No abstract available.
Heart Diseases* ; Heart*

We experienced a case of late infantile Batten's disease in a 4-year-7-month-old boy who was admitted to child neurology service of Kangnam St. Mary's hospital for evaluation of progressive psychomotor deterioration. He was in quite normal state of development until 3 years of age when his mother first became concerned because he showed such emotional change as crying and fear, Since then he acted strange and major motor milestones were progressively deteriorated, and eventually he was unable to walk and run at 4 years of age. At that time the patient began to have seizure and it was described as jerking movements of both arms simultaneously and generalized tonic clonic movements of upper and lower extremities. Denver developmental examination revealed a severe retardation in all his developmental milestones. On admission he has definitely mentally retarded, he had no speech and his vision was impaired. He had noted bilateral nystagmus. Fundi revealed pale sharp disc, dark degeneration of macula and marked attenuated retinal arterioles. Brain CT showed mild cortical atrophy. EEG showed paroxysmal burst spikes and slow waves which was compatible with myoclonic seizures. AEP and needle EMG studies were normal. A diagnosis of Batten's disease was made on the basis of brain biopsy which showed ballooning of the large neurons, granular lipopigment bodies in cytoplasm, bright fluorescence cytoplasmic granules under UV light and numerous dense bodies on EM finding. He died at the age of 12 years due to pneumonia.
Arm ; Arterioles ; Atrophy ; Biopsy ; Brain ; Child ; Crying ; Cytoplasm ; Cytoplasmic Granules ; Diagnosis ; Electroencephalography ; Fluorescence ; Humans ; Lower Extremity ; Male ; Mentally Disabled Persons ; Mothers ; Needles ; Neurology ; Neurons ; Pneumonia ; Retinaldehyde ; Seizures ; Ultraviolet Rays

Percutaneous vertebroplasty is a relatively recent procedure in the treatment of osteoporotic vertebral compression fractures. Bone cement embolism is a severe and potentially life-threatening complication of percutaneous vertebroplasty with cement. The risk for cement pulmonary embolism ranges between 3.5 and 23% for osteoporotic fractures. Bone cement leakage may be usually more frequent with vertebroplasty than with kyphoplasty. We experienced a 69-year-old female patient of an asymptomatic pulmonary embolus (length 8 cm) after kyphoplasty for an osteoporotic vertebral compression fracture
Aged ; Embolism ; Female ; Fractures, Compression ; Humans ; Kyphoplasty ; Osteoporotic Fractures ; Pulmonary Embolism ; Vertebroplasty

Purpose: The purpose of this pilot study was to assess the feasibility of a proposed study “To investigate the effects of applying a vibration stimulation to the paretic and non-paretic sides on balance and gait in stroke patients” before proceeding with the main study. Methods: A total of 30 patients who had suffered a stroke and who met the selection criteria participated in this study. However, only 14 patients completed the study. The study subjects were randomly assigned to vibration stimulation on either both sides (B group) or the paralyzed side (P group). The interventions were applied for six weeks. The patients were assessed using the Berg balance scale (BBS), Timed up and go (TUG), 10-meter walk (10 MW), and 6-minute walk (6 MW) tests. Results: There was a significant difference before and after the application of vibration stimulation in the BBS, TUG, 10MW, and 6 MW tests in the B group (p < 0.05). Similarly, there was also a significant difference observed in the 10 MW and 6 MW tests in the P group (p < 0.05). The difference between the two groups was not significant in the BBS, TUG, 10 MW, and 6 MW tests (p > 0.05). Conclusion This pilot study suggests that it would be feasible to conduct a large-scale randomized controlled trial (RCT) to examine the effects of applying a vibration stimulation to the paretic and non-paretic sides, on the balance and gait in stroke patients.

PURPOSE: To evaluate useful findings and diagnostic value of TI-201 thyroid scan in differentiating benign from malignant nodules. MATERIAL AND METHOD: We studied 77 cold thyroid nodules proven histologically(27 malignat and 50 benign). Early (5--15rain) and delayed images(3--5hours) were obtained after intravenous injection of thallium 201. In these nodules, we retrospectively analyzed the degree of TI-201 uptake in early and delayed images, histopathologic type, size, and presence or absence of cystic change in the sonograms of 22 malignant nodules. RESULTS: Useful finding for diagnosis of malignant nodules was strong uptake of TI-201 in early and delayed images(specificity:98%, sensitivity:63%, positive predictive value:94.4%). Useful finding for benign nodules was no uptake of TI-201 in delayed image(specificity :88.9%, sensitivity :68%, positive predictive value :91.9%). The accuracy of TI-201 thyroid scan in differentiating benign from malignant nodules was 66.2%. The nodules with strong TI-201 uptake in early image and low TI-201 uptake in delayed image were malignant in 29.4%. Cystic changes were found in 40% of malignant nodules with atypical TI-201 uptake. TI-201 thyroid scan showed high specificity in follicutar neoplasm and adenomatous goiter in which differentiation of benignancy and malignancy is difficult with only cytologic examination. CONCLUSION: We consider that TI-201 thyroid scan is valuable in differentiating benign from malignant nodules and when combined with fine needle aspiration and ultrasound examination, it will enable more accurate differential diagnosis between benign and malignant thyroid nodules.
Biopsy, Fine-Needle ; Diagnosis ; Diagnosis, Differential* ; Goiter ; Injections, Intravenous ; Retrospective Studies ; Sensitivity and Specificity ; Thallium* ; Thyroid Gland* ; Thyroid Nodule ; Ultrasonography

Choledochocele is a rare cystic dilatation of the distal common bile duct in the wall of the duodenum. It is a type III choledochal cyst among the five types according to Todani's modification of the Alonso-Lej classification, and this type lll cyst comprises less than 4% of all choledochal cysts. We experienced one case of choledochocele in a 41-year-old woman who presented with recurrent pancreatitis, and we report on this case, along with a review of the literature.
Adult ; Choledochal Cyst ; Common Bile Duct ; Dilatation ; Duodenum ; Female ; Humans ; Pancreatitis

OBJECTIVE: To clarify the relationship of skin temperature changes to clinical, radiologic, and electrophysiological findings in unilateral lumbosacral radiculopathy and to delineate the possible temperature-change mechanisms involved. METHODS: One hundred and one patients who had clinical symptoms and for whom there were physical findings suggestive or indicative of unilateral lumbosacral radiculopathy, along with 27 normal controls, were selected for the study, and the thermal-pattern results of digital infrared thermographic imaging (DITI) performed on the back and lower extremities were analyzed. Local temperatures were assessed by comparing the mean temperature differences (DeltaT) in 30 regions of interest (ROIs), and abnormal thermal patterns were divided into seven regions. To aid the diagnosis of radiculopathy, magnetic resonance imaging (MRI) and electrophysiological tests were also carried out. RESULTS: The incidence of disc herniation on MRI was 86%; 43% of patients showed electrophysiological abnormalities. On DITI, 97% of the patients showed abnormal DeltaT in at least one of the 30 ROIs, and 79% showed hypothermia on the involved side. Seventy-eight percent of the patients also showed abnormal thermal patterns in at least one of the seven regions. Patients who had motor weakness or lateral-type disc herniation showed some correlations with abnormal DITI findings. However, neither pain severity nor other physical or electrophysiological findings were related to the DITI findings. CONCLUSION: Skin temperature change following lumbosacral radiculopathy was related to some clinical and MRI findings, suggesting muscle atrophy. DITI, despite its limitations, might be useful as a complementary tool in the diagnosis of unilateral lumbosacral radiculopathy.
Electrodiagnosis ; Humans ; Hypothermia ; Incidence ; Lower Extremity ; Magnetic Resonance Imaging ; Muscular Atrophy ; Radiculopathy ; Skin ; Skin Temperature ; Thermography

PURPOSE: The purposes of this study were to evaluate the plain radiologic findings of the childhood intussusception and to evaluate the role of plain abdominal films in predicting the success of air or barium reduction. SUBJECTS AND METHODS: We retrospectively reviewed 140 cases with the diagnosis of intussusception in children. The radiological signs that included soft tissue mass, dilatation of small bowel suggesting obstruction, crescent sign, and target sign were evaluated in terms of frequency. The relationship between radiological findings and outcome of reduction was analyzed. The site of soft tissue mass or crescent sign seen on plain radiographs was correlated with the position of the apex of the intussusceptum seen at the beginning of barium enema. The degree of dilated small bowel was evaluated by calculating the proportion of air-filled small bowel occupying peritoneal cavity and measuring the maximal diameter of dilated bowel lumen. The radiological finding for small bowel obstruction is determined by observation of the degree of small bowel dilatation and/or air-fulid levels. RESULTS: Ninety-two cases out of 140 showed one or more radiographic signs. Two most common signs were soft tissue mass and small bowel obstruction. The success rate of air or barium reduction was significantly lower in patients with most severe degree of dilatation of small bowel and/or more than 7 air-fulid levels on erect view. The suspected location of intussusception on plain radiographs correlated well with the true location of intussusception seen in the first few seconds of barium reduction. CONCLUSION: Plain abdominal radiography is useful in the diagnosis of intussusception and provides helpful informations for the reduction procedure as well as for the exclusion of the contraindications such as bowel perforation.
Barium ; Child ; Diagnosis ; Dilatation ; Enema ; Humans ; Intussusception* ; Peritoneal Cavity ; Radiography, Abdominal ; Retrospective Studies

PURPOSE: Heart rate variability (HRV) is a tool used to measure autonomic nervous function; however, there is no evidence that it can be used to define sympathetic hyperactivity in men with lower urinary tract symptoms (LUTS). We suspected that LUTS would differ between sympathetic hyperactive and hypoactive patients. Therefore, we measured HRV and divided the LUTS patients into two groups, a sympathetic hyperactive group and a sympathetic hypoactive group according to the low frequency/high frequency (LF/HF) ratio and made clinical comparisons between the groups. METHODS: A total of 43 patients with symptomatic LUTS (International Prostate Symptom Score [IPSS] over 8) and 49 healthy volunteers were enrolled. No subjects had diseases that could affect the autonomic nervous system, such as diabetes or hypertension. Electrocardiographic signals were obtained from subjects in the resting state and HRV indexes were calculated with spectral analyses. We divided the LUTS patients into two groups by an LF/HF ratio of 1.9, which was the median value in the healthy volunteers, and compared the differences in clinical characteristics, IPSS, prostate-specific antigen (PSA), and transrectal ultrasound (TRUS) results. The parameters were compared by independent sample t-test by use of SPSS ver. 19. RESULTS: There were no significant differences in age, serum PSA, or volume of the prostate between the 2 LUTS groups. However, analyzing IPSS questionnaires between two groups showed that there were significant differences in mean of Q2 score (frequency) and storage symptom score ([Q2+Q4+Q7]/3) (P<0.05). CONCLUSIONS: We suggest that an imbalance of autonomic nervous system activity may be a factor that evokes varieties of symptoms in men with LUTS. LUTS patients with hypoactive sympathetic tone may suffer from frequency and storage symptoms.
Autonomic Nervous System ; Electrocardiography ; Heart Rate ; Humans ; Hypertension ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia

We experienced a case of glycogen storage disease(type Iia) in a 11 months old girl who was admitted to Pediatric service of Kangnam St. Mary's hospital for work-up of flaccidity and developmental delay. The baby was relatively well until 3 months ol age when she began to have poor sucking and swallowing, and also her crying was weak. The patient has been markedly behind in all her developmental milestones and revealed hypotonia uhich was apparent on ventral and vertical suspensions. The chest X-ray film showed cardiomegaly, and echocardiography was done twice to get a diagnosis of hypertrophic cardiomyopathy. ECG showed biventricular hypertrophy. The brain CT showed no abnormality. Needle EMG showed fibrillation and positive sharp waves typical of a myopathy. Total CPK was 349 IU/L with an increase in fraction of MM band. Light and electronmicroscopic findings of muscle biopsy were compatible with Pompe's disease of infantile type.
Biopsy ; Brain ; Cardiomegaly ; Cardiomyopathy, Hypertrophic ; Crying ; Deglutition ; Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Glycogen Storage Disease Type II ; Glycogen Storage Disease* ; Glycogen* ; Humans ; Hypertrophy ; Infant ; Muscle Hypotonia ; Muscular Diseases ; Needles ; Suspensions ; Thorax ; X-Ray Film