No abstract available.
Brain* ; Epilepsy*

Dyke-Davidoff-Masson syndrome is a rare clinical syndrome consisting of hemiatrophy of cerebral hemisphere, enlargement of ventricles and prominent pneumatization of petrous pyramid of the temporal bone. Its clinical manifestations are hemiparesis, several types of seizure, mental retardation and other neurologic deficits. We experienced a case of Dyke-Davidoff-Masson syndrome in a four months old boy who visited to our department due to right side upper extremity weakness and infantile spasm. The brain magnetic resonance imaging showed marked hemiatrophy of left cerebral hemisphere and enlargement of left lateral ventricle. So with the review of literatures, we report a case of Dyke-Davidoff-Masson syndrome with infantile spasm.
Brain ; Cerebrum ; Humans ; Infant ; Infant, Newborn ; Intellectual Disability ; Lateral Ventricles ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Paresis ; Petrous Bone ; Seizures ; Spasms, Infantile* ; Temporal Bone ; Upper Extremity

PURPOSE: To evaluate the pattern of distant lymph node metastasis in colorectal carcinoma and its correlation with distant organ metastasis. MATERIALS AND METHODS: We retrospectively reviewed abdominal CT scans of 46 patients with pathologically proven colorectal carcinoma. RESULTS: The incidence of distant lymphadenopathy in colorectal carcinoma was 30.4%(14/46). The most commonly involved distant lymph node was the left paraortic lymph node below the renal hilum(9/25). The most common type of distant lymphadenopathy was solitary type(7/14) and all of these lymphadenopathies were noted in the left paraortic lymph node below the renal hilum. Six cases of left sided colorectal carcinoma showed left paraortic lymphadenopathy with solitary type. The incidence of distant organ metastasis was 17. 4%(8/46) and markedly increased if distant lymphadenopathy was multiple and confluent, or confluent type(5/7). CONCLUSION: The incidence of distant lymphadenopathy in colorectal carcinoma was not high and the most common lymphadenopathy was the left paraaortic lymph node with solitary type below the renal hilum. The possibility of distant organ metastasis was high if distant lymphadenopathy was multiple and confluent, or confluent type.
Colorectal Neoplasms* ; Humans ; Incidence ; Lymph Nodes* ; Lymphatic Diseases ; Neoplasm Metastasis* ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Coronary Aneurysm* ; Mucocutaneous Lymph Node Syndrome*

Sleep disorders are very common among pediatric patients. Its prevalence is between 10% and 45% in preschool- and school-aged children. However parents commonly do not concern about their children's sleeping habits and for many pediatricians, there is not part of the routine office visit about a childs sleep. Sleep disorders were classified by International Classification of Sleep Disorder (ICSD) as dyssomnias, parasomnias, sleep disorders associated with mental, neurologic, or other medical disorders, and proposed sleep disorders. There are lots of differences in the causes, manifestations, and managements of sleep disorders between children and adults. The sleep disorders in childhood may manifest themselves as bedtime resistance, refusal to go to bed at a parentally described time, sleep-onset delay, inability to fall asleep within a reasonable time, prolonged nighttime awakening, and inability to return to sleep without assistance after waking during the night, and so have wide-ranging influences on children's behavior, mood, school performance, and family life. It's very important for pediatrician to concern about the sleep disturbances in childhood and so the problems of sleep in children should be early detected and managed.
Adult ; Child ; Classification ; Disulfiram ; Dyssomnias ; Humans ; Office Visits ; Parasomnias ; Parents ; Prevalence ; Sleep Wake Disorders*

BACKGROUND: Intermittent rhythmic delta activity (IRDA) is classified as a nonspecific abnormal EEG pattern. IRDA is clinically associated with alteration of consciousness, hydrocephalus, cerebral edema, deep midline lesions, subcortical lesions, and tumors of the posterior fossa and the third ventricle. Frontal IRDA(FIRDA) is usually seen in patients over age 15 years, whereas occipital IRDA(OIRDA) occurs mainly in children. We have investigated the clinical feature and significance of IRDA in children. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of 36 children with IRDA of EEG concerning diagnosis, neurologic examination, classification of epilepsy, and CT & MRI findings. RESULTS: 1) The location of the IRDA was frontal(FIRDA) in 11 of 36(30.5%), occipital(OIRDA) in 20 of 36(55.6%) and mixed in 5 of 36(13.9%) patients. 2) Thirty of 36(83.3%) have epilepsy (including 1 each with MELAS and tuberous sclerosis), 4 of 36(11.1%) have migraine and 2 of 36(11.1%) patients have meningitis. 3) Sixteen of 30(53.3%) have partial or partial with secondary generalized seizure, 10 of 30(33.3%) have generalized seizure and 4 of 30(13.3%) patients with epilepsy have absence seizure. 4) Neuroimaging studies (CT or MRI scan) were performed in 27 cases. Among 27 cases of studies, 6 cases(22.2%) were abnormal including; two cases of infections, and each case of infarction, venous angioma, arachnoid cyst, cortical atrophy, and tuberous sclerosis, respectively. CONCLUSIONS: IRDA may be considered an epileptiform pattern in childhood and FIRDA is frequently seen in children than previous reports.
Arachnoid ; Atrophy ; Brain Edema ; Child* ; Classification ; Consciousness ; Diagnosis ; Electroencephalography ; Epilepsy ; Epilepsy, Absence ; Hemangioma ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Imaging ; Medical Records ; MELAS Syndrome ; Meningitis ; Migraine Disorders ; Neuroimaging ; Neurologic Examination ; Retrospective Studies ; Seizures ; Third Ventricle ; Tuberous Sclerosis

59 children seen from Jan. 1990 to Jun. 1994 with epilepsy were retrospectively reviewed to evaluate the tendency of recurrence and the risk factors after the antiepileptic drug discontinuation. The population consisted of 59 children who were seizure free for more than 2 years and followed up for more than 1 year after the discontinuation via department of pediatrics, Yonsei University, Wonju College of Medicine. We analyzed risk factors of recurrence(age of seizure onset, seizure frequency before treatment, interval from seizure onset to start of treatment, duration from neurologic disorders, and EEG done just before discontinuation) between non-recurrent group(43 patients) and recurrent group(16 patients). The results were as follows: 1) In 59 patients with epilepsy, 16(27.1%) patients showed recurrence after the discontinuation and 14(87.5%) patients of those were developed during taperring and within less than 1 year. The probability of recurrent seizure by Kaplan-Meier curve at 12 and 24 months after discontinuation are 23.7% and 33.6% respectively. 2) There were significant differences on seizure frequency before treatement, duration from start of treatment to control (9.5months vs 31.1months), and associated neurologic disorders(11.6% vs. 56.2%) between non-recurrent and recurrent group. 3) There were no significant differences on age at seizure onset(70.6 months vs. 58.5months), interval from seizure onset to start of treatment(9.5months vs. 6.6months), length of seizure free(49.7months vs 39.3months), abnormal EEG finding done just before withdrawal(23.2% vs. 25.0% ) between non-recurrent and recurrent group.
Child ; Electroencephalography ; Epilepsy* ; Gangwon-do ; Humans ; Nervous System Diseases ; Pediatrics ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Seizures

Corticosteroids has been used in treatment of wide varieties of disease, but there was no report which related to the effects on cardic function with the long term corticosteroids therapy in children. We had been evaluated 18 patients with nephrotic syndrome who were admitted to department of pediatrics, Kyung Hee University Hospital until March 1987. Also we examined interventricular septal thickness, left ventricular posterior wall thickness and all parts of internal dimension of heart, and cardiac output and STI(Systolic Time Interval) by M-mode and Doppler echocardiography, and compared with body surface matched control group. Result are as follows;age and sex distribution were 4 4/12 to 14 6/12(9.11+/-3.55 years) and 15 males and 3 females. The duration of follow up was from 6 to 132 months(39.28+/-36.12 months). The interventricular septal thickness and left ventricular posterior wall thickness were more thickened in corticosteroids group than those of control. Systolic time interval, the index of left ventricular function, was more increased in corticosteroids group than in control group, but there was no differences in cardiac output between two groups. lthough longterm follow up studies are needed to confirm the cardiac effects of long term corticosteroids therapy, we conclude that long term corticosteroids therapy cause significant hypertrophy of cardiac muscle and periodic evaluation of cardiac function such as noninvasive Doppler echocardiographic studies are mandatory in patients with long term corticosteroids therapy.
Adrenal Cortex Hormones* ; Cardiac Output ; Child ; Echocardiography ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Heart ; Humans ; Hypertrophy ; Male ; Myocardium ; Nephrotic Syndrome* ; Pediatrics ; Sex Distribution ; Systole ; Ventricular Function, Left

No abstract available.

Among total 108 cases of biopsy-proven fibroadenomas of the breast, which obtained from the files of the Asan Medical Center during one year period from October 1998 to September 1999, 23 cases cytologically diagnosed as high risk group were reviewed to retrieve the mis-leading factors. Initial cytologic diagnoses of 23 cases were proliferative breast lesion with atypia(high risk) in 21 cases(91.3%) and papillary neoplasm in 2 cases(8.7%). When we reanalysed 23 cases by Masood scoring system, they were classified as one non-proliferative breast lesion(4.3%), 16 proliferative breast lesions without atypia (69.6%), and 6 proliferative breast lesions with atypia(26.1%). None were subject to the category of carcinoma. Cytologic features leading to the overdiagnosis of high grade epithelial lesions were as follows; cellular dissociation without nuclear atypia, nuclear pleomorphism, anisonucleosis, and occasional macronucleoli without nuclear enlargement, lack of myxoid stroma, and few naked stromal cells. To avoid cytologic overdiagnosis of fibroadenoma, mild to moderate nuclear pleomorphism without nuclear enlargement, and cellular dissociation without nuclear atypia should not be regarded as criteria of high risk group.
Neoplasm Metastasis