No abstract available.

No abstract available.

Vertigo, a definite rotational sensation, consists of a variety of syndromes. The purpose of this study was to accumulate information on various aspects of vertigo or dizziness. We performed a retrospective study about vertigo patients, who had admitted to our hospital for recent 2 years. From January 1994 to December 1995, 214 patients with the complaints of 'vertigo' and 'dizziness', who admitted to the department of Neurology, Ewha Womans University Hospital, were accepted for this study. All data were recorded on computer-oriented questionnaires in digital forms. The study forms consisted of five parts; (1) history and associated symptoms, (2) physical, neurologic and bedside examinations, (3) laboratory and brain imaging studies, (4) special tests including brainstem auditory evoked potentials and (5) clinical diagnosis. Of these 214 patients, secure diagnosis could be made in 186 patients or 86.9%. Of these, 92 patients had peripheral causes of vertigo, and 94 had central causes. Vestibular disorders accounted for the largest proportion of complaints of vertigo(48/92 or 52%). Of 94 patients with central causes of vertigo, vertebrobasilar insufficiency was the leading cause(25/94 or 27%). The most common site of the brain lesion proved by MRI was cerebellum(23/94 or 25%). BAEP study revealed abnormal findings in 6 cases of the 16 patients with central causes. This study not only offered a clinical information about vertigo, but also could be beneficial for further researches.
Brain ; Diagnosis ; Dizziness ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Neurology ; Surveys and Questionnaires ; Retrospective Studies ; Sensation ; Vertebrobasilar Insufficiency ; Vertigo

BACKGROUND AND OBJECTIVES: To evaluate the brain MR angiography(MRA) as a tool of diagnosis and follow up study in acute ischemic stroke. METHODS: We reviewed 90 patients of acute ischemic stroke who received thrombolytic therapy and underwent brain MRI with MRA from September 1994 to July 1995. They were divided into two groups according to carotid system and vertebrobasilar system and then positive MRA findings were defined as stenosis or occlusion of vessels in relation with MRI lesions. RESULTS: The positive MRA was shown more than 80% in large arteries and lower than 23% in small arteries. And also the MRA was shown the degree stenosis and underlying vessel abnormalities but could not precisely analyze the degree of improvement of vascular patency in this study. CONCLUSIONS: The MRA as a routine method addition to the MRI provides relatively reliable and noninvasive screening test and provides information that can be more complete evaluation and prognosis in patients of acute ischemic stroke.
Angiography* ; Arteries ; Brain ; Constriction, Pathologic ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Prognosis* ; Stroke* ; Thrombolytic Therapy ; Vascular Patency

The Guglielmi Detachable Coil(GDC), a soft platinum alloy micro-coil, has been used to treat certain intracranial aneurysms for recent several years. This detachable platinum coil was soldered to a stainless steel delivery guidewire. Intra-aneurysmal thrombosis was then initiated by applying a low positive direct electric current to the guidewire. Thrombosis occurred because of the attraction of negatively charged platinum coil positioned within the aneurysm. The passage of electric current detached the platinum coil tithin the clotted aneurysm from the stainless steel guide wire by electrolysis in 4 to 12 minutes. A 24-year-old unmarried woman visited our hospital complaining of severe headache on the right occipital area. The MRI and angiography demonstrated an unruptured right posterior communicationg artery aneurysm, emasured 10 x 15 mm in diameter with a medium sized neck. We tried GDC therapy for the aneurysm not to subject the patient to craniectomy, and the angiograhy after two times of GDC trials revealed a successful occlusion of the aneurysm . Adicussion about the problems during and after the procedure was presented, along with a brief review of the literature including the theoretical basis, clinical results and comparison with surgical treatment.
Alloys ; Aneurysm ; Angiography ; Arteries ; Electrolysis ; Female ; Headache ; Humans ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Neck ; Platinum ; Single Person ; Stainless Steel ; Thrombosis ; Young Adult

BACKGROUND: Overstimation of blood pressure(BP) by clinic measurements occur in about 20 to 30% of subjects(white-coat hypertension) who may, consequently, be misdiagnosed as hypertensives and received unnecessary medications. The clinical significance of white-coat hypertension and its effects on the cardiovascular wystem have not been studied systematically.This study was designed to evaluate the influences of white-coat hypertension and white-coat effect, defined as difference between clinic and ambulatory BP, on the LV mass and diastolic function. METHODS: LV mass index was calculated and LV systolic and diastolic function were assessed by the analysis of mitral and pulmonary venous flow velocity in 45 untreated essential hypertensives and 20 normotensives(NT). Ambulatory BP monitoring classified hypertensives as white-coat hypertensives(WCHT,n=20) and sustained hypertensives(SHT, n=25). RESULTS: 1) Left ventricular systolic indices were not different among the three groups. 2) Left ventricular mass inedx of WCHT(114.5+/-36.3g/m2) was similar to that of SHT(115.6+/-34.9g/m2) and was significantly greater than that of NT(86.5+/-37.7g/m2)(p<0.05). 3) Some of left ventricular diastolic parameters(isovolumic relaxation time, E/A ratio, A velocity, pulmonary systolic fraction, ratio of systolic to diastolic forward flow velocity) of WCHT and SHT were significantly different from those of NT(p<0.05), but there were no differences between two hypertensive groups. 4) Even though both systolic and diastolic white-coat effect in WCHT were significantly greater than those of SHT(o<0.05),white-coat effect did not influence on the left ventricular mass or function in both groups. CONCLUSION: An increased left ventricular mass and diastolic dysfunction in WCHT suggests that white-coat hypertension could not be considered as an entirely innocuous clinical condition.
Blood Pressure Monitoring, Ambulatory ; Hypertension* ; Relaxation

Today, the duodenal tuberculosis is a very rare disease. Final diagnosis of duodenal tuberculosis is difficult due to inconsistent symptoms and nonspecific duodenal lesions. We found 2 cases of duodenal tuberculosis by gastrascopy. In gastroscopic findings, there were undetermined ulcers and irregular nodular mucosal changes.
Diagnosis ; Rare Diseases ; Tuberculosis* ; Ulcer

PURPOSE: Benign childhood epilepsy with centrotemporal spikes (BCECT) or benign rolandic epilepsy (BRE) is not always benign in clinical or neuroimaging features. Recent studies have reported atypical forms of rolandic epilepsy with abnormal neurologic and/or neuroimaging findings, sometimes, also with poor seizure control. We investigated whether there are any differences in linear and nonlinear EEG analysis in typical and atypical rolandic epilepsies of childhood. METHODS: Ten patients with typical BRE group and seven patients with atypical BRE group were included in this study. We selected artifact-free 10-second epochs from 19 electrodes of 10-20 international EEG system from each patient. The power spectrum was calculated in delta, theta, alpha, beta, and gamma frequency ranges. The fractal dimension was analyzed as a nonlinear EEG analysis. We analyzed both EEGs with interictal spikes and without focal slowing or epileptiform activities. RESULTS: The spectral EEG analysis showed a significant increase of absolute and relative power of delta with decrease of alpha bands in atypical BRE group compared to typical group. There was no statistical difference in fractal dimension between the two groups. CONCLUSION: Atypical BRE group showed enhanced delta and decreased alpha power, suggesting a cortical dysfunction in this group with poor clinical outcome.
Electrodes ; Electroencephalography* ; Epilepsy ; Epilepsy, Rolandic* ; Fractals ; Humans ; Neuroimaging ; Seizures

Rhythm control therapy is the main strategy for restoring and maintaining sinus rhythm in patients with non-valvular atrial fibrillation (NVAF). Sinus rhythm is better restored and maintained with antiarrhythmic drugs than with placebo treatment. In addition, catheter ablation or combination therapy is more effective than antiarrhythmic drugs for treating NVAF. However, in most clinical trials to date, rhythm control therapy has resulted in neutral clinical outcomes compared with rate control therapy. The decision to undergo rhythm control therapy should be based on age, atrial fibrillation (AF)-related symptoms, type of AF, structural heart disease, and underlying comorbidities. For now, rhythm control therapy is indicated to improve symptoms in patients with NVAF who have refractory symptoms after adequate rate control therapy. The Korean Heart Rhythm Society organized the Korean AF Management Guideline Committee and analyzed all available data, including South Korean patients with NVAF. This review article provides general principles and detailed methodology for rhythm control therapy in South Korean patients with NVAF.
Anti-Arrhythmia Agents ; Atrial Fibrillation* ; Catheter Ablation ; Comorbidity ; Drug Therapy* ; Heart Diseases ; Heart* ; Humans

PURPOSE: To evaluate mid- and long- term follow-up results after total knee arthroplasty (TKA) with patella-friendly ADVANTIM(R) Total Knee System. MATERIALS AND METHODS: 46 cases out of 88 knee arthroplasty which was done from October 1997 to December 2000 were analyzed retrospectively, average follow-up period was 61 months. Patella was not resurfaced in all cases. Clinical results were evaluated using The Knee Society Clinical Rating System and patellar score, radiologic results using The Knee Society Roentgenographic Evaluation and Scoring System, patellar tilt and patellar shift. RESULTS: The average range of motion increased from 96 degrees preoperatively to 112.8 degrees at the last follow-up, the average flexion contracture decreased from 9.6 degrees preoperatively to 3.6 degrees at the last follow-up. The average knee score increased from 57.8 points preoperatively to 90.7 points at the last follow-up, the average function score from 39 points to 86 points. The average patellar score increased from 16.3 points preoperatively to 28.1 points at the last follow-up. Radiologic evaluation revealed a radiolucency of 18 knees(39.1%) which were not significant clinically. The incidence with patellar shift more than 5~10 mm were 9 knees(15.2%), but the average patellar score of these cases were 27.6 points. CONCLUSION: The mid- and long-term results of TKA with ADVANTIM(R) were reliable and satisfactory in terms of improvements of range of motion and restoration of function without patellar resurfacing.
Arthroplasty* ; Contracture ; Follow-Up Studies ; Incidence ; Knee* ; Patella ; Range of Motion, Articular ; Retrospective Studies