OBJECTIVES: This study was performed to verify and compare deterioration of executive functions in the children with Tourette's disorder (TS) with those with Attention Deficit Hyperactivity Disorder (ADHD) and to understand the differentes. METHOD: We administered Kaufman Assessment Battery for Children (K-ABC), Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST) on three groups of 18 children each: tow groups of outpatients, one pure TS and one pure ADHD, diagnosed using DSM-IV criteria, and the third, a control group of normal, healthy children who were selected considering age, sex and academic achievement. The children performed all testings without the use of medications RESULTS: In comparisons of CPT perfotmance, the ADHD group showed poor performance with significant difference in commission error, attentiveness and risk taking (p< .05), and the TS group showed significant difference in attentiveness (p< .05) when compared with the control group. There was significant difference between the ADHD group and the TS group in commission error (p< .05). In comparisons of WCST, the ADHD group and the TS group showed significantly poorer performance than the controls in number of trials administered, total number of errors, conceptual level response, number of categories complete, perseverative response and perseverative error (p< .05), but only the ADHD group showed poor performance in perseverative response and perseverative erro r (p< .05). When the results of CPT were analyzed after adjustment for IQ, the ADHD group showed significantly more errors than the TS disorder group in commission error, and only the ADHD group showed significant difference in attentiveness compared with the normal controls (p< .05). In WCST, while these two groups showed significant difference in number of trials administrated, only the ADHD group showed significantly poor performance compared with the normal children group in the 5 sub-categories such as total number of errors, perseverative response, perseverative error, conceptual level response and number of categories complete (p< .05). CONCLUSION: The abnormalities of executive functions appear in both ADHD and Tourette's disorder, but more apparent abnormalities in executive functions were shown in ADHD than in Tourette's disorder. Also the differences of executive functions suggest that these two diseases may have different psychopathophysiology in these dimensions.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Diagnostic and Statistical Manual of Mental Disorders ; Executive Function* ; Humans ; Outpatients ; Risk-Taking ; Tourette Syndrome* ; Wisconsin

Intraosseous ganglion of the scaphoid associated with occult ganglion is rare. A 27-year-old man who presented with a 4-month history of progressive left wrist pain visited our institution. The patient was diagnosed intrasosseous ganglion of the carpal scaphoid assosiated with occult ganglion. We obtained satisfactory result by arthroscopic procedure and report this case focusing on surgical technique with literature review.
Adult ; Arthroscopes ; Bone Cysts ; Ganglion Cysts ; Humans ; Wrist

This study aims to examine the effect of methylphenidate, which is the most extensively prescribed medicine treating children with Attention Deficit Hyperactivity Disorder (ADHD), on the children's neuropsychiatric functions by comparing the symptomatic differences before and after its medication. MEHTODS: The subjects of this study were 48 children who corresponded to the diagnostic criteria for ADHD of DSM-IV, did not have any problem in vision or hearing, did not have neurologic disorder such as epilepsy and brain damage, and did not have other long term medication. To evaluate the effects of behavioral response and medication, after stopping medication over a week we handed out questionnaires to the parents and conducted CPT to the subjects. A dose of 0.3-0.7 mg/kg (bid or tid) was medicated at 8AM and 1PM everyday. After 4 weeks of medication, the same tests were conducted. RESULTS: Average age of the subjects was 8.88+/-1.55. There were 44 boys (91.7%) and 4 girls (8.3%). Mean intelligence was 96.60+/-18.12 and mental processing was 102.90+/-16.51. On ADDES-HV, after medication attention, impulsivity and hyperactivity were significantly improved (p<0.05). On AcTeRS, after medication attention, impulsivity and social skill were significantly improved (p<0.05). On CAPs, after medication inattention and hyperactivity were significantly improved (p<0.05). On SNAP, after medication inattention impulsivity and hyperactivity were significantly improved (p<0.05). On the academic performance rating scale, after medication total score, learning ability, impulse control and social withdrawal were significantly improved (p<0.05). On performing CPT, after medication commissions error, hit reaction time standard error, variability of standard error and attentiveness were significantly improved (p<0.05). CONCLUSIONS: With these results, we recognized methy-lphenidate is more effective in children's impulsivity and hyperactivity than attention, contrary to the clinical observation.
Attention Deficit Disorder with Hyperactivity* ; Brain ; Child* ; Diagnostic and Statistical Manual of Mental Disorders ; Epilepsy ; Female ; Hand ; Hearing ; Humans ; Impulsive Behavior ; Intelligence ; Learning ; Methylphenidate* ; Nervous System Diseases ; Parents ; Surveys and Questionnaires ; Reaction Time

Bacillus Calmette-Guerin(BCG) has been widely used for the prophylaxis of superficial bladder tumor recurrence and for the treatment of bladder carcinoma in situ. More than 95% of patients who receive BCG instillation tolerate the treatment well and side reactions have been reported in less than 5% of patients. Most side effects are minor and self-limiting. However, a rear occurrence of severe systemic reactions have been reported. Among the severe systemic reactions, hypersensitivity pneumonitis should be considered in patients with pneumonic complications after BCG instillation in cases where the culture for mycobacteria is negative in the sputum, brochoalveolar lavage and blood specimen. In addition, a fiberoptic bronchoscopy with transbronchial lung biopsy demonstrates a fibrosis of the alveolar septums, where there is and an increased lymphocyte count without tuberculous inflammatory changes, the and CD4:CD8 ratio is increased and no symptomatic response to antituberculosis chemotherapy is observed. Here we report a 68 years old man with interstitial pneumonitis following intravesical BCG instillation.
Administration, Intravesical* ; Alveolitis, Extrinsic Allergic ; Bacillus ; Biopsy ; Bronchoscopy ; Carcinoma in Situ ; Drug Therapy ; Fibrosis ; Humans ; Lung ; Lung Diseases, Interstitial* ; Lymphocyte Count ; Mycobacterium bovis* ; Recurrence ; Sputum ; Therapeutic Irrigation ; Urinary Bladder Neoplasms* ; Urinary Bladder*

BACKGROUND: Fanconi's anemia(FA) is an autosomal recessive disease characterized by aplastic anemia and congenital malformations. As up to 30% of patients have no physical stigmata, the modern diagnosis of FA rests on chromosomal breakage of patient's cells induced by chemical clastogens such as diepoxybutane(DEB) or mitomycin-C(MMC). METHODS: We reviewed the clinical manifestations, laboratory findings, diagnostic methods, treatment and outcome of 6 patients diagnosed to have a FA at the Chonnam University Hospital for the last 6 years. RESULTS: Six cases(16.2 %) were found to have FA among 37 aplastic children who were diagnosed during the same period. The mean age at diagnosis was 6.3 years which was the usual onset of hematologic findings. All patients had features of aplastic anemia, and had one or more anomalies, such as low birth weight, hyperpigmentation, cafeau-lait spots, mental retardation, developmental delay, peculiar face(broad nasal bases, epicanthal folds, micrognathia), polydactyly, microcephaly, short stature, and dislocation of hip. We found increased breaks in cultured cells with DEB and MMC in 5 cases tested. The median duration of follow-up was 30 months. Oxymetholone and prednisolone treatment was partially beneficial in three cases. Immunosuppressive treatment with ALG/ATG was not successful in two cases tried. Four cases are living now, without transfusion in three. Two patients were died of disseminated fungal infection and transplant-related problems, respectively. CONCLUSIONS: Fanconi's anemia should be sought carefully in any patients with aplastic anemia because the prognosis, treatment modality, and the approach to bone marrow transplantation are quite different when the hematologic disorder is inherited rather than acquired.
Anemia, Aplastic ; Bone Marrow Transplantation ; Cells, Cultured ; Child ; Christianity ; Chromosome Breakage ; Diagnosis ; Dislocations ; Fanconi Anemia* ; Follow-Up Studies ; Hip ; Humans ; Hyperpigmentation ; Infant, Low Birth Weight ; Infant, Newborn ; Intellectual Disability ; Jeollanam-do ; Microcephaly ; Mitomycin ; Mutagens ; Oxymetholone ; Polydactyly ; Prednisolone ; Prognosis

We investigated the influence of photon energy, couch and collimator angle differences between arcs on dose distribution of RapidArc treatment planning for prostate cancer. RapidArc plans were created for 6 MV and 10 MV photons using 2 arcs coplanar and noncoplanar fields. The collimator angle differences between two arcs were 0degrees, 15degrees, 30degrees, 45degrees, 60degrees, 75degrees and 90degrees. The plans were optimized using same dose constrains for target and OAR (organ at risk). To evaluate the dose distribution, plans were analyzed using CI (conformity index), HI (homogeneity index), QOC (quality of coverage), etc. Photon energy, couch and collimator angle differences between arcs had a little influence on the target and OAR. The difference of dosimetric indices was less than 3.6% in the target and OAR. However, there was significant increase in the region exposed to low dose. The increase of V15% in the femur was 6.4% (left) and 5.5% (right) for the 6 MV treatment plan and 23.4% (left), 24.1% (right) for the noncoplanar plan. The increase of V10% in the Far Region distant from target was 54.2 cc for the 6 MV photon energy, 343.4 cc for the noncoplanar and 457.8 cc for the no collimator rotation between arcs.
Femur ; Photons ; Prostate ; Prostatic Neoplasms

A retrospective analysis was made of 20 patients with pineal region tumors who were treated at the Department of Neurosurgery, Capital Armed Forces General Hospital between May of 1987 and March of 1993. We performed ventriculo-peritoneal shunt in 17 patients with obstructive hydrocephalus. Tissue diagnosis was obtained in 7 patients before irradiation and 13 patients underwent irradiation without histological diagnosis. Among 7 biopsy-proven cases, 5 were germinoma, one was mixed germ cell tumor and another one was astrocytoma. The response to irradiation and tumor marker study revealed that 13 patients who did not have tissue diagnosis seemed to be germinomatous, non-germinomatous germ cell tumors and endodermal sinus tumor. So, the following results were obtained. 1) The patients were all young males. 2) The main presenting symptoms and signs were headache, vomiting and papilledema. 3) The tumors were mainly presented as a round well-enhancing masses with calcification. 4) Based on the classification of pineal tumor, germinoma was predominant tumor type. 5) The extrapineal metastasis was found in 5 cases(25.0%). 6) The tumor marker (alpha-FP or HCG) was positive in 5 cases(25.0%). 7) Germinoma showed excellent prognosis after the irradiation.
Arm ; Astrocytoma ; Classification ; Diagnosis ; Endodermal Sinus Tumor ; Germinoma ; Headache ; Hospitals, General ; Humans ; Hydrocephalus ; Male ; Neoplasm Metastasis ; Neoplasms, Germ Cell and Embryonal ; Neurosurgery ; Papilledema ; Pinealoma ; Prognosis ; Radiotherapy ; Retrospective Studies ; Ventriculoperitoneal Shunt ; Vomiting

OBJECTIVES: Behavioral stress has been suggested as one of important factors which destruct the physiologic antioxidant system. Studies about antioxidant activity changes in brain by repeated stress may be valuable data in the clarification of pathogenesis and development of treatment modalities for the psychologic stress-induced somatic disease. METHODS: We examined, therefore, immobilization stress -induced antioxidant defense chages in the rat brain. Superoxide dismutase, glutathione peroxidase and, glutathione reductase activities were measured in the dissected specimens of the cerebral cortex, hippocampus, striatum, brain stem, cerebellum and hypothalamus of adult male Sprague-Dawley rats subjected to 2 hour immobilization stress for 14 consecutive days. RESULTS: In this study, immobilization inhibited glutathione peroxidase and glutathione reductase activities in striatum and hypothalamus than any other brain regions. CONCLUSION: These results suggest that striatum and hypothalmus are subject to strong pro-oxidant impacts arising at the repeated immobilization stress.
Adult ; Animals ; Brain Stem ; Brain* ; Cerebellum ; Cerebral Cortex ; Glutathione Peroxidase ; Glutathione Reductase ; Hippocampus ; Humans ; Hypothalamus ; Immobilization ; Male ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase

This study examined 60 children with ADHD through K-ABC, ADDES-HV, ADD-H comprehensive teacher's rating scale (ACTeRS), CAP, SNAP, Academic Performance rating scale, K-PIC, CPT and WCST in order to estimate the effects of methylphenidate, and find out various factors which can influence on treatment responses and predictive factors of treatment. Boys showed better improvement in impulsiveness of behavior symptoms than girls, but girls showed better improvement in trials to completed the first category in WCST. In the aspect of age, the lower graders (age 7-9) showed improvement in sequential processing ability of intelligence but the higher graders (age 10-12) showed deterioration. In the aspect of sub-categories of ADHD, children with mixed type who had been worse in attention deficit and behavior symptoms in pretreatment state, showed significantly higher improvement than children with predominantly inattentive type in every scopes of behavior symptom check list. And in clusters of K-PIC, after treatments the group those who had have more anxiety or depression showed better improvement in omission error in CPT. In the aspect of intelligence level, children with average intelligence showed better improvement in impulsiveness and impulse control than the rests. In the aspect of executive functions, the less omission errors in CPT one made, the better improvement in attention and academic ability he showed. And the less perseverative response in WCST one had, the better improvement in hyperactivity he showed however his simultaneous processing abilities were deteriorated. With these results, this study confirms that methylphenidate is effective in behavior symptoms, academic performance, intelligence and various performance abilities of children with ADHD including attention and response control. In the cases of the children with severe ADHD symptoms, especially behavioral disinhibition and the children with mixed type of ADHD, it is considered useful to predict the results of treatments.
Anxiety ; Attention Deficit Disorder with Hyperactivity* ; Child* ; Depression ; Executive Function ; Female ; Humans ; Intelligence ; Methylphenidate

PURPOSE: We analyzed the frequency and characteristics of atherosclerotic plaques in the patients without coronary artery calcification (CAC) by the use of multidetector row CT (MDCT). In addition, we analyzed patients with negative CAC to guarantee the absence of coronary artery disease (CAD). MATERIALS AND METHODS: One hundred-ten patients with a suspicion of CAD and no CAC as detected on 16-slice and 64-slice MDCT were enrolled in this retrospective study. We analyzed the frequency of atherosclerotic plaques. For characterizing the atherosclerotic plaques, location, attenuation, volume, the degree of stenosis, and the remodeling index (RI) were analyzed. RESULTS: Atherosclerotic plaques were detected in 8 patients (7.3%). The plaques were located in the right coronary artery (n=3), left anterior descending artery (n=3), and left main coronary artery (n=2). Attenuation, volume, stenosis and RI were 41.4+/-16.6 HU (range, 20.2 - 69.9 HU), 55+/-55 mm3 (range, 15-179 mm3), 40.7+/-16.3% (range,16.0-68.0%) and 1.35+/-0.13 (range, 1.16-1.50). Lipid rich plaque and significant stenosis were detected in 6 patients and in 2 patients, respectively. CONCLUSION: Despite negative CAC as detected on MDCT, atherosclerotic plaque might have significant stenosis or lipid rich plaque. Therefore, negative CAC does not seem to guarantee the absence of CAD. Coronary CT angiography was recommended for patients with negative CAC.
Angiography ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Humans ; Plaque, Atherosclerotic ; Retrospective Studies