Since opening of the Yeungnam University Hospital in March 1983 till the end of 1986, total 156 cases of brain atrophy and encephalopathy (control) diagnosed at the neurology department were investigated, adopting C.T. criteria of brain atrophy. Among the 156 only 77 cases had available C.T. films. Of the 77,35 cases were normal (control) and 42 had brain atrophy. The following results are obtained: 1. A new C.T. criteria of brain atrophy and its degree were devised. (Table 8.9) 2. As the age increased, number of brain atrophy cases increased. 3. Degree of EEG abnormalities were not parallel with the degree of brain atrophy. 4. The most frequent EEG abnormalities with or without brain atrophy were moderate abnormalities. 5. The EEG abnormalities were improved with treatment in most of the cases. 6. The group with suspected organic brain lesions had 69% cases of brain atrophy, whereas the group with only headache or dizzines had 57% of no atrophy. 7. There exists a clinical entity of "Cryptogenic Brain Atrophy". (Park) 8. Recent literatures of Brain Atrophy were reviewed.
Atrophy* ; Brain* ; Electroencephalography ; Headache ; Neurology

No abstract available.

Laryngoscopy and endotracheal intubation in patients undergoing general anesthesia causes hypertension and tachycardia with concomitant increases in plasma catecholamine concentration. These transient stress responses are greatly exaggerated in patients with hypertension and cardiovascular disease and can lead to cardiac arrhythmia, pulmonary edema, cardiac failure and cerebral hemorrhage. Therefore, several attempts have been made to attenuate the hypertensive and tachycardiac responses, but none have been satisfactory. This study was designed to evaluate verapamil or propranolol as a valuable adjuvant in attenuating hemodynamic responses to tracheal intubation in 53 patients with hypertension. They were randomly divided into three groups according to premedication used. Group 1 (n=19) was without pretreatment, and group 2 (n=18) and group 3 (n=16) were pretreated with verapamil (0.1 mg/kg) iv and verapamil (0. 1 mg/kg)-propranolol (0.01 mg/kg) mixture iv, respectively, just prior to the intubation. Mean arterial pressure (MAP) and heart rate (HR) were measured, just prior to intubation (baseline), after induction, and at 1, 2, 3, 4, 5 and 7 minutes following intubation. The results were as follows. 1) In the control group. tracheal intubation produced increases in MAP (27% average increase from baseline) and heart rate (31% increase) at one minute after the procedure. 2) In group 2, verapamil abolished pressor response to tracheal intubation, but did not affect tachycardiac responses. 3) In group 3, the verapamil-propranolol mixture attenuated both pressor and tachycardiac responses to tracheal intubation. 4) The rate-pressure product increased after tracheal intubation by 61% and 31% in group 1 and group 2, respectively, but it remained unchanged in group 3. These findings suggest that intravenous verapamil-propranolol mixture is a valuable adjuvant in attenuating hypertensive and tachyeardiac responses to tracheal intubation.
Anesthesia, General ; Arrhythmias, Cardiac ; Arterial Pressure ; Cardiovascular Diseases ; Cerebral Hemorrhage ; Heart Failure ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy* ; Plasma ; Premedication ; Propranolol* ; Pulmonary Edema ; Tachycardia ; Verapamil*

Ibuprofen is currently widely prescribed in the pediatric population and has potentially very severe adverse events, even in the absence of an overdose. We treated a four year-old male who presented with severe jaundice, skin rash, xanthoma, eosinophilia and decreased hepatic function after overuse of ibuprofen for fever control. The liver biopsy revealed the vanishing bile duct syndrome. We report a case of vanishing bile duct syndrome associated with Ibuprofen overuse for the first case in Korea.
Bile Ducts* ; Bile* ; Biopsy ; Eosinophilia ; Exanthema ; Fever ; Humans ; Ibuprofen* ; Jaundice ; Korea ; Liver ; Male ; Xanthomatosis

Carbamazepine is widely used to manage of seizures and symptomatic treatment of trigeminal neuralgia and central pain. We experienced two cases of exceedingly rare but potentially fatal side effects following carbamazepine administration. One traumatic brain injured patient developed pancytopenia 3 weeks after beginning to take carbamazepine for prophylactic management of seizure and the other C6 incomplete spinal cord injured patient receiving carbamazepine for the management of central pain sequentially developed syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 1 week after administration. Because of more frequent indications of carbamazepine, these side effects must be borne in mind and cautious administration will be desirable.
Brain ; Carbamazepine* ; Humans ; Inappropriate ADH Syndrome* ; Pancytopenia* ; Seizures ; Spinal Cord ; Trigeminal Neuralgia

BACKGROUND: Staphylococci are major nosocomial pathogens and reveal an increase in resistant strains such as methicillin-resistant Staphylococcus aureus. For treatment of infection and prevention of dissemination, rapid and reliable identification methods are required but the conventional bacterial identification and susceptibility tests require at least 24 hours. In this study, we evaluated the polymerase chain reaction (PCR) of the antibiotic resistant genes by comparing with the disk diffusion susceptibility test for the detection of resistance to penicillin, oxacillin and gentamicin. METHODS: A hundred-thirty-five staphylococci including 95 S. aureus and 40 S. epidermidis were from clinical specimens from June to December 2000. Antimicrobial susceptibility tests were done using the NCCLS disk diffusion method. PCRs were performed with primer sets specific for mecA, blaZ and aac(6')-aph(2"). The species-specific PCR was also used to identify S. aureus and S. epidermidis. RESULTS: All four penicillin-susceptible staphylococci were negative for blaZ and 108 of 131 penicillin resistant-staphylococci were positive for blaZ. The concordance rate for PCR of the blaZ gene and penicillin disk diffusion test was 83.0%. 110 of 115 oxacillin-resistant staphylococci were positive for mecA and all five mecA negative oxacillin-resistant strains were positive for blaZ and have the phenotype beta-Lactamase hyperproducer. One of the oxacillin-susceptible S. aureus was positive for mecA. The concordance rate of PCR for the mecA gene and oxacillin disk diffusion test and those of the aac(6')-aph(2") gene and gentamicin disk diffusion test was 95.6% and 97.8%, respectively. CONCLUSTIONS: The disk diffusion tests misdiagnosed 25% of the mecA negative staphylococci as methicillin-resistant staphylococci (MRS) and lost one of the mecA positive strain. We considered that the detection of the mecA and blaZ gene using the PCR was more useful than the disk diffusion test for detection of methicillin-resistant staphylococci.
beta-Lactamases ; Diffusion ; Gentamicins ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxacillin ; Penicillins ; Phenotype ; Polymerase Chain Reaction*

Multiple gastric caner, now considered to be a sort of multiple primary cancer by Moertel's classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Although its incidence is rare and it has never been reported in Korea yet, the report of multiple gastric cancer is increasing with lengthened life survival and improved diagnostic method. We recently experienced two cases of triple gastric cancer, the one in 53-years-old male who had well differentiated adenocarcinoma(EGC IIb+c) on antrum, poorly differentiated adenocarcinoma on cardia and moderately differentiated adenocarcinoma on mid-body, and the other in 65-years-old female who had two poorly differentiated adenocarcinoma on cardia and anterior wall of low body and moderately differentiated adenocarcinoma (EGCIIc) on posterior wall of low body. Triple gastric cancer is rare, so we reported 2 cases of triple gastric cancer.
Adenocarcinoma ; Cardia ; Classification ; Female ; Humans ; Incidence ; Korea ; Male ; Stomach ; Stomach Neoplasms*

BACKGROUND: Apoptosis, also known as programmed cell death, is under genetic control and is mediated by apoptosis-specific genes, certain oncogenes and tumor suppressor genes. Caspase 3, a group of cystein proteases, is involved in the induction of apoptosis and has been considered to be correlated with apoptosis. Therefore, we tried to define whether caspase 3 is expressed in gastric adenoma and carcinoma, and correlated with apoptosis. METHODS: The apoptotic index and caspase 3 and Ki-67 immunoreactivity were observed in 25 gastric adenomas, 31 early gastric carcinomas (EGC) and 64 advanced gastric carcinomas (AGC) by in situ labelling and immunohistochemistry. RESULTS: The mean number of apoptotic bodies and caspase 3 immunoreactivity were significantly increased from adenoma through EGC to AGC. Ki-67 immunoreactivity was more increased in AGC than in adenoma and EGC. And the number of apoptotic bodies were positively correlated with caspase 3 and Ki-67 immunoreactivity, and caspase 3 immunoreactivity was negatively correlated with Ki-67 immunoreactivity even though they were statistically insignificant. CONCLUSIONS: Our results suggest that caspase 3 activation is important for inducing apoptosis, and both caspase 3 and apoptosis are increased along the tumor progression.
Adenoma* ; Apoptosis* ; Caspase 3* ; Caspases ; Cell Death ; Genes, Tumor Suppressor ; Immunohistochemistry ; Ki-67 Antigen ; Oncogenes ; Peptide Hydrolases ; Stomach

We report a case of paraplegia without neurologic deficit of upper extremities following cervical epidural catheterization using air during the loss of resistance technique. A 41-year-old woman diagnosed with complex regional pain syndrome had upper and lower extremity pain. A thoracic epidural lead was inserted for a trial spinal cord stimulation for treating lower extremity pain and cervical epidural catheterization was performed for treating upper extremity pain. Rapidly progressive paraplegia developed six hours after cervical epidural catheterization. Spine CT revealed air entrapment in multiple thoracic intervertebral foraminal spaces and surrounding epidural space without obvious spinal cord compression before the decompressive operation, which disappeared one day after the decompressive operation. Her paraplegia symptoms were normalized immediately after the operation. The presumed cause of paraplegia was transient interruption of blood supply to the spinal cord through the segmental radiculomedullary arteries feeding the spinal cord at the thoracic level of the intervertebral foramen caused by the air.
Adult ; Arteries ; Catheterization* ; Catheters* ; Epidural Space ; Female ; Humans ; Lower Extremity ; Neurologic Manifestations ; Paraplegia* ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Ischemia ; Spinal Cord Stimulation ; Spine ; Upper Extremity

OBJECTIVE: The purpose of this study is to examine radiological adjacent segment degeneration (ASD) and clinical results after two levels percutaneous pedicle screw fixation. METHODS: From 2007 to 2009, 34 patients who underwent percutaneous pedicle screw fixation on L3-4-5 or L4-5-S1 for lumbar degenerative disorders were selected. According to the presence of radiological ASD, ASD group and non-ASD group were compared for clinical results and radiologic results such as total lordotic angle (TLA), segmental lordotic angle (SLA) via lumbar X-rays during follow up periods. Furthermore, we compared pre-operative degree of disc degeneration at adjacent segment between two groups via MRI. RESULTS: The mean follow-up period and mean age were 27.38+/-9.45 months and 59.21+/-12.73 years. ASD group were 7 patients, and non-ASD group were 27 patients. The mean age of the ASD group (67.40+/-4.81) was significantly older than that of the non-ASD group (57.46+/-13.18). Pre-operative disc degeneration of cranial adjacent segment in ASD group were 6 patients (25.9%), whereas that in non-ASD group were 4 patients (14.8%), showing that preoperative disc degeneration was significantly more severe in the ASD group. CONCLUSION: Percutaneous pedicle screw fixation is favorable technique to prevent ASD for two levels fusion, however, when the patient is old or the preoperative disc degeneration of the adjacent segment is severe, there is the risk of postoperative ASD, and thus special attention should be paid during the follow-up period.
Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; Spinal Fusion