No abstract available.
Electroencephalography* ; Humans ; Neurologic Manifestations* ; Seizures*

No abstract available.
Trichosporon*

Widespread use of amitriptyline in clinical practice has led to extensive knowledge of its therapeutic and toxic effects. In cases of amitriptyline overdose, delirium, arrhythmia, convulsion, and adult respiratory distress syndrome have been reported, but amitriptyline-associated rhabdomyolysis has been rarely reported in the literature. Several drugs are associated with myositis or myopathy, but amitriptyline-related myositis has not been reported. We describe a 40-year-old woman with rhabdomyolysis and localized myositis in left proximal thigh after she had taken 625mg of amitriptyline.
Adult ; Amitriptyline ; Arrhythmias, Cardiac ; Delirium ; Female ; Humans ; Muscular Diseases ; Myositis* ; Respiratory Distress Syndrome, Adult ; Rhabdomyolysis* ; Seizures ; Thigh

No abstract available.
Mononeuropathies* ; Systemic Vasculitis ; Vasculitis*

Multilocular cystic nephroma is a rare disease, noninherited benign renal neoplasm occurring in both children and adults. It is necessary to make a differential diagnosis from all renal diseases with a cystic component, such as Wilms tumor, armatoma or polycystic dysplastic kidney in childhood. There are about only 200 case reports in the world since Walter Edmunds had described it first. We report a case of multilocular cystic nephroma presented with painless abdominal mass, treated with nephrectomy and confirmed with pathology.
Adult ; Child ; Diagnosis, Differential ; Humans ; Kidney ; Kidney Neoplasms ; Nephrectomy ; Pathology ; Rare Diseases ; Wilms Tumor

We present two cases of the patients with spinal muscular atrophy(SMA) confirmed by molecular genetic studies. The first one is 1-year-old female child with SMA type II(Dubowitz disease) who visited pediatric outpatient for developmental delay. She presented lower extremity hypotonia which progress to upper extremities and inability to sit alone. Spinal cord MRI showed normal findings but the needle electromyography suggested the possibility of myopathy. Following muscle biopsy findings were consistent with spinal muscular atrophy and PCR-SSCP(polymerase chain reaction-single strand conformation polymorphism) analysis showed homozygous deletion of telomeric SMN(survivor motor neuron) exon 7. The second is a 19-year-old female with SMA type III(Kugelberg-Welander disease) who visited neurologic outpatient for limbs weakness. She presented slowly progressive gait disturbance without muscle atrophy. The significantly decreased motor power of proximal limbs was observed. And findings of electromyography and muscle biopsy were consistent with spinal muscular atrophy. PCR-SSCP analysis revealed homozyous deletion of exon 7 of telomeric SMN and deletion of exon 8 of centromeric SMN gene. PCR analysis for NAIP(neuronal apoptosis inhibitory protein) exon 5 and 13 revealed no deletion in both cases. Molecular genetic analysis for SMN gene will be very useful for rapid diagnosis of spinal muscular atrophy.
Apoptosis ; Biopsy ; Child ; Diagnosis ; Electromyography ; Exons ; Extremities ; Female ; Gait ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Molecular Biology* ; Muscle Hypotonia ; Muscular Atrophy ; Muscular Atrophy, Spinal ; Muscular Diseases ; Needles ; Outpatients ; Polymerase Chain Reaction ; Spinal Cord ; Upper Extremity ; Young Adult

OBJECTIVE: This study was undertaken to evaluate the value of bone single photon emission computed tomography(SPECT), simply radiography, magnetic resonance imaging(MRI), and arthroscopy to see the severity of osteoarthritis(OA) and the meniscal tear in patients with chronic knee pain. METHOD: Total 25 patients who had chronic knee pain and suspected meniscal tear during the period from May 1997 through June 1998 were included in the study. The simple radiography, bone SPECT and MRI were performed in all 25 patients. The arthroscopy was done in 17 patients and arthroplasty in four. In order to see the severity of OA, the arbitrary grading was done by SPECT, and kellgren-Lawrence grading by simple radiography and Outerbridge grading by arthroscopy were used. RESULTS: In 21 patients, bone SPECT and MRI with either arthroscopy or arthroplasty were done. Among the seventeen of these 21 patients who had a meniscal tear either by arthroscopy or arthroplasty, the meniscal tears were found in 15 patients by SPECT, and 14 patients by MRI. Spearman rank correlation coefficient between SPECT grading and arthroscopic grading was 0.814, and the coefficient between simple radiographic grading and arthroscopid grading was 0.360. CONCLUSION: The bone SPECT of the knee seems to be more cost-effective in comparison to MRI and arthroscopy to see the severity of OA and the meniscal tear in patients who has chronic knee pain.
Arthroplasty ; Arthroscopy* ; Humans ; Knee* ; Magnetic Resonance Imaging* ; Radiography ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVES: Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients' attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. METHODS: This cross-sectional study analyzed data from 653 Koreans aged > or =60 years who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. RESULTS: Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one's blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013). CONCLUSIONS: This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.
Aged ; *Aging ; Asian Continental Ancestry Group ; Awareness ; Blood Pressure ; Body Mass Index ; Cross-Sectional Studies ; Female ; *Health Status ; Humans ; Hypertension/diagnosis/epidemiology/*prevention & control ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea/epidemiology ; Sex Factors

Although neurologic complications of multiple myeloma are common, brain-involvement is rare, despite the high frequency of the cranial lesions. The cranial plasmacytoma grows only from bone, dura mater or adjacent mucous membrane and cerebral structures are affected secondarily. It is less likely that a solitary cranial plasmacytoma exists, and patients who harbor these neoplasms should undergo complete evaluations to exclude multiple myeloma. Solitary plasmacytoma is radiosensitive and the definite treatment for the cranial plasmacytoma usually consists of complete surgical resection with adjacent radiation therapy. However, the treatment and prognosis of the cranial plasmacytoma depends on whether this neoplasm is primary or secondary. Most of patients develop cranial plasmacytoma as the presenting form of multiple myeloma and the treamtment of in these speical cases is usually unsatisfatory. We report a case of multiple myeloma presented with the motor weakness of both upper and lower extremities by a bulky cranial plasmacytoma invading cerebrum treated with surgery, radiation therapy and chemotherapy.
Cerebrum* ; Drug Therapy ; Dura Mater ; Humans ; Lower Extremity ; Mucous Membrane ; Multiple Myeloma* ; Plasmacytoma* ; Prognosis

OBJECTIVE: This study was designed for evaluating the clinical usefulness of the Korean Denver Developmental Screening Test II (KDDST II) for screening of speech-language delays, for evaluating the co-morbidity of psychiatric disorders and examining the prevalence of hearing impairment in speech-language delays. METHOD: Fifty eight preschoolers whose chief complaints fell into 'late talker', 'dysarticulation' or 'stuttering' performed KDDST II, speech-language evaluation and hearing screening. Psychiatric consultation was performed if the child had any behavioral or emotional red flags. RESULTS: More than 50% were classified as 'language delay only', 25.9% as 'language delay with speech disorder', 22.4% as 'phonological disorder only'. Eleven children (34.4%) with language delay were classified as 'global developmental delay'. Sensitivity of KDDST II as a screening tool of language delay was only 84.4%. Two cases of hearing impairment and 3 cases of complicated otitis media were detected by hearing screening. Seventeen children (29.3%) also had psychiatric disorders such as attention deficit hyperactive disorder, anxiety disorder, and autism spectrum disorder. CONCLUSION: Evaluation of whole spectrums of development and hearing screening were recommended in the children with speech-language delays. Psychiatric consultation should be also considered in a case of any behavioral or emotional concerns.
Anxiety Disorders ; Child ; Autism Spectrum Disorder ; Diagnosis* ; Hearing ; Hearing Loss ; Humans ; Language Development Disorders ; Language Development* ; Mass Screening ; Otitis Media ; Prevalence