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

BACKGROUND: Several studies on the frequency and distribution of unexpected antibodies of Koreans have been done by some investgators. But more studies are necessory to grasp the real frequency and distribution. We hoped to investigate the frequency and distribution of unexpected antiboddis of Koreans. METHODS: We performed 188 unexpected antibody identification tests to evaluate the distribution of unexpected antibodies from May 1997 to June 1998. The sera we tested are antibody screening positive ones sent from 11 hospitals and 1 blood center. We also analized the frequecny of unexpected antibodues from the data of Dongsan Medical Center's antibody screening tests. RESULTS: The frequency of unexpected antibody of this study (using tube method) was 1.0%. Both anti-Lea and anti-E (with anti-c) antibodies were the most frequent antibodies up to 31 cases (33.0%) each. Among the identified antibodies from Dongsan Medical Center which used tube method, anti-Lea antibody was the most frequent antibody (41.3%). Otherwise among the identified antibodies from other two hospitals which used gel card method, anti-E (with anti-c) antibody was the most frequent antibody (45.5%). The cause of all four cases of hemolytic disease of newborn was anti-E antibody. About half of the specimens' antibodies were not identified due to the problemes of identification cells, tested sera, test methods. CONCLUSION: Anti-Lea and anti-E (with anti-c) antibodies were the most frequent ones in Korean people. But the prequency was varied according to antibody screenig test methods. Anti-E antibody is the most important unexpected antibidy for hemolytic disease of newborn in Korea. To decrease the missed cases of antibody identification tests both Korean and foreign identification cells, enzyme method should be used.
Antibodies* ; Erythroblastosis, Fetal ; Hand Strength ; Hope ; Infant, Newborn ; Korea ; Mass Screening

Hibernoma is a rare benign tumor of a brown fat origin with hypervascularity. Although the magnetic resonance imaging features resemble a liposarcoma, its malignant potential is unknown. A complete local excision with meticulous hemostasis is the treatment of choice. We present a case of hibernoma in the psoas muscle with a review of the relevant literature.
Adipose Tissue, Brown ; Hemostasis ; Lipoma* ; Liposarcoma ; Magnetic Resonance Imaging ; Psoas Muscles*

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