Is superselective embolization of the brain AVMs, the possibilities of adjacent normal brain tissue damage necessitates preembolic evaluation. The authors performed the Sodium Amytal test on 15 patients with brain AVMs. In the AVM patients with negative Amytal test(30 cases), all patients showed normal pattern on EEG and neurologic examinations after embolization Among the five patients with positive Amytal test, three cases showed neurologic deficit and the others two didn't. In eleven patients. Repeated embolization without the Amytal test were done. Among them, 5 cases showed neurlogic deficit and the others were quite normal. In conclusion, the Amytal test is a useful method of evaluation of the risk to damage normal brain tissue which are supplied by superselected feeding vessels. Combining the EEG with this test is a sensitive and objective method in evaluating patients following the Amytal test. And it is essential to performed the Amytal test for repeat embolization procedures.
Amobarbital* ; Arteriovenous Malformations* ; Brain* ; Electroencephalography ; Humans ; Methods ; Neurologic Examination ; Neurologic Manifestations

The shoulder fusion is one of the good method to relieve pain, improve the function and stabilize the flail shoulder joint. But recent advance of arthroplasty, the procedure is less popular. Authors studied and analized 23 patients who received shoulder arthrodesis from Aug. 1978 to Aug. 1986 and reported functional outcome after shoulder arthrodesis. Among twenty three patients, brachial plexus palsy were eighteen, upper extremity residual poliomyelitis in three and shoulder joint turberculosis in two respectively. Postoperative follow up was 12 months to 9 years and 6 months, average being 2 years and 6 months. It took 14.4 weeks in average for shoulder arthrodesis. The postoperative abduction fusion angle was 33.8 degrees in average(20 degrees to 50 degrees). The active abduction after shoulder fusion was mean 51.8 degrees(20 degrees to 85 degrees). The abduction fusion angle between 20 degrees and 40 degrees was presented satisfactory results in the point of pain relief, functional assessment and patients satisfaction. High abduction fusion angle(more than 40 degrees) revealed pain around the fused shoulder area. The combined extra and intraarticular arthrodesis revealed better results. The Saber-cut approach was more valuable for secondary elbow reconstruction than Henry approach.
Arthrodesis ; Arthroplasty ; Brachial Plexus ; Elbow ; Follow-Up Studies ; Humans ; Methods ; Paralysis ; Poliomyelitis ; Shoulder Joint ; Shoulder ; Upper Extremity

No abstract available.
Macrophages, Alveolar* ; Mycobacterium tuberculosis* ; Mycobacterium*

PURPOSE: This study was performed to compare the clinical characteristics of 2009 pandemic influenza A(H1N1) [A(H1N1) pdm09] and seasonal influenza A infection in the pediatric cancer patients. METHODS: A retrospective review was performed in the pediatric cancer patients who had confirmed A(H1N1)pdm09 infection at Samsung Medical Center from August 2009 to February 2010. For the comparison, the medical records of pediatric cancer patients with seasonal influenza A from January 2000 to May 2009 were reviewed retrospectively. RESULTS: Eighty-two A(H1N1)pdm09 infections were confirmed in the pediatric cancer patients. Ten patients (12.2%) developed complicated clinical course by lower respiratory infections or extrapulmonary infections; 4 pneumonia, 1 bronchitis, 1 pericarditis with pneumonia, 1 encephalitis with pneumonia, 2 meningitis and 1 pericarditis. Three patients received mechanical ventilator and ICU care. Three pediatric cancer patients (3.7%) died. The risk factors related to complicated A(H1N1)pdm09 infections were date of infection (44-45th week 2009) and nosocomial infection. When comparing with previous seasonal influenza A infections, more prompt and aggressive antiviral therapy was given in A(H1N1)pdm09 infections. CONCLUSION: The A(H1N1)pdm09 infections caused a various clinical manifestations including fatal cases in pediatric cancer patient during pandemic season. There was no significant difference in clinical course between influenza A(H1N1)pdm09 and seasonal influenza A infections except the antiviral treatment strategy.
Bronchitis ; Child ; Cross Infection ; Encephalitis ; Humans ; Influenza, Human ; Medical Records ; Meningitis ; Pandemics ; Pericarditis ; Pneumonia ; Respiratory Tract Infections ; Retrospective Studies ; Risk Factors ; Seasons ; Ventilators, Mechanical

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*

No abstract available.
Erythromycin*

No abstract available.
Lung Neoplasms* ; Lung* ; Thorax*

Objectives: . Prognosticating idiopathic sudden sensorineural hearing loss (ISSNHL) is an important challenge. In our study, a dataset was split into training and test sets and cross-validation was implemented on the training set, thereby determining the hyperparameters for machine learning models with high test accuracy and low bias. The effectiveness of the following five machine learning models for predicting the hearing prognosis in patients with ISSNHL after 1 month of treatment was assessed: adaptive boosting, K-nearest neighbor, multilayer perceptron, random forest (RF), and support vector machine (SVM). Methods: . The medical records of 523 patients with ISSNHL admitted to Korea University Ansan Hospital between January 2010 and October 2017 were retrospectively reviewed. In this study, we analyzed data from 227 patients (recovery, 106; no recovery, 121) after excluding those with missing data. To determine risk factors, statistical hypothesis tests (e.g., the two-sample t-test for continuous variables and the chi-square test for categorical variables) were conducted to compare patients who did or did not recover. Variables were selected using an RF model depending on two criteria (mean decreases in the Gini index and accuracy). Results: . The SVM model using selected predictors achieved both the highest accuracy (75.36%) and the highest F-score (0.74) on the test set. The RF model with selected variables demonstrated the second-highest accuracy (73.91%) and F-score (0.74). The RF model with the original variables showed the same accuracy (73.91%) as that of the RF model with selected variables, but a lower F-score (0.73). All the tested models, except RF, demonstrated better performance after variable selection based on RF. Conclusion . The SVM model with selected predictors was the best-performing of the tested prediction models. The RF model with selected predictors was the second-best model. Therefore, machine learning models can be used to predict hearing recovery in patients with ISSNHL.

BACKGROUND AND OBJECTIVE: Percutaneous transluminal coronary angioplasty of chronic total occlusion has been limited by a relatively low success rate and a high restenosis rate. This study investigated procedural outcome, factors predictive of procedural success and safety of coronary angioplasty for chronic total coronary occlusion. MATERIALS AND METHODS: The study population was composed of 45 lesions attempting PTCA with or without stent implantation for recanalization of chronic total coronary occlusion between January 1997 and July 1999. The clinical and angiographic data of the 45 lesions were reviewed. The results of successful PTCA in 28 lesions were compared with those in 17 lesions whose PTCA was failed. RESULTS: The overall success of balloon angioplasty and stenting was achieved in 28 lesions (62.2%) and did not differ significantly by clinical variables. The most common cause of failure of balloon angioplasty was inability to pass the guide wire across the occlusion( 14 of 23 lesions, 61%). Procedural success was more common in patients with occlusions with a tapered entry configuration(77.2% vs. 47.8%, p=.042), with lesions without side branches(82.3% vs. 50%, p=.03). Multiple logistic regression analysis identified the absence of side branch(p<0.01) and the presence of a tapered entry configuration(p<0.05) as independent predictors of procedural success. One case(2.2%) needed emergency coronary bypass surgery after failure to recanalize the occluded vessel. There was no Q wave acute myocardial infarction, death. CONCLUSIONS: The favorable cases(>60%) of chronic total coronary occlusions can be successfully dilated by balloon angioplasty with or without stent implantation, with a major complication rate of 2.2%. Therefore, with careful patient selection, we need to try the aggressive recanalization for chronic total coronary occlusion.
Angioplasty ; Angioplasty, Balloon ; Angioplasty, Balloon, Coronary* ; Coronary Occlusion ; Emergencies ; Humans ; Logistic Models ; Myocardial Infarction ; Patient Selection ; Stents

No abstract available.