BACKGROUND: "Rebuild-up" phenomenon, induced by hyperventilation, is a characteristic finding on EEG in children with Moyamoya disease. Its mechanism, however, remains obscure. In this study, we examined the relationship between cerebral lesions on MRI, stenosis or occlusion of cerebral vessel on cerebral angiography, and EEG findings in children with Moyamoya disease. METHODS: We have reviewed medical records of 33 patients, who were confirmed as Moyamoya disease by cerebral angiography at Asan Medical Center. EEG and brain MRI were carried out in all subjects. RESULTS: 1) Epidemiologic data were : the male to female ratio was 1:1.1; highest rate(90.7%) of onset in age group below 10 years; mean age at clinical onset was 7.4 years; average diagnostic interval from clinical onset to diagnosis was 1.9 years. 2) The most common initial and recurrent or residual symptoms were motor deficit. 3) The most common site of occlusion or stenosis of cerebral vessel on cerebral angiography was anterior cerebral area(>97%) and the most common cerebral infarction area on brain MRI was anterior cerebral area, too. 4) The hyperventilation(for 3 minutes) on EEG were carried out in 25 patients and the prolonged build-up or rebuild-up phenomenon was observed in 13 patients(52%). 5) The prolonged build-up or rebuild-up phenomenon on EEG was observed in 6 of 15 patients who were occlusion of cerebral vessel, and in 7 of 10 patients who were stenosis of cerebral vessel on angiography. CONCLUSION: 1) The background slowings on EEG maybe suggestive of the infarction stage of Moyamoya disease in children. 2) The prolonged build-up or rebuild-up phenomenon might indicate the preinfarction stage of Moyamoya disease in children.
Angiography ; Brain ; Cerebral Angiography ; Cerebral Infarction ; Child ; Chungcheongnam-do ; Constriction, Pathologic ; Diagnosis ; Electroencephalography ; Female ; Humans ; Hyperventilation ; Infarction ; Magnetic Resonance Imaging ; Male ; Medical Records ; Moyamoya Disease*

From Jan. 1987 to May 1994, we carried out cementless total hip arthroplasties using hydroxyapatite-coated Omnifit system, and among these, 63 cases in 49 patients were followed up more than 24 months. The average Harris Hip Score was 46.3 points preoperatively, 95.4 points at POD 1 year and 96.2 points at POD 2 years. Two patients (3%) complained thigh pain at POD 2 years. On the radiologic findings, endosteal bone formation was noted in 34 cases (53,9 %), radiolucent lines were seen at the non-coating region of distal stem in 41 cases (65.3%), which were less than 2mm and not progressive. Cortical hypertrophy was noted in 5 cases (8.4%), and calcar atrophy was observed in 31 cases (49 %).
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Atrophy ; Durapatite* ; Hip ; Humans ; Hypertrophy ; Osteogenesis ; Thigh

No abstract available.
Biopsy, Fine-Needle* ; Diagnosis, Differential* ; Radionuclide Imaging* ; Thyroid Gland* ; Thyroid Nodule* ; Ultrasonography*

OBJECTIVE: Self-expanding stents are increasingly used for the treatment of complex intracranial aneurysms. The purpose of this study was to evaluate the usefulness and safety of a self-expanding nitinol stent (Enterprise) in the treatment of wide-necked intracranial aneurysms. METHODS: This was a retrospective study of 39 patients with 40 wide-necked intracranial aneurysms who were enrolled in a single-center registry of patients treated with the Enterprise between June 2009 and December 2011. Thirty patients were asymptomatic, four had cerebrovascular accident sequelae, and five had suffered subarachnoid hemorrhage. One aneurysm had reopened after prior coil embolization, while 39 had not been treated. Clinical charts, procedural data, and angiographic results, including both immediate post-procedural angiograms and follow-up imaging, were reviewed. RESULTS: The mean neck size of the aneurysms was 5.58 mm (range 3-15.1 mm). Embolization was successful in all patients. There were five procedure-related events. There were no fatalities, but one procedure-related morbidity was noted. The immediate angiographic results included eight complete occlusions (20%), six remnant necks (15%), and 26 remnant sacs (65%). At angiographic follow-up (mean: 11.3 months), out of 18 of the aneurysms treated with stent-assisted coiling, there were 13 (72.2%) complete occlusions, four (22.2%) remnant necks, and one recanalization (5.6%). CONCLUSION: Stent-assisted coiling using the Enterprise is effective for the treatment of wide-necked intracranial aneurysms. Further angiographic and clinical follow-up investigation will be needed for evaluation of the long-term outcomes.
Aneurysm* ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Neck ; Retrospective Studies ; Stents* ; Stroke ; Subarachnoid Hemorrhage

No abstract available.
Age Factors* ; Hematoma, Subdural, Chronic*

No abstract available.
Aneurysm* ; Arteries*

OBJECTIVE: To analyze the clinical characteristics of obese infertile women. MATERIAL AND METHOD: Height, weight, body mass index, menstrual pattern, glucose, insulin, glucose / insulin ratio, dehydroepiandrosterone sulfate (DHEA-S), testosterone, free testosterone and plasminogen activator inhibitor (PAI-1) of 15 obese infertile women were tested. RESULTS: Of 15 obese infertile women, the number of diabetes mellitus, hyperinsulinemia, and insulin resistance was 2 (13%), 2 (13%), 2 (13%), respectively. The incidence of increased DHEA-S, testosterone, and free testosterone was 7 (47%), 1 (7%), 6 (40%), respectively. Notably, all patients showed increased PAI-1. CONCLUSIONS: Obesity is associated with infertility as well as many kinds of health problems. Obesity is closely related to insulin resistance and it also causes hyperandrogenism. Increased PAI-1 is one of the important causes of thrombophilia. Consequently, in the workup of obese infertile patient, many aspects of health problems should be considered.
Body Weight ; Dehydroepiandrosterone Sulfate ; Diabetes Mellitus ; Female ; Glucose ; Humans ; Hyperandrogenism ; Hyperinsulinism ; Incidence ; Infertility ; Insulin ; Insulin Resistance ; Obesity ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Testosterone ; Thrombophilia

PURPOSE: To assess the combined effectiveness of angioinfarction and immunotherapy for improving survival in patients with stage IV renal cell carcinoma. MATERIALS AND METHODS:During the past 3 years, 13 patients of stage IV renal cell carcinoma were treated with angioinfarction and immunotherapy. Angioinfarction was performed on these 13 patients using absolute ethanol and occlusive baloon catheter. After angioinfarction, Interferon alpha was used for immunotherapy. For our analysis, 12 control patients of stage IV renal cell carcinoma without treatment were included in the study. Survival has been calculated according to the Kaplan and Meier method. RESULTS: The 1 year survival rate and median survival time in patients treated with angioinfarction and immunotherapy, were 46% and 13 months and in patients without treatment, 16% and 4 months, respectively. CONCLUSION:The combined treatment of angioinfarction and immunotherapy is of considerable value for improving survival in patients with stage IV renal cell carcinoma
Carcinoma, Renal Cell* ; Catheters ; Ethanol ; Humans ; Immunotherapy* ; Interferon-alpha ; Survival Rate

A rostro-caudal topography of the oculomotor nerve fascicles is relatively well known in animal but not in human. We experienced two cases of midbrain infarctions presenting with isolated oculomotor nerve palsies. The MRI of the patient who had monocular elevation palsy with ptosis revealed a lesion in the middle to lower midbrain, whereas that of the other who had monocular depression and adduction palsy with pupillary mydriasis showed a discrete lesion in the upper to middle midbrain. We present the rostro-caudal arrangement of the oculomotor fascicles within midbrain based on MRI findings.
Animals ; Depression ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Mesencephalon* ; Mydriasis ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Paralysis

OBJECTIVE: Because endometriosis is difficult to diagnose and has a high recurrence rate after treatment, a reliable serum marker of endometriosis is necessary. Therefore, the aim of this study is to measure the serum levels of CA125 and CA19-9 in patients with endometriosis before and after treatment and during recurrence, and to assess the usefulness of these levels in the diagnosis, clinical follow up and prediction of recurrence in endometriosis. METHODS: Eighty-eight patients who visited the department of Obstetrics and Gynecology of Ewha Mokdong Hospital from January 1994 to December 1998 and were diagnosed as endometriosis by laparoscopy or explo-laparotomy were enrolled as subjects. A retrospective analysis of serum CA125 and CA19-9 levels at 1 month before and 3 to 6 months after initiation of treatment was done. RESULTS: The serum CA125 and CA19-9 levels of endometriosis group(81.0+/-252.5, 36.6+/-53.4 ; mean+/-2SD, U/ml) before treatment was significantly higher than control group(11.6+/-12.8, 9.4+/-8.6)(p<0.05). Overall sensitivity rate for CA125, CA19-9 levels and both was 53.4%, 42.9% and 64.3% respectively. The sensitivity rate for endometriosis, stage 3 and 4(85.4%, 55.0%) was significantly higher than that, stage 1 and 2(p<0.05). The serum CA125 level in endometriosis group showed a significant increment according to stages(p<0.05) while the serum CA19-9 level showed an increasing trend(p=0.055) and both levels decreased significantly after treatment(p<0.05). The serum CA125 level was also higher at recurrence after treatment(p<0.05). CONCLUSIONS: The serum CA125 and CA19-9 levels are a useful marker for diagnosing severity of disease, monitoring efficacy of treatment and predicting recurrence in endometriosis.
Biomarkers ; Diagnosis ; Endometriosis* ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Laparoscopy ; Obstetrics ; Recurrence ; Retrospective Studies