PURPOSE: We tried to identify the factors associated with intracranial hemorrhage (ICH) in patients with acute brain infarction receiving a tissue plasminogen activator. We assumed that ICH is increased if intracranial pressure has been increased in brain infarction patients who underwent IV thrombolysis. In this study, we selected the optic nerve sheath diameter (ONSD) in a way that intracranial pressure (ICP) measurement. ONSD measurements were compared with the occurrence of brain hemorrhage. METHODS: This study was a retrospective analysis of data acquired between January 2013 and December 2015. We included 100 acute brain infarction patients who received brain MRI and underwent IV thrombolysis in the emergency department. The ONSD measurements were taken with MRI in the axial view and compared with the occurrence of brain hemorrhage. The factors contributing to ICH in patients with thrombolysis was analyzed by a binary logistic regression analysis. Receiver operating characteristic (ROC) curves were used to find the cut-off value of ONSD that maximized the sum of the sensitivity and specificity. Statistical analysis was performed using SPSS 20.0. RESULTS: The mean ONSD for patients without ICH was 5.50±0.57 mm, and for those with ICH was 5.97±0.54 mm. ONSD in the ICH group were significantly larger than in the non-ICH group (5.50±0.57 versus 5.97±0.54). CONCLUSION: ONSD in acute brain infarction patients who underwent IV thrombolysis is useful in the assessment of ICH risk.
Brain ; Brain Infarction ; Emergency Service, Hospital ; Humans ; Intracranial Hemorrhages* ; Intracranial Pressure ; Logistic Models ; Magnetic Resonance Imaging ; Optic Nerve* ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tissue Plasminogen Activator

No abstract available.
Coronary Artery Disease* ; Coronary Vessels*

OBJECTIVE: To report the clinical characteristics of the fetuses with agenesis of corpus callosum (ACC) diagnosed by prenatal ultrasonography. METHODS: Between 1998 and 2007, total twenty-two cases of ACC were identified. All cases were diagnosed by the direct evaluation of the corpus callosum using the ultrasonograpy with or without 3D multi-slice technique and color Doppler. Postnatal work-up was done by MRI or autopsy. RESULTS: The median gestational week was 26 weeks (19 to 34 weeks). The most common abnormal ultrasonographic finding was ventriculomegaly, shown in 19 (86.3%) of 22 cases. Absent cavum septum pellucidum and dilated upward displacement of third ventricle were also shown in 18 (81.8%) and 15 (68.2%) of 22 cases, respectively. Postnatal work-up performed in 9 cases (4 live-born babies and 5 still births) additionally confirmed the associated anomalies in three cases including a heart defect, an Aicardi syndrome, and trisomy 18. CONCLUSION: The analysis of 22 cases presented in this report provides the precise materials to understand ACC. Targeted ultrasonographic evaluation may be helpful for prenatal diagnosis of ACC but has the limitation in differentiation of an isolated ACC from complex defect. To solve this limitation, therefore, the meticulous prenatal work-up and counseling would be needed.
Agenesis of Corpus Callosum ; Aicardi Syndrome ; Corpus Callosum ; Counseling ; Displacement (Psychology) ; Fetus ; Heart ; Prenatal Diagnosis ; Septum Pellucidum ; Third Ventricle ; Trisomy

A complete cDNA sequence encoding a pore-forming subunit (Kir6.2) of ATP-senstive potassium channel in the adult worm, Clonorchis sinensis, termed CsKir6.2, was isolated from an adult cDNA library. The cDNA contained a single open-reading frame of 333 amino acids, which has a structural motif (a GFG-motif) of the putative pore-forming loop of the Kir6.2. Peculiarly, the CsKir6.2 shows a lack-sequence structure, which deleted 57 amino acids were deleted from its N-terminus. The predicted amino acid sequence revealed a highly conserved sequence as other known other Kir6.2 subunits. The mRNA was weekly expressed in the adult worm.
Adenosine Triphosphate/metabolism ; Amino Acid Sequence ; Animals ; Base Sequence ; Cloning, Molecular ; Clonorchis sinensis/*genetics/metabolism ; Helminth Proteins/*genetics/metabolism ; Human ; Molecular Sequence Data ; Potassium Channels, Inwardly Rectifying/*genetics/metabolism ; RNA, Helminth/chemistry/genetics ; Sequence Alignment ; Support, Non-U.S. Gov't

Congenital chloride diarrhea (CLD) is a rare inherited autosomal recessive disorder. Mutations of the solute carrier family 26 member 3 gene cause profuse, chloride ion rich diarrhea, which results in hypochloremia, hyponatremia and metabolic alkalosis with dehydration. If a fetal ultrasound shows bowel dilatation suggestive of bowel obstruction, or if a neonate shows persistent diarrhea and metabolic alkalosis, CLD should be considered in the differential diagnosis. The severity of CLD varies, but early detection and early therapy can prevent complications including growth failure. We report a case of dizygotic twins affected by CLD who had been born to non-consanguineous parents. Both of them showed growth failure, but one of the twins experienced worse clinical course. He showed developmental delay, along with dehydration and severe electrolyte imbalance. He was diagnosed with CLD first at 6-month age, and then the other one was also diagnosed with CLD.
Alkalosis ; Dehydration ; Diagnosis, Differential ; Diarrhea ; Dilatation ; Humans ; Hyponatremia ; Infant, Newborn ; Metabolism, Inborn Errors ; Parents ; Polyhydramnios ; Secondary Prevention ; Twins, Dizygotic

Ganglioneuroma is a rare benign tumor originating from the neural crest cells. It occurs most commonly in the retroperitoneum and posterior mediastinum and is often found in the neck or pelvis. It may be detected incidentally or detected by pressure effects on the adjacent structures due to its slow growth. However, some functional tumors may secrete catecholamines and present with some clinical symptoms. Complete surgical excision is the treatment of choice. We describe here a case of a retroperitoneal ganglioneuroma which was removed completely by surgery. We review the literature and discuss the clinical features of a ganglioneuroma.
Catecholamines ; Ganglioneuroma ; Mediastinum ; Neck ; Neural Crest ; Pelvis

PURPOSE: Home exposure to aeroallergens are an important environmental factor in allergic sensitization and in the development and exacerbation of asthma. Most studies of aeroallergens were dust mite in Korea, but cockroach distribution was little been known in Korea. The aim of this study was to evaluate species of cockroaches and seasonal distribution of cockroaches in Seoul area. METHODS: The study was performed during April 2000 through January 2001, from 63 houses in Korea. The total of 63 residential homes from different districts in Seoul were selected for the home environment survey. Bait traps (10 x 20 x 4 cm2, Zoro Zoro, Taisho Pharmacy, Tokyo, Japan) were placed on four different places of kitchen floor and one in the side of balcony in the house and left for 5 days to capture cockroaches. RESULTS: The cockroaches were captured in 23 houses(36.5%) out of 63 houses. And the inhabitant density of cockroaches was highest in the autumn(43.3%) followed by summer (29.2%), spring(18.3%) and winter(9.2%). In only 3 species were collected in Seoul area. The most common species were Blattella germanica showing 72.5% of the collected cockroaches, followed by Periplaneta japonica(25.2%) Periplaneta americana(2.3%). The total number of captured cockroaches was 504 and the number of nymph was 314(62.2%). Isolated house type showed higher trapping rates than the apartment. Positive skin test rates were 46.2% in the healthy control group and 43.8% in the allergy patients. CONCLUSION: Periplaneta americana was captured in Seoul area, which had not been found previously. The inhabitant density of cockroaches was the lowest in the winter.
Allergens* ; Asthma ; Cockroaches* ; Dust ; Humans ; Hypersensitivity ; Korea ; Mites ; Nymph ; Periplaneta ; Pharmacy ; Seasons* ; Seoul* ; Skin Tests

No abstract available.
Aneurysm, False* ; Inferior Wall Myocardial Infarction*

BACKGROUND AND OBJECTIVES: Little data exist relating to the mechanism of myocardial ischemia in patients with coronary artery ectasia (CAE). The purpose of this study was to evaluate the fractional flow reserve (FFR), as an index of myocardial ischemia, in patients with CAE. SUBJECTS AND METHODS: Ten patients (7 males, 54.0+/-12.6 years) who diagnosed as CAE, by coronary angiographies, between March 2002 and July 2002, were analyzed. The clinical diagnosis of all the patients was unstable angina. FFR were performed using a pressure wire on the patients diagnosed with slow flow CAE from their coronary angiograms. After measurement of the baseline FFR using adenosine 20 microgram for the right coronary artery, and 24 microgram for the left anterior descending artery, the changes in the FFR with 500 microgram of intracoronary nitrate and 2 mg of Nicorandil were observed. RESULTS: Smoking was the most frequently associated risk factor. Type I CAE, according to Markis' classification, was the most prevalent at 60.0%. The values of the baseline FFR in the left anterior descending artery and right coronary artery, following the intracoronary injection of adenosine were both normal, and there were no significant changes in the FFR following the intracoronary injections of nitrate and Nicoronadil. CONCLUSION: The value of the FFR with CAE was normal, and an intracoronary injection of vasodilators did not change the FFR in patients with CAE. Therefore, vasodilator therapy might be beneficial for patients with symptomatic CAE.
Adenosine ; Angina, Unstable ; Arteries ; Blood Flow Velocity ; Classification ; Coronary Angiography ; Coronary Disease ; Coronary Vessels* ; Diagnosis ; Dilatation, Pathologic* ; Humans ; Ischemia ; Male ; Myocardial Ischemia ; Nicorandil* ; Risk Factors ; Smoke ; Smoking ; Vasodilator Agents

BACKGROUND AND OBJECTIVES: Little data exist concerning the clinical outcome of patients with acute myocardial infarction (AMI) and angiographically normal coronary arteries (NCA). The purpose of this study was to evaluate the clinical outcome, the etiological factors and prognosis of these patients. SUBJECTS AND METHODS: The subjects were divided into two groups according to findings from coronary angiograms performed between January 1999 and December 2001, Group 1 : comprised of 46 patients, 34 males and 12 females, with a mean age of 50.4+/-11.9 years, had AMI with NCA ; Group II : 181 patients, 143 males and 38 females, with a mean age of 59.0+/-10.3 years, with AMI and total occlusion of the coronary arteries. RESULTS: The percentages of smoking and hypertension were similar between the two groups ; a higher prevalence rates of hyperlipidemia and diabetes were observed in group II compared to group I (p=0.03, 0.01). In group I, coronary spasm, combined inflammatory diseases and embolization were demonstrated in 32.6, 6.5 and 4.3% of subjects, respectively. The left ventricular ejection fraction was higher in group I than group II (51.5+/-11.3% vs. 46.2+/-10.5%, p=0.006). In-hospital outcomes, with the combined end-point defined as death, re-infarction and stroke was 0% in group I vs. 7.7% in group II (p=0.07). The mean long-term survival rate during the 26.5-month clinical follow-up were 100 and 92.2% in groups I and II (p=0.04), respectively. CONCLUSION: A coronary spasm is the most common cause of AMI with NCA, but these patients had the higher long-term clinical event-free survival.
Coronary Disease ; Coronary Vessels ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Myocardial Infarction* ; Prevalence ; Prognosis ; Smoke ; Smoking ; Spasm ; Stroke ; Stroke Volume ; Survival Rate