formation, and calcospherules.
Biopsy ; Brain ; Dilatation ; Extremities ; Granuloma ; Medical Records ; Seizures ; Snakes ; Sparganosis*

Authors analyzed clinical and electrophysiological features of 35 patients with alcoholic neuropathy who had visited the Boramae City Hospital. All patients were men. Most of the cases drank alcohol everyday. The duration of alcohol consumption is from 2 to 47 years (mean, 17.8 years). Patients with relatively short history of alcohol consumption had a tendency to take more inadequate meals. Clinically we found two distinct separable categories ; one was sensorimotor peripheral neuropathy associated with other alcoholic complications, such as Wemicke and Pellagra disease, delirium tremens, liver disease etc(24 patients). The other had subacutely progressing prominent weakness with sensory change, especially in lower extremities(ll patients). Electrophysiological studies showed decreased amplitudes of sensory or motor compound action potentials with relative preservation of conduction velocity favoring axonal neuropathy. Among the electrophysiological parameters, abnormalities in F-wave(78.3%), H-reflex(86.4%) and sural nerve conduction studies(78.8%) were more frequently observed than in others, which were thought to be more sensitive parameters with early involvement. In terms of electrophysiological pattern there were no definite diffemeces between the two groups.
Action Potentials ; Alcohol Drinking ; Alcohol Withdrawal Delirium ; Alcoholic Neuropathy* ; Alcoholics* ; Axons ; Hospitals, Urban ; Humans ; Liver Diseases ; Male ; Meals ; Pellagra ; Peripheral Nervous System Diseases ; Sural Nerve

PURPOSE: The aim of this study is to identify postoperative renal function and preoperative factors that can predict renal impairment after living donor nephrectomy. MATERIALS AND METHODS: We studied 172 patients undergoing living donor nephrectomy for kidney transplantation (115 males, 57 females). We analyzed the renal function measured by serum creatinine and the 99mTc- diethylenetriamine penta-acetic acid (DTPA) renal scan. Using a univariate and multivariate analysis, we also analyzed multiple independent variables for the remaining renal function following living donor nephrectomy, such as serum creatinine, glomerular filtration rate (GFR), age, sex, duration of follow-up, blood pressure, body mass index (BMI), serum calcium, serum phosphate, serum uric acid. RESULTS: The mean age of the donors was 34 years, and the mean duration of the follow-ups was 11 months. The mean serum creatinine at 11 months after kidney donation was increased compared to preoperative creatinine (1.26mg/dl vs. 0.93mg/dl), and significantly greater in the males than in the females (1.36mg/dl vs. 1.09mg/dl). Mean GFR measured by the 99mTc- DTPA renal scan at 11 months after kidney donation was 69.2 ml/min/ 1.73m2 and similar for men and women (72.3ml/min/1.73m2 vs. 68.3ml/ min/1.73m2). The univariate analysis showed that preoperative creatinine was significantly associated with postoperative creatinine only (p<0.001), and age and sex were associated with the change in creatinine (p=0.046, p<0.001). The univariate analysis also showed that preoperative GFR and age were significantly associated with postoperative GFR (p<0.001, p<0.001), and age was associated with compensatory change in GFR (p= 0.008). The multivariate analysis showed that preoperative GFR was the primary predictive factor of postoperative GFR (r=0.73, p<0.001), and age was an independent secondary predictive factor (r= 0.67, p<0.001). CONCLUSIONS: These results suggest that postoperative renal function has been preserved in kidney donors, and preoperative creatinine, preoperative GFR, and age at donation were the important predictive factors of renal function after living donor nephrectomy.
Blood Pressure ; Body Mass Index ; Calcium ; Creatinine ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Kidney ; Kidney Transplantation ; Living Donors* ; Male ; Multivariate Analysis ; Nephrectomy* ; Pentetic Acid ; Tissue Donors ; Uric Acid

OBJECTIVES: The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. METHODS: The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. RESULTS: Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). CONCLUSION: Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.
Academic Medical Centers ; Aged ; Compliance ; Delirium ; Follow-Up Studies ; Hospitalization ; Hospitals, General ; Humans ; Inpatients ; Korea ; Logistic Models ; Mood Disorders ; Outpatients ; Referral and Consultation