Movement disorders (chorea, athetosis, ballism) are a rare complication that develops during the course of bacterial meningitis although associations with tuberculous meningitis are established to some extent. Movement disorders are generally believed to reflect injury to the basal ganglia, thalamus, cerebellum and cerebral cortex. Ischemic infarctions of these areas have been proposed as the cause of dyskinesias in bacterial meningitis. We experienced a case of chorea which developed in the recovery phase of pnemococcal meningitis in a 37-month-old boy. The choreic movement was initially misinterpreted as a seizure, and anticonvulsants were administered. The movement continued during the alert state in spite of anticonvulsant therapy but subsided during sleep. EEG showed severely depressed background activitiy with no epileptiform discharge. When the movement was recognized as a choreic movement, anticonvulsants were withheld and haloperidol was administered orally. The abnormal movement gradually disappeared in 3 months. But like the two other previously reported cases of postmenigitic movement disorders, this patient shows severe impairment in cognitive and motor function in the 10 months of follow up. He can only recognize some close persons and can not control the trunk and extremities well. The movement disorder which develops in the recovery phase and lasts for a long period may be associated with poor neurologic prognosis.
Anticonvulsants ; Athetosis ; Basal Ganglia ; Cerebellum ; Cerebral Cortex ; Child, Preschool ; Chorea* ; Dyskinesias ; Electroencephalography ; Extremities ; Follow-Up Studies ; Haloperidol ; Humans ; Infarction ; Male ; Meningitis ; Meningitis, Bacterial ; Meningitis, Pneumococcal* ; Movement Disorders ; Prognosis ; Seizures ; Thalamus ; Tuberculosis, Meningeal

Mumps virus infections usually involve the parotid glands. It usually spreads from a human reservoir by airborne droplet of infected saliva. Therefore, early proper diagnosis and isolation of patients can help to inhibit dissemination of the disease. Diagnosis of mumps virus infection is mainly dependent on clinical inspection, palpation of the parotid and laboratory tests, because most mumps virus infections involve the parotid gland. Isolated submandibular gland involvement in mumps is rare and presents diagnostic challenge. We report unusual consecutive cases of mumps virus infections in two patients who were brothers, for whom bilateral submandibular glands were found to be involved paring parotid glands. These cases instruct us not to exclude mumps virus infection even in isolated uni/bilateral submandibular gland swelling.
Diagnosis ; Humans ; Mumps virus ; Mumps* ; Palpation ; Parotid Gland ; Saliva ; Siblings ; Submandibular Gland*

Primary sclerosing cholangitis is a cholestatic liver disease characterized by fibroobliterative inflammation of the entire biliary tree. It is a slowly progressive disease with an undulating course, resulting in biliary cirrhosis. The gold standard for establishing the diagnosis is cholangiographic demonstration of typical diffuse biliary stricturing and beading. We exprienced a case of primary sclerosing cholangitis by Endoscopic retrograde cholangiopancreatography (ERCP) demonstration. ERCP findings revealed multiple luminal narrowing, stricture and beaded dilatation of the intrahepatic duct. We report a case of primary sclerosing cholangitis localizing at intrahepatic bile duct, which is confused with cholangiocarcinoma.
Bile Ducts, Intrahepatic* ; Biliary Tract ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis, Sclerosing* ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Inflammation ; Liver Cirrhosis, Biliary ; Liver Diseases ; Phenobarbital

Pancreatic pseudocysts are a well-recognized complication of pancreatitis. Most occur in or adjacent to the pancreas. Occasionally, duodenal involvement may occur due to the nonperitonealized posterior surface of the duodenum is in direct contact with the head of the pancreas. But there is little awareness of the intramural and major extrinsic involvement of the duodenum with also occurs. A case was recently experienced involving an intramural pancreatic pseudocyst of the duodenum.
Duodenum* ; Head ; Pancreas ; Pancreatic Pseudocyst* ; Pancreatitis

The web of the common bile duct is an extremely rare anomaly and the cause of the obstructive jaundice. We experienced a case of the congenital web of common bile duct in a 42 years old male who complained of jaundice for 10 days prior to admission without choledocholithiasis and cholangitis. An endoscopic retrograde cholangiopancreatography revealed a common bile duct web (transverse, diaphragmatic type) and the diagnosis was confirmed by an endoscopic forcep biopsy. We reported a case of the congenita1 web of the common bile duct which was treated with a stent insertion and balloon dilatation.
Adult ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Choledocholithiasis ; Common Bile Duct* ; Diagnosis ; Dilatation* ; Humans ; Jaundice ; Jaundice, Obstructive ; Male ; Stents ; Surgical Instruments

Candidiasis of the gastrointestinal tract typically occurs in a setting of decreased re- sistance to opportunistic infection, but also occurs in apparently normal individuals. Mucosal lesions in the gastrointestinal tract predominantly involve the esophagus, and gastroduodenal and enteric candidial lesions, which are less frequent, have only infrequently been detected antemortem. A case was experienced involving esophageal and gastroduodenal candidiasis in the patient of hepatocellular carcinoma and spinal metastasis treated with emergent radiotherapy and corticosteroid. He complained of anorexia and dyaphagia in the 4th day of radiotherapy. Endoscopy revealed multiple, large raised, white plaques and patches covering the mid- and distal esophageal mucosa, and several superficial aphthous ulcerations covered with white plaques in the entire stomach, and two deep excavating ulcers at the angle and antrum. The duodenal mucosa was covered with multiple small, white plaques, and a huge penetraing ulcer was seen in the duodenal bulb. Endoscopic biopsy showed budding yeast and pseudohyphae infiltrating through the ulcerated mucosa. Cultures of the same material canfirmed the organism to be Candida albicans. The patient was treated with fluconazole for 2 weeks. The case of esophgeal and gastroduodenal candidiasis is reported with reviiew of relevant literature.
Anorexia ; Biopsy ; Candida albicans ; Candidiasis* ; Carcinoma, Hepatocellular ; Endoscopy ; Esophagus ; Fluconazole ; Gastrointestinal Tract ; Humans ; Mucous Membrane ; Neoplasm Metastasis ; Opportunistic Infections ; Radiotherapy ; Saccharomycetales ; Stomach ; Stomatitis, Aphthous ; Ulcer

Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric conditions. In 2007, the Korean Academy of child and Adolescent Psychiatry developed Korean ADHD practice parameter. Advances in the scientific evidence of ADHD caused practice parameter to be modified and updated. The present guidelines developed by ADHD translational research center summarize current literature for the treatment of ADHD in children and adults. This parameter includes the clinical evaluation for ADHD, comorbid conditions associated with ADHD, clinical feature and course, research on the etiology of the disorder, and psychopharmacological and non-pharmacological treatments for ADHD.
Adolescent ; Adolescent Psychiatry ; Adult ; Child ; Diagnosis* ; Humans ; Translational Medical Research*