OBJECTIVE: To identify the clinical characteristics of the patients with hypoxic-hypotensive brain injury (HBI) and to compare the prognosis of HBI with patients with traumatic brain injury (TBI). METHOD: Six patients with HBI and sixteen patients with TBI, who had been comatose for more than 8 hours, were enrolled. The functional status was evaluated by the Functional Independence Measure (FIM) score. RESULTS: The causes of HBI were: two respiratory arrest, three cardiac arrest, and one hypotensive shock. Most patients had memory disturbance, confusion, spasticity, contracture of joints, and weakness after the HBI. Other problems included dysphagia, ataxia or tremor, dementia, and concomitant medical problems. Among these clinical features, confusion and spasticity were serious obstacles in rehabilitation. The HBI patients had lower initial and discharge total FIM score, total FIM gain, total FIM efficacy, cognitive FIM efficacy, and motor FIM efficacy than the TBI patients. The HBI patients had a poor outcome due to more widespread brain damage, medical complications, and delayed rehabilitation treatments as compared with TBI patients. CONCLUSION: We concluded that HBI patients had more diffuse and severe deficit than TBI patients.
Ataxia ; Brain Injuries ; Brain* ; Coma ; Contracture ; Deglutition Disorders ; Dementia ; Heart Arrest ; Humans ; Joints ; Memory ; Muscle Spasticity ; Prognosis* ; Rehabilitation ; Shock ; Tremor

PURPOSE: To investigate the clinical outcomes of unilateral lateral rectus muscle advancement in patients with consecutive esotropia after bilateral lateral rectus muscle recession. METHODS: We investigated the results of 13 patients who underwent unilateral lateral rectus muscle advancement for consecutive esotropia after bilateral lateral rectus muscle recession. We evaluated the amount of deviation, changes of angle deviation, corrected amount/mm, and sensory status after each surgery. RESULTS: The average angle deviation of exotropia was 30.42+/-5.41PD, and the average amount of bilateral lateral rectus muscle recession was 6.73+/-0.59 mm. The average angle deviation of esotropia one day after the surgery was 13.17+/-5.15PD. Occlusion treatment was performed during follow-up. The surgery for consecutive esotropia was performed after an average of 12.0+/-7.25 months of follow-up. In Worth-4-dot tests, 12 patients showed diplopia, and 1 patient showed suppression after the surgery for exotropia. Nine patients showed diplopia, and 4 patients showed suppression just before the surgery for consecutive esotropia. One patient showed mild limitation of motion of the lateral rectus muscle (-1 degree). The average angle deviation before the surgery for consecutive esotropia was 19.42+/-4.20PD. An average of 6.73+/-0.79 mm of unilateral lateral rectus muscle advancement was performed. After surgery, the average angle deviation was 1.25+/-2.73PD esodeviation, and 1.42+/-4.44PD exodeviation after 6 months. In Worth-4-dot tests, 6 patients showed fusion, 2 patients showed diplopia, and 5 patients showed suppression after surgery for consecutive esotropia. CONCLUSIONS: Unilateral lateral rectus muscle advancement was an effective procedure for patients with consecutive esotropia under 25PD who did not show any limitation of motion after bilateral lateral rectus recession.
Diplopia ; Esotropia ; Exotropia ; Follow-Up Studies ; Humans ; Muscles

OBJECT: This study is to examine the validity of constitutional classification of Sa-sang medical theory. This theory classifies the human constitution to 4 types according to classical oriental philosophy on yin and yang. SUBJECTS AND METHOD: Subjects were 312 medical students and 288 neurotic patients with diagnosis of neurotic, stress related and somatoform disorders and minor depressive episodes according to ICD-10. Medical students were classified to 4 Sa-sang constitutions by Noh Jung Woo scale, by Dr. Kim Dal Lae himself and Questionnaire for the Sa-sang Constitution Classification(QSCC II). For assessmnent of symptoms and signs, Korean version of SCL-90, a constitution scale and personality scale which were designed for this study were used. These instruments were found to be reliable and valid through statistical analysis. Subjects were asked to rate these scales. The data were analysed with factor analysis and factor scores were compared among 4 Sa-sang constitutions by ANOVA and t-test. The data from patient group were analysed with factor analysis and the results were compared with the Sa-sang medical theory. RESULTS: Results of classification by 3 ways were inconsistent showing a significant difference among them. Among them, QSCC II was most reliable. In QSCC II, only the factor scores of factors of homophobia-obsession, weakness-sensitiveness-indigestion- chillness-skin syndrome, sexual weakness, passive-unsociable personality, introverted personality and rational personality, were significantly high in So-um (small yin) group of medical students. A factor of warmnes and active-sociable personality were significantly high in Tae-um(big yin) group. Also active-sociable and affective pesonality was partly related with So-yang(small yang) group. CONCLUSION: These results suggest that those present classification methods are inconsistent, that these methods are proving only parts of Sa-sang medical theory, and that objective and scientific studies are needed for reliability and validity of Sa-sang medical theory.
Classification ; Constitution and Bylaws* ; Diagnosis ; Humans ; International Classification of Diseases ; Philosophy ; Surveys and Questionnaires ; Reproducibility of Results ; Somatoform Disorders ; Students, Medical ; Weights and Measures

PURPOSE: To report the effectiveness of Minocin sclerotherapy in the treatment of renal cysts. MATERIALS AND METHODS: We performed minocin sclerotherapy to 19 patients with 21 renal cysts composed of 17 cases of solitary renal cyst and three cases of multiple renal cyst and one case of polycystic kidney comfirmed by ultrasound and CT. After aspiration of cyst fluid, if the amount was less than 50ml, 500mg of minocin was mixed with 3ml of normal saline,if more than 50ml, 1000mg of minocin mixed with 5ml of normal saline were injected, and each case was followed-up over 3 months by ultrasound. RESULTS: Of all 21 renal cysts, 14 cases were followed-up three months after minocin sclerotherapy. In 12 of 14 cases, the size of the cysts decreased by 10% or collapsed completely. Of the remaining two cases, one collapsed after 6 months while the other recurred after 6months. Three cases were followed up after 20 months and only one of them recurred. 19 of all 21 cases(91%) were cured, and two of 21 cases(9%) were recurred. Pain was the only complaint. and four of 10'cases needed analgesics. CONCLUSION: Sclerotherapy with minocin has low recurrence-rate and low complication, and relatively early high cure-rate.
Analgesics ; Cyst Fluid ; Humans ; Minocycline* ; Polycystic Kidney Diseases ; Sclerotherapy* ; Ultrasonography

PURPOSE: With the technical advancement in arterial embolization and subsegmental resection of liver neoplasm, emphasis has been on more detailed knowledge of normal arterial anatomy and its variation. We analysed the patterns of intrahepatic branches of right hepatic artery. MATERIALS AND METHODS: We retrospectively analyzed intrahepatic branching patterns of right hepatic artery in 165 cases. All cases had a single right hepatic artery which could be traced up to tertiary branches, and also performed rapid drip infusion CT scan, hepatic arteriography with antero-posterior and oblique views, superior mesenteric arteriorgraphy and indirect portography. RESULTS: lntrahepatic branching patterns of the right hepatic artery had eight types of variation. The most common intrahepatic branching pattern was type I: 107(64.5%) which represented 5, 8th branch emerging from the anterior segmental artery and 6, 7th branch from the posterior segmental artery. Type VII :26(15.8%) was the next common type which represented 6th branch emerging first from the posterior segmental artery and 7th branch emerging secondly from the posterior segmental artery. Type VII, VI, III were branched from the posterior segmental artery. Type IV, II, V were branched from the anterior segmental artery. CONCLUSION: These result could be helpful to the planning of treatment, such as hepatic subsegmentectomy or transarterial embolization of the hepatic neoplasm.
Angiography* ; Arteries ; Hepatic Artery* ; Infusions, Intravenous ; Liver Neoplasms ; Portography ; Retrospective Studies ; Tomography, X-Ray Computed*

PURPOSE: With the technical advancement in arterial embolization and subsegmental resection of liver neoplasm, emphasis has been on more detailed knowledge of normal arterial anatomy and its variation. We analysed the patterns of intrahepatic branches of right hepatic artery. MATERIALS AND METHODS: We retrospectively analyzed intrahepatic branching patterns of right hepatic artery in 165 cases. All cases had a single right hepatic artery which could be traced up to tertiary branches, and also performed rapid drip infusion CT scan, hepatic arteriography with antero-posterior and oblique views, superior mesenteric arteriorgraphy and indirect portography. RESULTS: lntrahepatic branching patterns of the right hepatic artery had eight types of variation. The most common intrahepatic branching pattern was type I: 107(64.5%) which represented 5, 8th branch emerging from the anterior segmental artery and 6, 7th branch from the posterior segmental artery. Type VII :26(15.8%) was the next common type which represented 6th branch emerging first from the posterior segmental artery and 7th branch emerging secondly from the posterior segmental artery. Type VII, VI, III were branched from the posterior segmental artery. Type IV, II, V were branched from the anterior segmental artery. CONCLUSION: These result could be helpful to the planning of treatment, such as hepatic subsegmentectomy or transarterial embolization of the hepatic neoplasm.
Angiography* ; Arteries ; Hepatic Artery* ; Infusions, Intravenous ; Liver Neoplasms ; Portography ; Retrospective Studies ; Tomography, X-Ray Computed*

PURPOSE: To evaluate the degree and change in refractive error and the relation of refractive error, the angle of deviation and amblyopia in patient with refractive accommodative esotropia. METHODS: Children with refractive accommodative esotropia were retrospectively included in the study. The factor studied were sex, age at the first visit, ocular alignment, refractive error and amblyopia. RESULTS: The average age at the first visit was 4.01+/-1.86 years. And, the average angle of esodeviation was 22.23+/-13.74PD for the near and 21.51+/-12.01PD for the distant. The average manifest and cycloplegic refraction measured at patient's first visit were +2.35+/-2.87D and +4.87+/-1.77D respectively. The difference between cycloplegic and manifest refraction decreased gradually. After 3 years, the average manifest and cycloplegic refraction were +3.42+/-1.80PD and +4.33+/-1.77D. The refractive error didn't significantly affect the degree of esodeviation (r=0.051). Twenty-three of patients were amblyopia. The refraction of amblyopic and non amblyopic patient was +5.07+/-1.85D and +4.50+/-2.47D, respectively. However, this difference was not statistically significant. CONCLUSIONS: Mean cycloplegic refraction decreased significantly over a 3-year period. After full correction with glasses, the difference between cycloplegic and manifest refraction decreased. The refractive error was not associated with the degree of deviation anlge, amblyopia occurrence and treatment success.
Amblyopia ; Child ; Esotropia* ; Eyeglasses ; Glass ; Humans ; Refractive Errors* ; Retrospective Studies

OBJECTIVE: To identify the neurobehavioral impairment in the traumatic brain injured (TBI) patients and to determine the relationship between the neurobehavioral impairment and functional recovery. METHOD: We analyzed and compared Functional Independence Measure (FIM) scores and neurobehavioral psychometry results in 16 patients with severe TBI. The neurobehavioral psychometry tests included Minimental Status Examination (MMSE), Galvestone Orientation and Amnesia Test (GOAT) as screening tools, Korean Wechsler Intelligence Scale (KWIS) for intelligence, Wechsler Memory Scale-Revised (WMS-R) test for memory function, Color Trail test (CTT) 1 and 2 for attention and concentration, Grooved Pegboard Test (GPT) and Finger Tapping Test (FTT) for motor function, Wisconsin Card Sorting Test (WCST) for executive function, and Symptom Checklist-90-Revision (SCL-90-R) for personality. RESULTS: At discharge, neurobehavioral psychometry of the TBI patients showed impairment of the attention and concentration as demonstrated by severe and moderate impairment in CTT 1 and CTT 2, repectively. Memory disturbance was also noted by the result of mental retardation in WMS-R. But GOAT and MMSE showed normal, KWIS was below average. Motor dysfunction was seen in GPT and FTT and mild executive dysfunction in WCST. Functional recuperation was influenced by attention and concentration, as the FIM score has significant correlation with CTT 1 and FTT. CONCLUSION: The TBI patients have the pervasive neurobehavioral impairment, especially severe dysfunction in the memory, attention and concentration. And functional recovery was significantly correlated with attention. The neurobehavioral psychometry will be useful in neurobehavioral evaluation in TBI patients. A further prospective study using Neurobehavioral psychometry would bring a more precise and valuable information.
Amnesia ; Brain Injuries ; Brain* ; Executive Function ; Fingers ; Goats ; Humans ; Intellectual Disability ; Intelligence ; Mass Screening ; Memory ; Wisconsin

OBJECTIVE: The purposes of this study were to identify the incidence of subcortical aphasia and to investigate the different linguistic characteristics and prognosis. METHOD: Twenty-nine stroke patients(18 men and 11 women) with aphasia were investigated in the study. On the basis of the findings of brain CT and MRI images, the patients were divided into either cortical aphasia group or subcortical aphasia group. Fifteen cortical aphasia patients and 14 subcortical aphasia patients underwent an aphasia screening test. Fluency, comprehension, speech, naming, repetition, reading, and writing abilities were evaluated as the modalities of language. All patients received the speech therapy and were reevaluated at three months after the initial evaluation. RESULTS: The incidence of subcortical aphasia was 48.3% of all aphasia patients from the stroke. Subcortical aphasia patients showed more variable types of aphasia and less linguistic damage than the cortical aphasia patients. The prognosis of subcortical aphasia patients was better than the cortical aphasia patients. Especially the cases of global aphasia from the subcortical lesions showed a rapid recovery and good prognosis. CONCLUSION: Early recognition of the subcortical aphasia and a comprehensive speech therapy would be beneficial for the improvement of linguistic function in the subcortical aphasia patients.
Aphasia* ; Brain ; Comprehension ; Humans ; Incidence ; Linguistics ; Magnetic Resonance Imaging ; Male ; Mass Screening ; Prognosis ; Speech Therapy ; Stroke* ; Writing

PURPOSE: Many of the enzymes handling environmental factors are polymorphic and may confer variable susceptibility to renal cell carcinoma (RCC). Among those, the author studied genetic polymorphisms of CYP2D6 (B & T) and CYP1A1 in RCCs and controls in Korean. MATERIALS AND METHODS: Using 132 RCCs and 94 controls, first PCR products were obtained in 104 RCCs and 94 controls with CYP2D6, and 74 RCCs and 56 controls with CYP1A1. Res triction enzyme - BstN I/EcoN I for CYP2D6 (B & T), and NCo I for CYP1A1-digestion was followed to analyze constitutive DNA. RESULTS: In both RCCs and controls, no mutant allele of CYP2D6 (B & T) was detected and the susceptibility for occurrence of RCC was unable to evaluate. With CYP1A1 RFLP, homozy gous wild type (WW) was seen in 68 (52.3%; 37 RCCs, 31 controls), heterozygous mutant type (WM) in 54 (41.5%; 32 RCCs, 22 controls) and homozygous mutant type (MM) in 8 (6.2%; 5 RCCs, 3 controls). The odds ratios (95% CI) of RCC susceptibility for CYP1A1 genotype were 1.15 for WM and 1.36 for MM. Even though not significant statistically, higher tendency in MM presented. CONCLUSION: There is no association between susceptibility for the occurrence of RCC and genetic polymorphism of CYP2D6 (B & T) and CYP1A1.
Alleles ; Carcinoma, Renal Cell* ; Cytochrome P-450 CYP1A1* ; Cytochrome P-450 CYP2D6* ; DNA ; Genotype ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Polymorphism, Restriction Fragment Length