PURPOSE: Neonatal seizures are mostly symptomatic and have variable atypical clinical features with very different EEG findings from those of post-neonatal period. This study was performed to determine the common types of epileptiform discharges and their relationship with abnormalities in imaging study in neonates with seizures. METHODS: Fourty one neonates under 7 days of age who had been hospitalized at the Hanyang university hospital from June 1993 to May 1997 were studied retrospectively. Their medical records, results of EEG and brain imaging study were reviewed. RESULTS: 1) The types of neonatal seizures were subtle, generalized tonic, multifocal clonic, focal clonic, myoclonic in order of frequency. 2) The most common epileptiform discharge was excessive sharp transients recorded in 28 cases and the rest showed multifocal spikes, sharp waves, repetitive alpha, repetitive theta in order. Epileptiform discharges appeared on the both hemisphere in 24 cases, right hemisphere in 9 cases and left hemisphere in 8 cases. 3) Imaging study showed no abnormal findings in 27 cases and abnormal findings in 14 cases such as brain edema, intracranial hemorrhage, leukomalacia, subarachnoid hemorrhage, cephalhematoma, craniosynostosis. 4) Among 14 cases with radiological abnormalities, 5 cases had localized abnormalities and 3 of them had the abnormal EEG discharges on the same area concomittantly. But in total only 3 cases of 17 cases with localized epileptiform discharges had abnormalities in imaging study on the same site and so significant relationship between two studies was not observed. 5) As for the prognosis of seizures, subsided in 23 cases without any antiepileptic drugs, 13 cases had no seizure after taking medicine for few days and 5 cases needed continuous antiepileptic drug. CONCLUSION: This study showed no meaningful relationship between abnormal EEG findings and localization by imaging study in neonatal seizure but we concluded that brain imaging study was needed to determine degree of encephalopathy in neonatal seizures.
Anticonvulsants ; Brain Edema ; Craniosynostoses ; Electroencephalography ; Humans ; Infant, Newborn* ; Intracranial Hemorrhages ; Medical Records ; Neuroimaging ; Prognosis ; Retrospective Studies ; Seizures* ; Subarachnoid Hemorrhage

No abstract available.
Female ; Meigs Syndrome*

Diagnosis of a thymic carcinoid was made on transthoracic fine needle aspiration in a 36-year old woman who had an anterior mediastinal mass on chest X-ray and CT scan. The aspiration smears showed numerous anastomosing ribbons and cords of small round tumor cells. The tumor cells had slightly eccentric nuclei and some granular cytoplasm. The small and uniform nuclei of the tumor cells had finely granular chromatin and thin nuclear membrane. The cytologic diagnosis of a carcinoid was confirmed on histopathologic, immunohistochemical, and electromicroscopic examination of surgical specimen.
Adult ; Alleles* ; Biopsy, Fine-Needle ; Carcinoid Tumor ; Carotid Body ; Child* ; Chromatin ; Cytoplasm ; Diagnosis ; Female ; Humans ; Immunoglobulin A* ; Nuclear Envelope ; Paraganglioma ; Thorax ; Tomography, X-Ray Computed

PURPOSE: To report a case of cataract surgery in an epikeratophakia patient. CASE SUMMARY: A 59-year-old female with a history of epikeratophakic surgery 20 years ago complained of decreased visual acuity of both eyes for several months. She had nucleosclerotic and posterior subcapsular types of cataracts. Phacoemulsification and posterior capsule intraocular lens implantation were performed in both eyes. During surgery, corneal edema was especially prominent at the cornea with epikeratophakic lenticules in both eyes. In the left eye, severe corneal edema after one day of surgery was observed; however, after one week, corneal edema had subsided and visual acuity of both eyes had improved. CONCLUSIONS: When it necessary that cataract surgery is performed in patients with epikeratophakic lenticules, it is important to anticipate the corneal edema intraoperatively and postoperatively. Moreover, the surgeon should consider the acute calculation of the target refraction of intraocular lens in an epikeratophakia patient.
Cataract* ; Cornea ; Corneal Edema ; Epikeratophakia* ; Female ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Middle Aged ; Phacoemulsification ; Visual Acuity

Merkel cell carcinoma is a rare and lethal skin cancer that mostly occurs in aged persons who are over 60 years old as a dome-shaped purple nodule on the sun-exposed areas of the head, neck and extremities. The mortality rate is high because this tumor has a propensity for local recurrence, regional lymph node metastasis and distant metastasis. Therefore, rapid and precise diagnosis and staging are critical to improve the prognosis. We reported here on a 68-year old man with Merkel cell carcinoma on his right cheek and he had regional cervical lymph node metastasis, as was detected by PET-CT scanning.
Aged ; Carcinoma, Merkel Cell ; Cheek ; Electrons ; Extremities ; Head ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Skin Neoplasms

PURPOSE: This study compared tear meniscus parameters between normal control, aqueous tear deficient dry eye, and meibomein gland dysfunction groups using Fourier-domain optical coherence tomography (FD-OCT). METHODS: This study included 33 normal eyes, 79 aqueous tear-deficient dry eyes (ATD), and 48 meibomein gland dysfunction dry eyes (MGD). Following routine examination including Schirmer test, tear break-up time, corneal staining, and tear meniscus parameters such as tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were obtained using FD-OCT. The differences among groups were assessed. RESULTS: The averages of TMH, TMD, and TMA were 295.58 +/- 58.36 microm, 166.67 +/- 30.43 microm, and 0.0360 +/- 0.01100 mm2 in normal eyes, respectively, 226.43 +/- 42.18 microm, 147.44 +/- 38.38 microm, and 0.0209 +/- 0.01015 mm2 in ATD, respectively, 272.81 +/- 64.21 microm, 159.37 +/- 44.05 microm, and 0.0295 +/- 0.01271 mm2 in MGD, respectively. Tear meniscus parameters were significantly lower in ATD. Tear meniscus parameters in MGD were higher than ATD and lower than normal eyes, but the TMA was the only statistically significant value. CONCLUSIONS: Although tear meniscus parameters in MGD were higher than ATD, they could not be distinguished from normal eyes. Tear meniscus evaluation using FD-OCT could be a useful measurement system in classification and treatment choice for dry eye patients.
Classification ; Dry Eye Syndromes ; Humans ; Tears* ; Tomography, Optical Coherence*

PURPOSE: To report a case of carcinoma ex pleomorphic adenoma observed during the patient's first operation. CASE SUMMARY: A 63-year-old female presented with proptosis and ptosis that was aggravated 1 year prior. On preoperative CT image, a 32 x 20 x 21 mm-sized well demarcated mass (suspected as pleomorphic adenoma) was observed and was removed entirely by anterolateral orbitotomy. The excised mass surface was uneven but the capsule appeared intact on gross examination. Hard, yellow-colored and soft, dark-colored materials were found concurrently on cross section. The histological examination showed malignant cells as part of the soft material and was diagnosed as carcinoma ex pleomorphic adenoma. CONCLUSIONS: We report a case of carcinoma ex pleomorphic adenoma of the lacrimal gland that presented with malignant change during the patient's first operation. Supposedly, during the process of mass growth, minimal rupture occurred causing malignant transformation. Clinically, although a mass is believed benign based on imaging, the possibility of malignant transformation of a tumor increasing rapidly or enlargement causing development of rapid proptosis should be considered.
Adenoma, Pleomorphic* ; Exophthalmos ; Female ; Humans ; Lacrimal Apparatus ; Middle Aged ; Mixed Tumor, Malignant ; Rupture

The fourth author's name was misprinted.
Fibroblast Growth Factor 2* ; Humans ; Pilot Projects*

PURPOSE: There has been an increasing trend in the use of contralateral prophylactic mastectomy (CPM) among women diagnosed with unilateral breast cancer or mutations in BRCA1 or BRCA2 to reduce the occurrence of contralateral breast cancer. This study aimed to examine trends in the CPM rate according to clinicopathologic and socioeconomic status at a single institution in Korea. METHODS: This study included 128 patients with mutations in BRCA1 or BRCA2. Patients were divided into a CPM group (n = 8) and a non-CPM group (n = 120) between May 2013 and March 2016. The main outcome variables, including epidemiology, clinical features, socioeconomic status, and tumor characteristics, were analyzed. RESULTS: A total of 8 CPMs were performed among 128 patients. All CPM patients were married. The proportion of professional working women was higher in the CPM group (P = 0.049). Most patients who underwent CPM graduated college, compared to less than a third of the non-CPM group (P = 0.013). The CPM group had a higher rate of visits to the Hereditary Breast and Ovarian Cancer (HBOC) clinic (P = 0.021). The risk-reducing salpingo-oophorectomy (RRSO) rate was significantly higher in the CPM group (P < 0.01). CONCLUSION: CPM rates were significantly different according to socioeconomic status. The CPM rate tends to increase in highly educated and professional working women. The socioeconomic status of patients is an important factor in the decision to participate in the HBOC clinic and undergo CPM or RRSO.
Breast ; Breast Neoplasms ; Epidemiology ; Female ; Humans ; Korea ; Mastectomy ; Ovarian Neoplasms ; Social Class ; Unilateral Breast Neoplasms ; Women, Working

Purpose: Sleep-disordered breathing is one of the complicating characteristics in patients with Prader-Willi syndrome (PWS). No detailed description and risk factors are suggested on breathing problems during sleep in Korean children with PWS. Methods: We reviewed clinical and sleep-study data in patients with PWS who underwent polysomnography before they took the growth hormone therapy. Results: Of the 27 patients with PWS, 25 (92.6%) had sleep-disordered breathing, of whom 14 showed moderate to severe sleep apnea. Obstructive dominance was prevalent (64%), followed by central dominance (24%). The apnea-hypopnea index (AHI) increased with increasing weight-for-height z-score (WHZ) (r = 0.50, P = 0.009), but did not differ by age. Apnea duration of over 12 months was longer in the patient group than in the infant group (15.1 ± 4.3 seconds vs. 9.4 ± 1.7 seconds, P = 0.001) and in the obese than nonobese groups (16.8 ± 4.3 seconds vs. 10.0 ± 2.0 seconds, P = 0.003). Desaturation below 70% was more common in the obese than nonobese subjects (3/9 vs. 0/18, P = 0.029). Age was not different between the central and obstructive apnea groups, but patients with central apnea tended to be younger than patients with obstructive apnea (median [range]: 8.0 months [6.0–12.0 months] vs.16.5 months [8.5–79.5 months], P = 0.092). In addition, patients with obstructive apnea showed higher AHI (12.8 [5.9–19.2] vs. 3.9 [3.4–4.5], P = 0.045). Conclusion Sleep-disordered breathing is common in PWS children with different intensity and patterns according to age and BMI. Close monitoring of breathing problems during sleep is required in PWS patients.