No abstract available.
Kidney Transplantation*

BACKGROUND AND OBJECTIVES: Although pain resulting from thalamic stroke was described by D jerine & Roussy in 1906, its pathomechanism & anatomical substrate have not been defined yet. Several clinical & experimental studies suggest that laterality of lesion for generation of central pain is as important as location of lesion. We performed this study to evaluate clinical features of thalamic pain syndrome, including incidence, onset interval from stroke, nature, distribution, accompaniments, and to assess the relationships between laterality & location of lesion and occurrence of pain. METHODS: We reviewed the medical records and brain imaging of all patients with thalamic stroke from 1990 to 1997. Patients with thalamic pain syndrome due to a single well-demarcated thalamic stroke were included, and excluded tumoral, non-vascular etilogy, and patients with sensory deficit without pain and excluded patients who had multiple cerebral lesions even they have thalamic pain syndrome. RESULTS: One-hundred one cases were selected under the inclusion criteria, and twenty-four patients(24%) with thalamic pain syndrome were identified from 101 thalamic stroke. Pain onset within the first week poststroke was 17(71%). The patients with allodynia were 8(33%), increased by movement, stress, and thermal contact. The painful area distributed mainly limbs(50%), especially arm(35%), face plus hemibody(34%), and hemibody below face(8%). Thalamic pain syndrome accompanied with the pain and temperature loss was 17(71%). Thirteen patients had a right-sided lesion, 11 left-sided lesion. The lesion causing thalamic pain syndrome mainly located in the posterolateral areas(75%). CONCLUSIONS: We conclude that the thalamic pain syndrome resulting from mainly posterolateral thalamic lesion cause the spontaneous pain on the contralateral body, especially upper extrimity, and accompanied with pain & tempterature loss. The laterality of lesion is not represent for generation of thalamic pain syndrome. Key word : thalamic stroke, central pain.
Humans ; Hyperalgesia ; Incidence ; Medical Records ; Neuroimaging ; Stroke*

Surgical results of 59 patients with constant exodeviation having at least 2 months of follow-up were reviewed. Fifty nine cases of constant exodeviation were classified by fixation patterns into alternating exotropia 38 cases and monocular exotropia 21 cases. The final surgical results and success rates were compared between the 2 groups and were analyzed according to the length of postoperative follow-up period. The surgical results were as follows: in alternating exotropia, 63.2% was satisfactory, 28.9% undercorrected and 7.9% overcorrected, in monocular exotropia, 85.7% was satisfactory, 9.5% undercorrected and 4.8% overcorrected. The mean follow-up period was 5.3 months in alternating exotropia and 5.9 months in monocular exotropia. Final surgical results were not affected by the length of postoperative follow-up period in alternating exotropia. However, in monocular exotropia, there was a strong tendency to become exotropic with a long term follow-up period(2-17 months). We suggest that the fixation patterns could have an influence on postoperative stability in exodeviation.
Exotropia* ; Follow-Up Studies ; Humans

Background: Post-dural puncture headache (PDPH) is one of the well-known complication of spinal anesthesia. Epidural blood patch is the treatment of choice for PDPH but is rarely used for the prevention of PDPH after spinal anesthesia. The purpose of this study is to observe the effectiveness of epidural blood patch for prevention of PDPH and to evaluate the complications after epidural blood injection. Methods: Three hundred patients (ASA I or II) receiving spinal anesthesia were studied. They were randomly devided into two groups. Patients in Group I, the control group, were maintained in a supine position for 24 hour after spinal anesthesia. Patients in Group II, the study group, received 3 ml of autologous blood in the epidural space after spinal anesthesia. PDPH was evaluated for 5 days. The incidence, location, onset, and duration of headache in the patients presenting with PDPH were measured for 5 days, and the complications following epidural blood patch in Group II were observed for 2 weeks. Results: The incidence of PDPH in group I was 11%, but 0% in group II. There were no specific complications following epidural blood patch in Group II. Conclusions: This study suggest that the 3 ml epidural autologous blood patch is an useful method for the prevention of PDPH in patients with spinal anesthesia.
Anesthesia, Spinal* ; Blood Patch, Epidural ; Epidural Space ; Headache ; Humans ; Incidence ; Post-Dural Puncture Headache ; Punctures* ; Supine Position

A case of recurrent fibrosarcoma arising from the distal portion of the left spermatic cord in a twenty-two-year-old male is presented, and is discussed on its incidence, differential diagnosis, treatment and prognosis with brief literature review.
Diagnosis, Differential ; Fibrosarcoma* ; Humans ; Incidence ; Male ; Prognosis ; Spermatic Cord*

An autopsy case of spontaneous rupture of urinary bladder followed by longstanding chronic and acute hemorrhagic cystitis associated with anomalous course of the right ureter and pyo-hydronephrosis, and acutely disseminated tuberculous pneumonia in a twenty-two-year-old Korean Army soldier is presented. Pathogenesis of spontaneous rupture of urinary bladder is briefly discussed.
Autopsy ; Cystitis* ; Humans ; Military Personnel ; Pneumonia ; Rupture, Spontaneous* ; Ureter* ; Urinary Bladder*

Surgical results of 59 patients with constant exodeviation having at least 2 months of follow-up were reviewed. Fifty nine cases of constant exodeviation were classified by fixation patterns into alternating exotropia 38 cases and monocular exotropia 21 cases The final surgical results and success rates were compared between the 2 groups and were analyzed according to the length of postoperative follow-up period. The surgical results were as follows: in alternating exotropia, 63.2% was satisfactory, 28.9% undercorrected and 7.9% overcorrected, in monocular exotropia, 85.7% was satisfactory, 9.5% undercorrected and 4.8% overcorrected. The mean follow-up period was 5.3 months in alternating exotropia and 5.9 months in monocular exotropia. Final surgical results were not affected by the length of postoperative follow-up period in alternating exotropia. However, in monocular exotropia, there was a strong tendency to become exotropic with a long term follow-up period (2-17 months). We suggest that the fixation patterns could have an influence on postoperative stability in exodeviation.
Exotropia* ; Follow-Up Studies ; Humans

Thirty cases of lacerated canaliculi were repaired by bicanalicular silicone intubation(Pilling(R) Intubation Set)with use of a silicone sponge for nasal fixation. The results were as follows: Canalicular laceration occurred mainly in males(25 cases), and in young age group(10-39yrs). An isolated inferior canalicular laceration was the most common and occurred in 23 cases. There was no significant difference in laterality between right and left. The average follow up period was 13.8 months and final results were better in patients who were repaired earlier and had a longer intubation time. Postoperative complications occurred in 7 cases and all of them were canalicular slits. Canalicular slits were not related to the duration of intubation and did not affect the final results significantly. The advantages of this operation were good cosmetic results, minimal irritation by tube, and easy removal of tube.
Follow-Up Studies ; Humans ; Intubation* ; Lacerations* ; Porifera ; Postoperative Complications ; Silicones*

The salt-sensitivity has been generally accepted as a mechnism of high blood pressure in elderly hypertensive patients, and so it may result in a difference of renal handling of sodium and potassium between normal healthy control and elderly hypertensive patient. So to evaluate an lbove difference, the amount of 24 hours' urinary excretion of Na+ & K+ were measured in healthy normotensive control (10 case) and elderly hypertensive group(10 case) according to normal diet (12-15gm of NaCl) for first 3 days and low salt diet (3~5)gm of NaCi) for next 3 days, also blood rewwure was mintored. The results were followed : 1) 24 hours' urinary excretion of NA+ was increased in hypertensive group more than control group at first day of normal diet and low salt diet significantly. 2) After a replacement of normal diet to low salt diet, a maximal decrement of 24 hours' urinary excretion of Na+ was 25% at first day in control but 40% at second day in hypertensive group only. 3) There was a similar pattern of urinary excretion of K+ as Na+ in hypertensive group, but it was not stastically significant. 4) There was no significant changes of blood pressure, serum electrolyte and BUN/creatinine according to salt intake in both group. From above findings. We can conclude that a urinary excretion of sodium is delayed in elderly hypertensive group, and it is suggested that a delayed excretion of sodium. is associated with retention of sodium in body. So a persistent restriction of sodium is recommended in elderly hypertensive patient.
Aged ; Blood Pressure ; Diet ; Humans ; Hypertension ; Potassium* ; Sodium*

We report a case of a 36 year old female with coronary artery obstructive disease(Left coronary osteal stenosis), who had been admitted due to severe headache and vomitting. In admission, she was diagnosed as moyamoya disease on cerebral angiogram. She had no history of hypertension, diabetes mellitus, hyperlipidemia, smoking. She had experienced angina for 2 years, and 1 year ago she ws diagnosed as bypass surgery with left main coronary artery angioplasty. In moyamoya disease, several portions of extracranial arteries have been found to be involved, but so far, only one case has been reported the coronary involvement on coronary angiogram in the world. And, there has not been a report about moyamoya disease combined with left main osteal lesion yet. This present case indicates that we need to exam for extracranial vascular system including the heart in moyamoya disease.
Adult ; Angioplasty ; Arteries ; Constriction, Pathologic* ; Coronary Vessels ; Diabetes Mellitus ; Female ; Headache ; Heart ; Humans ; Hyperlipidemias ; Hypertension ; Moyamoya Disease* ; Smoke ; Smoking