Metronidazole-induced encephalopathy is a very rare complication of the long standing use of metronidazole. The encephalopathy is bilateral and symmetric in nature. We report on the magnetic resonance imaging (MRI) and clinical course of metronidazole-induced encephalopathy in a 60-year-old female with a persistent anaerobic brain abscess after draining of the abscess. After 3 months of metronidazole administration, the patient complained of dysarthria, tingling sense of all extremities, and left hemiparesis. MRI revealed symmetric hyperintensity lesions in medulla, pons, dentate nuclei of cerebellum, and splenium of corpus callosum, all of which represent typical findings of metronidazole-induced encephalopathy. In addition, asymmetric lesions in midbrain, thalamus, putamen and cerebral subcortical white matter were noted. The patient recovered after discontinuation of metronidazole and the remaining abscess was successfully treated with meropenem and levofloxacine.
Abscess ; Brain ; Brain Abscess ; Brain Diseases, Metabolic ; Cerebellum ; Corpus Callosum ; Dysarthria ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Metronidazole ; Middle Aged ; Ofloxacin ; Paresis ; Pons ; Putamen ; Thalamus ; Thienamycins

Peroneal neuropathy presenting at birth is a rare disorder. Although neonatal mononeuropathies may be related to obstetrical complications, prenatal mechanisms should be also considered. We describe an infant who was born at term by cesarean section due to breech presentation with a unilateral footdrop. Lack of compound muscle action potential in the peroneal nerve and denervation potentials confined to the tibialis anterior and the extensor hallucis longus muscles in the electrophysiological studies on the fourth day of life strongly suggest an isolated peroneal neuropathy of intrauterine onset. Early and sequential electrodiagnostic studies will be important to provide better temporal and pathophysiologic definitions, the better timing of onset and prognosis for mononeuropathies presenting in newborn infants.
Action Potentials ; Breech Presentation ; Cesarean Section ; Denervation ; Female ; Humans ; Infant ; Infant, Newborn ; Mononeuropathies ; Muscles ; Parturition ; Peroneal Nerve ; Peroneal Neuropathies* ; Pregnancy ; Prognosis

PURPOSE:We compared the blood chemistry concerning calcium metabolism and bone mineral density (BMD) among the infants fed on soy-based formula (SF), breast milk feeding (BF) and casein-based formula (CF). METHODS:Fifty one term neonates delivered at Chungbuk National University Hospital from June 2001 to August 2003, were recruited. They were divided into three feeding groups (BF=20, SF=19, CF=12) by parent's own volition. Breast feeding and artificial formulae were given till three months of age, thereafter weaning food was added freely. Blood chemistry including calcium, phosphorus, and alkaline phosphatase were measured at 5, 12, and 36 months of age. BMD was measured at birth, 5, 12, and 36 months of age. RESULTS:Serum calcium and alkaline phosphatase were not different among the three feeding groups until 36 months of age. At 5 months of age, serum phosphorus (P<0.05) and BMD (P<0.001) were significantly lower in SF group, but thereafter no difference was found in theses parameter until 36 months of age. After birth lumbar spine BMD decreased to the lowest level at 5 months and increased to the birth level at 36 months of age. CONCLUSION:In spite of high mineral intake in SF group, the lowest serum phosphorus and lumbar BMD at 5 months of age suggest poor intestinal mineral absorption. Methods need to be developed to increase intestinal mineral absorption.
Absorption ; Alkaline Phosphatase ; Bone Density ; Breast Feeding ; Calcium ; Humans ; Infant ; Infant, Newborn ; Milk, Human ; Parturition ; Phosphorus ; Soy Milk ; Spine ; Volition ; Weaning

Neurofibromatosis type I is one of the most common neurocutaneous syndrome which is inherited by autosomal dominant manner, characterized by cafe au-lait spots, axillary freckling, Lisch nodules in iris, multiple neurofibromas and bone involvement with pseudoarthrosis, bowing of the long bone. And Moyamoya disease is a specific disease characterized by progressive idiopathic stenosis and eventual occlusion of the large cerebral arteries at the circle of Willis. In response to the stenosis, an abnormal network of small collateral vessels develops, creating the "puff of smoke". Intracranial lesions associated with Neurofibromatosis type I include optic glioma, sphenoid wing dysplasia, "unidentified bright objects" and cerebrovascular lesions such as Moyamoya syndrome and aneurysm. Moyamoya syndrome is an uncommon association of neurofibromatosis type 1 and lung mass has not frequently been found with neurofibromatosis and moyamoya syndrome. We report a case with Neurofibromatosis type I with Moyamoya syndrome and ganglioneuroma in lung with reviewing literatures.
Aneurysm ; Cerebral Arteries ; Circle of Willis ; Constriction, Pathologic ; Ganglioneuroma ; Iris ; Lung ; Moyamoya Disease ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1 ; Optic Nerve Glioma ; Pseudarthrosis

Typhoid fever can cause serious complications, such as enterobrosia, meningitis, pneumonia, myocarditis, hepatitis, osteomyelitis, and disseminated intravascular coagulation in 10-15% of the patients. Kidney complications are very rare, and a few cases have been reported in children. We are reporting a case of childhood typhoid fever complicated with acute nephritis present with albuminuria, hypertension, and renal failure.
Albuminuria ; Child ; Disseminated Intravascular Coagulation ; Hepatitis ; Humans ; Hypertension ; Kidney ; Meningitis ; Myocarditis ; Nephritis* ; Osteomyelitis ; Pneumonia ; Renal Insufficiency ; Typhoid Fever*

PURPOSE: Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders. previous report have examined the neurologic problems both in ASD and ADHD. METHODS: We studied 49 children with ASD and 51 with ADHD who had visited our hospital's neuropsychiatric clinic from January 1999 to December 2008. We examined age, EEG abnormalities, developmental delays, and seizures in both groups. RESULTS: 1) The mean age of children diagnosed with ASD was 4 years while that for ADHD was 9 years (P=0.000). 2) The percentage of abnormal EEG in children with ASD was 54.5% and that for those with ADHD was 25.4% (P=0.027). 3) The percentage of developmental delays in children with ASD was 89.8% and that for those with ADHD was 39.2% (P=0.000). 4) The mean age of first seizure in children with ASD was 13 years and that for those with ADHD was 6 years (P=0.005). CONCLUSION: The percentage of abnormal EEG and developmental delay in children with ASD was more than in those with ADHD. The mean age of diagnosis in children with ASD was younger than in those with ADHD and the mean age of first seizure in children with ASD was older than in those with ADHD. The percentage children with ASD who exhibited normalized EEGs upon follow-up was greater than that for children with ADHD.
Attention Deficit Disorder with Hyperactivity ; Autistic Disorder ; Child ; Autism Spectrum Disorder ; Developmental Disabilities ; Electroencephalography ; Epilepsy ; Follow-Up Studies ; Humans ; Seizures

Epidermal nevi are benign congenital hamartomas derived from the embryonal ectoderm. They may also be associated with anomalies of musculoskeletal, nervous, ocular, and rarely cardiovascular and urogenital system in an epidermal nevus syndrome. To find out these abnormalities, careful history taking, thorough physical evaluation, and long-term follow-up are advisable in a patient with wide spread epidermal nevus. We report a case of diffuse epidermal nevi involving the scalp, face, trunk, and limbs in a newborn.
Ectoderm ; Extremities ; Hamartoma ; Humans ; Infant, Newborn* ; Nevus* ; Scalp ; Urogenital System

PURPOSE: Attention deficit hyperactivity disorder (ADHD) is a syndrome characterized by inattention, impulsive disruptive behavior, impaired concentration, and motor restlessness. This study examined the relationships among electroencephalographic (EEG) findings, stimulant use, and seizure occurrence in children with ADHD. METHODS: We retrospectively studied 308 children with ADHD who visited the neuropsychiatric clinic of our hospital from January 2001 to December 2005. We retrospectively analyzed age distribution, etiology, abnormal EEG findings, and use of CNS stimulants. Among these children, brain waves was recorded in 84 patients. RESULTS: Eighty-four children (72 males, 85.7%, 9.3 years mean age; 12 females, 14.3%, 8.0 years mean age) with ADHD had electroencephalograms (EEGs) performed at our institute. Nineteen patients (22.6%) demonstrated epileptiform abnormalities, and 65 (77.4%) demonstrated normal EEGs. Stimulant therapy was applied to 59 of 84 patients (70.2%). Seizures occurred in 1 of 65 patients with a normal EEG (incidence, 1.5%) and 3 of 19 treated patients with epileptiform EEGs (incidence, 15.7%). CONCLUSION: These data suggest that patients with normal EEGs have minor risk for seizure. In contrast, patients with epileptiform EEGs have higher risk for seizure than patients with normal EEGs.
Age Distribution ; Attention Deficit Disorder with Hyperactivity ; Brain ; Brain Waves ; Central Nervous System ; Central Nervous System Stimulants ; Child ; Electroencephalography ; Female ; Humans ; Male ; Methylphenidate ; Psychomotor Agitation ; Retrospective Studies ; Seizures

PURPOSE: To evaluate the utility of ceramic-on-polyethylene articular bearing surface when cementless total hip arthroplasty is performed in patients older than 65 years through an analysis of the minimum five-year follow-up results using the ceramic femoral head and cross-linked polyethylene liner. MATERIALS AND METHODS: From March 2010 to September 2012, 51 patients (56 hips) who were older than 65 years were enrolled in this retrospective study. The mean age at surgery was 70.9±5.1 years old. A clinical assessment was analyzed using the Harris hip score. For the radiographic assessment, the cup inclination and anteversion, stem alignment, and wear amount were measured. The postoperative complications were also determined. RESULTS: The mean Harris hip score was improved from preoperative 48 points to postoperative 87 points (p < 0.05). The mean cup inclination was 40.9°±6.4° and the mean cup anteversion was 20.3°±8.1°. The mean cup anteversion of the elevated liner-used group (16 cases) was 14.3°±7.9° and the mean cup anteversion of the neutral liner used group (40 cases) was 22.4°±9.1° (p < 0.05). The mean stem alignment angle was 0° (range, varus 4°–valgus 4°). The mean linear wear amount was 0.458±0.041 mm and the average annual linear wear rate was 0.079±0.032 mm/yr. Six cases (10.7%) of intraoperative periprosthetic femoral fractures were encountered. CONCLUSION: Based on these results, the use of a ceramic-on-polyethylene articular bearing surface in elderly patients with cementless total hip arthroplasty is beneficial. On the other hand, careful effort is needed to prevent intraoperative periprosthetic femoral fractures.
Aged ; Arthroplasty, Replacement, Hip* ; Ceramics* ; Femoral Fractures ; Follow-Up Studies* ; Hand ; Head* ; Hip ; Humans ; Polyethylene* ; Postoperative Complications ; Retrospective Studies

PURPOSE: The purpose of this study was to establish normative data for holistic health parameters in the general Korean population and to investigate the factor associated with ideal life expectancy (ILE) among these holistic health parameters and sociodemographic variables. METHODS: This study used a questionnaire to obtain self-reported physical, mental, social, spiritual, and general health status and then evaluated their association with ILE. A total of 1,241 individuals responded to the questionnaire, from which we established a multidimensional health status reference data set representing the Korean population. To explain factors associated with ILE, we stratified results by age and gender and performed multiple logistic regression of sociodemographic variables and multidimensional health status. RESULTS: Women reported poor health status more frequently for all five health categories. The average ILE was 87.46 years versus 84.42 years of life expectancy in the general Korean population. Single marital status, higher income, and better social health were significantly associated with higher ILE. CONCLUSION: ILE could be a good indicator reflecting social wellness in a certain society. Comprehensive social health promotion programs can improve individuals' attitudes toward life expectancy, especially for vulnerable groups.
Dataset ; Female ; Health Promotion ; Holistic Health ; Humans ; Korea ; Life Expectancy ; Logistic Models ; Marital Status ; Self Report ; Socioeconomic Factors