No abstract available.
DNA* ; Ploidies*

BACKGROUND: Unexpected deaths of the patients at ED are surprising to the medical staffs as well as the families. It may also increase the possibilities of medico-legal problems. This study was conducted to review the unexpected death in ED and find the predictive factors leading patients to unexpected death. METHODS: A retrospective study with reviewing available medical records of 183 patients who were expired at ED of Shinchon Severance Hospital from Mar. 1997 to Feb. 1998 and 103 patients of Youngdong Severance Hospital from Mar. 1996 to Feb. 1998 was done. Analyses were 4one on 30 variables of physical findings, laboratory results, procedures and therapies. We used univariate analysis, such as t-test and x2-test and multiple logistic regression analysis. RESULTS: Of the total 286 deaths in ED, 153 cases were enrolled in this analysis. The number of unexpected deaths were 76. Age, mental status, fraction of neutrophil count, BUN level, whether endotracheal incubation was done, use of inotropics were the factors with statistical ,significance on the univariate analysis, but only comatose mentality, endotracheal incubated case, and use of the inotropics were significant on logistic regression analysis. The longer the ED length of stay, the higher the rate of mortality and unexpected death. CONCLUSION: This result suggest that medical attention is needed on the patients with comatose decreased mental stylus, endotracheally intubated case and needing inotropic agents to prevent unexpected deaths. Shortening the ED length of stay may also be a factor for decrease the unexpected death rate.
Coma ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Length of Stay ; Logistic Models ; Medical Records ; Medical Staff ; Mortality ; Neutrophils ; Retrospective Studies

In adolescents, sleep deprivation problem is getting worse, and increased caffeine consumption is considered to relieve the stress caused by sleep deprivation and academic burden. In this study, immediate neurologic effects of caffeine intake on adolescents were evaluated in three high school students using the γ-aminobutyric acid (GABA)/creatine ratio on magnetic resonance spectroscopy (MRS). MEGA-PRESS MRS and TE 135 ms single voxel MRS were performed in the anterior cingulate cortex before and after drinking a cup of coffee, which contained 104 mg of caffeine. GABA and creatine were measured on LCModel 6.3, respectively. In all three students, GABA/creatine ratios were decreased after caffeine intake. The GABA/creatine ratios obtained before caffeine intake were decreased after caffeine intake in all the three adolescents. In this preliminary study, caffeine intake caused an immediate decrease in the GABA/creatine ratio in the brain and it may be related to the neurologic effects of caffeine on an adolescent's brain.
Adolescent* ; Brain ; Caffeine* ; Coffee ; Creatine ; Drinking ; gamma-Aminobutyric Acid ; Gyrus Cinguli ; Humans ; Magnetic Resonance Spectroscopy ; Sleep Deprivation

In adolescents, sleep deprivation problem is getting worse, and increased caffeine consumption is considered to relieve the stress caused by sleep deprivation and academic burden. In this study, immediate neurologic effects of caffeine intake on adolescents were evaluated in three high school students using the γ-aminobutyric acid (GABA)/creatine ratio on magnetic resonance spectroscopy (MRS). MEGA-PRESS MRS and TE 135 ms single voxel MRS were performed in the anterior cingulate cortex before and after drinking a cup of coffee, which contained 104 mg of caffeine. GABA and creatine were measured on LCModel 6.3, respectively. In all three students, GABA/creatine ratios were decreased after caffeine intake. The GABA/creatine ratios obtained before caffeine intake were decreased after caffeine intake in all the three adolescents. In this preliminary study, caffeine intake caused an immediate decrease in the GABA/creatine ratio in the brain and it may be related to the neurologic effects of caffeine on an adolescent's brain.
Adolescent* ; Brain ; Caffeine* ; Coffee ; Creatine ; Drinking ; gamma-Aminobutyric Acid ; Gyrus Cinguli ; Humans ; Magnetic Resonance Spectroscopy ; Sleep Deprivation

No abstract available.

Chondroblastoma is a rare primary neoplasm of bone which involves the epiphysis of the long bone and develops mostly in the 2nd decade of life. We reviewed the cases of twenty patients with chondroblastoma who were treated at the Department of Orthopaedic Surgery, Yonsei University College of Medicine between 1969 and 1989. All patients were followed for 1 year or longer. The results were as follows. 1. The proximal end of the humerus(25%) and the proximal end of the femur(25%) were the most common sites. 2. 85% of patients were between 11 to 20 years old and male to female ratio was 3:2. 3. The most common symptom was pain and in 30% of patients it was appeared after minor trauma. 4. The average diameter of lesion is 4.2cm in its long axis and the more longer the duration, the more larger the size of lesion. 5. Involvement of the epiphyseal plate was twice as common in the patients with a closing plate as in those with an open one. 6. The most common microscopic finding was the presence of chondroblast and chondroid matrix. 7. Two patients(10%) had a local recurrence. 8. The final functional results were considered to be good in sixteen(80%) patients. 9. Accurste localization of the lesion during biopsy is very important especially in the case of deep seated lesion.
Biopsy ; Chondroblastoma ; Chondrocytes ; Epiphyses ; Female ; Growth Plate ; Humans ; Male ; Recurrence

BACKGROUND: The accurate and early diagnosis of acute myeloid leukemia (AML) is important to choose proper treatment option depending on the risk stratification. The delta neutrophil index (DNI) is a relatively new blood marker that indicates the proportion of immature granulocytes in peripheral blood circulation. This study aimed to evaluate the diagnostic value of the DNI for detecting AML in the early phase of acute leukemia. METHODS: We retrospectively analyzed laboratory tests and bone marrow study results of 163 pediatric patients with acute leukemia admitted to the emergency department, who were diagnosed with acute leukemia. An automatic analyzer (ADVIA 2120 Hematology System; Siemens Healthcare Diagnostics, Forchheim, Germany) was used to measure the DNI in the peripheral blood of each patient. RESULTS: The mean DNI was significantly different between the AML (N=39) and non-AML (N=124) groups (P < 0.05), and the DNI was the only significant marker for predicting AML in patients with acute leukemia (odds ratio, 1.328; P < 0.05). The DNI more than 4.4% has the highest predictability for distinguishing the patients with AML from the patients with acute leukemia. The mean DNI of the acute promyelocytic leukemia (APL, N=8) group was statistically higher than that of the non-APL group (N=31, P=0.019), but the DNI was not significant in the univariate logistic regression analysis. CONCLUSION: The DNI might be a promising peripheral blood marker for predicting AML in the early work-up of patients with acute leukemia.
Blood Circulation ; Bone Marrow ; Child ; Delivery of Health Care ; Early Diagnosis ; Emergency Service, Hospital ; Granulocytes ; Hematology ; Humans ; Leukemia* ; Leukemia, Myeloid, Acute ; Leukemia, Promyelocytic, Acute ; Logistic Models ; Neutrophils* ; Retrospective Studies

Young Simpson syndrome is a rare malformation syndrome characterized by congenital hypothyroidism, dysmorphic face, mental retardation, severe postnatal growth retardation, hypotonia and congenital heart abnormalities. In the present study, we report a case of 4-year-old girl with Young Simpson syndrome for the first case in Korea.
Child, Preschool ; Congenital Hypothyroidism ; Female ; Heart Defects, Congenital ; Humans ; Intellectual Disability ; Korea ; Muscle Hypotonia

Pellucid marginal degeneration is an uncommon, idiopathic, non-inflammatory, peripheral thinning disorder affecting the inferior cornea bilaterally. Protrusion of the cornea occurs above a band of thinning which is located 1 to 2mm from the limbus and measures 1 to 2mm in width. The disease is diagnosed usually between 20 and 50 years of age and its etiology remains obscure. We experienced two cases of pellucid marginal degeneration who had a histories of progressIve visual disturbance due to high irregular astigmatism. A 32 year old female(case.1) had the characteristic feature of pellucid marginal corneal degeneration with marked endothelial cell loss(OD. 624 +/- 32 cells/mm2, OS. 596 +/- 52 cells/mm2) in polymorphism. A 30 year old male(Case. 2) showed pellucid marginal corneal degeneration associated with rheumatoid athritis, but corneal endothelial cells appeared within normal ranges(OD. 2764 +/- 26, OS. 2812 +/- 34) with slight polymorphism. The Vision in these two cases improved to 20/20 with hard contact lens(Case. 1) and glasses(Case.2)
Adult ; Astigmatism ; Cornea ; Endothelial Cells ; Humans

Little has been known about what pathways subserve mirth and its expression laughter. We report two patients with cryptogenic gelastic seizures who provide some insight into the mechanisms of laughter. Invasive video-EEG monitoring showed ictal onset zone to be either in the left or right medial frontal cortex. After resection of the medial frontal area, including the epileptogenic focus, patients have been in gelastic seizure-free state. This suggests the possibility that medial frontal cortex is involved in the motor act of laughter.
Humans ; Laughter ; Seizures*