Reversible splenial lesion syndrome can be caused by viral infection. Rubella generally occurs in childhood, and it is rarely accompanied by neurological complications in adulthood. A 35-year-old man visited our hospital due to conjunctival injection, mild fever, and headache 3 days after experiencing skin rash. Brain magnetic resonance imaging (MRI) revealed distinct lesions involving white matter in the splenium of the corpus callosum approximately 3 days following the onset of symptoms. Enzyme immunoassay performed on serum and CSF samples was positive for rubella virus IgM. A follow-up brain MRI was performed 24 days after the onset of symptoms, and reduced lesion size with decreased signals were observed on diffusion weighted image. This case showed that rubella infection can result in reversible splenial lesion accompanied by only mild neurological symptoms.
Rubella

We performed dual color fluorescence in situ hybridization (FISH) for the bcr/abl fusion in CML using the peripheral blood smears without destruction of cell morphology to determine the bcr/abl fusion. Two patients of CML, one patient in accelerated phase and one patient in chronic phase, were selected. The blood smears were fixed in absolute methanol. FISH was performed with the Mbcr/abl translocation DNA probe mixture and the slides were stained with Wright's stain after FISH. The blood smears of both cases revealed distinct signals without destruction of cellular morphology. The normoblasts and lymphocytes revealed beautiful fused bcr/abl signals as well as granulocytes in both cases. The results provide a novel finding that the normoblasts and lymphocytes in CML are also neoplastic clonal cells which has not been demonstrated with a single-cell approach before.
DNA ; Erythroblasts* ; Fluorescence* ; Granulocytes ; Humans ; In Situ Hybridization ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Lymphocytes* ; Methanol

PURPOSE: We use many electronic devices for treating patients in our emergency department. Several studies have reported an association between electromagnetic field exposure and risk of cancer and other diseases. Our purpose was to measure the intensity of power-frequency magnetic fields in the emergency department and evaluate the conditions exceeded regulation guidelines for power-frequency magnetic fields. METHODS: Extremely low frequency magnetic fields were measured at 78 ordinary working spots in our tertiary hospital's emergency department (ED) and evaluated according to national regulatory guidelines and SWEDAC. Each spot was measured four times. During measurement, every electrical device in the emergency department was turned on. RESULTS: The average intensity of the magnetic fields in our emergency department was 0.99+/-1.27 mG. The maximum intensity was 8.3 mG, which was found in the pediatric section. CONCLUSION: The power-frequency magnetic field intensities of the various sections of our ED did not exceed national regulatory guidelines. However, pediatric and the minor emergency section showed magnetic fields intensities far above 2 mG. We found these high values outside the pediatric and waiting sections, where the electrical cabinet panel was located. We conclude that the electrical cabinet panel should be shielded and that similar studies are needed for other emergency departments.
Electromagnetic Fields ; Electronics ; Electrons ; Emergencies ; Emergency Service, Hospital ; Environmental Exposure ; Humans ; Magnetic Fields ; Magnetics ; Magnets

Erythromelalgia is a rare neurovascular pain syndrome characterized by a triad of redness, increased temperature, and burning pain primarily in the extremities. Erythromelalgia can present as a primary or secondary form, and secondary erythromelalgia associated with a myeloproliferative disease such as essential thrombocythemia often responds dramatically to aspirin therapy, as in the present case. Herein, we describe a typical case of a 48-year-old woman with secondary erythromelalgia linked to essential thrombocythemia in the unilateral hand. As this case demonstrates, detecting and visualizing the hyperthermal area through infrared thermography of an erythromelalgic patient can assist in diagnosing the patient, assessing the therapeutic results, and understanding the disease course of erythromelalgia.
Aspirin ; Burns ; Erythromelalgia ; Extremities ; Female ; Hand ; Humans ; Neuralgia ; Thermography ; Thrombocythemia, Essential

BACKGROUND: Surveillance of surgical site infection is a main component of nosocomial infection surveillance. To perform a valid comparison of rates among hospitals, among surgeons, across time, surgical site infection rates must account for the variation in patient's underlying severity of illness and other important risk factors. So, a risk index was developed to predict a surgical patient's risk of acquiring a surgical site infection. The risk index score, ranging from 0 to 3, was the number of risk factors present among the following: (1) a patient with an American Society of Anesthesiologists preoperative assessment score of 3,4,5, (2) an operation classified as contaminated or dirty-infected, and (3) an operation lasting over T hours, where T depends upon the operative procedure being performed. METHOD: We performed surgical site infection surveillance according to patient risk index after cardiovascular surgery from Mar 1, 1997 to May 31, 1997. In addition, we also monitored nosocomial infection of all patients after cardiovascular surgery Data was collected prospectively, Surgical site infection rate was classified according to patient risk index and compared with NNIS (National Nosocomial Infections Surveillance) semiannual report of 1995. RESULT: Overall nosocomial infection rate was 18.9% and among all patients detected by surveillance protocols, pneumonia was the most common (6.3%) nosocomial infection after cardiovascular surgery, and the remaining infections were distributed as follows: surgical site infection 45%, urinary tract infection 3.2%, bloodstream infection 3.2%. Surgical site infection rate for patient with scores of 0, 1, 2 and 3 were 0%, 3.1%, 4.6%, 66,7%, respectively and increased according to patient risk index (P<0.05). There is no statistical difference between our surgical site infection rate and 1995 NNIS semiannual report of surgical site infection rates (P>0.05). CONCLUSION: The patient risk index is a better predictor d surgical site infection risk than the traditional wound classification system and surgical site infection surveillance with patient risk index is useful for nosocomial infection surveillance after surgery.
Classification ; Cross Infection ; Humans ; Operative Time ; Pneumonia ; Prospective Studies ; Risk Factors ; Surgical Procedures, Operative ; Urinary Tract Infections ; Wounds and Injuries

An AVM located in or adjacent to the sylvian fissure is one of the most difficult to remove because it is surrounded by critical structures such as the basal ganglia and internal capsule and it involves the middle cerebral artery. We have operated on 6 cases of arteriovenous malformation(AVM) in and around the sylvian fissure. We describe the characteristic features of these AVMs from the anatomical and surgical points of view. The surgical results were satisfactory in 5 cases, and 1 patients died.
Arteriovenous Malformations ; Basal Ganglia ; Humans ; Internal Capsule ; Middle Cerebral Artery

The authors analyzed 28 cases with hypertensive cerebellar hemorrhage, diagnosed by computerized tomography(CT), between 1987 and 1990, in Chonbuk National University Hospital. The authors assessed the relationship of outcome to the CT appearance of the quadrigeminal cistern, which in some cases was obliterated by rostral displacement of the vermis resulting from the cerebellar mass. Obliteration of the quadrigeminal cisterns was classified on the CT scans into three grades:Normal(Grade I), Compressed(Grade II), or Absent(Grade III). There were 7 cases with Grade I, 9 with Grade II, and 12 with Grade II cisterns. Of the 28 cases, 6(85%) of those with Grade I, 7(78%) of those with Grade II, and none of those with Grade III cisterns respectively returned to their previous activities at 6 months or more after onset. A Grade I cisterns predicted a good outcome whether the hematoma was evacuated or not, as long as obstructive hydrocephalus, if present, was relieved early. However, a Grade II cistern was not predictive of a good outcome unless the hematoma was evacuated within 48 hours after onset of the hemorrhage. A Grade III cisterns predicted an unfavorable outcome. Taken together, these results strongly suggest that the CT grade of quadrigeminal cistern obliteration may be an indicator of outcome and may be useful in selecting treatment for patients with cerebellar hemorrhage.
Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Jeollabuk-do ; Tomography, X-Ray Computed

The authors analyzed 28 cases with hypertensive cerebellar hemorrhage, diagnosed by computerized tomography(CT), between 1987 and 1990, in Chonbuk National University Hospital. The authors assessed the relationship of outcome to the CT appearance of the quadrigeminal cistern, which in some cases was obliterated by rostral displacement of the vermis resulting from the cerebellar mass. Obliteration of the quadrigeminal cisterns was classified on the CT scans into three grades:Normal(Grade I), Compressed(Grade II), or Absent(Grade III). There were 7 cases with Grade I, 9 with Grade II, and 12 with Grade II cisterns. Of the 28 cases, 6(85%) of those with Grade I, 7(78%) of those with Grade II, and none of those with Grade III cisterns respectively returned to their previous activities at 6 months or more after onset. A Grade I cisterns predicted a good outcome whether the hematoma was evacuated or not, as long as obstructive hydrocephalus, if present, was relieved early. However, a Grade II cistern was not predictive of a good outcome unless the hematoma was evacuated within 48 hours after onset of the hemorrhage. A Grade III cisterns predicted an unfavorable outcome. Taken together, these results strongly suggest that the CT grade of quadrigeminal cistern obliteration may be an indicator of outcome and may be useful in selecting treatment for patients with cerebellar hemorrhage.
Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Jeollabuk-do ; Tomography, X-Ray Computed

Takayasu's arteritis is a chronic and occlusive inflammatory disease of uncertain etiology affecting medium to large sized arteries. We anesthetized a patient who had Takayasu's arteritis affecting both common carotid arteries, the left anterior descending coronary artery, and the left subclavian artery. During beating heart coronary artery bypass graft and aorto-carotid bypass graft we chose a cervical epidural block combined with light general anesthesia as an anesthetic technique. We managed the patient successfully with consistant hemodynamic stability. The operation was done without cardiopulmonary bypass and the patient was returned to consciousness immediately after the end of the operation. We extubated the endotracheal tube in the operating room without pain. The patient maintained hemodynamic stability in the intensive care unit and we controlled the pain via a cervical epidural catheter with morphine and 0.1% bupivacaine.
Anesthesia, General* ; Arteries ; Bupivacaine ; Cardiopulmonary Bypass ; Carotid Artery, Common ; Catheters ; Consciousness ; Coronary Artery Bypass, Off-Pump ; Coronary Vessels ; Hemodynamics ; Humans ; Intensive Care Units ; Morphine ; Operating Rooms ; Subclavian Artery ; Takayasu Arteritis* ; Transplants

Despite its rare occurrence, early diagnosis and appropriate treatment for neonatal herpes simplex virus infection are mandatory due to its high morbidity and mortality. In Korea, there has been no epidemiologic data on neonatal herpes simplex virus infection, and even case reports are rare. We observed a 16-day-old neonate who presented with fever and seizures. We diagnosed her with meningoencephalitis caused by herpes simplex virus type 2 based on the polymerase chain reaction test, and treated her with intravenous acyclovir and anticonvulsants. The seroprevalence of herpes simplex virus type 2 sharply increases in women in their 30s, and the average age for childbirth has increased to older than 30 years of age in Korea; we therefore expect that the incidence of neonatal herpes simplex virus type 2 infection will rise in Korea, and more attention should be directed to neonatal herpes simplex virus type 2 infection. We report this newborn patient's case along with a literature review.
Acyclovir ; Anticonvulsants ; Early Diagnosis ; Female ; Fever ; Herpesvirus 2, Human* ; Humans ; Incidence ; Infant, Newborn ; Korea ; Meningoencephalitis* ; Mortality ; Parturition ; Polymerase Chain Reaction ; Republic of Korea ; Seizures ; Seroepidemiologic Studies ; Simplexvirus