PURPOSE: To find out the characteristic MR findings of reversible posterior leukoen-cephalopathy syndrome (RPLS) due to various causes in children. MATERIALS AND METHODS: Eight children with RPLS underwent MR imaging, and the findings were retrospectively analyzed. All eight were acutely hypertensive at the time of a neurotoxic episode. Three had intra-abdominal tumors (one adrenal pheochromo-cytoma, one para-aortic paraganglioma and one para-aortic ganglioneuroma encasing the left renal artery); three were being treated with cyclosporine; one was being treat-ed with steroid; and one had hemolytic uremic syndrome. Initial cranial MR images were analyzed with particular emphasis on the distribution of the lesions. To assess possible sequelae, follow-up MR images were obtained in seven patients at least one week after the treatment of hypertension. Four underwent proton MR spectroscopy. RESULTS: Characteristic distribution of lesions in the occipital and posterior parietal lobes was identified in all cases regardless of the causes of RPLS. The cerebellum, basal ganglia, anterior parietal, and frontal lobe were involved in four, two, one, and one case, respectively. Cortical gray matter involvement was predominant in six and subcortical white matter involvement predominated in two patients. The distribution of lesions was bilateral and asymmetric. Gyriform enhancement was identified in six cases, and small hemorrhage was noted in one. In seven patients, the clinical and MR findings improved without sequelae on follow-up study. In one, proton MR spectroscopy demonstrated a high lactate peak at the time of the neurologic event. Nearnormal spectra were noted in three children who underwent proton MR spectroscopy after recovery. CONCLUSION: The MR findings of RPLS are characteristic in that lesions are distributed in the posterior region of the brain and they are reversible on follow-up study. In children with RPLS due to unknown causes, the possibility of intra-abdominal tumors should also be considered.
Basal Ganglia ; Brain ; Cerebellum ; Child* ; Cyclosporine ; Follow-Up Studies ; Frontal Lobe ; Ganglioneuroma ; Hemolytic-Uremic Syndrome ; Hemorrhage ; Humans ; Hypertension ; Lactic Acid ; Magnetic Resonance Imaging* ; Magnetic Resonance Spectroscopy ; Paraganglioma ; Parietal Lobe ; Posterior Leukoencephalopathy Syndrome* ; Protons ; Rabeprazole ; Retrospective Studies

Arrhythmogenic right ventricular dysplasia is a rare heart muscle disorder of unknown cause that primarily involves the right ventricle. It is characterized pathologically by fibrofatty replacement of the right ventricular myocardium. Clinical manifestations include structural and functional abnormalities of the right ventricle, electrocardiographic depolarization/repolarization changes, and presentation with sudden death or ventricular arrhythmias of right ventricular origin. It is one of the important causes of the ventricular arrhythmia or sudden death among apparently healthy young people. We report a case of arrhythmogenic right ventricular dysplasia with the review of the literature.
Arrhythmias, Cardiac ; Arrhythmogenic Right Ventricular Dysplasia* ; Death, Sudden ; Electrocardiography ; Heart Ventricles ; Myocardium

The coronary artery cross sectional area (CSA) is proportional to LV mass. We have measured the cross sectional area of the left and right coronary arteries in patients with ischemic heart disease to see whether it is related to the change in the LV mass. The following results were obtained ; 1) There were no significant difference in mean CSA of coronary arteries and LV mass determined by echocardiography and cineangiography between control and ischemic heart disease. 2) There were significantly increased ratio of left ventricular mass by cineangiogram to CSA of left anterior descending coronary artery in patients with myocardial infarction as compared with control group. 3) A linear relation between LV mass by cineangiogram and CSA of left coronary artery was noted in control group (r=0.53, P<0.05) and ischemic heart disease group (r=0.51, P<0.05). 4) A linear relation between LV mass determined by echocardiography and CSA of left coronary artery was noted in control group (r=0.55, P<0.05).
Cineangiography ; Coronary Vessels* ; Echocardiography ; Humans ; Myocardial Infarction ; Myocardial Ischemia

PURPOSE: Brain damage resulting from a combination of hypoxia and ischemia in the newborn infant remains a major cause of perinatal death, cerebral palsy, mental retardation and epilepsy. Metabolic stress, including ischemia, hypoxia and seizures, induces the expression of a variety of stress proteins including nuclear proto-oncogene c-fos. The induction of c-fos can be considered a biomarker of events resulting from ischemia-hypoxia. However, it has been suggested that the mechanism for c-fos activation in the fetal brain is not mature prior to postnatal day 13-21. This study was undertaken to determine the induction of c-fos in neonatal rat brain by hypoxia-ischemia and the regions of brain most vulnerable to hypoxia-ischemia. MEHTODS: Ten-day-old postnatal rat pups, subjected to unilateral carotid artery dissection combined with 2-hour hypoxia, were killed at 2 hours and 6 hours after hypoxia-ischemia, and their brains were examined by immunohistochemistry. RESULTS: Hypoxia-ischemia induced prominent expression of c-fos in the cingulate cortex and hippocampus in the postnatal rats 2 hours after the insult. CONCLUSION: Hypoxia-ischemia results in increased c-fos expression in 10-day-old rat pups. The results of this experiment also demonstrate that the neonatal rat hippocampus and cortex are the most sensitive brain regions to the induction of c-fos following hypoxia-ischemia.
Animals ; Anoxia ; Brain* ; Carotid Arteries ; Cerebral Palsy ; Epilepsy ; Gyrus Cinguli ; Heat-Shock Proteins ; Hippocampus ; Humans ; Immunohistochemistry ; Infant, Newborn ; Intellectual Disability ; Ischemia ; Proto-Oncogenes ; Rats* ; Seizures ; Stress, Physiological

PURPOSE: Brain damage resulting from a combination of hypoxia and ischemia in the newborn infant remains a major cause of perinatal death, cerebral palsy, mental retardation and epilepsy. Metabolic stress, including ischemia, hypoxia and seizures, induces the expression of a variety of stress proteins including nuclear proto-oncogene c-fos. The induction of c-fos can be considered a biomarker of events resulting from ischemia-hypoxia. However, it has been suggested that the mechanism for c-fos activation in the fetal brain is not mature prior to postnatal day 13-21. This study was undertaken to determine the induction of c-fos in neonatal rat brain by hypoxia-ischemia and the regions of brain most vulnerable to hypoxia-ischemia. MEHTODS: Ten-day-old postnatal rat pups, subjected to unilateral carotid artery dissection combined with 2-hour hypoxia, were killed at 2 hours and 6 hours after hypoxia-ischemia, and their brains were examined by immunohistochemistry. RESULTS: Hypoxia-ischemia induced prominent expression of c-fos in the cingulate cortex and hippocampus in the postnatal rats 2 hours after the insult. CONCLUSION: Hypoxia-ischemia results in increased c-fos expression in 10-day-old rat pups. The results of this experiment also demonstrate that the neonatal rat hippocampus and cortex are the most sensitive brain regions to the induction of c-fos following hypoxia-ischemia.
Animals ; Anoxia ; Brain* ; Carotid Arteries ; Cerebral Palsy ; Epilepsy ; Gyrus Cinguli ; Heat-Shock Proteins ; Hippocampus ; Humans ; Immunohistochemistry ; Infant, Newborn ; Intellectual Disability ; Ischemia ; Proto-Oncogenes ; Rats* ; Seizures ; Stress, Physiological

clinical and radiologic findings that mainly involve the white/gray matter of the parieto-occipital lobes. The purpose of this study was to determine its clinical and radiological characteristics. METHODS: A total of 15 pateints were involved in the study. Their medical records and radiological features of brain MRI were retrospectively reviewed and analyzed. RESULTS: Fifteen pateints were involved. (9 males and 5 females). The patients' ages ranged from 2-20 years (mean age:10 years). The brain MRI revealed fairly symmetric areas of increased T2 signal involving both white and gray matter of parieto-occipital regions. The condition seemed to be associated with cyclosporin A and steroid therapy or a variety of other conditions in which blood pressure rises acutely. CONCLUSION: Reversible posterior leukoencephalopathy syndrome is a complicated neurological condition, but a better understanding of this complex syndrome may obviate unnecessary investigations and lead to prompt and appropriate management of the associated problems.
Blood Pressure ; Brain ; Child* ; Cyclosporine ; Humans ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Male ; Medical Records ; Posterior Leukoencephalopathy Syndrome* ; Retrospective Studies ; Seizures

PURPOSE: We retrospectively reviewed the cases of ureteroscopic stone removal at our institution to define the efficiency of ureteroscopy for treatment of ureteral calculi. MATERIALS AND METHODS: Ureteroscopic stone removal was performed in 376 cases of ureteral stone from August, 1989 to December, 1997. There are 241 males and 135 females, and mean age was 45.6 years. Nine stones were located in the upper ureter, 27 in the mid ureter, 340 in the lower ureter. The stone size was less than 5mm in 125 cases, from 5 to 10mm in 185 cases and more than 10mm in 66 cases. Ureteroscopy was performed with 9.5Fr, 10Fr or 12.5Fr rigid ureteroscope under spinal, general or epidural anesthesia. RESULTS: Overall success rate of ureteroscopic stone removal was 95.1 percent. The success rates of upper, mid and lower ureteral stones were 55.6, 88.9 and 97.1 percents, respectively. According to the stone size, the success rates was 97.6 percent in stones less than 5mm, 94.6 percent in stones of 5 to 10mm and 92.4 percent in stones more than 10mm. Over all complication rate was 9.6 percent. Complications consisted of severe ureteral mucosal tearing(20 cases), ureteral perforation(8 cases), gross hematuria(3 cases), infection(3 cases) and urethral stricture(2 cases). All complications were treated successfully with conservative treatment except 2 cases of urethral stricture that required visual urethrotomies. CONCLUSIONS: Ureteroscopic stone removal could offer rapid relief of obstruction and colic due to mid and lower ureteral calculi with high success rate and minimal complications.
Anesthesia, Epidural ; Calculi ; Colic ; Female ; Humans ; Lithotripsy ; Male ; Retrospective Studies ; Ureter ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy ; Urethral Stricture

Although the survival rate in childhood cancer is increased with current improvements of diagnostic and therapeutic methods, the incidence of second malignancy is now increasing. Therefore close follow-up with high index of suspicion for second malignancies are important for cancer survivng patients. We report our experiences of 3 second malignancies which were glioblastoma multiforme after treatment of acute lymphoblastic lymphoma, Philadelphia positive leukemia after treatment of osteosarcoma and acute myelogenous leukemia occuring in the course of chemotherapy for acute lymphoblastic leukemia. It is imperative that survivors of childhood cancer be closely followed for the detection of not only the relapse of original disease but also the occurrence of second malignancy.
Drug Therapy ; Follow-Up Studies ; Glioblastoma ; Humans ; Incidence ; Leukemia ; Leukemia, Myeloid, Acute ; Neoplasms, Second Primary* ; Osteosarcoma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Radiotherapy ; Recurrence ; Survival Rate ; Survivors

No abstract available.
Shigella sonnei* ; Shigella*

BACKGROUND: Since the morning fluoride level of 10 uM is recommended for adults patients being treated for osteoporosis so far, measurement of serum fluoride level is important to detect abnormally high levels or to detect levels below the therapeutic windows. Aims of this study are to determine the normal range of serum ionic fluoride levels in Korean female adults (from 5th to 7th decade), and to evaluate the in vivo fluoride pharmacokinetics of monofluorophosphate in Korean adults. METHODS: Serum level of fluoride was measured from blood samples of 72 female subjects (age 43-69years) using an ion selective electrode. For pharrnacokinetics of monofluorophosphate-calcium (MFP-Ca), 6 subjects (age 27~45 years) were included to be withdrawn the blood hourly for the first S hours and the blood was withdrawn at 24 hours after a single dose of MFP-Ca. RESULTS: Mean level of serum fluoride was 1.64+-0.12uM in 5th, 6th, 7th decades adults, and there was no difference of serum fluoride levels among age groups. Peak serum fluoride level exhibited 5.02+-0.67pM, and returned to basal level on 24 hours after a single dose of MFP-Ca. CONCLUSION: This study shows that mean serutn fluoride of Korean female adults (from 5th to 7th decade) is not different from that of other reports, and a single dose of MFP-Ca does not cause serum fluoride levels above the recommended therapeutic windows of 5-10uM for 24 hours.
Adult* ; Electrodes ; Female ; Fluorides* ; Humans ; Osteoporosis ; Pharmacokinetics ; Reference Values