Hypertensive encephalopathy is characterized by an acute, severe rise in blood pressure associated with headache, nausea, vomiting, altered mental status, and focal neurologic deficits, and rapid improvement after control of blood pressure. An eight-year old boy had been admitted with symptoms of red urine, fever, headache, convulsion, and visual blurring of vision. Blood pressure was 140/90mmHg, and CSF exam revealed WBC 8/mm3, glucose 83mg/dL, protein 106mg/dL. Serum C3 was 8mg/dL, C4 17mg/dL, ASO 1,024 Todd units. Brain CT showed non specific findings, however, MRI revealed symmetric high signal intensity lesions on T2WI over the parieto-occipital areas bilaterally. These lesions had been completely resolved on the following MRI 4 weeks later.
Blood Pressure ; Brain* ; Fever ; Glomerulonephritis* ; Glucose ; Headache ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Male ; Nausea ; Neurologic Manifestations ; Seizures ; Vomiting

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels*

No abstract available.
Thyroid Gland* ; Thyroiditis*

Glanzmann's thrombasthenia is a rare autosomal recessive hemorrhagic disorder characterized by prolonged bleeding time, ad deficient or absent clot retraction in the presence of normal platelet count. The major underlying abnormality in this disease is grossly defective first-phase aggregation of platelet, which are unresponsive to ADP or other platelet agonists such as epinephrine, collagen, thrombin in any concentration. This disability is caused by a decrease or absence of the platelet membrans glycoprotein IIb-IIIa complex, a member of the integrin family of adhesive receptors involved in cell-cell and cell-matrix fibronectin, and vitronectin On the development of surface labeling technique, a variety of biochemical techniques such as radioimmunoassay, crossed immunoelectrophoresis and SDS-PAGE have been used to study the structure and the function of platelet membrane glycoproteins, and to detect the platelet functional defect. But all of these techniques demand a relatively large amount of homogeneous paletelet population that requires manipulation through isolation and washing procedures before analysis. In order to eliminaste such an intricate procedure, we have applied method for analyzing platelet surface components in whole blood using monoclonal antibody and flow cytometry to recognize the absence of severe reduction of platelet membrane glycoprotien llb-llla complex. Platelet analysis by flow cytometry is a successful alternative rapid diagnostic technique for Glanzmann's thrombasthenia patients as well as well as for carriers of this disease. Fow cytometry technique provides a sensitive tool for investigating platelet functional defects caused by altered expression or deficiency of platelet surface proteins.
Adenosine Diphosphate ; Adhesives ; Bleeding Time ; Blood Platelets* ; Clot Retraction ; Collagen ; Electrophoresis, Polyacrylamide Gel ; Epinephrine ; Fibronectins ; Flow Cytometry* ; Glycoproteins ; Hemorrhagic Disorders ; Humans ; Immunoelectrophoresis, Two-Dimensional ; Membrane Glycoproteins* ; Membrane Proteins ; Membranes* ; Platelet Count ; Platelet Membrane Glycoproteins ; Radioimmunoassay ; Thrombasthenia* ; Thrombin ; Vitronectin

It is supposed in Korea that institutional care for the elderly would increase while their home care would decrease. Assessment of the functional status is of much importance for effective caregiving for the institutionalized people. The functional status was evaluated in 89 elderly residents of an institution in Taegu, using the Korean version of the mini-mental state examination, the Blessed Dementia Rating Scale, the Barthel Activities of Daily Living, and the Motoricity Index. Vision and hearing were also examined. Based on scores of the Korean version of mini-mental state examination, 45% were found to have definite cognitive impairment and further 25% to have questionable cognitive impairment. About 35% of the subjects possibly had mild or more severe dementia on the Blessed Dementia Rating Scale. Fifty-seven percent had impairment in activities of daily living, and 66% had impairment in motor power. Sixteen percent and 20% had poor vision and hearing difficulty, respectively, to the degree of impairment in daily activities. These findings indicate that more than half of elderly people in institutional care may need either partial or total help from others.
Activities of Daily Living ; Aged* ; Daegu ; Dementia ; Hearing ; Home Care Services ; Humans ; Korea

BACKGROUND: Increased frequency of comminuted clavicle mid-shaft fractures and importance of functional satisfaction through early joint exercise has resulted in higher emphasis on surgical treatments. This study aimed to evaluate the clinical radiological results of treatment of clavicle mid-shaft fractures by open reduction and internal fixation using a plate with a small incision. METHODS: The subjects of this study were 80 clavicle mid-shaft fracture cases treated with internal fixation using a plate from October 2010 to July 2014. Clavicle mid-shaft fractures were internally fixated using anatomical plates or locking compression plates. Achievement of bone union, union period, and clavicle length shortening were evaluated radiologically, and clinical assessment was done by using Constant and University of California at Los Angeles (UCLA) scores. RESULTS: All 80 cases were confirmed to have achieved bone union through radiographs with an average union period of 10.9 weeks (range: 7–18 weeks). The average clavicle length of shortening in the affected side was 1.8 mm (range: 0–17 mm). The average UCLA score and Constant score were 33.6 (range: 25–35) and 92.5 (range: 65–100), respectively. Regarding complications, four cases reported skin irritation by metal plates, and one case reported a screw insertion site fracture due to minor trauma history. CONCLUSIONS: We were able to induce successful bone union and obtain clinically satisfactory results in displaced mid-shaft fractures of the clavicle without major complications such as nonunion through treatment of internal fixation using a plate.
California ; Clavicle* ; Joints ; Skin

No abstract available.
Hand* ; Surgical Flaps*

Pseudoaneurysm due to chronic pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality associated with the pseudoaneurysm, early detection and treatment is essential. Surgical ligation or resection of the aneurysm has a high mortality and therefore, transcatheter embolization is preferably carried out. We report a case in which gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis was successfully treated by transcatheter embolization using Gelfoam and Gianturco spring coils.
Aneurysm ; Aneurysm, False* ; Arteries* ; Gelatin Sponge, Absorbable ; Hemorrhage ; Ligation ; Mortality ; Pancreatitis, Chronic*

BACKGROUND: Scapular notching can happen at diverse location depending on implant design or operative technique, therefore, it is easily misdiagnosed. Thus, this study purposed to suggest a method helpful to assess scapular notching. METHODS: The subjects were 73 cases of reverse shoulder arthroplasty (RSA) for cuff tear arthropathy during the period from May 2009 to April 2014 and followed-up for over a year. There was medialized RSA in 22 cases, bone increased offset RSA (BIO-RSA) in 36 cases, and metal increased offset RSA (metal-RSA) in 15 cases. Scapular notching was not determined by bone defect at the inferior of glenosphere as Sirveaux's classification, but scapular notching at the site where the rotational route of the polyethylene of humeral implant met the scapular neck were examined. The results were compared with conventional method. RESULTS: By conventional method, scapular notching was observed in 10 cases (45.5%) in medialized RSA, 12 cases (33.3%) in BIO-RSA, and none in metal-RSA. By new method, it was observed in 9 cases (40.9%) in medialized RSA, 10 cases (27.8%) in BIO-RSA, and none of metal-RSA. The site of scapular notching was apart from glenoshpere in 18 cases, and at inferior of glenosphere in 1 case. Absorption of bone graft was observed in 4 (11.1%) out of 36 cases of BIO-RSA. CONCLUSIONS: It is hard to distinguish scapular notching from absorption of bone graft in BIO-RSA, and bone absorption at the lateral lower end of glenoid in medialized RSA. Thus, it is considered useful to assess scapular notching at the site where the rotational route of the polyethylene insert meets scapular neck.
Absorption ; Arthroplasty* ; Classification ; Neck ; Polyethylene ; Shoulder* ; Tears ; Transplants

Lymphomatous involvement of the heart, occurring at initial diagnosis and presentation, is extremely rare. We report here a case of 58 year old man who presented with generalized edema, pericardial effusion, and a large right atrial mass detected by transesophageal echocardiography. There is no other evidence of disseminated lymphoma in this patient. Tumor removal and pulmonary embolectomy was done. Pathologically, the mass was malignant lymphoma, diffuse large cell type. Unfortunately, we have no chance to perform the intensive chemotherapy. The patient discharged in moribund state.
Diagnosis ; Drug Therapy ; Echocardiography, Transesophageal ; Edema ; Embolectomy ; Heart ; Humans ; Lymphoma* ; Middle Aged ; Pericardial Effusion