Statistical observation was made on 968 out-patients and 74 in-patients in the Department of Urology Han Ill Hospital, during the period from April 1, 1968 to Mar. 31, 1969.
Humans ; Outpatients ; Urology*

No abstract available.
Urology*

85 cases of neurosyphilis were observed in Seoul National University Hospital over 6-year period (1979-1984). They were analyzed with respect to clinical symptoms and signs in individual types, serological data in both blood and CSF, changes of cytochemical compositions in CSF, and other significant findings. And some coparisons with other reports were made. They ranged from 22 to 66 years in age with the peak incidence in the forties (41%). Ratio of male to female was observed to be 4.3:1. There were 27 cases of asymptomatic neurosyphilis (NS) (32%), 14 cases of tabes dorsalis (16%), 18 cases of general paresis (21%), 2 cases of taboparesis (2%), 7cases of vascular NS (8%), 6 cases of meningeal NS (7%), 4 cases of syphilitic eight nerve involvement (5%), 4 cases of late syphilitic ocular involvement including optic atrophy (5%), and 3 cases of spinal form (4%). Except in 4 self-referral cases, alimentary system symptoms or illnesses were the main prolbems in asymptomatic neurosyphilitics (48%). Most symptomatic cases had the similar clinical pictures as described in the previous reports but some cases appeared to be combined with symptoms and signs of different types. In tabes dorsalis, patients presented paresthesia and hypoactive DTRs in lower limbs as the most frequent features. According to predominant manifestations, there were 4 cases of dementic form and 14 cases of psychotic form in general paresis but in most cases both features overlapped each other. In 8 cases of general paresis brain CT scans were performed, which revealed diffuse cerebral atrophy in five. Focal abnormalities of vascular NS were most frequently found in temporal areas (4 in 7 cases). Meningeal irritation signs were observed only in one among 6 cases 6 meningeal NS. All cases of eighth nerve involvement showed sensorineural hearing loss at high-tone level. Compared with TPHA, which was used as a criterion for the patient selection, VDRL reactivity was 98% in serum and 49% in CSF. It is notable that as for general paresis and meningeal NS, higher reactivity and elevated titers of CSF VDRL were associated with increase of cells and total protein in CSF, suggesting higher disease activity in both types. Unlike those from other countries, the domestic studies including this report show that general paresis occupies a relatively higher proportion than tabes dorsalis in Korea.
Atrophy ; Brain ; Digestive System ; Female ; Hearing Loss, Sensorineural ; Humans ; Incidence ; Korea ; Lower Extremity ; Male ; Neurosyphilis* ; Optic Atrophy ; Paresthesia ; Patient Selection ; Seoul ; Tabes Dorsalis ; Tomography, X-Ray Computed

BACKGROUND: Central nervous system dysfunction continues to be a major cause of morbidity after aorta and cardiac surgery under cardiopulmonary bypass (CPB). Pupillary reflexes are important component of the neurologic examination. The purpose of this study was to evaluate how the pupil reacts during hypothermic CPB under fentanyl anesthesia and its relation with postoperative neurologic deficits. METHODS: Fourteen patients undergoing ascending aortic dissection or aneurysm repair surgery under profound hypothermic CPB and circulatory arrest were enrolled. Pupil size and light reflex were evaluated at varying stages of CPB and temperatures. Temperatures were measured at different sites of perfusate, nasopharynx and rectum. Postoperatively neurologic assessments were performed to compare with the pupillary signs. RESULTS: Anesthetic induction with fentanyl decreased pupil size to pinpoint. Pupil dilated progressively under hypothermic CPB reaching fully dilated size at profound hypothermia. Rewarming returned the pupil to original size. Nasopharyngeal temperature correlated well with pupil size during cooling and rewarming. Light reflex was absent at any stage or temperature after anesthetic induction. Seven patients showed insignificant anisocoria and two died of other causes than neurologic deficit. One patient who was not in the anisocoria group exhibited delirium. CONCLUSIONS: Profound hypothermic CPB under fentanyl anesthesia dilates the pupil to a maximum size without light reflex overwhelming narcotic effect. Fully dilated pupil does not denote neurologic damage.
Anesthesia* ; Aneurysm ; Anisocoria ; Aorta ; Cardiopulmonary Bypass* ; Central Nervous System ; Delirium ; Fentanyl* ; Humans ; Hypothermia ; Narcotics ; Nasopharynx ; Neurologic Examination ; Neurologic Manifestations ; Pupil* ; Rectum ; Reflex ; Reflex, Pupillary ; Rewarming ; Thoracic Surgery

The discovery of C-T scan have facilitated the detection of post-traumatic hydrocephalus cases. Of those, 6 cases of hydrocephalus of non-parenchymatous in origin, in other words, normal pressure hydrocephalus were presented. They were diagnosed by repeated brain C-T and cisternography with Iodine 131-labeled human serum albumin. The symptomatology, diagnosis procedure and surgical results were discussed. Followings are the results. 1) The RIHSA cisternogram taken after 6 hrs, 12 hrs, 24 hrs and 48 hrs from lumbar injection showed abnormal features in all cases. 2) Surgical results were thought that there is much correlation with the age and improvement of mental impairments were seen, more or less, in all cases and improvement of gait disturbance and incontinence were seen in 5 cases and 4 cases respectively. 3) In those who sustained severe head injury with delayed recovery, the authors think, repeated check of brain C-T and cisternography is necessitated to perform the V-P shunt or V-A shunt to relieve the symptomatology of normal pressure hydrocephalus.
Brain ; Cerebrospinal Fluid Pressure ; Craniocerebral Trauma ; Diagnosis ; Gait ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure* ; Iodine ; Serum Albumin ; Ventriculoperitoneal Shunt

This is a case report and review of literature that deals with hemifacial microsomia corrected by costochondral graft, Lefort I osteotomy and bilateral intraoral sagittal split ramus osteotomy. Patient, 23 years old female, had visited to treat the esthetic problem due to a deviation of jaw. On the basis of clinical and radiographic examinations, she was diagnosed as hemifacial microsomia. First, costochondral graft was performed to bridge the defect between glenoid fossa and body of mandible. After 11 months,. Patient was performed a Lefort I osteotomy and bilateral intraoral sagittal split ramus osteotomy to create a symmetric jaw. Patient was satiesfied with final esthetics and there have been no evidence of infection ill now.
Esthetics ; Female ; Goldenhar Syndrome* ; Humans ; Jaw ; Mandible ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Transplants

No abstract available.
Child* ; Humans

PURPOSE: To evaluate the effect of panretinal photocoagulation (PRP) on visual acuity, visual field and subjective symptoms in very severe non-proliferative diabetic retinopathy (NPDR) patients. METHODS: Forty eyes of 20 patients with NPDR were evaluated. Complete ophthalmic examination, visual acuity, Humphrey field test and interview of questionnaire were evaluated before, 2 and 8 weeks after PRP. RESULTS: The mean corrected visual acuity was not significantly changed from before PRP to 2, 8 weeks after PRP (p>0.05). Visual field deteriorated in 2 weeks and then improved in 8 weeks after PRP, however the recovery did not reach to pre-PRP level (p<0.01). Number of significantly lowered retinal sensitivity test points in the central 0~15degrees field (p<0.01) was not significantly different between before and 8 weeks after PRP (p>0.05). Thoses number decreased in 15~30degrees field (p<0.01) following PRP. In spite of deterioration of visual field after PRP, subjective symptoms was rarely noted. CONCLUSIONS: Our result suggest that early PRP may be advisable for very severe NPDR patients to prevent the development of possible visual field deterioration following PRP.
Diabetic Retinopathy ; Humans ; Light Coagulation ; Surveys and Questionnaires ; Retinaldehyde ; Visual Acuity* ; Visual Fields*

BACKGROUND: This study was undertaken in surgical patients to evaluate the comparative analgesic, hemodynamic, sedative effects of clonidine or epinephrine when added to lidocaine solution in patients receiving epidural anesthesia. METHODS: The effects of clonidine were assessed in 38 men scheduled for knee surgery. Patients received 20 ml of 2% lidocaine with clonidine 50 microgram (group C50, n=11), with clonidine 100 microgram (group C100, n=10), with epinephrine 100 microgram (group E, n=9), or plane (group L, n=8) via epidural catheter. Sensory anesthetic level was assessed by pinprick and the time to L1 analgesia and the maximum number of segments of analgesia were checked. Systolic blood pressure (BP) and heart rate (HR) were measured at 2, 5, 10, 15, 20, 30, 45, 60 min after epidural injection. Sedation was defined on a scale of 0 to 3. The sedation score was checked at 5-minute intervals after epidural injection. Samples of venous blood were obtained before and 5, 10, 20, 30, 45, 60, 90 min after epidural injection. RESULTS: No significant differences in the time of L1 analgesia and number of segments of analgesia found at any observation period among the four groups of patients. There was no decrease in BP and no differences among four groups. HR decreased significantly in patients given clonidine, but did not change in those given lidocaine plain or with epinephrine. Significant differences were also observed in sedation scores between clonidine group and group L or E. Maximal plasma lidocaine concentrations in group C100 were similar to the group C50 and L, but were significantly greater than those in group E (p<0.05). CONCLUSIONS: These results indicate that the addition of clonidine to lidocaine for epidural anesthesia provides a sedative effect and relatively stable hemodynamics, and that clonidine in a concentration 1:200,000 in contrast to 1:200,000 epinephrine, tends to increase rather than to suppress the plasma lidocaine concentration.
Analgesia ; Anesthesia, Epidural* ; Blood Pressure ; Catheters ; Clonidine* ; Epinephrine ; Heart Rate ; Hemodynamics ; Humans ; Hypnotics and Sedatives ; Injections, Epidural ; Knee ; Lidocaine* ; Male ; Plasma

Alopecia of a scalp shows various shapes and extents of hair loss, from a small round patch to polymorphous patches or total global alopecia. But alopecia of a linear shape is very rare. Only a few such cases have currently been reported in the medical literature. We recently had the chance to observe and treat two cases of linear alopecia that developed on the occipital scalp. The lesions themselves were like alopecia areata that shows a smooth bald area without any abnormality except the hair loss, but histopathologically, the lesions were compatible with lupus erythematosus profundus.
Alopecia ; Alopecia Areata ; Hair ; Scalp