No abstract available.
Abortion, Spontaneous* ; Chorion* ; Chorionic Villi* ; Female ; Humans ; In Situ Hybridization ; Pregnancy

Spontaneous cervical epidural hematoma (SCEH) is a rare condition that causes paraparesis or quadriparesis. As spontaneous resolution is seldom expected, it usually requires surgical treatment for relieve symptoms. Even if spontaneous resolution occurs, relief from symptoms usually requires several hours to days. In contrast, hemiparesis is the most common symptom of a transient ischemic attack (TIA), and usually resolves over minutes to hours. We report here two patients with SCEH who presented with hemiparesis with severe neck pain. Both patients were taking antiplatelet drugs. Their neurological symptoms recovered spontaneously over a very short time. They were initially misdiagnosed as TIA. These cases show that patients with transient hemiparesis may have SCEH if there is severe neck pain and no cranial nerve involvement.

Carcinoma of the parathyroid gland is rare, comprising only 0.1% to 5% of all patients with primary hyperparathyroidism. It presents with severe hypercalcemia, bone disease, palpable neck mass, renal involvement and etc. Since the initial operation offers the best chance for cure, preoperative localization and intraoperative recognition of parathyroid cancer are essential. Recently parathyroid imaging has been described with 99mTc-sestamibi as an alternative to 201Tl. This newer agent has many physical and dosirnetric advantages and represents higher detection sensitivity than 201Tl-99mTc subtraction scan. We experienced a 41-year-old man presenting with recurrent hyperparathyroidism in spite of 2 previous operations. In preoperative localization, there was no abnormal uptake in 201Tl-99mTc subtraction scan but 99mTc-sestamibi scan revealed metastatic foci on right cervical area. He was successfully treated with modified radical neck dissection.
Adult ; Bone Diseases ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Neck ; Neck Dissection ; Parathyroid Glands ; Parathyroid Neoplasms* ; Technetium Tc 99m Sestamibi*

PURPOSE: This study evaluated the success and complication rates of endonasal dacryocystorhinostomy (DCR) in children and adults. METHODS: Fifty-six children (57 eyes) and 843 adults (870 eyes) who underwent endonasal DCR to treat nasolacrimal duct obstruction (NLDO) at the Department of Ophthalmology between April 1994 and March 2004 were included in this retrospective study. RESULTS: The mean age of patients was 7.7+/-2.83 years (2~15 years) in children and 51.8+/-14.10 years (16~81 years) in adults, with mean follow-up periods of 28.4+/-23.62 months (10~91 months) and 14.7+/-11.08 months (9~120 months), respectively. The primary success rate in children (94.7%) was significantly higher than that in adults (86.0%). Significantly more synechia formation was found in children (26.3%) than in adults (10.4%). However, granuloma and membranous obstruction in children (respectively 21% and 7.1%) were significantly less than in adults (respectively 37.9% and 15%). CONCLUSIONS: Although endonasal DCR in children has problems such as technical difficulty due to a narrower nasal cavity, postoperative care difficulties and higher rates of synechia formation, endonasal DCR is a safe and effective means of treating NLDO in children, with higher success rates than those in adults.
Adult* ; Child ; Dacryocystorhinostomy* ; Follow-Up Studies ; Granuloma ; Humans ; Nasal Cavity ; Nasolacrimal Duct ; Ophthalmology ; Postoperative Care ; Retrospective Studies

PURPOSE: The intestinal volvulus is difficult to diagnose, and if the treatment and diagnosis are delayed, there is a risk of high mortality. This study was performed to ensure the more proper management method and diagnostic modality of volvulus. METHODS: Between 1985 and 1998, 16 patients with a diagnosis of colonic and small intestinal volvulus were managed in Soonchunhyang University Chunan Hospital. Medical charts were reviewed, retrospectively and follow-up was done. RESULTS: 15 among the 16 patients with volvulus underwent the operation. The one case was diagnosed and expired before operation. The resection of the lesion and primary anastomosis had been generally selected as the procedure of choice. Segmental resection of the sigmoid colon with primary anastomosis was performed on 7 cases of the sigmoid volvulus. There were 6 cases of the small bowel volvulus, of which 5 cases got a segmental resection of the small bowel with primary repair and the one got a total resection of the small bowel with gastrocolostomy. The right hemicolectomy was performed in 2 cases which were the right colon volvulus. 9 cases of morbidity were developed; there were 5 cases of wound infection and others were enterocutaneous fistula, pulmonary infection, and septic shock respectively. There were three mortality. CONCLUSION: If the small bowel volvulus is present or gangrenous signs are developed, and the management of the intestinal volvulus is delayed, there can be serious complications and the course can be life-threatening. Therefore, if gangrene or small bowel volvulus are suspected, operative management should be seriously considered.
Chungcheongnam-do ; Colon ; Colon, Sigmoid ; Diagnosis ; Follow-Up Studies ; Gangrene ; Humans ; Intestinal Fistula ; Intestinal Volvulus* ; Mortality ; Retrospective Studies ; Shock, Septic ; Wound Infection

Primary aldosteronism, characterized by hypertension, hypokalemia, and hyperaldosteronemia resulting from chronic oversecretion of aldosterone independent of normal renin-angiotensin regulatory system, is due mostly to aldosteronoma or to bilateral cortical nodular hyperplasia. We report two cases of primary aldosteronism due to adrenal cortical adenoma, which were diagnosed by clinical data and abdominal computed tomographic scan. Clinical symptoms and laboratory data returned to normal after surgical adrenalectomy.
Adrenalectomy ; Adrenocortical Adenoma ; Aldosterone ; Hyperaldosteronism ; Hyperplasia ; Hypertension ; Hypokalemia

The intraspinal extradural meningeal cyst is a rare cause of compression of spinal cord. The most common clinical presentation is a slowly progressive myelopathy, but our case was presented with polyradiculopathy at admission. The authors believe that our case is particularly attributable to a ball-valve mechanism involving an idiopathic dural rent and a herniated segment of an underlying dorsal rootlet in the operative finding. As in our case, magnetic resonance imaging provides accurate diagnosis to identify an intraspinal extradural meningeal cyst. Closure of dural rent with marsupialization of the meningeal cyst through minimal laminectomy can be successfully managed with favorable clinical outcome as in our case.
Diagnosis ; Laminectomy ; Magnetic Resonance Imaging ; Polyradiculopathy ; Spinal Cord ; Spinal Cord Diseases

OBJECTIVES: The definition of a hidden youth is a young person who has completely withdrawn from society and shut himself or herself away for more than 3 months. Those pathologically-withdrawn youths have become a burden not only to society but also to the family. However, screening of these hidden youths cannot be done easily. This study focused on developing a primary effective screening tool for these hidden youths. METHODS: The 42 participants of this study were parents of hidden youths that are between 8 to 25 years old. They were selected from from mental health centers and psychiatric clinics around Seoul and Gyeonggi Province. We also recruited 239 parents of middle and high school students in the Seoul metropolitan area for a control group. In order to decide the concurrent validity of this questionnaire, we used the Symptom Checklist-90-Revision, Children's Depression Inventory, Beck Depression Inven-tory, Social Anxiety Scale for Children-Revised, Social Anxiety and Distress Scale, Avoidant Personality Disorder Scale, and State-Trait Anxiety Inventory for Children. SPSS version 12.0 was used for statistical analysis. RESULTS: Cronbach's alpha values, the reliability coefficient to represent internal consistency, were between 0.396 and 0.935, which showed relatively high internal consistency for this questionnaire. The test-retest coefficient was between 0.68 and 0.78, which was a statistically significant result. In a factor analysis, 4 factors such as avoidance, withdrawal, isolation, and apathy were extracted. In a concurrent validity test with SCL-90-R, the isolation factor showed a statistically-significant relationship with a phobic-anxiety sub-scale, and avoidance and withdrawal sub-scales were remarkably correlated with the interpersonal sensitivity sub-scale. CONCLUSION: Since the questionnaire for socially withdrawn youths has achieved statistically-satisfactory reliability and validity, it will be a useful method to screen for hidden youths in educational, community, and clinical settings.
Adolescent ; Anxiety ; Apathy ; Child ; Depression ; Humans ; Mass Screening ; Mental Health ; Parents ; Personality Disorders ; Reproducibility of Results ; Surveys and Questionnaires

OBJECTIVES: The definition of a hidden youth is a young person who has completely withdrawn from society and shut himself or herself away for more than 3 months. Those pathologically-withdrawn youths have become a burden not only to society but also to the family. However, screening of these hidden youths cannot be done easily. This study focused on developing a primary effective screening tool for these hidden youths. METHODS: The 42 participants of this study were parents of hidden youths that are between 8 to 25 years old. They were selected from from mental health centers and psychiatric clinics around Seoul and Gyeonggi Province. We also recruited 239 parents of middle and high school students in the Seoul metropolitan area for a control group. In order to decide the concurrent validity of this questionnaire, we used the Symptom Checklist-90-Revision, Children's Depression Inventory, Beck Depression Inven-tory, Social Anxiety Scale for Children-Revised, Social Anxiety and Distress Scale, Avoidant Personality Disorder Scale, and State-Trait Anxiety Inventory for Children. SPSS version 12.0 was used for statistical analysis. RESULTS: Cronbach's alpha values, the reliability coefficient to represent internal consistency, were between 0.396 and 0.935, which showed relatively high internal consistency for this questionnaire. The test-retest coefficient was between 0.68 and 0.78, which was a statistically significant result. In a factor analysis, 4 factors such as avoidance, withdrawal, isolation, and apathy were extracted. In a concurrent validity test with SCL-90-R, the isolation factor showed a statistically-significant relationship with a phobic-anxiety sub-scale, and avoidance and withdrawal sub-scales were remarkably correlated with the interpersonal sensitivity sub-scale. CONCLUSION: Since the questionnaire for socially withdrawn youths has achieved statistically-satisfactory reliability and validity, it will be a useful method to screen for hidden youths in educational, community, and clinical settings.
Adolescent ; Anxiety ; Apathy ; Child ; Depression ; Humans ; Mass Screening ; Mental Health ; Parents ; Personality Disorders ; Reproducibility of Results ; Surveys and Questionnaires

PURPOSE: To describe the clinical features of nonconvulsive status epilepticus (NCSE) associated with cephalosporins in patients with renal failure and to emphasize the importance of EEG in diagnosing NCSE in patients with altered consciousness.METHODS: We described the detailed clinical characteristics of 8 patients with renal failure who underwent cephalosporin-induced NCSE.RESULTS: Six of the patients showed unresponsiveness with preserved alertness and two patients presented confusion and irritability. 6 patients presented altered consciousness with intermittent jerky movements of face or arms. Altered consciousness developed 6+/-5 days (mean+/-SD) after starting the above antibiotics. The EEG showed continuous generalized high voltage 1.0 to 2.5 Hz sharp waves or sharp and wave complexes. All patients improved 3+/-1 days after withdrawing the offending antibiotics without administration of antiepileptic drugs.CONCLUSIONS: Cephalosporin-induced NCSE should be differentiated from metabolic encephalopathy in patients with renal failure, which is clinically difficult. Early detection with EEG and withdrawal of the offending antibiotics can result in full recovery.
Anti-Bacterial Agents ; Arm ; Brain Diseases, Metabolic ; Cephalosporins ; Consciousness ; Electroencephalography ; Humans ; Renal Insufficiency ; Status Epilepticus