The characteristics of radionuclide brain scan imaging of intracranial lesion are determined, in part, by the rate and quantity of radioactive material in the region of involvement, which is associated with alterations in the blood brain barrier. Findings, noted on the blood flow studies, often serve to direct attention to forthcoming imaging of specific pathological change on the status studies, e.g, carotid artery occlusion and cerebral infarction. We have seen that the 62 year old woman with left side hemiparesis shows typical "Flip-Flap" pattern in brain scan imaging, thought to be due to carotid artery occlusion.
Blood-Brain Barrier ; Brain ; Carotid Arteries ; Cerebral Infarction ; Female ; Humans ; Middle Aged ; Paresis

The purpose of this study was to compare the apical leakage of the root canal filled with the System B and the EndoTwinn (the combined application of heat and ultrasonic vibration). Sixty extracted premolars with straight root were cleaned and shaped to size 35. Group SB was obturated using System B and Group ET was filled with EndoTwinn. A size 35 of 0.06 tapered gutta- percha and Adseal were used and the plugger which could be introduced to 4 mm short of working length was selected in the obturation procedure. As the positive control, Group PC was not filled. In Group SB, ET and PC, all external surfaces of each tooth were coated with nail varnish leaving only 1 mm area around the apical foramen. In the negative control of Group NSB and Group NET, all of external tooth surface including apical foramen was coated with the nail varnish. The specimens were immersed in methylene blue dye solution for 2 days. Then the specimens were sectioned at each 1 mm from apex to 5 mm level. The final score of one specimen was given by summing up of the points at all levels. The dye leakage of Group ET was significantly less than that observed in Group SB (p < 0.05). And the frequency of gutta-percha pulling out from root canal when the plugger was removed was more often with the System B than with EndoTwinn but there was no significant difference.
Bicuspid ; Dental Pulp Cavity ; Gutta-Percha ; Hot Temperature ; Methylene Blue ; Paint ; Tooth ; Tooth Apex ; Ultrasonics

OBJECTIVE: This study was to estimate the prevalence of and identify the predisposing risk factors of delirium and to determine the effect of delirium on the prognosis, especially death in burn patients. METHOD: The study was completed by thorough examination of medical records, with additional confirmation, of the 245 patients who were admitted to the Burn ICU in Burn treatment center of Hangang Sacred Heart Hospital during last one year (Jan. 1. 1998-Dec. 31. 1998). Delirium was retrospectively diagnosed according to DSM-IV. Only when disturbance of consciousness and attention, cognitive dysfunction especially disorientation, or perceptual disturbance were observed, diagnosis of delirium were given. Final outcome such as death was discriminated through examination of medical records or question to those who knew the patient. RESULTS: One year prevalence of delirium in burn patients is 34.4%. Statistically significant predisposing risk factors of delirium were five;Age 65 and over (OR=45.51, 95% CI:6.07-341.11), burn size over 60% of total body surface (OR=6.48, 95% CI:3.16-13.28), current psychiatric disorder (OR=6.81, 95% CI:1.42-32.57), current medical disease (OR=3.00, 95% CI:1.40-6.45), alcohol abuse (OR=3.17, 95% CI:1.07-9.43) Statistically significant deathrelated risk factors were three;burn size over 60% of total body surface (OR=4.58, 95% CI:2.00-10.46), delirium (OR=2.94, 95% CI:1.25-6.94), current psychiatric disorder (OR=4.09, 95% CI:1.05-15.87). Aging is not the death-related factor in this study. CONCLUSION: Three factors, such as delirium, organic brain damage, and burn size over 60% of total body surface may predict higher risk of death in burn patients.
Aging ; Alcoholism ; Brain ; Burns* ; Consciousness ; Delirium* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Heart ; Humans ; Critical Care* ; Medical Records ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Factors

The elderly people are often afflicted with chronic illnesses of which depression and dementia comprise substantial proportion. The authors tried to figure out the impact of depression and dementia on the quality of life of elderly. 1,300 community residents over 65 years of age were selected by random sampling. Using Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy, the authors selected 3 groups of subjects, namely dementia group (N=113), depression group (N=157), normal control group (N=289). The 3 groups of subjects were examined with General Health Questionnaire 12-Quality of Life, Geriatric Depression Scale, Mini-Mental State Exam-K, and Physical Self-Maintenance Scale. The results were compared between groups and the correlations of each scales were examined. The quality of life was lower in the older, female, lower educational groups. The quality of life was significantly lower in dementia group and depression group than in normal elderly group. The subjective quality of life of depressed elderly got lower with increasing severity of depression. Demented elderly had low quality of life but no correlation was found between subjective quality of life and severity of depression. The score of Mini-Mental State Exam-K was found to have significant correlation with the quality of life in demented group. The quality of life of normal elderly and those with dementia had significant correlation with Physical Self-Maintenance Scale. Conclusively, the quality of life was decreased in both normal elderly group and dementia group. The severity of depressive symptoms were correlated with the decrease of quality of life in depression group, whereas the degree of cognitive impairment had significant correlation with quality of life in dementia group. Therefore, the subjective quality of life must be considered in the treatment of the depression and dementia, and further study about the relation between psychopathology and the various aspects of living and the quality of life in the elderly is needed.
Aged* ; Chronic Disease ; Classification ; Dementia ; Depression ; Female ; Humans ; Psychopathology ; Quality of Life* ; Surveys and Questionnaires ; Weights and Measures

To evaluate the effects of cyclosporin A (CyA) on clinical outcome and pathologic changes in children with IgA nephropathy (IgAN), we retrospectively evaluated 14 children (mean age 8.9+/-2.9 yr; eight males, six females) who were treated with CyA and steroids. The starting dose of CyA was 5 mg/kg per day, and the drug level was maintained at 100-200 ng/mL. The mean CyA level was 183.8+/-48.3 ng/mL (range 120.7-276.0 ng/mL) and the mean duration of CyA therapy was 10.9+/-1.9 months (range 8-12 months). After CyA therapy the mean 24 hr urinary protein excretion declined from 107.1+/-35.1 mg/m2/hr to 7.4+/-2.4 mg/m2/hr (P<0.001) and serum albumin increased from 3.3+/-0.6 g/dL to 4.3+/-0.3 g/dL (P<0.001). At a follow-up biopsy the histological grade of IgAN was improved in seven (50%) of the 14 patients, remained the same in three (21%), and was aggravated in four (29%). Serum creatinine, creatinine clearance, and blood pressure did not differ before and after CyA therapy. Two patients (14%) showed CyA-induced nephrotoxicity at the second biopsy. Our findings indicate that CyA therapy may be effective in reducing proteinuria and regressing renal pathology in a subset of children with IgAN.
Angiotensin-Converting Enzyme Inhibitors/*administration & dosage ; Child ; Cyclosporine/*administration & dosage ; Drug Combinations ; Female ; Glomerulonephritis, IGA/*diagnosis/*drug therapy ; Humans ; Immunosuppressive Agents/administration & dosage ; Male ; Steroids/*administration & dosage ; Treatment Outcome

BACKGROUND/AIMS: Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory and recurrent Clostridium difficile infection (CDI). Despite its excellent efficacy and recent widespread use, FMT has not been widely used in South Korea thus far. We describe our experience with FMT to treat refractory/recurrent CDI. METHODS: We conducted a chart review of patients who underwent FMT for refractory/recurrent CDI at Inha University Hospital, between March 2014 and June 2016. The demographic information, treatment data, and adverse events were reviewed. FMT was administered via colonoscopy and/or duodenoscopy. All stool donors were rigorously screened to prevent infectious disease transmission. RESULTS: FMT was performed in nine patients with refractory/recurrent CDI. All patients were dramatically cured. Bowel movement was normalized within one week after FMT. There were no procedure-related adverse events, except aspiration pneumonia in one patient. During the follow-up period (mean 11.4 months), recurrence of CDI was observed in one patient at one month after FMT due to antibiotics. CONCLUSIONS: FMT is a safe, well-tolerated and highly effective treatment for refractory/recurrent CDI. Although there are many barriers to using FMT, we expect that FMT will be widely used to treat refractory/recurrent CDI in South Korea.
Anti-Bacterial Agents ; Clostridium difficile* ; Clostridium* ; Colonoscopy ; Disease Transmission, Infectious ; Duodenoscopy ; Fecal Microbiota Transplantation* ; Follow-Up Studies ; Gastrointestinal Microbiome ; Humans ; Korea ; Pneumonia, Aspiration ; Recurrence ; Tissue Donors

Focal segmental glomerulosclerosis (FSGS) is a relatively common glomerular disease which is known to be the final pathway of glomerular injuries caused by variable etiologies. There are some renal diseases that are known to have a tendency of familial inheritance such as adult polycystic kidney disease, thin glomerular basement membrane disease, and Alport's syndrome, nephrotic syndrome with many other diseases. Fanconi et al. described the familial occurrence of the nephrotic syndrome first. Since then, a number of other reports have described the cases of nephrotic syndrome within families, though only a handful of families were confirmed as FSGS with histologic evidence. Recently, reports of familial occurrence of FSGS are increasing in number. These patients have been found to be steroid-resistant and unresponsive to immunosuppressive drugs, and most of them progressed to the end stage renal disease. The specific factors leading to glomerular change are not clearly known, but a genetic predisposition has been postulated. A number of reports pointed out the importance of HLA type as a genetic factor related to the pathogenesis of FSGS but the genetic and immunological linkages in FSGS have not been clearly defined yet. We report cases with 4 patients in two unrelated families with HLA-A24 recovered from FSGS after kidney transplantation.
Child* ; Genetic Predisposition to Disease ; Glomerular Basement Membrane ; Glomerulosclerosis, Focal Segmental* ; Hand ; HLA-A24 Antigen* ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Nephritis, Hereditary ; Nephrotic Syndrome ; Polycystic Kidney, Autosomal Dominant ; Wills

Dense deposit disease (DDD) is a rare primary glomerulonephritis characterized by continuous band- like intramembranous dense deposits detectable on electron microscopy. We describe a case of DDD with sequential mesangial proliferative glomerulonephritis, membranoproliferative glomerulonephritis, minor glomerular alterations, and a second round of mesangial proliferative glomerulonephritis during a 13-year period. Electron dense deposits were typical of DDD in the first and second biopsies taken one year apart. However, deposits dissolved and the glomerular cellularity and basement membrane normalized with clinical remission, which was achieved by a course of immunosuppressive therapy lasting seven years. The fourth biopsy was performed due to recurrence of microscopic hematuria and showed predominant mesangial IgA deposits without glomerular capillary alteration, which was interpreted as development of IgA nephropathy after remission of DDD or coexistence with nearly healed DDD in this patient.
Basement Membrane ; Biopsy ; Capillaries ; Dichlorodiphenyldichloroethane ; Electrons ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Hematuria ; Immunoglobulin A ; Microscopy, Electron ; Recurrence

To evaluate the distribution and changing patterns of renal diseases in Korea, a total of 4,514 cases of renal biopsy collected over a 23-year period between 1973 and 1995 were reviewed. Of 4,200 cases excluding 314 unsatisfactory biopsies, adult cases comprised 59.5% and pediatric cases, 40.5%. The male to female ratio was 1.5:1 in adults and 2.2:1 in children. Glomerulonephritis (GN) comprised 80.0% of the total. The most common primary GN in adults was minimal change disease (MCD) (26.6%), followed by IgA nephropathy (IgAN) (22.1%), membranous GN (MGN) (11.8%), and membranoproliferative GN (MPGN) (5.9%). In children, the primary GN incidence rates were MCD (24.8%), IgAN (10.3%), poststreptococcal (including postinfectious) GN (PSGN) (8.6%), and focal segmental glomerulosclerosis (FSGS) (4.0%). The most common secondary GN in adults was lupus nephritis and in children Henoch-Schonlein purpura nephritis. The most common cause of nephrotic syndrome was MCD in both adults and children, followed by MGN and FSGS. The elderly, aged sixty years and older, comprised 2.7% of cases and recorded equal numbers of MCD and MGN. The proportion of the biopsies found to be seropositive for HBs antigen was 27.9%, and these showed either MGN or MPGN pattern. Repeat biopsy was performed in 168 patients, due to previous biopsy failure in 15.5%. When the primary GN cases were analyzed at 5-year intervals, the prevalence of PSGN, which was greater than 25% during the 1973-1982 period, decreased abruptly in children thereafter, whereas the prevalence of FSGS increased slowly since the 1988-1992 period in both adults and children. The decrease of PSGN and the increase of FSGS suggest a role for socioeconomic and environmental factors in Korea.
Adult ; Age Distribution ; Biopsy ; Child ; Female ; Glomerulonephritis/pathology ; Glomerulonephritis/epidemiology ; Glomerulosclerosis, Focal/pathology ; Glomerulosclerosis, Focal/epidemiology ; Human ; Kidney/pathology* ; Kidney Diseases/pathology* ; Kidney Diseases/epidemiology* ; Korea ; Male ; Middle Age ; Prevalence ; Sex Distribution

Renal transplantation is the optimal treatment for end stage renal disease and it has been improved through the development of operative methods and immunosuppressants. However some patients must receive dialysis or undergo retransplantation after a loss of the primary graft due to rejection or other causes. Recently the frequency of retransplantation has begun to increase gradually. Some articles have reported that retransplantation results do not significantly differ in comparison with initial transplantation results when living related donor kidneys are used. Our study focused on the outcome of 445 first transplantation and 12 retransplantation cases. The sex distribution of retransplanted patients was 11 male and 1 female. The mean age (yrs) for recipients was 32.3 at the first transplantation and 39.1 at the retransplantation. The underlying causes of end stage renal disease were presumed to be chronic glomerulonephritis in all retransplantion patients; the mean duration of graft survival (mo) for first transplantation was 77.92. The causes of previous graft failure were as follows: 10 due to chronic rejection, 1 due to recurrent glomerulonephritis, 1 resulted from a graft rupture due to a motorcar accident. The interval (mo) between graft failure and retransplantation averaged 6.7 and 9 out of 12 patients underwent regrafting within 1 year of their previous graft loss. Recipient-donor relationships in first transplantations were as follows: 9 were living related and 3 were living non-related. Recipient-donor relationships in second transplantations were as follows: 4 were living related and 8 were living non-related. Acute rejection within 1 month of transplantation occurred in 4 primary transplantation patients and 2 retransplantation patients. The incidence of acute rejection within 1 month was as follows: 23% of 445 first renal transplantation patients, 16.7% of 12 second transplantation patients. The 1 year and 2 year graft survival rate was 100% and the mean survival duration (mo) was 33 for retransp
Dialysis ; Female ; Glomerulonephritis ; Graft Survival ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney* ; Male ; Rupture ; Sex Distribution ; Tissue Donors ; Transplants