Spontaneous subarachnoid hemorrhage(SAH) is a cause of high mortality and morbidity in the emergency department. Rebleeding has been well investigated, and it is now recognized that early operation can prevent rebleeding. However, ultra-early rebleeding, which may occur prior to early operation(within 24 hours after admission), worsens the clinical outcome of patients with SAH. To determine the risk factors of ultra-early rebleeding in patients with spontaneous SAH before early operation, we analyzed the cases of 383 patients admitted within 24 hours after their last attack of SAH between 1994 to 1996. In this analysis, diagnosis of rebleeding before admission was defined only if the patients experienced a definite clinical deterioration once more after an attack suggesting SAH. After admission patients who observed a sudden neurological deterioration were subject to repeat CT scanning and rebleeding was diagnosed only when new hemorrhage was observed on the CT scan in comparison with the previous scan. 45 cases(11.7%) of 383 patients had ultra-early rebleeding. The incidence of ultra-early rebleeding significantly increased in the patients who admitted hospital within 2 hours after attack. The incidence of ultra-early rebleeding also increased in the old-age group(70 years or more), patients with high systolic blood pressure, those who underwent angiography within 6 hours of the last SAH, and patients who had poor neurological condition.
Angiography ; Blood Pressure ; Diagnosis ; Emergency Service, Hospital ; Hemorrhage* ; Humans ; Incidence ; Mortality ; Risk Factors* ; Tomography, X-Ray Computed

BACKGROUND: Both atrophic gastritis and intestinal metaplasia may progress to gastric dysplasia. This study aimed to analyze the factors influencing progression of atrophic gastritis and intestinal metaplasia to dysplasia. METHODS: People diagnosed with atrophic gastritis and intestinal metaplasia for the first time received a follow-up endoscopy and were investigated for the cumulative incidence rate of gastric dysplasia by age, gender, smoking habit, alcohol intake, rice consumption and family history of stomach cancer. RESULTS: The cumulative incidence rate increased with age, consuming > or =3 bowls of rice per day and family history of stomach cancer. Multivariate analysis showed that the cumulative incidence rate of gastric dysplasia increased in subjects >61 years (RR=2.54, P=0.014), in those consuming > or =3 bowls of rice per day (RR=1.46, P=0.021) and in those with a family history of stomach cancer (RR=1.31, P=0.037). CONCLUSIONS: More active management, such as intensive endoscopic follow-up examinations, lifestyle change and education regarding gastric dysplasia, are required in those older than 61 years, having a higher intake of grain or with a family history of stomach cancer.
Edible Grain ; Endoscopy ; Follow-Up Studies ; Gastritis, Atrophic ; Humans ; Incidence ; Life Style ; Metaplasia ; Multivariate Analysis ; Risk Factors ; Smoke ; Smoking ; Stomach ; Stomach Neoplasms

Perioptic Neuritis ls a very rare clinical condition, in which optic disc swelling and inflammation is seen despite of normal intracranial pressure and visual acuity. These condition can be seen in syphilis, sarcoidosis, viral encephalitis, fungal infection. We have seen that the 45 years old woman with perioptic neuritis shows papilledema without IICP in spinal tapping, thought to be due to cryptococcal meningitis.
Encephalitis, Viral ; Female ; Humans ; Inflammation ; Intracranial Pressure ; Meningitis, Cryptococcal ; Middle Aged ; Neuritis* ; Papilledema ; Sarcoidosis ; Spinal Puncture ; Syphilis ; Visual Acuity

This review-article is aimed at shedding a light upon the nature of age-associated changes in the human skeletal system. When the anatomical, physiological and biochemical consequences of bone aging are considered together with the hardening, drying and the diminished repair capabilities of the elderly, it can be seen that fractures assume greater importance as a clinical problem in the geriatric population. Older people start out with a deficit of cortical bone, making them more fracture prone and once fractures occur, the necessary treatments (immobilization, use of casts, etc.) accelerate the rate of bone loss. In addition, aged individuals stand a higher risk for complications of the hospital and enforced bed rest that may ensue. The problems resulting from bone loss in the elderly may be partially alleviated by providing adequate health service support which should include consideration of the following points : 1. Age, sex and general health status ; 2. Habits and inclinations towards physical activities ; 3. Nutritional and endocrine background ; 4. Presence of any specific bone diseases, including osteoporosis, osteoarthritis, osteomalacia and ankylosis ; 5. Psychosocial adaptability and other behavioral elements.
Aged ; Aging ; Ankylosis ; Bed Rest ; Biology* ; Bone Diseases ; Health Services ; Humans* ; Motor Activity ; Osteoarthritis ; Osteomalacia ; Osteoporosis

No abstract available.
Foot ; Pemphigus

No abstract available.
Sympathectomy