Clinical observation was carried out for 147 patients with mucocutaneous lymph node syndrome (MCLS) who were admitted to the Department of Pediatrics, Wonju Christian Hospital during the period from June, 1983 to June, 1992. A spinal tap was performed on 114 of these patients and the following results were obtained. 1) The incidence of aseptic meningitis in patients with MCLS was 52.6%. (60 cases of the 114 cases who had spinal taps (52.6%).) 2) The predominent age group for aseptic meningitis was 6 months to 1 year of age (35%). 3) For the majority, the value of glucose and protein in the CSF were within normal limit or only mildly elevated. 4) The neurologic manifestations associated with aseptic meningitis in patients with MCLS were irritability (78.3%), vomiting (25.0%), nuchal rigidity (11.7%), convulsion (5.0%) and facial nerve palsy (1.7%) in that order.
Facial Nerve ; Gangwon-do ; Glucose ; Humans ; Incidence ; Meningitis, Aseptic* ; Mucocutaneous Lymph Node Syndrome* ; Muscle Rigidity ; Neurologic Manifestations ; Paralysis ; Pediatrics ; Seizures ; Spinal Puncture ; Vomiting

Hyponatremia is primarily a water balance disorder associated with high morbidity and mortality. The pathophysiological mechanisms behind hyponatremia are multifactorial, and diagnosing and treating this disorder remains challenging. In this review, the classification, pathogenesis, and step-by-step management approaches for hyponatremia in patients with liver disease are described based on recent evidence. We summarize the five sequential steps of the traditional diagnostic approach: 1) confirm true hypotonic hyponatremia, 2) assess the severity of hyponatremia symptoms, 3) measure urine osmolality, 4) classify hyponatremia based on the urine sodium concentration and extracellular fluid status, and 5) rule out any coexisting endocrine disorder and renal failure. Distinct treatment strategies for hyponatremia in liver disease should be applied according to the symptoms, duration, and etiology of disease. Symptomatic hyponatremia requires immediate correction with 3% saline. Asymptomatic chronic hyponatremia in liver disease is prevalent and treatment plans should be individualized based on diagnosis. Treatment options for correcting hyponatremia in advanced liver disease may include water restriction; hypokalemia correction; and administration of vasopressin antagonists, albumin, and 3% saline. Safety concerns for patients with liver disease include a higher risk of osmotic demyelination syndrome.

Purpose: Colorectal cancer (CRC) occurs in all age groups, and the application of treatment may vary according to age. The study was designed to identify the characteristics of CRC by age. Methods: A total of 4,326 patients undergoing primary resection for CRC from September 2006 to July 2019 were reviewed. Patient and tumor characteristics, operative and postoperative data, and oncologic outcome were compared Results: Patients aged 60 to 69 years comprised the largest age group (29.7%), followed by those aged 50 to 59 and 70 to 79 (24.5% and 23.9%, respectively). Rectal cancer was common in all age groups, but right-sided colon cancer tended to be more frequent in older patients. In very elderly patients, there were significant numbers of emergency surgeries, and the frequencies of open surgery and permanent stoma were greater. In contrast, total abdominal colectomy or total proctocolectomy was performed frequently in patients in their teens and twenties. The elderly patients showed more advanced tumor stages and postoperative ileus. The incidence of adjuvant treatment was low in elderly patients, who also had shorter follow-up periods. Overall survival was reduced in older patients with stages 0 to 3 CRC (P<0.001), but disease-free survival did not differ by age (P=0.391). Conclusion CRC screening at an earlier age than is currently undertaken may be necessary in Korea. In addition, improved surgical and oncological outcomes can be achieved through active treatment of the growing number of elderly CRC patients.

No abstract available.
Epilepsy ; Humans ; Seizures ; Ventricular Fibrillation

PURPOSE: To compare the effectiveness of intravitreal injections of bevacizumab and ranibizumab in patients with treatment-naive polypoidal choroidal vasculopathy (PCV). METHODS: Records from 106 consecutive patients who received intraviteral bevacizumab (n = 58, 1.25 mg) or ranibizumab (n = 52, 0.5 mg) for treatment of PCV were retrospectively reviewed. After three initial monthly loading injections, injection was performed as needed. The main outcome measures included best-corrected visual acuity (BCVA), foveal central thickness (FCT) as assessed by spectral domain optical coherence tomography, and the changes in polypoidal lesions based on an indocyanine green angiography. RESULTS: The average number of injections was 3.31 +/- 1.25 in the bevacizumab group and 3.44 +/- 0.92 in the ranibizumab group. Mean logarithm of the minimum angle of resolution of BCVA from baseline to 6 months after injection improved by 0.17 in the bevacizumab group (p = 0.03) and by 0.19 in the ranibizumab group (p = 0.01). Average FCT decreased from 322 +/- 62.48 microm to 274 +/- 40.77 microm in the bevacizumab group (p = 0.02) and from 338 +/- 50.79 microm to 286 +/- 36.93 microm in the ranibizumab group (p = 0.02). Polyp regression rate was 20.7% (12 of 58 eyes) in the bevacizumab group and 21.2% (11 of 52 eyes) in the ranibizumab group. There was no statistically significant difference between groups in BCVA improvement achieved, FCT improvement achieved, and polyp regression rate between groups. CONCLUSIONS: Intravitreal injections of bevacizumab and ranibizumab have similar effects in stabilizing of visual acuity, macular edema, and regression of polypoidal complex in PCV eyes over the short term.
Angiogenesis Inhibitors/administration & dosage ; Antibodies, Monoclonal, Humanized/*administration & dosage ; Choroid/*blood supply ; Choroid Diseases/diagnosis/*drug therapy/physiopathology ; Dose-Response Relationship, Drug ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fovea Centralis/pathology ; Fundus Oculi ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Peripheral Vascular Diseases/diagnosis/*drug therapy/physiopathology ; Retrospective Studies ; Time Factors ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity

Purpose: This study aimed to evaluate the association of redundant nerve roots of the cauda equina (RNRCEs) with the degree and duration of symptoms in patients with lumbar spinal canal stenosis. Materials and Methods: Between January 2017 and December 2018, 224 patients demonstrating central canal stenosis on lumbar spine MRI were included. Various imaging findings associated with spinal canal stenosis were investigated, as were the presence, level, type, and length of RNRCEs, and the presence of nerve root swelling. Clinically, the degree of symptoms and symptom changes after treatment were investigated. Multinomial logistic regression was used for statistical analysis. Results: RNRCEs were present in 142 patients (63.4%). Most RNRCEs were observed above the level of stenosis (47.3%). RNRCE was associated with the number of stenoses and symptom duration (p < 0.05). The presence, level, type, and length of RNRCE and nerve root swelling significantly affected the severity of symptoms (p < 0.05). The type of treatment influenced symptom changes (p < 0.05). Conclusion The recognition and assessment of RNRCEs on spinal MRI are clinically important because the presence, level, type, and length of a RNRCE may be associated with the degree of symptoms and help predict the clinical outcome according to treatment methods.

Background: Cutaneous manifestations are frequently observed in end-stage kidney disease (ESKD) and affect the quality of life (QoL) of patients undergoing maintenance hemodialysis (HD). Even patients undergoing HD who frequently visit hospitals do not receive active dermatological care. The aims of this study were to assess the cutaneous manifestations of patients undergoing HD and investigate changes in their QoL before and after active treatment by dermatologists. Methods: A 12-week prospective study was conducted in two HD centers. Patients in one center received dermatological intervention, while patients in the other center received conservative management by a nephrologist. Patients scored their QoL using the Dermatology Life Quality Index (DLQI) and the Skindex-29 at the start of the study and 12 weeks later. Two matched groups were formed using propensity score matching.Simple and multiple linear regression analyses were used to identify associations between dermatological treatment and the improvement in QoL. Results: In total, 120 patients were included, of whom 65 and 55 were in the intervention and control groups, respectively. Approximately 93.8% of the patients had dermatological manifestations, with pallor and xerosis being the most common. Improvement in QoL, as assessed using the DLQI, was confirmed after 12 weeks in the overall population. However, active intervention by a dermatologist did not significantly improve QoL. Conclusion Patients treated with dermatological intervention by a dermatologist did not achieve greater improvements in QoL than control patients. Therefore, careful assessment of skin issues in patients with ESKD should be undertaken by nephrologists, and the best possible treatment should be administered.

Background: Cutaneous manifestations are frequently observed in end-stage kidney disease (ESKD) and affect the quality of life (QoL) of patients undergoing maintenance hemodialysis (HD). Even patients undergoing HD who frequently visit hospitals do not receive active dermatological care. The aims of this study were to assess the cutaneous manifestations of patients undergoing HD and investigate changes in their QoL before and after active treatment by dermatologists. Methods: A 12-week prospective study was conducted in two HD centers. Patients in one center received dermatological intervention, while patients in the other center received conservative management by a nephrologist. Patients scored their QoL using the Dermatology Life Quality Index (DLQI) and the Skindex-29 at the start of the study and 12 weeks later. Two matched groups were formed using propensity score matching.Simple and multiple linear regression analyses were used to identify associations between dermatological treatment and the improvement in QoL. Results: In total, 120 patients were included, of whom 65 and 55 were in the intervention and control groups, respectively. Approximately 93.8% of the patients had dermatological manifestations, with pallor and xerosis being the most common. Improvement in QoL, as assessed using the DLQI, was confirmed after 12 weeks in the overall population. However, active intervention by a dermatologist did not significantly improve QoL. Conclusion Patients treated with dermatological intervention by a dermatologist did not achieve greater improvements in QoL than control patients. Therefore, careful assessment of skin issues in patients with ESKD should be undertaken by nephrologists, and the best possible treatment should be administered.