No abstract available.
Carotid Stenosis ; Endarterectomy, Carotid ; Hypoxia-Ischemia, Brain

During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complication. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-up in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examination in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examination in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis(n=5) and perforated appendicitis(n=1). Our results show that high-resolution, real-time US is an accureate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complication.
Abscess ; Adenocarcinoma ; Appendicitis* ; Appendix ; Diagnosis* ; Diverticulitis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography*

PURPOSE: Kindling refers to a process whereby repeated applications of an initially subconvulsive electrical or chemical stimulus to animals lead to persistent epileptogenic in generalized seizures. Metabotropic glutamate receptors (mGluRs) have been shown to be involved in many brain functions. Widespread distribution of the mGluRs suggests glutamate may be the primary modulator of G-protein coupled signal transduction in the central nervous system. To investigate the role of mGluRs in kindling, we studied the changes of mRNA gene expressions of mGluR1 and 5 on the hippocampus, amygdala, and basal ganglia in PTZ-induced kindled rats. METHODS: Male Wistar rats (n=6-4) were kindled by repeated administration, 5 times a week, by a subconvulsant dose of PTZ (35 mg/kg). After completion of kindling, the brains were analysed for mRNA gene expression of mGluR1 and 5 using reverse transcripted polymerase chain reaction (RT-PCR). RESULTS: The kindling score was significantly increased after 8 injections and the definitive kindling score (more than 4 point) was obtained after 10 injections. mRNA gene expressions of mGluR1 in hippocampus, amygdala, and basal ganglia were increased by 180.1+/-4.4%, 130.2+/-6.1%, 148.6+/-1.4% compared to controls (p<0.05), but those of mGluR5 were not significantly increased. CONCLUSIONS: Although the mRNA gene expression of mGluR5 did not show any marked changes in kindled rat brain, that of mGluR1 showed significant increase in hippocampus and amygdala. From these results, high density of mGluR1 may suggests glutamatergic systems plays a role in PTZ-induced kindling. But our results would not exclude the possibility that changes of mRNA gene expressions of mGluR1 and 5 are due to repeated seizure activity alone.
Amygdala ; Animals ; Basal Ganglia ; Brain ; Central Nervous System ; Gene Expression ; Glutamic Acid* ; GTP-Binding Proteins ; Hippocampus ; Humans ; Male ; Polymerase Chain Reaction ; Rats* ; Rats, Wistar ; Receptors, Glutamate* ; Receptors, Metabotropic Glutamate* ; RNA, Messenger ; Seizures ; Signal Transduction

PURPOSE: The purpose of this study was to identify international students' use of university health centers by individual characteristics and seasons. METHODS: This was a retrospective descriptive study using data obtained from the electronic record system of one university health center. The study participants were international undergraduate students who registered for any of two semesters between March 1, 2014 and February 28, 2015 and visited the university health center during their registration period. RESULTS: The most common reasons for visits were problems of head, eye, nose and throat systems, followed by respiratory system. Their visits mostly occurred in the fall and spring. The most frequently used services were distribution of oral medication followed by wound treatment. The number of visits per individual was statistically different by gender (u=-3.307, p=.001), but not by their major (chi2=.543, p=0.762) or nationality (chi2=5.518, p=.271). CONCLUSION: Further study is necessary to better define health needs and related factors for this unique population. The electronic record system provides great opportunities in development and application of need based health services for international students and for research in this area.
Ethnic Groups ; Head ; Health Services ; Humans ; Nose ; Pharynx ; Respiratory System ; Retrospective Studies ; Seasons ; Student Health Services ; Wounds and Injuries

BACKGROUND: A paradoxical embolism through the patent foramen ovale has been suggested as a possible cause of ischemic cerebrovascular disease in young patients without other cardiovascular risk factors, however, the transesophageal contrast echocardiographic examination is proved to be sensitive and accurate to detect the patent foramen ovale in vivo by demonstration a right-to-left shunting of microbubbles at the interatrial septum. METHODS: Transesophageal contrast echocardiographic examinations were performed in 16 young patients(32+/-6 years, 19~39) with ischemic cerebrovascular diseases without other cardiovascular risk factors. Contrast agents were injected twice in each patients, one with Valsalva maneuver and the other with coughing and the presence of the patent foramen ovale was confirmed by demonstrating echogenic contrast crossing the interatrial septum. RESULTS: The patent foramen ovale was demonstrated in five of sixteen patients(31.2%) during transesophageal contrast echocardiographic examination. Although the prevalence of the patent foramen ovale in normal population has not been examined in this study, the prevalence in patient group appears to be significantly higher than that of normal population. CONCLUSIONS: Taken together, a paradoxical embolism through the patent foramen oval appears to be one of the causative factors and a transesophageal contrast echocardiography is recommended especially in young ischemic cerebrovascular disease patients who have normal transesophageal echocardiographic findings and no known risk factors.
Contrast Media ; Cough ; Echocardiography* ; Embolism, Paradoxical ; Foramen Ovale, Patent* ; Humans ; Microbubbles ; Prevalence* ; Risk Factors ; Valsalva Maneuver

Autoimmune pancreatitis (AIP) is a benign disorder and a unique form of chronic pancreatitis with several characteristic features. A cystic formation that mimics a pseudocyst is a rare finding. There have been a few reports of AIP complicated by pancreatic cysts. We present a case of AIP with multiple pseudocysts and obstructive jaundice caused by IgG4-associated cholangitis. We initially missed the diagnosis due to the pseudocyst. Based on the computed tomography images, laboratory findings and the therapeutic response to steroids, the case was diagnosed as AIP with pseudocysts and associated cholangiopathy.
Cholangitis ; Jaundice, Obstructive ; Pancreatic Cyst ; Pancreatitis ; Pancreatitis, Chronic ; Steroids

A 68-year-old man developed mild quadriparesis 1 month prior to presentation. At 4 days before presentation, he developed dysarthria and more severe quadriparesis, predominantly on the left side of the body. MRI revealed edematous lesions in the medulla and throughout the spinal cord. Angiography showed a right tentorial dural arteriovenous fistula (DAVF). Despite successful treatment achieved by endovascular embolization, there was no improvement in the weakness of either leg. Early diagnosis of tentorial DAVF is important to prevent neurological complications such as encephalomyelopathy and hemorrhage.
Aged ; Angiography ; Central Nervous System Vascular Malformations* ; Dysarthria ; Early Diagnosis ; Hemorrhage ; Humans ; Leg ; Magnetic Resonance Imaging ; Quadriplegia ; Spinal Cord

Verrucous carcinoma that occurs only in the bladder is a very rare, well-differentiated squamous cell carcinoma. The tumor is a histologically and clinically distinctive variant of squamous cell carcinoma, and is almost exclusively associated with bilharzial infection. We report the radiologic findings of a case of verrucous carcinoma of the bladder unassociated with bilharzial infection.
Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Cystitis* ; Urinary Bladder*

PURPOSE: The proportion of interventional catheterization in congenital heart disease is being increased in Korea, especially in Sejong Heart Institute, so we performed statistical analysis on the cardiac catheterization cases. METHODS: Total 233 cases of congenital heart disease confirmed by cardiac catheterization at the Sejong Heart Institute between Jaunary 1995 and June 1995 were analyzed retrospectively. RESULTS: 1) The distribution of age has become more younger than that of previous reports that is, the proportion of the infant less than 1 year old was 34.8%. 2) The proportion of male sex was equal to that of female. TOF and TGA were observed predominantly in male patients, and PDA and UVH revealed female preponderance. 3) The relative frequencies of each individual congenital heart disease in order of frequency were as follows; TOF 37.3%, PDA 13.3%, VSD 8.2% and UVH 7.7%. 4) Among the 145 (62%) cases of hemodynamic study pre-operation and post-operation cases were 85 and 60 cases, respectively. The cases of interventional catheterization were 84 (36%), and those of endomyocardial biopsy were 4 (2%). 5) The frequencies of each interventional catheterization of 84 cases in order of frequency were as follows: defect closure 28 cases, balloon valvuloplasty 20 cases, balloon angioplasty 17 cases, coil embolization 15 cases, and balloon atrial septostomy 4 cases. 6) There were 2 cases of mortality associated with cardiac catheterization. CONCLUSIONS: The proportion of interventional catheterization in congenital heart disease is being increased in the Sejong Heart Institute, and this trend will spread to the other cardiac center in Korea.
Angioplasty, Balloon ; Balloon Valvuloplasty ; Biopsy ; Cardiac Catheterization ; Cardiac Catheters ; Catheterization* ; Catheters* ; Embolization, Therapeutic ; Female ; Heart ; Heart Defects, Congenital* ; Hemodynamics ; Humans ; Infant ; Korea ; Male ; Mortality ; Retrospective Studies

BACKGROUND: The etiologies of ischemic cerebrovascular diseases are various-thrombosis or artery to artery embolism, cardiogenic embolism and lipohyalinosis. In the past embolic cerebral infarct was thought to occur uncommonly. But these days substantial portion of patients have been found to have potential embolic sources by transesophageal echo cardiography and carotid duplex doppler. As transesophageal echocardiography has a high yield for identification of potential sources of cardiac embolism in patients with ischemic cerbrovascular diseases, its use has been increasing. In Korea an increasing number of patients with ischemic cerebrovascular diseases have been examined by transesophageal echocardiography since 1990. But in all the previous studies transesophageal echocardiographic evaluation has been confined to the patients with high probability of embolic cerebral infarct. All kinds of ischemic cerebrovascular diseases patients have never been examined by transesophageal echocardiography and carotid duplex doppler and the prevalence of potential embolic sources in Korean ischemic cerebrovascular disease patients is not known. The aim of this study was to evaluate the prevalence of potential cardiovascular embolic sources by transesophageal echocardiography and carotid duplex doppler in unselected patients with ischemic cerebrovascular diseases. METHODS: We evaluated all kinds of ischemic cerebrovascular diseases patients admitted from 1994. 9. 1. until 1995 9. 31. to the Departments of Neurology and Internal Medicine of Kangnam General Hospital. We evaluated them by transesophageal echocardiography, carotid doppler, brain CT(or brain MRI). A significant carotid stenosis was defined as a duplex scandetected lesion producing at least 50% vessel narrowing. The following echocardiographic findings were defined prospectively as potential cardiac sources of embolism : atrial appendage or left atrial cavity thrombus, spontaneous echocardiographic contrast, atrial septal aneurysm, interatrial shunt, ventricular aneurysm, ventricular thrombus, myxomatous mitral valve and protruding atherosclerotic plaque in the ascending aorta or transverse aortic arch. RESULTS: Of 64 patients admitted during the study period, 30 were excluded(Three patients were critically ill, and twenty seven patients refused diagnostic work-up.). Thorough diagnostic work-up was performed in 34 patients. Transesophageal echocardiographic positive findings were present in six patients(17.6%). Of them four(4/34, 11.7%) had spontaneous echo contrast, two(2/34, 5.8%) had left atrial thrombi, one(1/34, 2.9%) had ascending aorta atheroma. Eleven patients(11/34, 32.3%) had abnormalities in carotid doppler study. Five patients(5/34, 14.7%) had abnormalities both in transesophageal echocardiography and carotid doppler study. CONCLUSIONS: The results suggest that among ischemic cerebrovascular diseases patients substantial portion of patients have potential embolic sources. The prevalence of potential embolic sources in Korea may be higher than previously expected. Because the relative small number of the patients studied make it difficult to generalize the results, further studies with a large number of patients are needed.
Aneurysm ; Aorta ; Aorta, Thoracic ; Arteries ; Atrial Appendage ; Brain ; Carotid Stenosis ; Critical Illness ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Hospitals, General ; Humans ; Internal Medicine ; Korea ; Mitral Valve ; Neurology ; Plaque, Atherosclerotic ; Prevalence ; Prospective Studies ; Thrombosis