Intracerebral hemorrhage is the most serious complication of cerebral arteriovenous malformations (AVM). To identify angiographic characteristics of AVM which correlate with a history of hemorrhage, we retrospectively analyzed angiographic findings of 25 patients with AVM. Nine characteristics were evaluated; these include nidus size, location, arterial aneurysm, intranidal aneurysm, angiomatous change, venous drainage pattern, venous stenosis, delayed drainage and venous ectasia. These characteristics were correlated with hemorrhage, which was seen in 18 (72%) patients of CT or MR images. Venous stenosis (P<.05) and delaved venous drainage (P<.05) well correlated with a history of hemorrhage. Arterial aneurysm and intranidal aneurysm also had a tendency hemorrhage although they did not prove to be statistically significant. Detailed analysis of angiographic finding of AVM is important for recognition of characteristics which are related to hemorrhage and may contribute to establishing a prognosis and treatment planning.
Aneurysm ; Cerebral Hemorrhage ; Constriction, Pathologic ; Dilatation, Pathologic ; Drainage ; Hemorrhage* ; Humans ; Intracranial Arteriovenous Malformations* ; Prognosis ; Retrospective Studies

Tuberous sclerosis is an autosomal dominant disorder of cellular differentiation that affect the brain, skin, heart, kidney and other organs. We experienced three cases of tuberous sclerosis that affect multiple organs in mother and two daughters. We report these cases with brief review and related literatures.
Brain ; Heart ; Humans ; Kidney ; Mothers* ; Nuclear Family* ; Skin ; Tuberous Sclerosis*

No abstract available.
Asphyxia* ; Evoked Potentials, Auditory* ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature* ; Parturition*

PURPOSE: To report a case of multiple endocrine neoplasia type 2B (MEN 2B) diagnosed early based on conjunctival neuroma. CASE SUMMARY: A 15-year-old female presented with red eye and conjunctival mass in both eyes. A 5 x 5 mm-sized yellowish conjunctival mass adjacent to the limbus was observed in her right eye and a 3 x 3 mm-sized mass in her left eye. Excisional biopsy was performed and the patient was diagnosed with conjunctival neuroma. Other abnormalities were not found on the ophthalmic examination, but she had characteristic appearances such as thickened upper eyelid, mild telecanthus and nodular edematous upper lip. She was transferred to the Endocrinology Department for systemic evaluation in consideration of multiple endocrine neoplasia. Abdominal pelvic computed tomography and a 24-hr urine collection analysis showed asymptomatic pheochromocytoma. Thyroid ultrasonography and fine-needle biopsy revealed medullary thyroid carcinoma. Finally, MEN type 2B was confirmed by using a RET mutation gene test. CONCLUSIONS: Thyroid carcinoma can occur in MEN 2B in combination with pheochromocytoma and mucosal neuroma. Thickened corneal nerve fiber and perilimbal conjunctival mass have been regarded as ophthalmologic characteristics of MEN 2B and may be accompanied by telecanthus, thickened upper eyelid and marfanoid habitus. A biopsy of the mass is required for pathological diagnosis. Medullary thyroid carcinoma is the most significant clinical component of MEN 2B syndrome and thyroidectomy is indicated. MEN 2B may be a rare syndrome, but its consequences are serious and the ophthalmologist may play a lifesaving role in its diagnosis.
Adolescent ; Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Early Diagnosis* ; Endocrinology ; Eyelids ; Female ; Humans ; Lip ; Male ; Multiple Endocrine Neoplasia ; Multiple Endocrine Neoplasia Type 2b* ; Nerve Fibers ; Neuroma* ; Pheochromocytoma ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Ultrasonography ; Urine Specimen Collection

OBJECTIVE: To describe the clinical and ultrasonographic (US) findings in patients with scleredema adultorum of Buschke, who presented with sclerotic skin on their posterior neck. MATERIALS AND METHODS: After obtaining IRB approval, eight patients with scleredema adultorum of Buschke were enrolled. They underwent US examination of their posterior neck. The diagnoses were confirmed pathologically. The clinical history and US images were evaluated retrospectively. Dermal thickness was compared between the patient group and the age- and sex-matched control group. RESULTS: The patients included seven males and one female with a mean age of 51.5 years. All patients presented with thickening of the skin and/or a palpable mass on the posterior neck. Five (62.5%) of the eight patients showed erythematous discoloration. Six patients (75.0%) had a history of diabetes. The Hemoglobin A1c level was found to be increased in all patients. US images did not show any evidence of a soft tissue mass or infection. The mean dermal thickness in patients (7.01 ± 1.95 mm) was significantly greater than that in the control group (3.08 ± 0.87 mm) (p = 0.001). Multiple strong echogenic spots in the dermis were seen in all patients. Seven patients (87.5%) showed posterior shadowing in the lower dermis. CONCLUSION: When a patient with a history of diabetes presents with a palpable mass or erythematous discoloration of the posterior neck and US shows the following imaging features: 1) no evidence of a soft tissue mass or infection, 2) thickening of the dermis, 3) multiple strong echogenic spots and/or posterior shadowing in the dermis, scleredema adultorum of Buschke should be considered in the differential diagnosis.
Dermis ; Diagnosis ; Diagnosis, Differential ; Ethics Committees, Research ; Female ; Humans ; Male ; Neck* ; Retrospective Studies ; Scleredema Adultorum* ; Shadowing (Histology) ; Skin ; Ultrasonography

PURPOSE: The purpose of this study was to verify the effect of aromatherapy massage on constipation in the elderly. METHOD: This study for 10 day, employed a randomized control group pretest-posttest design. The experimental group received abdominal massage using essential oils with Rosemary, Lemon, and Peppermint, and the control group received a placebo massage. To evaluate the effect of aromatherapy, the degree of constipation was measured using the CAS(constipation assessment scale) and the number of bowel movements per week. Data was analyzed by repeated measures of ANOVA using the SPSS program. RESULT: The score of CAS of the experimental group was significantly lower than that of the control group. In addition the average number of bowel movements in the experimental group was higher than that of the control group. The effect of aromatherapy lasted 2 weeks after treatment, while the placebo effect lasted 7~10 days after treatment. CONCLUSION: The finding of this study showed that aromatherapy helps relieve constipation in the elderly.
Plant Oils/therapeutic use ; Oils, Volatile/*therapeutic use ; *Massage ; Male ; Humans ; Female ; Constipation/*therapy ; *Aromatherapy ; Aged, 80 and over ; Aged

PURPOSE: Secondary electrons generated by interaction between primary X-ray beam and block tray in megavoltage irradiation, result in excess soft radiation dose to the surface layer. To reduce the surface dose from the electron contamination, electron filters were attached under the tray when a customized block was used. MATERIALS AND METHODS: Cu, Al or Cu/Al combined plate with different thickness was used as a filter and the surface dose reduction was measured for each case. The measurement to find optimal filter was performed with 10cm x 10cm field size and 78.5cm source to surface distance. The measurement points are positioned with 2mm intervals from surface to maximum build-up point. To acquire the effect of field size dependence on optimal electron filter, the measurement was performed from 4cm x 4cm to 25cm x 25cm field sizes. RESULTS: The surface dose was slowly increased by increasing irradiation field but rapidly increased beyond 15cm x 15cm field size. Al plate was found to be inadequate filter because of the failure to have surface dose kept lowering than the dose of deep area. Cu 0.5mm plate and Cu/Al= 0.28mm/1.5mm combined plate were found to be optimal filters. By using these 2 filters, the absorbed dose to the surface layer was effectively reduced by 5.5%, 11.3%, and 22.3% for the field size 4cm x 4cm, 10cm x 10cm, and 25cm x 25cm, respectively. CONCLUSION: The surface dose attributable to electron contamination had a dependence on field size. The electron contamination was increased when tray was used. Specially the electron contamination in the surface layer was greater when the larger field was used. 0.5mm Cu plate and Cu/Al=0.28mm/1.5mm combined plates were selected as optimal electron filters. When the optimal electron filter was attached under the tray, excessive surface dose was decreased effectively. The effect of these electron filters was better when a larger field was used.

We report a case of polycythemia vera combined with coagulation disorder. The patient was 54 years old man who complained of continuous bleeding after incision of skin abscess 20days ago. Laboratory tests were revealed prolonged aPTT and slightly prolonged PT. Coagulation factor, I, VIII, IX, XI and fibrinogen decreased, however FDP did not increased. It appears that patient with polycythemia vera have chronic activation of coagulation system, probably initiated by activation of factor XII. Platelet aggregation test to ADP, collagen, epinephrine was also revealed poor response.
Abscess ; Adenosine Diphosphate ; Blood Coagulation Factors ; Collagen ; Epinephrine ; Factor XII ; Fibrinogen ; Hemorrhage ; Humans ; Platelet Aggregation ; Polycythemia Vera* ; Polycythemia* ; Skin

The purpose of this study is to compare thiopental sodium and propofol as to the effects of anesthesia induction and hemodynamic changes associated with endotracheal intubation. Forty healthy adult patients, scheduled for elective surgery under general anesthesia, were randomly assigned to receive either thiopental sodium 5 mg/kg (Group 1, n =20) or propofol 2 mg/kg (Group 2, n=20) as an induction agent. Endotracheal intubation was performed following injection of succinylcholine 1 mg/kg. Anesthesia was maintained with 1.5~2% ethrane and 50% N2O in O2. The results were as follows, 1) Both thiopental sodium and propofol revealed high incidence of pain in the site of injection (13/20, 10/20, respectively). 2) The time from the start of injection to spontaneous closing of eyes and to loss of eyelid reflex were 42 and 43 sec in group 1 and 46 and 51 sec in group 2, respectively. 3) The loss of respiratory efforts. Occured in all cases and took 65 and 59 sec, in group 1 and 2 respectively. 4) The blood pressure was more decreased in group 2 than group 1 during induction period, but there was no significant difference between two groups. Also, there was no significant difference of the heart rate between two groups. 5) The increments of systolic blood pressure and rate-pressure-product to endotrachal intubation in group 2 were less than group 1 at time of immediate and 1 minute after intubation. Also, the increments of mean arterial pressure, disastolic blood presure and heart rate were lessen in group 2 than group 1. The retum of blood pressure, heart rate and RPP to the control was fasten in group 2 than group l. In conclusion, propofol may be an alternative to thiopental sodium in patients who require endotracheal intubation without hemodynamic instability.
Adult ; Anesthesia* ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Enflurane ; Eyelids ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal* ; Propofol* ; Reflex ; Succinylcholine ; Thiopental*

To assess the anticonvulsant effect and toxicity, 47 patients of seizure disorder were given Sodium Valproate by the administration method based on the principle of single dose plasma level (one point method). The evaluation periods of drug effects were from 3 months to over 12. Results are summarized as follows. 1. The age distribution of subjects ranges from 16 to 53 years old with mean age of 24.5. Ratio of male to female is 5.1:4.9. 2. Anticonvulsant effect of Na Valproate was good for simple and complex absences, fair for generalized tonicclonic seizures and partial seizures with secondary generalization, and poor for simple partial seizures. 3. Drowsiness was the most freguently notified side effect, and other symptoms, complained were epigastric discomfort, headache, dizziness, nausea, increased appetite and anorexia in that order of frequency. Laboratory tests including blood chemistry showed no significant changes.
Age Distribution ; Anorexia ; Appetite ; Chemistry ; Dizziness ; Epilepsies, Partial ; Epilepsy ; Female ; Generalization (Psychology) ; Headache ; Humans ; Male ; Middle Aged ; Nausea ; Plasma ; Seizures ; Sleep Stages ; Sodium* ; Valproic Acid*