PURPOSE: In children disorders affecting brain white matter are not uncommon and MRI has high sensitivity to detect white matter lesions. We performed this study to find out the distribution of underlying diseases that show abnormal white matter image findings on brain MRI and the relationship between the underlying diseases and some particular patterns of MR imaging abnormalities. METHODS: Out of 1477 pediatric patients who visited the department of pediatrics of Yeungnam University Medical Hospital and took brain MRIs from January 1995 to June 2001, ninety five patients with white matter abnormalities on T2 MR images were evaluated retrospectively. This study excluded the patients with brain tumor, brain abscess, trauma, secondary white matter abnormalities due to hydrocephalus, cerebral infarct, and those whose main lesions were gray matter. RESULTS: The most common underlying disease was cerebral palsy(50 cases, 52.6%), followed by acute disseminated encephalitis(10 cases, 10.5%), intrauterine CMV infections (9 cases, 9.5%), inherited neurometabolic disorders(7 cases, 7.4%). In 12 patients(12.6%) with some neurological problems such as afebrile seizures and developmental delay, no underlying disease were found. The most common pattern of abnormal image findings was periventricular white matter lesions(45.3%) strongly related with cerebral palsy. The pattern of peritrigonal deep white matter lesions was found in 19 patients(20.0%), in 10 patients of whom no underlying diseases were found. The pattern of multiple round margined scattered lesions was found in all the 10 patients(10.5%) of acute disseminated encephalitis. CONCLUSION: There are diverse underlying diseases showing abnormal white matter image findings on MR in pediatric patients and particular patterns of abnormal image findings may serve to make a specific diagnosis possible. But not in a small group of children no diagnosis was established. Further studies regarding the underlying diseases affecting white matter lesions and more detailed knowledge of abnormal MR image findings are needed.
Brain ; Brain Abscess ; Brain Neoplasms ; Cerebral Palsy ; Child ; Diagnosis ; Encephalitis ; Humans ; Hydrocephalus ; Leukoencephalopathies* ; Magnetic Resonance Imaging ; Pediatrics ; Retrospective Studies ; Seizures

Infantile hypertrophic pyloric stenosis(IHPS) is one of the most common causes of nonbilious vomiting in early infancy, and is caused by hypertrophied pyloric muscle but its exact etiology and pathogenesis are still unknown. Fredet-Ramstedt pyloromyotomy has been accepted as the treatment of choice for IHPS. Atropine is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated a case of IHPS in a 33-day-old male infant by administering atropine sulfate intravenously. One day after atropine sulfate administration, he did not vomit any more. Ultrasonograms of the pyloric canal which were done on eight days and three weeks after atropine treatment revealed no limitation in the passage of gastric content, and no changes in the muscle thickness and length of the pyloric canal. Thereafter, he did not show up at follow ups, we received his mother's answer through phone that he did not suffer from vomiting and he was growing well at 5 months of age.
Atropine* ; Follow-Up Studies ; Humans ; Infant ; Male ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic* ; Ultrasonography ; Vomiting

No abstract available.

In complication of infective endocaditis splenomegaly and splenic infarction are not uncommon but splenic rupture is very rare. We report a case of splenic rupture complicated by infective endocarditis in 1 71-yr-old man who had been suffered from rheumatic heart disease (aortic regurgitation and stenosis and mitral regurgitation). The patient was admitted to mild fever and generalized weakness for 20 days. Diagnosis of infective endocarditis due to Staphylococcus epidermidis was made by clinical manifestaions and blood culture study.On 34th day of admissionthe patient suddenly displayed the symptoms and signs of massive intraperitoneal hemorrhage. Splenic rupture was revealed by paracentesis and radiologic studies. Rupture of spleen is an uncommon and usually fatal complication of infective endocarditis. Therefore early diagnosis and prompt treatment must be performed.
Constriction, Pathologic ; Diagnosis ; Early Diagnosis ; Endocarditis* ; Fever ; Hemorrhage ; Humans ; Paracentesis ; Rheumatic Heart Disease ; Rupture ; Spleen ; Splenic Infarction ; Splenic Rupture* ; Splenomegaly ; Staphylococcus epidermidis

PURPOSE: To describe MR findings of cerebral venous sinus thrombosis. MATERIALS AND METHODS: We reviewed 11 MR images of six patients with cerebral venous sinus thrombosis. The MR images were retrospectively analyzed in terms of location and signal intensity of the thrombi, parenchymal lesions such as hemorrhage and edema, and changes in follow-up study obtained in 4 patients. RESULTS: The thrombus in venous sinus was visualized on MRI in all six patients. The most frequently involved sites were superior sagittal sinus(n=4) and left transvere sinus(n=4). Signal intensity of the thrombus was isointense or hyperintense on both T1 - and T2-weighted images with loss of normal signal void of the sinus on all sequences in all patients. Parenchymal lesion was present in five of six cases, manifested as local hemorrhage in three and edema in three cases(one case overlapped). Local edema seen in three patients was completely resolved on follow-up study of seven to 29 days intervals. CONCLUSION: It is concluded that iso- or high signal intensity with loss of signal void in venous sinus is virtually diagnostic of venous sinus thromosis. If there are local parenchymal lesions such as hemorrhage and/or edema of unknown causes, cerebral venous sinus thrombosis should be included in differential diagnosis.
Diagnosis, Differential ; Edema ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Sinus Thrombosis, Intracranial* ; Thrombosis

There is no sport in which the knee does not play an integral role. Blazina described the clinical aspects and treatment of the “jumper's knee”. A jumper's knee is a tendinitis of the patella or less frequently quadriceps tendon at the inferior or superior pole of the patella, respectively. It is typically encountered in athletes who are involved in some type of repetitive activity such as jumping, climbing, kicking, or running. the pathology is still ill understood and further date on the etiology and treatment are scarce. Fourty seven cases of patella tendinitis were analyzed in clinical aspects. Results of the study are as follows: l. Of the 47 cases, male were 9 or 19.1%, female were 38 or 80.9%. 2. Complained pain on proximal pole of patella were 11 or 23.4%, both pole were 9 or 19.1%, distal pole were 27 or 57.4%. 3.0f 47 cases, 22 cases or 46.8% were Grade I, 20 cases or 42.5% were Grade II, 4 cases or 8.5% were Grade III, 1 case or 2.1% was Grade IV. 4. 1 case, Grade IV, was confirmed fracture on distal pole of patella by radiologic examination. 5. The Grade I & II patients had subsided an improved by a few days rest, Quadriceps and Hamstrings setting exercise, Ice massage and medication.
Athletes ; Female ; Humans ; Ice ; Knee ; Male ; Massage ; Patella ; Pathology ; Running ; Sports ; Tendinopathy ; Tendons

The morbidity of spondylolisthesis tends to increase in accordance with the popularization of sports and increase of mean life span by the development of medicine. We had applied surgical treatment for 39 cases of spondylolisthesis during the period of 8 yrs. from Jan. 1976 to Dec. 1983 at Department of Orthopaedic Surgery, National Police Hospital, among them 35 cases were followed up for mean 27 months. Twenty eight cases with posterolateral spinal fusion were isthmic spondylolisthesis and seven cases with posterior spinal fusion and facetectomy were degenerative type. We analysed them with clinical aspects and surgical treatment for 35 cases. The results were as follows: 1. The most common clinical symptoms were low back pain (96.7%) and tenderness (93.5%). 2. The degree of slipping was Grade I by Meyerding's classification in all cases and mean 12.5% by Taillard method. 3. In the 7 cases of isthmic spondylolisthesis, the degree of slipping increased on standing lateral view. And in these cases the clinical symptoms were aggrevated at welking. 4. In the degenerative spondylolisthesis with posterior spinal fusion and facetectomy, we found mean 70% spontaneous correction of slipping commpared with preoperative. 5. In postoperative evaluation we gained 94.3% above good according to Gill's criteria and no pseudarthrosis.
Classification ; Humans ; Low Back Pain ; Methods ; Police ; Pseudarthrosis ; Spinal Fusion ; Spondylolisthesis ; Sports

No abstract available.

No abstract available.
Folic Acid Deficiency* ; Folic Acid* ; Polyneuropathies*

PURPOSE: The effects of arbiturary acute anticonvulsants withdrawal in epileptic children were studied and relationship between status epilepticus and anticonvulsant withdrawal was analysed. METHODS: Medical records of 88 withdrawal episodes in 72 active epileptic children were analysed retrospectively according to the types of epilepsies, anticonvulsants. RESULTS: 1) When followed up after withdrawal, 42 cases (47.7%) had a recurrence of habitual seizure, 18 cases (20.5%) had no seizure and increased seizure frequency were found in 14 cases (16.0%). Three cases (3.4%) had no change in seizure frequency or severity and in 2 cases (2.3%) the frequency or severity of seizure were decreased after withdrawal. 2) Recurrence of habitual seizure, increased seizure frequency, more intense seizure or status epilepticus were noted in 55 of 71 withdrawal episodes in focal epilepsies (77.5%), in 9 of 17 withdrawal episodes (52.9%) in generalized epilepsies (P=0.041). These changes occurred in 36 of 55 cases (65.5%) in focal epilepsies, 3 of 9 cases (30.0%) in generalized epilepsies within 4 weeks after withdrawal (P=0.137). 3) Recurrence of habitual seizure, increased seizure frequency, development of more intense seizure or status epilepticus were found in 18 of 26 cases (69.2%) in carbamazepine monotherapy, 15 of 16 cases (93.8%) in phenobarbital monotherapy, 24 of 34 cases (70.6%) in polypharmacy (P=0.143). These changes occurred in 14 of 18 cases (77.8%) in carbamazepine monotherapy, 7 of 15 cases (46.7%) in phenobarbital monotherapy and 18 of 24 cases (75.0%) in polypharmacy within 4 weeks after withdrawal (P=0.122). 4) Four cases (4.5%) of status epilepticus occurred in 4 patients with focal epilepsies at 4 months (2 cases), 5 months, 23 months later after acute anticonvulsant withdrawal. CONCLUSION: Arbiturary acute anticonvulsants withdrawal in epileptic children were more common than expectation and councelling to avoid arbiturary anticonvulsant withdrawal must be entensified. Approximately half of the cases with anticonvulsant withdrawal showed a recurrence of habitual seizure and status epilepticus occurred in 4.5% of cases only. Other factors besides acute anticonvulsant withdrawal must be investigated to clarify the underlying mechanism of status epilepticus. A quarter of cases showed no seizure and even decrease in seizure frequency or severity after anticonvulsant withdrawal. These results suggest more considerated prescription of anticonvulsant is needed in practice.
Anticonvulsants ; Carbamazepine ; Child* ; Epilepsies, Partial ; Epilepsy ; Epilepsy, Generalized ; Humans ; Medical Records ; Phenobarbital ; Polypharmacy ; Prescriptions ; Recurrence ; Retrospective Studies ; Seizures ; Status Epilepticus