PURPOSE: Choledochal cyst is a rare malformation of the pancreatobiliary ductal system, manifested by dilatation of biliary tree with or without anomalous insertion of the common bile duct into pancreatic duct. The purpose of this study is to review the incidence of anomalous pancreatobiliary union(PBU) and the shape of common bile duct based on the angle of pancreatic duct and common bile duct union. MATERIALS AND METHODS: We analyzed cholangiopancreatographic findings of 21 patients with choledochal cyst, emphasizing PBU. The PBU was classified into acute-angled PBU, right-angled PBU, normal PBU, and unknown PBU on the basis of common bile duct insertion to pancreatic duct. The shape of common bile duct dilatation was evaluated with regard to angle of PBU. RESULTS: Fourteen of 21 patients had anomalous PBU with slender or ectatic form of common channels. Three patients had normal opening of common bile duct and pancreatic duct, and in remaining 4 patients the PBU was not visualized. Among 14 patients with PBU, 5 patients had right-angled PBU and 9 patients had acute-angled PBU. Cystic form of common bile duct dilatation was seen in 13 patients and cylindrical form was in 8 patients. Cystic dilatation of common bile duct was seen in 4 patients out of 5 right-angled PBU. CONCLUSION: Patients with choledochal cyst had high incidence of anomalous PBU with common channel (67%). The shape of common bile duct dilatation was cystic in 62% of patients, and the right-angled PBU was prone to be cystic dilatation (80%).
Biliary Tract ; Choledochal Cyst* ; Common Bile Duct ; Dilatation ; Humans ; Incidence ; Pancreatic Ducts

No abstract available.
Stevens-Johnson Syndrome*

PURPOSE: Congenital limb anomalies are manifested in various degree of severity and complexity bearing confusion for description and nomenclature of each anomaly. We retrospectively analyzed the roentgenograms of congenital limb anomalies for the purpose of further understanding of radiologic manifestations based on the embryonal defect and also to find the incidence of each anomaly. MATERIALS AND METHODS: Total number of the patients was 89 with 137 anomalies. Recently the uniform system of classification for congenital anomalies of the upper limb was adopted by International Federation of Societies for Surgery of the Hand (IFSSH), which were categorized as 7 classifications. We used the IFSSH classification with some modification as 5 classifications;failure of formation of parts, failure of differentiation of parts, duplications, overgrowth, and undergrowth. RESULTS: The patients with upper limb anomalies were 65 out of 89(73%), lower limb were 21(24%), and both upper and lower limb anomalies were 3(4%). Failure of formation was seen in 18%, failure of differentiation 39%, duplications 39%, overgrowth 8%, and undergrowth in 12%. Thirty-five patients had more than one anomaly, and 14 patients had intergroup anomalies. CONCLUSION: The upper limb anomalies were more common than lower limb. Among the anomalies, failure of differentiation and duplications were the most common types of congenital limb anomalies. Patients with failure of formation, failure of differentiation, and undergrowth had intergroup association of anomalies, but duplication and overgrowth tended to be isolated anomalies.
Classification ; Extremities* ; Hand ; Humans ; Incidence ; Lower Extremity ; Retrospective Studies ; Upper Extremity

PURPOSE: The purpose of this study was to evaluate whether the therapeutic effects of topiramate differ according to the types of migraine. METHODS: We recruited 38 children and adolescents with migraine who had been treated with topiramate. The effect of topiramate was evaluated on the basis of the change in the frequency of migraine attacks after treatment. RESULTS: Among patients having migraine with aura, 85.7% showed complete recovery, 1 (7.1%) showed partial recovery, and 1 did not show any recovery. Among patients having migraine without aura, 47.1% showed complete recovery, 29.4 % showed partial recovery, and 23.5% showed no recovery. Among patients suspected with migraine, 1 (20%) showed complete recovery, 1 (20%) showed partial recovery, and 3 (60%) showed no recovery. CONCLUSION: Our results indicated that topiramate exhibited excellent therapeutic effects for migraine accompanied with aura, and it was effective in migraine without aura. However, the effect of topiramate in patients suspected with migraine was uncertain.
Adolescent ; Child ; Epilepsy ; Fructose ; Humans ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura

A 63-year-old man complained of intermittent motor weakness of his arm. The magnetic resonance image (MRI) of his brain displayed a high signal lesion in right cingulate gyrus on T2 weighted image. One year later, he showed a stuporous mental status with repeated seizures, and the follow-up brain MRI showed heterogeneously enhanced mass associated with bleeding. He was treated with surgery and radiotherapy for secondary glioblastomas in right cingulate gyrus. One year more later, a mass recurred on the left frontal base, and gliosarcoma was diagnosed. After tumor resection, ventriculoperitoneal shunt, chemotherapy, and re-radiation therapy, all brain lesions were stable. Fourteen months after the diagnosis of gliosarcoma, he complained of dyspnea and back pain. Torso positron emission tomography/computed tomography revealed multiple metastatic lesions in both lungs, pericardium, pleura, liver, lymph nodes, and bones, and metastatic gliosarcoma was diagnosed. One month later, the patient died because of the systemic metastases. We present an unusual case of secondary gliosarcoma with stable brain lesions and extensive systemic metastases.
Arm ; Back Pain ; Brain ; Brain Neoplasms ; Diagnosis ; Drug Therapy ; Dyspnea ; Electrons ; Follow-Up Studies ; Glioblastoma ; Gliosarcoma* ; Gyrus Cinguli ; Hemorrhage ; Humans ; Liver ; Lung ; Lymph Nodes ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Pericardium ; Pleura ; Radiotherapy ; Seizures ; Stupor ; Torso ; Ventriculoperitoneal Shunt

No abstract available.
Hemangiopericytoma* ; Lung*

No abstract available.
Humans* ; Lymphocytes* ; Mycobacterium tuberculosis* ; Mycobacterium*

Meningococcal infections can be associated with abnormalities of the complement system, which contains 5 terminal complement proteins. Furthermore, deficiencies in 1 of these 5, complement component 7 (C7), leads to the loss of complement lytic function, and affected patients show increased susceptibility to recurrent meningococcal meningitis and systemic Neisseria gonorrhoeae infection. In September 2003, an 11-year-old female patient presented at our outpatient department with high fever, lower leg pain, headache, and petechiaes. She rapidly progressed to coma but later achieved full recovery due to prompt treatment. Her final diagnosis was meningococcal sepsis and arthritis. Her elder brother also had a similar bacterial meningoencephalitis history, which encouraged us to perform analyses for complement component and gene mutations. Resultantly, both the brother and sister were found to have the same mutation in the C7 gene. Subsequently, vaccinations of the meningococcal vaccine meningococcal vaccine (Menomune(R)) were administered. However, in September 2006, the brother expired due to acute micrococcus meningoencephalitis. At present, the 16-year-old female patient is healthy. Here, we report a Korean family with a hereditary C7 deficiency with susceptibility to meningococcal infections due to C7 gene mutation.
Adolescent ; Arthritis ; Child ; Coma ; Complement C7 ; Complement System Proteins ; Female ; Fever ; Headache ; Humans ; Immunologic Deficiency Syndromes ; Leg ; Meningitis, Meningococcal ; Meningococcal Infections ; Meningococcal Vaccines ; Meningoencephalitis ; Micrococcus ; Neisseria gonorrhoeae ; Outpatients ; Sepsis ; Siblings ; Vaccination

Objective: The purpose of this study was to verify the validity and reliability of Korean elderly by translating the Hayling Test, a test that measures semantic inhibition ability among executive functions. Methods: Total 91 participants were recruited in accordance with inclusion criteria and exclusion criteria for each group. Within them, 34 were normal from Dongjak-gu, Seoul, 29 were mild cognitive impairment (MCI) from clinics located in Seoul, and 28were Alzheimer’s disease (AD) from clinics located in Seoul, respectively. The one-way analysis of covariance, the Bonferroni veri-fication, the receiver operating characteristic (ROC) curve analysis, and the Brain Imaging analysis of voxel-based morphometrywere conducted in order to compare and analyze performance of demographics characteristics of each group, Hayling Test results, and The Continuous Performance Test-X (CPTX) results. Results: The comparison analysis showed the Hayling Test is more valid methodology than the CPTX test in discriminating nor-mal, MCI, and AD. Furthermore, ROC curves between normal and AD groups also demonstrated higher sensitivity (88%) and specificity (73%) of Hayling Test, and confirmed its diagnostic validity. In line with the above, brain imaging analysis displays sig-nificant positive correlation between temporal & frontal brain regions through the Hayling Test scores, however, this correlationwas not found for CPTX. Conclusion It is expected that the Haling Test, which measures language inhibition function, can be used simply and usefully in diagnosing dementia.

Presently, media for sanitation education consisting of a sanitation manual and a CD-ROM intended for restaurant employers and employees was developed and evaluated. The sanitation manual consisted of five principles: prevention of foodborne illness, personal hygiene, control of food production, instrument and equipment cleaning and sanitation, and management of environmental sanitation. The CD-ROM was composed of animations detailed real-life examples of Salmonella, Staphylococcus aureus, and Norovirus foodborned illness outbreaks; slides summarizing the five principles of the manual; and a poster entitled You can prevent foodborne illness listing and describing the principles. A 15 question evaluation survey was developed to gauge the efficacy of the animations. The survey was divided into five sections on comprehension of the instructions, content organization concerning understanding, content organization concerning the information presented, content organization concerning retention of interest (concentration), and recommendations concerning concentration. Ranked on a 5-point scale the survey produced a mean value of 3.80+/-0.39 and individual scores of 3.92+/-0.45 (learning instruction), 3.86+/-0.48 (understanding), 3.82+/-0.52 (information), 3.75+/-0.49 (concentration), and 3.67+/-0.58 (concentration-recommendation). Overall, evaluation results of the animation were good and easy to understand, with only a few respondents electing to watch the animations more than once. In terms of continuous and recurring education, sanitation training programs should be easy to learn and contain sufficient and specific examples of the importance of sanitation in achieving food safety.
CD-ROM ; Comprehension ; Surveys and Questionnaires ; Humans ; Hygiene ; Norovirus ; Restaurants ; Retention (Psychology) ; Salmonella ; Sanitation ; Staphylococcus aureus