A case of neurenteric cyst within the cervical canal is reported. He has been suffered from gradual aggravated quardriparesis since 4 months. On spine C-T scan and cervical myelographic examination, intradural extramedullary mass was detected. And so total laminectomy of C4, C5 and C6 was performed. We could diagnose by the pathological findings.
Laminectomy ; Neural Tube Defects* ; Spinal Canal* ; Spine

A daily count of air borne pollen was done within the city limits of Seoul, Korea for a period of two years (1984-1985) using Durham's Gravity Sampling Device. Two major pollen seasons, March through May, and the month of September, were easily distinguishable. The concentration of the different types of pollen as well as all of the pollens combined varied similarly both years to a significant degree. The pollen types found in the greatest numbers were Alnus (March), Populus (April), Quercus (April-May), Pinus(May), grasses (September), and weeds (September). The main weed pollens detected in September, sagebrush, ragweed and Japanese hop would also be considered to be important allergenic pollens of respiratory allergy in Korea. The results of the survey are discussed in the light of especially relevant published literature.
Air Pollution/analysis* ; Comparative Study ; Human ; Korea ; Pollen/analysis* ; Seasons

14 supratentorial and 6 infratentorial arachnoid cysts, diagnosed and treated at Kangnam St Mary's Hospital from 1983 to 1988, are reported. The most common presenting symptoms in children were craniomegaly, delayed development, increased ICP and neurological focal signs. Neuroradiological examination included plain skull X-ray, brain CT and metrizamide CT or isotope study. Therapeutic criteria according to the clinical and radiological findings were reviewed. The results were as follows; 1) The patient below age of 2 yrs who's brain had a potent ability of growth should be operated in any cases for reducing mass effect. 2) In sylvian lesion, Type II and III according to the classification of Galassi were well treated with C-P snunt. 3) In infratentorial lesion, all patients had hydrocephalus and the patient who had communicated with subarachnoid space in metrizamide CT were well treated with V-P shunt and who not communicated with subarachnoid space was well treated with Y-shunt. 4) We had good results by fenestration above the age of 3 yrs and by C-P shunt under the age of 2 yrs in supratentorial lesion.
Arachnoid Cysts* ; Brain ; Child* ; Classification ; Humans ; Hydrocephalus ; Metrizamide ; Skull ; Subarachnoid Space

Kimura disease (KD) is a chronic angiolymphoid proliferative disorder of soft tissue with eosinophilia and elevated IgE levels, with predilection for head and neck in young oriental men. Renal disease is often associated with it. We describe a 16-year-old male with KD and steroid-responsive minimal change nephrotic syndrome. After surgical resection of cervical tumor and steroid therapy, complete remission of nephrotic syndrome and KD was achieved and there has been no relapse of tumor and nephrotic syndrome with normal IgE levels over 12 months.
Adolescent ; Angiolymphoid Hyperplasia with Eosinophilia* ; Eosinophilia ; Head ; Humans ; Immunoglobulin E ; Male ; Neck ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Recurrence

The association between nephrotic syndrome and intravascular coagulation has been known for more than a century, but it was not until 1948 that a thrombotic diathesis in nephrotic patients was proposed. The prevalence of thrmbo-embolic complications is much higher in adult patients. Deep vein thrombosis of the leg is the most common complications in nephrotic adult and was responsible for one-third of the thrombo-embolic complications of nephrotic children. Arterial thrombosis occurs less frequently and is seen primarily in childern. We present a case of acute anterior myocardial infarction in a young man with nephrotic syndrome, secondary to minimal change glomerulonephritis, in which thrombosis of the proximal left anterior descanding artery was the actual cause of acute myocardial infarction.
Adult ; Arteries ; Child ; Disease Susceptibility ; Humans ; Leg ; Myocardial Infarction* ; Nephrosis, Lipoid ; Nephrotic Syndrome* ; Prevalence ; Thrombosis ; Venous Thrombosis

BACKGROUND AND PURPOSE: Chronic kidney disease (CKD) is an established risk factor for numerous cardiovascular diseases including stroke. The relationship between the baseline estimated glomerular filtration rate (eGFR) and clinical 3-month outcomes in patients with acute ischemic stroke were evaluated in this study. METHODS: This was a prospective cohort study involving a hospital-based stroke registry; 1373 patients with acute ischemic stroke were enrolled. Patients were divided into the following four groups according their eGFR (calculated using the CKD Epidemiology Collaboration equations): > or =60, 45-59, 30-44, and <30 mL/min/1.73 m2. The primary endpoint of poor functional outcome was defined as 3-month death or dependency (modified Rankin Scale score > or =3); secondary endpoints were neurological deterioration (increase in National Institutes of Health Stroke Severity score of > or =4 at discharge compared to baseline) during hospitalization and in-hospital mortality. RESULTS: The overall eGFR was 84.5+/-20.8 mL/min/1.73 m2 (mean+/-SD). The distribution of baseline renal impairment was as follows: 1,218, 82, 40, and 33 patients had eGFRs of > or =60, 45-59, 30-44, and <30 mL/min/1.73 m2, respectively. At 3 months after the stroke, 476 (34.7%) patients exhibited poor functional outcome. Furthermore, a poor functional outcome occurred more frequently with increasingly advanced stages of CKD (rates of 31.9%, 53.7%, 55.0%, and 63.6% for CKD stages 1/2, 3a, 3b, and 4/5, respectively; p<0.001). Multivariate analysis revealed that a baseline eGFR of <30 mL/min/1.73m2 increased the risk of a poor functional outcome by 2.37-fold (p=0.047). In addition, baseline renal dysfunction was closely associated with neurological deterioration during hospitalization and with in-hospital mortality. CONCLUSIONS: A low baseline eGFR was strongly predictive of both poor functional outcome at 3 months after ischemic stroke and neurological deterioration/mortality during hospitalization.
Cardiovascular Diseases ; Cohort Studies ; Cooperative Behavior ; Epidemiology ; Glomerular Filtration Rate* ; Hospital Mortality ; Hospitalization ; Humans ; Mortality ; Multivariate Analysis ; National Institutes of Health (U.S.) ; Prospective Studies ; Renal Insufficiency, Chronic ; Risk Factors ; Stroke*

BACKGROUND: Direct measurements of ionized magnesium (iMg) in serum by ion-selective electrodes have recently become available in clinical practice, and its usefulness needs to be investigated in dialysis patients because chronic renal failure is associated with disturbances in magnesium metabolism. METHODS: We measured serum iMg in 29 hemodialysis (HD) patients and 24 peritoneal dialysis (CAPD) patients using an ion-selective electrode. The results were compared with those from 30 age- matched control patients who were admitted due to non-renal diseases and were confirmed to have normal serum total magnesium (tMg) levels. RESULTS: Serum tMg was significantly higher in both HD (0.95 [0.81-1.06] mmol/L) and CAPD (0.86 [0.74-0.99] mmol/L) patients compared with the controls (0.74 [0.70-0.78] mmol/L). Serum iMg was significantly higher in HD patients (0.65 [0.60-0.72] mmol/L) compared with the controls (0.55 [0.51-0.57] mmol/L), but was not higher in CAPD patients (0.54 [0.50-0.60] mmol/L). Thus, the ionized fraction of serum magnesium (iMg/tMg) was significantly lower in CAPD patients (65.3 [58.8-68.2]%), but not in HD patients (68.7 [63.6-77.0]%), compared with the controls (72.2 [67.2-78.3]%). In dialysis patients, iMg/ tMg was significantly lower in those with residual renal function than in anuric patients (67.5 [63.6-74.8]% vs. 61.4 [56.4-70.7]%). CONCLUSION: In current practice, true hypermagnesemia may exist frequently in HD patients (at predialysis), but not in CAPD patients. The ionized fraction of serum magnesium may be reduced in CAPD patients, but not in HD patients.
Dialysis* ; Humans ; Ion-Selective Electrodes ; Kidney Failure, Chronic ; Magnesium* ; Metabolism ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis

BACKGROUND/AIMS: A high body mass index (BMI) is known to correlate with better survival in patients on hemodialysis (HD). However, the impacts of body composition and sarcopenia on survival have not been well studied in this population. METHODS: One hundred and forty-two prevalent HD patients were recruited and followed prospectively for up to 4.5 years. Low muscle mass (measured using a portable, whole-body, bioimpedance spectroscopic device) was defined as a lean tissue index (LTI) two standard deviations (SD) or more below the normal gender-specific mean for young people. Low muscle strength was a handgrip strength (HGS) of less than 30 kg in males and less than 20 kg in females. Sarcopenia was considered present when both LTI and HGS were reduced. RESULTS: The mean age was 59.8 ± 13.1 years; 57.0% were male and 47.2% had diabetes. Forty-seven patients (33.1%) had sarcopenia. During follow-up, 28 patients (19.7%) died, and low LTI (adjusted hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.10 to 6.97) and low HGS (HR 5.65; 95% CI, 1.99 to 16.04) were independently associated with mortality. Sarcopenia was a significant predictor for death (HR, 6.99; 95% CI, 1.84 to 26.58; p = 0.004) and cardiovascular events (HR, 4.33; 95% CI, 1.51 to 12.43; p = 0.006). CONCLUSIONS Sarcopenia was strongly associated with long-term mortality and cardiovascular events in HD patients. Assessment of muscle strength and muscle mass may provide additional prognostic information to survival in patients with end-stage renal disease.

PURPOSE: Simple cysts are a common structural abnormality in seemingly healthy individuals, but their clinical significance, especially on changes of renal function, remains unknown. We examined whether sporadic cysts can influence changes of renal function in apparent healthy individuals. METHODS: The records from 424 people who underwent two ultrasonographic examinations in a routine check-up at our health promotion center from 2000 to 2003 were reviewed. Patients who had a medical disease were excluded. The healthy individuals (n=199) were divided into two groups according to whether they had renal cysts (cyst group, n=61), or not (control group, n=138). Renal function was evaluated by serum creatinine level (Scr), creatinine clearance (Ccr), using the Cockcroft-Gault equation, and glomerular filtration rate (GFR), using the MDRD equation. RESULTS: Individuals in the cyst group were significantly older (44.18+/-7.55, 41.02+/-7.06, p=0.013) and more likely to be male (90.16%, 72.46%, p=0.006) than those without cysts. Compared with the control group, the cyst group had no significant differences in Scr (1.03+/-0.15 mg/dL, 1.08+/-0.11 mg/dL, respectively, p=0.06), in Ccr (82.34+/-13.26 ml/min, 81.00+/-12.6 ml/min, respectively, p=0.56) nor in GFR (84.35+/-11.65 ml/min/1.73m2, 82.47+/-10.27 ml/min/1.73m2, respectively, p=0.38). Furthermore, the parameters for changes of renal function were not significant over three years. Conclusions:The presence of renal cysts was associated with neither renal dysfunction nor a reduction in renal function over three years in Korean individuals without apparent renal disease.
Creatinine ; Glomerular Filtration Rate ; Health Promotion ; Humans ; Kidney Diseases ; Kidney Function Tests ; Male

PURPOSE: Compared with the practice of administrating subcutaneous erythropoietin injection two or three times a week in end-stage renal failure, a weekly administration reduces the frequency of injection and the workload in renal units. We investigated whether subcutaneous epoetin alfa administered weekly was as effective as the same weekly dosage given in two or three divided doses. METHODS: Eighty-three patients were randomized to treatment with subcutaneous epoetin alfa either once a week (n=44), or to their original dosage two or three times a week (control, n=39) for 12 weeks. If hemoglobin was out of range (9.0-12.0 g/dL), the dosage was changed. RESULTS: Mean hemoglobin levels at randomization and after 4, 8 and 12 weeks were 10.7, 11.1, 11.3 and 11.0 g/dL, respectively, in the once weekly group compared with 10.5, 11.3, 11.5 and 11.3 g/dL, respectively, in the control group. The mean weekly epoetin alfa dosage at randomization and after 4, 8 and 12 weeks were 142.8, 123.0, 116.7 and 112.3 IU/kg, respectively, in the once-a-week group compared with 128.4, 119.3, 103.5 and 101.2 IU/kg, respectively, in the control group. No statistically significant differences between the groups were apparent in changes in hemoglobin levels or epoetin alfa dosages at week 12. There was no significant difference between the groups in number of patients who maintained stable hemoglobin levels without epoetin alfa dose increases. CONCLUSION: This study demonstrates that a weekly subcutaneous administration of epoetin alfa is as effective and safe as injecting it two or three times a week administration in maintaining hemoglobin levels in stable hemodialysis patients.
Anemia ; Erythropoietin ; Humans ; Kidney Failure, Chronic ; Random Allocation ; Renal Dialysis ; Epoetin Alfa