Streptococcus pneumoniae is the most common pathogen of bacterial meningitis in childhood. It causes such intracranial complications as hydrocephalus, cerebral edema, inappropriate secretion of antidiuretic hormone(SIADH), and convulsion, and also such cerebral vascular complications as vasculitis, thrombosis, aneurysm, infarction, and subarachnoid hemorrhage. We report a male of 4 months old who had intracerebral cortical hemorrhage and sinovenous thrombosis complicated by streptococcus pneumoniae meningitis. Also, we reviewed the literature on intracerebral vascular complications related to bacterial meningitis.
Aneurysm ; Brain Edema ; Hemorrhage* ; Humans ; Hydrocephalus ; Infant ; Infarction ; Male ; Meningitis ; Meningitis, Bacterial ; Meningitis, Pneumococcal* ; Seizures ; Streptococcus pneumoniae* ; Streptococcus* ; Subarachnoid Hemorrhage ; Thrombosis* ; Vasculitis

PURPOSE: Esophageal cancer patients have a difficulty in the intake of meals through the blocked esophageal lumen, which is caused by an ingrowth of cancer cells and largely influences on the prognosis. It is reported that esophageal cancer has a very low survival rate due to the lack of nourishment and immunity as the result of this. In this study a new radioactive stent, which prevents tumor ingrowth and restenosis by additional radiation treatment, has been developed. MATERIALS AND METHODS: Using HANARO research reactor, the radioactive stent assembly (166Ho-SA) was prepared by covering the metallic stent with a radioactive sleeve by means of a post-irradiation and pre-irradiation methods. RESULTS: Scanning electron microscopy and autoradiography exhibited that the distribution of 165/166Ho (NO3) compounds in polyurethane matrix was homogeneous. A geometrical model of the esophagus considering its structural properties, was developed for the computer simulation of energy deposition to the esophageal wall. The dose distributions of 166Ho-stent were calculated by means of the EGS4 code system. The sources are considered to be distributed uniformly on the surface in the form of a cylinder with a diameter of 20 mm and length of 40 mm. As an animal experiment, when radioactive stent developed in this study was inserted into the esophagus of a Mongrel dog, tissue destruction and widening of the esophageal lumen were observed. CONCLUSION: We have developed a new radioactive stent comprising of a radioactive tubular sleeve covering the metallic stent, which emits homogeneous radiation. If it is inserted into the blocked or narrowed lumen, it can lead to local destruction of the tumor due to irradiation effect with dilatation resulting from self-expansion of the metallic property. Accordingly, it is expected that restenosis esophageal lumen by the continuous ingrowth and infiltration of cancer after insertion of our radioactive stent will be decreased remarkably.
Animal Experimentation ; Animals ; Autoradiography ; Computer Simulation ; Dilatation ; Dogs ; Esophageal Neoplasms* ; Esophagus ; Humans ; Meals ; Microscopy, Electron, Scanning ; Polyurethanes ; Prognosis ; Stents ; Survival Rate

PURPOSE: Asthmatic patients show marked circadian variation in disease severity, with bronchospasm far worse between midnight and 8 a.m. than at other times of the day. And many studies have demonstrated that symptoms are much relieved in the day-time while they worsen at night. Our study was conducted to examine the circadian variation of peak expiratory flow rate (PEFR) in asymptomatic asthmatic children after proper treatment by mini-Wright peak flow meter. METHODS: Thirty four asthmatic patients who have had no respiratory symptoms for the past one month were enrolled to our study. Control group included 25 patients who were admitted to Wonju Christian Hospital for inguinal hernia, aseptic meningitis, etc., but without respiratory symptoms. RESULTS: The mean age was 6.3 years, ranging from 4 to 11 years, in the stable asthmatic group. In control group, the mean age was 8.7 years ranging from 4 to 14 years. PEFR was checked at every 2 hours from 8 a.m. to 10 p.m. for 4 days. There were no significant differences in PEFR checked at all times between the asthma group and the control group except for the PEFR checked at 8 a.m. in moderate persistent asthma group. PEFR reached the nadir at 8 a.m. in both asthma and control groups. It rose to the highest level in the afternoon, then, it slightly fell in the evening and at night. There were significant differences between the PEFR checked at 8 a.m. and the PEFR checked at any other period of the day in each group (P< 0.05). The circadian variation in moderate persistent asthma group is much greater than that of other groups. CONCLUSION: Our study indicates that the moderate persistent asthma group with no current symptoms of asthma has an increased circadian variability. It is recommended, therefore, that special attention be paid to preventive treatment for the moderate persistent asthma group.
Asthma* ; Bronchial Spasm ; Child ; Circadian Rhythm* ; Gangwon-do ; Hernia, Inguinal ; Humans ; Meningitis, Aseptic ; Peak Expiratory Flow Rate*

An arterialized venous flap has the advantages of being thin and pliable, utilizing a large-caliber vein with a pedicle of almost any length, as well as obviating the need to sacrifice a donor artery. However, the main disadvantage of this flap is the partial necrosis of the large flap. The aim of this study was to investigate the efficacy of a surgical delay procedure and a combined surgical and chemical delay procedure on the survival of arterialized venous flaps. Ninety New Zealand white rabbits were divided into three groups: control group, a surgical delay group and a combined surgical and chemical delay group. These groups were further divided into subgroups depending on the delay period and the chemical agents. One arterialized venous flap was made from only one ear of each rabbit due to operative mortality, and 10 rabbits were distributed to each subgroup. The arterialized venous flap had an arterial inflow by anastomosis of the central auricular artery to the anterior branch of the central auricular vein and a venous outflow through the anterior marginal vein. The results were as follows ; 1. Control group : The arterialized venous flaps without any delay procedure showed complete necrosis of all flaps. 2. Surgical delay group : The mean percentages of survival areas of arterialized venous flaps were 36.6% in the 4-day delay group, 59.7% in the 7-day delay group. 3. Combined surgical and chemical delay group: a. A 3-day chemical delay in a continuation of a 4-day simultaneous surgical and chemical delay group: The mean percentages of survival areas of the arterialized venous flaps were 81.1% in the doxazosin mesylate group, 72.8% in the nitroglycerine patch group and 92.9% in a combination group of doxazosin mesylate and nitroglycerine patch. b. A 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay group : The mean percentages of survival areas of the arterialized venous flaps were 94% in the doxazosin mesylate group, 90.2% in the nitroglycerine patch group and 99% in a combination group of doxazosin mesylate and nitroglycerine patch. In conclusion, the surgical delay procedure increases the percentage of survival areas of the arterialized venous flap in proportion to the delay period. The combination group of surgical and chemical delay procedure had a significant increase of the percentage of survival areas than that of the surgical delay group(p < 0.001). The best survival of the flap was obtained from the subgroup which had a 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay with combined chemical agents.
Arteries ; Doxazosin ; Ear ; Humans ; Mortality ; Necrosis ; Nitroglycerin ; Rabbits* ; Tissue Donors ; Veins

An arterialized venous flap has the advantages of being thin and pliable, utilizing a large-caliber vein with a pedicle of almost any length, as well as obviating the need to sacrifice a donor artery. However, the main disadvantage of this flap is the partial necrosis of the large flap. The aim of this study was to investigate the efficacy of a surgical delay procedure and a combined surgical and chemical delay procedure on the survival of arterialized venous flaps. Ninety New Zealand white rabbits were divided into three groups: control group, a surgical delay group and a combined surgical and chemical delay group. These groups were further divided into subgroups depending on the delay period and the chemical agents. One arterialized venous flap was made from only one ear of each rabbit due to operative mortality, and 10 rabbits were distributed to each subgroup. The arterialized venous flap had an arterial inflow by anastomosis of the central auricular artery to the anterior branch of the central auricular vein and a venous outflow through the anterior marginal vein. The results were as follows ; 1. Control group : The arterialized venous flaps without any delay procedure showed complete necrosis of all flaps. 2. Surgical delay group : The mean percentages of survival areas of arterialized venous flaps were 36.6% in the 4-day delay group, 59.7% in the 7-day delay group. 3. Combined surgical and chemical delay group: a. A 3-day chemical delay in a continuation of a 4-day simultaneous surgical and chemical delay group: The mean percentages of survival areas of the arterialized venous flaps were 81.1% in the doxazosin mesylate group, 72.8% in the nitroglycerine patch group and 92.9% in a combination group of doxazosin mesylate and nitroglycerine patch. b. A 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay group : The mean percentages of survival areas of the arterialized venous flaps were 94% in the doxazosin mesylate group, 90.2% in the nitroglycerine patch group and 99% in a combination group of doxazosin mesylate and nitroglycerine patch. In conclusion, the surgical delay procedure increases the percentage of survival areas of the arterialized venous flap in proportion to the delay period. The combination group of surgical and chemical delay procedure had a significant increase of the percentage of survival areas than that of the surgical delay group(p < 0.001). The best survival of the flap was obtained from the subgroup which had a 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay with combined chemical agents.
Arteries ; Doxazosin ; Ear ; Humans ; Mortality ; Necrosis ; Nitroglycerin ; Rabbits* ; Tissue Donors ; Veins

PURPOSE: We developed predictive models using different programming languages and different computing platforms for machine learning (ML) and deep learning (DL) that classify clinical diagnoses in patients with epiphora. We evaluated the diagnostic performance of these models.METHODS: Between January 2016 and September 2017, 250 patients with epiphora who underwent dacryocystography (DCG) and lacrimal scintigraphy (LS) were included in the study. We developed five different predictive models using ML tools, Python-based TensorFlow, R, and Microsoft Azure Machine Learning Studio (MAMLS). A total of 27 clinical characteristics and parameters including variables related to epiphora (VE) and variables related to dacryocystography (VDCG) were used as input data. Apart from this, we developed two predictive convolutional neural network (CNN) models for diagnosing LS images. We conducted this study using supervised learning.RESULTS: Among 500 eyes of 250 patients, 59 eyes had anatomical obstruction, 338 eyes had functional obstruction, and the remaining 103 eyes were normal. For the data set that excluded VE and VDCG, the test accuracies in Python-based TensorFlow, R, multiclass logistic regression in MAMLS, multiclass neural network in MAMLS, and nuclear medicine physician were 81.70%, 80.60%, 81.70%, 73.10%, and 80.60%, respectively. The test accuracies of CNN models in three-class classification diagnosis and binary classification diagnosis were 72.00% and 77.42%, respectively.CONCLUSIONS: ML-based predictive models using different programming languages and different computing platforms were useful for classifying clinical diagnoses in patients with epiphora and were similar to a clinician's diagnostic ability.
Classification ; Dataset ; Diagnosis ; Humans ; Lacrimal Apparatus Diseases ; Learning ; Logistic Models ; Machine Learning ; Nuclear Medicine ; Programming Languages ; Radionuclide Imaging

PURPOSE: We developed predictive models using different programming languages and different computing platforms for machine learning (ML) and deep learning (DL) that classify clinical diagnoses in patients with epiphora. We evaluated the diagnostic performance of these models. METHODS: Between January 2016 and September 2017, 250 patients with epiphora who underwent dacryocystography (DCG) and lacrimal scintigraphy (LS) were included in the study. We developed five different predictive models using ML tools, Python-based TensorFlow, R, and Microsoft Azure Machine Learning Studio (MAMLS). A total of 27 clinical characteristics and parameters including variables related to epiphora (VE) and variables related to dacryocystography (VDCG) were used as input data. Apart from this, we developed two predictive convolutional neural network (CNN) models for diagnosing LS images. We conducted this study using supervised learning. RESULTS: Among 500 eyes of 250 patients, 59 eyes had anatomical obstruction, 338 eyes had functional obstruction, and the remaining 103 eyes were normal. For the data set that excluded VE and VDCG, the test accuracies in Python-based TensorFlow, R, multiclass logistic regression in MAMLS, multiclass neural network in MAMLS, and nuclear medicine physician were 81.70%, 80.60%, 81.70%, 73.10%, and 80.60%, respectively. The test accuracies of CNN models in three-class classification diagnosis and binary classification diagnosis were 72.00% and 77.42%, respectively. CONCLUSIONS ML-based predictive models using different programming languages and different computing platforms were useful for classifying clinical diagnoses in patients with epiphora and were similar to a clinician's diagnostic ability.

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization