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

Simultaneous or subsequent bilateral thalamic hemorrhagic events have ranged from 12 to 19 in prior reports, with a time lag between bilateral thalamic hemorrhage of up to two days. Herein, we report the first case of delayed (17 days) consecutive contralateral thalamic hemorrhage after spontaneous first thalamic hemorrhage. A 65-year-old female initially presented with a drowsy mentality with a left-side motor weakness (grade II/III). Brain computed tomography (CT) demonstrated right side thalamic and intraventricular hemorrhage. She regained alertness with mild residual motor weakness (grade III/IV) under medical management. Seventeen days later, a sudden and generalized tonic-clonic seizure developed. Brain CT scans revealed a new contralateral thalamic hemorrhage coincident with microbleeds. Neurologic status remained unchanged, consisting of a stuporous mentality with quadriparesis of grade II/II. We report the first case of delayed consecutive contralateral thalamic hemorrhage up to 17 days after first thalamic hemorrhage. The case highlights the need for close monitoring of patients with thalamic hemorrhage who experience microbleeds on the contralateral side, due to the possibility of delayed hemorrhage.
Aged ; Brain ; Female ; Hemorrhage* ; Humans ; Hypertension ; Intracranial Hemorrhages ; Quadriplegia ; Seizures ; Stupor ; Thalamus ; Tomography, X-Ray Computed

Simultaneous or subsequent bilateral thalamic hemorrhagic events have ranged from 12 to 19 in prior reports, with a time lag between bilateral thalamic hemorrhage of up to two days. Herein, we report the first case of delayed (17 days) consecutive contralateral thalamic hemorrhage after spontaneous first thalamic hemorrhage. A 65-year-old female initially presented with a drowsy mentality with a left-side motor weakness (grade II/III). Brain computed tomography (CT) demonstrated right side thalamic and intraventricular hemorrhage. She regained alertness with mild residual motor weakness (grade III/IV) under medical management. Seventeen days later, a sudden and generalized tonic-clonic seizure developed. Brain CT scans revealed a new contralateral thalamic hemorrhage coincident with microbleeds. Neurologic status remained unchanged, consisting of a stuporous mentality with quadriparesis of grade II/II. We report the first case of delayed consecutive contralateral thalamic hemorrhage up to 17 days after first thalamic hemorrhage. The case highlights the need for close monitoring of patients with thalamic hemorrhage who experience microbleeds on the contralateral side, due to the possibility of delayed hemorrhage.
Aged ; Brain ; Female ; Hemorrhage* ; Humans ; Hypertension ; Intracranial Hemorrhages ; Quadriplegia ; Seizures ; Stupor ; Thalamus ; Tomography, X-Ray Computed

Endotracheal obstruction may cause serious complications, including cardiovascular instability, pneumothorax, pulmonary edema and even brain death. A 21-year-old man was scheduled to undergo an open reduction for an orbital fracture. The patient had tracheostomy with an 8.0 mm tracheostomy tube 3 weeks ago and was breathing well spontaneously. When the cuff of tracheostomy tube was inflated for assisted manual ventilation and the induction of anesthesia, signs of partial endotracheal obstruction were observed, including high airway pressure, low tidal volume and high ETCO2. Large dried mucous plug was impacted in the tracheostomy tube. After removing this plug with a sterile surgical forcep, effective ventilation was recovered without complications. The case like this nearly fatal obstruction by large dried mucous plug was rarely reported, but it should be considered cautiously when a patient uses tracheostomy tube as an airway before general anesthesia.
Airway Obstruction ; Anesthesia ; Anesthesia, General ; Brain Death ; Humans ; Orbital Fractures ; Pneumothorax ; Pulmonary Edema ; Respiration ; Surgical Instruments ; Tidal Volume ; Tracheostomy ; Ventilation ; Young Adult

To expand the epidemiological understanding of Newcastle disease in Jeju Province, Korea, active surveillance was extensively performed through a virological examination for poultry farms and wild birds in Jeju Province during 2007~2008. Samples (swabs or fresh feces) were collected from a total of 6,485 birds including 6,405 domestic birds (chickens, ducks, pheasants, geese, quails, turkeys, and ostriches) and 80 wild birds. A total of 24 hemagglutinating agents were isolated from domestic birds on fourteen farms including five Korean native chicken, one layer chicken, two broiler chicken, four duck and two pheasant farms. The hemagglutinating agents were all identified as lentogenic NDV based on the reverse transcriptase polymerase chain reaction, sequence analysis of amino acids on the F cleavage site and mean death time in chicken embryos. The F gene-based phylogenetic analysis revealed that the NDV isolates were classified into genotypes 1 or 2 of class II. These lentogenic viruses were closely related to NDV vaccine strains used in Jeju Province. Active surveillance conducted for Newcastle disease indicates no scientific evidence of virulent NDV infection in chickens in Jeju Province, Korea since 2005.
Amino Acids ; Animals ; Birds ; Chickens ; Ducks ; Embryonic Structures ; Geese ; Genotype ; Korea ; Newcastle Disease ; Newcastle disease virus ; Poultry ; Quail ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis ; Turkeys

CD20 positive T cell lymphoma is a rare condition that is associated with the coexpressions of CD20 and T cell markers, such as, CD3, CD5, or UCHL-1. Positivity for CD20 in this tumor represents an aberrant immunophenotype, but the presence of monoclonal T cell receptor (TCR) gene rearrangements and negativity for immunoglobulin heavy chain gene rearrangement indicate that this tumor is a T cell lymphoma. The majority of cases of CD20 positive T cell lymphoma have been reported as immature peripheral T cell lymphoma not otherwise specified. However, we believe that this disease is likely to be re-listed as a new disease entity after its pathogenesis has been elucidated and more cases have been evaluated. Here, we present a case of peripheral T cell lymphoma coexpressing CD20 and T cell markers with a demonstrable TCR gene rearrangement, in a patient who had been misdiagnosed as having B cell type lymphoma 4 years previously. We hypothesize that in this case initially circulating normal CD20+ T cell subsets underwent neoplastic transformation and CD20 positive T cell lymphoma subsequently developed in the lymph node, and then recurred in the skin due to systemic disease or metastasized from the nodal disease.
Gene Rearrangement ; Genes, T-Cell Receptor ; Humans ; Immunoglobulin Heavy Chains ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Receptors, Antigen, T-Cell ; Skin ; T-Lymphocyte Subsets

Avian metapneumovirus (AMPV) is an emerging pathogen causing respiratory and reproductive illness in poultry worldwide. To demonstrate the presence of AMPV in domestic chickens in Korea, we attempted to isolate AMPV from affected chickens. A cytopathic agent was isolated using chicken tracheal ring culture from dead chickens from a broiler breeder farm with reduced egg production in Korea. This agent, termed SC1509 strain, subsequently passed in Vero cells with distinct cytopathic effects. The SC1509 strain was confirmed as avian metapneumovirus (AMPV) using both RT-PCR test and monoclonal antibody-based immunofluorescence assay. Sequence analysis based on the G glycoprotein revealed that the SC1509 strain had 22.5 to 96.0% nucleotide sequence identity and 11.1 to 92.7% predicted amino acid sequence identity with previously published AMPV strains, particularly with the highest sequence homology (95.8 to 96% for nucleotides and 92.2 to 92.7% for amino acids) to European strains belonging to genotype B. The SC1509 strain was phylogenetically clustered with genotype B viruses, confirming that the SC1509 strain belongs to genotype B. This is the first report of genotype B avian metapneumovirus from chickens in Korea.
Amino Acid Sequence ; Base Sequence ; Chickens ; Fluorescent Antibody Technique ; Genotype ; Glycoproteins ; GTP-Binding Proteins ; Herpesvirus 1, Cercopithecine ; Korea ; Metapneumovirus ; Nucleotides ; Ovum ; Poultry ; Sequence Analysis ; Sequence Homology ; Sprains and Strains ; Vero Cells

Among the four-hundred patients with cerebral aneurysms confirmed by cerebral angiography, we divided them into two age groups, one with ages 39 years or younger(young-aged group: 51 patients, 12.8%), and another with ages 65 years or older(old aged group: 45 patients, 11.3%). A comparison was undertaken in regard to clinical characteristics and overall outcome in two groups. In young-aged group, the female-to-male ratio was 2.2: 1 whereas, women was predominant by five times more in old aged group. Anterior communicating artery aneurysm was the most common site(43.1%) in young-aged group, unlike to old aged group where posterior communicating artery was the most common site(33.3%). The most common symptom was headache in both groups, and the hypertension was more frequent in young-aged group(45.5%) than old-aged group(33.3%). Surgery was performed in 43 patients(84%) in younger group, and 37 patients(82.2%) in elderly group. Young-aged group showed more favorable outcome(91%) than old-aged group(70%).
Aged ; Arteries ; Cerebral Angiography ; Female ; Headache ; Humans ; Hypertension ; Intracranial Aneurysm* ; Prognosis

Xanthogranulomatous cholecystitis is an uncommon inflammatory disease of the gall baldder characterised by a focal or diffuse destructive inflammatory process. The pathogenesis is uncertain, but an inflammatory response to extravasated bile due to acute inflammation and obstruction is likely. Macroscopically, the gall bladder wall is invariably thickened, and extensive adhesions to adjacent organs are frequent. Clinically, xanthogranulomatous cholecystitis can mimic gall bladder carcinoma and radiologic differential diagnosis is extremely difficult. Fistula to skin and duodenum was reported. We report the first case of cholecysto-colonic fistula due to xanthogranulomatous cholecystitis.
Bile ; Cholecystitis* ; Diagnosis, Differential ; Duodenum ; Fistula* ; Inflammation ; Skin ; Urinary Bladder