Neuromyelitis optica (NMO) is an idiopathic inflammatory demyelinating disease, characterized by optic neuritis and myelitis. NMO is a very uncommon and serious neurologic manifestation of systemic lupus erythematous (SLE). We report a 28-year-old man with NMO as neuropsychiatric manifestation of SLE. He was diagnosed as lupus nephritis at 16-year-old. He had optic neuritis at three years and seven months ago. Oral prednisolone was tapered off according to the improved eye symptoms. Two months later, he visited rheumatology clinics for urinary disturbance and paresthesia on both feet. A spinal magnetic resonance imaging revealed increased signal intensity in T2-weighted images from second to sixth cervical level and from eleventh to twelfth thoracic level. We diagnosed neuromyelitis optica and treated with intravenous cyclophosphamide therapy monthly for three times. He was discharged without any neurological deficits and has been followed up.
Adolescent ; Adult ; Cyclophosphamide ; Demyelinating Diseases ; Foot ; Humans ; Lupus Nephritis ; Magnetic Resonance Imaging ; Myelitis ; Neurologic Manifestations ; Neuromyelitis Optica* ; Optic Neuritis ; Paresthesia ; Prednisolone ; Rheumatology

The authors analysed retrospectively 41 cases of spontaneous IVH(intraventricular hemorrhage) which were treated with EVD(extraventricular drainage). In cases of poor drainage of CSF(cerebrospinal fluid) through the EVD catheter, infusion of urokinase was tried. The most common age groups of IVH patients were the 5th and 6th decades. Sexual incidence was 23 : 18 in male vs. female. The etioligies of the spontaneous IVH in order of frequency were hypertension, aneurysm rupture, AVM. The overall mortality rate was 49%, but a poor outcome was noted in 64% of the cases. The cases of high Graeb score & low GCS(Glasgow coma scale) score on admission showed poor outcome. Incidence of complication was 27%. Ventriculostomy was effective in many cases of IVH, especially in the early stage of stroke.
Aneurysm ; Catheters ; Coma ; Drainage ; Female ; Hemorrhage* ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Retrospective Studies ; Rupture ; Stroke ; Urokinase-Type Plasminogen Activator ; Ventriculostomy

No abstract available.
Cri-du-Chat Syndrome*

Tumorous lesion of intra- and suprasellar area showed unique clinical pictures and also was very hazardous and difficult to remove surgically because of the surrounding important anatomical structures. Here, authors analyzed 28 confirmed tumor of this area during last two and half years retrospectively. Histopathologically, 28 cases were classified in 14 pituitary adenoma cases(6 cases of nonfunctioning adenoma, 1 GH-secreting adenoma and 7 cases of prolactinoma), 7 craniopharyngioma cases, 3 meninigioma cases and each one case of germinoma, Rathke's cleft cyst, pituitary abscess and hamartoma. Sexual incidence was 6:22 in male vs female ratio. Twenty two cases were measured its diameter over 2cm and they extended to suprasellar area in all cases. Five cases of microadenoma were analyzed and they were all enclosed in sella turcica. Visual impairment was the most frequent and prominent clinical symptom, of which incidence was 78.57%(22 cases). The next frequent symptoms were headache and generalized lethargy. Diabetes insipidus was a presenting symptom in 4 cases and hydrocephalus was noted in 4 cases preoperatively. Surgical intervention was carried out in 23 cases, by the way, the performed type of surgery in 21 cases was a conventional transcranial frontotemporal(pterional) microsurgical method. Post-operatively, diabetes insipidus was complicated in 78.26% and pituitary hypofunction was noted 34.78%. Two cases of intracranial hemorrhage was developed after surgery and one was died. Through 6 to 28 months follow up, 82.1% of cases were improved in its clinical status including 7 cured cases.
Abscess ; Adenoma ; Craniopharyngioma ; Diabetes Insipidus ; Female ; Follow-Up Studies ; Germinoma ; Hamartoma ; Headache ; Humans ; Hydrocephalus ; Incidence ; Intracranial Hemorrhages ; Lethargy ; Male ; Meningioma ; Pituitary Neoplasms ; Retrospective Studies ; Sella Turcica ; Vision Disorders

A clinical analysis was carried out retrospectively with 54 cases of severe head injured patients(Glasgow Coma Scale score 3 to 8) to identify prognostic factors. Unawareness for over 1 month, abnormal papillary reaction, abnormal motor response pattern, and diffuse head injury with basal cisternal compression prove to be the most reliable predictors. Individual predictions of outcome provide a powerful too for assessing the relative efficacy of alternative treatments.
Coma ; Craniocerebral Trauma ; Head* ; Pupil ; Retrospective Studies

An endobronchial metastasis is defined as a subsegmental or a more proximal central bronchial metastasis of a nonpulmonary neoplasm in the bronchoscopically visible range. However, the frequencies of endobronchial metastasis range from 2 to 50% of pulmonary metastases from extrathoracic neoplasms by a different difinition of an endobronchial metastasis. Primary neoplasms of an endobronchial metastasis including breast cancer, colon cancer, renal cell carcinoma, and ovarian cancer are relatively common. However, an endobronchial metastasis arising from thyroid cancer, parotid gland tumor, bone tumor, bladder cancer, and stomach cancer has only rarely been reported in the literature. Here we report a case of an endobrochial metastases from a hepatocellular carcinoma
Breast Neoplasms ; Carcinoma, Hepatocellular* ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Parotid Gland ; Stomach Neoplasms ; Thyroid Neoplasms ; Urinary Bladder Neoplasms

OBJECTIVE: This study was designed to investigate whether the stroke occurrence is influenced by the seasonal and diurnal changes and also to know if the seasonal factor affects the functional outcome of stroke patients. METHOD: We analyzed the epidemiologic, etiologic, and clinical data collected from the chart reviews in 824 stroke patients who were admitted to the Asan Medical Center from April 1995 to May 1997. RESULTS: The highest incidence of the stroke was noted in the group of 60 years of age with the ratio of male to female, 1.27 : 1. The occurrence rate of ischemic stroke (60.4%) was higher than that of hemorrhagic stroke (34.9%) or other type stroke (4.7%). The highest occurrence of stroke was noted during the months of January and November. The seasonal preference was winter and autumn followed by summer and spring. The onset of stroke was relatively high between 6:00 am and 6:00 pm with regard to the diurnal variance. The functional improvement was not significantly affected by the seasonal change. CONCLUSION: The stroke occurred more in winter and autumn than in other seasons. And the functional recuperation was not influenced by the seasonal variation. A further multicenter prospective study using stroke registry would bring more precise and valuable informations.
Chungcheongnam-do ; Epidemiology ; Female ; Humans ; Incidence ; Male ; Seasons* ; Stroke*

OBJECTIVE: To investigate the functional outcomes of anterior cerebral artery (ACA) territorial infarcts in comparison to those of middle cerebral artery (MCA) territorial infarcts. METHOD: Medical records of 1998 stroke patients admitted to Asan Medical Center in Seoul, Korea, from January 1, 1992 to June 31, 1999 were reviewed. Fifty-three patients had ACA occlusions. Sixteen of 53 patients who were given comprehensive rehabilitation were involved in this study. Thirty-nine patients with MCA territorial infarcts served as a control group. The data collected from chart reviews included the age, sex, the hemiparetic side, days from onset to arrival at rehabilitation service, lengths of stay in rehabilitation service, and Functional Independence Measure (FIM) score of each patient. RESULTS: The ACA group showed better motor and total FIM score at discharge. They acquired better FIM efficiency, motor FIM gain, and motor FIM efficiency. Both groups showed no significant differences in cognitive FIM gain and efficiency. CONCLUSION: The ACA group had better performance in ADL than that of the MCA group as evidenced by the fact that it showed a higher FIM efficiency resulting from higher motor FIM efficiency after comprehensive rehabilitation management.
Activities of Daily Living ; Anterior Cerebral Artery* ; Chungcheongnam-do ; Humans ; Korea ; Medical Records ; Middle Cerebral Artery ; Rehabilitation ; Seoul ; Stroke*

PURPOSE: Thawed stem cells should be infused as early as possible because delay of infusion leads to decrease of cell viability and formation of DNA clumping. The procedure of 10% Dimethyl sulfoxide(DMSO) removal and a long distance from the thawing location to the patient are the main causes of delay of infusion that results in the loss of cell viability and apoptosis. Therefore, we investigated the changes of cell viability and apoptosis after thawing with lapse of time. METHODS: Five samples of mobilized peripheral blood were evaluated. We measured cell viability, colony forming unit(CFU) and apoptosis at 0, 1, 2, 4, and 24 hours after thawing. The state of stem cells were divided into live, apoptotic and dead with double staining using annexin V and 7-aminoactinomycin D(7-AAD) in flow cytometry. RESULTS: Viability of the total cells after thawing was 77.3(53.3-97.7)%. The percentage which recovered to initial CFU at 1, 2, 4 and 24 hours after thawing decreased to 63.9%, 50.2%, 45.8% and 11.6%, respectively. The proportion of apoptotic cells among CD34+ cells after thawing were increased from 0.2% at 0 hour to 16.5% at 1 hour, 21.9% at 2 hours, and then decreased to 15.0% at 4 hours, 2.7% at 24 hours because they were replaced by dead cells. CONCLUSION: Thawed cells changed to apoptotic and had less colony forming capacity from 1 hour after thawing, and were then replaced by dead cells from 4 hours after thawing.
Annexin A5 ; Apoptosis* ; Cell Survival ; DNA ; Flow Cytometry ; Humans ; Stem Cells*

BACKGROUND: In various studies in adults, caffeine may increase wakefulness and relieve pain, but caffeine overdose can cause many adverse serious effects on health. Caffeine intake has recently been increasing in adolescents. In spite of importance of caffeine effects on Korean adolescents, there are lack of scientific and systematic studies. The purpose of our study was to identify the relationship between caffeine consumption and effects on adolescents. METHODS: We performed study on 234 middle school students at one middle school in Daegu using a self-report questionnaire. We divided students to quartiles according to amount of caffeine intake. We used Beck Depression Inventory (BDI) to evaluate the degree of depression and Beck Anxiety Inventory (BAI) to evaluate the degree of anxiety. We also used Insomnia Severity Scale (ISI) to evaluate the degree of insomnia and Global Assessment of Recent Stress (GARS) to evaluate the stress in students. We used logistic regression analysis to identify the relationship between caffeine consumption and effects. RESULTS: Higher caffeine intake was associated with higher weight, height, lower academic achievement, and higher score in BDI, BAI, ISI, and GARS (P for trend <0.005). Higher caffeine intake quartile was associated with greater odds of having significant depression (BDI ≥10, P for trend=0.011), and insomnia (ISI ≥8, P for trend=0.015) after adjustment for factors that can affect the psychological status. CONCLUSION: We found that caffeine intake is associated weight, height, academic achievement, and higher score in BDI, BAI, ISI, and GARS. Caffeine intake was positively associated with the severity of depression and the severity of insomnia among adolescents in Korean.
Adolescent* ; Adult ; Anxiety* ; Caffeine* ; Daegu ; Depression* ; Humans ; Logistic Models ; Sleep Initiation and Maintenance Disorders ; Wakefulness