Fourty cases of postpartum heart failure occuring in Korean women in the Dept. of Int. Med., Pusan University Hospital are reported, with and analysis of clinical data including frequency, age, time of onset, clinical features, hemoglobin, liver function, electrocardiographic and chest X-ray findings. The following results were obtained. 1. The cases were mostly found in 20-29 years age group, 50% of the total cases. 2. Eighteen cases of fourty patients experienced the symptoms during the 2nd week after delivery and 12 cases complained the symptoms during 4th week. 3. Only six cases noted onset of heart disease following the 4th pregnancy, whereas sixteen patients experienced this phenomenon after the first gestation, eight patients after the 2nd gestation and ten patients after the 3rd pregnancy. 4. At the admission the patients were suffering from paroxysmal nocturnal dyspnea, orthopnea, exertional dyspnea and generalized edema. Physical findings revealed cardiomegaly, gallop rhythm, edema, pulmonary fine rales and systolic murmur in frequency. 5. Electrocardiograms were available at the time of presentation in thirty patients. Twenty four patients had left ventricular hypertrophy, 18 patients sinus tachycardia, 3 patients lower voltage. 6. The chest X-ray film showed the cardiomegaly in 15 cases, 83.3% of the obtained 18 cases, 12 cases pulmonary edema, 3 cases pericardial effusion. 7. The venous pressure was measured in 15 patients. In 5 cases the venous pressure was normal and in 10 increased above 150mmH2O. 8. With prompt treatment by rest, salt restriction, diuretics and digoxin the clinical symptoms improved in 31 cases but 9 patients died at the admission.
Busan ; Cardiomegaly ; Digoxin ; Diuretics ; Dyspnea ; Edema ; Electrocardiography ; Female ; Heart Diseases ; Heart Failure* ; Heart* ; Humans ; Hypertrophy, Left Ventricular ; Liver ; Pericardial Effusion ; Postpartum Period* ; Pregnancy ; Pulmonary Edema ; Respiratory Sounds ; Systolic Murmurs ; Tachycardia, Sinus ; Thorax ; Venous Pressure ; X-Ray Film

Cleidocranial dysostosis is a rare congenital developmental disorder in which membranous bones fail to ossify sufficiently, particularily in the calvarium and the clavicles where fibrous tissue replaces the bone. Authors report two cases of cleidocranial dysostosis occurred in a 44-year-old woman and her 19-year-old son.
Adult ; Clavicle ; Cleidocranial Dysplasia ; Female ; Humans ; Mothers ; Skull ; Young Adult

OBJECTIVE: The authors evaluated the accuracies and ease of use of several commonly used microanastomosis training models (synthetic tube, chicken wing, and living rat model). METHODS: A survey was conducted among neurosurgeons and neurosurgery residents at a workshop held in 2009 at the authors' institute. Questions addressed model accuracy (similarity to real vessels and actual procedures) and practicality (availability of materials and ease of application in daily practice). Answers to each question were rated using a 5-point scale. Participants were also asked what types of training methods they would chose to improve their skills and to introduce the topic to other neurosurgeons or neurosurgery residents. RESULTS: Of the 24 participants, 20 (83.3%) responded to the survey. The living rat model was favored for model accuracy (p < 0.001; synthetic tube -0.95 +/- 0.686, chicken wing, 0.15 +/- 0.587, and rat, 1.75 +/- 0.444) and the chicken wing model for practicality (p < 0.001; synthetic tube -1.55 +/- 0.605, chicken wing, 1.80 +/- 0.523, and rat, 1.30 +/- 0.923). All (100%) chose the living rat model for improving their skills, and for introducing the subject to other neurosurgeons or neurosurgery residents, the chicken wing and living rat models were selected by 18 (90%) and 20 (100%), respectively. CONCLUSION: Of 3 methods examined, the chicken wing model was found to be the most practical, but the living rat model was found to represent reality the best. We recommend the chicken wing model to train surgeons who have mastered basic techniques, and the living rat model for experienced surgeons to maintain skill levels.
Animals ; Cerebral Revascularization ; Chickens ; Microsurgery ; Neurosurgery ; Rats ; Wings, Animal

Operative clipping after previous endovascular coiling in an aneurysm is a different problem from primary clipping procedure for neurosurgeons. With the increasing use of coil embolization, neurosurgeons will more and more face the similar situation. We report surgical clipping cases of intracranial aneurysm regrown after endovascular coiling. Three patients with a history of subarachnoid hemorrhage due to ruptured aneurysm underwent endovascular treatment (EVT) with detachable coils. The aneurysms were in the posterior communicating artery, the middle cerebral artery, and distal anterior cerebral artery (DACA). Two near-total occlusions and one partial occlusion were achieved by EVT. After several months, angiographic follow-up revealed regrowth of the aneurysm requiring surgical clipping. Here, we report three cases in which surgical clipping was more difficult than a usual clipping procedure performed several months after EVT, because of adhesion and coil bulging into the aneurysmal neck. The difficulty of the treatment of the residual aneurysm after coiling is discussed, as are the surgical complications and limitations of clipping.
Aneurysm ; Aneurysm, Ruptured ; Anterior Cerebral Artery ; Arteries ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Neck ; Subarachnoid Hemorrhage ; Surgical Instruments*

No abstract available.
Child* ; Humans ; Male ; Penis* ; Replantation*

Traumatic intracranial pseudoaneurysms are rare and it is easy to overlook the evaluation of intracranial vascular injury in head trauma patients in the emergency room. If the result of missing an intracranial aneurysm however is catastrophic. I describe a case of a patient with intracranial internal carotid artery (ICA) pseudoaneurysm after head trauma and stress the importance of obtaining a three-dimensional-computed tomogram angiography (3DCTA) in cases of patients with skull base fracture or eyeball pain. We report a case which a patient complained of severe headache and right eyeball pain after head trauma. 3D-CTA revealed carotid-cavernous fistula and pseudoaneurysm of the right ICA. After performing transfemoral carotid angiography (TFCA) and a balloon occlusion test, we carried out endovascular trapping of ICA and extracranial-intracranial (EC-IC) bypass surgery. Afterward, the patient was discharged without neurological deficit after two weeks. We recommended 3D-CTA in cases of head trauma when the patient has skull base fracture or sphenoid sinus fracture.
Aneurysm, False* ; Angiography ; Balloon Occlusion ; Carotid Artery, Internal ; Craniocerebral Trauma* ; Emergency Service, Hospital ; Fistula ; Head* ; Headache ; Humans ; Intracranial Aneurysm ; Skull Base ; Sphenoid Sinus ; Vascular System Injuries

No abstract available.
Phenytoin* ; Stevens-Johnson Syndrome*

BACKGROUND: The etiology of Behçet's disease(BD) is not yet certain, and various hypotheses are suggested. In order to determine the role of dietary intake behavior in the pathogenesis of BD, we analyzed BD patients by questionnaire regarding their personal, social, and economic characteristics, and dietary intake behavior. METHODS: A series. of 79 patients who were registered at the Behçet's Disease Specialty Clinic at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea were studied. The patients were classified and the data from the patients were analyzed according to the revised Japanese criteria. RESULTS: All patients except for suspected type patients took an average amount of nutrition close to the Korean Recommended Dietary Allowance(RDA). However, on the whole, the amount of consumption of Vitamin B2 and C was low and in the case of females, the consumption of Ca and Fe was makedly insufficient in accordance with the Korean RDA. In case of the level of dietary and serum zinc, there was no significant difference in patients or among groups. CONCLUSION: Since the consumption of some vitamins and minerals of patients were low, the behavior of dietary intake of BD patients which is considered to have a possible role in development of disease should be studied further.
Asian Continental Ancestry Group ; Female ; Humans ; Korea ; Minerals ; Miners ; Riboflavin ; Seoul ; Vitamins ; Zinc

PURPOSE: Approximately 30% of patients with acute carbon monoxide (CO) poisoning display chronic neurological symptoms due to late encephalopathy, 1/3 in delayed neuropsychiatric sequelae (DNS) and 2/3 in persistent neurological symptoms (PNS). This study was conducted in order to determine whether diffusion tensor imaging (DTI) can sensitively represent damage to the brain in the acute phase after CO poisoning. METHODS: This prospective study included 132 patients with CO poisoning from February 2013 to February 2014. The patients were classified according to three groups: patients with asymptomatics; patients with PNS; and patients with DNS. Mean fractional anisotrophy (FA) and apparent diffusion coefficient (ADC) of regions of interest (ROI) in the acute phase were compared between the DNS or PNS groups and the asymptomatic group. DNS was considered present when the patient had clinical symptoms and signs of DNS within six weeks after exposure to CO poisoning. RESULTS: Late encephalopathy occurred at a rate of 18.9% (12.1% in the DNS, 6.7% in the PNS). DTI cannot sensitively represent brain damage of the DNS groups in the acute phase after CO poisoning. But low FA values of high frontal subcortex and low ADC values of globus pallidus in the DNS group clearly differed from those in the asymptomatic group. The PNS group showed significantly low FA and ADC values in centrum semiovale, several subcortics, globus pallidus, corpus callosum, and internal capsule. No significant difference in ADC was observed between patient groups. CONCLUSION: In the acute phase of CO poisoning, FA or ADC values sensitively represented damage to white matter in the some subcortex. However it had limited value in predicting the DNS because of no significant reduction of FA value in the centrum semiovale in the acute phase. However low values of FA and ADC in diffuse lesions in deep white matter and subcortex is a powerful predictor of the PNS.
Brain ; Carbon Monoxide ; Carbon Monoxide Poisoning* ; Corpus Callosum ; Diffusion ; Diffusion Tensor Imaging* ; Globus Pallidus ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Poisoning ; Prognosis ; Prospective Studies