Although the ultlrasonography has been regarded as a main procedure in the diagnosis of bile duct andgallbladder diseases, a few reports concerning the ultrasonographic findings of biliary ascariasis appeared in theliterature. Seven cases of real-time ultrasonographic diagnosis of biliary ascariasis were made in our hospitalduring last 15 months. In six, the diagnosis was confirmed by surgery or radiographic examination. The resultswere as follows; 1. The characteristic long, thick, highly reflective echo without distal acoustic shadowing inthe extra and/or in tra-hepatic ducts were seen in all six proven cases. 2. The echogenic, nonshadowing images ofthe worms were seen as single stripe in five cases(containing a central longitudinal, anechoic tube, suggestingits digestive tract in three cases ) or multiple stripes in one case. But so-called coiled appearance or amorphousfragments were not seen in our cases. 3. Associated findings were as follows; mild to moderate dilatation of theextrahepatic duct in all six duct in 1 case, intrahepatic stone in 1 case, contracted gallbladder containingsingle stone in 1 case and evidence of cholecystitis in 4 cases. 4. One false positive diagnosis of ascariasis inthe gallbladder is considered due to reverberation artefact. No false negative was seen.
Acoustics ; Artifacts ; Ascariasis ; Bile Ducts ; Cholecystitis ; Diagnosis ; Dilatation ; Gallbladder ; Gastrointestinal Tract ; Shadowing (Histology)

PURPOSE: Early detection of RDS is imperative in treatment of neonatal respiratory distress syndrome (RDS). Shake test and stable microbubble rating (SMR) test have been commonly used for early detection of RDS. In this study, we analyzed the cut-off point of SMR test to identify whether current dianostic criteria (SMR 10/mm2) correlates with actual development of RDS. METHODS: Retrospective analysis of SMR test performed on neonates with birth weight less than 2, 500 gm or gestational age less than 37 weeks or had the symptoms of respiratory distress from 1990 to 2001. We evaluate the correlations of SMR counts and actual development of RDS and calculated the sensitivity, specificity and diagnostic accuracy at each SMR count. RESULTS: The diagnostic accuracy was considerably high when microbubble count was between 7 and 11. SMR count 9, the mean of these numbers, was determined as the cut-off point with 81.4% diagnostic accuracy. Sensitivity and specificity was 59.1% and 95.8% respectively. CONCLUSION: Current diagnostic criteria of SMR test would be effective in expecting development of RDS.
Birth Weight ; Gestational Age ; Humans ; Infant, Newborn ; Microbubbles ; Respiratory Distress Syndrome, Newborn* ; Retrospective Studies ; Sensitivity and Specificity

Ramsay Hunt syndrome(RHS or herpes zoster oticus) is caused by reactivation of latent varicella-zoster virus(VZV) in the geniculate ganglion of the seventh cranial nerve. Unilateral facial paralysis is accompanied by herpetic vesicles on the external auditory canal or in the mouth. The prognosis is not good as that of idiopathic facial palsy. Aggressive treatment with acyclovir, in combination with steroids, is recommended. RHS is thought to affect adults primarily, but a few cases of children with RHS have been reported. We present a case of RHS combined with aseptic meningitis in a previously healthy 10-year-8-month-old boy. He showed a complete peripheral facial palsy on the right side with CSF pleocytosis. Eight days after the onset of the facial palsy, the characteristic herpetic vesicles appeared on the pinna of the right side. The analysis of sera confirmed the clinical diagnosis of RHS with a positive IgG and IgM-ELISA antibody titer of VZV. Although we administered acyclovir and prednisolone adequately to the patient, he has shown an incomplete recovery of the facial palsy on a follow-up visit. The physicians should be prudent in the diagnosis of idiopathic facial palsy or RHS, and must watch for the appearance of vesicles in children with facial palsy.
Acyclovir ; Adult ; Child ; Diagnosis ; Ear Canal ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Geniculate Ganglion ; Herpes Zoster ; Herpes Zoster Oticus* ; Herpesvirus 3, Human ; Humans ; Immunoglobulin G ; Leukocytosis ; Male ; Meningitis, Aseptic* ; Mouth ; Prednisolone ; Prognosis ; Steroids

PURPOSE: Over the past several decades, the survival rates of low birth weight(LBW; birth weight <2,500 g) infants have been improving. Many of these infants have had bronchial asthma(BA) at childhood and aldolescence. The aim of this study is to investigate whether LBW influenced the severity of BA in prealdolescent children and aldolescence by a retrospective case control study. METHODS: 15 LBW children(1,500 gdong hospital as the case group were compared with 2 BA children to each case as the control group(total 30 children) on the basis of following criteria:the same age, he/she attended Dae-Dong hospital or local medical center after 8 years old, birth weight was more than 2,500 g. Asthma severity was modified from 2003 Guideline for management of childhood asthma at The Korean Academy of Pediatric Allergy and Respiratory Disease. PFT(Pulmonary function test) were measured using a portable spirometer. The value are expressed as percentage predicted using standard reference values. Total IgE and specific IgE Ab. were assessed by the PRIST method and MAST Allergy Test. Methacholine challenge test and PC20 was assessed by the Masterlab. RESULTS: LBW group had:a significantly more severe symptoms between 8 year-old and 18 year-old than control group.(P=0.015) A significantly more used to ICSs(Inhaled corticosteroids) and add-on therapy than control group.(P=0.009)(P=0.0001) There were no significant differences in the PFT and PC20 and specific IgE Ab. between LBW group and control group. But, total IgE level is higher in the control group than in the LBW group. CONCLUSION: These results suggest that LBW is a risk factor for the severity of BA. We suggest that infants with birth weight of less than 2,500 g have a more severe risk of asthma during prealdolescent children and aldolescence than who were birth weight of more than 2,500 g.
Adolescent ; Asthma* ; Birth Weight ; Case-Control Studies ; Child* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Infant, Low Birth Weight* ; Infant, Newborn ; Methacholine Chloride ; Parturition ; Reference Values ; Retrospective Studies ; Risk Factors ; Survival Rate

To dtermine the optimal timing for Aortic Valve Replacement in patients of aortic insufficiency is very important, because irreversible myocardial damage can result before symtoms such as dyspnea, syncope and chest pain, appear for the first time. Henry suggested that the echocardiographic index of left ventricular end systolic dimension 55mm could be useful as an indicator of whether to operate or not. But Fioretti, et al., insisted that there was no significant difference postoperatively between those below 55mm and those over 55mm. To determine whether a left ventricular end systolic dimension greater than 55mm is one of the risk factors for AVR in patients with aortic insufficiency, we analyzed the serial echocardiographic examinations of 23 patients who underwent AVR for isolated AI. Group I patients (n=17) had a preoperative left ventricular end systolic dimension less than or equal to 55mm and Group II patients (n=6) had a preoperative left ventricular end systolic dimension greater than than 55mm. 1) left ventricular end systolic dimension decreased in both groups significantly, and there was a statistically significant difference between Group I and Group II at 12 modths after operation. 2) Left ventricular end diastolic dimension also decreased in both groups significantly, and there was a statistically significant difference between Group I and Group II at 12 months after operation. 3) Ejection Fraction was decreased markedly just postoperatively, but it was recovered soon in both groups, and there was no statistically significant differences of the ejection fractions between the two groups postoperatively. 4) SV1+/-RV6 in EKG, as an indicator of LV mass, was also analzed and it revealed significant reduction in both groups postoperatively, but we could not observe statistically significant differences between the two groups from 6 months after the operation. We concluded that the preoperative left ventricular end systolic dimension 55mm could be useful as an index to predict postoperative prognosis and to determine the timing of aortic valve replacement.
Aortic Valve* ; Chest Pain ; Dyspnea ; Echocardiography* ; Electrocardiography ; Humans ; Prognosis ; Risk Factors ; Syncope

Lawsonia intracellularis is not culturable with a standard bacteriologic culture. One step PCR assay as a clinical diagnostic method was developed for the rapid detection of porcine proliferative enteritis (PPE) caused by L. intracellularis. Primers were designed based on the p78 DNA clone of L. intracellularis. The one step PCR resulted in the formation of a specific 210-bp DNA product derived from L. intracellularis. The nonspecific amplification product was not detected with swine genomic DNA or other bacterial strains causing similar symptoms to L. intracellularis infection. The one step PCR was as sensitive as 100 pg of L. intracellularis genomic DNA. We applied this method to field specimens diagnosed as PPE by macroscopic observation. Of 17 mucosal scraping specimens, 16(94%) were identified as positive to PPE and 15(88%) of 17 feces specimens. These results suggest that the one step PCR can be used as a rapid diagnostic method for L. intracellularis infection.
Animals ; Base Sequence ; DNA Primers ; Desulfovibrionaceae Infections/diagnosis/*veterinary ; Ileum/microbiology/pathology ; Intestinal Mucosa/microbiology/pathology ; Lawsonia Bacteria/genetics/*isolation & purification ; Polymerase Chain Reaction/*methods ; Reproducibility of Results ; Sensitivity and Specificity ; Swine ; Swine Diseases/*diagnosis/microbiology

No abstract available.
Stem Cells*

Familial hemiplegic migraine(FHM) is an autosomal dominant subtype of migraine with aura, characterized by the occurrence of hemiplegia during the aura. Two subforms of FHM families exist; pure FHM in 80% and FHM families with cerebellar symptoms in 20%. Half of the known FHM families show genetic linkage to chromosome 19p13, and in these families FHM is caused by missense mutations in a neuronal P/Q type calcium channel alpha-1 subunit gene(CACNA1A gene). Linkages to 1q31 and 1q21-23 have also been established. Other families are linked neither to chromosome 19 nor 1. Clinical variabilities are partially associated with the various types of CACNA1A gene mutations. FHM is distinguished from more frequent migraine types by a clear, dominant inheritance pattern and the relative absense of other headache types. Further investigation of FHM will help to clarify the genetics of more common migraine. We describe a male patient with FHM with a brief review of the literature.
Calcium Channels ; Chromosomes, Human, Pair 19 ; Epilepsy ; Genetic Linkage ; Genetics ; Headache ; Hemiplegia ; Humans ; Inheritance Patterns ; Male ; Migraine Disorders ; Migraine with Aura* ; Migraine without Aura ; Mutation, Missense ; Neurons

PURPOSE: This study was performed to find out the role of routine lumbar puncture in children presented with their first seizure with Fever. METHODS: This study included 220 children, over a 5 year period, from April 1999 to March 2003, who visited or were admitted at Dae Dong Hospital with their first febrile convulsion. Lumbar puncture was performed in all children. We analyzed their age, family history, type of seizure, duration of seizure, cause of fever, and the results of lumbar puncture. RESULTS: In the sex distribution, males(58.6%) outnumbered females(41.4%) and the ratio was 1.2:1. 81.7% of the patients had febrile convulsion from 6 months- to 3 years of age(P<0.05). 30.5% also had family history of febrile convulsion. The types of seizure were generalized tonic-clonic(72.7%), generalized tonic(17.7%), and generalized clonic(6.4 %). For the duration of seizure, 90.4% of the patients were estimated less than 15 minutes(P<0.05). The causes of fever were pharyngotonsilitis(40.5%), gastroenteritis(19.1 %), pneumonia or bronchitis(13.2%), meningitis(11%), otitis media, urinary tract infection, and exanthem subitum. However, 9.1% of the patients were diagnosed meningitis, with 18 of 20 patients under 3 years of age. CONCLUSION: In the first seizure with fever, lumbar puncture is a useful method for meningitis, especially under 3 years of age.
Child* ; Exanthema ; Fever* ; Humans ; Meningitis ; Otitis Media ; Pneumonia ; Seizures* ; Seizures, Febrile ; Sex Distribution ; Spinal Puncture* ; Urinary Tract Infections

PURPOSE: To evaluate the various nationwide statistical data for 2002 in Korea and to compare it to statistical data obtained in 1996. METHODS: Questionaires were distributed to 104 hospitals to obtain vital statistics for live-births, their gestational age and birth weight, incidence of preterm infants, low birth weight infants (LBWI), very LBWI (VLBWI), and neonatal mortality for year 2002. RESULTS: Based on 53, 831 inborn and 11, 151 outborn population, from 64 responded hospitals, the incidence of preterm, term, and postterm were 17.5%, 81.4%, and 1.1%, respectively among inborn group. The incidence of preterm among outborn group was lower than that of inborn. The incidences of LBWI, normal birth weight (2.5-4.0 kg) infants, and large birth weight (>4.0 kg) infants were 15.3%, 80.6%, and 4.2%, respectively among inborn group. The incidence of LBWI was lower in outborn group as compared with the inborn group. Overall neonatal mortality rates of preterm, term, and postterm were 5.5%, 0.3%, and 0% and those of LBWI, normal birth weight (2.5-4.0 kg) infants, and large birth weight (>4.0 kg) infants were 6.1%, 0.2%, and 0.1%, respectively. Neonatal mortality rates of VLBWI and extremely LBWI (ELBWI) were 22.5% and 43.9%, respectively. CONCLUSION: Based on statistical data obtained for 2002 from 64 hospitals, the incidence of preterm and LBWI increased, however, the neonatal mortality rates of LBWI and VLBWI declined in 2002 compared to 1996 in Korea. Further continuation of efforts need to be given to improve standarized neonatal care in Korea.
Birth Weight ; Gestational Age ; Humans ; Incidence ; Infant ; Infant Mortality* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Korea* ; Vital Statistics