No abstract available.
Osteoma

Tuberous sclerosis is a rare heredofamilial disease involving multiple organs, classically associated with the clinical triad of adenoma sebaceum, epilepsy, and mental retardation. We have recently experienced a case of tuberous sclerosis, 18-year-old male patient, who had typical adenoma sebaceum and generalized epileptic seizure. Plain skull film showed multiple calcified paraventricular subependymal nodules and brain CT scan disclosed characteristic calcified tubers adjacent to the frontal horn and body of the lateral ventricle.
Adolescent ; Animals ; Brain ; Epilepsy ; Horns ; Humans ; Intellectual Disability ; Lateral Ventricles ; Male ; Skull ; Tomography, X-Ray Computed ; Tuberous Sclerosis*

Twenty three consecutive patients admitted to our department with the suspicion of juxtasellar tumor were subjected to computed tomographic examinations. The diagnostic accuracy of CT scan was compared to that of plain skull x-ray, carotid angiography, and pneumoencephalography. The characteristic CT findings of pituitary tumors, carniopharyngiomas and parasellar meningiomas were observed, including their contrast enhancement patterns. In pituitary adenomas, the author evaluated the enlargement of the sella turcica by calculating the sella turcica size index with the use of measured interclinoid distance on CT Polaroid pictures. The results were as following: 1) CT gave the highest accuracy of various diagnostic tools, indicating that CT has become the screening method of choice in the detection of juxtasellar masses along with its another advantage of noninvasiveness. 2) Pituitary adenomas showed significant enlargement of the sella turcica according to the author's sella turcica size index. Size index above 2.5 was thought to have to be interpreted as an abnormally enlaged sella turcica. 3) Suprasellar cistern was visualized in 87% of 23 normal CT scans as a pentagone(48%) or a hexagone(43%) or a tetragone(9%), but it was identified only in 51% of supratentorial mass lesions. 4) Pituitary adenomas invariably showed positive contrast enhancement(100%), but rarely contained calcification(10%) or dilatation of ventricles(8%). 5) Craniopharyngiomas generally contained large dense calcifications or partly calcified peripheral ring(83%) and cyst formation(83%). Contrast enhancement(67%) and hydrocephalus(50%) were often found, but enlargement of the sella turcica was unusual(3%). 6) As compared to the tendency of anterolateral growth in pituitary adenomas, craniopharyngiomas were often found to extend posterosuperiorly. 7) It was advantageous to perform the operation at the side of predominant location of the tumor in suprasellar cistern or at the side of the cystic portion of the tumor. 8) A case of hypothalamic glioma was operatively verified that appeared as an isodense suprasellar mass, showing marked contrast enhancement.
Angiography ; Craniopharyngioma ; Dilatation ; Glioma ; Humans ; Mass Screening ; Meningioma ; Pituitary Neoplasms ; Pneumoencephalography ; Sella Turcica ; Skull ; Tomography, X-Ray Computed

A nursing activity classification for hospitalized patients was performed based on an article review regarding nursing definition and nursing activity classification system. The study was conducted as follows: 1) Taxonomy was developed by the research team through the Delphi process and review article. The taxonomy consists of four nursing processes, (assessment, diagnosis, intervention and evaluation) and twelve nursing activity domains space (resperation, nutrition, elimination, exercise/alignment maintenance, comfort, hygiene, safety, spiritual support, counseling/ education, medication, communication, patient and information management). 2) First, nursing activities of the intervention process were listed and then classified by the nursing process of assessment, diagnosis, intervention and evaluation. The list consists of twelve nursing activity domains and 136 nursing activities. 3) A pilot study was conducted in two hospitals to verify validity and appropriateness of nursing activities. 4) The content validity index, which was calculated by 6 clinical practice experts, was 0.95. Also, a nursing activity classification system should also be developed in the department of community nursing and home health care nursing.
Classification* ; Diagnosis ; Education ; Home Health Nursing ; Humans ; Hygiene ; Korea* ; Nursing Process ; Nursing* ; Pilot Projects

OBJECTIVE: To review recurrence and prognosis of microivasive squamous cell carcinoma of the cervix that are associated with depth of invasion, pathologic finding and management(conservative or radical treatment) STUDY DESIGN: We conducted retrospective study in order to evaluate the results of therapeutic approaches in 46 patients with microinvasive cervical cancer from Jan 1987 to Oct 1996. RESULT: The mean age of patients was 44.6+ 8.86 years. Only one woman was nullipara, and the mean parity was 2.8, Overall diagnostic accuracy of pap smear and punch biopsy were 54.3% and 79.4%. As the depth of invasion was deeper, the diagnostic accuracy of punch biopsy increased(p<0.05), The confluence pattern and lymphovascular space involvement were observed in 39.1% and 4.9%. The confluence pattern was observed with statistical significant in advanced depth of stromal invasion. In the surgical management, vaginal hysterectomy was done in 28 patients, conization(l patient), total abdominal hysterectomy(8 patients) and radical hysterectomy with pelvic lymph node dissection(9 patients) was done, no positive node was in 104 pelvic lymph node dissected. Though all cone margin was free and all endocervical curettage was negative, residual lesion(2 patients) was present in the hysterectomy after conization, The median follow-up period was 64 months. There was no recurrence in all cases and 5 years survival rate was 100% CONCLUSION: We suggest that microinvasive carcinoma of the cervix may be the disease of good prognosis and no recurrence, and less radical therapy for the patients with microinvasive carcinoma may be sufficient.
Biopsy ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Conization ; Curettage ; Diagnosis* ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Lymph Nodes ; Parity ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms

BACKGROUND: Korea is an endemic area of viral hepatitis B with a rate of 5~10% carrier state. Therefore, hepatitis B vaccination is performed nationwide. But 5~15% of healthy individuals fail to respond adequately to the vaccine and an approved guideline for the nonresponders has not been developed yet. This study is designed to identify risk factors for those who lack anti-HBs after hepatitis B vaccination and to document the results of a double-dose revaccination in such nonresponders to the primary vaccination. METHODS: From Feb. 1996 to Aug, 1997, we assessed 51 healthy subjects(HBs Ag negative, anti-HBs negative, anti-HBc negative and a normal LFT). All subjects were vaccinated with Hepavax- B, 1.0ml, 24 by a rapid schedule(0, 1, and 2 months) and 27 by a standard schedule(0, 1, and 6 months). Anti-HBs titers were evaluated 3 months after the third vaccine and assessed the nonre-sponders (anti-HBs titer<2mIu/ml) and the hyporesponders(2~10mK/ml). All 13 nonresponders were revaccinated with 2ml of Hepavax-B 3 months after the primary vaccination. Anti-HBs titers were evaluated 1 month later. RESULTS: The differences in age(p<0.01) and smoking amount(p<0.05) between the responders and the hypo and the nonresponders were statistically significant. There were more males and higher body mass index in the hypo and the nonresponders but not statistically significant. The seroconversion rate after the double-dose vaccination was 92.3%(12/13) with an average titer of 5K08mlU/ ml(1-132.4mIU/ml). CONCLUSIONS: Increase in age and smoking amount were the risk factors of the nonresponders after the primary vaccination. Most of the hypo and the nonresponders to the primary vaccination responded adequately to the double-dose revaccination.
Body Mass Index ; Carrier State ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization, Secondary* ; Korea ; Male ; Risk Factors* ; Smoke ; Smoking ; Vaccination

PURPOSE: Attention Deficit Hyperactivity Disorder (ADHD) is known to be more common in children with epilepsy than in the general population. Thirty one to forty percent of ADHD is accompanied with epilepsy. Few studies regarding this matter have been reported in Korea. This study was aimed to evaluate the comorbidity of ADHD in children with epilepsy. METHODS: This is a two center based, retrospective and controlled study. Thirty four ADHD children with epilepsy from Chungbuk National University hospital and 38 ADHD children without epilepsy from Cheonju St. Mary's hospital were recruited from January 2005 to June 2010. RESULTS: In ADHD children with epilepsy, twelve (35.2%) had partial seizures, 11 (32.2%) did generalized seizures and 11 (32.2%) were unclassified. EEG abnormalities were found in the frontal lobe (15 cases), in the central lobe (7 cases), in the temporal lobe (6 cases), and in the occipital lobe (3 cases). In ADHD children with epilepsy, the combined type was major (76.4%) and in ADHD children without epilepsy, the inattentive type was major (50.5%) (P=0.004). Learning disability was mor common in ADHD with epilepsy than in ADHD without epilepsy (P=0.01). CONCLUSION: This study showed that ADHD children with epilepsy are more likely to have combined type (76.4%) and learning disability as compared with ADHD without epilepsy.
Attention Deficit Disorder with Hyperactivity ; Child ; Comorbidity ; Electroencephalography ; Epilepsy ; Frontal Lobe ; Humans ; Korea ; Learning Disorders ; Occipital Lobe ; Retrospective Studies ; Seizures ; Temporal Lobe

Infantile onset diabetes mellitus(especially, neonatal diabetes) is rare disorder and may be transient or permanent. Most patients are full-term but small-for-date infants and typical symptoms occur within the first 4-6 weeks of life, requiring insulin therapy. Neonatal diabetes differs from type 1 diabetes in many aspects and seems to form a distinct entity of inborn pancreatic malfunction. The transient cases often develop type 2 diabetes mellitus later in life. In recent reports, transient neonatal diabetes is associated with paternal uniparental isodisomy and unbalanced duplication of chromosome 6q22-23. In our study, clinical course of case 1 was compatible with transient neonatal diabetes, but chromosomal abnormalities such as above was not shown in DNA analysis. In case 2 and 3, we could not decide exactly on genetic basis.
Chromosome Aberrations ; Diabetes Mellitus, Type 1* ; Diabetes Mellitus, Type 2 ; DNA ; Genomic Imprinting* ; Humans ; Infant ; Insulin ; Uniparental Disomy

A case of anencephaly associatied with twin pregnancy that delivered by primary lo-wer flap transverse cesarean section at 35-weeks of gestation is presented with brief revi-ew of literatures.
Anencephaly* ; Cesarean Section ; Female ; Humans ; Pregnancy ; Pregnancy, Twin*

Authors report the clinical study on the usefulness of thyrotropin-releasing hormone tartrate(TRH-T) in the treatment of mild disturbance of consciousness. 20 patients suffering head trauma, subarachnoid hemorrhage, and intracerebral hemorrhage were given TRH-T intravenously for ten days. TRH-T was effective for the patients in whom the consciousness disturbance was mild, the duration in fixed consciousness level was short, and the brain was not distorted on CT scan. These features were most prominent in patients with subarachnoid hemorrhage. Three was no significant side effect, and TRH-T turned out to be safe.
Brain ; Cerebral Hemorrhage ; Consciousness* ; Craniocerebral Trauma ; Humans ; Subarachnoid Hemorrhage ; Thyrotropin-Releasing Hormone ; Tomography, X-Ray Computed