No abstract available.

No abstract available.

Although the same traumatic stress was experienced, the presenting symptoms and their severity might be different. The difference could be associated with the coping style. Thus we were interested in which coping style is more efficient in dealing with stress. Among the 624 survivors of Sampoong Accident we selected active coping group(n=67) and passive coping group(n=63) using the Ways of Coping Checklist. These two groups were compared on scores in Beck Depression Inventory, State-Trait Anxiety Inventory, Impact of Event Scale, MMPI, and 16 Personality Factor Questionnaire. The passive coping group reported that they were more anxious and depressive, and they showed more intrusive thought about traumatic stress, denial, and vulnerable factors of personality than active coping group. These results suggest that active coping style such as problem-focused coping and seeking social supports is more efficient and successful in case as Sampoong Accident. Therefore, for the survivors of extremely traumatic accident, training of active coping skills can be helpful for rehabilitation and adaptation in everyday life.
Adaptation, Psychological ; Anxiety ; Checklist ; Denial (Psychology) ; Depression ; Humans ; MMPI ; Surveys and Questionnaires ; Rehabilitation ; Survivors*

A 31-year-old man presented with dull headache and memory disturbance lasting for one week. Computed tomographic scans revealed acute hydrocephalus. The cerebrospinal fluid contained 53 leukocytes/mm3, with a mononuclear preponderance and no erythrocytes. Magnetic resonance imaging revealed hydrocephalus and leptomeningeal enhancement. Magnetic resonance angiography and digital subtraction angiography showed supraclinoid occlusion of the right internal carotid artery, which resembled unilateral moyamoya disease. Neuroendoscopic biopsy of a lesion in the septum pellucidum revealed noncaseating granulomas, which was consistent with sarcoidosis. The patient was successfully managed with intravenous methylprednisolone and ventriculoperitoneal shunting. To our knowledge, this is the first case of moyamoya-like vasculopathy associated with neurosarcoidosis.
Adult ; Angiography, Digital Subtraction ; Biopsy ; Carotid Artery, Internal ; Central Nervous System Diseases ; Erythrocytes ; Granuloma ; Headache ; Humans ; Hydrocephalus ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Memory ; Methylprednisolone ; Moyamoya Disease ; Sarcoidosis ; Septum Pellucidum ; Ventriculoperitoneal Shunt

OBJECTIVE: The anatomy of middle cerebral artery (MCA) bifurcation aneurysms has been noted to be unfavorable for endovascular treatment. Our purpose was to analyze the clinical and angiographic results of coiling of the MCA bifurcation aneurysms. METHODS: From January 2004 to April 2007, 26 patients harboring 29 MCA bifurcation aneurysms were treated with coils. Of these patients, 16 had subarachnoid hemorrhages (SAH). The bleeding source was a ruptured MCA bifurcation aneurysm in 11 patients and a ruptured aneurysm in a different location in 5 patients, respectively. Treatment-related complications, clinical outcomes, and postprocedural and follow-up angiography results were retrospectively evaluated. RESULTS: 29 MCA bifurcation aneurysms (11 ruptured, 18 unruptured) were occluded with coils in 26 patients. Occlusion was complete for 24 (82.8%) of the 29 aneurysms, incomplete for 3 (10.3%), and partial for 2 (6.9%) aneurysms. Procedural complications included thromboembolism in 6, a small nonocclusive thrombus formation in 1, and intraprocedural aneurysmal rupture in 1. All of symptomatic complications were thromboembolic events that occurred 3 patients with unruptured aneurysm and they discharged with moderate disability state. Follow-up angiograms were available on 16 patients with 18 aneurysms and 1 patient with an initial complete occlusion had a slight neck recanalization. CONCLUSION: Coiling of MCA bifurcation aneurysm could be achieved without treatment-induced neurologic deficit in 88.5% (23/26) of the patients while at the same time obtaining favorable anatomic results. Improvements in device technology and technique will certainly greatly increase the safety of coiling of MCA bifurcation aneurysm, widening its indications.
Aneurysm ; Aneurysm, Ruptured ; Angiography ; Follow-Up Studies ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Neck ; Neurologic Manifestations ; Retrospective Studies ; Rupture ; Subarachnoid Hemorrhage ; Thromboembolism ; Thrombosis

PURPOSE: Although neonatal intensive care and development of obstetrics play a role in improving survival rate in prematurity, cerebral palsy (CP) is still one of the neurologic sequelae. We tried to find what kinds of risk factors in the patients with abnormal neurosonographic findings who developed CP later. This study was performed to predict early enough who will develop CP later and to treat rapidly for rehabilitation. METHODS: The one hundred and forty one infants with intraventricular hemorrhage, cyst, or abnormal increased periventricular echodensity in serial neurosonographic findings were admitted to the neonatal intensive care unit of Gil general hospital from January 1992 to December 1994. Neurosonographic findings in CP group and non-CP group during postpartum 18 months to 54 months were analysed retrospectively. RESULTS: 1) 18 of one hundred and forty one cases with abnormal neurosonographic findings developed CP. The duration of mechanical ventilation of the CP group was 11.6+/-16.1 days. It is significantly shorter than that of the control group (non-CP group : 2.2+/-7.0 day). The duration of oxygen therapy in the CP group was 22.4+/-19.2 days. Which is also significantly shorter than that of the control group (non-CP group : 5.4+/-8.4 day) (P<0.01). 2) Increased periventricular echodensity and the size of the cyst in neurosonographic findings in the CP group is significantly different from those of the non-CP group P<0.01). 3) In CP group (N=18), Increased periventricular echodensity and cyst formation were located most commonly in the parietal region. 4) The grade of the intraventricular hemorrhage in the CP group was significantly different from that in the non-CP group (P<0.01). 5) The neurosonographic findings give the diagnostic accuracy for predicting CP. CONCLUSIONS: We studied the relationship of the abnormal neurosonographic findings, CP, and associated risk factors. In review, By using neurosonographic examination the risk of the development of CP could be predicted, and by early diagnosis of CP the quality of the life of CP-patient could be better.
Cerebral Palsy* ; Early Diagnosis ; Hemorrhage ; Hospitals, General ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Obstetrics ; Oxygen ; Postpartum Period ; Rabeprazole ; Rehabilitation ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Survival Rate

OBJECTIVE: Easy triggering of trauma-related episodic memory fragments caused by perceptual cues is tied to strong perceptual priming in the implicit memory system. And among benzodiazepines, only lorazepam has been consistently reported to have an atypical suppression effect on perceptual priming processes. The aim of this study was to investigate the effects of single doses of lorazepam, diazepam, and a placebo on intrusive memories after exposure to a distressing videotape and to explore whether the anti-intrusive effect of lorazepam is acquired as a result of the suppression of perceptual but not conceptual priming processes. METHODS: Under prospective, randomized, and double-blind conditions, we compared the anti-intrusion effect of a single dose of lorazepam (n=22) with that of diazepam (n=22) and a placebo (n=21) in young healthy Korean college students following exposure to a traumatic videotape. RESULTS: We present the first finding for an anti-intrusion effect of lorazepam. One day after the medication, lorazepam, rather than diazepam or the placebo, significantly reduced the extent of intrusion and data-driven processing of the traumatic information. There were no differences among the three conditions in state anxiety, depression, and an arousal scale throughout the experiment. CONCLUSION: Results from this study suggest the possibility of lorazepam as a candidate anti-intrusion drug, as well as the cautious use of diazepam in the treatment of PTSD patients. The anti-intrusive effect of lorazepam is directly related to its atypical inhibitory effect on implicit perceptual priming processes. The present study provides support for the enhanced perceptual priming hypothesis of PTSD.
Benzodiazepines ; Cues ; Diazepam ; Humans ; Lorazepam* ; Memory ; Memory, Episodic ; Prospective Studies ; Stress Disorders, Post-Traumatic ; Videotape Recording

BACKGROUND: The incidence of mycoplasmal pneumonia is predominantly at childhood and early adulthood, but in adults, its incidence is low and its symptoms and physical findings are nonspecific. The definite diagnosis of M. pneumoniae pneumonia can be made by sputum culture, but requires several weeks for positive results, and the early diagnosis must initially be based on the serologic tests and appropriate clinical findings. Thus, we evaluated the clinical aspects of M. pneumoniae pneumonia in the adults patients. METHOD: Among the admitted patients due to pneumonia, the definite diagnosis is anti-M. pneumoniae antibody titer of > 1:40 and a single cold agglutinin titer of > 1:64. The presumptive diagnosis is anti-M. pneumoniae antibody titer of > 1:40 or a single cold agglutinin titer of > 1:64 and the clinical characteristics or chest X-ray findings are compatible with M. pneumoniae pneumonia. We studied the age and sex distribution, seasonal distribution, clinical symptoms, physical findings, serologic test, chest X-ray findings, treatment and its progression. RESULTS: 1) The age distribution was even and the ratio of male to female was 1:1. 2) The monthly distribution was most common in January(16.7%) and the seasonal distribution in autumn and winter(autumn: 30%, winter: 33.3%). 3) The cold agglutinin titers were higher than 1:64 in 12 cases(40%), and reached the peak level around 2 weeks from onset and antimycoplasma antibody titers were higher than 1:160 in 5 cases(16.7%). 4) On the chest X-ray, pulmonary infiltration was noted in 28 cases(93.3%) among 30 cases and right lower lobe involvement was the most common(33.3%) and both lower lobe involvement was noted in 7 cases(23.3%). 5) The mean treatment duration was most common(33.3%) in 1 week to 2 weeks after admission and 26 cases(86.7%) were improved within 4 weeks. 6) On admission, there was fever(> or =38.9degreesC) in 17 cases(56.7%), and the fever subsided in 12 cases(70%) within 3 days after treatment using erythromycin. CONCLUSION: The mycoplasmal pneumonia in adults shows milder clinical patterns than that in childhood and can be completely recovered without complication by early diagnosis and treatment.
Adult* ; Age Distribution ; Diagnosis ; Early Diagnosis ; Erythromycin ; Female ; Fever ; Hospital Distribution Systems ; Humans ; Incidence ; Male ; Pneumonia* ; Seasons ; Serologic Tests ; Sex Distribution ; Sputum ; Thorax

We describe a case of an unruptured basilar top aneurysm that was associated with early rupture after incomplete coiling. A 62-year-old woman with a history of several small infarctions has undergone coiling of unruptured basilar top aneurysm. Two weeks after initial coiling the patient presented with Hunt and Hess grade IV subarachnoid hemorrhage consistent with a ruptured basilar top aneurysm. Repeat angiography revealed a rupture of recanalized basilar top aneurysm. Second embolization with additional coils resulted in complete occlusion. However, her neurological status was not improved afterward and she was transferred to department of rehabilitation one month after hemorrhage with comatous state. To our knowledge, this is the first case of fatal early rupture after coiling of unruptured aneurysm. It has been speculated that coiling could cause injury to aneurysmal wall and facilitate rupture.
Aneurysm* ; Angiography ; Female ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm ; Middle Aged ; Rehabilitation ; Rupture* ; Subarachnoid Hemorrhage

A 26-year-old man was admitted to our department due to intermittent left hemiparesis for 3 months. Magnetic resonance image showed subacute infarction in the right precentral gyrus. Digital subtraction angiography and magnetic resonance angiography revealed an aneurysmal protrusion at the right middle cerebral artery (MCA) bifurcation. It was difficult to differentiate the aneurysm from the occlusion of the middle trunk of the MCA trifurcation. Brain single photon emission computerized tomography showed a decrease in perfusion in the right posterior frontal lobe without vascular reserve. Therefore, we planned a superficial temporal artery-MCA anastomosis with an exploration of the right MCA bifurcation. Intraoperatively, the aneurysmal opacification on preoperative angiography proved to be the proximal stump of the occluded middle trunk of the MCA trifurcation. An aneurysmal protrusion at the MCA bifurcation does not always indicate an aneurysm. In diagnosing protruding vascular lesions at the MCA bifurcation, the possibility of a vascular stump should be considered according to their angioanatomical appearance and the history of the patient.
Adult ; Aneurysm* ; Angiography ; Angiography, Digital Subtraction ; Brain ; Frontal Lobe ; Humans ; Infarction ; Magnetic Resonance Angiography ; Middle Cerebral Artery* ; Paresis ; Perfusion ; Tomography, Emission-Computed, Single-Photon