In the management of carotid cavernous fistula, detachable balloon has become the treatment of choice.However, technical difficulties are not uncommon, and transarterial balloon embolization fail in 5% to 10% ofcases. Failure occurs because in some patients, the fistula orifice may be too small to allow entry. Using atracker catheter system with Guglielmi detachable coils, we achieved successful transarterial occlusion of acarotid cavernous fistula with a small fistula.
Balloon Occlusion ; Catheters ; Fistula* ; Humans

Sturge-Weber syndrome (SWS) is a rare sporadic neurocutaneous syndrome, characterized by port-wine nevus of face, ocular vascular abnormalities and leptomeningeal angioma. A 63-year-old man developed sudden onset of right hemiparesis and global aphasia. He had a past history of epilepsy. Physical examination showed no skin lesions. Brain CT demonstrated gyriform calcification in the left frontal area. Brain MRI revealed cortical atrophy in the left hemisphere with no diffusion restrictions. Fourteen hours later, he was completely recovered from aphasia and motor weakness. We report a case of atypical SWS with episode of acute hemiparesis which highlight the difficulty in distinguishing seizure from ischemic symptoms.
Aphasia ; Atrophy ; Brain ; Diffusion ; Epilepsy ; Hemangioma ; Neurocutaneous Syndromes ; Nevus ; Paresis ; Physical Examination ; Seizures ; Skin ; Stroke ; Sturge-Weber Syndrome

Cough-induced syncope is belongs to the heterogeneous group of situational syncope. It is characterized by the loss of consciousness occurring after excessive coughing. A 63-year-old man complained of cough syncope for 15 days. During vigorous coughing, he lost consciousness for a few seconds. He had past medical history of bronchial asthma and diabetes mellitus. Various tests for syncope including electroencephalogram, electrocardiogram, 24-hours Holter monitoring, echocardiogram, carotid sinus massage, tilt table test, carotid duplex, and brain MRI were normal. He was treated successfully with anti-tussives and bronchodilators. We report a case of cough-induced syncope in a patient with bronchial asthma.
Asthma ; Brain ; Bronchodilator Agents ; Carotid Sinus ; Consciousness ; Cough ; Diabetes Mellitus ; Electrocardiography ; Electrocardiography, Ambulatory ; Electroencephalography ; Humans ; Massage ; Syncope ; Tilt-Table Test ; Unconsciousness

Epileptic seizures have been shown to cause increased signal intensities on diffusion-weighted images (DWI). Extensive hemispheric involvement on MRI after status epilepticus was very rare. A 56-year-old man transferred to our hospital due to status epileticus. The status epilepticus lasted nearly 7 hours. Neurological examination showed confusional consciousness, left hemiplegia and hemineglect of left side. Brain DWI demonstrated extensive high signal intensities in the right posterior frontal, parietal, temporal and occipital lobes resembling acute cerebral infarction. EEG revealed periodic lateralized epileptiform discharges over the right hemisphere. Follow-up DWI showed more decreased signal intensity in right hemispheric lesions. This case demonstrates the importance of recognizing the characteristics that help differentiate status epilepticus from other disorders.
Brain ; Cerebral Infarction ; Consciousness ; Diffusion Magnetic Resonance Imaging ; Electroencephalography ; Epilepsy ; Follow-Up Studies ; Hemiplegia ; Humans ; Middle Aged ; Neurologic Examination ; Occipital Lobe ; Status Epilepticus

BACKGROUND: The objective of the study was to evaluate the predictive value of plasma D-dimer at admission after acute ischemic stroke, and to assess its effect on short-term functional outcome. METHODS: Fasting plasma D-dimer was measured in 290 consecutive patients (61.7% men, mean age 67.0±12.3 years) within 3 days after the onset of acute ischemic stroke. The outcomes were measured at 3-months after stroke onset, by the modified Rankin Scale (mRS). RESULTS: Atrial fibrillation, hypertension, diabetes and involvement of the insular cortex, the levels of serum high sensitive C-reactive protein and D-dimer, as well as incidence of women and age, were all significantly higher in the poor outcome group (P<0.05). After the adjustment of National Institutes of Health Stroke Scale (NIHSS) scores on admission, the plasma D-dimer levels positively correlated with mRS (Spearman partial rho=0.247, P<0.001). The cut-off value of D-dimer level for prediction of poor outcomes was 0.35 mg/L (sensitivity 0.70, specificity 0.63, area under the curve 0.71). Furthermore, two multivariated logistic regression analysis models were performed. One model excluded the NIHSS score as an independent variable, and demonstrated that D-dimer (odds ratio, 1.24 for every 1.0 mg/L, P<0.05) was independently associated with poor functional outcome. Conversely, the other model which included the NIHSS score, did not show any such association. CONCLUSIONS: Plasma D-dimer level is a useful marker for short-term outcomes in acute ischemic stroke, and may have a role in risk stratification for predicting a poor outcome.
Atrial Fibrillation ; C-Reactive Protein ; Cerebral Cortex ; Cerebral Infarction ; Fasting ; Female ; Humans ; Hypertension ; Incidence ; Logistic Models ; Male ; National Institutes of Health (U.S.) ; Plasma ; Prognosis ; Sensitivity and Specificity ; Stroke

Objective: The objective of this study is to assess the efficacy and safety of repeated sodium polynucleotide (Conjuran Ⓡ ) treatments in patients with knee osteoarthritis. Methods: The study was conducted by retrospectively examining 45 patients who repeated the treatment course of 5 injections of Conjuran Ⓡ twice within 6 months. For each course, pain reduction by the change of 100-mm Weight-Bearing-Pain Visual-Analog-Scale was compared with before administration until 6 months after administration. Improvement by Clinical Global Impression (CGI) and Patient Global Impression (PGI) were also investigated, as well as adverse reactions. Results: Pain analysis after administration of Conjuran Ⓡ confirmed that VAS decreased by 51.6% until 6 months (p＜0.001), and after that the effect was lost and was repeat for the 2 nd course. In the 2 nd , VAS continued to decrease by 58.7% compared to before the 1 st course (p＜0.001). Analysis of CGI, 88.9% of patients improved after the 1 st and 84.4% of patients improved after the 2 nd . In the PGI results, symptoms improved in 86.7% of patients after the 1 st and 82.2% after the 2 nd . No significant adverse event was reported. Conclusion The safety and efficacy results of patients receiving Conjuran Ⓡ for 2 nd treatment courses were similar to those for 1 st treatment course. In addition, the effect lasts for up to 6 months after administration, and the pain reduction effect is lost thereafter, so it is recommended to apply it at 6-month intervals if additional treatment is needed. Conjuran Ⓡ is an intra-articular injection that is effective in reducing knee pain and can be used repeatedly without adverse reactions.

OBJECTIVES: The aim of this study was to determine the association between oral health status and oral health impact profile (OHIP-14) among patients undergoing treatment in a dental hospital, in order to develop an oral health care method for improving oral health related quality of life (OHRQoL). METHODS: A total of 980 patients aged 7-89 years were selected from a dental hospital between May 2011 and March 2014. Questionnaires on oral health impact profile (OHIP-14K) were distributed to the patients, and their dental records were examined to find out their oral health status. RESULTS: OHIP-14 scores of patients with periodontal pockets over 4 mm and presence of chronic general disease were significantly higher than those without pockets and chronic disease (P<0.05). Factors such as age, gender, having prosthesis or dental implant, regular oral health care over a period of 1 year were not significantly associated with OHIP-14 scores. CONCLUSIONS: Periodontal health status and chronic general disease could be factors associated with OHRQoL. Thus, improving oral symptoms through professional oral care may help improve OHRQoL.
Chronic Disease ; Dental Implants ; Dental Records ; Gwangju ; Humans ; Korea ; Oral Health* ; Periodontal Diseases ; Periodontal Pocket ; Prostheses and Implants ; Quality of Life ; Surveys and Questionnaires

No abstract available.
Molar* ; Tooth*

No abstract available.
Arteriovenous Fistula* ; Cerebral Infarction ; Intracranial Embolism* ; Ultrasonography, Doppler, Transcranial