No abstract available.
Hantaan virus* ; Hemorrhagic Fever with Renal Syndrome* ; Prevalence*

PURPOSE: To review reversible posterior leukoencephalopathy syndrome. MATERIALS AND METHODS: We reviewed 22 patients (M:F=3:19; age, 17-46 years) with the characteristic clinical and imaging features of reversible posterior leukoencephalopathy syndrome. All underwent brain MRI, and in three cases both CT and MRI were performed. In one, MRA was obtained, and in eleven, follow-up MR images were obtained. We evaluated the causes of this syndrome, its clinical manifestations, and MR findings including the locations of lesions, the presence or absence of contrast enhancement, and the changes seen at follow-up MRI. RESULTS: Of the 22 patients, 13 had eclampsia (six during pregnancy and seven during puerperium). Four were receiving immunosuppressive therapy (three, cyclosporine; one, FK 506). Four suffered renal failure and one had complicated migraine. The clinical manifestations included headache (n=12), visual disturbance (n=13), seizure (n=15), focal neurologic sign (n=3), and altered mental status (n=2). Fifteen patients had hypertension and the others normotension. MRI revealed that lesions were bilateral (n=20) or unilateral (n=2). In all patients the lesion was found in the cortical and subcortical areas of the parieto-occipital lobes; other locations were the basal ganglia (n=9), posterior temporal lobe (n=8), frontal lobe (n=5), cerebellum (n=5), pons (n=2), and thalamus (n=1). All lesions were of high signal intensity on T2-weighted images, and of iso to low intensity on T1-weighted images. One was combined with acute hematoma in the left basal ganglia. In eight of 11 patients who underwent postcontrast T1-weighted MRI, there was no definite enhancement; in one, enhancement was mild, and in two, patchy. CT studies showed low attenuation, and MRA revealed mild vasospasm. The symptoms of all patients improved. Follow-up MRI in nine of 11 patients depicted complete resolution of the lesions; in two, small infarctions remained but the extent of the lesions had decreased. CONCLUSION: Reversible posterior leukoencephalopathy syndrome develops in patients with toxemia of pregnancy, renal insufficiency or complicated migraine, and those who undergo immonosuppresive therapy. The characteristic MR finding is edema in cortical or subcortical areas of the parietal and occipital lobes, without enhancement after Gd-DTPA injection. Early recognition of this readily treatable condition may obviate the need for extensive, invasive investigations, and prompt treatment can lead to a favorable prognosis.
Basal Ganglia ; Brain ; Cerebellum ; Cyclosporine ; Eclampsia ; Edema ; Female ; Follow-Up Studies ; Frontal Lobe ; Gadolinium DTPA ; Headache ; Hematoma ; Humans ; Hypertension ; Infarction ; Magnetic Resonance Imaging ; Migraine with Aura ; Neurologic Manifestations ; Occipital Lobe ; Pons ; Posterior Leukoencephalopathy Syndrome* ; Pre-Eclampsia ; Pregnancy ; Prognosis ; Rabeprazole ; Renal Insufficiency ; Seizures ; Temporal Lobe ; Thalamus

PURPOSE: The purpose of this study was to investigate the consumption behaviors of sugar-sweetened beverages and blood lipid profiles according to food-related lifestyles of adults in Incheon. METHODS: Subjects were recruited from 19 to 64 year old adults residing in Incheon who visited for the purpose of a health examination at D hospital. A total of 110 subjects consented to participate in this study and to allow their health examination records to be used at D hospital. Data were collected using self-administered questionnaires and anthropometric data, and blood lipid profiles were collected from health examination records. Statistical analysis was performed using the SPSS 20.0 program. RESULTS: In the factor analysis, food-related lifestyles were categorized into four factors: planned purchase seeking, taste seeking, well-being seeking, and convenience seeking. Using the K-average clustering method, food-related lifestyles of subjects were categorized into two groups: health and rationality-oriented group (HRG) and convenience purchase-oriented group (CPG). Average total scores of sugar-related nutrition knowledge in the HRG were significantly higher compared to the CPG, and average scores of consumption habits regarding sugar-containing foods in the HRG were significantly lower compared to the HRG. When subjects chose sugar-sweetened beverages, the CPG showed a significantly higher frequency of checking food labeling and considering nutrition compared to the CPG. Drinking frequency of carbonated beverages in the CPG was significantly higher compared to the HRG. CONCLUSION: There were significant differences in sugar-related nutrition knowledge and consumption habits of sugar-sweetened beverages between the two food-related lifestyle groups. These results could be useful for establishing guidelines for reducing consumption of sugar-sweetened beverages. In addition, it is necessary to continue sugar-related nutrition education by considering the food-related lifestyles of adults.
Adult* ; Beverages* ; Carbonated Beverages ; Drinking ; Education ; Food Labeling ; Humans ; Incheon* ; Life Style* ; Methods

PURPOSE: To evaluate the role of radiotherapy in the management of incompletely resected supratentorial low grade astrocytoma with the analysis of the survival, the pattern of failure, and the prognostic variables affecting survival. MATERIAL AND METHODS: Between January 1990 and December 1995, fifty- one patients with supratentorial low grade astrocytoma received radiotherapy after subtotal resection(16 patients) or stereotactic biopsy(35 patients) at Asan Medical Center. External radiotherapy was done by conventional fractionation with the total dose of 4820cGy to 6000cGy(median 5580cGy) and partial brain volume. The follow-up was done from 6 to 79 months(median 48 months). RESULTS: Overall actuarial survival rate at 2 and 5 years were 83.4% and 54.8%, respectively. Progression free survival at 2 and 5 years were 67.4% and 48.7%, respectively. The significant prognostic factors affecting overall survival rate were the performance status, T stage, histologic subtype, radiation field and radiation response. The major pattern of failure was local failure, such as progressive disease and primary site recurrence in 23 patients (45.1%). Progression free survivors excluding 2 patients were physically and intellectually intact without major neurologic deficit. CONCLUSION: Although the follow-up period of this study was relatively short, overall actuarial and progression free survival rate were encouraging. Patients with good performance status, lower T stage, pilocytic subtype, patients treated with small radiation field and radiation responder showed better survival. As the local failure was the major pattern of failure, the various efforts to decrease the local failure is necessary.
Astrocytoma* ; Brain ; Chungcheongnam-do ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Neurologic Manifestations ; Radiotherapy* ; Recurrence ; Survival Rate ; Survivors

BACKGROUND: Sepsis is a major insult leading to increased muscle breakdown and oxidation of amino acids. Disturbed plasma and brain amino acid levels may be important in the altered mental status observed in patients with infections and alteration in mental status due to sepsis has been associated with an increased mortality rate. Erythrocytes have been suggested as transport cells for amino acids and may be better than plasma for utilization and storage of amino acids in the body. Several reports suggested that amino acid alterations in plasma and erythrocytes have had an important role in sepsis. So we investigated the association between severity and prognosis of sepsis and amino acid levels in plasma and erythrocytes. METHODS: Heparinized plasma and erythrocytes were taken from 25 healthy controls, 10 infected patients and 15 septic patients. The amino acid levels were determined using high performance liquid chromatography after deproteinization with sulfosalicylic acid. RESULTS: Plasma amino acid pattern showed elevated levels of the aromatic amino acids (tyrosine and phenylalanine) and sulfur-containing amino acid (cystine) but decreased level of branched chain amino acid (isoleucine) in septic patients compared with healthy controls or infected patients. Patients with septic encephalopathy had higher levels of tyrosine, phenylalanine and sulfur-containing amino acid (methionine) than patients without septic encephalopathy. The ratios of erythrocytes to plasma showed no significant decrease in septic patients compared with healthy controls or infected patients. However, in patients with septic encephalopathy, methionine, leucine and phenylalanine levels were lower than in patients without septic encephalopathy. CONCLUSIONS: The results showed a characteristic pattern of amino acid derangements in plasma and erythrocytes of septic patients. This pattern was more prominent in severe sepsis. It was suggested that the severity and prognosis of septic patients could be predicted by measuring the amino acid levels of plasma and erythrocytes.
Amino Acids ; Amino Acids, Aromatic ; Brain ; Chromatography, Liquid ; Erythrocytes* ; Heparin ; Humans ; Leucine ; Methionine ; Mortality ; Phenylalanine ; Plasma* ; Prognosis ; Sepsis* ; Tyrosine

Familial adenomatous polyposis (FAP) includes early development of up to thousands of colorectal adenoma and of colonic adenocarcinoma in all untreated cases. Moreover, a variety of extracolonic manifestation are seen. Several reports have demontrated a high incidence of papillry carcinoma of thyroid. We experienced a case of familial adenomatous polyposis, presenting with thyoid papillry carcinoma, and reported with a brief review of literatures.
Adenocarcinoma ; Adenoma ; Adenomatous Polyposis Coli* ; Carcinoma, Papillary* ; Colon ; Incidence ; Thyroid Gland* ; Thyroid Neoplasms

BACKGROUND: Glomerular injury induced by angiotensin II (Ang II) may arise from its hemodynamic or non-hemodynamic actions including oxidative stress, or from such effects of Ang II acting in concert. The release of reactive oxygen species from podocytes may play a role in the pathogenesis of glomerular damage and proteinuria. METHODS: To investigate whether Ang II induces oxidative stress in vitro in glomerular epithelial cells (GEpC) and whether such oxidant stress may increase in vitro glomerular permeability model using cultured GEpC, we studied GEpC culture exposed to Ang II and antioxidant, probucol. For oxidative system assay, we measured the production of superoxide anion and hydrogen peroxide and the activity of superoxide dismutase (SOD). Scanning electron microscopy was performed on cells grown for one week on chamber slides. RESULTS: We found that in vitro permeability, which was prevented from probucol, increased significantly in media with 10-4 and 10-5 M of Ang II by 15.9% and 13%, respectively. Administration of the 10-5 M of Ang II significantly increased the superoxide anion productions by 39%, 61% and 30% at 1, 2 and 6 hours exposure time, respectively, compared to those of control and suppressed by probucol to control levels. At high concentration (10-5 M) Ang II suppressed the activity of SOD without affecting the production of hydrogen peroxide on the other hand, at low concentration (less than 10-5 M) Ang II showed reverse results. On ultrastructural examination, we could see the shortened and fused microvilli on GEpC surface by 10-5 M of Ang II, which change could be prevented by probucol. CONCLUSION: We could suggest that Ang II induces the generation of superoxide anion and the suppression of the activity of SOD, and subsequent oxidative stress leading to increase glomerular permeability by disruption of glomerular filtration barrier.
Angiotensin II* ; Angiotensins* ; Epithelial Cells* ; Glomerular Filtration Barrier ; Hand ; Hemodynamics ; Hydrogen Peroxide ; Microscopy, Electron, Scanning ; Microvilli ; Oxidative Stress* ; Permeability* ; Podocytes ; Probucol ; Proteinuria ; Reactive Oxygen Species ; Superoxide Dismutase ; Superoxides

Postpubertal mumps may result in ochitis and permanent testicular atrophy may develop following infection. This present study was initiated to evaluate the preventive effect of interferon-alpha2B on infertilty after mumps orchitis. There were 21 patients with mumps orchitis between May 1990 and June 1997. Patients were randomly distributed into 2 groups: group 1 patients (n=13) maintained therapy with interferon-alpha2B (3x10(6) IU per day) and group 2 were managed by conservatively. All of the patients were evaluated with testis size measurement, mumps virus titer, hormone level, and if possible semen analysis. For group 1 patients symptoms disappeared within 2 to 3 days and the volume of testis returned to normal within 11 days and testis atrophy was not observed in all patients in follow up. But asthenospermia was continued in 4 patients (unilateral 2, bilateral 2). For group 2 patients symptoms disappeared within 5 to 6 days and the volume of testis returned to normal within 10 days and testis atrophy was observed in 3 patients (unilateral 2, bilateral 1) in floow up. Asthenospermia was continued in 4 patients (unilateral 2, bilateral 2). Sperm count and morphology were recovered all the recover in group 1, 4 patients had persistent reduced sperm count and morphology in group 2, respectively. These observations suggest that systemic interferon-alpha2B treatment is highly effective in preventing infertility as well as testicular atrophy after mumps orchitis.
Atrophy ; Follow-Up Studies ; Humans ; Infertility* ; Male ; Mumps virus ; Mumps* ; Orchitis* ; Semen Analysis ; Sperm Count ; Testis

PURPOSE: To determine the significance of nerve root contrast enhancement in patients with residual or recurrent symptomatic postoperative lumbar spine. MATERIALS AND METHODS: Eighty-eight patients with 116 postoperative lumbar disc lesions causing radiating back pain underwent enhanced MR imaging. Intradural nerve root enhancement was quantified by pixel measurement, and affected nerve roots were compared before and after contrast administration. Extradural nerve root enhancement was assessed visually, and nerve root enhancement and clinical symptoms were correlated. Associated lesions such as recurrent disc herniation, scar tissue, nerve root thickening and nerve root displacement were also evaluated. RESULTS: Of 26 cases(22.4%) involving intradural nerve root enhancement, 22 (84.6%) showed significant clinical symptoms (p=0.002). and of 59 (50.9%) demonstrating extradural enhancement, clinical symptoms showed significant correlation in 47 (79.7%) (p=0.001). Nerve root enhancement, including eleven cases where this was both intra-and extradural, showed highly significant association with clinical symptoms in 74 of the 116 cases (63.8%) (p=0.000). Among 33 cases (28.4%) of recurrent disc herniation, nerve root enhancement was observed in 28 (84.8%) and in 24 of these 28 (85.7%), significant correlation with clinical symptoms was observed (p=0.000). Where epidural fibrosis was present, correlation between nerve root enhancement and clinical symptoms was not significant (p>0.05). Nerve root thickening and displaced nerve root were, however, significantly associated with symptoms(87.2% and 88.6%, respectively). CONCLUSION: In patients with postoperative lumbar spine, the association between nerve root enhancement revealed by MRI and clinical symptoms was highly significant.
Back Pain ; Cicatrix ; Fibrosis ; Humans ; Magnetic Resonance Imaging* ; Nerve Tissue ; Spine*

Systemic sclerosis is a connective tissue disease involving primarily the skin and subcutaneous tissue but may involve other organ systems such as the lungs, gastrointestinal tract, and heart. Systemic sclerosis is a rare childhood disease. The age of onset for patients with systemic sclerosis has its peak between 30 and 50 years of age. Only 1 to 2% of all patients with systemic sclerosis have disease onset before the age of 10 years of age. We report a case of systemic sclerosis in a 7-year-old female who showed Raynaud's phenomenon as an initial manifestation.
Age of Onset ; Child* ; Connective Tissue Diseases ; Female ; Gastrointestinal Tract ; Heart ; Humans ; Lung ; Scleroderma, Systemic* ; Skin ; Subcutaneous Tissue