PURPOSE: This paper evaluate and classified the risk factors that could possibly cause ischemic stroke in children, and investigate whether TOAST classification could be applied to the ischemic stroke in children. METHODS: From March 1995 to February 2002, we retrospectively reviewed the medical record of 87 patients under the age 16 who had been registered to the Ajou Stroke Registry. We evaluated the risk factors of ischemic stroke according to the Ajou Stroke Registry Protocol, and classified the risk factors into 6 main subgroups. In addition, the risk factors were investigated according to the age distribution. TOAST classification had been applied to children with ischemic stroke. RESULTS: There was 64 ischemic stroke(73.6%) and 23 hemorrhagic stroke(26.4%) among the 87 patients. In children with ischemic stroke, there was three major peak age; 13 patients younger than 1 year old(15.3%), 26 patients in age 5 to 8 years old(40.6 %), 22 patients in 9 to 12 years old(34.3%). Vasculopathy(48.6%) was the most common risk factor of the ischemic stroke in this study. Other important risk factors in order of frequency were hypertensive encephalopathy(12.5%), infectious disease(7.8%), metabolic disease(7.8%), and hematologic disease(6.2%). Moyamoya disease was the most common cause of ischemic stroke due to vasculopathy. If we analyze the risk factors according to the age at the presentation of ischemic stroke, 90% of the ischemic stroke due to vasculopathy had been developed after 5 years of age. However, ischemic stroke due to infectious disease had been developed less than 4 years of age. Major stroke was the most common subtype of the ischemic stroke in children, but TIA had been found in 80% of the patients with ischemic stroke due to moyamoya disease. TOAST classification determined the subtype of the ischemic stroke only in 2 children. Risk factors of ischemic stroke in the remained 62 patients were extremely variable, and could not be applicable to the TOAST classification. CONCLUSION: Risk factor of ischemic stroke were found in the 90% of patients. Although risk factors of ischemic stroke were extremely variable in children, cerebral vasculopathy including moyamoya disease was the most common. However, inherited metabolic disorder, coagulopathy, and hypertensive encephalopathy were also relatively common risk factors of ischemic stroke especially in children older than 5 years old. Therefore, we must extensively evaluate all the possible risk factors of ischemic stroke in children. TOAST classification could not be applicable in children because the risk factors of ischemic stroke were extremely variable.
Age Distribution ; Child* ; Child, Preschool ; Classification ; Communicable Diseases ; Humans ; Hypertensive Encephalopathy ; Medical Records ; Moyamoya Disease ; Retrospective Studies ; Risk Factors* ; Stroke*

Takayasu's arteritis is a chronic vasculitic disease of the aorta, its major branches and the pulmonary arteries, resulting in stenosing, occlusive or aneurysmal lesion. While the precise etiology of Takayasu's disease is unknown, an autoimmune mechanism or active tuberculous inflammation have been suggested. It is more common in young oriental women but has a rare incidence in children. We experienced a case of Takayasu arteritis type IV in an 8years old girl. The diagnosis was made by physial examination and digital substraction aortography(DSA) which showed narrowing of left common carotid artery, right subclavin artery and left renal artery. The perfusion defect at posterior segment of right upper lobe was noted in lung perfusion scan. Medical treatment and percutaneous transluminal angioplasty(PTA) were performed. In addition to case report, a brief review of literature was added.
Aneurysm ; Angioplasty* ; Aorta ; Arteries ; Carotid Artery, Common ; Child ; Diagnosis ; Female ; Humans ; Incidence ; Inflammation ; Lung ; Perfusion ; Pulmonary Artery ; Renal Artery ; Takayasu Arteritis*

Neurologic studies were done on 7 neuro-Behcet's syndrome patients, admitted from June 1985 to June 1986. They were from 30 to 43 years of age with mean age nf 35. 3;3 were male and 4 female. Symptoms fitting more than 3 of the 4 major diagnostic criteria included in Shimizu's classification preceded the neurological symptoms in all 7 patients and they progressed to neuro-Behcet syndrome approximately 5 years after the appearance of the first major syrnptoms of Behcet's syndrome, Severe headache was seen in all 7 patients. Ataxia, dysarthria, increased DTR, and herniplegia. were other rnajor signs found and psychiatric symptoms were present in 2 cases. The cases were neurologically classified as brain stem syndrome in 3 male patients, meningo-encephalitic syndrome in 1, and mixed type in 3. Characterletic laboratory findinge were lncreaeed mononuclear celle in CSF, peripheial blood leukocytosis, and decreased lymphocyte blastogenesis.
Ataxia ; Behcet Syndrome* ; Brain Stem ; Classification ; Dysarthria ; Female ; Headache ; Humans ; Leukocytosis ; Lymphocyte Activation ; Lymphocytes ; Male

The purpose of this study was to evaluate the role of anterior cervical plate after discectomy and autologous iliac bone graft in the treatment of cervical spondylosis. One hundred and seven cervical spondylotic patients from Jan. 1995 to Mar. 1998 were separated into two groups: Group 1. consisted of 58 patients treated with anterior discectomy, bone fusion, and anterior cervical plate fixations(54 cases of Caspar nonlocking plate and 4 cases of Orion locking plate system), Group 2. consisted of 49 patients treated with anterior discectomy and bone fusion. The mean follow-up duration was 26.5 months(from 6 to 45 months). The overall fusion rate did not showed any difference between the two groups, but in multi-level patients, graft materials related complications(extrusion or collapse of graft) were significantly high in group 2.(p<0.01). Group 1. patients ambulated on POD 1 with Philadelphia collar. The average admission period was 8.4 days following operation. Group 2. patients ambulated on POD 5-7 with Philadelphia collar. The average admission period was 11.9 days after surgery. In conclusion, bony fusion was successfully achieved in both groups and graft materials related complication rate showed no difference in the single level, but was significantly low in group 1 in the multilevel.
Diskectomy* ; Follow-Up Studies ; Humans ; Spondylosis* ; Transplants

We are reporting a case of 25-year-old male patient with elastosis perforance serpiginosa who showed multipte serpiginous plaques on his neck. Some of the lesions showed hypopigmented, hard, scar-tissue like plaques in the central part. Histologic examination showed hyperplasia and transepidermal elimination of elastic tissue. By electron microscopy, also, we could prove that the elastic fibers were increased in the dermis.
Adult ; Dermis ; Elastic Tissue ; Humans ; Hyperplasia ; Male ; Microscopy, Electron ; Neck

PURPOSE: To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. MATERIALS AND METHODS: We retrospectively reviewed effectivenss of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n=4), ruptured bullae (n=2), and histiocytosis-X(n=l). Three patients had iatrogenic pneumothorax caused by trauma (n=l) and surgery(n=2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. RESULTS: All catheters were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. CONCLUSION: Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.
Catheters* ; Chest Tubes* ; Drainage* ; Fluoroscopy* ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracotomy ; Thorax* ; Tuberculosis

PURPOSE: To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. MATERIALS AND METHODS: We retrospectively reviewed effectivenss of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n=4), ruptured bullae (n=2), and histiocytosis-X(n=l). Three patients had iatrogenic pneumothorax caused by trauma (n=l) and surgery(n=2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. RESULTS: All catheters were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. CONCLUSION: Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.
Catheters* ; Chest Tubes* ; Drainage* ; Fluoroscopy* ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracotomy ; Thorax* ; Tuberculosis

No abstract available.
Cardiomyopathies* ; Peripartum Period*

Dislocation of the clavicle at its sternal end is relatively rare, as compared with acromioclavicular dislocation. Among them, the posterior dislocation of the sternoclavicular joint was extremely rare. So, not more than fifty cases had been reported in the literature. Of these three main typesanterior, superior, and posterior-the anterior one is by far the most common. Most authors have stressed the difficulty in confirming the diagnosis with routine radiographs. We experienced a case of traumatic posterior dislocation of the sternoclavicular joint treated successfully by manipulative reduction. So, we report it with review of literature.
Clavicle ; Diagnosis ; Dislocations ; Sternoclavicular Joint

No abstract available.
Heart Septal Defects, Ventricular* ; Heart Ventricles* ; Pulmonary Atresia*