Posterior reversible encephalopathy syndrome (PRES) involves predominantly posterior subcortical white matter and cortex. PRES is associated with an abrupt and severe increase in blood pressure or administration of various immuno-suppresants. We present a 18-year-old female with PRES. She was admitted to our hospital with seizures. She had been suffering from acute hypertension (170/100 mmHg) associated with acute renal failure. Brain MRI showed reversible biparietal cortical and subcortical edema. We report a case of hypertension-induced PRES associated with acute renal failure. (J Korean Neurol Assoc 19(5):541~543, 2001)
Acute Kidney Injury ; Adolescent ; Blood Pressure ; Brain ; Edema ; Female ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Posterior Leukoencephalopathy Syndrome* ; Seizures

The paroxysmal kinesigenic choreoathetosis is characterized by choreathetoic, dystonic and/or tonic movements induced by sudden voluntary movements, without loss of consciousness, urinary incontinence and clonic movement. These attacks begin in childhood, and are occasionally familial. The response to anticonvulsants is usually excellent. We present 4 cases of paroxysmal kinesigenic choreoathetosis with a brief review of literature, which is believed to be the first report in Korea.
Anticonvulsants ; Korea ; Unconsciousness ; Urinary Incontinence

BACKGROUND: We evaluated the role and effects of prolotherapy in patients presenting with lower back pain and detected sacral asymlocation, by retrospectively analyzing the results of prolotherapy performed at our institute. METHODS: Twenty-three patients with referred pain in the lower back rather than distinct radiculopathy, were detected to have sacral asymlocation by simple X-ray from May 2004 through July 2005. The patients were treated with prolotherapy and manipulation by the Ongley's method around the lumbosacral junction, iliolumbar ligament, and sacroiliac joint. They were treated for approximately one to two week intervals, and during this period were rechecked by X-ray and evaluated using the visual analogue scale (VAS). RESULTS: A total of 23 patients were included in the study (10 male and 13 female), and the average age was 41 years. The average VAS at the time of visit was 8.5, the average treatment time was 4.7 days, and the average VAS after treatment was 2.1. CONCLUSIONS: Back pain, and associated leg and buttock pain, originate from several causes. In these case analyses, instability around the lumbosacral area and sacral asymlocation might have been important causes of patient back pain and associated buttock and leg pain. We therefore applied prolotherapy as well as manipulation techniques devised by Ongley to these patients, and obtained good results.
Back Pain* ; Buttocks ; Diagnosis* ; Humans ; Leg ; Ligaments ; Low Back Pain ; Male ; Pain, Referred ; Radiculopathy ; Retrospective Studies ; Sacroiliac Joint

Foreign-body reaction is characterised by a chronic, proliferative, inflammatory skin reaction. Histopathologically, foreign-body reaction typically exhibits a granulomatous response, which is marked by histiocytes and giant cells surrounding the foreign material. In addition, lymphocytes as well as plasma cells and neutrophils are usually present. The reaction can be caused by substances such as silk, nylon, wood, paraffin, silicon, talc, starch, oils, animal and vegetable spines or bristles and human hair. We report two cases of foreign-body reaction caused by wooden splinter, which has rarely been reported in previous literature.
Animals ; Foreign-Body Reaction* ; Giant Cells ; Hair ; Histiocytes ; Humans ; Lymphocytes ; Neutrophils ; Nylons ; Oils ; Paraffin ; Plasma Cells ; Silk ; Skin ; Spine ; Starch ; Talc ; Vegetables ; Wood

BACKGROUND: Thoracoabdominal aortic replacement is an extensive operation that opens both the pleural cavity and abdominal cavity, which has high mortality and morbidity rate. The authors have reported 9 cases of the thoracoabdominal aortic replacement in 2001. Since 2003 we have applied the deep hypothermic circulatory arrest to the Crawford type I and II thoracoabdominal aortic replacement. Therefore, we analysed the effect of the changes in operative techniques. MATERIAL AND METHOD: Between 1996 and 2005, we have performed 20 cases of thoracoabdominal aortic replacement. The underlying diseases were 8 cases of atherosclerotic aneurysm with 4 cases of ruptured aneurysm and 12 cases of aortic dissection with 10 cases of a previous operations. According to Crawford classification, there were 2 cases of type I, 7 cases of type II, 1 case of type III, 7 cases of type IV, and 3 cases of type V. We compaired the results of the patients who underwent thoracoabdmoninal replacement before 2001 which already has been reported and after then. RESULT: Before 2001 we have performed 9 cases of thoracoabdominal replacement and 5 patients were died of the operation. All three patients with type I and II were died. There was no case of thoracoabdominal replacement between 2001 and 2002, but after 2003 we have performed 11 cases of thoracoabdominal replacement which involved 1 case of type I, 5 cases of type II, 1 case of type III, 2 cases of type IV and 2 cases of type V. There was no mortality and no fetal complications. CONCLUSION: The deep hypothermic circulatory arrest is a safe method of extended thoracoabdominal aortic replacement.
Abdominal Cavity ; Aneurysm ; Aneurysm, Ruptured ; Circulatory Arrest, Deep Hypothermia Induced* ; Classification ; Humans ; Mortality ; Pleural Cavity

To define the risk factors affecting the early major morbidity and mortality after multiple-valve operations, the preoperative, intraoperative and postoperative informations were retrospectively collected on 124 consecutive patients undergoing a multiple-valve operation between October 1985 and July 1996 at the department of Thoracic and Cardiovascular Surgery of Pusan Paik Hospital. The study population consists of 53 men and 71 women whose mean age was 37.9+/-11.5 (mean+/-SD) years. Using the New York Heart Association (NYHA) classification, 41 patients (33.1%) were in functional class II, 60 (48.4%) in class III, and 20 (16.1%) in class IV preoperatively. Seven patients (5.6%) had undergone previous cardiac operations. Atrial fibrillations were present in 76 patients (61.3%), a history of cerebral embolism in 5 (4.0%), and left atrial thrombus in 13 (10.5%). The overall early mortality rate and postoperative morbidity was 8.1% and 21.8% respectively. Among the 124 cases of multiple-valve operation, there were 57 (46.0%) of combined mitral valve replacement (MVR) and aortic valve replacement (AVR), 48 (38.7%) of combined MVR and tricuspid annuloplasty (TVA), 12 (9.7%) of combined MVR, AVR and TVA, 3 (2.4%) of combined MVR and aortic valvuloplasty, 2 (1.6%) of combined MVR and tricuspid valve replacement, and others. The patients were classified according to the postoperative outcomes; Group A (27 cases) included the patients who had early death or major morbidity such as low cardiac output syndrome, mediastinitis, cardiac rupture, ventricular arrhythmia, sepsis, and others; Group B (97 cases) included the patients who had the good postoperative outcomes. The patients were also classified into group of early death and survivor. In comparison of group A and group B, there were significant differences in aortic cross-clamping time (ACT, group A:153.4+/-42.4 minutes, group B:134.0+/-43.7 minutes, p=0.042), total bypass time (TBT, group A:187.4+/-65.5 minutes, group B:158.1+/-50.6 minutes, p=0.038), and NYHA functional class (I:33.3%, II:9.7%, III:20%, IV:50%, p=0.004). In comparison of early death (n=10) and survivor (n=114), there were significant differences in age (early death:45.2+/-8.7 years, survivor:37.2+/-11.6 years, p=0.036), sex (female:12.7%, male:1.9%, p=0.043), ACT (early death:167.1+/-38.4 minutes, survivor:135.7+/-43.7 minutes, p=0.030), and NYHA functional class (I:0%, II:4.9%, III:1.7%, IV:35%, p=0.001). In conclusion, the early major morbidity and mortality were influenced by the preoperative clinical status and therefore the earlier surgical intervention should be recommended whenever possible. Also, improved methods of myocardial protection and operative techniques may reduce the risk in patients with multiple-valve operation.
Aortic Valve ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Busan ; Cardiac Output, Low ; Classification ; Female ; Heart ; Heart Rupture ; Humans ; Intracranial Embolism ; Male ; Mediastinitis ; Mitral Valve ; Mortality* ; Retrospective Studies ; Risk Factors* ; Sepsis ; Survivors ; Thrombosis ; Tricuspid Valve

Since the operative mortality rate of the Acute aortic dissection has been reducing, a more extensive primary repair of the dissected aorta is preferred for acute aortic dissection to reduce the needs of secondary procedures. We performed a total aortic arch replacement with distal stent-grafting in acute type A aortic dissection. The patient was a 50-years old man. He recovered from the operation and was followed up for 7 months. The pseudolumen in the descending aorta was obliterated with the stent.
Mortality

BACKGROUND: Pneumoconiosis is a parenchymal lung disease that results from the accumulation of coal dust in the lungs and the consequent tissue reaction. To evaluate the role of various personal factors in pneumoconosis and the significance of some serologic markers for assessing the disease activity related to pneumoconiosis, the Rheumatoid Factor(RF), α1-AT, C-Reactive Protein(CRT), ceruloplasmin and fibrinogen levels were measured. METHOD: All the patients were males, 45-76 years old, and the mean duration of coal dust exposure was 23.2 years. 51 patients were classified as having Simple Pneumoconiosis (SP), 59 had Progressive Massive Fibrosis (PMF). Fifty eight men with ages ranging from 26-70 years wer used as normal controls. The serum RF and CRT were titrated using an Autochemistry analyzer (HITACHI 7150 : Japan) and the α1-AT and ceruloplasmin levels were measured using a Nephelometer (Behring Nephelometer : Germany) and the fibrinogen levels were estimated by using and Autoanalyzer for hematologic coagulation. RESULT: There was a higher RF level in the SP, and PMF groups than in the control groups but there was no statistical difference. The CRP, α1-AT, and ceruloplasmin levels were also higher in the SP, and PMF groups. However, the fibrinogen concentration was within the normal ranges in both the SP and PMF groups. CONCLUSION: The CWP (Ed note : Define CWP) patients had significantly higher CRP, α1-AT, and ceruloplasmin levels compared to the control group. It is believed that these serologic changes could be used as a marker of the disease activity.
C-Reactive Protein ; Ceruloplasmin ; Coal* ; Dust ; Fibrinogen ; Fibrosis ; Humans ; Lung ; Lung Diseases ; Male ; Pneumoconiosis* ; Reference Values ; Rheumatoid Factor

BACKGROUND: The authors studied factors that affected operative mortality and clinical course by analysis of 98 patients who had underwent total correction of TOF at department of thoracic surgery, Pusan Paik hospital from Sept, 1985 to Aug, 1996 to predict the outcome of operation and improve the result of total correction. MATERIALS AND METHODS: To analyse the factors that affect operative mortality, patients were divided into two groups, non-survivor (group I) and survivor (group II), compared body surface area (BSA), aortic clamping time (ACT), total bypass time (TBT), preoperative PRV/LV, postoperative PRV/LV, operation method between them. These same patients were also divided into two groups, group A (non-survivor or severe complication group) and B (survivor and only mild complication group), comparing the same items. RESULTS: There were statistical differences between group I and II about postoperative PRV/LV as 0.67+/-0.13, 0.46+/-0.15. There were statistical differences between group A and B about postoperative PRV/LV as 0.62+/-0.12, 0.44+/-0.15. Transventricular cases were predominant in group A, transatrial cases in group B (p<0.01). CONCLUSIONS: We suggested that the operative results of TOF were better in cases of lower postoperative PRV/LV and transatrial approach.
Body Surface Area ; Busan ; Constriction ; Humans ; Mortality ; Survivors ; Tetralogy of Fallot* ; Thoracic Surgery

OBJECTIVES: To determine whether kinds of implants would influence on the radiologic outcomes in the treatment of unstable osteoporotic intertrochanteric fractures. MATERIALS AND METHODS: In this retrospective study, radiologic outcomes of 151 patients with unstable osteoporotic intertrochanteric fractures undergoing surgical treatments were compared based on the types of fixation implants as follows : PFNA (53 cases, group I), gamma nail 3(31 cases, group II), CHS with TSP (43 cases, group III), and helical blade type LCP-DHS with TSP (24 cases, group IV). On the follow-up radiographs after operations, we assessed differences of bone union durations, neck-shaft ankle changes, lag screw or helical blade slippages, and varus alpha angle changes among the study groups. RESULTS: All the radiologic outcomes evaluated in this study were not significantly different among the study groups. The average bone union durations of the group I, II, III and IV were 17.7, 18.0, 18.2, and 17.8 weeks, respectively (P=0.429). The average variation of neck-shaft angle of the group I, II, III and IV were 3.6degrees, 3.1degrees, 3.7degrees and 2.9degrees, respectively (P=0.273). The average lag screw or blade slippage of the group I, II, III and IV were 5.1 mm, 3.3 mm, 3.6 mm and 2.7 mm, respectively (P=0.154). The average variation of varus alpha of the group I, II, III and IV were 5.3degrees, 4.7degrees, 4.1degrees and 4.6masculine, respectively (P=0.894). CONCLUSIONS: This study indicates that four typical types of fixation implants for treating unstable osteoporotic intertrochanteric fractures would not lead to differences in postoperative radiological outcomes.
Animals ; Ankle ; Follow-Up Studies ; Hip Fractures ; Humans ; Nails ; Retrospective Studies