Four hundred and fifty patients of cerebrovascular accident who underwent computerized tomographic scanning during the 45 months, from January 1978 to October 1981, at department of internal medicine, Kyung Hee University Hospital, were studied and following results were obtained. 1. In Korea, intracerebral hematoma(48.2%) is more common than cerebral infarction(27.6%). 2. 87.3% of intracerebral hemorrhage were comfirmed while 61.5% of cerebral infarction were identified by brain CT. 3. Cerebrovascular accidents are definitely developing in 6th decade(40.6%) and male is more often affected. 4. hypertension is the most common underlying disease(72.3%) of cerebral hemorrhage, 52.4% of cerebral infarction. 5. hematoma occurs most frequently in basal ganglia(40.6%) and cerebral infarction occurs most frequently in global area(48.4%). 6. Changes of consciousness level were observed in 54.2% of the cases of mild degree hematoma. Mortality was 6.2% in mild degree hematoma and 88.2% in severe degree hematoma. 7. In 26.2% of cerebral hematoma, inital CSF findings were normal in spite of the evidence of cerebral hematoma confirmed by CT scanning.
Brain* ; Cerebral Hemorrhage ; Cerebral Infarction ; Classification* ; Consciousness ; Hematoma ; Humans ; Hypertension ; Internal Medicine ; Korea ; Male ; Mortality ; Stroke* ; Tomography, X-Ray Computed

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

A choroid detachment occurs most commonly after surgical operation for cataract, glaucoma, and retinal detachment. It is fairly characteristic for postoperative choroidal edema to be accompanied by hypotonia and a shallow anterior chamber. We have recently experienced 3 cases of choroid detachment after cataract operation, and acase of choroid detachment combined with retinal detachment after trabeculectomy. They were also accompanied by hypotonia and shallow anterior chamber, but had not would leakage. Among 4 cases, a case of choroid detachment was performed suprachoroidal tapping, the remaining were treated with prednisolone, cycloplegics, and pressure dressing. They were not of consequence and subsided without being noticed. A brief review of relating literatures was described.
Anterior Chamber ; Bandages ; Cataract ; Choroid* ; Edema ; Glaucoma ; Muscle Hypotonia ; Mydriatics ; Prednisolone ; Retinal Detachment ; Trabeculectomy

BACKGROUND/AIMS: Chronic hepatitis C virus (HCV) infection is often associated with extrahepatic autoimmune disease, and autoantibodies such as anti-nuclear antibody (ANA) or anti-smooth muscle antibody (ASA). The presence of autoantibodies may make discrimination between chronic hepatitis C with autoimmune features and type 1 autoimmune hepatitis difficult. We studied the prevalence of autoantibodies in patients with chronic HCV infection and their clinical significance. MATERIALS AND METHODS: ANA, ASA, anti-mitochondrial antibody (AMA), anti-microsomal antibody (AmA), rheumatoid factor (RF), anti-cardiolipin antibody (aCL) and lupus anti-coagulant (LA) were tested in 116 patients (80 chronic hepatitis C, 36 liver cirrhosis). Genotypes of HCV were determined in 25 patients by INNO LiPA. RESULTS: The overall prevalence of autoantibody was 65.5%. The most common autoantibody was aCL (34.5%), followed by ANA (25%), RF (18%), LA (15.5%), ASA (6.9%), anti-microsomal antibody (6%) and AMA (1%). The positive rate of either ANA or ASA was 30.2%, but both were positive in 1.7% only. There was no difference in the demographic features, biochemistry, HCV genotypes and disease status between autoantibody-positive and autoantibody-negative patients. CONCLUSIONS: Autoantibodies were commonly found in patients with chronic HCV infection. But, the presence of autoantibodies may be a non-specific finding in chronic hepatitis C infection without clinical significance.
Autoantibodies* ; Autoimmune Diseases ; Biochemistry ; Discrimination (Psychology) ; Genotype ; Hepacivirus ; Hepatitis C, Chronic* ; Hepatitis, Autoimmune ; Hepatitis, Chronic* ; Humans ; Liver ; Prevalence* ; Rheumatoid Factor

Although the incidence of avascular necrosis of the pmximal end of the femur has declined by early diagnosis and gentle dynamic reduction, it is still one of the major complication in treatment of congenital dislocation of the hip. From 65 cases, followed up at least one year after reduction at the Department of Orthopaedic Surgery, Busan National University Hospital from January, 1980 to June, 1984, the authom studied the factom causing avascular necrosis of the femoral head and its radiographic classification. The following results were obtained. 1. Based on Salter's criteria, avascular necrosis of the femoral head was considered in 16 of the 65 hips, a rate of 24.6%. 2. Based on the classification of Bucholz and Ogden, radiographic patterns of avascular necrosis were: type 1, 6(37.5%); type 2,3(18.8%); type 3, 5(31.3%); type 4, 2(12.5%). 3. Generally, the older the child when treatment was initiated, the more likely was avascular necrosis to develop, and the more severe was its damage. 4. The incidences of avascular necrosis in various treatments were: Pavlik harness, 10%; manipulative reduction, 17%; medial approach open reduction 40%; Salters innominate osteotomy only, 36%; femoral osteotomy with pelvic osteotomy, 20%. The high incidence in medial approach open reduction and Salters innominate osteotomy may be due to failure of previous manipulative reduction. 5. The preliminary traction of 14 days or more substantially reduced the incidence of avascular necrosis. 6. There was particularly high incidence of avascular necrosis in cast immobilization of Lorenz position. 7. The correlation between adductor tenotomy and avascular necrosis was not noticed. There was no avascular necrosis in the normal contralateral hip after cast immobilization.
Busan ; Child ; Classification ; Dislocations ; Early Diagnosis ; Femur ; Head ; Hip ; Humans ; Immobilization ; Incidence ; Necrosis ; Osteotomy ; Tenotomy ; Traction

The authors have reviewed 11 cases of prosthetic replacement for severe proximal humeral fractures which were treated from March 1989 to December 1993, paying particular attention to the range of motion attained after surgery and the factors which influence the limitation of shoulder motion. The results of this study were as follows: l. Among the 11 cases, 10 cases showed sttisfactory pain relief. 2. Active motion of the shoulder averaged 91° of forward flexion, 72.8° of abduction and 35° of external rotation. 3. The humeral offset averaged 30.9mm in normal shoulder and 18.9mm in affected shoulder. 4. In 6 cases which the humeral offset measured over 20mm, active motion averaged 104° of forward flexion and 83° of abduction and 5 cases showed satisfactory results. 5. In 5 cases which the humeral offset measured under 20mm, active motion averaged 104° of forward flexion and 83 of abduction and 5 cases showed unsatisfactory results. 6. Prosthetic replacements were performed within 1 week after injury in 7 cases and among these 5 cases showed satisfactory results. The range of motion after prosthetic replacement for severe proximal humeral fracture was disappointing. We concluded that limited range of motion is mainly due to reduced humeral offset and restoration of humeral offset by appropriate reattachment of greater tuberosity will allow better clinical result.
Range of Motion, Articular ; Shoulder ; Shoulder Fractures

BACKGROUND: Telomerase activity in precancerous conditions of lung adenocarcinomas has not been well studied. This study is designed to investigate the role of telomerase in premalignant lesions of urethane-induced mouse lung adenocarcinoma. METHODS: We harvested A/J mouse lung tissues at 3, 6, 9, 12, 28, 41, and 48 weeks after intraperitoneal urethane treatment, and classified each lesion in terms of histologic findings. We examined telomerase activity using a modified version of the telomeric repeat amplification protocol assay using both gel-based and enzyme linked immunosorbent assay methods. An immunohistochemical analysis of proliferating cell nuclear antigen (PCNA) was performed. RESULTS: In urethane-induced mouse lung tissues, it was sequentially developed from hyperplasia, adenoma, and eventually to adenocarcinoma. Telomerase activity began to show a positive level in tissues with no histologically visible nodule after urethane administration. It revealed a statistically significant increase in hyperplasia compared to the "control" lung tissue (p<0.05), which was proportionally elevated relative to adenoma and adenocarcinoma. There was a direct correlation between telomerase activity and the PCNA labeling index (p<0.05). CONCLUSIONS: The elevation of telomerase activity in normal-appearing lung lesions is thought to be a possible marker of early detection of pulmonary adenocarcinoma.
Adenocarcinoma ; Adenoma ; Animals ; Cell Transformation, Neoplastic ; Enzyme-Linked Immunosorbent Assay ; Hyperplasia ; Lung ; Mice ; Precancerous Conditions ; Proliferating Cell Nuclear Antigen ; Telomerase ; Urethane

BACKGROUND/AIMS: Spontaneous bacterial peritonitis (SBP) is a major problem associated with liver cirrhosis which has high mortality. Increased production of inflammatory mediators, such as tumor necrosis factor-a (TNF-a) and interleukin- (IL-) may be associated with development of renal impairment, one of the most important prognostic parameters in SBP. The aim of this study is to investigate the changes of these cytokines in ascitic fluid and plasma in patients with SBP and the relationship between these cytokines and development of renal impairment. METHODS: Forty patients with liver cirrhosis and ascites were studied 21 with SBP and 19 with sterile ascites. TNF-a and IL- levels in ascitic fluid and plasma were determined by ELISA at the time of diagnosis in both groups and 48 hours after antibiotics treatment in SBP patients. RESULTS: TNF-and IL- levels in ascitic fluid and plasma were significantly higher in patients with SBP than those without SBP (ascitic fluid TNF-a: 2.5+/-0.5 vs. 1.6+/-0.2; plasma TNF-a: 2.3+/-0.5 vs. 1.5+/-0.2; ascitic fluid IL-: 3.8+/-0.5 vs. 3.0+/-0.4; plasma IL-: 3.4+/-0.5 vs. 2.3+/-0.3, log pg/mL)(p<0.001). In patients with SBP, levels of TNF-a and IL- in ascitic fluid and plasma decreased 48 hours after antibiotics treatment. Eleven patients with SBP (11/21, 52%) developed renal impairment. Patients with renal impairment had significantly higher ascitic fluid and plasma TNF-a levels than those without renal impairment (median 2.5 vs. 2.1 for ascitic fluid, p=0.006; median 2.4 vs. 2.0, log pg/mL for plasma, p=0.04). Although four out of eleven (36%) patients who developed renal impairment died during hospitalization, all the patients without renal impairment survived (p=0.09). CONCLUSION: Our results suggest that the levels of TNF-a and IL- in ascitic fluid and plasma are increased in SBP and elevated levels of TNF-a in ascitic fluid and plasma may be associated with development of renal impairment, thus indicating poor prognosis in patients with SBP.
Anti-Bacterial Agents ; Ascites ; Ascitic Fluid* ; Cytokines ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Hospitalization ; Humans ; Liver Cirrhosis ; Mortality ; Necrosis* ; Peritonitis* ; Plasma* ; Prognosis

No abstract available.
Chorionic Gonadotropin* ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans* ; Progesterone* ; Superovulation*

Aconitum species have been used in western and eastern medicine for centuries. In present, chinese medicine uses the drug to treat weak constitution, poor metabolism, dysuria, cardiac weakness, gout rheumatism in the limbs, neuralgia. Poisoning may occur from intentional or accidental ingestion, and the concentration of the toxic alkaloids - aonitine, mesaconitine, and hypoconitine - varies depending on species, place of origin, time of harvest, and processing procedure. In addition to cardiac arrhythmias, and hypotension, the alkaloids cause GI upset & neurological symptoms, especially numbness of the mouth and parethesia in the extrimities. The alkaloid causes a prolonged sodium current in cardiac muscle with slowed repolarization. The aconitine acts as a agonist of Na-channel receptor. Vaughan-Williams' classification I antiarrhythmic agents which belong to might be the first choice for the therapy of aconitine induced arrhythmias. The modification of the sodium system by aconitine seems to be responsible for the prolongation of the action potential and the appearance of extrasystoles and fibrillation. We experienced a 67-year-old male patient who suffered chest discomfort and palpitation with ventricular tachycardia through to be caused by aconitine. After treatment for 3days he recovered well and discharged. We report this case with literature review.
Aconitine ; Aconitum ; Action Potentials ; Aged ; Alkaloids ; Arrhythmias, Cardiac ; Asian Continental Ancestry Group ; Cardiac Complexes, Premature ; Classification ; Constitution and Bylaws ; Dysuria ; Eating ; Extremities ; Gout ; Humans ; Hypesthesia ; Hypotension ; Male ; Metabolism ; Mouth ; Myocardium ; Neuralgia ; Poisoning ; Rheumatic Diseases ; Sodium ; Tachycardia, Ventricular* ; Thorax