No abstract available.
Kidney Transplantation* ; Pancreatitis*

No abstract available.
Renal Dialysis* ; Urea*

There have been few description of spontaneous epidural hematoma of spinal cord in the young. Duration of symptoms in previous cases has varied from hours to days. We recently evacuated a 16-year-old boy with cord compression from an extradural clot, who complained of abdominal pain & diarrhea before becoming spinal epidural hematoma occurred in the young.
Abdominal Pain ; Adolescent ; Diarrhea ; Hematoma ; Hematoma, Epidural, Spinal* ; Humans ; Male ; Spinal Cord

Effectively functioning arterio-venous fistula (AVF) is so important as to be called a lifeline of the patient with end stage renal disease by maintaining hemodialysis. Not infrequent development of complications of AVF is a major cause of patient's admission and medical cost. Rescue therapy of complicated AVF had several advantages; delay or prevention of new AVF formation, prevention of temporary percutaneous central vein cannulation, and maintenance of psychologic stability. PURPOSE: In order to analyse the patterns of AVF complications and the short- and long-term results of rescue therapy, we made a clinical review retrospectively. PATIENTS & METHODS: We performed AVF in 1503 cases from Jan. 1986 to Dec. 1997. Among them, we performed 93 rescue therapies in 70 patients. Rescue therapy is defined to be a secondary procedure to correct complications while maintaining the primary anastomosis. Secondary procedures in immediate postoperative failure due to technical cause, such as improper selection of vein, were excluded. RESULTS: The most common indication of rescue therapy in 93 cases was thrombosis (78 cases, 83.9%), which is followed by aneurysm in 9 cases, venous hypertension in 2 cases, steal syndrome in 2 cases, high output cardiac failure in 1 case. Autogenous veins were used in initial operation in 55 cases and PTFEs in 38 cases. Early failure within 1 month after rescue therapy happened in 20 cases (21.5%). Complications occured in 4 cases, such as infection (2), brachial plexus injury (1), and arm edema. (1) Mean follow up duration was 3.9 months (1~123 months). Secondary patency rate after 3, 6, 12, 24 months were 70.3+/-3.97, 62.0+/-4.89, 50.6+/-5.85, 37.9+/-7.03% respectively. Secondary patency rate in successfully rescued patients excluding early failure within 1 month after rescue therapy were 91.5+/-3.11, 80.9+/-4.46, 68.9+/-6.15, 54.1+/-8.19%. CONCLUSIONS: Thrombosis or malfunction due to neointimal hyperplasia was the most common complication in AVF. Early and proper rescue therapy in complicated fistula could salvage the AVF. So careful and prompt evaluation of the inflow and outflow of the complicated fistula is necessary, and every effort to rescue the fistula should be made.
Aneurysm ; Arm ; Brachial Plexus ; Catheterization ; Edema ; Fistula* ; Follow-Up Studies ; Heart Failure ; Humans ; Hyperplasia ; Hypertension ; Kidney Failure, Chronic ; Polytetrafluoroethylene ; Renal Dialysis* ; Retrospective Studies ; Thrombosis ; Veins

BACKGROUND: The prevalence of cognitive impairment in the elderly has been increasing in recent years with the growing of the aged population. Clinical assessment of cognitive function and mood is very important because cognitive impairment and depression commonly coexist in the elderly. The elderly interacts with the other family members, so cognitive impairment of the elderly influence family function. The objectives of this study were to delineate the factors correlated with cognitive function and to explore the relationship of depression and family function with cognitive function. METHODS: This study was done during 20 day period from July to August, 1996. The subjects were home residents aged 60 years or more living in a subcounty of Kyungpook Province, Korea. The final analysis included 195 subjects(male 95, female 100). The questionnaire included sociodemographic data, MMSE-K(Korean version of Mini Mental State Examination) for evaluation of cognitive function, BDI for evaluation of depression and family APGAR score for evaluation of family function. The results were analyzed by descriptive, comparative and correlative analysis. RESULTS: Mean MMSE-K score was 25.3+/-4.3 with female subjects(23.9+/-4.8) having significantly higher cognitive impairment when compaired to male subjects(26.6+/-3.2)(P<0.001). MMSE-K score was associated with gender, age, year of education(P<0.001), BDI and APGAR score(P<0.05). Religion, smoking and alcohol use were not associated with MMSE-K score. The prevalence of dementia by MMSE-K was 9.7% in definite dementia (MMSE-K<_19) and 23.1% with questionable dementia(20<_MMSE-K<_23). In male, the prevalence was 1.1% and 20.0% respectively. In female, the prevalence was 18.0% and 26% respectively, indicating difference between male and female subjects(P<0.001). CONCLUSIONS: In the elderly, female gender, older age and lower educational level were associated with cognitive function impairment. There was a positive correlation between cognitive function and family function. The group with impaired cognitive function had more depression than the normal group.
Aged* ; Apgar Score ; Dementia ; Depression* ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Male ; Prevalence ; Smoke ; Smoking ; Surveys and Questionnaires

No abstract available.
Biopsy* ; Cytoplasm* ; Follow-Up Studies* ; Glomerulonephritis* ; Kidney Transplantation*

No abstract available.
Animals ; Dogs* ; Liver Transplantation* ; Liver* ; Metabolism*

An open multicenter trial was conducted to assess the efficacy and tolerability of oral terbinafine in the treatment of onychomycosis during 10 months from April, 1992 to February, 1993. Of patients with clinically and mycologically proved onychomycosis recruited from the Department of Dermatology of 29 university and training hospitals in the Korea, 143 patients who could be followed up at the end of the study were evaluated. The group of fingernail infection received orally terbinafine 250mg once daily for 8 weeks and the group of toenail infection for 16 weeks. After stopping treatment, all patients were followed up for 12 weeks. The results were as follows: 1. On the mycological study at the initial visit, 101 causative organisms were isolated from 99 pateints and Trichophyton rubrum was common organism (40 strains). 2. The length of healthy, unaffected nail were increased significantly more than two-fold after the end of treatment and at the follow-up investigation, those were 11.8mm in fingernail group and 9.8mm in toenail group. 3. The mean of all clinical symptom scores on entry diminished significantly by the time of the end of treatment and cleared mostly at the follow-up. 4. The mycological cure rate(negative microscopy and culture) was 56.5% for fingernails and 69.3% for toenails at the end of treatment and 100% for fingernails and 89% for toenails at the follow-up investigation. 5. overall efficacy assessed by the patient and by the investigator were evaluated as more than moderate in 93.1% and 94.5% of patients and overall tolerability were evaluated as more than moderate in 100% of patients by both of them. 6. The adverse effects of terbinafine were noted in 10 patients(7%) out of the 143. The most frequent drug-related adverse events were mild-to-moderate gastrointestinal disturbances. Any changes in liver biochemical tests were not considered clinically relevant. In conclusion, oral terbinafine is effective and safe in the treatment of onychomycosis. Our results demonstrate that a treatment period of 8 weeks for fingernail onychomycosis and 16 weeks for toenail onychomycosis is sufficient.
Dermatology ; Follow-Up Studies ; Humans ; Korea ; Liver ; Microscopy ; Nails ; Onychomycosis* ; Research Personnel ; Trichophyton

BACKGROUND/AIMS: To reduce the rate of recurrence and to prevent postoperative liver failure, it is necessary to determine the extent of hepatic resection preoperatively in primary liver cancer patients. The aim of this study was to examine the clinical significance and correlation among several preoperative liver function tests. METHODS: Twenty-nine patients who underwent hepatic resection for hepatocellular carcinoma from November 1994 to March 1995 at the Department of Surgery, Seoul National University Hospital were analyzed. Fifteen patients had gross cirrhosis. Major resections were performed in two patients, segmentectomy in 6 patients, subsegmentectomy and limited resection in 21 patients. Maximal removal rate of indocyanine green (ICG Rmax), ICG retention rate at 15 min(ICG R15), oral glucose tolerance test(oral GTT), arterial ketone body ratio(AKBR) and computed tomographic volumetry, as well as conventional liver function test and prothrombin time were done preoperatively. RESULTS: There were significant correlations among Child's class, prothrombin time and ICG R15. AKBR, oral GTT, ICG Rmax, liver volume had no correlations with any other tests. Liver failure occurred in 2 patients(6.9%). No tests, except ICG R15, could predict the patients with liver failure. ICG R15 value of these two patients were 27% and 29%, respectively while those of the remaining 27 patients ranged from 1 to 22% (mean 11.9%). CONCLUSION: Neither standard liver function tests nor hepatic function studies such as AKBR, oral GTT, CT volumetry were useful as preoperative prognostic indicators in hepatic resection. ICG R15 test is a simple test and good predictor of liver failure after hepatic resection.
Carcinoma, Hepatocellular ; Fibrosis ; Glucose Tolerance Test ; Hepatectomy ; Humans ; Indocyanine Green ; Liver ; Liver Failure ; Liver Function Tests ; Liver Neoplasms ; Mastectomy, Segmental ; Prothrombin Time ; Recurrence ; Seoul

No abstract available.
Behcet Syndrome* ; Renal Insufficiency*