As, until now, many studies have failed to establish the clinical effect of numerous neuroprotectives, antithrombotic therapy must be emphasized as one of critical options among limited treatment strategies in acute ischemic stroke. Based on the accumulating evidences that platelets and coagulating proteins play an important role in the thrombus formation, antiplatelets and anticoagulants are served as antithrombotics. Recently, major advances have been made in understanding the effects of antiplatelets and anticoagulants. Large randomized clinical trials have highlighted the effectiveness and safety of early and continuous antiplatelet therapy in reducing atherothrombotic stroke recurrence. Urgent anticoagulation has been used often to prevent early recurrent stroke and to improve neurological outcomes, however, its formal use in acute stroke has been the subject of debate even in cardioembolic stroke. That's because anticoagulants also increase the risk of fatal or disabling intracranial hemorrhage and it is difficult to monitor proper anticoagulation. Although early administration of anticoagulants should be considered to prevent the secondary injury and the propagation of thrombosis in patients with atherothrombotic stroke, more evidences are needed especially in patients with infractions secondary to large artery thrombosis or cardioembolism. This review discusses recent advances related to antithrombotic strategies and putative neuroprotectives.
Anticoagulants ; Arteries ; Blood Platelets ; Humans ; Intracranial Hemorrhages ; Organothiophosphorus Compounds ; Proteins ; Recurrence ; Stroke ; Thrombosis

Background and Objectives: This study aimed to describe the ischemic stroke subtypes and risk factors in young Korean adults, focusing mainly on traditional risk factors and management of ischemic stroke. Methods: The study patients were the fi rst-ever acute cerebral ischemic infarction age 49 years or below admitted to the Kyung Hee University Medical Centre from September 2003 to June 2009, with ischaemic stroke patients >50 years as control. The stroke subtypes was categorized according to Trial of Org 10172 in Acute Stroke Treatment classifi cation. The traditional risk factors of ischemic stroke were examined. For those known to have hypertension and diabetes prior to onset of stroke, their adherence to treatment of hypertension and diabetes was also assessed. Results: Close to half of the patients ≤49 years were due to premature atherosclerosis from small vessel occlusion and large artery atherosclerosis. The most common risk factor in declining order was hypertension, smoking, dyslipidemia and obesity. On logistic regression analysis, hypertension, dyslipidemia, and obesity were strongly associated with small vessel occlusion. In patients who were known to have hypertension and diabetes prior to the onset of stroke, the younger patients were less adherent to the treatment as primary prevention than the older stroke patients. Conclusion: This study suggests that premature atherosclerosis from small vessel occulusion is the most common cause of ischaemic stroke among young adults in Korea. Non-adherence to primary preventive treatment of hypertension and diabetes is common.

No abstract available.
Aged ; Alcohol-Induced Disorders, Nervous System/etiology/*pathology ; Alcoholism/complications/*pathology ; Cerebellum/*pathology ; Diagnosis, Differential ; Early Diagnosis ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Reproducibility of Results ; Sensitivity and Specificity ; Spinocerebellar Degenerations/*etiology/*pathology

No abstract available.
Infarction*

PURPOSE: Virtual colonoscopy is the most recently developed tool for detecting colorectal cancers and polyps, but its effectiveness is limited. In our study, we compared the result of preoperative virtual colonoscopy to result of preoperative and postoperative colonoscopy. We evaluated also the accuracy of preoperative virtual colonoscopy in patients who had obstructive colorectal cancer that did not allow passage of a colonoscope. METHODS: A total of 164 patients who had undergone preoperative virtual colonoscopy and curative surgery after the diagnosis of a colorectal adenocarcinoma between November 2008 and August 2013 were pooled. We compared the result of conventional colonoscopy with that of virtual colonoscopy in the nonobstructive group and the results of preoperative virtual colonoscopy with that of postoperative colonoscopy performed at 6 months after surgery in the obstructive group. RESULTS: Of the 164 patients, 108 were male and 56 were female patients. The mean age was 62.7 years. The average sensitivity, specificity, and accuracy of virtual colonoscopy for all patients were 31.0%, 67.2%, and 43.8%, respectively. In the nonobstructive group, the average sensitivity, specificity, and accuracy were 36.6%, 66.2%, and 48.0%, respectively, whereas in the obstructive group, they were 2%, 72.4%, and 25.4%. Synchronous cancer was detected via virtual colonoscopy in 4 of the 164 patients. CONCLUSION: Virtual colonoscopy may not be an effective method for the detection of proximal colon polyps, but it can be helpful in determining the therapeutic plan when its results are correlated with the results of other studies.
Adenocarcinoma ; Colon* ; Colonic Polyps ; Colonography, Computed Tomographic* ; Colonoscopes ; Colonoscopy ; Colorectal Neoplasms* ; Diagnosis ; Female ; Humans ; Male ; Methods ; Polyps ; Sensitivity and Specificity

No abstract available.
Etoposide* ; Fluorouracil* ; Stomach Neoplasms*

No abstract available.
Bleomycin* ; Drug Therapy, Combination* ; Etoposide* ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

Klinefelter' syndrome is a disorder of sexual differentiation in males, characterized by the presence of two or more X-chromosomes, hypogonadism, and lack of secondary sexual characteristics. The association between Klinefelter' syndrome and glomerulonephritis has been reported, while cases of glomerulonephritis associated with Klinefelter' syndrome are rare. We report the Korean case: a 31-year-old man with Klinefelter' syndrome who developed glomerulonephritis. The patient's urine analysis shows microscopic hematuria and the result of kidney biopsy was minimal change disease. The onset and course of his disease might have been influenced by the sex hormone imbalance.
Biopsy ; Glomerulonephritis ; Hematuria ; Humans ; Hypogonadism ; Kidney ; Male ; Nephrosis, Lipoid ; Sex Differentiation

STUDY DESIGN: Retrospective study. PURPOSE: To determine the prevalence of high risk patient with osteopenia requiring pharmacologic treatment and investigate the difference of 10-year fracture probability whether bone mineral density (BMD) include or not in Korean FRAX model. OVERVIEW OF LITERATURE: Many people with the fracture have osteopenia rather than osteoporosis, and BMD alone could be considered as a chance to prevent fracture. METHODS: Three hundred sixty-nine patients who was diagnosed as osteopenia were divided into two groups according to age (group 1, under 65 years; group 2, over 65 years), and 10-year fracture probabilities were calculated by FRAX algorithm with and without femur neck T-score. RESULTS: The high risk patients of the fracture who had above 3% of 10-year hip fracture probability were 15 cases in group 1 and 121 cases in group 2. In 193 patients of group 1, the mean 10-year fracture probability with BMD was significantly higher than the results without BMD (hip fracture: p=0.04, major osteoporotic fracture: p=0.01). Unlike the results of the group 1, the mean 10-year fracture probability without BMD was significantly higher than the results with BMD in 176 patients of group 2 (hip fracture: p=0.01, major osteoporotic fracture: p=0.01). CONCLUSIONS: Total of 136 cases (36.8%) as a high risk of the fracture with osteopenia could be overlooked treatment eligibility in Korean. The Korean FRAX model without BMD could be effective in predicting fracture risk especially in the individuals who were over 65 years.
Bone Density ; Bone Diseases, Metabolic* ; Femur Neck ; Hip ; Humans ; Osteoporosis ; Osteoporotic Fractures ; Prevalence ; Retrospective Studies ; Risk Assessment

Polycythemia vera (PV) is a chronic myeloproliferative disorder that is characterized by increased production of leukocytes, erythrocytes, and platelets. Arterial and venous thromobotic complications are common in the clinical course of this disorder. There have been a few reports of acute ischemic stroke with PV. A case of PV associated with progression of middle cerebral artery stenosis and recurrent ischemic stroke is presented herein.
Blood Platelets ; Cerebral Infarction* ; Constriction, Pathologic ; Erythrocytes ; Leukocytes ; Middle Cerebral Artery ; Myeloproliferative Disorders ; Polycythemia Vera* ; Polycythemia* ; Stroke