No abstract available.
Neoplasm Metastasis* ; Vena Cava, Inferior*

No abstract available.
Central Nervous System ; Epilepsy ; Sarcoidosis

PURPOSE: Benign childhood epilepsy with centrotemporal spikes(BECT) is characterized by an excellent prognosis. Therefore, the necessity for the use of antiepileptic drugs is controversial. The object of this study is to know about the long-term follow-up of BECT, comparing daily treatment with antiepileptic drug(AED) versus no medication. METHODS: We retrospectively studied 56 cases of BECTs, examined at Pediatric Neurology Clinic, Korea University Medical Center as reference study time, August 2002. Thirty-eight patients didn't have mediation(group I), while eighteen patients received one or two AED(group II). We evaluated demographics, clinical manifestations at diagnosis, EEG findings and clinical courses in groups I & II. RESULTS: There was no significant differences of sex, age, seizure frequency, seizure type, seizure onset time, family history and EEG findings between group I & II. The reasons to start AED were: parents' anxiety(three cases), frequent seizure(12 cases) and daytime seizure(three cases). There was no evolution of status epilepticus and no difficulty in school performance. CONCLUSION: AED treatment was of no advantage and long-term prognosis was good regardless of treatment strategy. So it is advisable not to choose AED as the first line of therapy, provided that the patient himself/herself or the family understands the benign nature of BECT.
Academic Medical Centers ; Anticonvulsants ; Demography ; Diagnosis ; Electroencephalography ; Epilepsy ; Epilepsy, Rolandic* ; Follow-Up Studies ; Humans ; Korea ; Neurology ; Prognosis ; Retrospective Studies ; Seizures ; Status Epilepticus

A narrow internal auditory canal (IAC) with duplication is a rare anomaly of the temporal bone. It is associated with congenital sensorineural hearing loss. Aplasia or hypoplasia of the vestibulocochlear nerve may cause the hearing loss. We present an unusual case of an isolated narrow IAC with duplication that was detected by a CT scan. In this case, the IAC was divided by a bony septum into an empty stenotic inferoposterior portion and a large anterosuperior portion containing the facial nerve that was clearly delineated on MRI.
Child ; Ear, Inner/*abnormalities/radiography ; Female ; Hearing Loss, Sensorineural/*congenital ; Humans ; Tomography, X-Ray Computed

Acute hemorrhagic leukoencephalitis (AHLE) is an acute, rapidly progressing, fulminant demyelinating disease. It is a rare disease of the central nervous system with high mortality; survivors commonly present with significant neurological deficit. We report the case of a 16-month-old girl who survived AHLE and presented with the associated neurologic deficit. The patient came into the emergency department with febrile seizure. She showed bilateral pinpoint-sized pupils and hyperactive deep tendon reflexes. Her mental status was initially drowsy and rapidly progressed to stupor. Extensive demyelination and microbleeds were found in the cerebral white matter, thalamus and left cerebellum on Magnetic resonance imaging (MRI) scans. Her mental status was improved by intravenous administration of immunoglobulin and methylprednisolone. Five months after being discharged, increased white matter connectivity was found on color-coded follow-up MR diffusion tensor imaging (DTI) as compared to previous MRI. We therefore suggest adding the DTI technique when a follow-up MRI is performed in patients with AHLE. It could be useful to visualize the status of axonal injury and to encourage patients and their parents to continue the rehabilitation program.
Administration, Intravenous ; Axons ; Central Nervous System ; Cerebellum ; Child ; Demyelinating Diseases ; Diffusion Tensor Imaging* ; Diffusion* ; Emergency Service, Hospital ; Female ; Follow-Up Studies* ; Humans ; Immunoglobulins ; Infant ; Leukoencephalitis, Acute Hemorrhagic* ; Magnetic Resonance Imaging ; Methylprednisolone ; Mortality ; Neurologic Manifestations ; Parents ; Pupil ; Rare Diseases ; Reflex, Stretch ; Rehabilitation ; Seizures ; Seizures, Febrile ; Stupor ; Survivors ; Thalamus ; White Matter

Acute hemorrhagic leukoencephalitis (AHLE) is an acute, rapidly progressing, fulminant demyelinating disease. It is a rare disease of the central nervous system with high mortality; survivors commonly present with significant neurological deficit. We report the case of a 16-month-old girl who survived AHLE and presented with the associated neurologic deficit. The patient came into the emergency department with febrile seizure. She showed bilateral pinpoint-sized pupils and hyperactive deep tendon reflexes. Her mental status was initially drowsy and rapidly progressed to stupor. Extensive demyelination and microbleeds were found in the cerebral white matter, thalamus and left cerebellum on Magnetic resonance imaging (MRI) scans. Her mental status was improved by intravenous administration of immunoglobulin and methylprednisolone. Five months after being discharged, increased white matter connectivity was found on color-coded follow-up MR diffusion tensor imaging (DTI) as compared to previous MRI. We therefore suggest adding the DTI technique when a follow-up MRI is performed in patients with AHLE. It could be useful to visualize the status of axonal injury and to encourage patients and their parents to continue the rehabilitation program.
Administration, Intravenous ; Axons ; Central Nervous System ; Cerebellum ; Child ; Demyelinating Diseases ; Diffusion Tensor Imaging* ; Diffusion* ; Emergency Service, Hospital ; Female ; Follow-Up Studies* ; Humans ; Immunoglobulins ; Infant ; Leukoencephalitis, Acute Hemorrhagic* ; Magnetic Resonance Imaging ; Methylprednisolone ; Mortality ; Neurologic Manifestations ; Parents ; Pupil ; Rare Diseases ; Reflex, Stretch ; Rehabilitation ; Seizures ; Seizures, Febrile ; Stupor ; Survivors ; Thalamus ; White Matter

PURPOSE: Allergic inflammation in the airway of asthmatics was characterized by recruitment and activation of inflammatory cells. The recognition of the underlying inflamatory nature of asthma led to suggestions that early intervention of the airway inflammation by inhaled corticosteroid could provide the key to improve a clinical outcome of asthma treatment in children. The assessment of airway inflammation may be indirectly achieved by measuring inflammatory markers in serum. We have tried to measure ECP, soluble (s) ICAM-1, sVCAM-1, IL-6 and sIL-6 receptor(R) levels in serum of children with acute asthma, to define efficacy of monitoring inflammation with soluble markers and then compare them in two treatment modalities of inhaled salbutamol or combined with budesonide. METHODS: Thirty-five children with acute asthma were randomly classified into two study groups : group I consisted of 17 subjects with inhaled budesonide plus beta-agonist and the 18 subjects of group II with beta-agonis alone. Of two groups, eosinophil, ECP, sICAM-1, sVCAM-1, IL-6 and sIL-6R were quantitatively measured at acute and stable phases in asthma, and the results compared relevantly. RESULTS: 1) The initially elevated levels of the inflammatory markers such as ECP, sICAM-1, sVCAM-1 and sIL-6R except for IL-6 were significantly decreased in stable phase. However, there was no significant difference between two groups in ECP and inflammatory markers in acute asthmatics. 2) The observed reduction in symptom score and %PEFR followed by budesonide nebulization regularily until the improvement of clinical symptom was significant, whereas beta-agonist salbutamol inhalation has less effect on the variables. Interestingly, ECP levels depicted inverse correlation with %PEFR in acute phase of asthma, and ECP and infalmmatory markers were relevant to the clinical symptom in long-term follow-up. 3) There was a trend for some correlation between sICAM-1 and CRP, sVCAM-1 and CRP, but not ECP and IL-6 in two study groups, respectively. CONCLUSION: Treatment with an inhaled steroid plus beta-agonist had significantly caused improvement of clinical symptoms, and the decrements of peak flow variability, eosinophil, ECP, sICAM-1, sVCAM-1 and sIL-6R as potential markers of the airway inflammation, when compared with a group treated with beta-agonist alone. The measurements of ECP and other inflammatory markers may be enormously useful for the evaluation of the successful anti-inflamatory therapy for asthma in children.
Albuterol ; Asthma* ; Budesonide* ; Child* ; Early Intervention (Education) ; Eosinophil Cationic Protein ; Eosinophils ; Follow-Up Studies ; Humans ; Inflammation ; Inhalation ; Intercellular Adhesion Molecule-1* ; Interleukin-6* ; Vascular Cell Adhesion Molecule-1*

PURPOSE: We wanted to evaluate the cerebral metabolites in patients with chronic renal failure (CRF) and who were undergoing hemodialysis by performing proton MR spectroscopy and we wanted to evaluate the correlation between the changes in the cerebral metabolite ratios and the duration after starting the initial hemodialysis. MATERIALS AND METHODS: Proton MR spectroscopy was performed in 15 patients with CRF and who were undergoing hemodialysis and in ten healthy volunteers. The changes in N-acetylaspartate (NAA), choline-containing compounds (Cho), myo-inositol (Myo), glutamine/glutamate complex (Glx), and creatine (Cr) were analyzed. MR spectroscopy was performed before and after hemodialysis. RESULTS: For the patients with CRF before hemodialysis, the Cho/Cr ratio in the gray matter (p<0.001) and the Myo/Cr ratio in both the gray and white matter (p<0.01) were significantly elevated compared with those in the control subjects. For the patients with CRF after hemodialysis, their Cho/Cr ratios were significantly reduced in both the gray and white matter compared with that before hemodialysis (p<0.05). There was a significant positive correlation between the Cho/Cr ratio and serum Cr in the gray matter of CRF patients after hemodialysis (r=0.54, p<0.05). The cerebral metabolite ratios were not significantly correlated with the duration after starting the initial hemodialysis. CONCLUSION: The cerebral metabolite patterns are significantly different between the patients with CRF and who are undergoing hemodialysis and the normal controls. The cerebral metabolite ratios are not significantly correlated with the duration after starting the initial hemodialysis.
Creatine ; Dialysis ; Healthy Volunteers ; Humans ; Kidney Failure, Chronic* ; Magnetic Resonance Spectroscopy* ; Protons* ; Renal Dialysis*

Treatment of pelvic malignancy persistent or recurrent after surgery, radiation therapy or chemot-herapy presents a difficult therayeutie challenge. Those patients with central recurrence can be considered as candidate for radical resection. However we must consider many factors for the choice of treatment modality for advanced or recurrent pelvic rnalignancy as follows; the size and location of the recurrent cancer, dose of radiation therapy given, general conditions of the patient and the experience of the surgeon. Pelvie exenteration, when appropriate, is suecessful treatment for recurrent or persistent pelvic malignancy; 5-year survivai has been reported to be as high as 50%. We experienced seven cases of pelvic exepteration for pelvic malignancy between Mar. 1990 and Feb. 1993, Accordingly we present the cases with a brief review of the literatures. Seung Kew Baik, et al..: PeIlvic Exenteration in Treatment of Pelvic Malignancy: 3 Years Experience
Humans ; Pelvic Exenteration* ; Recurrence

PURPOSE: We aimed to investigate the efficacy of and functional recovery after intracerebral transplantation of different doses of mouse mesenchymal stem cells (mMSCs) in immature rat brain with hypoxic-ischemic encephalopathy (HIE). METHODS: Postnatal 7-days-old Sprague-Dawley rats, which had undergone unilateral HI operation, were given stereotaxic intracerebral injections of either vehicle or mMSCs and then tested for locomotory activity in the 2nd, 4th, 6th, and 8th week of the stem cell injection. In the 8th week, Morris water maze test was performed to evaluate the learning and memory dysfunction for a week. RESULTS: In the open field test, no differences were observed in the total distance/the total duration (F=0.412, P=0.745) among the 4 study groups. In the invisible-platform Morris water maze test, significant differences were observed in escape latency (F=380.319, P<0.01) among the 4 groups. The escape latency in the control group significantly differed from that in the high-dose mMSC and/or sham group on training days 2-5 (Scheffe's test, P<0.05) and became prominent with time progression (F=6.034, P<0.01). In spatial probe trial and visible-platform Morris water maze test, no significant improvement was observed in the rats that had undergone transplantation. CONCLUSION: Although the rats that received a high dose of mMSCs showed significant recovery in the learning-related behavioral test only, our data support that mMSCs may be used as a valuable source to improve outcome in HIE. Further study is necessary to identify the optimal dose that shows maximal efficacy for HIE treatment.
Animals ; Brain ; Brain Injuries ; Brain Ischemia ; Humans ; Hypoxia-Ischemia, Brain ; Infant, Newborn ; Learning ; Memory ; Mesenchymal Stromal Cells ; Methionine ; Mice ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Stem Cells ; Sulfonium Compounds ; Transplants ; United Nations