PURPOSE: This study aimed to examine the development of socializing and emotional expressions through vocalizations and joint attention (JA) behaviors in Korean-speaking children with autism spectrum disorder (ASD), compared to those with developmental delay (DD). MATERIALS AND METHODS: Video samples were collected from 28 toddlers with ASD and 18 age-matched toddlers with DD, and vocalizations were each coded in detail for the purpose of this retrospective research. In addition to some statistical analysis, Computerized Language Analysis was conducted to obtain the final results. RESULTS: Although they produced a higher number of vocalizations than the DD group, the ASD group did not engage in emotional or social interactions with their caretakers, whereas the DD group did. The children with ASD used more atypical vocalizations and socially unengaged vocalizations than the children with DD did. JA using vocalizations in the ASD group, in particular, was largely dyadic, with triadic types occurring at a significantly lower frequency than those in the DD group. CONCLUSION: Results from this study indicate the importance of assessing early vocalizations in toddlers with ASD, suggesting that some common symptoms of ASD, such as lack of typical, emotional, and social functions in early vocalizations, could be used to develop screening and intervention programs related to ASD.
Autism Spectrum Disorder* ; Autistic Disorder* ; Child ; Child Behavior ; Communication Disorders ; Developmental Disabilities ; Humans ; Interpersonal Relations ; Joints ; Mass Screening ; Mother-Child Relations ; Retrospective Studies

BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) has been known as a method of local treatment for early gastric cancer (EGC) or gastric adenoma. The purpose of this study was to identify the factors affecting complete resection rate (CRR) of EMR and to identify histological discrepancy between endoscopic biopsy and the resected specimen obtained by EMR. METHODS: Forty four gastric adenomas and twenty seven EGCs in 63 patients were treated by EMR from January, 1999 until August, 2002. We analysed the factors affecting CRR on the basis of location, macroscopic type, size, piecemeal resection, and EMR methods. RESULTS: The CRR in antrum was 72%. The CRR of the method using endoscopic resection with hypertonic saline-epinephrine solution, injection, precutting and snaring (ER-HSE) was 78%. The CRR according to en bloc resection was 77%. Sixty six percents of histological coincidence was noted between the endoscopic biopsy and the resected specimen of gastric adenoma. CONCLUSIONS: In this study, the CRR of the ER-HSE method and the lesion located in antrum is higher than that other groups. Gastric adenoma should be removed by EMR because of histologic discrepancy between the endoscopic biopsy and the resected specimen.
Adenoma* ; Biopsy* ; Humans ; SNARE Proteins ; Stomach Neoplasms*

Tuberculous colitis, an important extra-pulmonary tuberculosis, is still prevalent in the developing countries and has been resurging in the Western world. The duration and dose of anti-tuberculous therapy have not yet been clarified in the tuberculous colitis. We experienced a case of tuberculous colitis, which relapsed after 9 months of therapy. A 28-year-old man presented with hematochezia and was diagnosed as tuberculous colitis on the basis of colonoscopic findings. He was treated with anti-tuberculous agents for 9 months successfully. Three months later, however, he complained of hematochezia again, suggesting the relapse of tuberculous colitis. He had taken anti-tuberculous therapy for another 15 months and showed no evidence of relapse. Although anti-tuberculous therapy is efficient for tuberculous colitis, rare cases of reactivation should be reminded.
Adult ; Colitis/*drug therapy/microbiology ; English Abstract ; Humans ; Male ; Recurrence ; Tuberculosis, Gastrointestinal/*drug therapy

PURPOSE: This study was performed to evaluate the availability of classification of lacunar syndrome and of diffusion weighted MRI as initial diagnostic tools for patients with lacunar syndrome. METHODS: From January 1 to October 31, 2001, we prospectively studied patients presenting with lacunar syndrome. All patients were scanned using diffusion-weighted MRI and were then classified into categories based on the diagnosis pure motor stroke and ataxic hemiparesis, sensory motor stroke, pure sensory stroke, dysarthria-clumsy hand syndrome, and others. RESULTS: The total number of patents was 72 ; 60 cases of lacunar infarcts and 12 cases of lacunar hemorrhage. There were 42 cases of pure motor stroke and ataxic hemiparesis, 17 cases of sensory motor stroke, 8 cases of dysarthria-clumsy hand syndrome, 3 cases of pure sensory stroke, 2 cases of others. Lacunar syndrome can be caused by lesions in a variety of locations, and specific location can cause a variety of lacunar syndromes. With diffusion-weighted MRI, lacunar syndromes were visible in 91.7% of the patients (66/72) and lacunar infarcts were visible in 90% (54/60). The mean size of the lacunar infarcts was 11.90+/-5.04 mm and the mean volume of lacunar hemorrhages was 4.70+/-2.08 ml. CONCLUSION: This study showed that the classification of lacunar syndrome was of little benefit in the diagnosis and treatment of a lacunar infarct. Diffusion-weighted MRI, however, was a good initial diagnostic tool in cases of lacunar infarcts. An additional study of the availability of diffusion weighted MRI for use in cases of hemorrhagic lesions is needed.
Classification* ; Diagnosis ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Hand ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Paresis ; Prospective Studies ; Stroke ; Stroke, Lacunar*

It is well known that Rhododendron sclippenbashii contains the toxic material grayanotoxin. So, Koreans do not eat it, but they do eat azalea although it contains grayanotoxin. That is why there have been no reports about Rhododendron sclippenbashii intoxication after ingesting it intentionally, not accidentally. In this case, the patient was admitted to the emergency room with several toxic symptoms after intentionally consuming 50 blossoms of Rhododendron sclippenbashii to get rid of thirst. Treatment with saline infusion and atropine was successful and the outcome was favorable enough in this case to produce a complete cure without any sequelae at discharge. But toxic symptoms were seen for 24 hours, although the symptoms usually fade in 9 hours. Therefore, we should carefully treat and observe, for over 24 hours, the patient who intentionally ingests about 50 blossoms of Rhododendron sclippenbashii.
Adult ; Atropine ; Bradycardia ; Drug Combinations ; Emergencies ; Flowers ; Humans ; Intention ; Piperonyl Butoxide ; Pyrethrins ; Rhododendron ; Thirst

PURPOSE: Serious complications from snake bite envenomization are relatively rare in Korea. According to standrad treatment guidelines for local and systemic injuries, antivenin is not recommended for snake bite cases when victims show minimal clinical symptoms. However, there are no published stidies about the effectiveness of antivenin treatment in such cases in Korea. In order to provide actual documentation to support a standard for treatment, we evaluated the effectiveness of antivenin use by comparing clinical outcomes in snake bite patients exhibiting minimal clinical symptoms (traditional snake bite severity grades 0 and I). METHODS: We retrospectively reviewed 140 snake bite cases of patients with minimal clinical symptoms who visited the emergency departments of Chungnam National University Hospital, Cheonan Medical Center, and Chungnam Seosan Medical Center in Korea from January 2000 to December 2006. We categorized the patients into antivenin (group 1) and non-antivenin (group 2) treatment groups. We compared clinical outcomes and characteristics of the two groups. RESULTS: Neither demographic factors nor clinical outcomes showed statistical significance between the groups. CONCLUSION: In case of snake bite victims in Korea, antivenin treatment should not generally recommended as treatment for victims exhibiting minimlal clinical symptoms.
Antivenins ; Chungcheongnam-do ; Demography ; Emergency Service, Hospital ; Humans ; Korea ; Retrospective Studies ; Snake Bites* ; Snakes* ; Treatment Outcome

Rapid ammonia elevation in blood with accompanying mental change should be considered as a true medical emergency. In such a case, action leading to immediate diagnosis and the earliest possible treatment must occur in order to minimize permanent brain damage. Hyperornithinemia- Hyperammonemia-Homocitrullinuria (HHH) syndrome is a rare inborn errors of metabolism and autosomal recessive metabolic disorder caused by a deficiency of the mitochondrial ornithine transporter at the cellular level. Emergency physicians should take account of the possibility of HHH syndrome in patients with unreasonable hyperammonemia coupled with altered mental status. We report a case of a 59-year old man who presented with headache, nausea, vomiting and altered mental status. His serologic test showed hyperornithinemia, hyperammomemia, and homocitrullinuria. He was treated with fluid therapy and hemodialysis. His clinical manifestation improved and he was discharged after hemodialysis
Amino Acid Transport Systems, Basic ; Ammonia ; Brain ; Emergencies ; Fluid Therapy ; Headache ; Humans ; Hyperammonemia ; Metabolism, Inborn Errors ; Nausea ; Ornithine ; Renal Dialysis ; Serologic Tests ; Urea Cycle Disorders, Inborn ; Vomiting

PURPOSE: To evaluate clinical predictors of cervical abscess in adult patients who present a sore throat. METHODS: We prospectively studied adult patients (18 years of age or older) who presented with a sore throat at one of three hospitals (Chungnam national university hospital, Chungbuk national university hospital, and Konyang university hospital) from June 2010 to June 2011. The enrolled patients received a neck computed tomography scan, and their clinical manifestations were investigated. We evaluated several clinical variables in order to predict the existence of cervical abscess by use of multiple logistic regression analysis, and assessed the ability of the results of these variables to accurately diagnose cervical abscess using a receiver operating characteristic curve. RESULTS: A total of 109 patients were enrolled in this study. We identified two clinical variables (swelling and voice change) useful in predicting the existence of cervical abscess, and the AUC acquired by adding the scores of the two clinical factors was 0.89 (p<0.01). The sensitivity and specificity of these clinical factors to predict cervical abscess were 0.96 and 0.69 when the cut off value was determined to be 2. CONCLUSION: Two clinical factors (swelling and voice change) were useful in predicting the appearance of cervical abscesses. Consideration should be made for the need for incision and drainage of a cervical abscess if a patient presents swelling, or swelling and voice change.
Abscess ; Adult ; Area Under Curve ; Drainage ; Emergencies ; Humans ; Logistic Models ; Neck ; Pharyngitis ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Voice

PURPOSE: To evaluate clinical predictors of cervical abscess in adult patients who present a sore throat. METHODS: We prospectively studied adult patients (18 years of age or older) who presented with a sore throat at one of three hospitals (Chungnam national university hospital, Chungbuk national university hospital, and Konyang university hospital) from June 2010 to June 2011. The enrolled patients received a neck computed tomography scan, and their clinical manifestations were investigated. We evaluated several clinical variables in order to predict the existence of cervical abscess by use of multiple logistic regression analysis, and assessed the ability of the results of these variables to accurately diagnose cervical abscess using a receiver operating characteristic curve. RESULTS: A total of 109 patients were enrolled in this study. We identified two clinical variables (swelling and voice change) useful in predicting the existence of cervical abscess, and the AUC acquired by adding the scores of the two clinical factors was 0.89 (p<0.01). The sensitivity and specificity of these clinical factors to predict cervical abscess were 0.96 and 0.69 when the cut off value was determined to be 2. CONCLUSION: Two clinical factors (swelling and voice change) were useful in predicting the appearance of cervical abscesses. Consideration should be made for the need for incision and drainage of a cervical abscess if a patient presents swelling, or swelling and voice change.
Abscess ; Adult ; Area Under Curve ; Drainage ; Emergencies ; Humans ; Logistic Models ; Neck ; Pharyngitis ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Voice

PURPOSE: This study compared the postoperative outcomes and complications between laparoscopic totally extraperitoneal (TEP) hernia repair and open Lichtenstein hernia repair. METHODS: A total of 64 cases (30 cases by the TEP method and 34 cases by Lichtenstein repair) were enrolled in this study. The operative time, the hospital stay, the VAS score, the amount of analgesic used, the postoperative complications and recurrence were compared between the 2 methods. RESULTS: The mean operative time was 71 min for the TEP group, which was not significantly longer than that for the Lichtenstein group (66 min). The mean postoperative hospital stay was 3.7 days for the TEP group, which was significantly shorter than that for the Lichtenstein group (4.2) (p=0.035). The mean postoperative analgesic dose was 0.9+/-0.7 and 1.1+/-1.0 within 24 hours and 0.2+/-0.5 and 0.7+/-0.8 after 24 hours, respectively. The dose of analgesic after 24 hours was significantly lower for the TEP group (p=0.011), but the dose within 24 hours and the total dose was not significantly different. The VAS score was 2.3+/-1.0 and 2.6+/-0.9 at 12 hrs and 1.2+/-0.8 and 1.7+/-0.8 at 48 hrs, respectively. The VAS score was significantly lower for TEP group than that for the Lichtenstein group at 48 hrs (p=0.011), but there was no significant difference between the groups at 12 hrs. There was one recurrence in the TEP group. CONCLUSION: For the TEP group, the hospital stay was significantly shorter than that for the Lichtenstein group and this is maybe because the postoperative pain after 24 hours from the operation was less for the TEP group. Laparoscopic TEP repair may be performed efficiently with an acceptable operating time and a shorter hospital stay, as compared to open Lichtenstein hernia repair.
Hernia ; Herniorrhaphy ; Length of Stay ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Pyrazines ; Recurrence