No abstract available.
Humans ; Phenotype*

A clinical study was done on 16 cases of cerebellar hemorrhage and 3 cases of cerebellar infarction which were diagnosed with brain CT scan at Keimyung university Dongsan hospital from July 1981 to June 1985 and conclusions obtained are as follows. 1. The incidence of cerebellar hemorrhage and infarction was 3.5% and 0.6% of all spontaneous intracranial parenchymal hemorrhage and infarction, respectively. 2. The most prevalent age group was 7th decade and sex ratio was higher in male in cerebellar stroke. 3. Major single percipitating factor of cerebellar stroke was hypertension. 4. Most of cerebellar stroke showed catastrophic or sudden onset type. 5. The most common initial symptoms of cerebellar stroke were nausea and vomiting, followed by headache and dizziness or vertigo, in order of frequency. 6. The most common neurologic signs on admission were impaired consciousness, constricted pupil with preserved light reflex and cerebellar signs. 7. The common site of cerebellar hemorrhage was right hemisphere, followed by vermis and left hemisphere, in order of frequency, and that of cerebellar infarction was right posterior hemisphere. 8. The better the consciousness on admission, the better the outcome of cerebellar stroke. 9. The following parameters indicated good prognosis with medical therapy, so called benign cerebellar hemorrhage: clear consciousness on admission, gradual onset type, less than 20cc of hematoma, no or mild hydrocephalus, no ventricular hematoma, no vermis involvement on CT scan.
Brain ; Consciousness ; Dizziness ; Headache ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Infarction ; Male ; Miosis ; Nausea ; Neurologic Manifestations ; Prognosis ; Reflex ; Sex Ratio ; Stroke ; Tomography, X-Ray Computed ; Vertigo ; Vomiting

Clincal studies were made on 166 cases of spontaneous subarachnoid hemorrhage (SAH), were admitted to the keimyung university Dongsan hospital from January 1981 to March 1984. The age and sex distribution, causes of SAH, clinical symptoms and signs, computed tomographic (CT) findings, aneurysmal site, number and size, comparison between the highest density on CT findings and site of aneurysm confirmed by angiography,relationship between CT class and clinical grade, complication, and relationship between hospital course and clinical grade on admission were analysed. The results summarized as follow. 1. The most prevalent age group was between 41-60 years of age, and above 61 years, 31-40 years and below 30 years of age in the order of frequency. Male to female ratio was 43.4 : 56.6. 2. The most common causes of 100 cases of SAH confirmed by cerebral angiography was cerebral aneurysm (75 cases), and the other causes were unknown cause (16 cases), arteriovenous malformation (6 cases), moyamoya disease (3 cases) in the order of frequency. 3. The clinical symptoms on admission in the order of frequency were headache, nausea and vomiting, brief loss of consciousness, dizziness, seizure, and urinary incontinence. The neurological findings showed stiffneck, hemiparesis, cranial nerve palsies, papilledema and/or hemorrhage on the fundus, and Babinski sign in that order. 4. CT findings (158 cases) revealed typical high densities consistent with SAH in 125 cases (79.1%), associated with the low density (13 cases), and visible cerebral aneurysm (5 cases), while negative findings were 33 cases (20.9%). 5. The most common site of aneurysm among the 75 cases of SAH confirmed by the cerebral angiography was the region of the anterior communicating artery (AcomeA) which accounted for 30 cases (35.3%), and posterior communicating artery (PcomeA) and middle cerebral artery (MCA) 23 cases (27%), respectively, the internal carotid artery 5 cases (5.9%), the anterior ecrebral artery (ACA) 2 cases (2.4%), the posterior inferior cerebellar artery and basilar artery 1 cases (1.2%), respectively in the order of frequency. Among the 75 cases of cerebral aneurysms, single aneurysms were 67 cases (89.3%) and multiple aneurysms were 8 cases (10.7%). The most common size of the aneurysms was 6-10 mm (47 cases), and below 5 mm (30 cases), and above 10 mm (8 cases) in the order of frequency. 6. Sixteen out of 27 cases of AcomA aneurysms present the highest density on CT scan in the anterior hemispheric fissure, 9 out of 22 cases of PcomA aneurysms in syulvian fissure and 6 cases in suprasellar cistern, and all cases of MCA aneurysm (21 cases) in the ipsilateral aneurysmal site. 7. Comparison between CT grade by Davis (1980) and clinical grade by Hunt-Hesse (1968) revealed that the 93 of 94 patients (pts) with CT class 1 or 2 belong to under clinical grade 3, the 17 of 64 pts with CT class 3 or 4 belong to clinical grade IV or V, and the 17 of 18 pts with clinical grade IV or V belong to CT class 3 or 4. 8. The most common complication was the hydrocephalus (30.1%), and cerebral arterial spasm (24.1%), SIADH (8.4%), and rebleeding confirmed by lumbar puncture and/or CT (4.2%), in the order of frequency. 9. One hundred and four pts (62.7%) out of total 166 patient with SAH were improved, whereas 39 pts (23.5%) were not improved or signed out without clinical improvement, and 23 pts (13.8%) were died. The 81 (77.9%) of 104 pts who were improved belong to clinical grade I or II on admission, the 18 (78.3%) of 23 pts who were expired belong to clinical grade III or IV, and the 19 (48.7%) of 39 pts who were signed out without improvement belong to clinical grade III to V.
Aneurysm ; Arteries ; Arteriovenous Malformations ; Basilar Artery ; Carotid Artery, Internal ; Cerebral Angiography ; Cranial Nerve Diseases ; Dizziness ; Female ; Headache ; Hemorrhage ; Humans ; Hydrocephalus ; Inappropriate ADH Syndrome ; Intracranial Aneurysm ; Male ; Middle Cerebral Artery ; Moyamoya Disease ; Nausea ; Papilledema ; Paresis ; Reflex, Babinski ; Seizures ; Sex Distribution ; Spasm ; Spinal Puncture ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed ; Unconsciousness ; Urinary Incontinence ; Vomiting

PURPOSE: This study was to assess clinically the success rates and technical complications of cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks. MATERIALS AND METHODS: 75 (single crowns: 51, splinted crowns: 24) cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks which were restored in 67 patients were investigated for the evaluation of the success rates and technical complications. All restorations were cemented with temporary cement. Age, gender, restoration position, opposing teeth, restoration type were assessed as possible factors affecting technical complications. RESULTS: During the mean observation period of 22.2 months, cumulative success rates of all restorations were 66.9 (73.2 - 60.6)%. Retention loss was found in 16 restorations (single crowns: 14, splinted crowns: 2), abutment screw loosening and veneer porcelain fracture were found in each 2 single crowns, respectively. According to a Kaplan-Meier survival analysis of single crowns and splinted crowns, the cumulative success rates were 58.9 (66.6 - 51.2)%, 87.5 (96.1 - 78.9)%, respectively. There was a statistically significant difference. The other possible factors did not have a significant effect on the technical complications. CONCLUSION: Retention loss was the most frequent technical complication. Abutment screw loosening and veneer porcelain fracture were found rarely in single crowns only. Age, gender, restoration position, and antagonist did not have significant effect on the technical complications. Splinted crowns had a higher success rate than single crowns.
Crowns* ; Dental Porcelain ; Humans ; Splints* ; Tooth

No abstract available.

Objective/BACKGROUND: Serum levels of anti-acetylcholine receptor antibody (AChR-Ab), interleukin-2 (IL-2) and soluble interleukin-2 receptor (sIL-2R) may represent markers of disease severity in myasthenia gravis (MG). This study was performed to evaluate the correlations between disease severity and immunological parameters such as serum AChR-Ab, IL-2 and sIL-2R level and between each immunological parameters. METHODS: Serum levels of AChR-Ab, IL-2 and sIL-2R were measured in 30 MG patients and in 22 healthy controls. Results : Serum levels of AChR-Ab and sIL-2R were higher in MG than in healthy controls (p<0,01). The occurrence of IL-2 positive serum samples was 46.7% in MG but none in controls. There were no significant correlations between disease severity and immunological parameters and between each immunological parameters. Conclusions : Serum IL-2 and sIL-2R levels may not represent markers of disease severity in MG, In order to further document the correlation between each parameters, follow-up of individual patients with serial serum samplings may be necessary.
Humans ; Interleukin-2* ; Myasthenia Gravis

Diabetic ketoacidosis is an acute complication of diabetic mellitus. The most common triggering factors are infection, insulin therapy omission and the onset of the disease, but if these are excluded, other less frequent etiologic factors must be ruled out. We report a case of 22-year-old woman with Graves' disease presented as diabetic ketoacidosis. She was diagnosed type 1 diabetes mellitus at 13 years old and continually has been treated with insulin therapy until now. She typically showed tachycardia at rest in spite of correction of metabolic acidosis. Hyperthyroidism worsens glycemic control in diabetic patients and may precipitate diabetic ketoacidosis. Hyperthyroidism always should be investigated in diabetic patients presenting diabetic ketoacidosis without obvious triggering factors.
Acidosis ; Adolescent ; Diabetes Mellitus, Type 1 ; Diabetic Ketoacidosis* ; Female ; Graves Disease ; Humans ; Hyperthyroidism* ; Insulin ; Ketosis ; Tachycardia ; Young Adult

BACKGROUND/AIMS: For many years, conventional treatment for multiple myeloma (MM) not ineligible for high-dose therapy has been the combination of oral melphalan and prednisone (MP). However, melphalan-based regimens are associated with numerous complications. Another alkylating agent, cyclophosphamide, has similar effects on MM and is associated with fewer reports of complications. Therefore, cyclophosphamide-based regimens have usually been used as salvage therapy in patients with refractory or relapsed MM, despite the development of newer drugs. The purpose of this report was to evaluate the efficacy and tolerability of cyclophosphamide and prednisone as a first-line therapy for MM. METHODS: For the period January 2002 to June 2012, we retrospectively analyzed 29 patients newly diagnosed with MM who underwent a treatment regimen consisting of intravenous cyclophosphamide (1,000 mg/kg) for 1 day and prednisone (100 mg) for 4 days. RESULTS: The rate of response to this regimen was 31.1 percent. The median progression-free survival (PFS) was 5.5 months and the median overall survival (OS) was 47.3 months. The regimen was well tolerated. Adverse effects of grades above III were as follows: anemia in seven patients (24.1%), neutropenia in five patients (17.2%), and thrombocytopenia in two patients (6.8%). These adverse effects were easily adjusted. No one developed a secondary malignancy or hemorrhagic cystitis. CONCLUSIONS: Although PFS was less than for the MP regimen, median OS was better than for the MP regimen. Furthermore, the cyclophosphamide-prednisone regimen was well tolerated, and the adverse effects that did occur were easily adjusted. The cyclophosphamide-prednisone combination regimen may represent an effective and well tolerated first-line therapy for non-transplant candidates with MM.
Anemia ; Antineoplastic Combined Chemotherapy Protocols ; Cisplatin ; Cyclophosphamide ; Disease-Free Survival ; Humans ; Melphalan ; Methotrexate ; Multiple Myeloma ; Neutropenia ; Prednisone ; Retrospective Studies ; Salvage Therapy ; Thrombocytopenia

Myasthenia gravis is relatively common in young women and therefore sometimes associated with pregnancy. Since pregnancy influences the course of the myasthenia gravis, and the drugs used for its treatment may influence gestation, the obstetrical management of myas-thenic patient merits special consideration. In myasthenia gravis, it is generally thought that the anesthesia of chice is regional anesthesia during vaginal delivery and general anesthesia during Cesarian section. But in Cesarina section for a pregnant myasthenic with pulmonary disease, epidural or subarachnoid block may be preferable to avoid postoperative hazards. We performed epidural anesthesia with lidocaine in a 39-year-old elderly primigravida myasthenic with COPD and obtained good intra and postoperative results.
Adult ; Aged ; Anesthesia ; Anesthesia, Conduction ; Anesthesia, Epidural ; Anesthesia, General ; Female ; Humans ; Lidocaine ; Lung Diseases ; Myasthenia Gravis ; Pregnancy ; Pulmonary Disease, Chronic Obstructive

BACKGROUND/AIMS: Recently, many cases of vitamin K-dependent coagulopathy of unknown origin have been reported. Such patients lack any relevant family history and have no systemic disease, raising suspicion of superwarfarin intoxication. We evaluated individual risk factors causing coagulopathy and hemorrhagic symptoms in patients with suspected superwarfarin intoxication. In addition, we determined how to effectively treat vitamin K-dependent coagulopathy caused by suspected superwarfarin intoxication. METHODS: Seven patients with suspected superwarfarin intoxication who lacked any definitive history of rodenticide ingestion were included. Thirty-one patients initially diagnosed with rodenticide poisoning were also included. We performed a retrospective chart review of all subjects and examined clinical data including patient demographics and medical histories. RESULTS: Patients initially diagnosed with rodenticide poisoning were divided into two groups, one of which had a laboratory abnormality (prothrombin time [PT] > 13 seconds) and another group with PTs in the normal range. There was no significant difference between the two groups in any of age, gender, the extent of chronic alcohol consumption, the causative rodenticide, psychiatric problems, ingestion of drugs interacting with warfarin, the extent of intoxication, or the type of ingestion attempt. The albumin level of the former group was significantly lower than that of the latter group (p = 0.014). Furthermore, a significant difference between the two groups was evident in terms of simultaneous ingestion of rodenticide and alcohol (p = 0.023). CONCLUSIONS: Most patients with superwarfarin poisoning did not exhibit any complication. When such complications were evident, they were associated with serum albumin level and coingestion of rodenticide and alcohol.
4-Hydroxycoumarins/*poisoning ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking/adverse effects/blood ; Anticoagulants/*poisoning ; Blood Coagulation/*drug effects ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Partial Thromboplastin Time ; Prothrombin Time ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Rodenticides/*poisoning ; Serum Albumin/metabolism ; Vitamin K/*blood ; Vitamin K Deficiency Bleeding/blood/*chemically induced/diagnosis/therapy ; Young Adult