No abstract available.
Child* ; Dehydration* ; Humans

Isolated acute monoarticular septic arthritis of the sternoclavicular joint is a extremely rare disorder, and is usually associated with predisposing factors such as contiguous foci of infection, heroin addiction, rheumatoid arthritis, diabetes mellitus and maintenance hemodialysis. This case occurred in healthy adult. The etiological agent was staphylococcus aureus. Good result wads achieved by applying appropriate antibiotic therapy combined with an adequate drainage.
Adult ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Causality ; Diabetes Mellitus ; Drainage ; Heroin Dependence ; Humans ; Renal Dialysis ; Staphylococcal Infections ; Staphylococcus aureus ; Sternoclavicular Joint

PURPOSE: The prevalence of developmental delay is 5-10% of the total pediatric population and early diagnosis and proper intervention are essential but a challenge for clinicians. We performed this study for several purposes. First is to know the distribution & characteristics of developmental disorders in Korea. Second is to identify all possible causes of these disorders through a multidisciplinary diagnostic approach, and thus to find out the clinical variables that are helpful in finding the etiology. And finally to develop a useful protocol that eliminates the cost of unnecessary tests and raises the diagnostic rate of the cause. METHODS: 518 patients(M 349, F 169) were studied who visited Ilsan Hospital Developmental Disorder Clinic(DDC) for the evaluation of developmental delay from April 2001 to Jan 2005. RESULTS: The mean age was 51.5+/-32.9 months, ranging from 2 months to 16.0 years of age with a majority of the preschool children(<6 yr)(79.3%). Phenomenological diagnosis consisted of 133 cases of mental retardation, 122 cases of autistic disorders, 101 cases of delayed language disorders, 27 cases of cerebral palsies, and 91 cases labeled as simple developmental delay requiring follow up due to age less than 2 years of age. Etiologic diagnosis was obtained in 119 cases(22.9%) out the 518 cases of developmental delays. 37 cases of chromosomal anomalies, 23 cases of Periventricular leukomalacia and hypoxic ischemic encephalopathy, 21 cases of syndromes, 7 cases of malformation of cortical development, 4 cases of myopathies, 4 cases of neuropathies, and 4 cases of cerebral infarctions were found. Among the clinical variables, low birth weight, facial dysmorphism, hypotonia, focal neurologic signs, and abnormalities in MRI, chromosome, EEG and EMG studies contributed to the yields of etiologic diagnosis significantly. CONCLUSION: Possible etiology was determined in about 23% of the subjects. The most important part of the assessment for the identification of etiology is thorough history taking, physical and neurologic examination. Neuroimaging study is useful in case of micro or macrocephaly, focal neurologic signs. Genetic studies increasingly produce a yield, when there is family history of inherited disorder and there are dysmorphic features. Routine metabolic screening test has limited utility. Development of a useful screening protocol adequate for Korean situation is required.
Cerebral Infarction ; Diagnosis ; Early Diagnosis ; Electroencephalography ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant, Low Birth Weight ; Infant, Newborn ; Intellectual Disability ; Korea ; Language Disorders ; Leukomalacia, Periventricular ; Macrocephaly ; Magnetic Resonance Imaging ; Mass Screening ; Muscle Hypotonia ; Muscular Diseases ; Neuroimaging ; Neurologic Examination ; Neurologic Manifestations ; Paralysis ; Prevalence

The safety of endoscopic retrograde cholangiopancreatography(ERCP) in patients with acute pancreatitis(AP) was confirmed in the past decade. Especially in ease of acute gallstone panereatitis, early ERCP/EST(endoscopic sphincterotomy) may reduce the incidence of complications by removing gallstone which causes acute attack of pancreatitis. To assess clinical usefulness of ERCP/EST in the setting of AP, we reviewed clinical records of 58 patients with AP who had undergone ERCP /EST during the same period of admission.(continue...)
Cholangiopancreatography, Endoscopic Retrograde* ; Gallstones ; Humans ; Incidence ; Pancreatitis*

Salmeterol is a long acting, highly selective, beta2-adrenergic agonist. It prevents asthma symptoms in patients with mild or moderate disease and improves nocturnal asthma and sleep quality. We evaluated the bronchodilator and bronchoprotective effect and duration of action of inhaled salmeterol in patients wlth asthma. We compared the bronchodilator and bronchoprotective effects of salmeterol with salbutamol in 34 patients with asthma. Diagnosis of asthma was confirmed with methacholine challenge test or airway reversibility test. We performed the symptom index questionnaire, peak expiratory flow rate, pulmonary function test and methacholine challenge test. Symptom scores were more improved with salmeterol treatment than salbutamol treatment. After salmeterol inhalation, mean FEV1 increased from 1.95L(pre-treatment) to 2.04L(early stage in the treatment), 2.06L(late stage), 2.03L(follow up). There was no difference in FEV1 between early stage and late stage after salmeterol treatment. With salmeterol, there was a significant increases in PC30 on methacholine challenge test ( PC20 4.96 : 16.42). Salmeterol is a potent, long-acting bronchodilator, with a slower onset and longer duration of bronchodilation than salbutamol. It also has bronchoprotective effect and shows low incidence of adverse effects.
Albuterol ; Asthma ; Diagnosis ; Humans ; Incidence ; Inhalation ; Methacholine Chloride ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Salmeterol Xinafoate ; Surveys and Questionnaires

Endoscopic retrograde biliary drainge is a useful method of palliative treatment of malignant biliary obstruction with respect to safety, rapidity in decompression of obstruction. However, despite of efforts to prolong patency of the stents, the main long term complication of current-widely used plastic endoprosthesis is to tendency for the stents to become clogged by sludge leading to recurrent jaundice and cholangitis, finally, obstruction of stents. Recently, in an effort to improve the patency of stent, variety of self-expandable metallic endoprosthesis have developed and which can be compressed into and inserted through small lumen catheter with large-bored lumen in expandable state. However, most of these open mesh of self-expandable stents allows tumor in growth which causes reobstruction, and additionally it is nearly impossible to retrieve the inserted prosthesis. Recently developed coil metal stent(Endocoil, Intent Co.), which, unlikely other previous metallic stent, has possibility of retrieving prosthesis and prevention of tumor ingrowth. We experienced a case of 52-year old male sufferd from malignant biliary obstruction due to recurrence of cancer at peripancreatic lymph nodes and combined with common bile duct stones on both proximal and distal side of the stricture, in whom Endocoil was implanted with sucessful decompression of obstruction and simultaneous removal of biliary stones located at both side of stricture.
Catheters ; Cholangitis ; Common Bile Duct ; Constriction, Pathologic* ; Decompression ; Humans ; Jaundice ; Jaundice, Obstructive* ; Lymph Nodes ; Male ; Middle Aged ; Palliative Care ; Plastics ; Prostheses and Implants ; Recurrence ; Sewage ; Stents*

Although variation is the rule with pancreatic duct morphology, certain variants occur as a result of altered embroological development. These ductal configurations, most striking deviations from the normal configuration, may be classfied according to alterations of embryological development. These congenital variants of pancreatic duct may be important for several reasons. First, the pseudomass effect of ductal anomalies can be mistaken for carcinoma by the inexperienced radiologists. Second, whether or not the anomaly is important, it is present in many patients with recurrent pacreatitis. Original descriptions were based on small sampling of postmortem studies and surgical specimen, but more recently the advent of endoscopic retrograde cholangiopancreatography(ERCP) has confirmed of the work of early anastomists and increased awareness of these variants. To evalute of frequency, characteristics of associated disease and clinical significance of pancreatic anomalies, we have reviewed of 5330 case of ERCP filmes which were undertaken between July, 1973 and August, 1993. Having reviewed of ERCP filmes, we found out 9 case of pancreatic duct variants. Among them, 7 cases were classified as ductal duplication anomalies, 4 cases of number variation, most, bifuricaiton and 3 cases of form variation, which were composed of loop, spiral and terminal N. Three cases of fusion anomalies were also noted, which were 2 cases of panceratic divisum and 1 case of incomplete pancreatic divisum. The associated diseases were 6 cases of bile duct and galbladder stones and 3 cases of pancreatic cancer. We could not find out the case of congenital anomalies as cause of obstructive pain and pseudomass effect.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde* ; Humans ; Pancreatic Ducts* ; Pancreatic Neoplasms ; Pancrelipase ; Strikes, Employee

No abstract available.
Child* ; Chromosome Aberrations* ; Cytogenetic Analysis* ; Cytogenetics* ; Humans

This article presents the knowledges regarding the evaluation and the management of attention-deficit/hyperactivity disorder (ADHD). Probably the most important components to a comprehensive evaluation of patients with ADHD, are the clinical interview, the medical examination, and the completion and scoring of behavior rating scales. The treatments of ADHD are followings: pharmacologic treatment such as stimulants, atomoxetine, modafinil, and bupropionn, and non-pharmacologic treatment such as parental education/training and cognitivebehavioral treatment.
Atomoxetine Hydrochloride ; Benzhydryl Compounds ; Humans ; Parents ; Propylamines ; Weights and Measures

This study is verifying the hypothesis that distraction followed by recompression may promote fracture healing of the osteoporotic bone on the assumption that distraction induces increased callus formation at the distracted gap and recompression results in fusiform callus, having biomechanically stronger fracture stiffness. Sixty-six Sprague-Dawley rats, in which osteoporosis were induced 6-8 weeks after oophorectomy, were separated into two groups. Group I was control group that had fracture healing by simple external fixation. Group II was experimental group that had fracture healing by monofocal distraction-compression. Radiomorphometric study revealed that there was significantly increased amount of callus and ensuing bone formation, which becehe obvious from 20 days after osteotomy in group II compared with group I. Biomechanical study also showed that tensile break strength was significantly higher in group II compared with group I with time. It is concluded that monofocal distraction-compression method may be one of the useful method to promote fracture healing of the estrogen deficient osteoporotic bone.
Animals ; Bony Callus ; Estrogens ; Female ; Fracture Healing* ; Osteogenesis ; Osteoporosis* ; Osteotomy ; Ovariectomy ; Rats* ; Rats, Sprague-Dawley