BACKGROUND: Intermediate myasthenia syndrome(IMS) is thought to have clinical importance because it may cause sudden respiratory failure during the recovery phase of a cholinergic crisis of organophosphate poisoning. We designed this study to identify the prevalence, the inducing agent, clinical predictor, and the proposed treatment of IMS. METHODS: Patients who had admitted with the diagnosis of acute organophosphate poisoning from 1992 to 1998 at two teaching hospitals were enrolled in this study. We selected the cases of IMS based on a review of medical records using modified He's criteria. RESULTS: Twelve(12) out of 110 patients with acute organophosphate poisoning were diagnosed for a prevalence at 10.9%. The drug inducing IMS were identified as dichlorvos, fenthion, EPN, methidathion, and phosphamidon. The occurrence of IMS was not related to either the initial treatment with atropine and pralidoxime, or the level of serum cholinesterase. Complications were pneumonia, sepsis, pancreatitis, and pseudomembranous colitis, etc. Eleven(11) patients were discharged without sequelae, and one patient was discharged as a hopeless care. CONCLUSION: This study suggests that IMS is not rare, so close observation is required to detect IMS in organophosphate-poisoning patients. Also, more studies are required to find predictors and treatments.
Atropine ; Cholinesterases ; Diagnosis ; Dichlorvos ; Enterocolitis, Pseudomembranous ; Fenthion ; Hospitals, Teaching ; Humans ; Medical Records ; Organophosphate Poisoning ; Pancreatitis ; Phosphamidon ; Pneumonia ; Prevalence ; Respiratory Insufficiency ; Sepsis

No abstract available.
Mediastinitis*

No abstract available.
Mediastinitis*

Twenty four cases of acromioclavicular seperation were admitted and treated at Severance Hospital, Yonsei University from October 1964 to September 1975. Of these, six cases were subluxations and eighteen cases were dislocations. Acromioclavicular joint injury is relatively rare and there are many methods of treatment. In our cases, all the six subluxations and seven of the eighteen dislocations were treated by conservative method, while eleven of the eighteen dislocations were treated by operative method. The results of all the subluxated cases were satisfactory. In cases of dislocation, the results were considerably better in operated cases with Weavers method.
Acromioclavicular Joint ; Dislocations ; Methods

OBJECTIVES: This study was aimed to investigate the differences in intelligence and neuropsychological test findings between patients with obsessive-compulsive disorder (OCD) and normal controls, and to find out brain functions. METHODS: To examine the brain functions, Halsted Reitan neuropsychological test, computerized neuropsychological test, Wechsler Memory scale and K-WAIS were applied. Subjects of this study consisted of 12 patients with OCD and 17 normal controls who were matched for age, handedness and education year. RESULTS: The verbal intelligence of OCD was significantly higher than that of normal controls. But there was no significant difference in total and performance intelligence between groups. The total time of tactual performance test in OCD was significantly delayed than that in normal controls. Also the visual recall or Wechsler memory scale in OCD was more impaired than that in normal controls. CONCLUSION: These findings support that visual-spatial memory, which is related to basal ganglia, is impaired in OCD.
Basal Ganglia ; Brain ; Education ; Functional Laterality ; Humans ; Intelligence* ; Memory ; Neuropsychological Tests* ; Obsessive-Compulsive Disorder*

No abstract available.
Humans ; Prothrombin Time* ; Prothrombin*

This study is concerned with a comparison of lower tibial and fibular epiphyseal growth and deformities of the ankles in normal and paralysed children. The data were based on 87 children with residual paralysis due to poliomyelitis an 20 non-paralysed children who were admitted to Severance Hospital and Sam Yook Children's Rehabilitation Center. The difference in level between the lower tibial and fibular ends and between the lower epiphysial lines of the tibia and fibula in X-rays of the ankles were measured in order to investigate the growth pattern of the lower tibio-fibular epiphysis. The difference between the level of the lower ends of the fibula was an avergage of 15.3mm in the normal and 6.2mm in paraysed children. Thus the fibular ends in paralysed limbs was an average of 9.1mm less than that of the normal. The difference between the level of the lower epiphyseal lines of the tibia and the fibula was an average of 13.7mm in normal and 5.5mm in paralysed children. Therefore, the level of the fibular epiphyseal lines in paralysed limbs was sn average of 8.2mm less than that of normal. In paralysed limbs, the lower tibial epiphyses showed lateral epical wedge shaped deformities. The tilting angle of the ankles and the wedging angle of the of the lower tibial epiphyses were measured in erder to investigate the degree of deformities of the ankles and the lower tibial epiphyses in paralysed limbs. The tilting angle of the ankles averaged 1.3° in normal and 7.6° in paralysed limbs. The wedging angle of the lower tibial epiphyses averaged 3.7° in normal and 11.5° in paralysed limbs. In paralysed children, muscle strength examination was performed to clarify the relationship between the degree of growth disturbance and the severity of the muscular paraysis. This lead us to conclude that: 1. In paralysed children, the growth disturbance of the lower fibular epiphyses was greater than that of the lower tibial epiphyses. 2. The difference of the growth disturbance between the tibial and fibular epiphyses was not due to muscle imbalance of the foot invertors and evertors but to muscle weakness. 3. In paraysed children, the shape of the lower tibial epiphyses changed to a wedge shape, a deformity which might be considered secondary to growth disturbance of the fibula. 4. In paralysed children, the lower tibial ends were tilted upward and laterally. This was thought to be the cause of valgus deformities of the ankles. 5. The relationship between the degree of muscle paralysis and the deformities of the ankles was not proved in this study.
Ankle ; Child ; Congenital Abnormalities ; Epiphyses ; Extremities ; Fibula ; Foot ; Humans ; Muscle Strength ; Muscle Weakness ; Paralysis ; Poliomyelitis ; Rehabilitation Centers ; Tibia

BACKGROUND: Postoperative morbidity and mortality in destroyed lung are relatively high. We tried to identify the prognostic factors affecting postoperative morbidity and mortality in destroyed lung through a retrospective study. MATERIAL AND METHOD: The retrospective study was undertaken in 112 patients who had undergone pneumonectomy or pleuropneumonectomy for destroyed lung at Severance Hospital from 1970 to 2000. We analyzed the correlation between postoperative morbidity and mortality and etiology, duration of disease, preoperative FEV1, presence or absence of preoperative empyema, operation timing, the side of operation, duration of operation, and operation type. RESULT: There were 55 men and 57 women, aged 20 to 81 years (mean 44 years). Etiologic diseases were tuberculosis in 86 patients(76.8%) including tuberculous empyema in 20 and tuberculous bronchiectasis in 4, pyogenic empyema in 12(10.7%), bronchiectasis in 12(10.7%), and lung abscess in 2(1.8%). Postoperative morbidity were 25%(n=28) and postoperative mortality was 6%(n=7). The presence of preoperative of empyema(p=0.016), pleuropneumonectomy(p=0.037) and preoperative FEV1 of less than 1.75 L(P=0.048) significantly increased the postoperative morbidity. If operation time was less than 300min, postoperative morbidity(p=0.002) and mortality(p=0.03) were significantly low. CONCLUSION: Postoperative morbidity and mortality in destroyed lung were acceptable. Postoperative morbidity and mortality were significantly low when operation time was less than 300 min. Preoperative existence of empyema, pleuropneumonectomy and preoperative FEV1 of less than 1.75 L significantly increased postoperative morbidity.
Bronchiectasis ; Empyema ; Empyema, Tuberculous ; Female ; Humans ; Lung Abscess ; Lung* ; Male ; Mortality* ; Pneumonectomy ; Retrospective Studies ; Tuberculosis

We report a case of reversible encephalopathy syndrome in a 16-year-old girl with acute myelogenous leukemia (AML), who is undergoing during consolidation chemotherapy composed of BH-AC (N4-behenoyl-1-beta-D-arabinofuranosyl cytosine) and idarubicin. On the 6th day of chemotherapy, she was in a drowsy state following generalized tonic clonic seizure lasting 20 minutes. MR images revealed extensive cortical and subcortical white matter brain edema. Alertness returned over the 24 hr following by the discontinuation of BH-AC and intravenous administration of diphenylhydantoin, although she complained of intermittent headaches and visual disturbance. She gradually recovered from these symptoms during subsequent 7 days. Previously noted abnormal signal intensities have nearly disappreared on follow-up MRI obtained on the 22nd day after the first seizure. She was discharged without any neurologic sequela. This case suggests that BH-AC, a derivative of cytosine arabinoside (1-beta-D-arabinofuranosylcytosine) could be a cause of reversible encephalopathy syndrome.
Adolescence ; Antineoplastic Agents/therapeutic use ; Antineoplastic Agents/adverse effects* ; Brain/radiography ; Case Report ; Cytarabine/therapeutic use ; Cytarabine/analogs & derivatives* ; Cytarabine/adverse effects ; Female ; Human ; Leukemia, Myelocytic, Acute/drug therapy ; Leukemia, Myelocytic, Acute/complications* ; Magnetic Resonance Imaging ; Seizures/radiography* ; Seizures/chemically induced

BACKGROUND: Calcium antagonists are highly effective agents for lowering high blood pressure and play a very important role in the treatment of Patient with ischemic heart disease and various other cardiovascular disorder. Manidipine, a dihydropyridine-type ccalcium channel blocker, is a potent relaxant of the arteriolar smooth muscle. We studied ths new calcium channel blocker to evaluated the efficacy and safety in patients with essectial hypertension. METHODS: Twenty patients(ten women and ten men;range of age, 30-66 years old)with mild-to-moderate essential hypertension were enrolled in this study. After a placebo run-in phase of two weeks duration, 5mg-20mg manidipine once daily orally was administered for eight weeks. RESULTS: 1) At the end of 8 weeks of manidipine therapy, systolic and diastolic blood pressure were significantly reduced from 160.1+/-11.8/105.5+/-5.1mmHG in sitting, 160.1+/-12.1/104.5+/-5.4mmHG in supine, 157.1+/-17.0/104.1+/-5.3mmHg in standing to 128.4+/-10.1/85.2+/-5.7mmHg in sitting, 129.1+/-10.2/84.2+/-5.9mmHg in supine, 128.1+/-12.8/86.7+/-5.9mmHg in standing(p<0.01). 2) The pulse rate did dnot change significantly. 3) The reduction of mean systolic and diastolic blood pressur at the end of 8 weeks were 31.5+/-14.5/20.3+/-7.4mmHg in sitting. 4) There was no serious side effect except mild symptom, mild headache(6 casem 30%) and facial flushing(1 case, 5%). CONCLUSION: These results indicate that manidipine is an effective and safe antihypertensive agent in the treatment of mild and moderate essential hypertension.
Blood Pressure ; Calcium ; Calcium Channels ; Female ; Heart Rate ; Humans ; Hypertension* ; Muscle, Smooth ; Myocardial Ischemia