The authors performed prospectively the transcranial Doppler monitoring of bilateral anterior and middle cerebral arteries in 15 patients with ruptured cerebral aneurysm. The entry criteria for the study were confined to the patients who were admitted within 3 days after bleeding and had clinical grades of I, II, or III. The mean frequency shifts of bilateral anterior and middle cerebral arteries were increased immediately after ictus and showed continous further elevation between the 3rd and 8th rupture days. After that, they normalized slowly. The increase of frequency shift preceded clinical ischemic symptoms and an early steep increase of frequency shift was correlated to a high chance for suffering delayed ischemic deficits. The thick clots in subarachnoid cisterns shown on CT scans taken within the third rupture day were correlated well to the severe increase of frequency shifts. The aggressive treatment was done on asymptomatic patients who showed relatively rapid increase of frequency shifts, and they had shown no or trasient mild ischemic symptoms.
Hemorrhage ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Prospective Studies ; Rupture ; Tomography, X-Ray Computed

A prospective study was carried out to evaluate the validity of TROPT troponin T rapid assay in early diagnosis of acute myocardial infarction(AMI) in patients with ischemic chest pain, in comparison with conventional diagnostic tools such as serum troponin T(c-TnT) level, creatine Kinase(CK), CK-MB level and initial EKG finding. The study was performed at the emergency department(ED) of Yong Dong Severance hospital from March 1st 1996 to February 28th 1997. One hundred eighty one patients visiting ED with chief complaint of atraumatic chest pain within 24 hours of visit were eligible for the study. Those who lacked enough data collection and those who had chest paint of noncardiac origin and EKG of PSVT were excluded from the study. The overall study population was a total of 131 patients. Initial EKG, TROPT rapid assay, CK, CK-MB and c-TnT level were obtained simultaneously. Diagnosis of AMI was made according to the international diagnostic criteria for AMI. Of the 131 patients 61 patients(46.6%) were diagnosed as AMI. Within 4 hours of their symptom onset, initial EKG showed the highest sensitivity(63.2%) whereas the sensitivities of TROPT rapid assay, c-TnT, CK and CK-MB were poor(0-0.7%). From 4-8 hours, the sensitivities of c-TnT, CK and CK-MB were higher than that of TROPT rapid assay(80% vs. 30%). The sensitivites of TROPT rapid assay, c-TnT, CK and CK-MB rose over time and reached 100% after 8 hours symptom onset. The specificities of the TROPT rapid assay, c-TnT, CK & CK-MB and EKG were all 100% within 8 hours after symptom onset. Discrepancy between TROPT rapid assay and c-TnT was noted in nine patients(6.9%). In this study TROPT rapid assay was valuable in the diagnosis of AMI after 8 hours of symptom onset.
Chest Pain* ; Creatine ; Data Collection ; Diagnosis ; Early Diagnosis ; Electrocardiography ; Emergencies ; Humans ; Paint ; Prospective Studies ; Thorax* ; Troponin ; Troponin T

No abstract available.
Spinal Muscular Atrophies of Childhood*

No abstract available.
Spinal Muscular Atrophies of Childhood*

No abstract available.
Humans*

No abstract available.
Humans*

We performed an 18F-fluorodeoxyglucose (FDG) position emission tomography (PET) in two patients with complex partial status epilepticus (CPSE). Ictal FDG studies usually occur by chance, because of the unpredictable nature of seizures and the short half-life of flourine-18. In addition to that, ictal PET studies are often contaminated by postictal hypometabolism due to the relatively long FDG uptake period. We experienced two patients with prolonged states of mental confusion. During the confused state, eletrophysiologic and neuroimaging studies were done to confirm the diag-nosis of CPSE. Ictal PET studies showed hypermetabolism during status epilepticus compared with interictal PET. There has been no case report about ictal PET in Korea. We present two cases of ictal PET with a review of the literature
Half-Life ; Humans ; Korea ; Neuroimaging ; Seizures ; Status Epilepticus*

We performed an 18F-fluorodeoxyglucose (FDG) position emission tomography (PET) in two patients with complex partial status epilepticus (CPSE). Ictal FDG studies usually occur by chance, because of the unpredictable nature of seizures and the short half-life of flourine-18. In addition to that, ictal PET studies are often contaminated by postictal hypometabolism due to the relatively long FDG uptake period. We experienced two patients with prolonged states of mental confusion. During the confused state, eletrophysiologic and neuroimaging studies were done to confirm the diag-nosis of CPSE. Ictal PET studies showed hypermetabolism during status epilepticus compared with interictal PET. There has been no case report about ictal PET in Korea. We present two cases of ictal PET with a review of the literature
Half-Life ; Humans ; Korea ; Neuroimaging ; Seizures ; Status Epilepticus*

The authors performed prospectively the transcranial Doppler monitoring of middle cerebral arteries in 37 patients with ruptured cerebral aneurysm. The entry criteria for the study were confined to the patients who had clinical Grades of 1, 2, or 3, and were operated within 4 days after bleeding. There were several sonographic risk factors of developing delayed ischemic deficits; 1) An early steep increase of flow velocity exceeding 120 cm/sec. 2) An increase of maximum flow velocity more than 140 cm/sec. 3) The flow velocity increasing simultaneously with the onset of delayed ischemic deficit in which case preventive treatment was impossible. 4) Prolonged elevation of flow velocity for more than 7 days despite of aggressive treatment. It seemed to be mandatory to start preventive and aggressive treatment for the asymptomatic patients who showed higher flow velocity than 140 cm/sec. Transcranial Doppler sonography has another potential on deciding the timing of surgery.
Hemorrhage ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Prospective Studies ; Risk Factors ; Ultrasonography ; Ultrasonography, Doppler, Transcranial

We reported a case of recurrent arteriovenous malformation, which had been operated on before and disappeared on postoperative angiography. Though a postoperative angiogram after the first operation indicated complete excision of the lesion, the patient returned with intracerebral hemorrhage, and an angiogram indicated reappearance of the lesion. Total excision was carried out at the second operation. It is concluded that long term follow-up angiography or vascular imaging procedures are required in particular cases of cerebral arteriovenous malformation with hematoma, difficulty in hemostasis and/or deep seated lesion.
Angiography* ; Arteriovenous Malformations ; Cerebral Hemorrhage ; Follow-Up Studies ; Hematoma ; Hemostasis ; Humans ; Intracranial Arteriovenous Malformations ; Recurrence*