A collodion baby is born with a tough, inelastic parchment-like membrane covering the whole body surface. As the meinbrane fissures and peels, a more characteristic ichthyosiform change is evident beneath the collodion membrane. Uncommonly, normal skin is found under it. We herein present two cases af collodion baby, which were confirmed as a sporadic case of lamellar ichthyosis and a case of lamellar exfoliation of the newborn, respectively, after long-term clinical observation. It is necessary that detailed genetical and molecular biological studies should be perforrned in order to elucidate the fur:damental, molecular changes that cause these dramatic cutaneous changes.
Collodion* ; Humans ; Ichthyosis, Lamellar ; Infant, Newborn ; Membranes ; Skin

After the spontaneous relief of initial symptoms by traumatic carotid-cavernous fistula (CCF), paradoxical worsening of patient's condition can be followed. We present a case of a 60-yr-old man whose audible bruit from a traumatic CCF had completely disappeared. A few days later, however, the patient had spontaneous intracerebral hematoma with cortical venous drainage. Complete obliteration of the fistula was achieved after embolization. When initial audible bruit in traumatic CCF disappears suddenly, cerebral angiography should be performed to differentiate venous hypertension by the hemodynamic changes of the cavernous sinus channels from spontaneous resolution of CCF.
Brain/pathology ; Carotid Arteries/pathology ; Carotid-Cavernous Sinus Fistula/*complications/*pathology/therapy ; Cerebral Angiography/methods ; Cerebral Hemorrhage, Traumatic/*etiology/therapy ; Humans ; Male ; Middle Aged ; Research Support, Non-U.S. Gov't ; Tomography, X-Ray Computed/methods

No abstract available.
Fever* ; Humans

The prediction of possibility which patient will develop vasospasm constitutes a further advance in the management of this complication. So the possible clinical risk factors predicting ischemic complication of subarachnoid hemorrhage were retrospectively investigated in patients with ruptured intracranial aneurysm. A comparative analysis of risk factors contributing to symptomatic vasospasm was carried out between 40 patients with symptomatic vasospasm as DID(Delayed Ischemic Neurologic Deficit) group and 52 patients without symptomatic vasospasm as Non-DID group, those who were selected among 349 cases of ruptured intracranial aneurysm admitted to department of neurosurgery at Presbyterian Medical Center, Jeon Ju for 6 years from August, 1982 to July, 1988. Peripheral WBC count, clinical grade, hematocrit, blood glucose level, EKG findings, age, sex and aneurysm location of admission failed to show a prognostic value as a factor developing delayed ischemic neurologic deficit in the patients. However a statistically significant rise in peripheral WBC count was observed at the beginning of clinical deterioration and also systolic blood pressure at admission were significantly higher in DID than Non-DID group. The results suggest that the increase of peripheral WBC count observed at the time of neurological deterioration of delayed onset and high systolic blood pressure at admission might be a risk factor for developing vasospasm.
Aneurysm* ; Blood Glucose ; Blood Pressure ; Electrocardiography ; Hematocrit ; Humans ; Intracranial Aneurysm ; Jeollabuk-do ; Neurologic Manifestations ; Neurosurgery ; Protestantism ; Retrospective Studies ; Risk Factors* ; Subarachnoid Hemorrhage*

Thirty-four patients with various intracranial lesions underwent the stereotatic surgery using the Pelorus system, which consists of integrated skull set, phantom and Arc adaptor, between September, 1987 and October, 1988.10 of 12 biopsies(83%) were diagnosed as 4 metastatic tumors, 3 glioblastoma multiforme, 1 cerebral infarction and 1 calcification. Fifteen patients with the spontaneous intracerebral hematoma and 2 with the abscess were treated successfully. Two patients with the malignant tumors underwent the stereotatic isotope implantation with I125. Only one case of transient hemiparesis among 34 procedures developed. From the results, the use of a simple interlocking plate system, rather than a bulky frame produce benifits evident during application with capabilities and accuracy of most other stereotactic system. It has offered the advantages of stereotaxis to a currently possible wide range of patients, which it can be used to diagnose and treat.
Abscess ; Cerebral Infarction ; Glioblastoma ; Hematoma ; Humans ; Paresis ; Skull

OBJECTIVE: To categorize the spinal cord injury level and American Spinal Injury Association (ASIA) impairment scale into functional classification of shooting and to give information about shooting sport for the disabled to medical staffs, and to remind importance of sports activities for rehabilitation. METHOD: Seventy nine spinal cord injured players were classified into each functional classes by two international classifier. During the classification process, demographic data such as age, sex, duration, injury type and questions including attitude toward disabled shooting or benefits or difficulties from shooting were collected by interview. RESULTS: Functional classes of players were closely related to injury level and ASIA impairment scale. Average duration of shooting experience of men (8.01 years) was significantly different from that of women (5.29 years)(p<0.05). Self-motivated (39.3%) and disabled friends (21.5%) were leading motive providers followed by medical staff (20.2%), other shooting player or coach (12.7%), family (6.3%). Promoting self confidence (32.5%) was number one benefit from shooting and followed by making friends (22.1%), increasing independence (18.3%), and increasing in social participation (12.7%). CONCLUSION: We report the functional classification result of spinal cord inured player and we found that sports activities promote social activities and help to develop self confidence.
Asia ; Classification* ; Female ; Friends ; Humans ; Male ; Medical Staff ; Rehabilitation ; Social Participation ; Spinal Cord Injuries ; Spinal Cord* ; Spinal Injuries ; Sports

No abstract available.
Humans

BACKGROUND AND AIMS: Endoscopic stent placement has become accepted palliative therapy for malignant biliary tract obstruction (MBTO). The main problem of plastic stent are the clogging or migration. The new self expandable super-elastic metallic coil stent (Endo-coilTM, Instent Inc.) is claimed to allow large lumen and prolong biliary-stent patency. In a prospective randomised trial, we compared the efficacy and frequency of stent dysfunction of EndocoilTMand plastic stent (PercuflexR, Microvasive Co.). METHOD: Between Aug. 1994 and Mar. 1995, we assigned 29 patients (21 males and 8 females, mean age 63 years) with unresectable MBTO due to cancer of bile duct (17), pancreas (6) periampullary (3), gallbladder (2) and perichoedochal LN (1). Thirteen of patients under-went EndocoilTMstents (24 Fr) and other 16 patients underwent plastic stents (12 Fr) insertion via transpapillary route. Successful insertion of stents was attained all cases and no serious complication occured. RESULTS: All patients with EndocoilTM stents and 11 (68%) patients with plastic stents were relieved completely from jaundice (T. bilirubon <3.0 mg/dl). There was no differences in decreasement of bilirubin between two groups after 7 days and 30 days after stents insertion. Median patency of the stents was significantly prolonged in patients with EndocoilTM stents compared with those with plastic stents(205 days vs 92 days). The stent dysfunction was noted 2 cases (15%) in EndocoilTM due to tumor ingrowth. In contrast, stent dysfunction was occured in 10 cases (62%) of plastic stents due to clogging (7 cases) and migration (3 cases). The patients' overall median survival was not different significantly between two groups (EndocoilTM250 days vs plastic 196 days). CONCLUSIONS: Both ndocoilTMand plastic stents offer effective bile drainage in MBTO. However EndocoilTM stents may be more effective for providing longer periods of drainage due to lower frequency of stent dysfuction than plastic stents.
Bile ; Bile Duct Neoplasms ; Biliary Tract* ; Bilirubin ; Drainage ; Female ; Gallbladder ; Humans ; Jaundice ; Male ; Palliative Care ; Pancreas ; Plastics* ; Prospective Studies ; Stents*

OBJECTIVE: To confirm the relationship between initial trunk performance and functional outcomes according to gait ability, and whether initial trunk performance is of predictive value in terms of functional prognosis in patients with stroke. METHODS: We reviewed 135 patients who suffered from stroke. Trunk performance of the patients was evaluated using the Trunk Impairment Scale (TIS). The patients were divided into 2 groups according to gait ability at initial stage of stroke. Correlation analyses were performed to assess relationship between initial TIS and functional outcomes. We also evaluated the relationship between initial TIS and the Korean version of Modified Barthel Index (K-MBI) subitems. Finally, stepwise multiple regression analyses were performed to examine the predictive validity of initial TIS and its subscales with functional outcomes. RESULTS: For both groups, initial TIS was correlated with K-MBI and Functional Ambulation Categories at 4 weeks after stroke; however, the relationship did not remain stable at 6 months in ambulatory patients. All K-MBI subitems, which were associated with trunk movement, as well as others about basic skills was correlated with initial TIS. Finally, when of subscales TIS, dynamic sitting balance (TIS-D) was included in by stepwise multiple regression analyses, high proportion of the explained variance was represented. CONCLUSION: The strong relationship between trunk performance and functional outcomes in patients with stroke emphasizes the importance of trunk rehabilitation. Indeed, an evaluation of a patient's initial TIS after stroke, especially TIS-D, could be helpful in predicting patient's functional prognosis.
Activities of Daily Living ; Gait ; Humans ; Postural Balance ; Prognosis* ; Rehabilitation ; Stroke* ; Walking

For many years it has been known that the dosage of thiopental required to induce anesthesia depends on the age of the patient, but this information ha resulted from clinical experience with the drugs rather than from planned study. In our study, to elucidate the influence of age on the size of the sleeping dosage of thiopental, 144 patients who underwent minor orthopedic and gynecological operations were studied. This patients had no evidence of a disease other than that scheduled for operation and were within normal values in hematologic examination, liver function and kidney function. Using a simple "yes" or "no" verbal command response, as sleeping response, to a single bolus of thiopental in mg/kg body weight, we have attemted to minimize uncontroliable factors such as cerebral perfusion, circulation time and plasma protein binding which would alter response to thiopental infusions continued to the end points. The results were as follows: 1) There was no statistical difference in verbal command response to thiopental according to age in age groups below 59 years. 2) Compared with age groups below 59 years, 60~79yrs, group failed to respond to the verbal command in 33% by 2.2mg/kg and 100% by above 2.6mg/kg.(p<0.05) 3) The mean time for loss of verbal command response after thiopental injection was 27.4+/-10.3 seconds and 80.4% of theses patients lost lid reflex with a mean time of 41.7+/-9.1 seconds after thiopental injection. 4) All groups showed statistically non-significant alterations of systolic blood pressure and heart rate after injection of thiopental.
Anesthesia ; Blood Pressure ; Body Weight ; Heart Rate ; Humans ; Kidney ; Liver ; Orthopedics ; Perfusion ; Plasma ; Protein Binding ; Reference Values ; Reflex ; Thiopental*