Posterior reversible encephalopathy syndrome (PRES) involves predominantly posterior subcortical white matter and cortex. PRES is associated with an abrupt and severe increase in blood pressure or administration of various immuno-suppresants. We present a 18-year-old female with PRES. She was admitted to our hospital with seizures. She had been suffering from acute hypertension (170/100 mmHg) associated with acute renal failure. Brain MRI showed reversible biparietal cortical and subcortical edema. We report a case of hypertension-induced PRES associated with acute renal failure. (J Korean Neurol Assoc 19(5):541~543, 2001)
Acute Kidney Injury ; Adolescent ; Blood Pressure ; Brain ; Edema ; Female ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Posterior Leukoencephalopathy Syndrome* ; Seizures

PURPOSE: We compared the outcome of transurethral electro-vaporization of the prostate (TVP) with that of transurethral resection of the prostate (TURP) in patient with benign prostate hyperplasia (BPH). MATERIALS AND METHODS: Fifty-four patients with BPH were treated with TVP (Group I) and sixty-two with TURP (Group II). Patients were assessed at baseline for both safety and efficacy and in follow-up at 1 and 3 months. Efficacy parameters evaluated included American Urological Association (AUA) symptom score, peak urinary flow rate (Qmax) and post-void residual urine volume (ml). Safety parameters evaluated included incidence of side effects, operative time, postoperative catheterization time, change in hematocrit and serum sodium. RESULTS: The mean prostate size was 28.4+/-4.8gm in GroupI and 37.1+/-5.3gm in Group II. The mean operation time was shorter in Group I (48.2+/-10.5min) than in Group II (75.2+/-32.6min) (p<0.05). The change of hematocrit (%) was lower in Group I (from 40.2+/-4.1 to 38.7+/-4.1) than in Group II (from 40.3+/-3.8 to 34.9+/-5.5), (p<0.05). The mean catheterization time was 3.2+/-1.2 days and 4.9+/-1.9 days (p<0.05). The change of peak urinary flow rate, post-void residual urine volume, AUA symptom score, incidence of postoperative complications was not significantly different between each group. CONCLUSIONS: Although the TURP is the gold standard for the treatment of symptomatic BPH with high success rate, significant morbidities are associated with this procedure. Our early clinical experience highlights several advantages of electro-vaporization, particulary the low incidence of postoperative morbidity.
Catheterization ; Catheters ; Follow-Up Studies ; Hematocrit ; Humans ; Hyperplasia ; Incidence ; Operative Time ; Postoperative Complications ; Prostate* ; Prostatic Hyperplasia* ; Sodium ; Transurethral Resection of Prostate

No abstract available.

The idiopathic long-QT syndrome is an infrequent inherited disorder, characterized by prolonged QT interval and by the occurrence of life-threatening tachyarrhythmia, particularly in association with emotional or physical stree. In its characteristic presentation, with obvious QT prolongation and stree induced syncope with torsades de points, the diagnosis is straightforward for physicians aware of the disease. But sometimes in cases of borderline QT prolongation and vague symptom, a correct diagnosis is delayed and frequently misdiagnosed as a seizure disorder. The mortality of untreated symptomatic patients with LQTS exceeds 20% in the year after their first syncopal episode and aapproaches 50% within 10 years. But this high mortality rate has been significantly reduced by the use of pharmacological or surgical antiadrenergic therapy or both. So early detection of the disease and antiadrenergic treatment sympathetic innervation to the heart. Second, there was intrinsic gene abnormality in the mechanisms responsible for cardiac repolarization. We report one case of LQTS in a 24 years old female patient who had been suffering from stree related syncope. Her initial EKG had prologed QT interval(588msec) and increased QT intrval dispersion(200msec). In the Holter monitor, long and short cycle sequence induced (pause-dependent) torsades de pointes was detected. She has been treated by beta-blocker and has maintained her condition without recurrence of the symptoms.
Diagnosis ; Electrocardiography ; Epilepsy ; Female ; Heart ; Humans ; Long QT Syndrome ; Mortality ; Recurrence ; Syncope ; Tachycardia ; Torsades de Pointes ; Young Adult

It is very important for the anesthesiologists to manage this kind of patient during anesthesia because of severe hemodynamic change that is induced by aortic clamping and declamping, and its secondary effect on visce, heart and spinal cord, etc. To minimize the sudden severe hemodynamic change, we used the following agents and techniques in this clinical report. 1) Ethrane anesthesia with intermittent Innovar administration to minimize cardiac irritability. 2) To prevent secondary damage by distal hypotension during aortic clamping and declamping. 1. slight overhydration. 2. mannitol. 3. diuretics. 3) To prevent secondary damage by proximal hypertension during aortic clamping. 1. d-tubocurarine for muscle relaxation. 2. Morphine. 3. Chlorpromazine. 4. phentolamine. More over, we recommend this kind of anesthetic method in some other surgeries such as coarctation of aorta, aortic aneuryam and pheochromocytoma, etc. which may exhibit severe hemodynamic change during anesthesia.
Anesthesia ; Aortic Coarctation ; Chlorpromazine ; Constriction ; Diuretics ; Enflurane ; Heart ; Hemodynamics ; Humans ; Hypertension ; Hypertension, Renovascular* ; Hypotension ; Mannitol ; Morphine ; Muscle Relaxation ; Phentolamine ; Pheochromocytoma ; Spinal Cord ; Tubocurarine

BACKGROUND: The possible role of apolipoprotein E (APOE for gene, apoE for protein) allele in atherosclerotic diseases is not clearly understood. For the putative role of APOE genotypes, we examined APOE polymorphism among patients with stroke. METHODS: A total of 202 ischemic stroke patients were involved in this study. The genotype DNA was isolated from whole blood and the APOE alleles were determined by polynicrase chain reaction. RESULTS: The genotype of APOE epsilon3/3 was the most common allele in the stroke group and the control group. The frequencies of APOE epsilon2, epsilon3, epsilon4 allele in stroke group were 0.052, 0.851, and 0.097, respectively. There was no significant difference in APOE genotypes between the stroke group and the control group. No significant associations lions were found for the APOE genotypes and the serum lipid profiles. CONCLUSION: These findings suggest that APOE was not related to the stroke,
Alleles ; Apolipoprotein E2 ; Apolipoproteins E ; Apolipoproteins* ; DNA ; Genotype ; Humans ; Lions ; Stroke

No abstract available.
Neurofibroma, Plexiform* ; Urinary Bladder*

PURPOSE: The aim of this study was to evaluate the utility of contrast-enhanced MRI with first-pass and delayed images in prediction of myocardial viability after acute myocardial infarction. MATERIALS AND METHODS: Ten patients (M:F=:4, mean age =6 5 years) with acute myocardial infarction underwent first-pass image after bolus injection of gadolinium (one image/sec for 120sec)and delayed image (7 2 minutes later). According to 60 segments on midventricular level, the assessment of MRI were concerned about location of lesion, depth of lesion, enhancement on first-pass image and enhancement pattern on delayed image. MRI findings were compared with wall motion on resting echocardiography and stress or follow-up echocardiography. RESULTS: 1) MRI findings were classified into 4 types: normal enhancement on first-pass and delayed images (type 1), normal enhancement on first-pass image and nontransmural hyperenhancement on delayed image (type 2), non-transmural enhancing defect on first-pass image and transmural enhancement with endocardial non-enhancing defect on delayed image (type 3), and transmural enhancing defect on first-pass image and transmural hyperenhancement on delayed image (type 4).2) Type 2 suggested viable myocardium and type 3 had high porbability of viability. Type was compatible with non-viable myocardium. CONCLUSION: Enhancing defect on first-pass image and involving thickness on both the first-pass image and delayed image in contrast enhanced MRI may predict myocardial viability.
Echocardiography ; Follow-Up Studies ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Myocardial Infarction* ; Myocardium

OBJECTIVE: The purpose of this study was to compare the skeletal, dental, and soft-tissue treatment effects of nonextraction therapy using the modified C-palatal plate (MCPP) to those of premolar extraction (PE) treatment in adult patients with Class II malocclusion. METHODS: Pretreatment and posttreatment lateral cephalographs of 40 adult patients with Class II malocclusion were retrospectively analyzed. The MCPP group comprised 20 patients treated with total arch distalization of the maxillary arch while the PE group comprised 20 patients treated with four PE. Fifty-eight linear and angular measurements were analyzed to assess the changes before and after treatment. Descriptive statistics, paired t-test, and multivariate analysis of variance were performed to evaluate the treatment effects within and between the two groups. RESULTS: The MCPP group presented 3.4 mm of retraction, 1.0 mm of extrusion, and 7.3° lingual inclination of the maxillary central incisor. In comparison, the PE group displayed greater amount of maxillary central incisor retraction and retroclination, mandibular incisor retraction, and upper lip retraction (5.3 mm, 14.8°, 5.1 mm, and 2.0 mm, respectively; p < 0.001 for all). In addition, the MCPP group showed 4.0 mm of distalization and 1.3 mm of intrusion with 2.9° distal tipping of the maxillary first molars. CONCLUSIONS: These findings suggest the MCPP is an effective distalization appliance in the maxillary arch. The amount of incisor retraction, however, was significantly higher in the PE group. Therefore, four PE may be recommended when greater improvement of incisor position and soft-tissue profile is required.
Adult ; Bicuspid* ; Humans ; Incisor ; Lip ; Malocclusion ; Molar ; Multivariate Analysis ; Retrospective Studies

Axillary arch is relatively common variation of muscle in the axilla. There were several attentions on axillary arch due to its anatomical and surgical importance. During educational dissection, a variant muscle was found in right arm of 68-year-old female cadaver. The variation of muscle originated from the lateral edge of the latissimus dorsi muscle as muscular form. And then, it crossed the axillary artery and median nerve as tendinous form. Finally it became wide as muscular form and inserted into the pectoralis major. We reported this variant muscle and discussed its clinical significances.
Aged ; Arm ; Attention ; Axilla ; Axillary Artery ; Cadaver* ; Female ; Humans ; Median Nerve ; Superficial Back Muscles