A clinical analysis of vasospasm as seen angiographically after the onset of subarachnoid hemorrhage was carried out in 22 out of 4 cases of ruptured intracranial aneurysms experienced in our department from January, 1978 to May, 1979. The following results were obtained. The incidence of vasospasm was 50%. 2) Angiographic filling abnormalities(vasospasm) were morphologically classified into 4 types:tapering, diffuse, segmental and nodular types. 3) No significant difference was found in the location of the arteries with vasospasm in relation to the site of the ruptured aneurysm. In this study, the most frequent occurance of spasm was noted in cases of internal carotid aneurysm(69.2%). 4) Discrepancy in the incidence of angiographic spasm between the group with only one subarachnoid hemorrhage(41.9% out of 31 cases) and the other group with more than one hemorrhage(50% out of 44 cases) was demonstrated. While vasospasm occurred frequently within 9 days after the last hemorrhage in cases with more than two hemorrhage, the appearance of vasospasm was frequently seen angiographically between 10 to 17 days after hemorrhage in cases with only one hemorrhage. 5) There was no relationship between the age and the incidence of spasm, and most cases with spasm showed bloody and xanthochromic C.S.F. 6) Neurological findings were as follows:mental disturbance 12 cases, cranial nerve palsy 3 cases, paresis 3 cases, seizure 2 cases and visual disturbance 2 cases. These neurologic deficits may not be related to the spasm. 7) Follow up carotid angiography was performed in 9 cases of those treated by direct approach. Among 5 cases with vasospasm in preoperative angiogram, the spasm persited in 2 cases and was not no longer visualized in 3 cases. On the other hand, in 2 cases without preoperative spasm, postoperative spasm was detected. 8) Of 23 cases of ruptured aneurysms treated surgically(including 3 cases of carotid ligation), 2 out of 15 cases with spasm expired and all 8 cases without spasm were cured. 9) The diffuse type(using above classification) had the worst postoperative prognosis:i.e., among 9 cases with that type of spasm, 2 cases expired and one case resulted in a mild neurologic deficit. Other types of spasm had no special relationship with the postoperative prognosis.
Aneurysm, Ruptured ; Angiography ; Arteries ; Cranial Nerve Diseases ; Follow-Up Studies ; Hand ; Hemorrhage ; Incidence ; Intracranial Aneurysm* ; Neurologic Manifestations ; Paresis ; Prognosis* ; Seizures ; Spasm ; Subarachnoid Hemorrhage

PURPOSE: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. MATERIALS AND METHODS: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. RESULTS: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. CONCLUSION: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.
Arthritis ; Arthroscopy ; Contracture ; Debridement ; Elbow ; Follow-Up Studies ; Humans ; Joints ; Osteoarthritis ; Osteophyte ; Pathologic Processes ; Range of Motion, Articular ; Ulnar Nerve

Variable manifestations of neurofibromatosis are properly defined as a hereditary, harmatomatous disorder, probably of neural crest origin, involving not only neuroectoderm and mesoderm but also endoderm, with the potential of appearing in any organ system of the body. Recently, we have experienced 3 cases of neurofibromatosis, one case associated with glioblastoma multiforme in left frontal lobe, another case associated with multiple neurofibromas in thoracic region and cauda equina, the third case associated with retroperitoneal neurofibroma and dural ectasia.
Cauda Equina ; Dilatation, Pathologic ; Endoderm ; Frontal Lobe ; Glioblastoma ; Mesoderm ; Neural Crest ; Neural Plate ; Neurofibroma ; Neurofibromatoses*

An unusual case of meningioma with a large cyst on the sellar region which was misinterpreted to craniopharyngioma was reported. A 6-year-old boy was admitted to our hospital on May 8, 1980 because of headache, blurred vision and walking disturbance. On admission, neurological examination revealed marked diminished visual acuity associated with optic atrophy in both eyes, gait disturbances, incoordination and precocious puberty. Plain skull film showed marked digital markings and seperation of the coronal suture. Right carotid angiography in AP view revealed widening of the U-loop and space occupying lesion on the suprasellar region in lateral view. Neither detection of the tumor feeding artery nor tumor stain was seen. Conary ventriculography revealed marked dilation of the both lateral ventricles and blockage of the foramen of Monro. CT scan disclosed a well defined low density area and small multilobulated cysts in the suprasellar region. The margin of the tumor and low density area were markedly enhanced by contrast media. At operation, the tumor was found to consist of a yellowish brown nodule firmly adherent to the diaphragma sellae and a large cyst. The tumor was partially removed together with the whole cyst wall. The resected nodule was relatively hard and had multiple small cysts in it's cut surface. Postoperative course was uneventful. The neurological deficits except precocious puberty were much improved on discharge time. Reviewing the literature and the pathogenesis of cystic change in meningiomas were discussed.
Angiography ; Arteries ; Ataxia ; Central Nervous System Cysts* ; Cerebral Ventricles ; Child ; Contrast Media ; Craniopharyngioma* ; Gait ; Headache ; Humans ; Lateral Ventricles ; Male ; Meningioma* ; Neurologic Examination ; Optic Atrophy ; Puberty, Precocious ; Skull ; Sutures ; Tomography, X-Ray Computed ; Visual Acuity ; Walking

PURPOSE: Adiponectin is an adipocyte-derived plasma protein with various metabolic effects that include increasing insulin sensitivity, antiatherogenic, and antiinflammatory properties. The purpose of this study was to investigate the association of cord plasma adiponectin levels with body size, ponderal index, and gender in newborns and also age and body mass index in their mothers. METHODS: The cord blood was obtained from 99 healthy newborns (male 46, female 53, gestational age of 32-41 weeks) and the concentrations of adiponectin were analyzed by a radioimmunoassay kit. Anthropometric parameters of the newborns including birth weight and length were measured. Maternal weight and height were identified, and their body mass index was calculated. RESULTS: The cord plasma adiponectin levels of the newborns whose gestational age was longer than 39 weeks were significantly higher compared with those of gestational age shorter than 39 weeks (15.0+/-9.9 vs 8.4+/-8.9 microgram/mL, P=0.001). The cord plasma adiponectin concentrations were positively correlated with gestational age and length at birth of the newborns. There was no correlation between cord plasma adiponectin levels and sex, birth weight or ponderal index of the newborns. Any significant correlation was not found between cord plasma adiponectin levels and maternal age or body mass index. CONCLUSION: These findings indicate that cord plasma adiponectin concentrations are positively associated with gestational age and length at birth of neonates. However there is no correlation between cord plasma adiponectin levels and maternal age or body mass index.
Adiponectin* ; Birth Weight* ; Body Mass Index ; Body Size ; Female ; Fetal Blood* ; Gestational Age ; Humans ; Infant, Newborn* ; Insulin Resistance ; Maternal Age ; Mothers ; Parturition* ; Plasma ; Radioimmunoassay

OBJECTIVES: Children with attention-deficit hyperactivity disorder (ADHD) often have difficulties in social behavior. The aim of this study was to evaluate the effectiveness of a short-term training program for improving social skills, selfperception and attention deficits. METHODS: The subjects were nine children diagnosed with ADHD with (or without) other mental disorders using the Diagnostic Interview Schedule for Children (DISC-ADHD) module. Children were given eight sessions of a social skills training program. Parents of children simultaneously participated in their own training which was designed to support their children's generalization of skills. Assessments included child, parent and teacher ratings of social skills, self-perception and attention deficit at baseline and post-treatment. RESULTS: Social skills training led to significant improvements in child-reported measures of self-esteem, in teacherreported measures of social skills, and in parent-reported measures of attention deficit. CONCLUSION: This study suggests that short-term social skills training programs for children with ADHD may improve their social skills, self-perception and attention deficits.
Appointments and Schedules ; Child ; Generalization (Psychology) ; Humans ; Mental Disorders ; Parents ; Self Concept ; Social Behavior

To assess the validity of urine albumin concentration (UAC) and the urine albumin:creatine ratio (UACR) in a random urine specimen (RUS) for screening diabetic nephropathy in Korea, a total of 105 ambulatory diabetes mellitus patients (male:female, 52:53), ages 40-75 years (median 59 years) collected 105 RUSs after completing a timed 24 hour urine collection. Albumin was measured by immunonephelometry. According to the timed urinary albumin excretion rate (UAER) measured in the 24 hour collection (criterion standard), samples were classified normoalbuminuric (UAER < 20 micrograms/min; n = 50), microalbuminuric (UAER 20-200 micrograms/min; n = 30), and macroalbuminuric (UAER > 200 micrograms/min; n = 25). The receiver operating characteristics (ROC) curve of UAC and UACR in a RUS for screening of microalbuminuria (normo- and microalbuminuric samples; n = 80) and macroalbuminuria (micro- and macroalbuminuric samples; n = 55) were plotted. Pearson's coefficients of correlation of 24 hour UAER vs. UAC and UACR were 0.81 and 0.75, respectively (P < 0.001). The point of intersection with a 100%-to-100% diagonal for microalbuminuria were as follows: 31.0 mg/l for UAC and 32.5 mg/g for UACR; for macroalbuminuria 181 mg/l for UAC and 287.3 mg/g for UACR. The sensitivity and specificity of the cut-off points for microalbuminuria were 77% and 82% for UAC and 77% and 92% for UACR. The sensitivity and specificity of the cut-off points for macroalbuminuria were 84% and 90% for UAC and 88% and 90% for UACR. In present study, no difference was observed when comparing the performance of UAC and UACR based on a statistical comparison by McNemar test. The repeated measurements of UAC and UACR in the same individual were statistically similar and were correlated with each other. Based on these results, albumin measurements (UAC and UACR) in a RUS were considered as a valid test for screening diabetic nephropathy.
Adult ; Aged ; Aged, 80 and over ; Albuminuria/diagnosis* ; Diabetic Nephropathies/diagnosis* ; Female ; Human ; Male ; Middle Age

OBJECTIVE: Attention deficit hyperactivity disorder is known to be a disorder with high genetic trait. Recently the relationship between alleles frequency distribution and ADHD, has been actively researched. In Korea, the relationship between the genetic type and alleles for COMT (Catechol-O-methyltransferase) gene, has been studied in ADHD patients. METHODS: Thirty three patients diagnosed with ADHD according to the DSM-IV diagnostic criteria were selected for the study. The diagnosis and clinical features were confirmed by Korean version Child behavior check list, Korean version Conner's parent rating scale, Attention deficit Diagnostic System, Korean version Spielberger state-trait anxiety scale etc. For the control group, the parents of patients were chosen. Blood samples were taken from the 99 subjects. DNA was extracted from blood lymphocytes, PCR was performed for COMT NlaIII VNTR Polymorphism. Allele and genotype frequencies were compared using the Chi-square test. For the family-based analyses, we used the TDT and HHRR method. RESULTS AND CONCLUSION: In comparing the ADHD transmitted group and the not transmitted group, No significant difference was seen between the COMT genetic type and alleles distribution. As a result, it is viewed that there is not relationship between ADHD and the dopamine transporter gene, but final decision is indefinite. Follow up studies with larger patient or pure subgroups are expected.
Alleles ; Anxiety ; Attention Deficit Disorder with Hyperactivity ; Catechol O-Methyltransferase* ; Child ; Child Behavior ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Dopamine Plasma Membrane Transport Proteins ; Genotype ; Humans ; Korea ; Lymphocytes ; Parents ; Polymerase Chain Reaction

PURPOSE: We analyzed pelvic ultrasonography (USG) findings in girls with central precocious puberty (CPP) and assessed the role of uterine and ovarian measurements in discriminating between CPP and other pubertal conditions. METHODS: Seventy-four girls (chronological age 7.8 +/- 0.5 years, bone age 9.9 +/- 0.8 years) with precocious pubertal signs were enrolled. Measurements of uterine and ovarian parameters by pelvic USG included antero-posterior diameters of the uterine fundus and cervix, diameter of each ovary, number of follicles, and maximal diameter of the largest follicle. The pelvic USG parameters were compared between girls with CPP (n = 49) and girls with atypical premature thelarche (PT) (n = 25). RESULTS: Antero-posterior diameter of uterine fundus (1.05 +/- 0.34 vs. 0.74 +/- 0.78 cm, P = 0.001), maximal ovarian diameter (2.13 +/- 0.48 vs. 1.84 +/- 0.74 cm, P = 0.048) and mean ovarian area (2.31 +/- 0.79 vs. 1.69 +/- 0.71 cm, P = 0.002) were significantly greater in girls with CPP than in girls with atypical PT. For the diagnosis of CPP, the sensitivity and specificity of A-P diameter of uterine fundus (> 0.9 cm) was 65.3% and 84.0%, the sensitivity and specificity of maximal ovarian diameter (> 2.0 cm) was 55.1% and 76%, and the sensitivity and specificity of mean ovarian area (> 2.0 cm2) was 62.9% and 80.0%. CONCLUSION: Girls with CPP had significantly higher dimensions of the uterus and ovary measurements compared to girls with atypical PT, but sensitivity and specificity were not high enough to differentiate CPP from atypical PT. Pelvic USG may help the diagnosis of CPP in girls.
Sensitivity and Specificity

Recently the transcriptional up-regulation of human beta-defensin 2 (HBD-2) by lipopolysaccharide (LPS) was found to be associated with NF-kappaB binding site. Although the general mechanisms of NF-kappaB activation by LPS stimulation are well understood, less is known about the signal transduction pathway leading to LPS-induced NF-kappaB activation in human corneal epithelial (HCE) cells. The aim of this study was to investigate the intracellular signals involved in LPS-induced HBD-2 mRNA expression in HCE cells. Pretreatments of inhibitors for NF-kappaB, protein tyrosine kinase, p38 mitogen activated protein kinase (MAPK), and c-Jun N-terminal kinase (JNK) attenuated the LPS-induced NF-kappaB DNA binding activity and HBD-2 mRNA expression. Furthermore, pretreatments with inhibitors for protein kinase C (PKC), phosphatidylcholine-phospholipase C, phosphatidylinositol-phospholipase C, or phosphatidate phosphohydrolase prevented LPS-induced HBD-2 mRNA expression and HBD-2 prmoter-driven luciferase activity. However, the increased expression of HBD-2 mRNA and the increased DNA binding activity of NF-kappaB induced by LPS were not changed by the blockage of extracellular signal-regulated kinase (ERK) and of addition of antioxidants. Forskolin, a protein kinase A (PKA) agonist did not induce HBD-2 mRNA expression. These data demonstrate that LPS-induced HBD-2 mRNA expression via NF-kappaB is, at least in part, dependent on PKC, p38 MAPK, JNK, and protein tyrosine kinase status, but appears to be independent on PKA, ERK and ROS in HCE cells. Taken together, there may be more than one signaling pathways that lead to LPS-induced up-regulation of HBD-2 mRNA expression in HCE cells.
Antioxidants ; Binding Sites ; Colforsin ; Cyclic AMP-Dependent Protein Kinases ; DNA ; Epithelial Cells* ; Humans* ; JNK Mitogen-Activated Protein Kinases ; Luciferases ; NF-kappa B ; p38 Mitogen-Activated Protein Kinases ; Phosphatidate Phosphatase ; Phosphotransferases ; Protein Kinase C ; Protein Kinases ; Protein-Tyrosine Kinases ; RNA, Messenger* ; Signal Transduction ; Up-Regulation