No abstract available.
Radiosurgery* ; Trigeminal Neuralgia*

PURPOSE: More effective diagnosis and treatment through a survey on clinical aspect for the last 5 years and interrelation between cold agglutinin titer and mycoplasma antibody titer of Mycoplasma pneumoniae pneumonia. METHODS: 369 patients hospitalized in the department of pediatrics of Chung Goo Sung Shim Hospital for the 5 years from January 1990 to December 1994 have been surveyed, which diagnosed to be Mycoplasma pneumoniae pneumoniaby physical findings or chest x-ray findings with the titer of 1:64 in cold agglutinin test or the titer of 1:80 in Mycoplasma antibody test or forefold increase of any one or both of 2 titers in follow-up tes RESULTS: 1) More cases were found in 1990(76 cases, 20.6%) and 1994(181 cases, 49%) and the monthly distribution showed irregular fluctuations. Male to female ratio was 1:1.2 and high incidence was in the age of 3 to 5 years(27.9%), but 46 cases(12.5%) affected the infants below 1 year old. 2) Cough, fever, sputum were the most chief complaints. More moist rales, pharyngial injection, wheezing were found in physical examination. 86.7% of pneumonic infiltration were found in x-ray findings, 35.8% of which were both lung infiltration. The most common affected site was Rt. lower lobe and then Lt lower lobe and then followed by Rt. upper lobe. 71.8% of the whole cases were hospitalized for 5-8 days. 3) EM administration started 10-12 days after the onset in 29.3%. Mean duration of hospitalization of the cases administrated within 6 days from onset was 7.5+/-2 days, which was shorter than 8.4+/-3.5-that of the cases administrated after 6days from onset. The observation on those duration meant little atatistically(p>0.1) 4) The measure of Mycoplasma antibody titer in 142 cases among 245 positive cold agglutinin test case showed 61.3% of positive ratio. Positive ratio of cold agglutinin test peaked from 13th to 15th day after onset(89%) and went down(33%) after 19th day. Positive ratio of Mycoplasma antibody titer was at its summit(91%) from 7th to 9th day and went down(63%) after 16th day. decreased to 63% after 16 days. 264 cases tested simultaneously for cold agglutinin titer and Mycoplasma antibody titer. Titers of each simultaneous test for cold agglutinin and Mycoplasma antibody were in proportion each other(p<0.005, N=264, r=0.51). CONCLUSIONS: Mycoplasma pneumoniae pneumonia prevailed every 4 years(1990, 1994) and monthly distribution had been irregular. The most cases were found at age of 4 and 5. Mycoplasma antibody titer seems more effective for early diagnosis for Mycoplasma antibody titer showed high positive rate earlier and the rate went down earlier than cold agglutinin titer. The earlier diagnosis and treatment are required because of tendency of later erythromycin administration.
Child* ; Cough ; Diagnosis ; Early Diagnosis ; Erythromycin ; Female ; Fever ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Infant ; Lung ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pediatrics ; Physical Examination ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory Sounds ; Sputum ; Thorax

Purpose: To report a case with corneal decompensation in a patient of pseudoexfoliation syndrome.Case summary: A 70-year-old woman was referred to our clinic to evaluate decreased visual acuity in the right eye. She had no history of previous ocular surgery or laser treatment. The best corrected visual acuity was 0.5 in both eyes. The patient had diffuse corneal edema in the epithelium and stroma in the right eye. The left eye showed diffuse endothelial pigment deposits. Deposition of pseudoexfoliation material on the iris and anterior lens capsule was observed in both eyes. The intraocular pressure was 15 mmHg in both eyes without treatment. Specular microscopy was limited in the right eye due to the corneal edema and the left eye showed endothelial cell loss, increased pleomorphism, and atypical guttata. Anterior segment optical coherence tomography revealed irregular thickening of the corneal stroma and protrusion of Descemet’s membrane in the right eye. Conclusions In patients with pseudoexfoliation syndrome, corneal decompensation can occur without intraocular pressure elevation and glaucomatous damage.

Purpose: To report a case with corneal decompensation in a patient of pseudoexfoliation syndrome.Case summary: A 70-year-old woman was referred to our clinic to evaluate decreased visual acuity in the right eye. She had no history of previous ocular surgery or laser treatment. The best corrected visual acuity was 0.5 in both eyes. The patient had diffuse corneal edema in the epithelium and stroma in the right eye. The left eye showed diffuse endothelial pigment deposits. Deposition of pseudoexfoliation material on the iris and anterior lens capsule was observed in both eyes. The intraocular pressure was 15 mmHg in both eyes without treatment. Specular microscopy was limited in the right eye due to the corneal edema and the left eye showed endothelial cell loss, increased pleomorphism, and atypical guttata. Anterior segment optical coherence tomography revealed irregular thickening of the corneal stroma and protrusion of Descemet’s membrane in the right eye. Conclusions In patients with pseudoexfoliation syndrome, corneal decompensation can occur without intraocular pressure elevation and glaucomatous damage.

Hepatie hilar ductal carcinoma is relatively rare, but the prognosis is known to be poor because an early diagnosis is difficult. Because the majority of patients are already infiltrated into adjacent organ by itself at the diagnosis, the rate of resectability is low. The best method of treatment is curative resection, and the range of tumor invasion is very important. The preoperative diagnosis is difficult because the cholangiography may be normal in cases of superficial invasion. Multifocal lesions within the biliary tract may be identified in as many as 10 percent of patients, Especially, the papillary type has the best prognosis and is associated with multiple tumors within the bile duct. We report a case that percutaneous transhepatic cholangiogram showed normal distal common bile duct, but the hepatic hilar confluence and ampulla of Vater lesion was confirmed as adenocarcinoma.
Adenocarcinoma ; Ampulla of Vater* ; Bile Ducts ; Biliary Tract* ; Carcinoma, Ductal ; Cholangiocarcinoma* ; Cholangiography ; Common Bile Duct ; Diagnosis ; Early Diagnosis ; Humans ; Pancreas* ; Prognosis

Clinical and endoscopic features on 86 patients with acute upper gastrointestinal mucosal lesien were evaluated. Males were predaminant about 3 times of female. Most of patients were in 4 th to 6 th decade. The prevalent locations were proximal part of the stomach and dodenal bulb. Most,freqent chief camplaints was epigastric pain. Eeloscopieally aoute ulcers were characterized by shallow in depth, variant size and shape, rather clear ulcer margin without mucosal fold eonvergence and multiple lesions rather than sigle. The inducing factors of the acute mucosal lesiona whiah were noted were alcohol, HCI, analgesics, herb drug, steroid, antibiotlies and orgaaie ipheephorus.
Analgesics ; Female ; Humans ; Male ; Stomach ; Ulcer

BACKGROUND: Since 1992, we developed the technique for video endoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Compensatory hyperhidrosis, however, is the main cause of patient dissatisfaction after video-assisted thoracoscopic sympathectomy. According to many authors, initial satisfaction rate was high(94-98%), but it was declined with time (66%) due to mainly to embarrassing side effects. MATERIAL AND METHOD: From January 1992 to February 1998, the thoracoscopic T2 sympathicotomy, T2 sympathectomy and T2-4 sympathectomy were performed in 315 patients suffering from Essential hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Eighty-nine patients underwent T2 sympathicotomy, and Eighty-eight patients underwent division T2 sympathectomy. RESULT: All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis. The global rate of compensatory sweating were ; 64.0% in T2 sympathicotomy, 73.8% in T2 sympathectomy and 87.8% in T2-4 sympathectomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathicotomy 15.7%(14/89) and in T2 sympathectomy 32.8%(28/88) than in T2-4 sympathectomy 58.0%(80/138) with significancy in statistic analysis(p<0.05). Video- assisted thoracoscopic sympathectomy is an effective minimally invasive and effective procedure. CONCLUSION: We suggest that the incidence and degree of compensatory hyperhidrosis was closely related to the extent of thoracic sympathectomy.
Humans ; Hyperhidrosis* ; Incidence ; Korea ; Respiratory Center ; Seoul ; Sweat ; Sweating ; Sympathectomy*

In recent years, an increasing number of patient with AOVMs have been recognized using MRI. When an AOVM is located in a region associated with an unacceptable surgical risk, stereotactic radiosurgery offers an alternative treatment. We treated 21 patients with AOVM using gamma knife radiosurgery from June, 1990 to December, 1993 at Asan Medical Center. The indications for radiosurgery were as follows:1) Patients who had episodes of hemorrhage from a lesion that had the characteristic images of AOVM in MRI. 2) Patients who had seizures and the focus of these seizures corresponded to the lesions. 3) Patients were excluded if the lesions were located superficially or were accessible to microsurgery. Nine patients presented with hemorrhages and twelve with seizures. The marginal dose was ranged from 10 to 25 Gy at or above the 50% isodose line. Of eight patients followed 12 months or less after radiosurgery, two patients had improved neurologic deficits and one had decreased the seizure frequency with mediciation. Among seven patients followed 12-24 months, MRI showed a reduction of the lesion in one patient and no change in five patients. One patient had perifocal edema. In two patients with seizures, one patient was seizure free without medication and one patient was controlled with medication. In six patients between 24 and 44 months, two patients had smaller lesions and three patients had perifocal edema. Among four patients who had seizures, one patient was seizure free without medication and three had decreased the seizure frequency with medication. Postoperative complications developed two patients, but one patient showed improvement of neurologic deficits after a short period of steroid medication. Stereotactic radiosurgery offers a treatment to a selective patients with intracranial AOVMs.
Chungcheongnam-do ; Edema ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Microsurgery ; Neurologic Manifestations ; Postoperative Complications ; Radiosurgery* ; Seizures

PURPOSE: Peritoneal seeding of gastric cancer is known to have a poor prognosis. With the diagnosis of peritoneal seeding, there is no effective treatment modality. Gastrectomy with chemotherapy or primary chemotherapy is basically one of major options for this condition. This study was conducted to compare the clinical outcomes of these treatments and to identify the better way to improve the prognosis of patients with peritoneal seeding. MATERIALS AND METHODS: Between 2001 and 2007, gastric cancer patients with peritoneal seeding by preoperative or intraoperative diagnosis were reviewed retrospectively. The enrolled patients were divided as primary gastrectomy and primary chemotherapy group. Clinicopathologic characteristics and clinical outcomes of groups were analyzed and compared. RESULTS: Fifty-four patients were enrolled. 21 patients belonged to the group of primary gastrectomy and 33 patients were to the primary chemotherapy group. Among 33 patients of the primary chemotherapy group, 17 patients were received only chemotherapy and 16 patients were received gastrectomy due to the good responses of primary chemotherapy. The 3 years survival rates were 14% in primary gastrectomy group, 55% in patients who received gastrectomy after primary chemotherapy, and 0% in patients with primary chemotherapy only. CONCLUSIONS: Although this study had many limitations, some valuable information was produced. In terms of survival benefits for the gastric cancer patients with peritoneal seeding, primary gastrectomy and additional gastrectomy after primary chemotherapy revealed the better clinical outcomes. But, prospective randomized clinical study and multi-center study are should be performed to decide proper treatment for gastric cancer patients with peritoneal seeding.
Gastrectomy ; Humans ; Prognosis ; Retrospective Studies ; Seeds ; Stomach Neoplasms ; Survival Rate

Posterior reversible encephalopathy syndrome (PRES) is characterized by headache, vomiting, confusion, and seizure. In addition, PRES is associated with reversible bilateral cortical and subcortical edema on occipital lobe or parieto-occipital lobe. Eclampsia is a rare condition to pregnant and puerperal women and one of common causes of the PRES. The clinical and radiologic manifestations can be resolved without irreversible complication by early diagnosis and appropriate treatment. The authors report a case of eclamptic encephalopathy associated with PRES, in which an 18-year-old woman had clinical manifestations of visual disturbance, headache, and tonic-clonic seizure at 34 hours after vaginal delivery. High signal intensities are seen in both parieto-occipital lobes and left basal ganglia on fluid attenuated inversion recovery (FLAIR) images and T2 weighted images performed at emergency room. But no significant signal change in both parieto-occipital lobes on diffusion weighted images (DWI). Because seizure was repeated, then anticonvulsant was administered at intensive care unit. On the second day, the clinical manifestations were resolved as blood pressure was normalized. The FLAIR imaging and DWI sequences can play an important role in the diagnosis of PRES.
Adolescent ; Basal Ganglia ; Blood Pressure ; Diagnosis ; Diffusion ; Early Diagnosis ; Eclampsia ; Edema ; Emergency Service, Hospital ; Female ; Headache ; Humans ; Intensive Care Units ; Occipital Lobe ; Posterior Leukoencephalopathy Syndrome* ; Pregnancy ; Seizures ; Vomiting