No abstract available.
Humans

No abstract available.
Humans

PURPOSE: To describe the clinical, MR imaging, and pathologic findings of pediatric meningiomas. MATERIALS AND METHODS: The authors retrospectively reviewed the medical records and MR images of 16 pediatric patients with pathologically proven meningioma. Mean patient age at diagnosis was 14 years (range, 3-18). MR images were reviewed for details of lesion sizes, locations, signal intensity (SI), marginal characteristics, internal architectures, enhancements, and dural and parenchymal changes. The findings of other imaging modalities and of pathological examinations were also analyzed. RESULTS: Mean tumor size was 5.24 cm (range, 1.3-18.1 cm) and locations were supratentorial in 12 and infratentorial in 4. SI of masses were variable, that is, high in 9, iso in 4, and low in 3 on T2 weighted images (T2WI), and low (n=11), iso (n=4), or high (n=1) on T1WI images. All lesions were visualized as well-demarcated enhancing masses. Five of the tumors were heterogeneous with cystic or necrotic components. Dural attachment was observed in 11 patients and adjacent brain edema in 10. Tumors exhibited hyperdense (n=6) or isodense (n=4) on nonenhanced CT scans, and 3 of the 7 angiograms demonstrated blood supply from the internal carotid artery. Pathologic examinations revealed the following subtypes; transitional cell (n=4), meningotheliomatous (n=4), chordoid (n=2), fibrous (n=2), clear cell (n=1), hyalinized (n=1), rhabdoid papillary (n=1), and atypical (n=1). CONCLUSION: Pediatric meningiomas occur usually in teenagers, have diverse pathological types, and may produce atypical imaging findings, such as, a heterogeneous internal content or findings suggestive of intraaxial tumors.
Adolescent ; Brain Edema ; Brain Neoplasms ; Carotid Artery, Internal ; Humans ; Hyalin ; Medical Records ; Meningioma ; Retrospective Studies

BACKGROUND: Falling in elderly persons can lead to disability, hospitalizations, and premature death. It may also result in a psychological trauma termed fear of falling. Although it has been reported in developed countries that such fear may lead to staying home or other self-restriction of activities with debilitating physical consequenoes, it has not been studied yet in Korea. So we conducted this study to examine relative frequency of fear of falling and its association with measures of falling, activities of daily living, depression, frailty in elderly persons living in a home for the aged. METHODS: We conducted a cross-sectional study of a sample of 152 subjects among 163 elders living in a home for the aged in Seoul Data on demographic and medical characteristics, and cognitive(MMSEK), functional(ADL, Instrumental ADL), and psychological(GDS-K) functioning, and measures of fall and frailty were obtained during assessments. We asked the subjects whether they had fear of falling in a dichotomous manner. RESULTS: The incidence of falls in the prior year was 29.6%, and the relative frequency of fear of falling was 57.2%. The variables associated with fear of falling with a statistical significance were as follows; old age(>or=80years), no education, no alcohol drinking, no smoking, use of assistive device, experience with falls and fall with injury in the prior 12 months, any disability in ADL, 3 or more disability in IADL In a stepwise logistic regression analysis, experience with falls(OR 2.80, 95% CI 1.12-6.97), 3 or more disability in IADL(OR 2.99, 95% CI 1.33-8.78), and no alcohol drinking(OR 3.23, 95% CI 1.36-7.95) were still associated independently with fear of falling. CONCLUSIONS: Fear of falling is common in the institutionalized elderly persons in Korea, and is associ- ated with decreased instrumental activities, recent experience with falls, and no alcohol drinking. There fore it represents the need for effective intervention to prevent and limit the consequences of falls and fear of falling in elderly persons.
Activities of Daily Living ; Aged* ; Alcohol Drinking ; Cross-Sectional Studies ; Depression ; Developed Countries ; Education ; Hospitalization ; Humans ; Incidence ; Korea ; Logistic Models ; Mortality, Premature ; Self-Help Devices ; Seoul ; Smoke ; Smoking

In South Korea, attempted suicide by paraquat (PQ) intoxication is fairly common, and is lethal by pulmonary fibrosis and hypoxemia. However, the treatment of PQ poisoning is primarily supportive management. To increase the survival rate associated with PQ intoxication, many treatments have been developed. Here, we treated a case of PQ intoxication with steroid pulse therapy. A 23-year-old man was admitted to the hospital because of PQ intoxication. He drank two mouthfuls of Gramoxon (24% commercial paraquat). His vital signs were stable, but he had a throat infection, and navy blue urine in the sodium dithionite test. Standard treatment, including gastric lavage with activated charcoal was performed, and emergent hemoperfusion with a charcoal filter was initiated 11 h after PQ ingestion. Pharmacotherapy was initiated 18 h after PQ ingestion with the administration of 5 mg dexamethasone. On day 10, chest PA showed pulmonary fibrosis. Therefore, we initiated steroid pulse therapy, with 1 g methylprednisolone in 100 mL of D5W administered over 1 h repeated daily for 3 days, and 1g cyclophosphamide in 100 mL of D5W administered over 1 h daily for 2 days. On day 15, dexamethasone therapy was initiated. On day 30, pulmonary fibrosis was improved. Thus, if pulmonary fibrosis becomes exacerbated after dexamethasone therapy during the subacute stage, pulse therapy with methylprednisolone and cyclophosphamide could be helpful.
Anoxia ; Charcoal ; Cyclophosphamide ; Dexamethasone ; Dithionite ; Eating ; Gastric Lavage ; Hemoperfusion ; Humans ; Methylprednisolone ; Mouth ; Paraquat ; Pharynx ; Pulmonary Fibrosis ; Republic of Korea ; Suicide, Attempted ; Survival Rate ; Thorax ; Vital Signs ; Young Adult

OBJECTIVES: The aim of this study was to develop auditory-verbal and visual-spatial memory tasks using smart devices for children aged 8 to 10 years and examine their validity. METHODS: One-hundred and fourteen school-aged children were recruited through internet advertising. We developed memory tasks assessing auditory-verbal memory, visual-spatial memory, and working memory, and then examined their construct validity by examining the developmental trend of the children's mean scores with age. In order to examine the concurrent validity of the tasks, we conducted correlation analyses between the children's scores on the newly developed auditory-verbal, visual-spatial memory and working memory tasks and their scores on well-known standardized tests of memory and working memory, including the auditory-verbal memory subtests of the Korean Luria-Nebraska Neuropsychological Battery for Children, Korean Rey-Osterrieth Complex Figure Test, digit span and arithmetic subtest of Korean Educational Development Institute Wechsler Intelligence Scale for Children Revised, and Corsi block test. RESULTS: The memory and working memory scores measured by the newly developed tasks tended to increase with age. Further, there were significant correlations between the scores of the four cognitive tasks and the corresponding scores of the standardized assessment tools. CONCLUSION: This study revealed promising evidence for the validity of the memory tasks using smart devices, suggesting their utility for school-aged children in research and clinical settings.
Child* ; Humans ; Intelligence ; Internet ; Luria-Nebraska Neuropsychological Battery ; Memory* ; Memory, Short-Term

The aim of this report was to discuss the development and content of a guide on clinical performance and basic clinical skills for medical students. We published the first edition of this guide in 2010 and will publish the second edition in 2016. Initially, we took a survey on important clinical presentations and fundamental clinical and technical skills in 41 medical schools in Korea. Ultimately, we chose 80 core clinical presentations and 56 clinical skills. In the guide to basic clinical skills, we described the physical examination and technical skills according to the preprocedural preparation, procedure, and postprocedural process. In the guide on clinical performance, we reviewed patient encounters-from history taking and the physical examination to patient education. We included communication skills, principles of patient safety, and clinical reasoning schemes into the guides. In total, 43 academic faculty members helped develop the basic clinical skills guide, 75 participated in establishing the clinical performance guide, and 16 advisors from 14 medical specialty societies contributed to the guide. These guides can help medical students approach patients holistically and safely.
Clinical Competence/*standards ; Educational Measurement/*methods ; Humans ; *Practice Guidelines as Topic ; Republic of Korea ; *Students, Medical

Lateral eyebrow mass with primary skull lesion are rare in pediatric population. Although epidermoid cyst and dermoid cyst are the most commonly encountered skull lesions in pediatric population, Langerhans cell histiocytosis (LCH) is rarely reported. We report a case of LCH arising from the lateral eyebrow with osteolytic lesion involving the frontal bone. A 5-year-old boy was presented with a hard, fixed mass in his lateral eyebrow. Contrast magnetic resonance imaging revealed inhomogeneous enhancement of the mass with direct invasion of the frontal bone and adjacent dura mater. Under general anesthesia, linear incision at the lateral eyebrow region was made. Intraoperative evaluation revealed hard, fixed and well-defined soft tissue mass. The final extirpated mass was 2.5 x 2.4 cm in size, and was accompanied by a 1 x 1 cm sized defect on the frontal bone with intact dura mater. The surgical wound was closed primarily by a layer-by-layer fashion. Histologic examination was later performed for definite diagnosis. The histologic examination revealed abnormal proliferation of Langerhans cell with granuloma formation. Radionuclide bone scan and positron emission tomography was taken and revealed free of multi-organ involvement. At 3 months after surgery, natural looking contour at the lateral eyebrow region was observed with no tumor recurrence. Differential diagnosis of the hard and fixed mass at the lateral eyebrow region affecting the primary skull lesion from pediatric population includes epidermoid cyst, dermoid cyst and LCH. Generally, brief physical examination with plain X-ray view can be performed for clinical evaluation, but for a definite diagnosis, contrast MRI may be helpful.
Anesthesia, General ; Child ; Dermoid Cyst ; Diagnosis, Differential ; Dura Mater ; Epidermal Cyst ; Eyebrows ; Frontal Bone ; Granuloma ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Magnetic Resonance Imaging ; Physical Examination ; Positron-Emission Tomography ; Recurrence ; Skull

Angiofollicular lymph node hyperplasia is a relatively rare benign lesion. In 1954 Casteman described the first case of this process occurring in the anterior mediastinum. This lesion was subsequently described in a number of case reports under various names including Castleman's disease, lymph nodal hamartoma, follicular lympho-reticuloma, angiofollicular lymph-node hyperplasia, angiomatous lymphoid hamartoma, and benign giant lymphoma. Although the mediastinum is the most common location, they also occur in other areas of the body, usually where lymph nodes are normally found. However, intraspinal location has been seldom described in literatures. Recently, authors experienced a case of angiofollicular lymph node hyperplasia in the thoracic spinal canal, which was operated upon for paraparesis below T10, in a 17 year old male. The tumor was located between the levels of T8 to T10, and was encircling the subjacent spinal cord. This lesion was successfully removed. The patient is in good condition postoperatively. A brief review of pertinent literatures was made.
Adolescent ; Giant Lymph Node Hyperplasia* ; Hamartoma ; Humans ; Hyperplasia ; Lymph Nodes ; Lymphoma ; Male ; Mediastinum ; Paraparesis ; Spinal Canal* ; Spinal Cord

Although diseases of the parotid gland are relatively uncommon in children, a variety of benign and malignant lesions may occur and the use of imaging is essential for accurate diagnosis and treatment. Ultrasonography (US) is the initial imaging modality utilized for suspected parotid lesions, and its use may suggest a correct diagnosis in an adequate clinical setting. The use of computed tomography (CT) and magnetic resonance imaging (MRI) are useful for the assessment of large and atypical lesions. These modalities also allow the ability to image the deep parotid lobe and to better define the nature of a lesion. CT is the preferred imaging modality for inflammatory processes, including suspected sialolithiasis, abscesses and salivary duct obstructions, whereas MRI is usually used to evaluate tumors due to excellent anatomic resolution and a lack of ionizing radiation exposure, especially in children. This report describes the imaging findings of various parotid gland lesions in children. Familiarity with these findings will aid in lesion characterization and should facilitate optimal clinical management.
Abscess ; Child ; Humans ; Magnetic Resonance Imaging ; Parotid Gland ; Radiation, Ionizing ; Recognition (Psychology) ; Salivary Ducts ; Salivary Gland Calculi ; Tomography, X-Ray