PURPOSE: The correlation between sonographic findings and clinical symptoms was investigated in the patients with mesenteric lymphadenitis who had recurrent acute abdomen. MATERIALS AND METHODS: Seventy-eight children with recurrent acute abdominal pain without obvious primary disease were evaluated by sonography. The initial and follow-up sonography were performed in 17 children. The abdomen was divided into 3 areas. The number and size of mesenteric lymph nodes were observed in each zone, and was compared with the clinical findings. RESULTS: In 56(71.8%) of 78 cases, good correlation was seen in the area of the greatest size and number of the lymph nodes in the sonography. Most severe symptom, was seen in the right lumbar area(49 cases) and umbilical area(7 cases). In 17 cases of follow up, 14 cases showed decrease size and number of mesenteric lymph nodes while 2 cases showed increase in size and number of the nodes with aggravated symptoms. CONCLUSIONS: Ultrasonography was useful to detect and localize the enlarged mesenteric lymph nodes. Initial and follow-up sonography showed good correlation between the changes in number and size of the lymph nodes and symptoms.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Child* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Mesenteric Lymphadenitis* ; Ultrasonography*

PURPOSE: To evaluate the characteristic MR findings in injury of the anterior cruciate ligament (ACL) with associated bony lesions. MATERIALS AND METHODS: We reviewed MR findings and the corresponding arthroscopic or operative results of 48 patients with ACL injuries, and evaluated ACL signal intensity and contour. In associated bony lesions, we determined the location of avulsion fracture and bony bruise. RESULTS: Cmplete ACL tears were seen in 27 cases, partial tears in 13, and avulsion injury in eight. Complete tears showed heterogeneously increased signal intensity with contour bulging in ten cases (37 %), and combined bony lesion in 14 (52 %). ACL with a thin continous low signal intensity band surrounding heterogeneously-increased signal intensity suggested partial tears, and was seen in three of 13 proven cases (23 %) of partial ACL tears ; combined bony lesion was seen in four such cases (31 %). There were eight cases of avulsion fracture ; the most frequent site was the anterolateral portion of the tibial spine (n=6). The most frequent sites of bony lesion were at the midportion of the lateral femoral condyle (n=6), and the posterior portion of the lateral tibial plateau (n=6) ; the next most frequent site was the anterior portion of the lateral tibial plateau (n=5). CONCLUSION: Tearing of the ACL was seen on MRI as ligament discontinuity, and heterogeneously increased signal intensity with ACL contour bulging. The most frequent sites of associated bony lesions were the midportion of the lateral femoral condyle, and the posterior portion of the lateral tibial plateau. In associated bony lesions, bony contusion suggested ACL tearing, but avulsion fracture suggested ligament avulsion injury without tear.
Anterior Cruciate Ligament* ; Contusions ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Spine

Ulcerative colitis is a chronic relapsing inflammatory disease localized on the colon. This disease is rare in children under 10 years of age. We experienced a case of ulcerative colitis in a 3-year-old male child. He was admitted due to fever, abdominal pain and diarrhea for 5 days, followed by rectal bleeding for 2 days. The diagnosis was established by clinical features, endoscopic and histologic findings. Taking combined medication of prednisolone and sulfasalazine, he achieved symptomatic remission and remained asymptomatic.
Abdominal Pain ; Child* ; Child, Preschool* ; Colitis, Ulcerative* ; Colon ; Diagnosis ; Diarrhea ; Fever ; Hemorrhage ; Humans ; Male ; Prednisolone ; Sulfasalazine ; Ulcer*

Truncus arteriosus is characterized by a single arterial vessel arising from the base of the heart and giving origin to the systemic, pulmonary and coronary circulation. To evaluate the incidence, types, and associated anomalies, 18cases of truncus arteriosus diagnosed by angiocardiography, were reviewed and were compared with other reports. Ten of them were confirmed by operation. The overall incidence of truncus arteriosus was 0.127%. Accordin to Collett and Edwards classification. Type I was encountered in 11cases(61%), type II in 4cases(22%), and type III in 3cases(17%), All the patients had subtruncal ventricular septal defects. Eight patients showed truncal valve regurgitation and valve stenosis was noted in one case. A right aortic arch was present in 9 cases. Associated anomalies were atrial septal defect(8cases), patent ductus arteriosus(3cases), coarctation of the aorta(2cases), isolation of the left subclavian artery(2 cases), and right aortic arch with an aberrant left subclavian artery(1case). Truncus arteriosus is an uncommon congenital cardio vascular malformation. In the group of cases which we encountered, type I was the most common anomaly. Frequently associated anomalies were right aortic arch, incompetent truncal valve and atrial septal defect.
Angiocardiography ; Aorta, Thoracic ; Classification ; Constriction, Pathologic ; Coronary Circulation ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence* ; Truncus Arteriosus* ; Vascular Malformations

Objectives: The response of schizophrenia or schizoaffective disorder patients to antipsychotics remains insufficient. Therefore, augmentation with additional antipsychotics is common in clinical practice. This study examined the efficacy and safety of amisulpride augmentation in schizophrenia patients partially responsive to antipsychotics. Methods: Twenty-nine schizophrenia or schizoaffective disorder patients without treatment response to antipsychotics monotherapy were included in this study. Psychotic symptoms were evaluated using Brief Psychiatry Rating Scale (BPRS), Clinical Global Impression-Severity (CGI-S), and Clinical Global Impression-Improvement (CGI-I). The side effects were evaluated using Barnes Akathisia Rating Scale (BARS) and Simpson-Angus Scale (SAS) at baseline, 4 weeks, 8 weeks, and 12 weeks after the amisulpride augmentation. Results: Among the 29 patients, 28 completed the study. At week 12, the mean BPRS score (p<0.001) and CGI-S score (p=0.002) showed significant improvement compared to the baseline. There was no increase in extrapyramidal symptoms according to SAS (p=0.090) and BARS (p=0.137) after the amisulpride augmentation. Conclusion This study demonstrated the efficacy and safety of amisulpride augmentation in schizophrenia or schizoaffective disorder patients partially responsive to antipsychotics. Further studies investigating the efficacy of amisulpride augmentation therapy using placebo control are necessary to confirm the results.

PURPOSE: Our aim was to evaluate the usefulness of fluid-attenuated inversion recovery (FLAIR) MR imaging for detection of acute subarachnoid hemorrhage (SAH) compared with unenhanced CT. MATERIALS AND METHODS: We compared FLAIR MR images with unenhanced CT scans in 28 patients with acute SAH. Findings of SAH on CT and MR images were graded as 0 (absence), 1 (suspicious), 2 (definite) in the cerebral sulci, sylvian fissure, basal cistern, and cisterns of the posterior fossa. We also compared FLAIR MR images of 28 patients with those of 35 normal subjects, and then the sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of acute SAH were calculated. RESULTS: FLAIR MR image was superior to CT in detecting SAH in the posterior fossa (1.41+/-.74 vs 0.78+/-.80; p<0.05) and cortical sulci(1.11+/-.80 vs 0.70+/-.83; p<0.05). There was no significant difference between FLAIR MR image and CT in detecting SAH in the basal cistern and sylvian fissure. The sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of SAH were 100% in all. CONCLUSION: FLAIR MR image is useful in detecting acute SAH, especially in patients with small amount of SAH or SAH in the posterior fossa.
Humans ; Magnetic Resonance Imaging* ; Sensitivity and Specificity ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

PURPOSE: This study aimed to determine the CT findings of nasolacrimal fossa and their clinical significance. MATERIALS AND METHODS: Twenty-nine of 116 patients who underwent facial CT scanning after trauma showed evidenceof nasolacrimal fracture. We retrospectively analyzed CT findings to evaluate fracture patterns of thenasolacrimal fossa and canal and associated facial fractures. To determine the frequency of associatedcomplications, clinical records were reviewed were reviewed. RESULTS: Three types of fracture were identified:avulsion, comminuted, and linear Forty-one nasolacrimal fractures, 20 of which involved the nasolacrimal fossa and21 the nasolacrimal canal, were found in the 29 patients. Of the 20 fractures involving the nasolacrimal fossa,ten were avulsion, eight were linear, and two were comminuted. Seventeen of 21 fractures involving thenasolacrimal canal were comminuted and four were linear ; all nasolacrimal fractures were associated with otherfacial fractures. Twenty-five of 29 fractures were the complex midfacial-type (naso-ethmoid) ; the remaining fourwere simple and unilateral. Nasolacrimal sac and dvct-related complications were documented in only two patients ;they experienced epiphora associated with avulsion fracture of the nasolacrimal fossa, though the problem wasresolved by conservative treatment without surgery. CONCLUSION: Fractures of the nasolacrimal fossa and canalwere accompanied by simple or complex facial fractures. Injury-associated complications were rare, and all wereassociated with avulsion fractures of the nasolacrimal fossa.
Humans ; Lacrimal Apparatus Diseases ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To correlate CT attenuation and MR signal intensity with concentration of protein solution. MATERIALS AND METHODS: CT and MR examinations of a phantom containing bovine serum albumin solutions of various concentrations ranging from 0 to 55% were performed. CT Hounsfield units(HUs), MR signal intensities, and apparent diffusion coefficients (ADCs) of each albumin solution were measured, and CT HUs and MR signal intensities of the solutions were compared with those of cerebrospinal fluid (CSF), white matter, and cortical gray matter. RESULTS: CT HU increased gradually with increasing albumin concentration. On T1-weighted images(T1WI), signal intensity increased with increasing albumin concentrations of up to 35% but then decreased. On T2-weighted images(T2WI), gradually decreasing signal intensity and increasing albumin concentration were oibserved. Fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted images (DWIs) showed that signal intensity peaked at a concentration of 10% and then gradually decreased. The ADC of the solution gradually decreased as concentration increased. Compared with those of normal brain structures, the CT HUs of solutions at concentrations of over 20% were higher than those of white and gray matter. At T1WI, the signal intensities of 10-45% solutions were similar to or higher than that of the gray matter. At T2WI, the signal intensities of solutions above 25, 35, and 40% were lower than those of CSF, gray matter, and white matter, respectively. FLAIR images showed that the signal intensities of 5-35% solutions were higher than that of gray matter. CONCLUSION: The CT attenuation of albumin solution increased gradually with increasing concentration. MR signal intensities peaked at 35% concentration on T1WI and at 10% on FLAIR and DW images, respectively, and then gradually decreased. T2WI and ADC map images showed gradually decreasing signal intensity and ADC as albumin concentration increased.
Brain ; Cerebrospinal Fluid ; Diffusion ; Serum Albumin, Bovine

PURPOSE: The purpose of this study is to correlate CT findings of the patients with chronic subdural hematoma(SDH) showing a sedimentation level with their clinical and operative findings. MATERIALS AND METHODS: We selected 9 patients who showed a sedimentation level within the hematoma after reviewing the CT findings of 55 patients with SDH. We also analyzed their age, initial symptoms, cause of head injury, latent period, the level of consciousness on admission, CT findings, and operative findings. RESULTS: All of the 9 patients were aged persons(over 52 years). They had a history of acute exacerbation of neurologic symptoms. Five of them had an apparent history of head trauma more than one month before the exacerbation. The CT scans showed unilateral, crescent-shaped subdural fluid collection with a sedimentation level except a case of bilateral SDH and 2 cases of planoconvex-shaped SDH. The interface of the sedimentation level was sharp in 3 cases and indistinct in 6 cases. None had bleeding tendency and the hemoglobin level was slightly decreased in 2 patients. All patients revealed membrane of the hematoma during operation. The upper portion of the sedimentation was liquefied blood and the lower portion was fresh blood clots. We could observe fresh RBC's in the hematoma microscopically. CONCLUSION: A sedimentation level in chronic SDH was operatively proved to represent rebleeding, and was clinically manifested as an acute exacerbation of symptoms.
Consciousness ; Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural, Chronic* ; Hemorrhage ; Humans ; Membranes ; Neurologic Manifestations ; Tomography, X-Ray Computed

BACKGROUND: Oversight on the bioethical compliance of national R&D projects or research personnel is currently conducted exclusively by IRB (Institutional Review Board) within the relevant research institute. Considering current state of affairs in Korea, there is an imperative to establish a national oversight system for bioethical compliance, conduct comprehensive oversight on bioethical compliance of national R&D projects, and enhance subject protection system. METHODS: We examined opinions from researchers and IRB personnels regarding ethical oversight system on R&D projects. Additionally, we looked at IRB assessment by KAIRB (Korea Association of Institutional Review Board) in order to identify status and problems with current IRB system in Korea. Assessment was also done for four other countries (US, UK, Germany, Singapore) through in-person visits as well as surveys in writing for a total of 6 months (2012.12.1~2013.5.31). The research comprised of two aspects: system management and R&D project audit. Based on this, we examined current status and problems of the existing system in Korea and made recommendations for improvement. RESULTS: Regulatory objectives and backgrounds of biomedical researches are different from each country due to different characteristics of bioethical oversight system. This shows that each country sets up its own regulations and procedures to fit each situation. Bioethical compliance oversight system greatly varied between the countries. From this study, it can be seen that improvement of existing procedures and oversight system or establishment of new ones are essential in Korea. CONCLUSION: In terms of system management, a dedicated government organization need to be established for bioethical compliance, subject protection, IRB inspection, training, evaluation, and certification of systems, and also support for IRB e-system. Regarding R&D project oversight, it is essential to confirm IRB review results before start of a research, to conduct a review on ethical aspects of research plans, and to carry out continued oversight on bioethical compliance through interim reports.
Academies and Institutes ; Certification ; Compliance* ; Ethics Committees, Research ; Germany ; Humans ; Korea ; Research Personnel* ; Social Control, Formal ; Writing