No abstract available.

Traumatic injury can result not only in physical disability but also in mental and behavioral sequelae. It is very important to properly judge the severity of disability as well as the need for assistance and future medical treatment. It is very difficult to establish objective guidelines for assessing mental and behavioral disabilities due to the inherent peculiarity of the disabilities. This study uses reports generated for court because they need to be more judicious than reports for other types of evaluation. We analyzed reports concerning the facts and problems associated with evaluation of mental and behavioral disabilities. We hope this study will help further our understanding of mental and behavioral disabilities.

BACKGROUND: V. vulnificus infection is found between May and October when the man who has hepatic disorder or immunity disorder eats raw shellfish and it causes the systemic symptoms such as sudden fever, chilling, shock and stupor and local skin lesions like blob and necrosis. This disease has 46~61% of fatality rate in spite of intensive treatment. This study conducts the examination of history, epidemic study, ingesting raw fish and bacteriologic investigation in the patients with similar clinical symptoms to the above and examines the diagnostic correlations. METHOD: It is conducted with 31 cases who admitted at emergency medical center of Chosun University Hospital from May of 1995 to September of 1998 and are suspected to have V. vulnificus infection. It analyze bacteriologic examination, the survey of residence, eating raw shellfish, hepatic disorder, alcohol drinking habits and skin lesion. RESULTS: 1)the rate of male and female is 15.5:1 and in the age, 18 cases are in fifties, seven ale in fifties and six are over sixties. 2) Clinically, V. vulnificus is detected in 20 of 31 cases which is suspected to have V. vulnificus i18c1ion and it is not detected in 5 cases. Other bacteria are detected in 6 cases and they include staphylococcus aureus, pseudomonas species, beta hemotytic streptococcus and E-coil. 3) In local distribution, Kohung has 10 cases, Shinan and Mokpo have six, Haenam and Kangjin have aye, Yongkwang and Muan have five, Naju and Yongam have five and Kwangju has one. 4) Eating fishes and raw shellfishes is found in 31 cases. In the kind of shellfishes, eating raw clam is 10 cases, raw thin-shelled surf calm is 8 cases, raw oyster is 5 cases and sliced raw fish is 4 cases and pickled sea floods ate 4 cases. 5) The cases with hepatic disorder are 23 and 15 Gases with heavy alcohol dunking Carrier are included. The cases with Diabetic Mellitus are four and those with pulmonary tuberculosis are two. Two cases have not basal diseases. 6) On the opinion of skin lesion, 20 cases show vesicular necrosis, 7 cases have dendriform erythema, 3 cases have papule and one case doesn't show clear skin lesion. CONCLUSION: When V. vulnificus infection is detected, it is fatal and those who have hepatic disorder or heavy alcohol drinking habit must avoid eating fishes and shellfishes raw in summer. It is important to have emergency treatment for the patient whose V. vulnificus infection is suspected. It is considered that the administration of initial antibiotics is effective by generalizing the clinical symptom, epidemic opinion and patient history even before the results of bacteriologic confirmed.
Alcohol Drinking ; Anti-Bacterial Agents ; Bacteria ; Bivalvia ; Eating ; Emergencies ; Emergency Treatment ; Erythema ; Female ; Fever ; Fishes ; Floods ; Gases ; Gwangju ; Humans ; Jeollanam-do ; Male ; Necrosis ; Ostreidae ; Pseudomonas ; Shellfish ; Shock ; Skin ; Staphylococcus aureus ; Streptococcus ; Stupor ; Tuberculosis, Pulmonary ; Vibrio vulnificus* ; Vibrio*

Respiratory syncytial virus(RSV) is currently implicated as the most common and otentially serious viral respiratory pathogen of young infants. Apnea in association with RSV infection occurred in about 18% of the infants. Premature birth and a young postnatal age were risk factors for development of apnea with RSV disease. We experienced a case of RSV infection in a 37 day-old premature girl. The presenting complaint was apnea, with respiratory signs and symptoms developing later. She required mechanical ventilation.
Apnea* ; Female ; Humans ; Infant ; Premature Birth ; Respiration, Artificial ; Respiratory Syncytial Viruses* ; Risk Factors

Tuberculous uveitis is a rare manifestation of tuberculosis infection. Although early diagnosis is important to saving the sight of patients, it is difficult. In dialysis patient, the diagnosis of tuberculosis is often delayed because of non-specific symptoms and extrapulmonary involvements. We report a case involving a 37-year-old man receiving hemodialysis who was presented with persistent fever and left- sided blurred vision. At ophthalmic examination, active papillitis, vitritis, and peripapillary retinal detachment were observed. Neck computed tomography showed multiple necrotic lymphadenopathies (LAPs) in right lateral neck, which was proven as tuberculous lymphadenitis on histological examination. After anti-tuberculosis therapy, fever was subsided and LAPs were improved. Visual acuity was also improved.
Adult ; Dialysis ; Early Diagnosis ; Fever ; Humans ; Hyperthermia, Induced ; Neck ; Papilledema ; Renal Dialysis ; Retinal Detachment ; Tuberculosis ; Tuberculosis, Lymph Node ; Uveitis ; Vision, Ocular ; Visual Acuity

STUDY DESIGN: A retrospective study of the effectiveness of traction thoracolumbosacral orthosis (TLSO) in idiopathic scoliosis. OBJECTIVE: To compare the results of traction TLSO and conventional TLSO. SUMMARY OF LITERATURE REVIEW : No report has been published about longitudinal traction and lateral force before cast molding in the nonoperative treatment of idiopathic scoliosis. MATERIALS AND METHODS: Twenty-one cases of traction TLSO (group I) and 17 cases of conventional TLSO (group II) were studied. Traction TLSO was made as follows: 1. Cervical traction was applied to the patient standing under the frame with application of lateral force with compression pad. 2. Cast molding. 3. Fabrication of plastic jacket and application of pads. The mean age of group I was 12 years and of group II, 13 years. We evaluated the effectiveness of traction TLSO with Cobb`s angle reduction, trunk pain and dyspnea. Statistical analysis was made with SPSS. RESULTS: In group I, mean pre-brace Cobb`s angle was 31.1 degrees and in group II, 29.6 degrees. Flexibility of the curves was 78% and 75%, respectively. Mean reduction rate of Cobb`s angle after 3 days of brace application was 59.5% and 15.4%, respectively. One year later, reduction of Cobb`s angle was 15.4 degrees in group I and 2.7 degrees in group II. Reduction rate of Cobb`s angle after 1 year of brace application was 54.2% and 7.9%, respectively. Post-brace pain and dyspnea were similar in both groups. CONCLUSION: Traction TLSO was superior to conventional TLSO in terms of angle reduction, but was similar in subjective symptoms.
Braces ; Dyspnea ; Fungi ; Humans ; Orthotic Devices* ; Plastics ; Pliability ; Retrospective Studies ; Scoliosis* ; Traction*

PURPOSE: To report a case of anterior segment ischemia after superior and inferior rectus muscle surgery in a patient with superior rectus muscle enlargement. This is the first report in the Republic of Korea of anterior segment ischemia after two rectus muscles surgery. CASE SUMMARY: An 80-year-old male was referred to our clinic with a 3 years history of diplopia. The patient had 30 prism diopters right eye hypertropia in the primary position and downgaze limitation. The orbital computed tomography scan revealed enlargement of the right superior rectus muscle. He underwent right superior rectus recession and inferior rectus resection. On postoperative day 2, slit lamp examination revealed diffuse corneal edema, Descemet's membrane folding, an aqueous flare and a dilated pupil. Treatment with 45 mg oral steroid was initiated, and 1% prednisolone acetate and 0.5% Levofloxacin eye drops were administered. At postoperative 1 month, the patient was orthophoric in the primary position, and there was no corneal edema, pupil abnormality or aqueous flare. CONCLUSIONS: Base on the present case, the possibility of anterior segment ischemia should be considered after even two muscles surgery, and older patients with vertical muscle surgery should be considered more carefully.
Aged, 80 and over ; Aqueous Humor ; Corneal Edema ; Descemet Membrane ; Diplopia ; Humans ; Ischemia ; Levofloxacin ; Male ; Muscles ; Oculomotor Muscles ; Ophthalmic Solutions ; Orbit ; Prednisolone ; Pupil ; Republic of Korea ; Slit Lamp ; Strabismus

We clinically reviewed four patients who were suffering from aseptic meningitis combined with polio-like paralysis and performed radiological. neurological and virological studies on them. Three patients were admitted to the department of Pediatrics. Asan Medical Center from March to August 1990, and one patient was admitted to the department of Pediatrics. Kangnam General Hospital. The results were as follows; 1) During the period of study, 18 patients (10.1%)out of 178 aseptic meningitis patients also suffered from hand, foot and mouth disease, and three patients (1.69%) out of 178 patients also suffered from polio-like paralysis. 2) The age of the patients who also suffered from polio-like paralysis were eight months, 22 months, 23 months and four years old respectively. Three patients were male and one patient was female. 3) Paralysis developed three to five days after aseptic meningitis infection. 4) In two cases, Magnetic Resonance Imaging (MR) showed two small cavitary lesions that means anterior horn cell necrosis in concordant with residual paralysis. Axial T1-weighted image showed decreased signal intensity and axial T2-weighted image showed increased signal intensity. In another case 20 days after onset of illness MR was performed, the transverse myelitis showed mild swelling of cornus medullaris. Follow up MR in 2 months revealed atropic change in lower thoracic spinal cord. 5) The electromyography and nerve conduction velocity test revealed acute polyradiculoneuropathy. 6) Serologic virus study were carried out in three cases for Coxsackievirus A16 and Enterovirus 71. The Enterovirus 71 antibody titer were 1:128 in two cases and 1:64 in one case. The Coxsackievirus A16 antibody titer were less than 1:4. This study showed that the causative agents for polio-like paralysis during this period seemed to be the Enterovirus 71 infection.
Anterior Horn Cells ; Chungcheongnam-do ; Cornus ; Electromyography ; Enterovirus ; Female ; Follow-Up Studies ; Hand, Foot and Mouth Disease ; Hospitals, General ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis, Aseptic* ; Myelitis, Transverse ; Necrosis ; Neural Conduction ; Paralysis* ; Pediatrics ; Polyradiculoneuropathy ; Spinal Cord

PURPOSE: To determine the hemodynamics of the pancreas by investigating the enhancement patterns of pancreaticparenchyma, as seen on spiral CT, after the administration of various amounts of contrast medium, and to determineoptimal scan time by knowing the peak time of normal pancreatic parenchyma. MATERIALS AND METHODS: Between January1995 and April 1997 55 cases of normal abdominal CT with dynamic enhancement study on pancreas, the subject were38 cases(28 persons) with good image, aged 21-65 years, men were twenty-one and women were seven. Non-ioniccontrast medium, 30ml(n=15), 60ml(n=9), 990ml(n=7), and 120ml(n=7) were injected at a rate of 3ml/sec. From 20sec. after the start of injection, 15 images were obtained at 3-sec intervals. Before and after injection, R.O.I.was applied to each image, and for the aorta and pancreatic parenchyma, Hounsfield units(H.U.) were measured; timeof enhancement and maximal H.U. were also measured. RESULTS: After 30, 60, 90, and 120ml of contrast mediuminjection, mean maximal H.U. of pancreatic parenchyma was 36+/-7, 54+/-6, 68V13, and 92+/-8, respectively; mean valueat peak parenchymal enhancement of the pancreas was 27+/-3, 32+/-3, 42+/-3, and 52+/-3, respectively. Time intervalsof maximal enhancement of aorta and pancreatic parenchyma could not be obtained in 30ml injection, but 5,4+/-2.5,4.2+/-1.6, and 6.0+/-2.1sec in 60, 90, and 120ml injection, respectively. CONCLUSION: Maximal H.U. of parenchymalenhancement of the pancreas is directly proportional to the amount of injected contrast medium and the peak timeof parenchymal enhancement was 12sec after the injection of contrast material. Time interval of maximalenhancement of aorta and pancreatic parenchyma was 5.2+/-2.1sec.
Aorta ; Contrast Media ; Female ; Hemodynamics ; Humans ; Male ; Pancreas* ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

BACKGROUND: We aimed to study the regional cerebral PET activation patterns during memory tests in medial temporal lobe epilepsy (mTLE) patients and to see whether the activation study could lateralize memory dominance. METHODS: Participants included 6 right mTLE patients, 6 left mTLE patients, and 6 controls. Language was dominant in the left hemisphere in all the participants. PETs were performed while presenting a set of 30 line drawings of com-mon objects with 4 second intervals between each drawing. After 30 minutes, PETs were repeated while presenting a set of drawings with half of the obejcts changed. RESULTS: During the encoding, activated areas were dispersed in mTLE in the superior frontal gyrus, the primary sensory cortex, the premotor area, the supramarginal and angular gyri ipsilaterally or contralaterally, in addition to the inferior and middle frontal gyri activated in the controls. During the retrieval, activated areas were localized in the bilateral inferior frontal gyri and the right medial temporal area in the controls, but also in the premotor area, the primary sensory cortex, and the angular gyrus in mTLE. In the encoding and also in the retrieval, the activated fields of the prefrontal areas contralateral to the epileptogenic zone became wider compared to the controls and those ipsilateral to the epileptogenic zone became smaller. CONCLUSIONS: Cortical areas involved in the encoding and retrieval of the episodic memory are dispersed and contralaterally lateralized to the epileptogenic zone. Lateralization is most prominent in the prefrontal areas.
Brain Mapping* ; Brain* ; Electrons* ; Epilepsy, Temporal Lobe* ; Humans ; Memory ; Memory, Episodic* ; Positron-Emission Tomography* ; Temporal Lobe*