The authors retrospecitviely analyzed the MRI findings of the 8 head-injured patiens who had showed persistent unconsciousness and severe neurologic deficite after trauma. T2-weighted MR images disclosed high signal intensity lesions of various size and shape at lobar white matter and corpus callosum, subcortical gray matter, brain stem, and cerebral cortex, and assisted greatly in understanding the neurologic deficits of the corresponding patients. The lesions were mostly multiple and involved multiple structures. CT's revealed in those patients only small hemorrhages, suspicious low densities, such nonspecific findings as slit ventricles and diffuse brain atrophy, or no abnormality at all. Post-traumatic parenchymatous lesions detected by MR images were either missed or quite underestimated on CT's. MRI was very supeior to CT in the detection and anatomic localization of nonhemorrhagic intraaxial cerebral injuries. especially in the cases of small corical contusions, brainstem and white matter injuries. For the evaluation of the acute posttraumatic patients, CT ios indicated in order to fastly detect intracranial hemagomas which may need emergent surgical evacuation. If CT findings does not explain the neurologic degicits of the patients, especially in the late stage. MRI is indicated. MRI is expected to play a major role in the diagnosis of shear injuries involoving white matter and brainstem where CT has been of little contribution or misleading.
Atrophy ; Brain ; Brain Stem ; Cerebral Cortex ; Contusions ; Corpus Callosum ; Diagnosis ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Neurologic Manifestations ; Unconsciousness

PURPOSE: SCORing atopic dermatitis (SCORAD) index is the best validated scoring system in atopic dermatitis (AD). But this scoring system has limitation to the interobserver and intraobserver variation. This study was designed to evaluate the correlation between the severity of AD classified by the SCORAD index and the laboratory tests. METHODS: We evaluated 67 children admitted in the pediatric allergy and respiratory division of Busan St. Mary's Medical Center from April 1 to 30, 2011. SCORAD index was measured by one same physician. The patients were classified into mild to moderate and severe groups by SCORAD index. We identified sex, age and family history of allergic disease. We checked laboratory tests including mycoplasma immunoglobulin (Ig) M, total IgE, eosinophil count, eosinophil cationic protein, specific IgE, total protein, albumin, IgG, IgA, IgM, IgD, and inflammatory index (lactate dehydrogenase, C-reactive protein, erythrocyte sedimentation rate) and skin culture. RESULTS: There were no statistically significant differences between two groups in age, sex, parental allergic history, skin culture, mycoplasma IgM, specific IgE, immunoglobulin, and inflammatory index. The SCORAD index has statistically significant positive correlations with serum total eosinophil count, and total IgE, and negative correlations with total protein, and albumin. CONCLUSION: Our study suggest that serum total eosinophil count, total IgE, total protein, and albumin can be used to evaluate the severity of AD and make up for the SCORAD index.
Blood Sedimentation ; C-Reactive Protein ; Child ; Dermatitis, Atopic ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin A ; Immunoglobulin D ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Mycoplasma ; Observer Variation ; Oxidoreductases ; Parents ; Skin

One Hundred and eight patients received operation for acute subdural hematoma were evaluated in prognostic factors. They were admitted to the Neurosurgical Department in S.R.C.H during the 3 years from January, 1986 to December, 1988. The results were as follows ; 1) The patients were consist of 85 male patients and 23 female patients with the sex ratio 3.7 : 1. 2) Evaluated prognostic factors were age and sex, preoperative Glasgow coma scale(GCS), preoperative pathological physical findings, time interval from injury to operation, type of injury, midline shift, location of hematoma, thickness of hematoma, and operative procedure. 3) On the statistical analysis, factors of GCS and midline shift were considerable significant factors. 4) In the overall results of 108 patients, 47 patients(43.5%) had good recovery, 9 patients(8.3%) had moderate disabled state, 2 patients(1.9%) were severe disabled state, 4 patients(3.7%) were vegetative state, and 46 patients(42.6%) died.
Coma ; Female ; Hematoma ; Hematoma, Subdural, Acute* ; Humans ; Male ; Persistent Vegetative State ; Sex Ratio ; Surgical Procedures, Operative

A 34-year-old male patient was first admitted to our Department on October 16, 1965. He complained of frontal headaches especially in the morning and ild right hemiparesis over the previous 6 months, which were progressively more severe as time went by. On examination, he was mentally clear ut slightly dysphasic: there were mild right hemisparesis and marked bilateral papilledema. Angiogram showed a left posterior frontal vascular tumor. At operation on November 3, 1965, total excision of a posterior frontal parasagittal tumor was performed. To the naked eye, this seemed to be a meningioma; the tumor was egg-sized, round but somewhat lobulated, graysish white in color, firm and fibrotic appearance, and it attached to the superior longitudinal sinus, involving without occluding it. Histologically. It was considered a meningioma of firbrolastic type, containing small amount of capillaries and some areas of collegen deposition around the fibroblasitc cell masses with foci of meningoendothelial cluster; though some doubt was expressed over its innocence. He tolerated the resection of frontal tumor well, and remained in relatively good health for 7 years, as to do his usual farmer work with minimal right hemiparesis. There were some episodes of generalized seizure during there periods. The patients was readmitted on December 25, 1972, however, because of frontal headaches and vomiting over recent 6 months and dysphasia, mental confusion developing rapidly over the previous 3 months. Urinary incontinence was also complained of. On examination he was drowsy, apathetic and mentally confused, more so than when first admitted. There was a goose-egg sized tense bulging in the left frontotemporal region, previously operated. Central-typed right facial palsy, right hypoglossal palsy and bilateral marked papilledema were noted. There were spastic hemiparesis, greater in the upper extremity, and long tract signs on the right side. Angiogram revealed a posterior frontal parasagittal vascular tumor, much as before. At operation on January 5, 1973, subtotal resection of tumor was performed, remaining the deep-seated parasagittal posterior frontal mass. The gross appearance of tumor was necrotic partially on the surfaces, potato-shaped with nodularith and pinkish white in color. On sectioning cut surface was slightly myxoid with cystic degeneration in the center. There was also patchy degeneration, showing yellow tinge in the cut surface. Microscopically, there were prominent hypercellularity with many mitoses, atypism, pleomorphism and degenerative process. Vascutar reaction with amyloid-like infiltration in perivascular area was also demonstrated as with focal pseudocartilagenous degeneration and partial hemorrhage; overall findings were highly suggestive of recurrent memingioma with malignant change (sarcomatous change) in left posterior frontal parasagittal region.
Adult ; Aphasia ; Capillaries ; Facial Paralysis ; Headache ; Hemorrhage ; Humans ; Male ; Meningioma* ; Mitosis ; Muscle Spasticity ; Papilledema ; Paralysis ; Paresis ; Seizures ; Superior Sagittal Sinus ; Tolnaftate ; Transcutaneous Electric Nerve Stimulation ; Upper Extremity ; Urinary Incontinence ; Vomiting

A 44-year-old Korea woman was admitted to our department on March 5, 1973 with complaints of low back pain and radiating leg pain on the right side which have persisted for past 4 years. Howeve , the patient had a history of radiating leg pain on the left side about 8 years ago. Physical examination revealed paravertebral muscle spasm on both sides, limited backward bending, normal straight leg raising test, decreased ankle jerk on both sides and mild sensory change in the right L5 dermatome. Plain radiograms of the lumbar spine showed decreased normal lumbar lordosis and narrowing of L4-5 and L5-S1 interspaces. Myelogram demonstrated partial obstruction by marked bilateral indentation filling defect at L4-5 level, narrowing of dye column below that level, and abnormal root sleeves. Under the impression of herniated L4-5 intervertebral disc, total laminectomies of the 4th and 5th lumbar vertebrae were performed and found relatively hypertrophic limagentum flavum and bilaterally conjoined roots commonly originating from dural sac. Following decompression that would was closed routinely. Postoperatively all symptoms were improved.
Adult ; Animals ; Ankle ; Decompression ; Female ; Humans ; Intervertebral Disc ; Korea ; Laminectomy ; Leg ; Lordosis ; Low Back Pain ; Lumbar Vertebrae ; Physical Examination ; Spasm ; Spine

The authors have analyzed the factors influencing the outcome of the 168 patients with acute epidural hematoma who had been managed in our hospital for 3 years from July 1986 to June 1989. 1) Sex incidence showed that male patients were 4.8 times more commonly affected than females, and the most commonly affected age group was the 3rd decade. 2) The most common cause of injury was motor vehicle accidents. The patients with unknown cause of injury which probably suggested significant delay in starting the clinical managements had a higher mortality rate. 3) The most common site of hematoma was the FTP convexity(63.6%). The patients with diffuse hematoma in the fronto-temporo-parietal region had a high mortality and deteriorated level of consciousness. 4) Skull fractures were not seen only in 9.5% of the patients with acute epidural hematoma. 5) The main factors associated with the higher mortality rate were rapid development of hematoma, pupillary dilatation, low score in Glasgow Coma Scale on arrival, and more midline shifting on brain CT. 6) The patients with concomitant intracranial lesions had a high mortality rate(25.8%), and the patients with acute epidural hematoma alone had a low rate(2%), and the overall mortality rate of the patients with acute epidural hematoma was 11.3%.
Brain ; Consciousness ; Dilatation ; Female ; Glasgow Coma Scale ; Hematoma* ; Humans ; Incidence ; Male ; Mortality ; Motor Vehicles ; Skull Fractures

Trigeminal neurinoma is a rare condition arising from the gasserian or trigeminal nerve root. It comprises 0.2% of all brain tumors, and usually affects middle life, but about 10% of it appears in adolescents. Middle fossa syndrome, symptoms and signs of cerebellopontine angle tumor and mixture of these may be developed through the extension of the tumor. Symptoms and signs of cerebellar and midbrain compression may also be elicited in some stage of the tumor. Erosion of the Anteromedial portion of the petrous apex and defect of the flow of the middle fossa contribute to the diagnosis. Air studies and cerebral antiography have been used, and recently pantopaque basal cisternography has been introduced. The route of operation depends upon the main localization of the tumor, but transtemporal approach with tentorial section is widely used for dumbbell-shaped tumor. A case of cerebellopontine angle tumor which had been postoperatively proved to be a trigeminal neurinoma is reported.
Adolescent ; Brain Neoplasms ; Diagnosis ; Humans ; Iophendylate ; Mesencephalon ; Neurilemmoma* ; Neuroma, Acoustic ; Puberty* ; Trigeminal Nerve

Trigeminal neurinoma is a rare condition arising from the gasserian or trigeminal nerve root. It comprises 0.2% of all brain tumors, and usually affects middle life, but about 10% of it appears in adolescents. Middle fossa syndrome, symptoms and signs of cerebellopontine angle tumor and mixture of these may be developed through the extension of the tumor. Symptoms and signs of cerebellar and midbrain compression may also be elicited in some stage of the tumor. Erosion of the Anteromedial portion of the petrous apex and defect of the flow of the middle fossa contribute to the diagnosis. Air studies and cerebral antiography have been used, and recently pantopaque basal cisternography has been introduced. The route of operation depends upon the main localization of the tumor, but transtemporal approach with tentorial section is widely used for dumbbell-shaped tumor. A case of cerebellopontine angle tumor which had been postoperatively proved to be a trigeminal neurinoma is reported.
Adolescent ; Brain Neoplasms ; Diagnosis ; Humans ; Iophendylate ; Mesencephalon ; Neurilemmoma* ; Neuroma, Acoustic ; Puberty* ; Trigeminal Nerve

OBJECTIVES: As a baseline study to aid in the development of proper policy, we investigated the current condition of unpreparedness of documents required when issuing copies of medical records and related factors. METHODS: The study was comprised of 7,203 cases in which copies of medical records were issued from July 1st, 2007 through June 30th, 2008 to 5 tertiary referral hospitals. Data from these hospitals was collected using their established electronic databases and included study variables such as unpreparedness of the required documents as a dependent variable and putative covariates. RESULTS: The rate of unpreparedness of required documents was 14.9%. Multiple logistic regression analysis revealed the following factors as being related to the high rate of unpreparedness: patient age (older patients had a higher rate), issuance channels (on admission > via out-patient clinic), type of applicant (others such as family members > for oneself > insurers), type of original medical record (utilization records on admission > other records), issuance purpose (for providing insurer > medical use), residential area of applicant (Seoul > Honam province and Jeju), and number of copied documents (more documents gave a lower rate). The rate of unpreparedness differed significantly among the hospitals; suggesting that they may have followed their own conventional protocols rather than legal procedures in some cases. CONCLUSIONS: The study results showed that the level of compliance to the required legal procedure was high, but that problems occurred in assuring the safety of the medical information. A proper legislative approach is therefore required to balance the security of and access to medical information.
Coat Protein Complex I ; Compliance ; Electronics ; Electrons ; Humans ; Insurance Carriers ; Logistic Models ; Medical Records ; Outpatients ; Tertiary Care Centers

PURPOSE: This study was conducted to compare clinical features between Mycoplasma pneumonia and viral pneumonia. METHODS: We retrospectively analyzed the medical records of 428 patients requiring hospitalization among children younger than 18 years of age in 5 hospitals in Seoul and Gyeonggi-do. There were 131 patients with M. pneumonia and virus coinfection, 167 patients with M. pneumonia without virus coinfection, and 130 patients with viral pneumonia. All subjects had radiographic evidence of pneumonia with specimens available for both M. pneumonia and viral testing. Virus was identified using the polymerase chain reaction assay in a nasopharyngeal or oropharyngeal swab. M. pneumoniae pneumonia was diagnosed serologically. RESULTS: Human rhinovirus was detected in 60.3% (79 of 131) of children with M. pneumonia accompanied by virus coinfection. Respiratory syncytial virus (RSV) was detected in 38.2% (50 of 130) of children with viral pneumonia. The mean age was significantly lower in the viral pneumonia group than in the M. pneumonia group with and without virus coinfection. The sex distribution did not differ significantly among the 3 study groups. The procalcitonin level was higher in viral pneumonia and erythrocyte sedimentation rate level was higher in the M. pneumonia group although no significant difference was found in C-reactive protein level between the M. pneumonia and viral pneumonia groups. CONCLUSION: Clinical features and inflammatory markers between M. pneumonia and viral pneumonia may be useful for the treatment of community-acquired pneumonia.
Blood Sedimentation ; C-Reactive Protein ; Child* ; Coinfection ; Cross-Sectional Studies* ; Gyeonggi-do ; Hospitalization ; Humans ; Medical Records ; Mycoplasma* ; Pneumonia ; Pneumonia, Mycoplasma* ; Pneumonia, Viral ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Rhinovirus ; Seoul ; Sex Distribution