No abstract available.
Child* ; Humans ; Purpura, Thrombocytopenic, Idiopathic*

To determine the comparative accuracy of two Doppler tests, the findings of 38 patients who had undergone a complete evaluation by supraorbital Doppler test, frontal Doppler test and angiography were studied. When stenosis of 60 percent or more in diameter was considered as a true positive finding, the Doppler tests of 76 internal carotid arteries of the 38 patients showed the following results. Supraorbital Doppler test: eight false positive, three false negative, and 65 correct findings, with an overall accuracy of 85%. The authors, therefore, concluded that the suprorbital Doppler test was more sensitive and accurate than the frontal Doppler test in screening the patients with possible carotid artery occulusive diseases.
Angiography ; Carotid Arteries* ; Carotid Artery, Internal ; Constriction, Pathologic ; Humans ; Mass Screening

OBJECTIVE: Although anterior cervical discectomy and fusion (ACDF) is the standard treatment for degenerative cervical disc disease, concerns regarding adjacent level degeneration and loss of motion have suggested that arthroplasty may be a better alternative. We have compared clinical and radiological results in patients with cervical disc herniations treated with arthroplasty and ACDF. METHODS: We evaluated 53 patients treated for cervical disc herniations with radiculopathy, 21 of whom underwent arthroplasty and 32 of whom underwent ACDF. Clinical results included the Visual Analogue Scale (VAS) score for upper extremity radiculopathy, neck disability index (NDI), duration of hospital stay and convalescence time. All patients were assessed radiologically by measuring cervical lordosis, segmental lordosis and segmental range-of-movement (ROM) of operated and adjacent disc levels. RESULTS: Mean hospital stay (5.62 vs. 6.26 days, p<0.05) and interval between surgery and return to work (1.10 vs. 2.92 weeks, p<0.05) were significantly shorter in the arthroplasty than in the fusion group. Mean NDI and extremity VAS score improved after 12 months in both groups. Although it was not significant, segmental ROM of adjacent levels was higher in the fusion group than in the arthroplasty group. And, segmental motion of operated levels in arthroplasty group maintained more than preoperative value at last follow up. CONCLUSION: Although clinical results were similar in the two groups, postoperative recovery was significantly shorter in the arthroplasty group. Although it was not significant, ROM of adjacent segments was less in the arthroplasty group. Motion of operated levels in arthroplasty group was preserved at last follow up.
Animals ; Arthroplasty ; Convalescence ; Diskectomy ; Extremities ; Follow-Up Studies ; Humans ; Length of Stay ; Lordosis ; Neck ; Radiculopathy ; Return to Work ; Upper Extremity

BACKGROUND: The ability of the body to maintain its temperature is evidently decreased in patients with thermal injury. The aim of this study is was to evaluate the effect of inhaled sevoflurane and intravenous propofol with remifentanil on core body temperature in burn patients. METHODS: Sixty patients scheduled for burn surgery were divided into 4 groups. Within the major burn patients, intravenous propofol and remifentanil group (group I) followed by a continuous infusion of propofol and remifentanil. In inhaled sevoflurane group (group II), propofol 2mg/kg was given intravenously over 10 seconds as a single bolus and was maintained with nitrous oxide and oxygen and 2-2.5% sevoflurane. In minor burn patients, the intravenous propofol and remifentanil group (group III) and inhaled sevoflurane group (group IV) were treated in the same manner. After induction of anesthesia, esophageal stethoscope was placed to monitor the core temperature every five minutes in all patients. RESULTS: During operation, the core temperature of major burn patients was about 0.7-1.0 degreesC greater than that of minor burn patients. Until 95 minutes after induction of anesthesia, this difference showed statistical significant. However, there was no statistical significance after 100 minutes (P < 0.05). There were no statistically significant differences between group I and group II and group III and group IV for burn patients as well. CONCLUSIONS: Compared to minor burn patients, the core temperature of major burn patients was greater, and anesthetics type and administration route during operation had no effect on the core temperature in these patients.
Anesthesia ; Anesthetics ; Body Temperature ; Burns ; Humans ; Methyl Ethers ; Nitrous Oxide ; Organothiophosphorus Compounds ; Oxygen ; Piperidines ; Propofol ; Stethoscopes

We report a case of cutaneous cryptococcosis resembling verrucous granuloma on the lower lip in a 18-year-old female. She presented with a 3x1.5 cm sized painful verrucous granuloma with white, yellowish crust on the lower lip for 1 year. She had gotten many shunt operations for unexplained hydrocephalus. Histopathological examination showed numerous encapsulated round spores, epithelioid cells and giant cells in the dermis. A tissue culture on Sabouraud's dextrose agar without cycloheximide showed whitish creamy colonies. The organism was identified as Cryptococcus neoformans. The lesion disappeared with the treatment of oral itraconazole (100 mg/day) for 12 weeks.
Adolescent ; Agar ; Cryptococcosis* ; Cryptococcus neoformans ; Cycloheximide ; Dermis ; Epithelioid Cells ; Female ; Giant Cells ; Glucose ; Granuloma* ; Humans ; Hydrocephalus ; Itraconazole ; Lip ; Spores

We have studied thirty two cases of inappropriately treatable and intractable epileptics to various anti-convulsants. Zonisamide had a definite anti-epileptic activity in eleven subjects(52.4%) of intractble epilepsy. Five patients(45.5%), who were previously inappropriately treatable epileptic patients became seizure free on zonisamide. Two subjects were withdrawn from study because of side effect and two subjects were also withdrawn because of uncontrolled seizure. Zonisamide is not only effective in intractable epileptic patients but also in first trial for untreated epileptic patients.
Epilepsy ; Humans ; Seizures

The authors experienced 5 cases of congenital intestinal obstruction combined with microcolon. We had studied on this rare case, and reviewed the literature and references.
Intestinal Obstruction*

Hanging is traditionally classified as complete, incomplete by the completeness of suspension and typical, atypical by the point of suspension and location of knot. It has been well known that the signs of hanging including subconjunctival petechiae are different according to the type of hanging. We evaluated the incidence of subconjunctival petechiae on 260 cases of hanging and classified the point of suspension and location of knot, ligature mark, and position on cases with subconjunctival petechiae. The subconjunctival petechiae was found in 33.6% of all cases, mostly seen in incomplete, atypical hanging. However, about 30% of incomplete, atypical hanging showed no definite subconjunctival petechiae. The patterns of location of ligature mark, type of knot, and position were somewhat different between positive and negative cases of subconjunctival petechiae in incomplete, atypical hanging.
Classification ; Incidence* ; Ligation ; Purpura*

OBJECTIVE: Perfusion-computed tomography (CT) is useful and quick diagnostic tool for evaluating ischemic stroke patients. We evaluated three measurement maps, cerebral blood flow (CBF), cerebral blood volume (CBV) and time to peak (TTP) for their usefulness in deciding on revascularization surgery using CT parameters after single photon emission computed tomography (SPECT) findings in chronic steno-occlusive disease patients. METHODS: We retrospectively investigated 47 patients with unilateral internal carotid artery (ICA) or middle cerebral artery (MCA) steno-occlusive disease . All patients underwent digital subtraction angiography (DSA) as well as an acetazolamide challenge with SPECT and perfusion CT. Patients who showed decreased reserve capacity with a Diamox challenge were classified in the positive group, whereas patients who had no difference in reserve capacity were placed in the negative group. RESULTS: Thirty-one patients were positive and the remaining 16 were negative. Differences in rCBV and rCBF parameters between normal cerebral hemispheres and cerebral hemispheres with steno-occlusive disease did not correlate with SPECT results, but TTP values did. SPECT results seemed relevant when TTP differences between hemispheres with normal and steno-occlusive disease were more than 1.55 times. CONCLUSION: Perfusion CT is a useful tool for the rapid, adequate diagnosis of large territorial infarcts, and the TTP map of perfusion CT is a sensitive and reliable parameter to show the status of collateral circulation in chronic cerebrovascular ischemic disease.
Acetazolamide ; Angiography, Digital Subtraction ; Blood Volume ; Carotid Artery, Internal ; Cerebrum ; Collateral Circulation ; Hemodynamics ; Humans ; Middle Cerebral Artery ; Perfusion ; Retrospective Studies ; Stroke ; Thymine Nucleotides ; Tomography, Emission-Computed, Single-Photon

Endovascular treatment of ethmoidal dural arteriovenous fistula (DAVF) has not been widely performed because of the technical difficulty of the procedure and the potential risk of central retinal artery occlusion. We report the case of a patient who underwent Onyx embolization through the ophthalmic artery in bilateral ethmoidal DAVF; to our best knowledge this is the first report.
Central Nervous System Vascular Malformations ; Humans ; Ophthalmic Artery ; Retinal Artery Occlusion