Cancer-related facial pain refractory to pharmacologic management or nondestructive means is a major indication for destructive pain surgery. Stereotactic mesencephalotomy can be a valuable procedure in the management of cancer pain involving the upper extremities or the face, with the assistance of magnetic resonance imaging (MRI) and electrophysiologic mapping. A 72-year-old man presented with a 3-year history of intractable left-sided facial pain. When pharmacologic and nondestructive measures failed to provide pain alleviation, he was reexamined and diagnosed with inoperable hard palate cancer with intracranial extension. During the concurrent chemoradiation treatment, his cancer-related facial pain was aggravated and became medically intractable. After careful consideration, MRI-based stereotactic mesencephalotomy was performed at a point 5 mm behind the posterior commissure, 6 mm lateral to and 5 mm below the intercommissural plane using a 2-mm electrode, with the temperature of the electrode raised to 80degrees C for 60 seconds. Up until now, the pain has been relatively well-controlled by intermittent intraventricular morphine injection and oral opioids, with the pain level remaining at visual analogue scale 4 or 5. Stereotactic mesencephalotomy with the use of high-resolution MRI and electrophysiologic localization is a valuable procedure in patients with cancer-related facial pain.
Aged ; Analgesics, Opioid ; Electrodes ; Facial Pain* ; Humans ; Magnetic Resonance Imaging ; Morphine ; Palate, Hard ; Upper Extremity

A clinical observation was performed on 2,122 cases of premature infants who were admitted to Ilsin Christian during the past 5 years from Jan. 1986 to Dec. 1990. The results were as follows; 1) The incidence of prematurity was 5.7%, overall mortality rate was 15.8%, and the sex ratio of male to female was 1.5:1. 2) Concomitant maternal diseases were premature rupture of membrane 457 cases (21.5%), preeclampsia & eclampsia 424 cases (19.9%), multiple pregnancy 250 cases (11.7%) etc, in the order of frequency. 3) Prematurity was most prevalent among multipara over 3. 4) Incidence of prematurity according to maternal age was frequent in woman more than 35 years old. 5) Mortality of prematurity was higher inversely propotional to birth weight & gestational age. 6) Main causes of death were IRDS 45 cases (43%), congenital anomaly 72 cases (21.6%), sepsis 31 cases (9.3%), and unknown 84 cases (25.0%). 7) Clinical problems were hyperbilirubinemia 38.9%, hypoglycemia 28.6%, IRDS 18%, sepsis & other infections 8.1% etc, in the order of frequency. 8) Most deaths were seen within first 24hr (74.5%).
Adult ; Birth Weight ; Cause of Death ; Eclampsia ; Female ; Gestational Age ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Incidence ; Infant, Newborn ; Infant, Premature ; Male ; Maternal Age ; Membranes ; Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Multiple ; Rupture ; Sepsis ; Sex Ratio

Ambulatory BP monitoring was performed in a patients with pheochromocytoma before and after removal of the tumor. Before surgery, it did not show any significant diurnal variation. But, after surgery the diurnal variation was restored.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Humans ; Pheochromocytoma*

No abstract available.
Adrenocorticotropic Hormone* ; Animals ; Heart* ; Mice*

No abstract available.
Humans ; Nitroblue Tetrazolium* ; Skin* ; Tuberculosis, Cutaneous*

Diabetes is associated with increased risk of cardiovascular disease, with atherosclerosis responsible for most associated morbidity and mortality. Atherosclerosis often causes acute thrombotic events through plaque rupture and formation of platelet-rich thrombi. The principal clinical manifestations of atherosclerosis are coronary artery disease, ischemic stroke, and peripheral arterial disease. Endothelial dysfunction, oxidative stress, and low-grade inflammation are key features in the pathophysiology of atherosclerosis.
Atherosclerosis ; Biomarkers ; Cardiovascular Diseases ; Coronary Artery Disease ; Diabetes Mellitus ; Inflammation ; Oxidative Stress ; Peripheral Arterial Disease ; Rupture ; Stroke

Purpose: Dislocation is the second most common cause of failure, after implant loosening, in revisional THA (Total hip arthroplasty), and its evaluation and treatment still remain controversial issue. This study was undertaken to evaluate the risk factors after THA using the posterolateral approach and posterior soft tissue repair. Materials and Methods: Between January 1998 and May 2003, 211 consecutive primary total hip replacement arthroplasties using the posterolateral approach and posterior soft tissue repair were performed by the same surgeon. To compare the dislocation groups (6 cases) with the non-dislocation groups (205 cases), we randomized 120 of the non-dislocation cases. The risk factors for hip dislocation were categorized into patient factors and surgical factors. Patient factors included gender, age, preoperative diagnosis, underlying systemic disease, and alcoholic history. Surgical factors included position of the component (acetabular version and inclination, femoral anteversion), leg length discrepancy, and sum of anteversions of the cup and stem. Their parameters were measured on postoperative radiographs. Statistics were performed with Fishe`s Exact test and T test. Results: Dislocations occurred at an overall incidence rate of 2.8% (6/211cases). There were 4 (1.9%) cases of anterior dislocations and 2 (0.9%) cases of posterior dislocations. Dislocations occurred on average at postoperative day 6.1 and all dislocated hips were reduced with the closed method, except for one case that was treated surgically. There was no statistical significance in patient factors between the two groups, except for neurologic disease and alcoholic history. However, the sum of the acetabular and femoral anteversions in the anterior dislocation group was larger than that of the non-dislocation group by approximately 19 degrees. Conclusion: Our results demonstrated that by using the posterior approach and repair of soft tissue, the posterior dislocation rate after total hip replacement arthroplasty can be reduced and the sum of the acetabular and femoral anteversions had more influence on dislocations after THAs than did either anteversion alone.
Acetabulum ; Alcoholics ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Diagnosis ; Dislocations ; Hip Dislocation* ; Hip* ; Humans ; Incidence ; Leg ; Risk Factors*

BACKGROUND: Surgical endarterectomy had been known to be the standard treatment modality in management of carotid stenosis. However, endarterectomy had several limitations in high-risk patients, particulary with coronary artery disease. Carotid angioplasty and stenting has been suggested to be a safer and more cost-effective alternative to carotid endarterectomy in the management of symptomatic carotid artery disease. The purpose of this study is to evaluate the feasibility and safety of elective carotid artery stent implantation in patients with carotid artery stenosis. METHOD: We treated 19 patients with symptomatic and asymptomatic stenosis of >60% in 19 carotid arteries with balloon angioplasty followed by elective stent implantation. Of all carotid stenting procedures, 18 stents were implanted in obstructing atherosclerotic plaques and in one for Takayasu's arteritis. Of all patients, 10 patients were symptomatic with a history of stroke or transient ischemic attacks which were ipsilateral to the treated carotid artery. 12 patients represented a high-risk subset with myocardial infarction, previous coronary artery bypass graft and coronary artery stenosis. 6 months follow up angiogram was done in 7 patients, a patient(Takayasu's arteritis) showed restenosis. Result: Angiographic and procedural success rate were 100%, and there were no acute or subacute stent thrombosis. Immediately after initial carotid stenting, the mean(+/-SD) stenosis was reduced from 74.9+/-13.6% to 10.2+/-8.7% and the minimal luminal diameter was increased from 1.4+/-0.8mm to 5.3+/-1.0mm corresponding to an acute gain of 3.9mm. There were no major or minor stokes during follow-up. CONCLUSION: Percutaneous carotid angioplasty with stenting is a safe and feasible procedure. It is associated with high immediate success rates and relatively low complications in the management of carotid artery stenosis. Carotid stenting seems to be a reasonable alternatives to medical management for the treatment of carotid stenosis in patients deemed to be poor candidates for standard carotid endarterectomy.
Angioplasty ; Angioplasty, Balloon ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Stenosis* ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Stenosis ; Endarterectomy ; Endarterectomy, Carotid ; Follow-Up Studies ; Humans ; Ischemic Attack, Transient ; Myocardial Infarction ; Phenobarbital ; Plaque, Atherosclerotic ; Stents* ; Stroke ; Takayasu Arteritis ; Thrombosis ; Transplants

BACKGROUND: Lambert-Eton myasthenic syndrome(LEMS) is characterized by the clinical triad of muscle weakness, hyporeflexia, and autonomic dysfunction. In contrast to myasthenia gravis.LEMS is not commonly associated with respiratory failure. Any case of respiratory failure in LEMS has not been reported in Korea. CASE DESCRIPTION: The first case is a 61-tear-old male complained of proximal muscle weakness and dysarthria associated with severe dry mouth for 3 month and developed respiratory failure. The second case is a 65-tear-old male who began complaining of muscle weakness, weight loss, dry mouth, and recurrent respiratory difficulty for 14 months. Repetitive nerve stimulation(RNS) test for ulnar nerve showed CMAP with low amplitude, a significant decremental response at the low rate stimulation and a marked incremental response at the high rate stimulation in the left abductor digiti muscles in both cases. The first case had small cell carcinoma of the lung, but the second case presented with respiratory failure in the absence of malignancy. CONCLUSION:We experienced two cases of LEMS presenting respiratory failure. To our knowledge, this is the first report of respiratory failure in LEMS in Korea.
Carcinoma, Small Cell ; Dysarthria ; Humans ; Korea ; Lambert-Eaton Myasthenic Syndrome* ; Lung ; Male ; Mouth ; Muscle Weakness ; Muscles ; Reflex, Abnormal ; Respiratory Insufficiency* ; Ulnar Nerve ; Weight Loss

BACKGROUND: Lambert-Eton myasthenic syndrome(LEMS) is characterized by the clinical triad of muscle weakness, hyporeflexia, and autonomic dysfunction. In contrast to myasthenia gravis.LEMS is not commonly associated with respiratory failure. Any case of respiratory failure in LEMS has not been reported in Korea. CASE DESCRIPTION: The first case is a 61-tear-old male complained of proximal muscle weakness and dysarthria associated with severe dry mouth for 3 month and developed respiratory failure. The second case is a 65-tear-old male who began complaining of muscle weakness, weight loss, dry mouth, and recurrent respiratory difficulty for 14 months. Repetitive nerve stimulation(RNS) test for ulnar nerve showed CMAP with low amplitude, a significant decremental response at the low rate stimulation and a marked incremental response at the high rate stimulation in the left abductor digiti muscles in both cases. The first case had small cell carcinoma of the lung, but the second case presented with respiratory failure in the absence of malignancy. CONCLUSION:We experienced two cases of LEMS presenting respiratory failure. To our knowledge, this is the first report of respiratory failure in LEMS in Korea.
Carcinoma, Small Cell ; Dysarthria ; Humans ; Korea ; Lambert-Eaton Myasthenic Syndrome* ; Lung ; Male ; Mouth ; Muscle Weakness ; Muscles ; Reflex, Abnormal ; Respiratory Insufficiency* ; Ulnar Nerve ; Weight Loss