OBJECTIVE: The authors reviewed experience with patients harboring intracerebral hematoma (ICH) treated by stereotactic computed tomography (CT) guided thrombolysis and aspiration and evaluated feasibility, safety and prognostic factors of this procedure. METHODS: One hundred and ten patients with supratentorial ICH >25 ml without underlying structural etiology or coagulopathy were recruited. The patients with Glasgow Coma Scale (GCS) <5 were excluded. A catheter was directed stereotactically into the ICH under CT guidance. Hematoma aspiration was followed by instillation of urokinase. This was repeated every 6 hours until less than half of its initial volume remained. For analysis of prognostic factors, we classified them into two groups;good (Glasgow Outcome Scale (GOS) > or =4) and bad (GOS<4) prognosis group, and performed comparative analysis between two groups. RESULTS: Mean age was 59.8 years. The baseline hematoma size ranged from 15 to 72 mL. ICH volume reduced by an average of 74.2%. At 6 months after the procedure, 56 patients had achieved a good recovery, 29 patients were dependent, and 10 remained vegetative. Fifteen patients died in hospital. The main good prognostic factors were young age, small ICH volume, high GCS, absence of rebleeding, underlying disease and complications. CONCLUSION: CT-guided thrombolysis and aspiration appears safe and effective in the reduction of ICH volume. Patients of ICH presenting with bad prognostic factors should require frequent radiological investigation and more meticulous procedure. Further studies are needed to assess optimal thrombolytic dosage and must include controlled comparisons of mortality, and disability outcome.
Catheters ; Glasgow Coma Scale ; Hematoma* ; Humans ; Mortality ; Prognosis ; Urokinase-Type Plasminogen Activator

In this study, I made researches of 510 mothers who breed their infants in total (256 boys & 254 girls), among which 410 in urban area and 100 in the rural area, as an object of the investigation so as to make an intensive examination and analysis of the actual state of feeding nutritive method, grasp several related factors, and finally suggest the elementary data for both campaign encouraging breast feeding and the infant feeding education. 1. Mothers showed the meaningful local differences as in an education and income level at 1% and as in a delivery type at 5%. 2. To have decided the feeding conditions according to the residences by the Kaup index distribution (P<0.05) resulted in a meaningful difference according to regions and also made us be more thoughtful of the overnutrition in the urban area than in the rural area, and it didn't showed a meaningful difference the nutritive state according to the infant feeding method thought desirable (P<0.01). 3. The feeding methods consist of breast feeding at 21.8%, artificial feeding at 48.8%, and the mixed one at 29.4%. As for the feeding method thought desirable, breast feeding was 52%. Even though they were thinking that breast feeding is better, the breast feeding case didn't go beyond 32.5% only and as for the actual feeding methods it showed a meaningful difference according to the feeding method thought desirable (P<0.01). 4. Regarding the reasons why they chose breast milk, it was 64%, the most because mother's milk contains the immune system, 63.1% for the baby's health, 52.3% because of its most because breast milk is of little quantity, 37.8% because of the mother's occupation, 14.1% because they have fed the baby artificially from the beginning and so on. Considering the reasons why they chose the mixed feeding, it was 70.7%, the most because the amount of breast milk a little, 27.3%, the next one, because of the mother's occupation and so on. 5. The respondents who answered that how to increase the number of breast feeding population depends on the reinforcement of breast feeding education for the women were 190 (37.3%), the most among all 150 persons and those who had the opinion that they should spread and actualize the temporary childcare rest (from office) system for the women who have jobs were the secondly most, 107 (21%).
Breast Feeding ; Surveys and Questionnaires ; Education ; Feeding Methods* ; Female ; Hand Strength ; Humans ; Immune System ; Infant* ; Milk ; Milk, Human ; Mothers ; Nutritional Support ; Occupations ; Overnutrition ; Thinking

Double outlet right ventricle, a complex of congenital cardiac anomalies in which both great arteries arise wholly or in large part from the morphologic right ventricle presents diverse clinical manifestations according to the morphological characteristics. Eighty cases with DORV were diagnosed and operated at Yonsei Cardiovascular Center from 1988 to 1992. The analysis of the morphological characteristics of this anomaly and comparative study of operative methods and mortality according to the morphological classification led to the following results: 1) The location of VSD varied to be subaortic in 40 cases, subpulmonic in 15, doubly committed in 6 and noncommitted in 19 cases. The great arteries were interrelated in D-malposition in 43 cases and L-malposition in 18 and 26 cases among above mentioned 61 cases revealed the side-by-side relationship. Ten of the cases showed normal position and the rest 9, A-malposition. 2) Pulmonary stenosis was found in 60 cases, and when associated with subpulmonic VSD, occurring less frequently. PDA and ASD secundum were associated in successional order and only 3 cases were verified to carry aortic arch anomalies such as coarctation and interruption, all with subpulmonic VSD. 3) Intraventricular tunnel repair was possible in every case associated with subaortic VSD and the postoperative prognosis was excellent. In comparison, most of the cases associated with other types of VSD in which only palliative surgery or various types of intraventricular repair were performed, the general outcome was poor. But total cavopulmonary connection, one of the physiological corrective methods, showing a better postoperative prognosis is being carefully considered for its broad adoptation in future. In conclusion, double outlet right ventricle, a pathophysiological complex of various anomalies, should be thoroughly evaluated for the morphological characteristics to decide the most appropriate types of operation and for consequent improvement of prognosis.
Aorta, Thoracic ; Arteries ; Classification ; Double Outlet Right Ventricle* ; Heart Ventricles ; Mortality ; Palliative Care ; Prognosis ; Pulmonary Valve Stenosis

Crystalline retinopathy is a tapetoretinal degeneration characterized by glistening yellow intraretinal crystals in the posterior pole, chorioidal sclerosis, and corneal crystalline dystrophy. We have recently encountered a 36 year-old female patient with bilateral intraretinal crystalline depositions who presented with a complaint of visual disturbance in her right eye for the last six months. Typical fundus findings of crystalline deposition in the posterior pole, tapetoretinal dysfunctions in the electrophysiologic tests and choriocapillaris filling defects in the fluorescein angiogram suggest that this the disorder is a widespread choriocapillaris and tapetoretinal disorder. There are no significant abnormal findings in serologic and radiologic examinations.
Adult ; Crystallins* ; Female ; Fluorescein ; Humans ; Retinitis Pigmentosa ; Sclerosis

Hemangioma appearing on the conjuntiva is a rare benign tumor which may be derived from vessels of conjuntiva, sclera, ocular muscles and orbit. Recently, we have experienced two cases of well encapsulated movable, round and slightly nodular conjuntival masses which had smooth, dark bluish-red colored surfaces. The masses were simply excised and histopathologic study revealed cavernous hemangioma.
Hemangioma ; Hemangioma, Cavernous* ; Muscles ; Orbit ; Sclera

No abstract available.
Catheters* ; Heart Defects, Congenital*

No abstract available.
Follow-Up Studies* ; Lung Neoplasms* ; Lung*

We report an unusual case of lateral medullary infarction after successful embolization of the vertebral artery dissecting aneurysm (VADA). A 49-year-old man who had no noteworthy previous medical history was admitted to our hospital with a severe headache. Computed tomography (CT) revealed a subarachnoid hemorrhage, located in the basal cistern and posterior fossa. Cerebral angiography showed a VADA, that did not involve the origin of the posterior inferior cerebellar artery (PICA). We treated this aneurysm via endovascular trapping of the vertebral artery distal to the PICA. After operation, CT revealed post-hemorrhagic hydrocephalus, which we resolved with a permanent ventriculoperitoneal shunt procedure. Postoperatively, the patient experienced transient mild hoarsness and dysphagia. Magnetic resonance image (MRI) showed a small infarction in the right side of the medulla. The patient recovered well, though he still had some residual symptom of dysphagia at discharge. Such an event is uncommon but can be a major clinical concern. Further investigation to reveal risk factors and/or causative mechanisms for the medullary infarction after successful endovascular trapping of the VADA are sorely needed, to minimize such a complication.
Aneurysm ; Aneurysm, Dissecting ; Arteries ; Cerebral Angiography ; Deglutition Disorders ; Headache ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Spectroscopy ; Middle Aged ; Pica ; Risk Factors ; Subarachnoid Hemorrhage ; Ventriculoperitoneal Shunt ; Vertebral Artery

BACKGROUNDS: When measuring lung function and response to bronchodilator, MDI(metered-dose inhaler) is commonly used but unfamiliarity of its use and cold sensation by the puffed gas decrease reliability of the result. Spacer can reduce the cold freon effect and undesired oropharyngeal deposition caused by the rapid evaporation of the propellant and there are many studies which showed more effectiveness of spacer on the treatment of children with asthma but no study whether it is effective on the bronchodilator response test in the first medical examination of old age. Therefore, we tested whether the use of spacer can reduce the cold freon effect and improve the bronchodilator response in the first medical examination of old age. METHODS: Two hundred of elderly patients( 65years) who had never used MDI were measured the bronchodilator response. Subjects were randomised to either spacer-user or spacer-nonuser. Twenty minutes after 400 g fenoterol was administered, FEV1 (forced expiratory volume in one second) was measured. Bronchoconstriction was defined as a decrease in FEV1 by 10% or greater after bronchodilator inhalation. We further devided each group into normal or obstructive group, obstructive group was defined as FEV1<80% of predicted and FEV1/FVC<70%. RESULTS: In normal group, spacer-user(n=83) showed greater bronchodilator response than spacer-nonuser(n=66), 6.43% vs 3.81% respectively(p<0.05) and two case of bronchoconstriction occured only in spacer-nonuser. In obstructive group, there is no significant difference in bronchodilator response between spacer-user(n=18) and spacer-nonuser(n=33), 12.32% vs 11.16% respectively(p>0.05) but brochoconstriction(n=1) occured only in spacer-nonuser. CONCLUSION: Spacer improved bronchodilator response and prevented bronchoconstriction, in the first medical examination of old age.
Aged ; Asthma ; Bronchoconstriction ; Child ; Chlorofluorocarbons ; Fenoterol ; Humans ; Inhalation ; Lung ; Sensation

Ultrasonography is a predominantly accurate, relatively simple unique diagnsotic method of obstructive jaundice. The ultrasonographic findings of obstructive jaundice are dilated intra- and extrahepatic duct with intraluminal hyperreflective echo or mass in and/or around the bile duct. The superiority of high resolution real time ultrasonography for the diagnosis of obstructive jaundice is based on the easy detectability of extra-and intrahepatic bile ducts by its multiple sectional images in a short time, the flexibility of probe and the small crystal size. Author evaluated real time sonographic findings 46 obstructive jaundice patients confirmed by surgery or radiographical examinations. The results were: 1. Diameter of extrahepatic duct in obstructive jaundice were varied from normal to 4.0 cm, mostly 8 to 10 mm in diameter (26%). Degree of dilatation of biliary duct appeared more prominent in cancer patients than any other causes of obstruction. 2. The site of obstruction was detected in85% (39/46) and its common site was common bile duct in 63% (29/46). 3. The diagnostic accuracy of choledocholithiasis and cancer was 82% (22/27) and 44% (4/9), respectively. Diagnostic accuracy of the real time ultrasonography in obstructive jaundice was over all 75% (34/46).
Bile Ducts ; Bile Ducts, Intrahepatic ; Choledocholithiasis ; Common Bile Duct ; Diagnosis ; Dilatation ; Humans ; Jaundice, Obstructive ; Methods ; Pliability ; Ultrasonography