Stroke is one of the leading causes of death in Korea. According to the report from Korean national statistical office, the mortality rate of stroke was 73.2/100,000 persons in 2000. In Western countries, stroke mortality rates declined gradually from 1970, which accelerated markedly around 1990. Since then, there has been no further decrease in stroke mortality rates until now and the situation has been similar in Korea. In the past, hemorrhagic stroke in Korea similar to other Far East Asian countries. However, the ratio of hemorrhagic to ischemic stroke has been reversed since mid-1980s. This trend might be due to the westernization of diet and life style as well as better control of hypertension. The case fatality rate from one of the large hospital-based stroke registry was 7.2% within 30 days after the onset of acute ischemic stroke, which is similar to those of other series from western countries with an advanced medical care systems. It may be attributed to the inclusion of more asymptomatic or milder patients with small lesions detected by neuroimaging. Importantly, the delay of hospital visit after the onset of stroke and the lower compliance for secondary prevention remain serious problems in managing acute stroke in Korea. Despite recent advances in the diagnosis and management of stroke, there has not been a nationwide population-based epidemiologic data on stroke in Korea. Therefore the application of Internet technology to develop multi center cooperative hospital-based registry could be an important step toward a long-waited nationwide stroke registry.
Asian Continental Ancestry Group ; Cause of Death ; Compliance ; Diagnosis ; Diet ; Epidemiology* ; Far East ; Humans ; Hypertension ; Internet ; Korea* ; Life Style ; Mortality ; Neuroimaging ; Secondary Prevention ; Stroke*

No abstract available.
Intestinal Fistula*

Vascular dementia is defined as a clinical syndrome of acquired intellectual impairment resulting from a brain injury due to a cerebrovascular disorder. It incorporates various vascular pathophysiological mechanisms and changes in the brain, and has diverse cause and clinical manifestations. The main suptypes of vascular dementia include 1) multi-infarct dementia, 2) strategic infarct dementia, and 3) subcortical vascular dementia. Both multi-infarct dementia and strategic infarct dementia show heterogeneity in etiologies, changes of the brain, as well as clinical manifestations. On the contrary, subcortical vascular dementia is suggested to be a more homogenous group. To better understand the clinical features of vascular dementia, cases corresponding to each subtype of vascular dementia are briefly discussed this review.
Brain ; Brain Injuries ; Cerebrovascular Disorders ; Dementia ; Dementia, Multi-Infarct ; Dementia, Vascular* ; Population Characteristics

No abstract available.
Child* ; Fetal Growth Retardation* ; Growth Hormone* ; Humans

Apert's syndrome is an uncommon, congenital disturbance in the growth of bone and soft tissue affecting principally the head, the hands and the feet. So there is skull malformation, most often oxycephaly, associated with malformation of both hands and feet. This syndrome was first reported by Apert in 1906. Since that time, over 200 cases have been reported. Recently we have experienced two cases of typical Apert's syndrome. We made a brief literature review.
Craniosynostoses ; Foot ; Hand ; Head ; Skull

No abstract available.
Pancreatic Pseudocyst*

No abstract available.
Colon* ; Rectum*

No abstract available.
Hemorrhage*

Cancer-related facial pain refractory to pharmacologic management or nondestructive means is a major indication for destructive pain surgery. Stereotactic mesencephalotomy can be a valuable procedure in the management of cancer pain involving the upper extremities or the face, with the assistance of magnetic resonance imaging (MRI) and electrophysiologic mapping. A 72-year-old man presented with a 3-year history of intractable left-sided facial pain. When pharmacologic and nondestructive measures failed to provide pain alleviation, he was reexamined and diagnosed with inoperable hard palate cancer with intracranial extension. During the concurrent chemoradiation treatment, his cancer-related facial pain was aggravated and became medically intractable. After careful consideration, MRI-based stereotactic mesencephalotomy was performed at a point 5 mm behind the posterior commissure, 6 mm lateral to and 5 mm below the intercommissural plane using a 2-mm electrode, with the temperature of the electrode raised to 80degrees C for 60 seconds. Up until now, the pain has been relatively well-controlled by intermittent intraventricular morphine injection and oral opioids, with the pain level remaining at visual analogue scale 4 or 5. Stereotactic mesencephalotomy with the use of high-resolution MRI and electrophysiologic localization is a valuable procedure in patients with cancer-related facial pain.
Aged ; Analgesics, Opioid ; Electrodes ; Facial Pain* ; Humans ; Magnetic Resonance Imaging ; Morphine ; Palate, Hard ; Upper Extremity

To investigate the changes of electrolytes and bio-chemical components during hemodialysis in 15 patients(7 men and 8 women) with end-stage renal disease undergoing long-term hemodialysis were studied. The mean age of 15 patients undergoing long-term hemodialysis was 45 year(range ; 26-62). The mean duration of hemodialysis was 58 months(range: 19-143) at time of the study. Hemodialysis was performed with acetate dialy- sate having 37mEq/1 acetate and 8.57g/100ml glu-cose(group A), with bicarbonate dialysate having 8 mEq/1 acetate and 30mEq/1 bicarbonate without glu-cose(group B) for 4-hour. Each blood sample was drawn for blood gas analysis, blood glucose, blood urea nitrogen and electrolytes from the arterial line at 0, 1, 2, 3, and 4-four during hemodialysis. In group A, the body temperature measured at 1 hour increased significantly compared with that of predialysis. The blood glucose level increased pro-gressively during dialysis. In group B, the body temperature measured at 1 hour also increased sig- nificantly compared with that of predialysis. However, the blood glucose level increased progressively during dialysis as removing urea in blood during dialysis. These results suggested that blood urea nitrogen may be a cause of hypothermia. Mean corpuscular volume(MCV) increased significantly at 2-hour in group A and returned to baseline values at 4-hour. In group B, the mean level of glucose value in dialysate of outlet line of dialyzer increased to 38.3mg/dl from zero in inlet line, and PaC&z decreased significantly because of diffusion of COz across the dialyzer. In Group A, PaOz decreased significantly at 1-hour and returned to baseline values at 4-hour, whereas HCC4 was increased significantly at 4-hour. The intracellular potassium content may decreased in long-term hemodialysis patients cornpared with normal control. In Group A, hernoglobin diphosphoglycerate(2, 3-DPG) concentraion increased from 10.9 pmoVg before dialysis to 19.9pmol/g after dialysis. Despite substantial anemia, hemoglobin 2, 3-DPG prior to dialysis was significantly lower than the value obtained in the normal control(17.5+4.3 p moVg). In group A, the blood lactate level decreased significantly at 1-hour and returned to baseline values at 4-hour. Our data suggested that body temperature might be increased due to removal of urea nitrogen, and blood glucose may be decreased because of the dif- fusion across dialyzer. In addition, this study showed that intracellular potassium content was lowered, the MCV of RBC was increased during hemodialysis. Transient decrement of PaCOz during early phase of dialysis and decreased hemoglobin 2, 3-DPG of despite anemia before dialysis improved with the increment of blood pH and HCC4 at the end of dialysis.
Anemia ; Bays ; Blood Gas Analysis ; Blood Glucose ; Blood Urea Nitrogen ; Body Temperature ; Dialysis ; Diffusion ; Electrolytes* ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Hypothermia ; Kidney Failure, Chronic ; Lactic Acid ; Male ; Nitrogen ; Potassium ; Renal Dialysis* ; Urea ; Vascular Access Devices