No abstract available.
Accidents, Traffic*

PURPOSE: We report the treatment and prognosis of two patients who experienced pain in their face associated with skin lesions and acute decreased visual acuity and were diagnosed with optic neuritis caused by the herpes zoster virus. CASE SUMMARY: Two patients were diagnosed with herpes zoster ophthalmicus after experiencing an acute decrease in visual acuity and were sent to our clinic for examination. On ophthalmic evaluation, the results were positive for relative afferent pupillary defect (RAPD) and showed abnormal VEP levels. On MRI T1, one case showed a high signal along the optic nerve sheath. Both patients with optic neuritis were treated with Acyclovir (Zovirax(R), GlaxoSmithKline, U.K.), which is an antiviral drug, at a dose of 10 mg/kg every 8 hours for 5 days, and a combination of prednisolone at a dose of 250 mg every 6 hours. After general therapy, they took Acyclovir (250 mg) orally 3 times daily for 14 days, with steroids (40 mg), and decreased the dosage after two weeks. We saw no improvement of visual acuity in either case, which still showed RAPD. CONCLUSIONS: Optic neuritis secondary to herpes zoster ophthalmicus rarely occurs, but it is difficult to treat and has a poor prognosis. We should keep in mind that optic neuritis can occur in patients who were diagnosed with herpes zoster ophthalmicus.
Acyclovir ; Herpes Zoster ; Herpes Zoster Ophthalmicus ; Herpesvirus 3, Human ; Humans ; Optic Nerve ; Optic Neuritis ; Prednisolone ; Prognosis ; Pupil Disorders ; Skin ; Steroids ; Visual Acuity

Cerebral arterial embolism which resulted in total occlusion of right proximal middle cerebral artery was occured in 33 years old female patients with severe mitral stenosis and atrial fibrillation during percutaneous mitral balloon valvuloplasty(PMV). The occluded artery could be detected by transfemoral carotid angiography and recanalized immediately by intra-arterial infusion of urokinase. There were no cerebral hemorrhage by CT scan after intra-arterial urokinase infusion and the patients discharged without any neurologic sequale 7 days after thrombolysis. We report a case of successful recanalization with intraarterial infusion of urokinase in patient with cerebral arterial embolism occurred during PMV.
Adult ; Angiography ; Arteries ; Atrial Fibrillation ; Cerebral Hemorrhage ; Embolism* ; Female ; Humans ; Infusions, Intra-Arterial* ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve Stenosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator*

No abstract available.
Child* ; Glomerulonephritis, Membranoproliferative* ; Humans

Twenty-five patients with unstable fracture or fracture-dislocation of the thoracolumbar and lumbar spines were treated with Cotrel-Dubousset instrumentation. Internal fixation was done in two ways; long rodding in seventeen patients and short rodding in eight. Short segment posterolateral or posterior autogenous iliac bone graft was done in all cases. The amount of correction of the collapsed anterior vertebral body height and the local kyphotic angle at the immediate post-operation were similar between the two groups, but loss of correction at last follow-up was more severe in the short rodding group. Instrument failure was also more common in the short rodding group. In conclusion, it was found that short segment stabilization of spine fractures with Cotrel-Dubousset instrument can effectively reduce fracture but can not maintain reduction until fusion. Therefore, long rodding was reconfirmed to be the better method of stabilization of the thoracolumbar and lumbar spines fractures.
Body Height ; Follow-Up Studies ; Humans ; Methods ; Spine ; Transplants

To evaluate exercise capacity, treadmill test and exercise pulmonary function test with cycle ergometer were preformed in 52 patients(pts) (M/F : 18/34, mean age : 43+/-11 yrs) with mitral stenosis before and 5~10 days after percutaneous mitral balloon valvuloplasty(PMV). Twenty four pts had atrial fibrillation. The results are as follow : 1) The mitral valve area increased from 0.9+/-0.2 to 1.8+/-0.3cm2(P<0.001). 2) The duration of exercise time on treadmill test(modified Bruce protocol) increased from 7.7+/-3.3min to 11.1+/-2.6min(P<0.001), but peak heart rate(HR) and maximum double product(MDP) did not change significantly. After exclusion of the patients with atrial fibrillation, peak HR and MDP increased from 157+/-24beats/min and 22350+/-8220mmHg beat to 165+/-19beats/min and 26290+/-5770mmHg beat respectively(P<0.05). 3) Diffusion capacity and diffusing capacity/alveolar volume at rest decreased from 95+/-25% and 112+/-24% to 87+/-22% and 100+/-18% respectively(p<0.001). 4) FVC, FEV1, FEV1/FVC, FEF25~75% and maximum voluntary ventilation increased from 77+/-12%, 79+/-16%, 104+/-10%, 69+/-25%, and 68+/-14%, to 80+/-11%, 84+/-14%. 106+/-9%, 78+/-25%, and 74+/-12%, respectively(P<0.05). But total lung capacity, residual volume and functional residual capacity did not change significantly. 5) Maximum oxygen consumption, anaerobic threshold, oxygen pulse and maximum work load during exercise increased form 53+/-14%, 34+/-8%, 6.2+/-2.1ml/min and 48+/-18 watts to 61+/-13%, 39+/-7%, 7.3+/-2.0ml/min and 58+/-20 watts respectively(P<0.0005). We conclude that oxygen transport and exercise capacity improve within 10days after PMV and the improvement results from not only hemodynamic improvement but also improvement of static pulmonary function.
Anaerobic Threshold ; Atrial Fibrillation ; Balloon Valvuloplasty* ; Diffusion ; Exercise Test ; Functional Residual Capacity ; Heart ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Oxygen Consumption* ; Oxygen* ; Residual Volume ; Respiratory Function Tests ; Total Lung Capacity ; Ventilation

The tendency of glioblastoma to metastasize to the cerebrospinal fluid (CSF) is well documented, reaching approximately 20% in autopsy series. Nevertheless, clinical symptoms from spinal seeding seem to be infrequent or are at least rarely diagnosed. The authors report a case of a 41-year old female patient with a cerebral glioblastoma multiforme who developed paraplegia due to a pathologically confirmed spinal metastasis.
Adult ; Autopsy ; Cerebrospinal Fluid ; Female ; Glioblastoma* ; Humans ; Neoplasm Metastasis* ; Paraplegia

BACKGROUND: Vibrio vulnificus sepsis, a highly fatal and relatively common disease in Korea, requires rapid bacteriological diagnosis for optimal management of the patient. The Vitek GNI+ card(bioMerieux Vitek. Inc., MO., USA) has been introduced to accomplish more accurate and more rapid reporting for gram-negative bacilli identification. The present study evaluated the ability of the Vitek GNI+ card to identify the species of V. vulnificus. METHODS: A total 103 strains of V. vulnificus isolated from clinical specimens in Chonnam University Hospital during 1986-1999, were tested. Identification of GNI+ card was carried out in accordance with the instructions of the manufacturer, except the suspension medium of 0.85% NaCl rather than the original concentration of 0.45%. Additional tests for growth on TCBS, salt tolerance, and the antimicrobial susceptibility to colistin were also performed. RESULTS: At the completion of the appropriate incubation period, the GNI+ system correctly identified 96.1%(99 strains) of the total isolates. The misidentification rate for the GNI+ system was 3.9%(4 strains) of the total isolates. The misidentified organisms were confirmed to V. vulnificus by the additional tests. The average time to identify the organisms by GNI+ System was 6.8 +/- 1.4 hour. Total 103 isolates could be separated into 24 different bionumber types in Vitek system. CONCLUSION: This results indicate that Vitek GNI+ card is adequate for the identification of clinical isolates of V. vulnificus within several hours, but additional tests should be performed for a few isolates misidentified by the Vitek GNI+ card.
Colistin ; Diagnosis ; Humans ; Jeollanam-do ; Korea ; Salt-Tolerance ; Sepsis ; Vibrio vulnificus* ; Vibrio*

Haemophilus paraphrophilus is a normal inhabitant of the naso- and oropharynx and has been rarely reported as a cause of endocarditis. H. paraphrophilus is a slow-growing and fastidious gram-negative bacterium and belongs to the HACEK group. We experienced a case of infective endocarditis due to H. paraphrophilus. The organism was repeatedly isolated from the blood cultures of a 60 year -old patient presenting with high fever, chills, cardiac murmur, and change of mental state. The patient had a history of mitral and tricuspid valve replacements and had been followed up for complications of cirrhosis of liver such as esophageal varix and oral bleeding. The isolate was identified as H. paraphrophilus by the characteristics, including factor V requirement, negative indole, urea and ornithine decarboxylase and acid production from glucose and lactose. Antimicrobial susceptibility testing by the disk diffusion method showed that the organism was susceptible to ampicillin, chloramphenicol, tetracycline, trimethoprim/sulfamethoxazole, cefotaxime, ceftazidime, aztreonam, imipenem, and ciprofloxacin. The patient expired on hospital day 8, probably due to complications of cirrhosis of liver To our knowledge, this is the first case of infective endocarditis caused by H. paraphrophilus in Korea.
Ampicillin ; Aztreonam ; Cefotaxime ; Ceftazidime ; Chills ; Chloramphenicol ; Ciprofloxacin ; Diffusion ; Endocarditis* ; Esophageal and Gastric Varices ; Factor V ; Fever ; Fibrosis ; Glucose ; Haemophilus paraphrophilus* ; Haemophilus* ; Heart Murmurs ; Hemorrhage ; Humans ; Imipenem ; Korea ; Lactose ; Liver ; Ornithine Decarboxylase ; Oropharynx ; Tetracycline ; Tricuspid Valve ; Urea

BACKGROUND: Pleural eosinophilia is rare and commonly considered to be an indicator of good prognosis. The diagnostic significance of eosinophilic pleural effusions remains controversial despite a century of observation and discussion. This study was conducted to assess the prevalence of eosinophilia in 446 consecutive samples of pleural fluid, to review the cause of eosinophilic pleural effusion and to determine whether the presence of eosinophils increases the likehood of benign conditions. METHOD: A retrospective analysis was performed upon patients that underwent first thoracentesis due to pleural effusion between January 1999 and December 1999. RESULTS: Eosinophilic pleural effusions were identified in 24 of the 446 patients (5.4%). Malignancy, parapneumonic effusion and tuberculosis were determined the major causes of pleural effusion (80.6%). Malignancy was diagnosed as frequently in eosinophilic effusions as in non-eosinophilic effusions (54.2% vs 50.5%, p=0.725). No difference was found in the prevalence of eosinophilic and non-eosinophilic effusion according to the etiology. The mean blood eosinophil ratio in patients with eosinophilic pleural effusion was 5.4% and no significant correlation existed between the blood and pleural eosinophilic count. CONCLUSION: Pleural eosinophilia is not helpful for differentiating benign and malignant etiology and is not related with blood eosinophilia or repeated tapping.
Eosinophilia ; Eosinophils* ; Humans ; Pleural Effusion* ; Prevalence ; Prognosis ; Retrospective Studies ; Tuberculosis