To make guideline to the diagnosis and treatment and of the intracranial nodular lesions, the authors made a clinical analysis on 81 pediatric patients who had showed nodular lesions on brain CT scan at Severance Hospital from Mar. 1979 to Feb. 1989 and the results were summarized as follows. 1) The peak incidence of intracranial nodular lesions was found in the 2nd decade(61.7%). There was no sexual difference. 2) The most common clinical symptom was seizure(92.6%) and the predilection site was parietal area. The nodular enhancing type on brain CT scan showed not only the most common type but also the most favorable clinical course. 3) As the etiology of the intracranial nodular lesions, tuberculosis, paragonimiasis, cysticercosis, tumor(meningioma), and aspergillosis were confirmed or suspected, but tuberculosis was the most common. CSF routine examination, chest PA, PNS X-rays, skin test for paragonimiasis and tuberculosis, CSF ELISA test for cysticercosis and paragonimiasis should be routine as the diagnostic studies. 4) We made treatment principle for intracranial nodular lesions. In cases that initial brain CT scan show low density or calcified density without contrast enhancement, we treat those patients with anticonvulsants and steroid with regular check-up. If the lesion increases in size or new enhancement develops on follow up CTY scan, medications for the suspected etiology should be added. In cases that initial brain CT scan show enhancing lesions, treatment is started with anticonvulsants and medications for the etiology with regular check up. If the lesion increase in size on follow up CT scan or seizure is uncontrolled. Surgery should be considered.
Anticonvulsants ; Aspergillosis ; Brain* ; Child* ; Cysticercosis ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Humans ; Incidence ; Meningioma ; Paragonimiasis ; Rabeprazole ; Seizures ; Skin Tests ; Thorax ; Tomography, X-Ray Computed* ; Tuberculosis

Patients receiving hemodialysis have various complications with a high mortality rate and require specialized treatment at an institution equipped with an appropriate workforce, equipment, and facilities. The Korean Society of Nephrology (KSN) is conducting hemodialysis unit accreditation to manage the quality of hemodialysis institutions, present standard treatment guidelines, and establish a network between regional medical institutions for the safe treatment of hemodialysis patients. This study aimed to summarize the previous accreditation results and discuss future directions. Methods: After the proposal of hemodialysis unit accreditation in 2009, pilot projects were undertaken for hemodialysis units and dialysis subspecialist training hospitals in the metropolitan area for 5 years. Since 2016, five hemodialysis unit accreditation projects have been conducted. Results: The cumulative number of participating units was 599, and the number of accredited units was 473 (average accreditation rate, 79.0%). The participating units consisted of clinics (58.6%), non-university hospitals (28.2%), and university hospitals (13.2%). Overall, 92.4% of university hospitals, 81.2% of clinics, and 68.0% of non-university hospitals were accredited. Over 5 years, new units were added annually to apply for accreditation, and the rate of previous participants applying for reaccreditation was high (77.7%). However, considering that the total number of member institutions of the KSN is 637, the number of units with valid accreditation as of 2020 was low (267 [41.9%]). Conclusion: The efforts of the KSN and its members, as well as institutional support from the government, are required for quality management of hemodialysis units through hemodialysis unit accreditation.

No abstract available.
Child* ; Humans

OBJECTIVE: The purpose of this study is to evaluate the role of acetazolamide brain SPECT in the assessment of delayed ischemic neurological deficits(DINDs) following aneurysmal subarachnoid hemorrhage. METHODS: Prospective analysis of consecutive patients with aneurysmal subarachnoid hemorrhage was made from July 1999 to December 2000. Regular neurological examination and Transcranial Doppler(TCD) monitoring were done for monitoring development of DINDs. Postoperative cerebral angiography and acetazolamide brain SPECT were performed according to our spasm-monitoring algorithm. Correlation of three diagnostic tools with development of DINDs was evaluated and concordance rates between each diagnostic tool were investigated. RESULTS: A total of 65 patients were included. DINDs were developed in 44.6% of patients. Spasm evidences on TCD monitoring, cerebral angiography and acetazolamide brain SPECT were observed in 38.5%, 40.0%, 41.5% of patients. Although there is no statistical significance, acetazolamide brain SPECT was more correlated with DINDs development than other two tools. Spasm evidence on TCD were not proceeded the development of DINDs in 58.6% of patients with DINDs. Concordance rate between acetazolamide brain SPECT and cerebral angiography was highest. However, there are significant numbers of discordance between two tools. CONCLUSION: Three diagnostic tools are complementary to each other in the assessment of DINDs. However, considering that DINDs is basically attributable to cerebral hemodynamic alteration rather than arterial morphologic change, acetazolamide brain SPECT seems to be the most useful tool in the evaluation of DINDs.
Acetazolamide* ; Aneurysm* ; Brain* ; Cerebral Angiography ; Hemodynamics ; Humans ; Microcirculation ; Neurologic Examination ; Prospective Studies ; Spasm ; Subarachnoid Hemorrhage* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Hyperplasia* ; Melanoma*

No abstract available.
Hepatitis C* ; Interferons* ; Polymyositis*

No abstract available.
Carcinoma, Adenoid Cystic* ; Humans ; Knee* ; Male

Type IV spinal cord arteriovenous malformation is a spinal vascular anomaly supplied by the anterior spinal artery and drained directly into an enlarged venous outflow. Direct fistula lies completely outside the spinal cord and pia mater. We report a case of intradural perimedullary arteriovenous fistula in 58-years-old man who presented with progressive paraparesis. Angiographically single fistulous perimedullary communication with moderate-sized abnormal venous engorgement was demonstrated through anterior spinal artery. Direct surgical obliteration of the fistulous site was performed. Spinal angiographic evaluation and recognition of their exact pathophysiology according to individual types of spinal AVMs is the most important in successful execution of planned surgery and to achieve the good outcome.
Arteries ; Arteriovenous Fistula* ; Arteriovenous Malformations ; Fistula ; Hyperemia ; Paraparesis ; Pia Mater ; Spinal Cord*

Type IV spinal cord arteriovenous malformation is a spinal vascular anomaly supplied by the anterior spinal artery and drained directly into an enlarged venous outflow. Direct fistula lies completely outside the spinal cord and pia mater. We report a case of intradural perimedullary arteriovenous fistula in 58-years-old man who presented with progressive paraparesis. Angiographically single fistulous perimedullary communication with moderate-sized abnormal venous engorgement was demonstrated through anterior spinal artery. Direct surgical obliteration of the fistulous site was performed. Spinal angiographic evaluation and recognition of their exact pathophysiology according to individual types of spinal AVMs is the most important in successful execution of planned surgery and to achieve the good outcome.
Arteries ; Arteriovenous Fistula* ; Arteriovenous Malformations ; Fistula ; Hyperemia ; Paraparesis ; Pia Mater ; Spinal Cord*

Since 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, and the coronavirus disease 2019 (COVID-19) pandemic currently continues.In response to this unprecedented pandemic, several researchers and medical staff have struggled to find appropriate treatments for COVID-19. Patients with mild symptoms can recuperate with symptomatic care, however establishing treatment for severe to critically ill patients who can have a high mortality has been essential. Accordingly, the guidelines for COVID-19 treatment have evolved through numerous trials and errors and have been relatively well established to date. In the Republic of Korea, several evidence-based guidelines for COVID-19 treatment were released and revised, reflecting various research and regional medical conditions. To date, approximately 3 years after the beginning of the COVID-19 pandemic, we are reflecting on the changes in the guidelines thus far and have summarized the treatment experience of severe to critically ill patients with COVID-19. The Korean guidelines for COVID-19 treatment have been updated continuously as the National Institutes of Health (NIH) guidelines have changed. Dexamethasone is currently used as the backbone for the treatment of severe to critically ill patients with COVID-19, and remdesivir, baricitinib, and tocilizumab can be added depending on a patient’s situation. In addition, venous thromboembolism prophylaxis is one of the important adjunctive therapies for patients with severe COVID-19. In the clinical field, treatment of severely ill patients with COVID-19 based on guidelines is widely practiced by medical staff and established currently.