The Measurement of CSF glucose and CSF glucose-to-blood glucose ratio is a very useful laboratory test for the differential diagnosis of meningitis. We have observed the change of blood glucose & CSF glucose-to-blood glucose ratio according to the time of blood sampling in 84 patients with aseptic meningitis who had been admitted to the department of pediatrics, Dong Kang hospital from May 1993 to June 1993. The results obtained were as follows: 1) The blood glucose level examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 98.29+/-16.20mg/dl and 106.49+/-19.47mg/dl, respectively. 2) The blood glucose level examined with blood sample drawn just before lumbar puncture and one 30 min. after lumbar puncture was 96.47+/-21.52mg/dl and 117.00+/-22.12mg/dl, respectively. 3) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 67.70+/-12.40% and 62.83+/-12.62%, respectively. 4) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 70.10+/-21.77% and 56.35+/-13.75%, reskpectively. We concluded that a simultaneous blood glucose level should be taken just before lumbar puncture.
Blood Glucose ; Diagnosis, Differential ; Glucose* ; Humans ; Meningitis ; Meningitis, Aseptic* ; Pediatrics ; Spinal Puncture

No abstract available.
Endometriosis* ; Female

PURPOSE: Accurate clinical diagnosis of acute appendicitis is more difficult in children since they may not be able to communicate their complaints adequately, and findings on physical examination may be nonspecific.The uncertainty in diagnosis may lead to a delay of surgery or to unnecessary laparotomy. Prompt diagnosis is important due to their complications such as perforation, abscess formation, and peritonitis. The authors conducted this study in order to find out usefulness of ultrasonography in diagnosis of acute appendicitis in children. METHODS: The authors was performed ultrasonographical examination to 290 children with abdominal pain under the age of 15 during a recent 16-months period from January 1994 to April 1995. High-resolution ultrasonography was used according to the graded compression method. The ultrasonographic findings were correlated with pathologic outcome in 87 cases. RESULTS: 1) Among 290 patients with abdominal pain, acute appendicitis was 81 cases (27.9%), and there were mesenteric lymphadenitis, terminal ileitis, intussusception, acute gastroenteritis, and nonspecific findings. 2) Sex ratio of acute appendicitis was 1.53:1. The acute appendicitis was occurred 13.6% in under the age of 5 and 86.4% in over the age of 6. Mean age was 10.6 3) The most frequent symptom was abdominal pain followed by vomiting, fever, nausea, and diarrhea. 4) Leukocytosis (>10,000/cu.mm) was occurred in 71 of 81 (87.7%) cases of acute appendicitis and 24 of 28 (85.7%) cases of acute appendicitis with perforation. 5) The perforation rate was higher in delayed diagnosis and in younger children. 6) Ultrasonography had a sensitivity of 97.5%, specificity of 96.2%, positive predictive value of 90.8%, and negative predictive value of 99.0% on diagnosis in acute appendicitis. CONCLUSIONS: Upon the above results, the authors were able to conclude that graded compression ultrasonography had high sensitivity and specificity and was useful for the diagnosis of acute appendicitis in children. And the ultrasonography can be applied as rapid, noninvasive, and well-tolerated investigation. So, it has diagnostic value as screening test in children whose chief complaint is abdominal pain.
Abdominal Pain ; Abscess ; Appendicitis* ; Child* ; Crohn Disease ; Delayed Diagnosis ; Diagnosis* ; Diarrhea ; Fever ; Gastroenteritis ; Humans ; Intussusception ; Laparotomy ; Leukocytosis ; Mass Screening ; Mesenteric Lymphadenitis ; Nausea ; Peritonitis ; Physical Examination ; Sensitivity and Specificity ; Sex Ratio ; Ultrasonography* ; Uncertainty ; Vomiting

No abstract available.
Brain* ; Technetium Tc 99m Exametazime*

No abstract available.
Brain* ; Technetium Tc 99m Exametazime*

The major purpose of this study was to assess the post-operative quality of life after performing a pylorus-preserving gastrectomy (PPG) in early gastric cancer patients, comparing the results with patients who underwent a conventional gastrectomy (CG). There were 48 patients with gastric cancer who underwent surgical intervention at the Department of Surgery, Taejon St. Mary's Hospital, The Catholic University of Korea School of Medicine from November 1995 through June 1996. Out of 48 gastric cancer patients, 13 patients (27.1 %) were early gastric cancers. Seven patients of these 13 patients underwent a PPG and the others underwent a CG. The indications for PPG were ; 1) a lesion at least 5 cm proximal to the pyloric ring, 2) a lesion in the middle third of the stomach, 3) a lesion less than 40 mm in maximum length, and 4) especially a lesion located at the greater curvature. Localization of the lesion was precisely performed through a gastrotomy during the operation. Dissections of the No. 7, 8, and 9 nodes (D1 +) were performed in cases of ulcerated lesions (type III) or poorly differentiated lesions. The proximal and distal portions of the stomach were anastomosed together 2-3 cm proximal to the pyloric ring to preserve the pyloric function. Gastrografin studies were performed on the sixth or the seventh day following PPG, and disclosed that the pylori were almost normal in appearance and function. Compared to a CG, the duration of nasogastric decompression was longer by one day, the start of oral feeding was delayed by two days, and the duration of the hospital stay was longer by five days after PPG. Three months following PPG, the amount of food taken in a meal was 70-90 % compared to that of the pre-operative amount, oral feedings took place three to four times a day, and the performance status was excellent (grade 0). Endoscopic examination revealed two cases of food stasis without subjective symptoms and a case of bile reflux with minimal mucosal edema after the PPG. After the CG, three out of the six cases had bile reflux with mucosal redness and erosion. In conclusion, it seemed that for early gastric cancer a pylorus-preserving gastrectomy, with selective lymphnodal dissection, was superior to the standard operation in terms of post-operative quality of life.
Bile Reflux ; Daejeon ; Decompression ; Diatrizoate Meglumine ; Edema ; Gastrectomy* ; Humans ; Korea ; Length of Stay ; Meals ; Quality of Life ; Stomach ; Stomach Neoplasms* ; Ulcer

Symptomatic hepatic cysts are infrequently seen. A 82-year-old woman was admitted because of growing abdominal mass and pain. On admission, the mass was palpated on right upper quadrant of the abdomen. Ultrasonography and computed tomography disclosed a huge cystic lesion of the liver. It measured 22.5 x 19.0 x 18.0 cm and had a thick wall that was irregular. Because of the patient's symptoms and the radiologic findings, the decision was made to aspirate the cyst percutaneously under fluoroscopic guidance. Percutaneous drainage yielded approximately 3300 cc of yellow brownish fluid. A cytologic evaluation of the fluid was negative for malignant cells, and a fluid analysis was described as predominantly inflammatory in nature. Cultures revealed a growth of Klebsiella oxytoca. After drainage of the cystic fluid, we instilled contrast medium. No communication between the cyst and bile ducts was seen. Seven days later, the patient was discharged. Four months after treatment, no reaccumulated fluid was observed by ultrasonography. Ten months after treatment, the patient is healthy without abdominal discomfort. We report a case of the infected huge hepatic cyst successfully treated with fluoroscopic-uided percutaneous drainage.
Abdomen ; Aged, 80 and over ; Bile Ducts ; Drainage* ; Female ; Humans ; Klebsiella oxytoca ; Liver ; Ultrasonography

OBJECTIVE: To investigate the prevalence of chronic obstructive pulmonary disease (COPD) in stroke patients, and to assess the difference in swallowing function between stroke patients with COPD (COPD group) and stroke patients without COPD (control group). METHODS: The subjects included 103 stroke patients. They underwent the pulmonary function test and were assigned to either the COPD group or the control group. Their penetration-aspiration scale (PAS) scores and functional dysphagia scale scores were compared by performing a videofluoroscopic swallowing study. The intergroup differences in lip closure, bolus formation, mastication, and the oral transit time, laryngeal elevation, cricopharyngeal dysfunction, oronasal regurgitation, residue in pyriform sinus and vallecula, pharyngeal transit time, aspiration, and esophageal relaxation were also compared. RESULTS: Thirty patients were diagnosed with COPD. The COPD group showed statistically higher PAS scores (4.67+/-2.15) compared to the control group (2.89+/-1.71). Moreover, aspiration occurred more frequently in the COPD group with statistical significance (p<0.05). The COPD group also showed higher occurrence of cricopharyngeal dysfunction, albeit without statistical significance. CONCLUSION: This study shows that a considerable number of stroke patients had COPD, and stroke patients with COPD had higher risk of aspiration than stroke patients without COPD.
Deglutition Disorders ; Deglutition* ; Humans ; Lip ; Mastication ; Prevalence ; Pulmonary Disease, Chronic Obstructive* ; Pyriform Sinus ; Relaxation ; Respiratory Aspiration ; Respiratory Function Tests ; Stroke*

PURPOSE: Nowadays, checkbite methods and a digital sensor are used to analyze the movement of mandible. However, there are no study comparing two methods. Therefore, this study has compared measuring the condylar inclination methods by using the new ARCUSdigma 2 system and the checkbite method. MATERIALS AND METHODS: Young 20 adults without any orthodontic treatment experiences, missing teeth, and restorations with the change of occlusal plane were tested. Angles of condylar path were measured 3 times each, based on Camper's line, by using two methods. KaVo PROTAR Evo 7 semi-adjustable articulator was used and the data were statistically analyzed. RESULTS: The anterior sagittal condylar inclination by ARCUSdigma 2 system were measured as 26.97degrees(+/-7.38degrees) on the left side and 29.80degrees(+/-8.19degrees) on the right side. The lateral condylar inclination were measured as 5.75degrees(+/-3.47degrees) on the left side and 8.10degrees(+/-4.98degrees) on the right side. 2. The anterior sagittal condylar inclination by checkbite method were measured as 25.20degrees(+/-6.53degrees) on the left side and 28.18degrees(+/-7.38degrees) on the right side. The lateral condylar inclination were measured as 10.97degrees(+/-5.63degrees) on the left side and 12.03degrees(+/-5.22degrees) on the right side. There was no statistically significant difference between male and female (P>.05). 3. The lateral condylar inclinations of ARCUSdigma 2 were statistically significantly smaller than that of checkbite method (P<.05). CONCLUSION: In Both of 2 methods, there was no statistically significant difference between male and female (P>.05). However, the lateral condylar inclinations of ARCUSdigma 2 were statistically significantly smaller than that of checkbite method (P<.05).
Adult ; Dental Articulators ; Dental Occlusion ; Female ; Humans ; Male ; Mandible ; Tooth

We describe below a case of Zellweger syndrome case with facial dysmorphism, profound hypotonia, and hepatomegaly. He died at the age of 2 months. Zellweger syndrome is a disease marked by the absence of hepatic and renal peroxisomes. Because peroxisomes have many vital anabolic and catabolic functions within the cell, their absence results in profound cellular dysfunction. A biochemical study of plasma revealed elevation of very long chains of fatty acids and pipecolic acid, consistent with peroxisomal disorder. The cultured skin fibroblasts showed a marked decrease in plasmalogen synthesis enzyme : dihydroxyacetonephosphate acyl transferase(DHAP-AT) The clinical characteristics and biochemical findings led to the diagnosis of Zellweger syndrome. The pattern of inheritance is autosomal recessive, hence genetic counseling can help the families. In infantile hypotonia patients with unknown cause, peroxisomal disorder should be included in the differential diagnosis. We report the first confirmed case of Zellweger syndrome by enzyme assay in Korea.
Cell Culture Techniques ; Diagnosis ; Diagnosis, Differential ; Enzyme Assays ; Fatty Acids ; Fibroblasts ; Genetic Counseling ; Hepatomegaly ; Humans ; Infant, Newborn ; Korea* ; Muscle Hypotonia ; Peroxisomal Disorders ; Peroxisomes ; Plasma ; Skin ; Wills ; Zellweger Syndrome*