With the development of electrophysiologic technique, a more detailed topographical organizations of motor cortex, especially hand area have been introduced in animal experiment. To the best our knowledge, in cerebral infarction, only one patient with isolated weakness of intrinsic hand muscles has been reported. We present two patients with cerebral infarction who showed isolated weakness in their intrinsic hand. Patient 1; A 76-year-old woman with coronary artery obstructive disease developed abrupt weakness in flexion of right thumb, index, middle finger and in adduction of thumb. Brain MRI showed a small discrete lesion in the posterior bank of left precentral gyrus. An angiography revealed an occlusion of left central sulcus artery. Prominent thumb adduction weakness was remained 11 days later. Patient 2; A 57-year-old hypertensive man was admitted because of recurrent TIA and decreased grasp power of right hand, especially flexion and adduction of thumb, index finger and middle finger. Brain MRI showed focal lamina necrosis in left precentral gyrus. An angiography revealed an occlusion of left internal carotid artery. Findings in our patients suggest that the similar arrangement of efferent zone for cortical hand area found in monkeys also may exist in human beings.
Aged ; Angiography ; Animal Experimentation ; Arteries ; Brain ; Carotid Artery, Internal ; Cerebral Infarction ; Coronary Vessels ; Female ; Fingers ; Hand Strength ; Hand* ; Haplorhini ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged ; Motor Cortex ; Muscles* ; Necrosis ; Thumb

PURPOSE: This study was aimed to evaluate the cell cycle arrest and apoptosis induction after irradiation and epidermal growth factor(EGF) treatment in three human epithelial tumor cell lines(A431, Siha, KB). MATERIALS AND METHODS: Single irradiation of 2, 5 and 10 Gy was done on three cell lines with 5.38 Gy/min dose rate using Cs-137 irradiator at room temperature. Also, EGF of 10 ng/ml was added immediately after 10 Gy irradiation. Cell growth was evaluated by counting the living cell number using a hemocytometer at 1 day, 2 days, 3 days, 4 days and 5 days after irradiation. Cell cycle arrest and apoptosis induction were assayed with the flow cytometry at 8 hours, 12 hours, 1 day, 2 days, 3 days, 4 days and 5 days after irradiation. RESULTS: Growth of irradiated three cell lines were inhibited in proportion to radiation dose. EGF treatment after irradiation showed various results according to cell lines. On all cell lines, G2 arrest was detected after 8 hours and maximized after 12 hours or 1 day. Amount of G2 arrest was positively dose dependent. But, EGF showed no significant change on G2 arrest. G2 arrest was recovered with time at 2 Gy and 5 Gy irradiation. But, at 10 Gy irradiation, G2 arrest was continued. Apoptosis was detected at 10 Gy irradiation. On EGF treated group after irradiation, A431 and Siha cell lines showed slightly increased apoptosis but there was no statistically significant difference. KB cell line showed no marked change of apoptosis induction. CONCLUSION: Irradiation effects cell cycle arrest and apoptosis induction in three human epithelial tumor cell lines but epidermal growth factor doesn't effect change of cell cycle arrest and apoptosis induction.
Apoptosis* ; Cell Count ; Cell Cycle Checkpoints ; Cell Cycle* ; Cell Line ; Cell Line, Tumor* ; Epidermal Growth Factor* ; Flow Cytometry ; Humans* ; KB Cells

As a part of plan to construct a multifunctional hospital information system, We planned to develop a chemotherapy order system. First, a software developing team was established which is composed of hematooncology staffs, special pharmacists and programmer who are responsible for OCS. We set up an outline of this system after collecting various kinds of sources such as foreign examples, gathered protocol that are used for chemotherapy, and organized these protocol in programming the chemotherapy order system. This project is expected to provide accurate prescription, to shorten the time to prepare prescription, to standardize the protocol of chemotherapy within the medical center, to manage an effective dispensing schedule and to be used as a source for education and research.
Appointments and Schedules ; Drug Therapy* ; Education ; Hospital Information Systems ; Humans ; Pharmacists ; Prescriptions

The incidence of tuberculosis (TB) had gradually been declining all over the world, but in recent years, TB has been increasing due to the spread of the human immunodeficiency virus (HIV). When immune-suppression status deteriorates further, extrapulmonary TB generally appears more often. Abdominal TB is one type of extra-pulmonary TB, which may involve the gastrointestinal tract, peritoneum, lymph nodes or solid viscera. We encountered a case who had initially been diagnosed as having abdominal TB, had progressed to acute respiratory distress syndrome and was eventually confirmed as having developed acquired immune deficiency syndrome. In cases of coinfection of TB and HIV, it is reported that immunological responses become poor and complications with higher morbidity frequently occur. Therefore, the Korean guidelines for TB should be revised to ensure whether HIV infection exists in TB patients.
Acquired Immunodeficiency Syndrome* ; Coinfection ; Gastrointestinal Tract ; HIV ; HIV Infections ; Humans ; Incidence ; Lymph Nodes ; Peritoneum ; Respiratory Distress Syndrome, Adult ; Tuberculosis* ; Viscera

PURPOSE: To evaluate the clinical characteristics and treatment result of Coats' disease in children. METHODS: Data on demographics, clinical presentation, and ocular findings were analyzed for 67 eyes of 67 patients with Coats' disease by retrospective chart review. Among these, treatment results were analyzed from 56 eyes which had received local treatment or subretinal fluid drainage (SRFD). Treatment was considered successful when telangiectatic vessels or exudates had regressed after local treatment or when pupillary block glaucoma was treated or prevented after SRFD. RESULTS: Mean age at diagnosis was 5.0 years (5 months-15 years) and 90% were males. 67% of retinal telangiectasias were located in the temporal. There were exudative retinal detachments in 46 (69%) eyes. Among them, SRFD was performed in 19 (28%) to treat or prevent pupillary block glaucoma. The mean age at diagnosis of patients that underwent treatment was 5.1 years. In 37 of 56 patients, 95% of retinal telangiectasias were regressed after primary local treatment, and 21 eyes (31%) underwent SRFD. Management of glaucoma was achieved after SRFD in 16 patients, and one more SRFD was needed after primary SRFD in 5 patients. CONCLUSIONS: In Coats' disease, it is necessary to eradicate retinal telangiectasia with local treatment and to follow up carefully for secondary glaucoma, which can be treated with SRFD in cases of severe exudative retinal detachment.
Child* ; Cryotherapy ; Demography ; Diagnosis ; Drainage ; Exudates and Transudates ; Follow-Up Studies ; Glaucoma ; Humans ; Male ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Subretinal Fluid ; Telangiectasis

We report a 72-year-old man suffering from recurrent attacks of transient drowsy mentality during meal or on orthostatic body position. Markedly disturbed collateral blood flow to right hemisphere was observed on conventional cerebral angiography. Acute and old ischemic lesions in the right internal borderzone area were also noticed on magnetic resonance image. Postprandial and orthostatic hypotension in the present case could be the cause of the recurrent neurological deficit developed in the primarily disturbed collaterals in the right middle cerebral territory.
Aged ; Carotid Artery, Internal* ; Cerebral Angiography ; Humans ; Hypotension* ; Hypotension, Orthostatic ; Ischemic Attack, Transient* ; Meals

OBJECTIVE: A dural arteriovenous fistula (DAVF) of the anterior cranial fossa is rare. We report a case of a DAVF of the anterior cranial fossa which was treated surgically, following endovascular treatment failure. METHODS & RESULTS: The subject was a 53-year-old male with a headache caused by a hematoma in the right frontal lobe. A vascular abnormality of the anterior cranial fossa was suspected on brain computed tomographic angiography. The subsequent transfemoral cerebral angiography revealed that the AVF of the anterior cranial fossa was mainly fed by the left anterior ethmoidal artery. Endovascular therapy using N-butyl cyanoacrylate was attempted. However, the procedure failed to occlude the fistula due to the existing feeding artery (the right anterior ethmoidal artery). Consequently, a surgical approach was undertaken and the lesion was successfully obliterated. CONCLUSION: We report a rare case of an intracerebral hematoma caused by a DAVF, which was successfully managed surgically following, endovascular treatment failure.
Angiography ; Arteries ; Arteriovenous Fistula ; Brain ; Central Nervous System Vascular Malformations ; Cerebral Angiography ; Cerebral Hemorrhage ; Cranial Fossa, Anterior ; Cyanoacrylates ; Fistula ; Frontal Lobe ; Headache ; Hematoma ; Humans ; Male ; Middle Aged ; Treatment Failure

OBJECTIVE: To report our experience with pyogenic spondylitis treated with anterior radical debridement and insertion of a titanium mesh cage and to demonstrate the effectiveness and safety of the use of a titanium mesh cage in the surgical management of pyogenic spondylitis. METHODS: We retrospectively analyzed the clinical characteristics of 19 patients who underwent surgical treatment in our department between January 2004 and December 2008. The average follow-up period was 11.16 months (range, 6-64 months). We evaluated risk factors, cultured organisms, lab data, clinical outcomes, and radiographic results. Surgical techniques for patients with pyogenic spondylitis were anterior radical debridement and reconstruction with titanium mesh cage insertion and screw fixation. All patients received intravenous antibiotics for at least 6 weeks postoperatively, and some patients received oral antibiotics. RESULTS: The infections resolved in all of the patients as noted by normalization of their erythrocyte sedimentation rates and C-reactive protein levels. The mean pain score on a Visual Analog Scale was 7.8 (range, 4-10) before surgery and 2.4 (range, 1-5) after surgery. The Frankel grade was improved by one grade in seven patients. After surgery, the average difference of the angle was improved about 6.96degrees in all patients. At the last follow-up, the mean loss of correction was 4.86degrees. CONCLUSION: Anterior radical debridement followed by the placement of instrumentation with a titanium mesh cage may be a safe and effective treatment for selected patients with pyogenic spondylitis. This surgical therapy does not lead to recurrent pyogenic spondylitis.
Anti-Bacterial Agents ; Blood Sedimentation ; C-Reactive Protein ; Debridement ; Follow-Up Studies ; Humans ; Pyridines ; Retrospective Studies ; Risk Factors ; Spondylitis ; Thiazoles ; Titanium

BACKGROUND: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et at retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. METHOD: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. RESULTS: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in nineteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), Poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to Inoculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(P<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. CONCLUSION: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement arid serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.
Anti-Bacterial Agents ; Bacteria, Anaerobic ; Chemistry ; Chest Tubes ; Diagnosis ; Drainage ; Empyema* ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Length of Stay ; Lung ; Pleural Effusion ; Retrospective Studies ; Staphylococcus aureus ; Thoracotomy ; Thorax* ; Tomography, X-Ray Computed* ; Ultrasonography

OBJECTIVE: Stent-assisted coil embolization of intracranial wide-necked aneurysm requires long-term postoperative antiplatelet therapy to prevent in-stent thrombosis. This study aimed to demonstrate results of temporary stent placement for coiling wide necked small intracranial aneurysms, which eliminated need for antiplatelet agents, and to discuss its feasibility and safety.METHODS: Data of 156 patients who underwent stent-assisted coil embolization between 2011 and 2014 were retrospectively analyzed. Thirteen cases of temporary stent-assisted coil embolization were included, and their clinical and radiological results were evaluated.RESULTS: The aneurysms treated were all unruptured except one case. All of them had wide neck with mean dome-to-neck ratio of 0.96 and were small-sized aneurysms with mean maximal diameter of 4.2 mm. There was no technical failure in retrieval of stent after completion of embolization of the target aneurysm. Immediate angiography revealed 11 complete and two partial embolization (one residual neck and one residual aneurysm). Two cases encountered thrombosis complication, and they were managed without neurological sequelae. The mean follow-up period was 43 months, angiographic follow-up revealed two cases with minor recurrence, and clinical outcome was good with modified Rankin scale score of 0.CONCLUSION: Temporary stent-assisted coil embolization of small wide-necked intracranial aneurysm using fully retrievable stent appears safe and effective. Further application and evaluation of this technique in more cases with larger size aneurysm is warranted.
Aneurysm ; Angiography ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Neck ; Platelet Aggregation Inhibitors ; Recurrence ; Retrospective Studies ; Stents ; Thrombosis