No abstract available.
Adult* ; Cerebrospinal Fluid* ; Humans

Respiratory failure is the most serious manifestation and usual cause of death in acute organophosphate poisoning, and is common in acute cholinergic crisis. But the respiratory failure may appear suddenly in a patient who is recovering from the cholinergic crisis, even while receiving conventional therapy. These are case report of 37 years old male and 24 years old female with intermediate syndrome in organophosphate poisoning. The two patients ingested organophosphate(fenthion and mixture of DDVP with chlorpyrifos respectively) incidentally and in a sucide attempt respectively. After apparent recovery from the cholinergic crisis with a conventional therapy but before the expected onset of delayed polyneuropathy , the respiratory failure appeared suddenly with a muscular weakness, affecting predominantly the proximal limb muscles, neck flexors, territories of several motor cranial nerves. The two patients needed mechanical ventilatory support and recovery from the intermediate syndrome was complete in both patients, although one subsequently developed hypoxic encephalopathy. The clinical manifestation and electrophysiologic study support the clinical diagnosis of intermediate syndrome. The syndrome carries a risk of death, because of respiratory paralysis, if not recognized early and treated adequatedly. Prompt endotrachial intubation and mechanical ventilatory support is the cornerstone of treatment of the intermediate syndrome. Therefore, all patient should be observed in a hospital for up to 5 days after poisoning.
Adult ; Cause of Death ; Chlorpyrifos ; Cranial Nerves ; Diagnosis ; Dichlorvos ; Extremities ; Female ; Humans ; Hypoxia, Brain ; Intubation ; Male ; Muscle Weakness ; Neck Muscles ; Organophosphate Poisoning* ; Poisoning ; Polyneuropathies ; Respiratory Insufficiency* ; Respiratory Paralysis ; Young Adult

The present study involves 30 craniopharyngioma patients who were admitted to the Department of Neurosurgery, Yonsei Medical college from April, 1965 to December, 1978. All 30 patients received surgery, the results of which were analyzed and evaluated as follows. 1. They consisted of 22 male and 8 female patients. Sixty percent of all patients were under 20 years of age. 2. Chief complaints were as follows:headache(80.0%), decreased visual acuity(80.0%), visual field cut(46.3%), nausea and vomiting(40.3%), papilledema(40.0%), optic atrophy(33.3%), diabetes insipidus(27.0%), and mental disturbance(27.0%). 3. They were diagnosed mainly by cerebral angiography until 1977, at times combined with pneumoencephalography, isotope brain scan, and Conray ventriculography. Since 1978 using the CT brain scan we have been able to reduce risk during and after neuroradiological study, and accurately determine location, size, shape and invasiveness of the tumor. 4. Surgical procedures were performed in 32 cases of craniopharyngioma using several approaches;transfrotal approaches;transfrontal approach:29 cases, transsphenoidal approach:2 cases, and sterotaxic cyst puncture:1 cases. In 8 cases(27.0%) total resection of the tumor was performed, subtotal resection in 23 cases(71.9%), and aspiration of the cyst in one case(3.1%). 5. In the above 32 surgeries, 24 cases(75.0%) of craniopharyngioma were performed by microsurgery, 8 cases involved total resection and 16 cases subtotal removal. As a result of microsurgery, it was possible to remove the tumor from the surrounding structures with less damage. 6. To manage hydrocephalus during the operation, extraventricular drainage was applied in 8 cases(27%) and in 7 cases(23.3%) ventriculoatrial or ventriculoperitoneal shunts were employed pre-or postoperatively. 7. Postsurgical radiation therapy was given to 8 patients in the dosage of 5000-7000 rad during 6 to 8 week period following surgery.
Brain ; Cerebral Angiography ; Craniopharyngioma* ; Drainage ; Female ; Humans ; Hydrocephalus ; Male ; Microsurgery ; Nausea ; Neurosurgery ; Pneumoencephalography ; Ventriculoperitoneal Shunt ; Visual Fields

PURPOSE: To confirm the adhesion and matrix formation of chondrocytes which were cultured on chitosan beads and to elucidate the difference between the porous chitosan beads and non-porous chitsan beads as scaffold for chondrocytes. MATERIALS AND METHODS: Chondrocytes isolated from rabbit articular cartilage were cultured in vitro on porous and non-porous chitosan bead for 2 weeks. Histochemical (H&E stain, Toluidin blue stain) and scanning electromicroscopic approaches were used to compare the differences between two groups. RESULTS: In both groups, adhesion and proliferation of chondrocytes were observed on scanning electron microscopy. which were more active in the porous chitosan bead group. On histochemical staining with toluidine blue, the porous chitosan bead group showed stronger metachromasia than that of the non-porous chitosan bead. CONCLUSION: It is concluded that both chitosan beads could work as an effective scaffold for culturing chondrocytes, and that porous chitosan bead may be a better scaffold than non-porous chitosan bead because of cavities in former bead.
Cartilage, Articular ; Chitosan* ; Chondrocytes* ; Microscopy, Electron, Scanning ; Tolonium Chloride

OBJECTIVE: To investigate the prevalence of chronic obstructive pulmonary disease (COPD) in stroke patients, and to assess the difference in swallowing function between stroke patients with COPD (COPD group) and stroke patients without COPD (control group). METHODS: The subjects included 103 stroke patients. They underwent the pulmonary function test and were assigned to either the COPD group or the control group. Their penetration-aspiration scale (PAS) scores and functional dysphagia scale scores were compared by performing a videofluoroscopic swallowing study. The intergroup differences in lip closure, bolus formation, mastication, and the oral transit time, laryngeal elevation, cricopharyngeal dysfunction, oronasal regurgitation, residue in pyriform sinus and vallecula, pharyngeal transit time, aspiration, and esophageal relaxation were also compared. RESULTS: Thirty patients were diagnosed with COPD. The COPD group showed statistically higher PAS scores (4.67+/-2.15) compared to the control group (2.89+/-1.71). Moreover, aspiration occurred more frequently in the COPD group with statistical significance (p<0.05). The COPD group also showed higher occurrence of cricopharyngeal dysfunction, albeit without statistical significance. CONCLUSION: This study shows that a considerable number of stroke patients had COPD, and stroke patients with COPD had higher risk of aspiration than stroke patients without COPD.
Deglutition Disorders ; Deglutition* ; Humans ; Lip ; Mastication ; Prevalence ; Pulmonary Disease, Chronic Obstructive* ; Pyriform Sinus ; Relaxation ; Respiratory Aspiration ; Respiratory Function Tests ; Stroke*

OBJECTIVES: It is well known that pneumoconiotic patients experience impairments of macrophage function, as well as poor penetration of drugs into the fibrotic nodules and the immune system. Resultantly, pneumonia is frequently involved in pneumoconiotic patients and its treatment is not easy. Therefore, we conducted a clinical evaluation of immunoglobulin G which is known to be effective in severe infectious diseases. METHODS: We randomly selected 45 pneumoconiotic patients with pneumonia and classified them into 2 groups. The experimental group (IgG group) was scheduled to receive antibiotics and IgG (5 g I.V./day for 7 days). The control group was treated with antibiotics alone. Sputum gram stain (counts of WBCs and microorganisms), body temperature, arterial oxygen tension, and counts of peripheral venous blood leukocytes and band neutrophils were used as markers to assess the response effect therapy at time periods of 0, 2, 4, 6, and 8 days after completion of therapy. We compared the clinical scores between the two groups. RESULTS: The experimental IgG treated group was composed of 27 patients, and the control group comprised 18 patients. There was no statistical differences between two groups in terms of age, pneumoconiotic profusion, impairment degree of pulmonary function, or frequency of pathogen isolation in the sputum before medication. The experimental IgG treated group showed lower clinical scores as compared with the control group (p=0.083). CONCLUSIONS: These results suggest that IgG infusion with antibiotics will have an effect on pneumonia therapy in pneumoconiosis patients that are under 60 years and exhibit simple pneumoconiosis.
Anti-Bacterial Agents ; Body Temperature ; Communicable Diseases ; Humans* ; Immune System ; Immunoglobulin G* ; Immunoglobulins* ; Leukocytes ; Macrophages ; Neutrophils ; Oxygen ; Pneumoconiosis ; Pneumonia* ; Sputum

PURPOSE: Myelodysplastic syndrome (MDS) in children needs to be elucidated in terms of clinical characteristics, natural history, the most effective treatment and prognostic factors, as the disease is very rare and its definition and classification has not reached a consensus by many physician. This study was aimed to describe the characteristics and the disease courses of Korean children with MDS, and to analyze the usefulness of prognostic scoring systems in the prediction of transformation to acute myelogenous leukemia (AML) and overall survival among subgroups. MATERIALS AND METHODS: Fourteen children with MDS seen at Chonnam University Hospital and additional 59 patients identified by the review of Korean literature were evaluated to define clinical characteristics and disease courses. Kaplan-Meier (K-M) probability of leukemic transformation and overall survival were plotted. FAB subtypes, subgroups by Boumemouth Scoring System (BSS), and International Prognostic Scoring System (IPSS) risk groups were compared to predict transformation to AML and overall survival. RESULTS: The median age of 14 patients was 36.5 months. The sex ratio was 3.7:1 (M: F). The frequency of FAB subtypes in Korea was similar to that of other countries except for higher proportion of RA (37%). K-M 3-yr probability of AML transformation and survival for Korean patients were 54.7%, and 49.8%, respectively. Although FAB system, BMS and IPSS were all capable of discriminating subgroups in the prediction of AML transformation and survival, they did not reach the significant level possibly due to small number of patients assigned to each subgroup. CONCLUSION: The clinical characteristics of Korean children with MDS were not different from those of other countries. This study showed the high rate of AML transformation and poor survival in children with MDS.
Child ; Classification ; Consensus ; Humans ; Jeollanam-do ; Korea ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes* ; Natural History ; Prognosis ; Sex Ratio

A case of epidermoid cyst in the cerebello-pontine angle, resulting in trigeminal neuralgia, is presented. There were no abnormal findings in the clinical and radiologic examination except the typical neuralgic pain. The tumor was found incidentally during posterior fossa exploration for neurovascular decom pression of the trigeminal nerve under diagnosis of primary trigeminal neuralgia. The patient was treated with only removal of the tumor.
Diagnosis ; Epidermal Cyst* ; Humans ; Trigeminal Nerve ; Trigeminal Neuralgia*

PURPOSE: The purpose of this study was to identify the complex course of the mandibular canal using 3D reconstruction of microCT images and to provide the diagram for clinicians to help them understand at the interforaminal region in Korean. MATERIALS AND METHODS: Twenty-six hemimandibles obtained from cadavers were examined using microCT, and the images were reconstructed. At both the midpoint of mental foramen and the tip of anterior loop, the bucco-lingual position, the height from the mandibular inferior border, the horizontal distance between two points, and position relative to tooth site on the mandibular canal were measured. The angle that the mental canal diverges from the mandibular canal was measured in posteriorsuperior and lateral-superior direction. RESULTS: The buccal distance from the mandibular canal was significantly much shorter than lingual distance at both the mental foramen and the tip of anterior loop. The mandibular canal at the tip of anterior loop was significantly located closer to buccal side and higher than at the mental foramen. And the mental canal most commonly diverged from the mandibular canal below the first premolar by approximately 50° posterior-superior and 41° lateral-superior direction, which had with a mean length of 5.19 mm in front of the mental foramen, and exited to the mental foramen below the second premolar. CONCLUSION: These results suggest that it could form a hazardous tetrahedron space at the interforaminal region, thus, the clinician need to pay attention to the width of a premolar tooth from the mental foramen during dental implant placement.
Bicuspid ; Cadaver ; Dental Implants ; Tooth ; X-Ray Microtomography

PURPOSE: The cortical bone thickness on the anterior region is important for achieving implant stability. The purpose of this study was to examine the thickness of the cortical and cancellous bones on the anterior region of the maxilla and mandible. MATERIALS AND METHODS: Twenty-five cadaver heads were used (16 male and 9 female; mean death age, 56.7 years). After the long axis of alveolar process was set up, it was measured in 5 levels starting from 2 mm below the cementoenamel junction (L1) at intervals of 3 mm. All data was analysed statistically by one-way ANOVA at the .05 significance level. RESULTS: The cortical bone thickness according to measurement levels in both the labial and lingual sides increased from L1 to L5, and the lingual side below L3 was significantly thicker than the labial side on the maxilla and mandible. In particular, the labial cortical bone thickness in the maxilla was the thinnest compared to the other regions. The cancellous bone thickness according to measurement levels increased from L1 to L5 on the maxilla, and on the mandible it was the thinnest at the middle level of the root. CONCLUSION: For implant placement on the anterior region, a careful evaluation and full knowledge on the thickness of the cortical and cancellous bone are necessary, therefore, these results may provide an anatomic guideline to clinicians.
Alveolar Process ; Axis, Cervical Vertebra ; Cadaver ; Head ; Humans ; Male ; Mandible ; Maxilla ; Tooth Cervix