No abstract available.
Hematuria*

Carotid bruit is a physical sign derived from the turbulence of carotid blood flow and has been rgarded as one of the imponant risk factor of ischemic stroke. To estimate a crude prevalence of carotid bruit in ischemic stroke in Korea at present time, and evaluate the correlation of carotid bruit with carotid stenosis and site of ischemic lesion, we investigated the brain imaging studies (computed tomography and / or magnetic resonance imaging)and cerebral angiographict finding of fifty patiens with caoti bruit.Thirty-nine (3.9 %) ot of nine hundred and ninety-six ischemic stroke patients had bruit around the carotid bifurcation. And the other eleven cases who did not have ischemic stroke were detected to have carotid bruit during the routine neurological examination at the bedside.Th presence of infarction in one side of carotid territory was not significantly differentwhether the bruit was heard or not in that side, but the presece of carotid stenosis in angiographY had a tendency to be significantly different by the audible bruit on that side. Carotid bruit does not necessarily reflect the infarction of that side, but can only be used as a predictor of ipsilateral extracranial carotid occlusive disease in this preliminary study. Further extensive prospective study is needed for the exact prevalence of rate and the clinical usefulss of the carotid bruit in Korea.
Angiography ; Carotid Stenosis ; Humans ; Infarction ; Korea ; Neuroimaging ; Neurologic Examination ; Prevalence ; Risk Factors ; Stroke

BACKGROUND: Previous studies indicated that there was important correlation between early patency of infarct-related artery, preservation of ventricular function, and improved survival after thrombolytic therapy for acute myocardial infarction. An increased infusion rate of rt-PA has been shown to result in faster thrombolysis and a high patency rate of occluded vessel in myocardial infarction. Therefore, we evaluated the effect of simplified triple bolus injection of rt-PA on early patency of infarct-related artery and evaluated safety and efficacy of triple bolus injection. METHOD: Patients with acute myocardial infarction presenting up to 6 hour from the onset of chest pain were recruited for the study. Aspring(100-200mg) was given immediately. Total dose for 1.5mg/kg of rt-PA(minimum 75mg, maximum 100mg) was administered as triple bolus intravenous injections. The half of total dose was injected initially, the quarter of total dose was injected at 10 minutes after 1st injection and the remainder was injected at 40 minutes after 1st injection. Five thousand units of heparin was given and 1,000-1,500unit/hr was given continuously. Coronary angiogram was performed at 60 minutes and 7-10 days after the first bolus injection. RESULTS: At 60 minutes, eleven of fourteen patients (78.6%) showed TMI grade-3 of patency in infarct-related coronary artery. There were two patients of hemorrhagic complications. One patient developed cerebellar hemorrhage at third day after rt-PA injection, and the other developed bleeding at femoral sheath site. There was no in-hospital mortality and reinfarction. CONCLUSION: In patients with acute myocardial infarction, the simplified triple bolus injection of rt-PA is associated with high early patency(TMI grade-3) in infarct-related coronary artery, with low risk of major bleeding comlications comparable to other studies.
Arteries ; Chest Pain ; Coronary Vessels ; Hemorrhage ; Heparin ; Hospital Mortality ; Humans ; Injections, Intravenous ; Myocardial Infarction* ; Thrombolytic Therapy ; Tissue Plasminogen Activator* ; Ventricular Function

Until now, tight-fitting material, such as a ring on a digit, has been treated primarily using ring cutter techniques. If this was not available, most physicians would attempt to pull materials out using simple instruments available in the emergency room. The material selected most often was lubricant. However, for cases in which the tight-fitting material was unusual in that the finger was fully covered so that the joint or distal part could not be located in order to check on complications, there have been no methods for consideration with references. Therefore, we treated a patient whose finger was stuck in an unusual circumstance, and removed it manually using the lubricant and compressor technique.
Emergencies ; Fingers ; Humans ; Joints

Restorative proctocolectomy (total proctocolectomy and ileal J pouch anal anastomosis) has been accepted as the operation of choice in the setting of chronic ulcerative colitis and familial adenomatous polyposis. The purpose of this study was to assess operative safety and functional outcome after restorative proctocolectomy. A total of sixteen patients underwent surgery between January 1996 and December 1999. Hand sewn anastomosis with diverting ileostomy was performed in 9 patients and double stapled anastomosis in 7 patients. The underlying disease was ulcerative colitis in 9 cases and familial adenomatous polyposis in 7. Postoperative complications developed in 8 cases (50%), and intestinal obstruction was found in 4 cases (2 cases were operated upon). Anastomosis related complications were stenosis (n=2), leak (n=1) and perianal abscess (n=1). All patients were followed up at the outpatient clinic using questionnaires, with a mean follow up period of 19.9 months. The frequency of bowel movement was 8.2 per day in hand sewn anastomosis (HS), and 12 per day in double stapled anastomosis (DS) 3 months after surgery (period 1). This frequency decreased to 5.5 per day in HS, and 4.6 per day in DS after one year (period 2). Day and night continence was shown in 12/15, and 5/15, respectively in period 1, but improved to 10/11, and 10/11, respectively in period 2. Night time incontinence was noted in 10 of 15 patients in period 1 (seepage 3/15, soiling 7/15). The need to take anti-diarrheal medication, and to use a pad was noted in 2/15, and 10/15, respectively in period 1, but no patient took antidiarrheal medication or wore a protective pad in period 2. Postoperative urinary function was satisfactory in 13/14 patients. Postoperative sexual function was analyzed in a total of 8 patients, who showed good erection (5/5), ejaculation (5/5) and satisfactory sexual life (5/5). In females, 3 patients showed a satisfactory sexual life. In conclusion, restorative proctocolectomy for chronic ulcerative colitis and familial adenomatous polyposis can be performed safely with excellent functional outcomes, including bowel movement, urinary and sexual functions one year after surgery.
Adenomatous Polyposis Coli/surgery ; Adult ; Colitis, Ulcerative/surgery ; Defecation ; Ejaculation ; Female ; Human ; Male ; Patient Satisfaction ; Penile Erection ; Proctocolectomy, Restorative*/adverse effects ; Safety ; Sex Behavior ; Treatment Outcome

PURPOSE: To determine the usefulness of cerebral perfusion computed tomography (CT) in patients with acute cerebral ischemic infarction. MATERIALS AND METHODS: Twelve patients with acute middle cerebral artery infarction underwent conventional CT and cerebral perfusion CT within 25 hours of the onset of symptoms. For each patient, perfusion CT scans were obtained at the levels of the basal ganglia and 1 cm caudal to them. Using special imaging software, perfusion imaging maps for cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to peak (TTP) were created, and the infarcted lesion was evaluated on each map. MTT and TTP delay times were measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Lesion size on each perfusion map was determined and compared with the value obtained by diffusionweighted MR imaging (DWMRI). RESULTS: In all patients, perfusion CT maps depicted the perfusion defect lesion, for which the MTT and TTP delay was remarkable. A comparison of lesion size between each perfusion map and DWMR images showed that the closest correlation involved CBF maps (8/12, 67%). On MTT maps, the lesion was larger than at DWMRI, suggesting that MTT mapping can be used to evaluate ischemic penumbra. CONCLUSION: Perfusion mapping facilitates the evaluation not only of the ischemic core and ischemic penumbra, but also of hemodynamic status in the area of the perfusion defect. This finding demonstrates that perfusion CT can be useful for the diagnosis and treatment of patients with acute cerebral ischemic infarction.
Basal Ganglia ; Blood Volume ; Cerebrum ; Diagnosis ; Hemodynamics ; Humans ; Infarction* ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Perfusion Imaging ; Perfusion* ; Tomography, X-Ray Computed

PURPOSE: The restorative proctocolectomy has been accepted as the operation of choice for chronic ulcerative colitis and familial adenomatous polyposis. The purpose of this study was to assess the operative safety and the functional outcome after a total proctocolectomy and ileal-pouch anal anastomosis. METHODS: The medical records of 16 patients who had undergone a total proctocolectomy and ileal-pouch anal anastomosis for ulcerative colitis (n=9) and familial adenomatous polyposis (n=7) from January 1996 to December 1999 were reviewed. The mean length of follow-up was 19.9 months, and we evaluated functional outcome using a prepared questionnaire. RESULTS: A hand-sewn anastomosis with diverting ileostomy was performed in 9 patients, and a double stapled anastomosis was done in 7 patients. Postoperative complications occurred in 8 cases (50%): intestinal obstructions in 4 patients and anastomosis related complications in 4 patients, i.e. stenosis (n=2), leak (n=1) and perianal abscess (n=1). The defecation frequency and the, day and night continence were improved in the first period (one year after surgery) compared to the second period (3 months after surgery). The need for anti-diarrheal medication, and for the use of a pad was also decreased in the second period compared to the first period. Postoperative urinary function was satisfactory in 13 of 14 patients. Postoperative sexual function was assessed in 8 patients (5 males, 3 females) and showed in good erection (5/5), ejaculation (5/5), and satisfactory sexual life (8/8). CONCLUSION: Satisfactory functional outcomes regarding the frequency of bowel movement and fecal incontinence and operative safety can be achieved after a restorative proctocolectomy for chronic ulcerative colitis and familial adenomatous polyposis.
Abscess ; Adenomatous Polyposis Coli ; Colitis, Ulcerative ; Constriction, Pathologic ; Defecation ; Ejaculation ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Ileostomy ; Intestinal Obstruction ; Male ; Medical Records ; Postoperative Complications ; Proctocolectomy, Restorative* ; Surveys and Questionnaires

Churg-Strauss syndrome (CSS) or allergic granulomatous angiitis is a rare syndrome that is characterized by hypereosinophilic systemic necrotizing vasculitis affecting small- to medium-sized arteries and veins. In general, it occurs in individuals with pre-existing allergic asthma. When CSS appears in patients, it has the following characteristics: eosinophilia of more than 10% in peripheral blood, paranasal sinusitis, pulmonary infiltrates, histological proof of vasculitis with extravascular eosinophils, and mononeuritis multiplex or polyneuropathy. Therapeutic trials dedicated to Churg-Strauss syndrome have been limited due to the rarity of this disorder and the difficulty in making a histological diagnosis. Proper treatment of patients with CSS is not widely known. In this case study, we report on our experience with an unusual patient case, characterized by purpura and a perforation of the small intestine after inadequate steroid therapy.
Arteries ; Asthma ; Churg-Strauss Syndrome ; Eosinophilia ; Eosinophils ; Humans ; Intestinal Perforation ; Intestine, Small ; Mononeuropathies ; Polyneuropathies ; Purpura ; Sinusitis ; Vasculitis ; Veins

Primary intraventricular oligodendroglioma is uncommon and radiological calcification at that location is quite rare. We are reporting a case of huge primary calcified intraventricular oligodendroglioma in the trigone and occipital horn of the left lateral ventricle totally removed through a left parieto-occipital transcortical approach. The clinical, radiological and surgical details of the case are presented with review of literature.
Animals ; Horns ; Lateral Ventricles ; Oligodendroglioma

No abstract available.
Humans