No abstract available.
Meningitis*

The clinical analysis of cranial nerve injuries was performed on 435 cases with cranoicrerbral trauma. This prospective study included the correlation between cranial nerve injuries and risk factors such as intracranial hematoma, initial Glasgow Coma Scale(GCS) score, pneumocephalus, and other combined injuries. The results were revealed as follows : 1) 133 cranial nerve injuries(on 97 patients) were noted among 435 craniocerebral trauma victims(97/435=22.2%). 2) The order of frequent cranial nerve injuries was facial nerve(7.3%), olfactory nerve(6.9%), oculomotor nerve(4.4%), abducens nerve(3.9%), optic nerve(3.2%), etc. 3) Bilateral involvment of cranial nerve injuries was noted in 16.5%(22/133). 4) The incidence of immediate onset of cranial nerve injuries was 66.9%(89/133). 5) The incidence of cranial nerve injuries was significantly high in patients with pneumocephalus and low initial GCS score. 6) The functional recovery of injured cranial nerve within 3 months was noted in 30.1%(40/133).
Coma ; Cranial Nerve Injuries* ; Cranial Nerves* ; Craniocerebral Trauma* ; Hematoma ; Humans ; Incidence ; Pneumocephalus ; Prospective Studies ; Risk Factors

A propecive analysis of 50 patients with acute interhemisphric subdural hemorrhage and tentorial hemorrhage, an unusual pattern of acute subdural hematoma, who were managed in a uniform way was analyzed to related outcome to hemorrhagic site, initial Glasgow Coma Scale(GCS) and combined injuries. The incidence of acute interhemisphric subdural hemorrhage(ISH) and tentoria hemorrhage(TH) after head trauma was 3.83%, 50 cases among 1303 head injured cases. And 80% of the above hemorrhage disapperaed within two weeks after trauma. There was no significant relationship between feature of hemorrhage and intial GCS(P>0.05), but there was highly significant relationship between initial GCS and Glasgow Outcome Scale(GOS) (p<0.001). There noted significant relationship between initial combined injury and GOS(p<0.01), and also brainstem injury and GOS(p<0.001).
Brain Stem ; Coma ; Craniocerebral Trauma ; Head ; Hematoma, Subdural* ; Hematoma, Subdural, Acute ; Hemorrhage* ; Humans ; Incidence

PURPOSE: The purpose of this study was to identify effects of action learning approaches on learning outcomes of students taking nursing management courses. METHODS: The questionnaire surveys were completed between March 2011 and June 2012 by 109 undergraduate seniors in the nursing department of C University. Survey data were obtained 3 times: before, in and after the study of nursing management. The course consisted of lectures and clinical practices. Learning outcomes were measured through problem solving skills, team efficacy, and class satisfaction. Collected data were analyzed using repeated measures ANOVA with the SPSS 20.0 program. RESULTS: Scores for problem solving skills (F=13.67, p<.001) and team efficacy (F=4.49, p=.012) showed statistically significant increases after the course. The scores also increased significantly after the lectures for 5 of 9 problem solving skill subscales: analysis skill, divergent thinking, decision making, assessment, feedback, and after the clinical practices for 2 subscales: divergent thinking, and execution and risk taking. Class satisfaction score also increased after both the lectures and the clinical practices. CONCLUSION: The findings from this study suggest that an action learning approaches for nursing management courses would be a useful teaching and learning method to achieve learning outcomes.
Decision Making ; Humans ; Learning ; Lectures ; Problem Solving ; Surveys and Questionnaires ; Risk-Taking ; Teaching ; Thinking

The authors report two cases of clozapine-induced acute hepatitis. Two patients developed asymptomatic hepatitis and got better with conservative care. We decreased the dosage of clozapine and added hepatic protectors, resulting in normalized laboratory findings. The authors also reviewed side effects of clozapine in this report. We reviewed the suggested mechanism of either clozapine or chlorpromazine-induced hepatitis. Clozapine influences the liver cell via cytochrome P 450 and chlorpromazine does so via mild cholestasis. There may be a possibility that a patient who has experienced drug-induced hepatitis is vulnerable to clozapine-induced acute hepatitis. In this respect, those who have experienced drug-induced hepatitis must be observed more closely.
Chlorpromazine ; Cholestasis ; Clozapine ; Cytochrome P-450 Enzyme System ; Drug-Induced Liver Injury ; Hepatitis* ; Humans ; Liver

If hypertensive emergencies are left untreated, multiple damages on heart, brain and kindney can develop. So rapid control of blood pressure within safty with effective antihypertensive agents is mandatory. For the comparison of antihypertensive effects among hydralazine (IV or IM), clonidine (IV), and nifedipine (sublingual) in hypertensive emergency, which were frequently used in our hospital, we performed propective study with hypertensive emergency patients(243 cases) who visited emergency room from Oct. 1986 until Aug. 1987. The results are as follows ; 1) For 58 patients who recieved hydralazine (IV or IM), initial mean arterial blood pressure(MAP) was 167.2+/-21.5mmHg and 15 minutes later 138.9+/-24.4mmHg, 45 minutes later 141.7+/-21.1mmHg, 90 minutes later, 133.9+/-26.6mmHg and, respectively. For 55patients who recived clonidine(IV), initial MAP was 164+/-21.9mmHg and 15minytes later 137.4+/-18.9mmHg, 45 minutes later 127.5+/-34.9mmHg, respectively. For 130 patients who recived nifedipine(sublingual), initial MAP was 159.8+/-21.4mmHg and 15 minutes later 143.0+/-22.8mmHg, 45 minutes later 127.5+/-21.1mmHg, 90 minutes later 119.3+/-20.0mmHg, respectibely. 2) Pulse rate showed 12.9% increase afer administration of hydralazine, 15.8% decrease in clonidine, 5.6% increase in nifedipine, respectively. 3)Severe reduction of blood pressure(systolic BP<130mmHG) after administration of following antihypertensive agents was found. i.e., hydralazine 5.2%, clonidine 1.8%, nifedipine 1.5%, respectively. 4) In 4 cases(6.9%) out of the 58 cases using hydralazine, 3 cases(5.5%) out of the 55 cases using clonidine, 9 cases(6.9%) out of the 130 cases using nifedipine, acute paradoxic hyertensive effects were observed.
Antihypertensive Agents ; Blood Pressure ; Brain ; Clonidine* ; Emergencies* ; Emergency Service, Hospital ; Heart ; Heart Rate ; Humans ; Hydralazine* ; Nifedipine*

Hypertensive encephalopathy is an acute clinical syndrome that shows central nerve dysfunction with sudden and marked elevation in blood pressure. But its pathophysiologic mechanisms, clinical courses and prognosis are still not clear. In order to study clinical manifestations and response to treatment in patients with hypertensive encephalopathy, we reviewed 45 patients with hypertensive encephalopathy who were admitted in Dept. of Internal Medicine, National Medical Center, from January 1975 to December 1984. The following results were obtained: 1) The ratio of male to female was 1.1:1. The peak age of incidence was in the 6th and 7th decade with mean age of 57.5 years. 2) Among 45 patients, only 29 had known history of hypertension and the average duration of hypertension was 8.1+/-3.6 years. 3) The most common sympotm was severe headache (68.9%). And altered consciousness, nausea and/or vomiting, focal neurologic signs and visual disturbance were also common symptoms in decreasing order of frequency. 4) Funduscopic examination showed hypertensive retinopathy in 20 of 24 (91.7%) patients and lumbar puncture revealed increased CSF pressure in 12 of 20 (60%) patients. 5) In most patients, the mean interval to symptomatic improvement was 2.1 days after administration of anti hypertensive agents, but in 6 patients with initial mean arterial blood pressure above 170mmHg, 4 patients showed delayed response and 2 patients were expired.
Antihypertensive Agents ; Arterial Pressure ; Blood Pressure ; Consciousness ; Female ; Headache ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Hypertensive Retinopathy ; Incidence ; Internal Medicine ; Male ; Nausea ; Neurologic Manifestations ; Prognosis ; Spinal Puncture ; Vomiting

Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

An intracerebral aneurysm usually bleeds into the subarachnoid space in addition it may also rupture into the subdural space or into the brain, and it is reported that approximately 2-8 percent of all ruptured aneurysm have an associated subdural hematoma. We had experienced 4 cases of subdural hematoma following ruptured intracerebral saccular aneurysm from 1983 to 1985. They were distal anterior cerebral artery aneurysm and middle cerebral artery aneurysm, and 2 cases of anterior communicating artery aneurysm. There were no relationship between the amount of subdural hematoma and clinical course. With a view to the clinical course, 3 cases were acute, and one was chronic.
Aneurysm* ; Aneurysm, Ruptured ; Brain ; Hematoma, Subdural* ; Intracranial Aneurysm ; Rupture ; Subarachnoid Space ; Subdural Space

We report our experience of renal polyomavirus infection after renal allograft leading to graft dysfunction. A fourty seven-years-old male patient, has been on Tacrolimus based dual immunosuppression, showed graft dysfunction with rising serum creatinine at post-transplant day 140. His graft function had been good without any acute rejection episode. A tentative diagnosis of acute rejection was rendered and core needle biopsy was performed. Viral infection was initially suggested by the occurrence of markedly enlarged tubular epithelial cells containing large nuclei with smudgy chromatin pattern. Confirmatory diagnosis of human polyomavirus induced interstitial nephritis was obtained by electron microscopy, which showed viral particles in the nuclei of tubular epithelial cells. After Tacrolimus was converted to cyclosporine, renal function was stabilized. A review of the literature indicates that asymptomatic infection, ureteric stricture, and hemorrhagic cystitis are other possible manifestations of polyomavirus in the human urogenital tract. According to some prior reports, polyomavirus induced interstitial nephritis might be a cause of graft loss. But our patient has retained a stable graft function with a chnange of immunosuppression.
Allografts* ; Asymptomatic Infections ; Biopsy, Large-Core Needle ; Chromatin ; Constriction, Pathologic ; Creatinine ; Cyclosporine ; Cystitis ; Diagnosis ; Epithelial Cells ; Humans ; Immunosuppression ; Male ; Microscopy, Electron ; Nephritis* ; Nephritis, Interstitial ; Polyomavirus Infections ; Polyomavirus* ; Tacrolimus ; Transplants ; Ureter ; Virion