Cortical dysplasia(CD) represents a spectrum of neuropathologic changes reflecting a derangement of the normal process of neocortical development. We have presented 32 patients who underwent cortical recectiom for intractable seizures and demonstrated the neuropathologic features, which could be explained by a disturbance in the process of neural development in the farm. It could be characterized by light microscopic features: cortical laminar disorganization, neurons in the molecular layer, subpial re=ants of granule calls, remnants of marginal glioneuronal heterotopia, neuronal heterotopia in the white matter, polymicrogyria, neuronal cytomegaly and balloon cell change. Even though cortical dyslamimtion was the consistent finding of all the cases, the neuronal cytomegaly and balloon cell change were diagnostic hallmarks in the study. The cytomegatic neurons were strongly reactive to silver impregration and to immunohistochemical marrkers of neurons, such as neurofilament protein (NF, 68 and 200 kDa) and neuron-specific enolase(NSE). They showed hypertrophic endoplmmic reticul= and increased number of mitochondria in their cytoplasm and incomplete synapses in electron microscopic study. The balloon cells were positively stained by glial fibrillary acidic protein, NSE and vimentin and were filled with intermediate filaments in their cytoplasm. These results indicated that both cytomegalic neurons and balloon cells are produced by faulty cell differentiation involving neuroblast in the former, and both neuronal and glial stem cell lines in the latter.
Cell Differentiation ; Cytoplasm ; Glial Fibrillary Acidic Protein ; Humans ; Intermediate Filaments ; Malformations of Cortical Development* ; Mitochondria ; Neurons ; Seizures ; Silver ; Stem Cells ; Synapses ; Vimentin

Deveolopmental coax vara represents coax vara not present at birth but rather developing in early childhood, showing a progressive deterioration in the proximal femoral neck-shaft angle during growth. In order to determine the factors that could affect the results of corrective osteotomy, we evaluated the results of 15 developmental coax vara in 12 patients who had been treated with the femoral osteotomy at the Department of Pediatric Orthopedic Surgery, Seoul National University Children's Hospital, from February 1983 to March 1993. Of the 12 patients, there were 6 boys and 6 girls. Three patients had bilateral operations, 5 patients on the right, and the remaining 4 patients on the left. Average at the onset of symptoms was 4 years plus 5 months(range; from 1 year to 7 years plus 2 months), and average age at the tome of operation was 6 years plus 3 months(range; from 2 years plus 4 months to 10 years). We could obtain the following results: 1. Average post-operative loss of neck-shaft angle was 5% in the cases in which post-operative neck-shaft angle was converted more than 130 degrees, and was 8% in the cases in which post-operative neck-shaft angle was converted less than 130 degrees. 2. Loss of neck-shaft angle was higher during the first post-operative period, and was higher in cases in which the triangular osseous defect was persistent post-operatively. There was no correlation between the post-operative neck-shaft angle and disappearance of triangular osseous defect. 3. The femoral anteversion was converted 8.7 degrees to 27.2 postoperatively. 4. The premature arrest of the capital femoral physis was higher in cases in which the neck-shaft angle was less than 130 degrees postoperatively. 5. Leg length discrepancy, which was 2.1 cm preoperatively, did not change in cases in which the neck-shaft angle was more than 130 degrees postoperatively. However, it was converted to 3.3 cm in cases in which the neck-shaft angle was less than 130 postoperatively. 6. we could observe the femoral head deformity in 6 out of 7 cases in which the operation was performed after 7 years of age. We could draw the following conclusion based on our results: 1. We must correct the neck-shaft angle more than 130 degrees. 2. We could not equalize the leg length discrepancy by corrective osteotomy alone. 3. It may be reasonable to perform the corrective osteotomy before 7 years of age.
Congenital Abnormalities ; Coxa Vara ; Female ; Head ; Humans ; Leg ; Orthopedics ; Osteotomy ; Parturition ; Seoul

Purpose: Acetaminophen overdose accounts for the largest proportion of pediatric poisoning reported in South Korea. We investigated the characteristics and prognosis of pediatric acetaminophen overdose. Methods: We retrospectively reviewed medical records of patients younger than 19 years with acetaminophen overdose who visited the emergency department (ED) of Pusan National University Children’s Hospital from January 2009 through December 2022. We investigated age, sex, dose, clinical findings, and treatment, and compared the differences in the variables according to the intentionality of ingestion and the presence of hepatotoxicity. Results: Among the 132,691 pediatric patients who visited the ED during the period, 555 did for drug intoxication, of whom 51 with acetaminophen overdose were included in this study. The overdose was intentional in 43 patients (the intentional group; median age, 15.4 years [interquartile range, 13.9-16.8]) and accidental in 8 patients (the accidental group; 7.7 years [2.3-15.4]). The mean ingested dose was higher in the intentional group than in the accidental group (170.3 ± 129.0 vs. 105.3 ± 37.5 mg/kg; P = 0.016). Hospitalization tended to be implemented more frequently in the intentional group (53.5% vs. 12.5%; P = 0.081). All patients with hepatotoxicity (n = 10) belonged to the same group, and showed a higher or longer median age (15.9 [14.6-17.1] vs. 13.8 years [13.7-16.4]; P = 0.030), mean ingested dose (13,230.0 ± 10,544.8 vs. 7,654.0 ± 6,752.3 mg; P = 0.043), mean time from ingestion to arrival at the ED (22.6 ± 23.4 vs. 5.5 ± 6.4 hours; P = 0.048), and frequency of hospitalization (80.0% vs. 39.0%; P = 0.048). Conclusion It is necessary to track the occurrence of hepatotoxicity in patients who intentionally ingest acetaminophen.

Purpose: Acetaminophen overdose accounts for the largest proportion of pediatric poisoning reported in South Korea. We investigated the characteristics and prognosis of pediatric acetaminophen overdose. Methods: We retrospectively reviewed medical records of patients younger than 19 years with acetaminophen overdose who visited the emergency department (ED) of Pusan National University Children’s Hospital from January 2009 through December 2022. We investigated age, sex, dose, clinical findings, and treatment, and compared the differences in the variables according to the intentionality of ingestion and the presence of hepatotoxicity. Results: Among the 132,691 pediatric patients who visited the ED during the period, 555 did for drug intoxication, of whom 51 with acetaminophen overdose were included in this study. The overdose was intentional in 43 patients (the intentional group; median age, 15.4 years [interquartile range, 13.9-16.8]) and accidental in 8 patients (the accidental group; 7.7 years [2.3-15.4]). The mean ingested dose was higher in the intentional group than in the accidental group (170.3 ± 129.0 vs. 105.3 ± 37.5 mg/kg; P = 0.016). Hospitalization tended to be implemented more frequently in the intentional group (53.5% vs. 12.5%; P = 0.081). All patients with hepatotoxicity (n = 10) belonged to the same group, and showed a higher or longer median age (15.9 [14.6-17.1] vs. 13.8 years [13.7-16.4]; P = 0.030), mean ingested dose (13,230.0 ± 10,544.8 vs. 7,654.0 ± 6,752.3 mg; P = 0.043), mean time from ingestion to arrival at the ED (22.6 ± 23.4 vs. 5.5 ± 6.4 hours; P = 0.048), and frequency of hospitalization (80.0% vs. 39.0%; P = 0.048). Conclusion It is necessary to track the occurrence of hepatotoxicity in patients who intentionally ingest acetaminophen.

Purpose: Acetaminophen overdose accounts for the largest proportion of pediatric poisoning reported in South Korea. We investigated the characteristics and prognosis of pediatric acetaminophen overdose. Methods: We retrospectively reviewed medical records of patients younger than 19 years with acetaminophen overdose who visited the emergency department (ED) of Pusan National University Children’s Hospital from January 2009 through December 2022. We investigated age, sex, dose, clinical findings, and treatment, and compared the differences in the variables according to the intentionality of ingestion and the presence of hepatotoxicity. Results: Among the 132,691 pediatric patients who visited the ED during the period, 555 did for drug intoxication, of whom 51 with acetaminophen overdose were included in this study. The overdose was intentional in 43 patients (the intentional group; median age, 15.4 years [interquartile range, 13.9-16.8]) and accidental in 8 patients (the accidental group; 7.7 years [2.3-15.4]). The mean ingested dose was higher in the intentional group than in the accidental group (170.3 ± 129.0 vs. 105.3 ± 37.5 mg/kg; P = 0.016). Hospitalization tended to be implemented more frequently in the intentional group (53.5% vs. 12.5%; P = 0.081). All patients with hepatotoxicity (n = 10) belonged to the same group, and showed a higher or longer median age (15.9 [14.6-17.1] vs. 13.8 years [13.7-16.4]; P = 0.030), mean ingested dose (13,230.0 ± 10,544.8 vs. 7,654.0 ± 6,752.3 mg; P = 0.043), mean time from ingestion to arrival at the ED (22.6 ± 23.4 vs. 5.5 ± 6.4 hours; P = 0.048), and frequency of hospitalization (80.0% vs. 39.0%; P = 0.048). Conclusion It is necessary to track the occurrence of hepatotoxicity in patients who intentionally ingest acetaminophen.

Purpose: Acetaminophen overdose accounts for the largest proportion of pediatric poisoning reported in South Korea. We investigated the characteristics and prognosis of pediatric acetaminophen overdose. Methods: We retrospectively reviewed medical records of patients younger than 19 years with acetaminophen overdose who visited the emergency department (ED) of Pusan National University Children’s Hospital from January 2009 through December 2022. We investigated age, sex, dose, clinical findings, and treatment, and compared the differences in the variables according to the intentionality of ingestion and the presence of hepatotoxicity. Results: Among the 132,691 pediatric patients who visited the ED during the period, 555 did for drug intoxication, of whom 51 with acetaminophen overdose were included in this study. The overdose was intentional in 43 patients (the intentional group; median age, 15.4 years [interquartile range, 13.9-16.8]) and accidental in 8 patients (the accidental group; 7.7 years [2.3-15.4]). The mean ingested dose was higher in the intentional group than in the accidental group (170.3 ± 129.0 vs. 105.3 ± 37.5 mg/kg; P = 0.016). Hospitalization tended to be implemented more frequently in the intentional group (53.5% vs. 12.5%; P = 0.081). All patients with hepatotoxicity (n = 10) belonged to the same group, and showed a higher or longer median age (15.9 [14.6-17.1] vs. 13.8 years [13.7-16.4]; P = 0.030), mean ingested dose (13,230.0 ± 10,544.8 vs. 7,654.0 ± 6,752.3 mg; P = 0.043), mean time from ingestion to arrival at the ED (22.6 ± 23.4 vs. 5.5 ± 6.4 hours; P = 0.048), and frequency of hospitalization (80.0% vs. 39.0%; P = 0.048). Conclusion It is necessary to track the occurrence of hepatotoxicity in patients who intentionally ingest acetaminophen.

Pulmonary actinomycosis is a chronic suppurative disease usually caused by Actinomyces israelii, characterized by suppuration, sinus tract formation, and purulent discharge containing yellowish "sulfur granules". It is usually caused by aspiration of contaminated material from mouth or oropharynx. The diagnosis of pulmonary actinomycosis is difficult and its initial clinical manifestations mimic tuberculosis or neoplasm. We experienced a case of thoracic actinomycosis in a 47-year old male patient who had complained of cough, chest pain and fever for 2 months. The diagnosis was confirmed pathologically by ultrasonography guided gun-biopsy of pleural mass and thoracoscopic wedge biopsy of parenchymal lung lesion.
Actinomyces ; Actinomycosis* ; Biopsy ; Chest Pain ; Cough ; Diagnosis ; Fever ; Humans ; Lung ; Male ; Middle Aged ; Mouth ; Oropharynx ; Suppuration ; Tuberculosis ; Ultrasonography

BACKGROUND: Excitotoxicity and epileptogenesis have often been associated with glutamate receptor activation. Some evidence indicates that selective down regulation of AMPA receptor may be the mechanism of delayed neuronal cell death in the hippocampus. METHODS: We used in situ hybridization to examine the hybridization density (HD) of NMDA and AMPA receptors on excitotoxicity and epileptogenesis in the hippocampus of the kainic acid (KA)-induced rat seizure model. Some Sprague-Dawley rats were injected with KA, and others with MK-801 prior to KA injection. The rats were killed at 8 hours or 4 weeks after KA or MK-801/KA injection. HD of [3H]MK-801 and [3H]AMPA bind-ing in subfields of the hippocampus was measured by an image analyzer. RESULTS: After 8 hours of KA injection, [3H]MK-801 binding was increased in CA1 and CA3, and decreased in dentate gyrus, and [3H]AMPA binding was decreased in all of CA1, CA3 and fascia dentata, and pretreatment of MK-801 did not affect [3H]AMPA binding in all of CA1, CA3 and dentate gyrus. After 4 weeks, both [3H]MK-801 and [3H]AMPA binding were prominently increased in inner molecular layer of dentate gyrus. CONCLUSIONS: Glutamate receptors, especially NMDA receptor, were associ-ated with excitotoxicity in the hippocampus but the selective down regulation of GluR2 subunit of AMPA receptor without NMDA receptor activation may not be sufficient to cause excitotoxic neuronal cell death in CA1 and CA3. In addition, the synaptic reorganization in inner molecular layer of dentate gyrus was proved to be chronically hyperex-citable in function and may contribute epileptogenesis.
Animals ; Autoradiography* ; Cell Death ; Dentate Gyrus ; Dizocilpine Maleate* ; Down-Regulation ; Glutamic Acid* ; Hippocampus ; In Situ Hybridization ; Kainic Acid ; N-Methylaspartate ; Neurons ; Rats ; Rats, Sprague-Dawley ; Receptors, AMPA ; Receptors, Glutamate* ; Receptors, Ionotropic Glutamate* ; Seizures*

Background: By analyzing small bowel capsule endoscopy (SBCE) performed in two large hospitals in Kazakhstan, we aimed to explore the characteristics of patients representative of Central Asia and the technical characteristics of SBCE. Methods: SBCE cases were retrospectively analyzed. A descriptive analysis was conducted on the patients’ demographic data, diagnosis, and clinical symptoms. The results of SBCE, such as the lesions found, transit time and retention rate in the stomach and small bowel, and bowel visualization quality, were analyzed. Complications related to SBCE were investigated. Results: SBCE was performed in 123 patients. Abdominal pain (81.3%) and chronic diarrhea (66.7%) were the most common symptoms, followed by weight loss (25.2%) and gastrointestinal bleeding (15.4%). The most common disease was Crohn’s disease (52.0%). Definite lesions, such as ulcers, polyps, and bleeding, were identified in 55.3% of patients. SBCE was successfully completed in all cases except for 11 (9.1%). The average small bowel transit time was 4 hours and 28 minutes. Excellent visualization (>75% of mucosa) was reported in 82.5% of patients. No patients experienced complications. Conclusions SBCE performed in Kazakhstan showed a high diagnostic yield with high-quality patient selection and no complications.

Background: By analyzing small bowel capsule endoscopy (SBCE) performed in two large hospitals in Kazakhstan, we aimed to explore the characteristics of patients representative of Central Asia and the technical characteristics of SBCE. Methods: SBCE cases were retrospectively analyzed. A descriptive analysis was conducted on the patients’ demographic data, diagnosis, and clinical symptoms. The results of SBCE, such as the lesions found, transit time and retention rate in the stomach and small bowel, and bowel visualization quality, were analyzed. Complications related to SBCE were investigated. Results: SBCE was performed in 123 patients. Abdominal pain (81.3%) and chronic diarrhea (66.7%) were the most common symptoms, followed by weight loss (25.2%) and gastrointestinal bleeding (15.4%). The most common disease was Crohn’s disease (52.0%). Definite lesions, such as ulcers, polyps, and bleeding, were identified in 55.3% of patients. SBCE was successfully completed in all cases except for 11 (9.1%). The average small bowel transit time was 4 hours and 28 minutes. Excellent visualization (>75% of mucosa) was reported in 82.5% of patients. No patients experienced complications. Conclusions SBCE performed in Kazakhstan showed a high diagnostic yield with high-quality patient selection and no complications.