BACKGROUND: Coagulation abnormalities account for 1% to 5% of the causes of adult stroke. The importance of pro-thrombotic condition as a cause of stroke has been the subject of intense controversy. The role of protein S deficiency in the etiology of stroke and the clinical pattern of cerebral infarction caused by the prothrombotic state are still unclear. We investigated clinical characteristics of cerebral infarction caused by free protein S (FPS) deficiency. METHODS: We enrolled patients with cerebral infarction over 2 years. Cerebral infarction was classified into transient ischemic attack, lacunar infarction, embolic infarction, and thrombotic infarction. We assayed free protein S, prothrom-bin time (PT), and activated partial thromboplastin time (APTT) within 24 hours after stroke and measured free protein S and protein S Ag at 3 months after cerebral infarction. All patients underwent a cardiological examination and neu-roimaging study, and cerebral angiography was done only when necessary. RESULTS: Eight patients (1.67%) among 474 patients with cerebral infarction had FPS deficiency as a cause of stroke. Four were male and four were female. The history of venous thrombosis was not noted. The age of patients were from 24 to 83 years old at the time of stroke. Two patients had family members with FPS deficiency. The types of stroke were variable, such as thrombotic infarction in 3 patients, lacunar infarction in 4 patients, and embolic infarction in one patient. Cerebral arterial stenosis was noted in 3 patients. Other associated risk factors of stroke were smoking, hypertension, pregnancy, low HDL cholesterol, sinus bradycardia, left ventricular hypertrophy on EKG, and old age. All patients had normal PT, APTT, and liver function test. CONCLUSIONS: FPS deficiency can be a risk factor for cerebral infarction in young patients as well as old patients. Free protein S (FPS) deficiency may increase risk of cerebral infarction in the presence of other risk factors of stroke but this requires confirmation by a large study in unselected patients.
Adult ; Aged, 80 and over ; Bradycardia ; Cerebral Angiography ; Cerebral Infarction* ; Cholesterol, HDL ; Constriction, Pathologic ; Electrocardiography ; Female ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Infarction ; Ischemic Attack, Transient ; Liver Function Tests ; Male ; Partial Thromboplastin Time ; Pregnancy ; Protein S Deficiency* ; Protein S* ; Risk Factors ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar ; Venous Thrombosis

The hyperlipoproteinemias are the disturbance of lipid transport resulted from accelerated synthesis or retarded degradation of lipoproteins that transport cholesterol and trigycerides through plasma. These diseases are classified as type I, type IIa, type IIb, type III, type IV, type V, and hyper- -lipoproteinemia by lipoprotein phenotype. Type V hyperlipoproteinemia is uncommon in childhood and characterized by elevation of triglyceride levels due to increases in both VLDL and chylomicrons and lipoprotein electrophoresis shows increased pre- , , and chylomicron bands. We experienced a case of hyperlipoproteinemia type V in a 12 year old male who presented no specific signs and symptoms. So, we report a case of hyperlipoproteinemia type V with brief review of the literatures.
Child ; Cholesterol ; Chylomicrons ; Electrophoresis ; Humans ; Hyperlipoproteinemia Type V* ; Hyperlipoproteinemias ; Lipoproteins ; Male ; Phenotype ; Plasma ; Triglycerides

We define acute respiratory failure(ARF) as present whenever the ratio of arterial oxygen tension (PaO2) and inspired oxygen concentrarion(FiO2) is below the normal predicted range for the patient's age and/or the arterial carbon dioxide tension(PaCO2) is above 45 in the absence of respiratory compention for metabolic alkalosis. Adult respiratory distress syndrome(ARDS) which is associated with shock, trauma, infection, inhalation of toxic gas, aspiration of gastric content and drugs etc, first received wide-spread attention in 1967. ARDS is a descriptive term that is characterized by a combination of refractory hypoxemia and severly decreased lung compliance. Numerous specific incidents or illnesses may be complicated by, or associated with ARDS. Early diagnosis and improvement in physiological therapy including PEEP therapy have been successful in treating the early and mild episodes of ARDS. This report describes three cases of ARF following anesthesia and reviews the literature.
Adult ; Alkalosis ; Anesthesia* ; Anoxia ; Carbon Dioxide ; Early Diagnosis ; Humans ; Inhalation ; Lung Compliance ; Oxygen ; Respiratory Insufficiency* ; Shock

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

Spondylolisthesis and spondylolysis is one of the major causes of the low back pain and orthopaedic surgeons frequently encounter this problems with increasing tendency. In 19th century, spondylolisthesis had been studied by the European obstetrician as the main cause of dystocia. Advancement of the radiological techniques enabled us to know more precise degree of slipping. Therefore, many surgical techniques have been used. Spondylolysis has been also studied as the precursor of the spondylolisthesis. This report is based upon the analysis of the records of 26 patients who had operated at the Department of Orthopaedic Surgery of National Medical Center from 1972 to 1981. The results were as follows. 1. Most common age group was 30–50 age group and theres no sexual difference. 2. Most common symptoms were lumbago and radiating pain and the most common sign was Lasegue sign. 3. Most common type was isthmic type and location was 5th lumbar vertebra, and degree of slipping was grade I by Meyerding's method. 4. The fusion of the grafted bone were observed in 24 cases among 26 cases: of which the duration were 3 months in 16 cases and remaining 8 cases had duration between 3 and 6 months. 5. Postoperative analysis under the basis of the functional recovery was satisfactory in 93% of cases by Gill's criteria.
Dystocia ; Female ; Humans ; Low Back Pain ; Methods ; Pregnancy ; Spine ; Spondylolisthesis ; Spondylolysis ; Surgeons ; Transplants

No abstract available in English.
Gangrene

Many techniques have been tried to avoid the adverse effect of succinylcholine administe-red for endotracheal intubation especially wish the complication of increased IOP, hyperk-alemia, aspirationl pneumonia and post operative muscle pain, One of these is that the prior administration of a small, subparalyzing dose(15 ug/kg) of non-depolarizing muscle relaxant would shorten the onset time of an intubating dose(80 ug/kg) of muscle relaxant. Intra-venous lidocaine has bean effective in attenuating the reflex intra-ocular response to laryngoscopy Therefore, we determined the effectiveness of this drug regimen with and without intra venous lidocaine to attenuate the IOP, blood pressure and heart rate response to laryngos-copy and endotracheal intubation. Forty patients were divided intro two groups. Group l (n=20) administered saline 5 ml. Group ll(n=70) administered 2% preservative free lidocaine(1.5 mg/kg) as pretreatment drug. The results are as follows : 1) There was no statistically significant difference of intubation condition between one and another group. Among the forer patients, Grade 1,2,3,4 are 8(20%), 19(47.5%), 13(32.5%),0, in orders. 2) In the Saline Group, IOP, BP, HR increased significantly after laryngoscopy compared wiith control value. (p<0.001, P<0.05/p<0,001, p<0.005) and maintained above control values to 4~5 minutes later. 3) In the Lidocaine Group, IOP, BP, HR increased slightly after laryngoscopy compared with control value, but thege changes were not statistically significant, and decreased below control values in 2 min, 2min, 3 min after laryngoscopy each to each. From the above results, it is suggested that combined method of pretreatment of 2% lidofaine(1.5 mg/tg) and divided dose of pancuronium is valuable in general anesthesia of ophthalmic patient who need to attenuate the IOP.
Anesthesia, General ; Blood Pressure ; Heart Rate ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Lidocaine ; Myalgia ; Pancuronium* ; Pneumonia ; Reflex ; Succinylcholine

Clinical study was made on 675 cases of newborn infant who were born by vacuum extraction during the period of January 1971 through December 1975. The results obtained were as follows: 1. The incidence of vacuum extraction among 4,153 deliveries was 16.3% and there was a slight decreasing tendency annually. 2. The highest maternal age incidence was 26 to 30 years of age and vacuum extraction rate was higher in primipara (75.6%) than multipara (24.4%). 3. There were more male (62.2%) than female (37.8%) and 91.6% of the infants were born with 40 to 41 weeks of gestational age and 89.3% of in infants weighing between 2,500 to 4,000g at birth. 4. The majority (774.6%) of the newborn infant had good (10) Apgar score at one minute and only 5.6%had score below 7. 5. The major complication was head injuries and which were 91.1% of increased size of caput succedaneum, 3.1% of scalp abrasion, 3.4% of cephalhematoma, 0.3% of intracranial hemorrhage, and 0.3% of linear skull fracture, Visible jaundice was found in 9.0% of the newborn infants among those 80.3% showed total serum bilirubin level of 15mg/100ml or less, 19.7% showed 20mg/100ml or more but there was no case of severe jaundice required exchange transfusion.
Apgar Score ; Bilirubin ; Craniocerebral Trauma ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Intracranial Hemorrhages ; Jaundice ; Male ; Maternal Age ; Parturition ; Scalp ; Skull Fractures ; Vacuum*

We observed the histopathologic findings of 21 biopsed materials those initial clinical impression was suspected as granuloma pyogenicum. Also we compared the cange in the number of mast cells in the lesion of the granuloma pyogenicum with those in the normal appearing skin by Giemsa stain, and the stainability of mucopolysaccharides in the stromal edema of granuloma pyogenicum lesion with that in the normal appearing skin by Alcian blue-PAS stain. The results were as fallows: The various microscopic diagnoses made in 8 cases, which was clinically granuloma pyogenicurn. These 8 cases were granulation tissue(3), subungual exostosis(1), dermatofibrorna(1), sebaceous epithelioma(l), liporna with granulation tissue(1), and malignant melanoma(1). 2. The number of mast cells in the granuloma pyogenicum lesion were increased (p<0.01), especially in the lesion which showed marked capillary endothelial proliferation, and the amount of mucopolysaccharides was increased in the stromal edema of the granuloma pyogenicum lesion.
Azure Stains ; Capillaries ; Diagnosis ; Edema ; Glycosaminoglycans ; Granuloma* ; Granuloma, Pyogenic* ; Mast Cells ; Skin

Gluteal fibrosis is rare in Kores. We thought the probable primary etiology of gluteal fibrosis might be repeated intramuscular injection into the buttock, Inability to adduct the legs in the sitting position and flex the hips in neutral position had been observed. Four cases(3 persons) of gluteal fibrosis in adult from October 1986 to February 1987 are presented with much improvement of squatting and flexion of hip in neutral position after operation.
Adult ; Buttocks ; Fibrosis ; Hip ; Humans ; Injections, Intramuscular ; Leg