The authors reviewed the medical records of 103 patients who were diagnosed and treated as myasthenia gravis (MG)at Seoul National University Hospital from March 1979 to March 1984. Among them 16 cases were selected according to the criteria of crisis in MG defined by Blaugrund SM et al(1964) and were studied with a special emphasis on crisis as a natural course of MG in Korea. The authors studied about the incidence of crisis, the aggravating factors or causes, the relationship between crisis and thymus pathology, and the clinical appllcability of the modified classification of crises in MG including a newly-defined steroid-inducd crisis. The results were not significantly different from those by others in general. The incidence rate of crisis was 16% and highest in the female group having the onest of MG in the fourth decade of life. Four patients(25%) had thymomas(2, noninvasive: 2, invasive). The intervals between the onset of MG and the first crises were significantly shorter in male patients and thymoma group, showing the more fulminant course in them. Some probable risk factors were suggested, though not analyzed statistically, which might foretell the prognosis of each patient having MG and might help management and prevention of crisis. They were as follows: (1) Female with onset of MG in her fourth decade, (2) Male with duration less than one year, (3) Patient with thymoma, (4) Patient classified into Osserman's group III, (5) Patient with brittle MG, (6) Patient with an infectious process, especially with repiratory infection Early detection of respiratory insufficiency, intensive respiratory care, and removal of aggravating causes as soon as possible played the critical role in the management of patients at crises. It could also be concluded that steroid therapy was an important therapeutic step during crisis in brittle myasthenics. The outcome of crises was 19% of fatality rate in crises(3 deaths among 16 cases) and 3% mortality rate in MG. There was no recurrence in 11 survivors and followup was lost in two other survivors.
Classification ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Male ; Medical Records ; Mortality ; Myasthenia Gravis* ; Pathology ; Prognosis ; Recurrence ; Respiratory Insufficiency ; Risk Factors ; Seoul ; Survivors ; Thymoma ; Thymus Gland

BACKGROUND AND OBJECTIVES: The transradial approach for coronary intervention has a lower incidence of access site complications and can increase patient comfort after percutaneus tansluminal coronary angioplasty(PTCA). The purpose of this study is to compare procedural success and complication rates of percutaneous transradial coronary stenting which was performed by four operators in two hospitals with those using transfemoral approach. MATERIALS AND METHOD: From September 1998 to July 1999, one hundred seventy five consecutive patients(201 lesions) treated with coronary stent implantation were enrolled for this study : 84 patients underwent transradial coronary stenting(Radial Group), and 91 patients transfemoral coronary stenting(Femoral Group). RESULTS: Seven patients who failed coronary cannulation via radial artery were crossed over to the Femoral Group. The measurements of the radial artery were not done. Patient demographics were similar in both groups. Procedural success was similar in both group(95.2% in Radial Group vs. 97.8% in Femoral Group, p=S). All transradial coronary stenting were possible using conventional guiding catheters which are used in transfemoral intervention. Local vascular complication rates showed a trend toward a reduction in the Radial Group(2.4% vs. 8.8%, p=.06). CONCLUSION: This study showed the similarity in the safety and efficacy of transradial coronary stenting compared to those of transfemoral approach.
Catheterization ; Catheters ; Demography ; Humans ; Incidence ; Radial Artery ; Stents*

No abstract available.
Hysterectomy*

No abstract available.
Thyrotropin*

BACKGROUND: The clinical use of intracoronary stents is impeded by the risk of subacute stent thrombosis and complications associated with the anticoagulant regimen. The use of high pressure balloon dilatations and confirmation of adequate stent expansion by intravascular ultrasound provide assurance that anticoagulation therapy can be safely omitted. Therefore, we evaluated the effect of anticoagulation of subacute thrombosis sfter stenting retrospectively on a consecutive series of patients who received palmaz-Schatz coronary stents with high pressure balloon dilatation. METHOD: From March 1995 to August 1995, 62 patients underwent Palmaz-Schatz coronary stent implantation. After deploying stents successfully, high pressure overdilatation of the stents was performed in all patients. According to post-stent anticoagulation, 32 patients received aspirin 200 mg/day, ticlopidine 500 mg/day and warfarin for two months, 30 patients received aspirin and ticlopidine. RESULTS: The clinical or angiographic variables were not significantly different between the two groups. There was no acute or subacute thrombosis in the two groups. The hospital stay after stenting was significantly shorter in the patients without antcoagulation than in patients with anticoagulation. CONCLUSION: The Palmaz-Schatz stent can be safely implanted without anticoagulation provided that stent expansion is daequate by the use high pressure balloon dilatation This technique significantly reduces hospital time and vascular complications and has a low stent thrombosis rate.
Aspirin ; Dilatation* ; Humans ; Length of Stay ; Retrospective Studies ; Stents* ; Thrombosis ; Ticlopidine ; Ultrasonography ; Warfarin

OBJECTIVE: The natural course of unruptured vertebral artery dissection remains unclear. The clinical manifestation of unruptured vertebral artery dissection varies from headache, focal neurologic deficits caused by ischemia to subarachnoid hemorrhage with high mortality. The purpose of this study is to investigate the clinical course of unruptured vertebral artery dissection. METHODS: From March 2011 to April 2013, 7 patients with headache or nuchal pain by spontaneous vertebral artery dissection visited our institute were retrospectively reviewed. Their clinical data was obtained by medical records and radiologic studies including computed tomographic angiography, magnetic resonance imaging, magnetic resonance angiography and digital subtraction angiography. RESULTS: No patient experienced fatal outcome by subarachnoid hemorrhage or vertebrobasilar ischemia during follow-up period. Radiologic studies also did not show the evidence of subarachnoid hemorrhage or vertebrobasilar ischemia. Follow-up angiography showed the decreased size or disappearance of aneurysm in 3 patients. CONCLUSION: This study suggests that the natural course of unruptured vertebral artery dissection is not aggressive. Patients with unruptured vertebral artery dissection could be managed with conservative treatment including anticoagulants and/or antiplatelet agents.
Aneurysm ; Aneurysm, Dissecting ; Angiography ; Anticoagulants ; Fatal Outcome ; Follow-Up Studies ; Headache ; Humans ; Ischemia ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Medical Records ; Mortality ; Neurologic Manifestations ; Platelet Aggregation Inhibitors ; Retrospective Studies ; Subarachnoid Hemorrhage ; Vertebral Artery Dissection* ; Vertebral Artery* ; Vertebrobasilar Insufficiency

Objective: : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods: : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results: : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

A dynamic impression is a functional impression that records the functional movement of the patient's own muscle and muscle attachment. This process reduces the number of random factors. This article describes a method for making a special tray using a dynamic impression concept that was made from provisional dentures used for implant healing. The individual tray is used to make a wash-impression to record the features of the mucosa in detail. The main advantage of this technique is that it provides a functional relationship of the implant components to the supporting tissues without overextension because provisional denture had been used for 2 months and the border length of individual tray was nearly the same as that of provisional denture. The delivery of the prosthesis constructed using this impression technique is time-saving because there is no need for border molding and there are fewer post-insertion appliance adjustments.
Denture, Overlay* ; Dentures ; Fungi ; Mucous Membrane ; Muscles ; Prostheses and Implants

BACKGROUND: Cerebellar hemorrhage may present with a wide spectrum of clinical manifestations, from a benign course with little to no neurological deficit to a rapidly fatal course with hydrocephalus and brainstem compression. However, controversy remains concerning the management of patients with cerebellar hemorrhage. The aim of this study was to set the criteria for conservative or surgical treatment and predictive factors of poor outcomes. METHODS: During the 5-year period from July 1997 through July 2002, a series of 64 consecutive patients with spontaneous cerebellar hemorrhage was evaluated. On admission, all patients underwent a standard neurological examination, and a computed tomography (CT) scan. The location and size of hematoma, hypertension, hydrocephalus, intraventricular hemorrhage and compression of quadrigeminal cistern on a CT scan were compared with the Glasgow coma scale (GCS) and Glasgow Outcome Scale (GOS). RESULTS: Patients with GCS scores of 13 or more at admission and with a hematoma of less than 15 mL showed good outcomes. Patients with GCS scores of 10 or less at admission or with a hematoma measuring 15 mL or more had poor outcomes. Patients with intraventricular hemorrhage (p<0.05), compression of quadrigeminal cistern (p<0.05), and hydrocephalus (p<0.05) in the brain CT had poor outcomes. CONCLUSIONS: In treating patients with spontaneous cerebellar hemorrhage, an initial GCS and CT scan were quite helpful in determining treatment strategies. For patients whose CT scan show intraventricular hemorrhages, compression of the quadrigeminal cistern, and hydrocephalus, intensive therapy should be deemed necessary.
Brain ; Brain Stem ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Neurologic Examination ; Prognosis ; Tomography, X-Ray Computed

Hemangioma and vascular malformation is a common vascular benign lesion in the head and neck region. The lesion is a congenital malformation observed in neonates. The treatment this lesion includes surgical excision, cryotherapy, selective embolization and treatment with sclerotic agents. We present three cases of benign oral vascular lesions treated with an intralesional injection of sodium tetradecyl sulfate. The lesions virtually disappeared after three sessions of sclerotherapy, leaving an inconspicuous scar. No side effects were observed. Sclerotherapy with sodium tetradecyl sulfate is effective in treating benign oral vascular lesions, and the use of the sodium tetradecyl sulfate provides alternative or support for surgical methods.
Cicatrix ; Cryotherapy ; Head ; Hemangioma ; Humans ; Infant, Newborn ; Injections, Intralesional ; Neck ; Sclerotherapy ; Sodium ; Sodium Tetradecyl Sulfate ; Vascular Malformations