Fatal complications including cerebral edema and neurologic collapse occur during treatment of diabetic ketoacidosis(DKA). A 6-week-old female infant with fever, dehydration and drowsy mental status was diagnosed as DKA and neurologically deteriorated during treatment. The cranial computed tomography scan revealed multifocal brain infarctions of the left caudate nucleus, bilateral frontal periventricular white matter, and right parietal cortex. A moderate amount of hemorrhage was also noted in both lateral ventricles. She recovered rapidly with supportive treatment over time. The clinical course and radiologic findings of this patient emphasize the importance of brain infarction as a cause of persistent neurologic loss in children with DKA.
Brain Edema ; Brain Infarction* ; Brain* ; Caudate Nucleus ; Child ; Dehydration ; Diabetic Ketoacidosis* ; Female ; Fever ; Hemorrhage* ; Humans ; Infant* ; Lateral Ventricles ; Rabeprazole

PURPOSE: We wanted to evaluate the normal glenoid size of Koreans in their 7th and 8th decades by conducting Computed tomographic (CT) studies. MATERIALS AND METHODS: The CT images were obtained from the normal scapulae of the patients (mean age: 68.8) who had humeral fracture. A display workstation version 2.0.73.315 was used to measure the scans to determine the maximal superoinferior (SI) and anteroposterior (AP) diameters of the glenoid vault. RESULTS: The average diameters of curvature of the glenoid were 31.2 mm (range: 27 to 34 mm) in the superior-inferior direction and 26.1mm (range: 22 to 31mm) in the anterior-posterior direction. CONCLUSION: This study showed the normal glenoid size of Koreans and it is different from the size that the international literature reported. It should be an important factor for the treatment of fracture or in designing arthroplasty implants.
Arthroplasty ; Humans ; Humeral Fractures ; Scapula ; Shoulder

PURPOSE: We wanted to evaluate the effectiveness of posterolateral approach for open reduction and internal fixation of posterior malleolar fragment with trimalleolar fracture of ankle joint. MATERIALS AND METHODS: There were 27 cases of trimalleolar fracture in our hospital from Jan. 2005 to Dec. 2007. We investigated 10 patients who underwent operation with the posterolateral approach. The mean follow up period was 20 (6-36) months. Preoperative posterior malleolar fragment involved above 25% of articular surface in 10 cases and displaced more than 2 mm in 4 cases. We analyzed the radiologic type of posterior malleolar fragments and complications, and evaluated the AOFAS score. RESULTS: All cases showed primary union mean 11.8 (8-14) weeks. The complication focal skin necrosis in one case and all patients showed excellent AOFAS score. CONCLUSION: The posterolateral approach may be a useful for open reduction and internal fixation of posterior malleolar fragment with trimalleolar fracture, especially simultaneous management of lateral malleolar fracture.
Ankle Joint ; Follow-Up Studies ; Humans ; Necrosis ; Skin

Diabetes has been associated with more severe outcomes and higher mortality in coronavirus disease 2019 (COVID-19) patients compare to morbidity and mortality in patients without diabetes. Several mechanisms may play a role in this greater morbidity and mortality, especially uncontrolled hyperglycemia, an impaired immune system, pre-existing proinflammatory states, multiple comorbidities, and dysregulated angiotensin-converting enzyme 2 signaling. Thus, the diabetes medical community emergently needs to know about COVID-19 and its effects on patients with diabetes, as they must take precautions to carefully manage these patients during the COVID-19 pandemic. The Korean Diabetes Association provides some guidance and practical recommendations for the management of diabetes during the pandemic. This report provides insight into the association between diabetes and COVID-19, proper management of diabetes in patients with COVID-19 and an official suggestion by the Korean Diabetes Association for managing the COVID-19 outbreak.

No abstract available.
Cerebral Veins ; Humans ; Thrombosis

Anterior cerebral artery (ACA) dissection with simultaneous subarachnoid hemorrhage (SAH) and cerebral infarction is very rare and its treatment continues to be debates. We present a case of simultaneous SAH and cerebral infarction caused by dissection of the ACA that was successfully treated by bypass surgery and an endovascular procedure.
Aneurysm, Dissecting ; Anterior Cerebral Artery ; Cerebral Infarction ; Endovascular Procedures ; Subarachnoid Hemorrhage

BACKGROUND: Concerns of patients on sexual activity after total hip arthroplasty have not been well studied in Asian patients. This study aimed to determine the following: (1) what are the concerns of patients related to sexual activity after total hip arthroplasty? (2) what are the changes in sexual activity after total hip replacement in Korean patients? METHODS: Details of sexual activity and concerns were obtained using a questionnaire designed specifically for the study. The questionnaire was administered to 64 patients in a face-to-face interview at an outpatient clinic. RESULTS: Preoperatively, 53.1% of patients experienced difficulties, primarily due to hip pathology and limitations of motion. The median time to the resumption of sexual activity was 3 months postoperatively, and most patients had no increase in the frequency of sexual activity after the total hip replacement. In 39.1% of patients were seen having difficulties with leg positioning following total hip replacement, and they were likely to change coital positions. The most common concern regarding sexual activity of patients was the fear of dislocation. Furthermore, patients with a higher stress level had lower satisfaction rates. Most patients were unable to obtain information on sexual activity following the total hip arthroplasty, and they did not consult with a physician due to the private nature of the topic. CONCLUSIONS: Dislocation was the most common concern of patients during sexual activity following a total hip arthroplasty, and a higher stress level was found to be associated with a lower satisfaction rate. Because most patients were unprepared to consult a physician, the provision of appropriate information before a consultation might be beneficial.
Adult ; Aged ; Arthroplasty, Replacement, Hip/adverse effects/*methods/*psychology ; Female ; Hip Dislocation/psychology ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Preoperative Period ; Questionnaires ; Republic of Korea ; Retrospective Studies ; Sexual Behavior/*psychology ; Young Adult

Limbic encephalitis (LE) is characterized by short-term memory loss, disorientation, agitation, seizures, and histological evidence of mesial temporal lobe inflammation. Leucine-rich, glioma inactivated 1 (LGI1) is the autoantigen associated with limbic encephalitis that was previously attributed to voltage-gated potassium channels. We report herein a 54-year-old female with LGI1-related limbic encephalitis who presented with recurrent episodes of episodic memory impairment, depressive mood, and phantosmia. Her symptoms dramatically improved with steroid therapy.
Antibodies* ; Dihydroergotamine ; Female ; Glioma ; Humans ; Inflammation ; Limbic Encephalitis* ; Memory, Episodic ; Memory, Short-Term ; Middle Aged ; Potassium Channels, Voltage-Gated ; Seizures ; Temporal Lobe

Hyperplastic polyps are common gastric lesions that are characterized by nonneoplastic epithelial hyperplasia. However, to our knowledge, there are no reports of a hyperplastic polyp arising from an endoscopic mucosectomy site of early gastric cancer. We describe the CT findings with a histopathology correlation in a case of a hyperplastic polyp arising from a mucosectomy site that mimicked polypoid gastric cancer.
Endoscopy ; Hyperplasia ; Polyps* ; Stomach Neoplasms*

PURPOSE: Hepatic veno-occlusive disease (VOD) is a life-threatening complication occurring early after stem cell transplantation (SCT). Early diagnosis and effective treatment has not been established in severe VOD. Because there are few reports on VOD in Korean children, we evaluated the clinical characteristics of VOD following SCT in children. METHODS: We retrospectively reviewed the chart of all patients (n=116) receiving SCTs in CNUH Pediatric BMT center between May, 1991 and June, 2004. RESULTS: VOD developed in 11 patients (9.5%) (median age, 9.8 years; range, 2 to 13.9). Underlying diagnoses were ALL (n=3), severe aplastic anemia (n=3), AML (n=2), acute biphenotypic leukemia (n=1), neuroblastoma (n=1), and myelodysplastic syndrome (n=1). The median day of onset of VOD was D+9 (range, D-3 to D+19). VOD was classified as moderate in 5 and severe in 6 cases. Maximum level of serum total bilirubin was 2.9 mg/dL (range, 2.1 to 9.2) in moderate VOD and 7.3 mg/dL in severe VOD (range, 2.0 to 24.2) at D+18 (range, D-5 to D+59). We successfully treated VOD with various combinations including tPA and heparin (2/5, 40%), ursodeoxycholic acid (2/5, 40%), N-acetylcysteine (3/5, 60%), and defibrotide (1/2, 50%). All of 5 patients with moderate VOD survived at D+100 (range, 5.5+ to 66.6+ months). Five of 6 (83%) patients with severe VOD died within first 19 day from complications of VOD. CONCLUSION: This retrospective study showed that the incidence of VOD was 9.5%, and the mortality of severe VOD was still high which would necessitate early diagnosis, effective prevention and treatment.
Acetylcysteine ; Anemia, Aplastic ; Bilirubin ; Child ; Diagnosis ; Early Diagnosis ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Heparin ; Hepatic Veno-Occlusive Disease* ; Humans ; Incidence ; Leukemia, Biphenotypic, Acute ; Mortality ; Myelodysplastic Syndromes ; Neuroblastoma ; Retrospective Studies* ; Stem Cell Transplantation ; Ursodeoxycholic Acid