Reversible splenial edema has been often reported in epilepsy patients. Clinical presentation is reported to be silent in general. We experienced a patient with splenial lesion and cognitive dysfunction. A 21-year-old man underwent video-EEG monitoring for preoperative evaluation. He had suffered from viral encephalitis eight years ago and developed chronic drug-resistant epilepsy. After antiepileptic drugs withdrawal, he developed eight episodes of secondarily generalized tonic-clonic seizures for several hours and some seizures were repeated without recovery of consciousness. Majority of ictal EEG onset presumed to originate from the left frontal region. After seizures he had shown disorientation and irritability with gradual recovery. Brain MRI demonstrated a splenial lesion. Though splenial lesion disappeared on follow-up MRI, neuropsychological test demonstrated frontal lobe dysfunction 6 months later compared with that performed just before the video-EEG monitoring. We report a patient with isolated reversible splenial lesion associated with long term dysfunction of frontal lobe.
Anticonvulsants ; Brain ; Consciousness ; Edema ; Electroencephalography ; Encephalitis, Viral ; Epilepsy ; Follow-Up Studies ; Frontal Lobe* ; Humans ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Seizures ; Status Epilepticus* ; Young Adult

This study is a retrospective analysis of 1244 cases of the inguinal hernia in children under the age of fifteen years who were operated at the department of pediatric surgery, Inje University Busan Paik Hospital from March, 1997 to February, 2007. The ratio of male to female was 3.6:1. The type of hernia was indirect in all of the cases. The hernia was on the right side in 656 cases (53.9 %), left side in 467 cases (37.5 %), and bilateral in 121 cases (9.7 %). The hernia presented most frequently in infants under age 12 months; 364 cases (29.2 %). Fifty-nine cases (21.7 %) were in female and 305 cases (31.3 %) in male. There were 428 cases (33.6 %) in 1-3 years age group, 295 cases (23.7 %) in 4-6 years, 112 cases (9.0 %) in 7-9 years, 39 cases (3.1 %) in 10-12 years and 16 (1.2 %) in 13-15 years. The content of hernia sac was small bowel (59 %), omentum (31 %) in males and the ovary and tube (54 %) and small bowel (26 %) in female. The incidence of combined operation at the time was 3.2 %, and consisting of orchiopexy (67.5 %), frenulotomy (12.5 %), appendectomy (10 %), circumcision (5 %), and fistulotomy (5%). The incidence of combined disease was 2.8 % and consisting of undescended testis, Hirschsprung's disease, idiopathic hypertrophic pyloric stenosis, imperforate anus, and congenital heart disease. After unilateral inguinal hernia repairs, contralateral hernias developed in 34 patients. The laterality of the primary site of hernias were left in 19 cases (55.8 %), and right 15 cases (44.1 %). The 936 cases (75.2 %) were operated under general anesthesia; Mask bagging 663 cases (53.2 %), endotracheal intubation 257 cases (20.6 %), and laryngeal mask 16 cases (1.2 %). The remainder 308 cases (24.7 %) were operated under regional caudal anesthesia.
Anesthesia, Caudal ; Anus, Imperforate ; Appendectomy ; Child ; Circumcision, Male ; Cryptorchidism ; Female ; Heart Diseases ; Hernia ; Hernia, Inguinal ; Hirschsprung Disease ; Humans ; Incidence ; Infant ; Intubation, Intratracheal ; Laryngeal Masks ; Male ; Masks ; Omentum ; Orchiopexy ; Ovary ; Pyloric Stenosis, Hypertrophic ; Retrospective Studies

Background and objectives: Carvedilol is a cardiovascular drug, beta- and alpha1-adrenoceptor antagonist, currently approved for the treatment of hypertension, angina, congestive heart failure by FDA. Carvedilol has been shown to attenuate oxygen free radical-initiated lipid peroxidation and to inhibit neointimal formation of aorta following vascular injury by balloon angioplasty. We have investigated the effect of carvedilol on DNA synthesis of vascular smooth muscle cells (VSMC) stimulated by platelet-derived growth factor (PDGF)-BB. MATERIALS AND METHOD: Rat aortic smooth muscle cells were obtained by the combined collagenase and elastase methods. Cells between the 4th and 8th passages were used for the experiments. Incorporated radioactivity of [3H]-thymidine was measured by liquid scintillation spectrometry. RESULTS: PDGF-BB (1 nM) increased [3H]-thymidine incorporation about 70-100% over basal value in cultured VSMC. PDGF-stimulated increase in DNA synthesis was significantly suppressed by simultaneous administration of carvedilol. In contrast, propranolol did not significantly affect 3[H]-thymidine uptake in rat aortic VSMC. CONCLUSION: The present study demonstrate that carvedilol significantly inhibits the proliferation of vascular smooth muscle cell in our condition. These results indicate that carvedilol may be effective in the treatment of cardiovascular diseases principally associated with abnormal vascular smooth muscle growth.
Angioplasty, Balloon ; Animals ; Aorta ; Cardiovascular Diseases ; Cell Proliferation ; Collagenases ; DNA ; Heart Failure ; Hypertension ; Lipid Peroxidation ; Muscle, Smooth, Vascular* ; Myocytes, Smooth Muscle ; Oxygen ; Pancreatic Elastase ; Platelet-Derived Growth Factor ; Propranolol ; Radioactivity ; Rats ; Spectrum Analysis ; Vascular System Injuries

As a part of plan to construct a multifunctional hospital information system, We planned to develop a chemotherapy order system. First, a software developing team was established which is composed of hematooncology staffs, special pharmacists and programmer who are responsible for OCS. We set up an outline of this system after collecting various kinds of sources such as foreign examples, gathered protocol that are used for chemotherapy, and organized these protocol in programming the chemotherapy order system. This project is expected to provide accurate prescription, to shorten the time to prepare prescription, to standardize the protocol of chemotherapy within the medical center, to manage an effective dispensing schedule and to be used as a source for education and research.
Appointments and Schedules ; Drug Therapy* ; Education ; Hospital Information Systems ; Humans ; Pharmacists ; Prescriptions

No abstract available.
Drug Therapy* ; Etoposide* ; Humans ; Leukemia* ; Mitoxantrone*

PURPOSE: The purpose of this study is to evaluate migration of technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) labeled immature and mature dendritic cells (DC) in the mouse. METHODS: DC were collected from bone marrow (BM) of tibiae and femurs of mice. Immature and mature DC from BM cells were radiolabeled with 99mTc-HMPAO. To evaluate the functional and phenotypic changes of DC from radiolabeling, the allogeneic mixed lymphocyte reaction (MLR) and fluorescence-activated cell sorting (FACS) analysis were performed before and after labeling with 99mTc-HMPAO. Migration of intravenously injected DC (iv-DC) was assessed by serial gamma camera images of mice with or without subcutaneous tumor. Percent injected dose per gram (%ID/g) was calculated in lungs, liver, spleen, kidneys, and tumor through dissection of each mice after 24 hours of injection. RESULTS: Labeling efficiency of immature and mature DC were 60.4 +/- 5.4% and 61.8 +/- 6.7%, respectively. Iv-DC initially appeared in the lungs, then redistributed mainly to liver and spleen. Migration of mature DC to spleen was significantly higher than that of immature DC (38.3 +/- 4.0 % vs. 32.2 +/- 4.1 % in control group, 40.4 +/- 4.1% vs. 35.9 +/- 3.8 % in tumor group; p< 0.05). Migration to tumor was also significantly higher in mature DC than in immature DC (2.4 +/- 0.3% vs 1.7 +/- 0.2%; p=0.034). CONCLUSION: Assessment of migration pattern of DC in mice was possible using 99mTc-HMPAO labeled immature and mature DC. Migration of mature DC to spleen and tumor was higher than that of immature DC when they were i.v. injected.
Animals ; Bone Marrow ; Dendritic Cells* ; Femur ; Flow Cytometry ; Gamma Cameras ; Kidney ; Liver ; Lung ; Lymphocyte Culture Test, Mixed ; Mice* ; Radionuclide Imaging ; Spleen ; Technetium Tc 99m Exametazime ; Tibia

Although acute appendicitis is one of the most common surgical diseases, very rare but serious complications can occur including retroperitoneal abscess complicated by acute appendicitis. The early diagnosis of retroperitoneal abscess is often difficult and delayed because its clinical course is often insidious and does not present with typical symptoms of acute appendicitis. We experienced a 65-year-old male patient who was diagnosed with acute appendicitis with retroperitoneal abscess. As the retroperitoneal abscess was not fully removed via emergency operation, postoperative percutaneous drainage was performed but not effective. Retroperitoneal abscess can be cured by 2nd operation with retroperitoneal approach. We report here an unusual case of retroperitoneal abscess complicated by acute appendicitis.
Abscess ; Aged ; Appendicitis ; Drainage ; Early Diagnosis ; Emergencies ; Humans ; Male

BACKGROUND: Atherosclerosis is a diffuse disease process that produce thickening of the vascular wall because of intimal deposition of lipid, fibrous tissue, and calcific material. Nowadays it is possible to evaluate atherosclerotic changes of carotid arteries accurately by developed noninvasive techniques such as ultrasonography. Left ventricular hypertrophy (LVH) is known to be an important risk factor for cardiovascular events in hypertension. The purpose of this study was to establish whether the carotid intimal - medial thickness (IMT) correlates with the severity of LVH. METHOD: We measured intimal-medial thickness (IMT) for 12 sites in carotid arteries (near and far walls in common carotid, bifurcation, and internal carotid arteries of both sides) by B-mode ultrasonography in both 38 normotensive and 72 hypertensive patients. Left ventricular measurements were made according to the recommendations of the American Society of Echocardiography. Left ventricular mass was derived from the formula described by Devereux et al. and each left ventricular mass value was indexed to body surface area. And then we have investigated whether hypertensive patients have significant changes of carotid IMT and IMT correlates with left ventricular mass index (LVMI). RESULTS: (1) Most hypertensive patients had diffuse thickening of the carotid artery and some had focal or multiple plaques. (2) In general, mean IMT was widest in the carotid bifurcation. (3) The mean IMT of all 12 segments increased about 40% in hypertensive patients compared with normal control group. (4) LVMI significantly correlates with IMT of carotid artery, especially bifurcation site and mean all 12 segments. CONCLUSION: The mean IMT may serve as a useful marker of the severity of atherosclerosis in hypertensive patients. The significant association between carotid IMT and LVMI suggests a simultaneous correlation of carotid atherosclerosis with left ventricular hypertrophy in hypertension.
Atherosclerosis ; Body Surface Area ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Artery, Internal ; Echocardiography ; Humans ; Hypertension ; Hypertrophy, Left Ventricular* ; Risk Factors ; Ultrasonography

The case of sigmoid volvulus combined with a transomental hernia is reported. A 70-year-old man was admitted to our hospital with mild abdominal pain and distension. Although no signs of peritoneal irritation were apparent, a plain abdominal X-ray showed a markedly dilated loop of the sigmoid colon, and CT revealed a whirl pattern of the sigmoid mesentery. These findings suggested sigmoid volvulus. Colonoscopic reduction was attempted as an initial nonoperative treatment, and an urgent laparotomy was performed after the reduction failed. The sigmoid loop was herniated through the great omentum, with torsion in the clockwise direction. The colon was manually untwisted in the counter-clockwise direction, and the sigmoid loop was released by dividing the great omentum. During this one-stage operation, intraoperative colonic irrigation, sigmoid resection, and primary anastomosis were performed. The postoperative course was uneventful. Although sigmoid volvulus combined with a transomental hernia is rare, urgent surgical intervention is essential on failure of endoscopic reduction.
Abdominal Pain ; Aged ; Colon ; Colon, Sigmoid ; Hernia ; Humans ; Intestinal Volvulus ; Laparotomy ; Mesentery ; Omentum