Orthostatic headache after suboccipital craniectomy has been rarely reported. A 32-year-old man underwent emergent suboccipital craniectomy due to acute bilateral cerebellar infarctions with massive brain edema. Although his neurological deterioration halted after the craniectomy, he still suffered from a severe disabling orthostatic headache. We performed two epidural blood patches at the levels of the lumbar and thoracic spine. He improved considerably a few days after the repetitive epidural blood patches. Epidural blood patches may be a useful treatment modality for post-craniectomy postural headaches.
Adult ; Blood Patch, Epidural* ; Brain Edema ; Headache* ; Humans ; Infarction ; Spine

The authors report jerky seesaw nystagmus, extorsional downbeating in the right eye and intorsional upbeating in the left eye, in a patient with right internuclear ophthalmoplegia (INO). This pattern of nystagmus may occur by disrupting pathways from contralateral posterior and anterior semicircular canals by a lesion in the medial longitudinal fasciculus. Depending on damage to the pathways from contralateral vertical canals, various patterns of dissociated torsional-vertical nystagmus may accompany INO.
Humans ; Ocular Motility Disorders* ; Semicircular Canals

No abstract available.
Hemianopsia* ; Isoniazid ; Tuberculosis

The authors report jerky seesaw nystagmus, extorsional downbeating in the ipsilesional eye and intorsional upbeating in the contralesional eye, in a patient with internuclear ophthalmoplegia (INO) from focal pontine lesion. This pattern of nystagmus may occur by disrupting pathways from contralateral posterior and anterior semicircular canals by a lesion in the medial longitudinal fasciculus. Depending on the pathways involved, various patterns of dissociated torsional-vertical nystagmus may accompany INO.
Humans ; Ocular Motility Disorders* ; Semicircular Canals

Obesity-Hypoventilation syndrome (OHS) is characterized by morbid obesity, hypoxia, and hypercapnea during wakefulness without parechymal lung disease or severe obstructive sleep apnea. A woman was admitted because of mental deterioration and diagnosed as OHS on the basis of obesity and hypoventilation, while awake, after ruling out other causes. By bilevel positive airway pressure (BiPAP) therapy, hypercapnea and hypoxia were resolved. We report that BiPAP can be an effective treatment for severe hypercapnea and hypoxia in OHS, which obviate the need for invasive endotracheal intubation.
Anoxia ; Female ; Humans ; Hypoventilation ; Intubation, Intratracheal ; Lung Diseases ; Obesity ; Obesity Hypoventilation Syndrome* ; Obesity, Morbid ; Sleep Apnea, Obstructive ; Wakefulness

BACKGROUND: Gait disturbance is one of the most disabling symptoms of Parkinson's disease (PD). To better understand of the dynamics of gait in PD, we quantitatively evaluated the spatiotemporal and kinematic parameters of gait in PD patients and normal controls with 3-demensional gait analysis system. METHODS: The diagnosis of PD was based on UK Brain Bank criteria. Subjects with PD were recruited from Parkinson disease clinic of Korea University Medical Center. The severity was indicated by Hoehn and Yahr stage and Unified Parkinson disease rating scale (UPDRS). The gait analysis and assessment was performed in the off condition. RESULTS: Thirty PD patients and thirty normal controls were included. The statistical significant results of gait analysis between PD and control groups were as followings; reduced walking velocity, reduced stride length, increased double supporting time, reduced pelvic oblique movement with preserved pelvic tilting, reduced maximal flexion and extension of hip joint, reduced flexion angle of knee joint especially in terminal stance phase and swing phase, and reduced plantar flexion of ankle. But there were no significant difference between PD and control groups in cadence. And these parameters except cadence had significant correlation with clinical disability in PD patients. The cadence did not correlated significantly with clinical disability. CONCLUSIONS: The PD patients showed statistically gait cycle change with preserved cadence, reduced range of motion in hip, knee, and ankle joint with preserved ankle dorsiflexion in the profiles. These features were aggravated in advanced stage.
Academic Medical Centers ; Ankle ; Ankle Joint ; Brain ; Diagnosis ; Gait* ; Hip ; Hip Joint ; Humans ; Knee ; Knee Joint ; Korea ; Parkinson Disease* ; Range of Motion, Articular ; Walking

BACKGROUND/AIMS: Recently, treatment using an endoscopic device is actively being developed. Techniques for incision and bleeding control have been developed, but endoscopic suturing remains to be perfected. Using an endoscopic suturing technique, a variety of diseases could be managed noninvasively. We have attempted to use a new endoscopic suturing device which enables a continuous suture using a flexible upper endoscope. METHODS: A suturing device was designed where a semicircular needle could sew through tissue by rotation making a continuous suture possible. RESULTS: We successfully sutured the stomach tissue of a dog using an optimized suturing device model. CONCLUSIONS: The initial model was found to have some problems. However, we hope to develop a continuous suturing device for flexible upper endoscope procedures in Korea.
Animals ; Dogs ; Endoscopes ; Endoscopes, Gastrointestinal* ; Endoscopy ; Hemorrhage ; Hope ; Korea ; Needles ; Stomach ; Sutures*

BACKGROUND: Although several hospital-based stroke studies were published, there has not been any reliable data representing the clinical characteristics of stroke in Korea. We analyzed the clinical characteristics of patients with ischemic stroke registered in the Korean Stroke Registry (KSR), which is the largest prospective hospital-based nation-wide stroke registry in Korea. METHODS: The KSR provided standardized protocols for collecting data, which includes the data of demographics, subtypes of stroke, risk factors, and neurological outcome at discharge. The brain imaging studies, including CT or MRI, were performed in all cases. RESULTS: KSR registered 10,811 patients of acute ischemic stroke between Nov. 2002 and Jun. 2004. The large-artery atherosclerosis was the most common subtype (37.3%), followed by small vessel occlusion (30.8%). Hypertension (65.4%) was the most common risk factor, followed by smoking (34.5%) and diabetes (28.3%). Although most of the hypertensive and diabetic patients had been diagnosed before the stroke, less than 45.4% and 32.5% of them were under regular control. The steno-occlusive lesion of extracranial carotid artery was only 29.3% and the ratio of intra- to extracranial artery disease was more than 2 in KSR. Only 20.5% of patients were admitted within 3 hours after stroke onset and 2.1% were treated with intravenous thrombolysis. In-hospital case-fatality was 5.2%, which is relatively comparable to those of previous studies. CONCLUSIONS: The KSR provided informative data in understanding the clinical characteristics of ischemic stroke in Korea. Further analysis of KSR will facilitate clinical trials and development of guidelines for the management of stroke patients.
Arteries ; Atherosclerosis ; Carotid Arteries ; Cerebrovascular Disorders ; Demography ; Epidemiology ; Humans ; Hypertension ; Korea ; Magnetic Resonance Imaging ; Neuroimaging ; Prospective Studies* ; Registries ; Risk Factors ; Smoke ; Smoking ; Stroke*