PURPOSE: To draw attention to the radiological findings of a benign variant of cerebral astrocytoma in a young patient. MATERIALS AND METHODS: A 24-year-old man with generalized tonic-clonic seizure of 7 years' duration and normal neurological examination was examined with plain skull series, brain CT and MRI, and cerebral angiography. MR imaging was performed with a 0.5 Tesla Toshiba MRT-50A scanner (TIWI, PDWI, T2WI, 0.1 mmol/kg of Gd- DTPA, SE). RESULTS: 1 ) Plain skull series: A radiolucent lesion with a partial radiopaque rim of about 2.5 x 3 cm size in the right anterior parietal bone.2) B rain CT scan: A cystic mass in the right frontoparietal cortex of midconvexity with pressure erosion on the adjacent skull and partial enhancement at outer and anterior portion.3) Brain MRI:A hypointense mass containing a small, intensely enhancing isointensity anterolaterally on Tl-weighted images, which was hyperintense with better delineation of bulging cortical-based appearance on T2-weithted images. No peritumoral edema.4) Cerebral anglography: An avascular mass. CONCLUSION: The diagnosis of pleomorphic xanthoastrocytoma(PXA) should be entertained in patients in whom a superticially placed enhancing intracerebral tumor containing cystic portion that seems to be in contact with the meninges develops during juvenile years.
Astrocytoma ; Brain ; Cerebral Angiography ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Meninges ; Neurologic Examination ; Pentetic Acid ; Rabeprazole ; Rain ; Seizures ; Skull ; Tomography, X-Ray Computed ; Young Adult

Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma of the bone are merely different clinical expressions of one disease. Lichtenstein grouped these three clinical syndromes and proposed that this disease be termed histiocytosis X. This grouping was based on the histologic similarities and the possibility of transformation of one syndrome into another. The cause of histiocytosis X remains unknown. Histiocytosis X is a condition that presents single or multiple lesions, distributed in the soft tissue, lymph nodes, various organ and bones, especially in the areas of marked reticuloendothelial activity. The authors reviewed the clinical findings, radiographs and the treatment of the twenty-six patients with histiocytosis X diagnosed on the base of pathologic findings at Severance Hospital, between January, 1971 and December, 1980. Among the twenty-six patients, twenty-one patients could be followed, ranging from one month to six years, with an average follow-up of 1.6 years. The results obtained were as follows: 1. There was a slight male predominance (61.6%). The age ranged from 2 months to 42 years (average 8.2 years). Sixty-five percents of patients were the child under 4 years of age. 2. Hand-Schuller-Christian disease (50%) was the most common form of this disease. Letterer-Siwe disease developed in the youngest (average 1.2 years) and eosinophilic granuloma in the eldest (average 20.4 years). 3. The common manifestations were hepatomegaly, skin rashes and anemia in Letterer-Siwe disease; palpable mass, pain and exophthalmos in Hand-Schuller-Christian disease; pain and mass in eosinophilic granuloma. 4. The common sites of the skeletal lesions were skull, spine and femur, etc. 5. The patients with single skeletal lesion improved regardless of the methods of treatment. 6. Vinblastine, methotrexate and/or prednisone were valuable agents for the multiply involved patients. 7. Prognosis was poor for the patients who were young at onest, or who had multiple systemic involvements, but in case only with skeletal involvement the prognosis was good. Eosinophilic granuloma is the most benign variant, while Letterer-Siwe disease is the most malignant type.
Anemia ; Child ; Clinical Study ; Eosinophilic Granuloma ; Exanthema ; Exophthalmos ; Femur ; Follow-Up Studies ; Hepatomegaly ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Lymph Nodes ; Male ; Methotrexate ; Prednisone ; Prognosis ; Skull ; Spine ; Vinblastine

Nontyphoidal Salmonella are gram negative bacilli organism, which may induce systemic infection such as febrile enteritis, bacteremia, and osteomyelitis. Main route of infection is known as food but also possible through reptile, amphibian, and fish raised as pets in the house. There is no known cases report of Salmonella infection through pets in Korea and also rare in the overseas. We report 2 patients who visited Severance children's hospital with chief complaint of fever and diagnosed as nontyphoidal salmonellosis. Each case had a history of raising turtle or tropical fish with possibility of Salmonella infection through these pets. Increasing incidence of raising pet reptile and fish lately, contact precaution and proper prevention and control of Salmonella infection of these pets especially in children under 5 years old are necessary due to higher risk of serious complications of salmonellosis.
Amphibians ; Bacteremia ; Child ; Enteritis ; Fever ; Fishes ; Humans ; Incidence ; Korea ; Osteomyelitis ; Reptiles ; Salmonella ; Salmonella Infections ; Turtles

PTC is the single most valuable diagnostic method available to evaluate the size, shape and site of the causesof obstuctive jaundice among various radiological procedures. The authors reviewed and radiologically classifiedthe PTC films of 203 cases of obstructive jaundice from July 1977 to June 1983 at Presbyterian Medical Center,Jeon-ju confirmed clinically, operatively and pathologically. The resuls are as follows; 1. The most common causeof obstructive jaundice was bile duct stoen (64/203:31.53%) and the other causes were bile duct cancer(43/203:21.18%), pancreas cancer(41/203:20.19%), biliary ascariasis &/or clonorchiasis(20/203:9.85%), ampulla andduodenal cancer (7/203:3.45%), fibrotic stenosis of sphincter of Oddi(6/203: 2.96%) etc. in that order. Of theseprimary involvement with cancer was more frequent (91/203:44.33%) than stone. 2. 88.33%(179/203) of patients wasover 40-year-of- age and the sex ratio between male and female was about 2:1. 3. The average maximal diameter ofextrahepatic bile duct just proximal to the site of obstruction or stenosis by stones or by cancers was nearlyequal(2.36cm:2.38cm). 4. Cancers caused complete bile duct obstruction in about 75%(68/91) of cases and also wereassociated with intrahepatic duct dilatation about 92%(84/91) of cases. But in contrast biliary calculi showedgood drainage of contrast medium in 75%(48/64) of cases and 92%(59/64) showed normal diameter of intrahepaticduct. 5. The differential PTC findings between bile duct cancer and pancreas cancer were not so distinct but inbiel duct cancer the obstruction site of the bile duct was more irregular and serrated than pancreas cancer, whilethe latter showed a more downward convexity and a smoother end. Moreover annular filling defect with overhangingedges was seen only in bile duct cancer.
Ascariasis ; Bile Duct Neoplasms ; Bile Ducts ; Cholestasis ; Constriction, Pathologic ; Dilatation ; Drainage ; Female ; Gallstones ; Humans ; Jaundice ; Jaundice, Obstructive ; Male ; Methods ; Pancreas ; Pancreatic Neoplasms ; Protestantism ; Sex Ratio

Acute necrotizing encephalopathy is a recently established disease entity, proposed by Mizuguchi et al in 1995, that shows a characteristic symmetric and multifocal involvement of both thalamus, brainstem tegmentum, cerebral periventricular white matter, and cerebellar medulla. It is known to be prevalent in Japan and other Far Ease countries. The etiology of the acute necrotizing encephalopathy remains unknown. The typical course of acute necrotizing encephalopathy is the development of the irreversible neurologic symptoms related to brain lesions. The diagnosis can be made on the basis of the combination of a typical clinical profile and characteristic radiologic findings. We experienced a first case of acute necrotizing encephalopathy in a 9 month old boy in Korea. We report this case with the brief review of related literatures.
Brain ; Brain Stem ; Diagnosis ; Humans ; Infant ; Japan ; Korea ; Male ; Neurologic Manifestations ; Thalamus

No abstract available.
Pierre Robin Syndrome*

Angiolymphoid hyperplasia with eosinophilia(ALHE) is a benign angiomatous neoplasm which usually arises from skin, blood vessel, soft tissue, heart and rarely from bone. The authors experienced a case of ALHE which involved the distal femur of 35-years old male and treated by marginal excision and autogenous cancellous bone graft with plate fixation.
Angiolymphoid Hyperplasia with Eosinophilia ; Blood Vessels ; Femur ; Heart ; Humans ; Hyperplasia ; Male ; Skin ; Transplants

The hemodynamic interactions of lidocaine and diltiazem during halothane anesthesia were studied using eight mongrel dogs. The animals were anesthetized with inhalation of 1.0 MAC of halothane(GroupH) continuously throughout the experiment. 30 minutes after the inhalated and end-tidal halothane concentration reached equilibrium, 0.2 mg/kg of diltiazem was given intravenously over 2.0 min. From that point 8 ug/kg/min of diltiazem was continuously infused (group HD). Then a small dose of lidocaine(group HD1; iv bolus 1.5 mg/kg over l min, followed by continuous iv infusion at the rate of O.l mg/kg/min for 30 min) and a large dose of lidocaine (group HDI; iv bolus 1.0 mg/kg over I min, followed by continuous iv infusion at the rate of 0.3 mg/kg/min for 30 min) were administered serially. In group HD, PR interval increased significantly(22.2%) and coronary perfusion pressure decreased significantly(l9.3%), compared with group H. Compared with group H, significant increase in PR interval(44.4%), and decreases in diastolic arterial blood pressure(28%), mean arterial blood pressure(20.1%) and rate pressure product(35.2%) occured in group HD1. In group HDL, a significant decrease in heart rate(20.7%) and coronary perfusion pressure(33.0%) also occured, compared with group H. No significant changes in oxygen transport and consumption existed among groups. The most significant result of the injection of lidocaine diltiazem during halothane anesthesia in dogs was increase in PR interval. Even in high doses of lidocaine, only slight hemody- namic depression resulted and no significant changes in tissue oxygenation occurred. Therefore, the combined administration of diltiazem and lidocaine in clinical doses during halothane anes- thesia in dogs is a relatively safe administrative method.
Anesthesia* ; Animals ; Depression ; Diltiazem* ; Dogs* ; Halothane* ; Heart ; Hemodynamics* ; Inhalation ; Lidocaine* ; Oxygen ; Perfusion

Cognitive dysfunction has been commonly reported in epilepsy and should be appropriately evaluated for children with epilepsy due to their developing cognition. Neuropsychological tests have been often performed to reveal the objective status of cognitive function. Advances in computer science has allowed quantitative electroencephalography (qEEG) to be widely used in various fields examining neuropsychiatric disorders. As such, we can investigate brain function through qEEG in a different manner and more fully understand the cortical network while performing tasks. Among qEEG methods, the frequency analysis is a method for looking at the mean or peak frequency, absolute or relative spectral power, and amplitude of each frequency band in the EEG. The qEEG analysis may help us evaluate cognitive dysfunction in childhood epilepsy, although some limitations and difficulties may exist.
Brain ; Child ; Cognition ; Electroencephalography ; Epilepsy ; Humans ; Neuropsychological Tests

PURPOSE: Migraine is a common disorder in childhood. Its associated symptoms such as nausea or dizziness etc. are frequently complained about and worsen discomfort in cases of pediatric migraine. This study aimed to investigate the relieving effect of preventive therapy on the associated symptoms as well as headache-related characteristics. METHODS: We reviewed the clinical data of subjects aged seven to eighteen years who were diagnosed with migraine and had received prophylactic medication for more than two months. The headache-related characteristics and associated symptoms were analysed with prophylactic drugs at one month and three months after medication. RESULTS: The gender ratio was 11:10 and the mean age was 10.8 years. One month after medication, the duration of headache was reduced in ten of nineteen, a reduction in frequency was observed in fourteen, and improvement in headache intensity in nine. The duration time was shortened in three of eight subjects three months after initiation of medication, the frequency reduced in five, and decreased intensity in seven. Nausea was absent in eight of fifteen one month after treatment, abdominal pain in seven of thirteen, dizziness in five of sixteen, photophobia in six of seventeen, and phonophobia in seven of sixteen. The ratio of disappearance of associated symptoms increased three months after initiation of treatment. CONCLUSION: Prophylactic medication may be effective in relieving migraine-associated symptoms as well as improving headache-related characteristics.
Abdominal Pain ; Adolescent ; Aged ; Child ; Dizziness ; Headache ; Humans ; Hyperacusis ; Migraine Disorders ; Nausea ; Photophobia