No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Apoptosis* ; Caspase 3* ; Endothelial Cells* ; Perforin* ; Vibrio vulnificus* ; Vibrio*

BACKGROUND: Cardiogenic embolic infarction is the most preventable type of ischemic stroke. This study was under-taken to compare the infarct size, prognosis, and risk factors between cardiogenic embolic infarction (CE) and large artery atherosclerotic infarction (LAA). METHODS:We reviewed the medical records and brain computed tomography/magnetic resonance image (CT/MRI) scans of patients with CE or LAA during the period between January 1996 and May 1998. Patients with lacunar and posterior circulation infarctions were excluded. A slice of brain CT/MRI scan showing the largest lesion was selected in each patient and the area of infarction was then measured. Prognosis was determined by the Modified Rankin Disability Scale (MRDS) and was grouped as either good (MDRS 0, 1, 2) or poor (MDRS 3, 4, 5). RESULTS: The study included 103 patients : 50 with CE (NVAF in 23, VHD with or without AF in 13, prosthetic valve in 6, and others in 8) and 53 with LAA (large artery thrombosis in 29, and artery to artery embolism in 24). The infarct size of CE (23.2+/-14.7 cm2) was significantly larger than that of LAA (11.4+/-10.5 cm2) (p<0.001). The infarct size of NVAF (29.0+/-19.1 cm2) was significantly larger than that of VHD with or without AF (19.2+/-11.5 cm2) (p<0.05). Patients with CE had a worse prognosis (poor in 46%) than those with LAA (poor in 23%) (p<0.05). CONCLUSIONS Our results showed that CE led to larger lesions and worse outcomes. Therefore, we emphasize the importance of primary and secondary preventions of stroke in patients with cardiogenic embolic sources.
Arteries* ; Brain ; Embolism ; Heart Valve Diseases ; Humans ; Infarction* ; Medical Records ; Prognosis* ; Risk Factors ; Secondary Prevention ; Stroke ; Thrombosis

Duret hemorrhage is characterized by an upper brainstem hemorrhage due to increased intracranial pressure by mass effect such as subdural hematoma or a brain tumor. The anteroposterior elongation and downward displacement of the upper brainstem by transtentorial herniation results in the compression and tearing of the paramedian perforating vessels that feed the upper brainstem tegmentum. The consequent hemorrhage that involves the upper brainstem renders recovery to be almost impossible. Following a tricuspid valve replacement surgery, a 56-year-old woman developed a left fronto-temporo-parietal nontraumatic subdural hematoma resulting in transtentorial herniation of the left mesial temporal lobe. A successful surgical evacuation of the hematoma was done with clinical improvement. Two days later, she was referred to neurology with an aggravated right side weakness, dysarthria, and a newly developed extraocular movement disturbance. A brain CT and MRI showed a pontine hemorrhage. We report a case of pontine hemorrhage, a Duret hemorrhage, after the surgical evacuation of nontraumatic subdural hematoma.
Brain ; Brain Neoplasms ; Brain Stem ; Dysarthria ; Female ; Hematoma ; Hematoma, Subdural* ; Hemorrhage* ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Middle Aged ; Neurology ; Temporal Lobe ; Tricuspid Valve

We performed original and modified technique of Mays' glanuloplasty in 6 and 12 cases respectively. The results were as follows: 1. 6 cases of mild from of hypospadias (2 cases of coronal, 4 cases of dist. penile) and 12 cases of severe form of hypospadias (5 cases of prox. penile, 6 cases of penoscrotal, 1 case of perineal) on pre-chordectomy but all cases became severe from of hypospadias (2 cases of prox. penile, 15 cases of penoscrotal, 1 case of perineal) on post-chordectomy. 2. The postoperative complications were 3 cases (50.0%) (1 case of meatal stenosis, 2 cases of meatal necrosis) in original technique of Mays' glanuloplasty and 2 cases of meatal stenosis (16.7%) in modified technique of Mays' glanuloplasty.
Constriction, Pathologic ; Female ; Hypospadias* ; Male ; Postoperative Complications

The management of LcP disease is dependent on the prognosis yet. This may be difficult to predict for the individual child, particularly at the onset of the disease when radiological sign may be minimal. But some form of conservative treatment is generally commenced before the prognosis become apparent. The purpose of this study was to determine the validity of Catterall's grouping and value of other radiological and clinical factors in predictiong prognisis and also the correlation between the clinical and radiological results at the conclusion of the pathological precess in LCP disease. Between the clinical and radiological results at the conclusion of the pathological process in LCP disease. Between June 1986 and July 1995, 64 childrens with LCP disease were tearted in Kyungpook University Hospital, 44 hips of 40 childrens who had adequate clinical and radiological data were reviewed. The average follow-up period was 5.4 years. The results obtained were followings: 1.The mean age at first visit or diagnosis was 6.7 years. 2. Of 40 childrens, 4 childrens had bilateral involvement. Boys were more predominat. 3. The degree of uncovering of femoral head and medial joint space at the presentation seemed to be prognostic factor for the end results. 4. Catterall & lateral pillar classification seemed to be difficult at presentation of the disease but also an important guide to determine the prognosis.
Child ; Classification ; Diagnosis ; Follow-Up Studies ; Gyeongsangbuk-do ; Head ; Hip ; Humans ; Joints ; Legg-Calve-Perthes Disease ; Prognosis

BACKGROUND: Post-intubation injury is known to be the most common cause of tracheal stenosis. Treatment strategy for tracheal stenosis varies accoring to the extent of pathologic lesion. Focal mucosal lesion can be treated with laser photoablation, but full thickness tracheal lesion should be treated with resection and anastomosis. MATERIAL AND METHOD: From Aptil 1998 to May 1999, twelve patients suffering from tracheal stenosis as a complication of endotracheal intubation were managed by resection and end-to-end anastomosis in the Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital. RESULT: There was no operative mortality. Five temporary vocal cord paralysis and one wound infection occurred as early complications. During 18 months of follow-up, re-stenosis was not found. CONCLUSION: Tracheal resection and anastomosis can be considered as an excellent surgical treatment for tracheal stenosis which developed as a complication of endotracheal intubation.
Follow-Up Studies ; Humans ; Intubation, Intratracheal ; Mortality ; Tracheal Stenosis* ; Vocal Cord Paralysis ; Wound Infection

No abstract available.
Ectopia Cordis*

Neurofibromatosis type 1 (NF1; also known as von Recklinghausen's neurofibromatosis) is inherited in an autosomal dominant fashion, although it can also arise due to spontaneous mutation. Gastrointestinal involvement of NF1 is seen in 10% to 25% and causes symptoms in fewer than 5%. Histologically, the gastro intestinal (GI) manifestation of NF1 occurs in three forms: hyperplasia of the gut neural tissue, stromal tumors, and duodenal or periampullary endocrine tumors. A 31-year-old female, diagnosed with NF1, presented with poor oral intake and vomiting for 10 days prior to admission. Preoperative gastrofiberscopic finding was gastric outlet obstructing polypoid duodenal bulb lesion. The patient underwent hemigastrectomy with antecolic gastrojejunostomy due to gastric outlet obstruction. The final pathologic report was submucosal neurofibromatous proliferation with Brunner's gland hyperplasia located at the duodenal bulb in the NF1 patient. We report this case with a review of literatures.
Adult ; Female ; Gastric Bypass ; Gastric Outlet Obstruction ; Humans ; Hyperplasia ; Neurofibromatoses ; Neurofibromatosis 1 ; Vomiting

There are many methods for postoperative pain relief. For example,intramusoular or in- travenous administration of analgesics,nerve block,wound infiltration or intravenous injaction with local anesthetics, epidural or intrathecal injection of opioids or local anesthetics, TENS, cryoanalgesia, psychological support are available, We managed postoperative pain by means of intrathecal morphine injection or epidural morphine with bupivacaine mixture administration. In the group 1, morphine 0.2mg was injected intrathecally just after the operation. In the group 2, the mixture of morphine with bupivacaine was infused into epidural space continuously for 3days. The results were as follows; 1. The pain score was significantly decreased in group 2 compared to group 1.(P<0.05) 2. In group 1,there was signficantly more itehing sensation than in group 2.(P<0.05), but there were no significst differences in other complications 3. There was no significant difference in gas passing time. 4. The feeling of satisfaction was high in both groups,and there was no significant difference. 5. It was technically more difficult and the cost was higher in group 2.
Analgesics, Opioid ; Anesthetics, Local ; Bupivacaine* ; Epidural Space ; Injections, Spinal ; Morphine* ; Pain, Postoperative ; Sensation ; Transcutaneous Electric Nerve Stimulation