PURPOSE: Periventricular leukomalacia(PVL) is associated with various neurologic sequelae such as cerebral palsy and cortical blindness. The aim of this study was to analyse the correlation between the degree of PVL on MRI and clinical features or its severity. METHODS:Thirty-eight children with PVL on MRI among children brought to Pusan National University Hospital between January 1996 and August 1999 with development delay, cerebral palsy or epilepsy were included into the study group. We reviewed medical records of the patients including the gestational age, birth weight and neurologic sequelae. The grade for PVL was divided into 1 to 3, and it was based on abnormally increased signal intensity in periventricular white matter or a reduced amount of periventricular white matter or both, and compensatory focal ventricular enlargement. We analysed the relationship of the grade of PVL and various clinical findings. RESULTS: The age ranged from 11 months to 13 years old with a mean of 42 months. History of cesarean delivery and ventilator care were significantly frequent for the severe grade of PVL. Birth weight was significantly lower according to grade of PVL. Gestational age was lower according to the grade of PVL, but was not significant statistically. Incidence of cerebral palsy was significantly higher on the severe grade of PVL. Incidence of epilepsy and mental retardation were 34.2Yo and 23.9M, not associated with the grade of PVL. CONCLUSION: Incidence of cerebral palsy was associated with the severe grade of PVL, so we think MRI can be helpful in predicting neurodevelopmental outcome. (J Korean Pediatr Soc 2000;43 798-805)
Adolescent ; Birth Weight ; Blindness, Cortical ; Brain* ; Busan ; Cerebral Palsy ; Child ; Epilepsy ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Intellectual Disability ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging* ; Medical Records ; Ventilators, Mechanical

PURPOSE: The periventricular leukomalacia(PVL) tends to increase the risk of developing motor neurologic sequelae, delayed cognitive development, visual impairment, and epilepsy. Although several developmental screening test methods are being used, one of the oldest and best known developmental screening test was restandardized and revised as Denver Development Screening Test II(Denver II). The objective of this study is to analyse the correlation between the degree of PVL on MRI and the results of Denver II. METHODS: Among the children brought into Pusan National University Hospital between January 1996 and August 1999 with developmental delay, all of the 36 children with PVL on MRI were selected for the study. Denver II was checked in all these patients for screening of developmental delay with the review of medical records. Depending on the grade of PVL, total sample was classified into three groups, and it was based on abnormally increased signal intensity in periventricualr white matter or a reduced amount of periventricular white matter or both, and compensatory focal ventricular enlargement. We analysed the relationship of the grade of PVL and the results of Denver II. RESULTS: The 36 total patients were composed of 22 boys and 14 girls, with the age distribution between 11 to 72 months and the mean of 34.4 months. Delayed occurrence of gross motor sector were 5 cases(44.4%) in group 1, 16 cases(80.0%) in group 2, 7 cases(100.0%) in group 3. Incidence of delay was significantly higher in the high grade PVL group. Delayed rate of other sectors(fine motor-adaptive, personal-social) were higher in the high grade PVL group. But it was not statistically significant. Delayed rate of language sector has no correlation with grade of PVL on MRI. CONCLUSION: Incidence of dealy of gross motor sector was significantly higher in the high grade PVL group. However, language sector has no correlation with grade of PVL on MRI.
Age Distribution ; Brain* ; Busan ; Child ; Epilepsy ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Mass Screening* ; Medical Records ; Vision Disorders

No abstract available.

PURPOSE: We evaluated the efficacy and safety of transdermal 1% testosterone gel in Korean men with late-onset hypogonadism from Aug. 2004 to Dec. 2005 in a prospective, fixed-dose, placebo-uncontrolled, open label, multicenter study. MATERIALS AND METHODS: From the 5 urological centers in Korea, a total of 87 male patients older than 40 years who were diagnosed with late-onset hypogonadism with serum testosterone lower than 350 ng/dl or serum free testosterone lower than 73.5 pg/ml were enrolled. Among the 87 enrolled 68 patients completed the daily application of 1% testosterone gel according to the standard consumer guidelines for the full 12-week period. We compared the data at baseline and at 4, 8, and 12 weeks follow-up using the Aging Males' Symptoms (AMS) scale, the International Index of Erectile Function (IIEF)-15, the International Prostate Symptoms Score (IPSS), and the serum levels of total and free testosterone and prostate specific antigen (PSA). RESULTS: The mean age of the patients was 56.5+/-12.7 years. The total scores for the AMS scores at baseline, 4, 8, and 12 weeks were 43.5+/-12.2, 36.6+/-12.3, 33.8+/-11.2, and 34.2+/-11.0, respectively (p<0.0001 vs. baseline). Total and free testosterone levels at baseline were 259.8+/-119.4 ng/dl and 50.5+/-24.7 pg/ml, and at 12 weeks were 594.5+/-376.6 ng/dl and 139.5+/-110.7 pg/ml, respectively (p<0.0001 vs. baseline). IIEF scores increased from 34.7+/-8.5 at baseline to 43.2+/-8.7 at 12 weeks (p<0.0001). There were no significant changes in serum PSA levels. The most commonly reported adverse events were acne and itching at the site of application. The majority of adverse events were mild, reversible, and short in duration. CONCLUSIONS: Testogel(R) showed highly effective clinical and biochemical recovery with good tolerance in Korean men with late-onset hypogonadism.
Acne Vulgaris ; Aging ; Andropause ; Follow-Up Studies ; Humans ; Hypogonadism* ; Korea ; Male ; Prospective Studies* ; Prostate ; Prostate-Specific Antigen ; Pruritus ; Testosterone*

OBJECTIVE: We evaluated the effect of rapid influenza diagnostic tests (RIDTs) on patient management in an emergency department for 3 years after 2009, and also identified factors associated with the choice of treatment for patients with influenza-like illnesses.METHODS: The study period consisted of three influenza epidemic seasons. Patients older than 15 years who underwent RIDTs in the emergency department and were then discharged without admission were included.RESULTS: A total of 453 patients were enrolled, 114 of whom had positive RIDT results and 339 had negative results. Antiviral medication was prescribed to 103 patients (90.4%) who had positive RIDT results, while 1 patient (0.3%) who tested negative was treated with antivirals (P<0.001). Conservative care was administered to 11 RIDT-positive patients (9.6%) and 244 RIDT-negative patients (72.0%) (P<0.001). Symptom onset in less than 48 hours, being older than 65 years, and the presence of comorbidities were not associated with the administration of antiviral therapy.CONCLUSION: RIDT results had a critical effect on physician decision-making regarding antiviral treatment for patients with influenza-like illnesses in the emergency department. However, symptom onset in less than 48 hours, old age, and comorbidities, which are all indications for antiviral therapy, were not found to influence the administration of antiviral treatment.
Antiviral Agents ; Comorbidity ; Diagnostic Tests, Routine ; Emergencies ; Emergency Service, Hospital ; Humans ; Influenza, Human ; Seasons

Background: and Purpose Fatigue is common in demyelinating disorders of the central nervous system (CNS), including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).We aimed to validate the usefulness of the Functional Assessment of Chronic Illness Therapy– Fatigue (FACIT-F) and the Fatigue Severity Scale (FSS) relative to the Korean version of the Modified Fatigue Impact Scale (MFIS-K) in Korean patients with MS, NMOSD, and MOGAD. Methods: There were 294 patients with MS (n=120), NMOSD (n=103), or MOGAD (n=71) enrolled in a prospective demyelinating CNS registry. Fatigue was measured using the FACIT-F, MFIS-K, and FSS. Sleep quality, quality of life, depression, and pain were evaluated using the Pittsburgh Sleep Quality Index (PSQI), 36-item Short-Form Survey (SF-36), and Beck Depression Inventory-II (BDI-II). Results: The MFIS-K, FACIT-F, and FSS scores showed high internal consistencies and strong correlations with each other in the MS, NMOSD, and MOGAD groups. The scores on all three fatigue scales were correlated with PSQI, SF-36, and BDI-II results in the three groups. The areas under the receiver operating characteristic curves for the FSS and FACIT-F were 0.834 and 0.835, respectively, for MS, 0.877 and 0.833 for NMOSD, and 0.925 and 0.883 for MOGAD. Conclusions These results suggest that the MFIS-K, FSS, and FACIT-F are useful and valuable assessment instruments for evaluating fatigue in Korean patients with MS, NMOSD, and MOGAD.

OBJECTIVE:To evaluate the normal figure of intracranial and intraspinal cerebrospinal fluid(CSF) dynamics, we report the results of the various parameters of cine phase contrast(PC) magnetic resonance(MR) CSF flow images throughout the whole neuraxis. METHODS: The MR images were obtained with 1.5T unit using the cine PC sequence with cardiac gating and gradient echo imaging in 10 normal persons(mean age, 30.4 years). The temporal velocity information from the anterior and posterior cervical pericord subarachnoid spaces, third and fourth ventricles, aqueduct, and lumbar cistern were plotted as wave forms. The wave forms were analyzed for configurations, amplitude parameters, and temporal parameters. The statistical significance of each parameter was examined with paired t-test. RESULTS: The actual flow of CSF were clearly visible with cine MR images. Throughout the whole neuraxis, the distinct reproducible configuration features were not obtained at ventricular or lumbar cistern, but at aqueduct and cervical pericord spaces. The temporal parameters were more important than the amplitude parameters. CONCLUSION: In this study, the authors demonstrated normal CSF dynamics and obtained further precision by plotting the temporal velocity information from the images as a waveform. This important basic information may be useful for understanding altered physiology in disease states such as syringomyelia and hydrocephalus.
Cerebrospinal Fluid* ; Fourth Ventricle ; Hydrocephalus ; Magnetic Resonance Imaging ; Physiology ; Subarachnoid Space ; Syringomyelia

A spermatic cord leiomyoma is an uncommon disease. A leiomyoma can originate anywhere, including the genitourinary system, where smooth muscle is present. 70 and 30% of spermatic cord leiomyomas are benign and malignant, respectively. The preoperative diagnosis of a leiomyoma is difficult; the only definite diagnostic method is histological confirmation. A retroperitoneal lipoma probably constitutes the largest group of solid abdominal tumors. However, their etiology is unknown and the symptoms insidious, and recurrences and sarcomatous changes frequently occur. The clinical diagnostic methods are the clinical symptoms, a physical examination and radiological evaluations, such as intravenous urography, computed tomography and angiography, and so on, but an abdominal CT scan provides the most useful information. A fifty-six-old man presented with a five-month history of a suddenly enlarging right inguinal mass. He had undergone a right inguinal hernia operation, with medication for hypertension. Herein, a rare case of a huge retroperitoneal lipoma, with a spermatic cord leiomyoma, is reported.
Angiography ; Diagnosis ; Hernia, Inguinal ; Hypertension ; Leiomyoma* ; Lipoma ; Muscle, Smooth ; Physical Examination ; Recurrence ; Retroperitoneal Space ; Spermatic Cord* ; Tomography, X-Ray Computed ; Urogenital System ; Urography

BACKGROUND: The pneumoperitoneum created by CO2 insufflation during laparoscopic cholecystectomy has several potential hemodynamic and respiratory consequences. The purpose of this study is to investigate the effects of augmented minute ventilation on cardiovascular and ventilatory changes and to prevent hypercarbia due to CO2 insufflation during laparoscopic cholecystectomy. METHODS: Thirty-six patients were divided into three groups according to the level of minute ventilation. The three groups were: control group C (minute ventilation 100 ml/kg, respiratory rate 12 per minute), group R (MV 150 ml/kg, RR is 18 per minute) and group V (MV 150 ml/kg, tidal volume is 1.5 times as much as group C). We repeatedly measured mean arterial pressure , pulse rate , arterial blood gas analysis and end tidal carbon dioxide and peak inspiratory airway pressure before CO2 insufflation, 15 and 30 minutes after CO2 insufflation and 15 minutes after CO2 deflation. RESULTS: During CO2 insufflation, MAP significantly increased but PR showed little changes in all three groups. PaCO2 and PetCO2 increased in group C, whereas in group R and V, they remained unchanged during CO2 insufflation. But the level of PaCO2 in group V decreased more than in the other two groups after CO2 deflation,. PIP in group V increased 3 times as much as the control value. CONCLUSIONS: These results suggest that augmented minute ventilation in group R and V, prevented hypercarbia during CO2 insufflation and increasing the tidal volume in controlled ventilation was more effective than increasing respiratory rate after CO2 deflation.
Anesthesia, General* ; Arterial Pressure ; Blood Gas Analysis ; Carbon Dioxide ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Heart Rate ; Hemodynamics ; Humans ; Insufflation ; Laparoscopy ; Pneumoperitoneum ; Respiratory Rate ; Tidal Volume ; Ventilation*

No abstract available.
Carcinoma, Renal Cell/*complications/pathology/surgery ; Danazol/therapeutic use ; Humans ; Kidney Neoplasms/*complications/pathology/surgery ; Male ; Middle Aged ; Nephrectomy ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic/blood/drug therapy/*etiology