A total of 57 patients with basilar apex aneurysms were treated at our hospital from January 1990 to May 2011. The 57 patients were comprised of 18 male and 39 female patients aged from 31 to 81 years old (Mean age: 58.4 years old). Twenty nine cases were treated surgically and 28 cases underwent endovascular coiling. Medical and surgical records, postoperative angiographies, and follow up angiographies were reviewed retrospectively. Basilar apex aneurysm remains the ultimate challenge to neurovascular surgeons. Mortality and morbidity of endovascular coiling cases was relatively lower than that of surgical cases.

This study aimed to evaluate the role of D-dimer in terminal cancer patients. Among 343 incurable cancer patients, only 4 patients (2.8%) had normal D-dimer levels, and the majority (n=115, 81.0%) had levels >2.0 μg/mL. The survival time was significantly differed according to D-dimer levels with a median of 48 days when D-dimer levels were <2 μg/mL and 19 days when D-dimer levels were higher. D-dimer levels were negatively correlated with survival according to Spearman’s rank correlation analysis (coefficient -0.335, p<0.001). In terminal cancer patients, D-dimer concentrations did exhibit prog-nostic significance.

Proportion of elderly patients is gradually increasing in the republic of Korea. However, intravenous recombinant tissue plasminogen activator (rt-PA) therapy is recently not recommended in elderly acute ischemic stroke patients, although old age is not a proven contraindication to intravenous rt-PA. The purpose of this study was to investigate the safety and prognosis of intravenous thrombolysis in elderly patients.

The aim of this study is to investigate the clinical significance of acanthosis nigricans scales and locations in order to validate the relation of hyperinsulinemia and insulin resistance in obese children. We conducted a retrospective analysis of clinical records of obese children who visited Chosun University Hospital between January 2013 and February 2014 due to their obesity. Five anatomical sites were examined for evaluation of acanthosis nigricans. Clinical characteristics were compared according to the presence and severity of acanthosis nigricans. Among 55 children, 37 children had acanthocis nigricans. A consensus score of acanthosis nigricans was calculated by summing the scores of five locations. The diagnostic categories were: No acanthosis nigricans group, mild group, moderate group, and severe group. Elevated acanthosis nigricans total score showed strong association with elevated BMI, triglyceride, and c-peptide in all groups. Elevated acanthosis nigricans total score also showed strong association with elevated fasting insulin and HOMA-IR. We also found that the neck was the most frequent location of acanthosis nigricans. However, acanthosis nigricans on axilla showed strong association with elevated fasting insulin and HOMA-IR. Estimation of scales and locations of acanthosis nigricans could be useful as a clinical alternative for determining hyperinsulinemia and insulin resistance in obese children.

Recently there are increasing numbers of people participating in sports activities. Accordingly, the rate of sports injuries is increasing as well. In this light, this study was conducted to investigate the extent of acute damage and its forms by examining the current state of patients with sports injuries. This research study was conducted between January of 2008 and December of 2010 in Chosun University Hospital through retrospective review of the medical records of patients with sportsrelated injuries. The total number of patients with sports injuries who visited the emergency center was 887. The number of male patients was 726 (81.85%), far more than the number of female patients (18.15%). More than half of the patients, accounting for 419 (47.23%), had injuries on their face; second and common parts, in which injuries occurred, were upper and lower body, accounting for 146 (16.45%) and 193 (21.75%), respectively. The majority of patients did not undergo surgical treatment. Only 113 (12.73%) patients underwent surgical treatment. In addition, more than 80% of them were not hospitalized but 170 of them needed to be hospitalized. Most sports injuries occurred in young male patients. This can interrupt participation in sports activities for a long time and result in lower quality of life. Hence proper preventative measures and scientific treatment methods are needed.

Increased total IgE and eosinophil count levels are thought to provoke the occurrence of urticaria. The purpose of this study is to measure serum total IgE levels, specific IgE sensitization rates, and blood eosinophil count and to investigate the relationship between those factors. Among children who visited the Department of Pediatrics at Chosun University Hospital from January 2011 to December 2013, we retrospectively analyzed 63 patients with acute urticaria. Positive rates of the total serum IgE level, specific IgE, and blood eosinophil count were analyzed in patients with acute urticaria. A total of 63 patients were included in the study and the rate of males to females was 1: 0.8. Mean age of patients was 6.41±4.97 years (range 0-17 years). Among the subjects, 42.9% of patients showed an elevated serum total IgE and 63.5% of patients showed at least more than one allergen-specific IgE by MAST (multiple allergosorbent test). The mean number of allergens detected in positive patients was 2.42±2.56/patient. The serum total IgE and allergen specific IgE showed significant positive correlation (OR = 0.290, p=0.02). This study is meaningful as it revealed a positive correlation between serum total IgE and allergen specific IgE in urticaria patients.

We studied clinical utility of open door laminoplasty with foraminotomy in CSM with multilevel radiculopathy. We divided into two groups; the first group underwent laminoplasty with formainotomy, and the second group underwent laminoplasty and multiple ant. approaches. In the first group, the JOA score increased from a preoperative 13.3 to postoperative 16.0 (range, 10 to 18), and in the second group from 12.8 to 15.5 (range, 10 to 18). However, the pre-operative VAS score was 6.1, 6.5 and, 2 weeks after surgery, had decreased to 2.4, 1.4, the last score was the same, 1.8, finally. The open door lami-noplasty with foraminotomy was easily performed and clinical profiles were similar to those for the laminoplasty and multi-ple anterior approach.

Polyethylene and polystyrene are frequently used resins for making food container including cup noodle bowls. In the pre-sent study, we investigated the potential risks of polyethylene and polystyrene cup noodle containers by cytotoxicity tests such as agar diffusion assay, filter diffusion assay, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. We exposed CCL-1 mouse fibroblast cell line to the polyethylene and polystyrene cup noodle containers indirectly through agar gel. We also used eluents derived from the cup noodle containers by storing them for 24 h at 70℃ in liquids, such as distilled water or dimethylsulfoxide (DMSO). Both polyethylene and polystyrene cup noodle container specimen were found to be non-cytotoxic in agar diffusion assay as well as filter diffusion assay. The eluents from polystyrene using DMSO showed slight cytotoxicity in MTT assay.

Hydroureter could occur in a state where the whole ureter was remarkably expanded. The causes of occurrence are anatomi-cal urinary tract obstruction or vesicoureteral reflux, and it could occur unilaterally or bilaterally according to its reason. A 38-year-old man presented with left flank pain. Abdominal CT showed a severely atrophied left kidney and a large retroperi-toneal cyst near the left kidney. The pathologic finding showed that the cyst wall is composed of transitional epithelium, lamina propria, muscle, and adventitia, and final diagnosis was hydroureter. The unilateral marked hydroureter misdiagnosed as a retroperitoneal cyst was quite rare. We report on this rare case with literature.

In treatment of right ventricular failure with pulmonary hypertension, milrinone has not only an inotropic effect but also a vasodilating effect, thus, recently, it has been widely used. Recent studies have reported on the direct stimulation effects of doxapram on the central nervous system. A 91-year-old female underwent hemiarthroplasty under spinal anesthesia. When transported to the recovery room, right ventricular failure, cardiogenic shock, and mental deepening occurred. After stabiliz-ing vital signs, milrinone, doxapram was administered. We report on the effective use of milrinone for acute right ventricular failure and the active use of doxapram for reduced consciousness and hypoventilation.

The association of colorectal cancer with ulcerative colitis (UC) is well-recognized. However, not much is known regarding the increased risk of extra-intestinal malignancies with UC. Several studies have revealed that patients with UC are at in-creased risk of hepatobiliary cancer, nonmelanoma skin cancer, and myeloid leukemia. A 41-year-old man was diagnosed with UC in 1993 and had three relapses over the next three years. Six months after the fourth remission, he developed pan-cytopenia and was diagnosed with acute promyelocytic leukemia (APL). He achieved complete remissions of APL through chemotherapies, and, since then, no recurrences of APL and UC were observed.

Treatment of spontaneous retroperitoneal hemorrhage (SRH) is mainly conservative. However, if intra-abdominal hypertension (IAH) or abdominal compartment syndrome (ACS) develops, the treatment strategy should be more aggressive. Surgical decompression has been the gold standard; however, it is very invasive and highly morbid. Thus, percutaneous catheter drainage (PCD) has been introduced as an alternative therapeutic option. We report on a case of successful PCD for prevention of progression of IAH to ACS in a patient with SRH after coronary stent implantation. This case showed that PCD can be an efficacious and safe method for treatment of IAH with impending ACS.

We experienced an 18-month-old patient with congenital lobar emphysema who underwent one-lung ventilation. With con-sideration that positive pressure ventilation could induce cardiopulmonary distress, induction was performed with spontane-ous breathing using sevoflurane without neuromuscular blocking agent. Bronchospasm occurred after intubation and posi-tion change, twice. He was relieved by administration of neuromuscular blocking agents. We discussed induction methods with minimal positive-pressure ventilation and the treatments for bronchospasm.

Stress induced cardiomyopathy is characterized by transient systolic dysfunction of the apical segment of the left ventricle, in the absence of obstructive coronary artery disease. The clinical presentation of stress induced cardiomyopathy is similar to that of an acute myocardial infarction. Onset of stress induced cardiomyopathy is frequently triggered by intense emotional or physical stress. Hypoglycemia is one type of physical stress that causes stress induced cardiomyopathy. We report on a case of this syndrome associated with hypoglycemia.

Acute pulmonary embolism (PE) is a common and often catastrophic disease. Early diagnosis and treatment of PE is im-portant, however, prompt diagnosis is difficult due to nonspecific clinical manifestations. On the other hand, syncope may develop as a presenting symptom of PE, and defecation activity could trigger PE. In Korea, PE associated with defecation has not been previously reported. We report on a case of acute massive PE presenting as defecation syncope in a 26-year-old female with a serous borderline tumor of the ovary.

Pulmonary angiography has been regarded as the gold standard tool for diagnosis of pulmonary embolism. However, due to its invasive nature and the development and growing availability of non-invasive diagnostic imaging tests, such as computed tomographic pulmonary angiography, the role of pulmonary angiography in diagnosis of pulmonary embolism has waned rapidly, so that pulmonary angiography has become a state-of-the-art procedure available in a decreasing number of centres. Pulmonary angiography is the definitive diagnostic test, but complications of this procedure, including puncture site prob-lems, cardiac arrhythmia, and cardiac or vessel injury have been reported. However, few cases of cardiac vein rupture during pulmonary angiography have been reported. Here we report on a case of cardiac vein rupture which occurred during pulmo-nary angiography in an 82-year-old woman who underwent pulmonary angiography.

Atrial fibrillation (AF) is a common, benign, and transient type of supraventricular arrhythmia encountered during the early postoperative period after a pulmonary resection. However, it sometimes might result in hemodynamic deterioration. We report on a case of new-onset atrial fibrillation in a 74-year-old male patient after right lower lobectomy, which was not controlled with intermittent bolus injection of esmolol and diltiazem. Successful pharmacological cardioversion was achieved with intravenous (6 mg/hr for 2 hours) followed by oral (90 mg q day) diltiazem 20 hours after this treatment. The literature on the risk factors and management of atrial fibrillation after pulmonary resection is reviewed.

A 63-year-old woman with a history of nephrolithiasis and long-term hemodialysis (HD) presented with abdominal pain. Abdominal computed tomography (CT) showed urinoma induced by renal forniceal rupture, and three causative calculi. No active stone growth or new stones were observed when compared with previous CT, however, fragmentation and migration of an existing stone was observed. After ureteroscopic lithotripsy and stenting with a double-J catheter, the patient made a full recovery. To the best of our knowledge, this is the first case of spontaneous renal forniceal rupture in an anuric HD patient caused by calculi. Renal forniceal rupture can occur, even in anuric HD patients.

Multivessel spontaneous coronary artery dissection is extremely rare. There are no guidelines regarding optimal treatment of spontaneous coronary artery dissection. The treatment depends on clinical symptoms, extent and location of the dissection, and the hemodynamic status of the patient. Although percutaneous coronary intervention might be required for all of the dissecting arteries, this case demonstrated the importance of an appropriate selection of treatment modalities for spontaneous coronary artery dissection.