OBJECTIVE: The purpose of this study was to analyze risk factors that are associated with intracranial lesion, and to propose criteria for classification of mild head injury (MHI), and appropriate treatment guidelines. METHODS: The study was based on 898 patients who were admitted to our hospital with Glasgow Coma Scale (GCS) score of 13 to 15 between 2003 and 2007. The patients' initial computerized tomography (CT) findings were reviewed and clinical findings that were associated with intracranial lesions were analyzed. RESULTS: GCS score, loss of consciousness (LOC), age and skull fracture were identified as independent risk factors for intracranial lesions. Based on the data analysed in this study, MHI patients were divided into four subgroups : very low risk MHI patients are those with a GCS score of 15 and without a history of LOC or headache; low risk MHI patients have a GCS score of 15 and with LOC and/or headache; medium risk MHI patients are those with a GCS score of 15 and with a skull fracture, neurological deficits or with one or more of the risk factors; high risk MHI patients are those with a GCS score of 15 with abnormal CT findings and GCS score of 14 and 13. CONCLUSION: A more detailed classification of MHI based on brain CT scan findings and clinical risk factors can potentially improve patient diagnosis. In light of our findings, high risk MHI patients should be admitted and treated in same manner as those with moderate head injury.
Adult ; Brain ; Craniocerebral Trauma ; Glasgow Coma Scale ; Head ; Humans ; Light ; Risk Factors ; Skull Fractures ; Unconsciousness

PURPOSE: Enterovirus infection in children can manifest various disease and enterovirus have many serotypes. This study was aimed to investigate neurologic manifestations according to serotypes of enterovirus in pediatric inpatients in Incheon. METHODS: We collected the stool samples from the admitted pediatric patients in Inha University Hospital from January 2015 to September 2016. Enterovirus detection and serotypes identification were performed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) and semi-nested RT-PCR. RESULTS: A total of 527 samples were collected during study period and 170 patients (32.2%) were diagnosed with enterovirus infections. Genetic sequences of enteroviruses were identified: echovirus 18 (50, 40.5%), enterovirus 71 (12, 9.6%), coxakievirus A10 (10, 8.0%), echovirus 6 (7, 5.6%). Virus in patient with meningitis were identified: echovirus 18 (15, 75%), coxakievirus B5 (2, 10%), enterovirus 71 (2, 10%), and echovirus 6 (1, 5%). Neurologic manifestations of echovirus 18 are headache (15, 30%), vomiting (17, 34%), meningeal irritation sign (10, 20.0%). And enterovirus 71 have headache (3, 25%), vomiting (3, 25%), meningeal irritation sign (2, 16.0%), seizure (1, 8.3%), neurologic sequelae (1, 8.3%). Echovirus 18 and neurologic manifestation have a statistically significant correlation with other serotypes (r=0.701, P < 0.01) CONCLUSION: Echovirus 18 infection was more prominent in neurological symptoms than in other serotypes. The major serotype of meningitis was echovirus 18 but there was no reported neurologic sequelae. Enterovirus infection has different neurological symptoms, depending on the serotypes.
Child ; Echovirus 6, Human ; Enterovirus B, Human ; Enterovirus Infections ; Enterovirus* ; Headache ; Humans ; Incheon* ; Inpatients* ; Meningitis ; Neurologic Manifestations* ; Reverse Transcriptase Polymerase Chain Reaction ; Seizures ; Serogroup* ; Vomiting

No abstract available.
Antibodies, Antineutrophil Cytoplasmic* ; Wegener Granulomatosis*

BACKGROUND: Although current guidelines do not recommend immediate anticoagulation therapy (IAC) for acute ischemic stroke, judicious debates are still lingering on whether it might be done for acute cardioembolic stroke (ACES). We surveyed current practice patterns of anticoagulation therapy for ACES in Korea, and analyzed their related factors. METHODS: Using a web-based system, all neurology staffs of training hospitals in Korea surveyed about when and how they commenced anticoagulation therapy in the hypothetical cases with ACES. RESULTS: Of the 359 subjects invited, 281 responded to the e-mail, of whom 76 abstained from participating. The number of participants was therefore 205 (57.1%). Although a few physicians (4.4%) always performed IAC and some (10.7%) never did, most physicians made different decisions according to infarct size and presence of hemorrhagic transformation (HTr): IAC was performed more often in cases with medium-sized or small infarct than large one (68.2% vs. 35.9%, P<0.001), and in cases without HTr (68.6% vs. 34.9%, P<0.001). The most common method of administration was 'heparin followed by warfarin' (68.2%), and then 'warfarin alone' or 'warfarin with aspirin'. If IAC was not commenced, it resumed most commonly between 1 and 2 weeks after the onset (44.0%). CONCLUSION: Quite many neurologists in Korea did IAC in selective ACES, e.g. small sized infarction without HTr. Further studies are needed to prove the efficacy of IAC therapy in this selective population.
Atrial Fibrillation ; Electronic Mail ; Heparin ; Infarction ; Korea ; Neurology ; Stroke ; Taurine

No abstract available.
Plasma Exchange* ; Plasma* ; Purpura, Thrombotic Thrombocytopenic*

PURPOSE: To evaluate the imaging findings of a traumatic dissection of subcutaneous fatty tissue and the treatment. MATERIALS AND METHODS: Fifteen lesions from 13 patients treated by sonography were investigated in our study. The lesions were treated by aspiration only, aspiration followed by steroid injection, and by surgical procedure. Based on the treatment, five factors such as location, size and extent of the lesions, nature of the contents, and treatment effectiveness were assessed. RESULTS: A total of 6 lesions in the thigh, 4 in the leg, 3 in the knee, and 1 each in proximal forearm and flank. All lesions were found in subcutaneous fatty tissue with an average size of 8.9 cm. The nature of the contents was serous (n = 2), hemorrhaging (n = 9), and an abscess (n = 1). Without treatment, three lesions disappeared. Five of the 7 lesions vanished after being treated by aspiration. Only one out of three lesions disappeared when they were treated by steroid injection after aspiration. The three hemorrhaging lesions disappeared after operation, but one serous lesion remained. CONCLUSION: Dissection of subcutaneous fatty tissue represents a cystic mass with serous fluid or hemorrhage. The effectiveness of lesion treatment may relate to the location, size, and content of the lesion.
Abscess ; Adipose Tissue ; Forearm ; Hemorrhage ; Humans ; Knee ; Leg ; Polymethacrylic Acids ; Thigh ; Treatment Outcome

Telomerase activity is usually detected in most tumor tissues but not in normal tissues. Recently, there is increasing evidence that telomerase activity is associated with cell proliferation without malignancy, whereas there is little information about telomerase activity and its relationship with cell proliferation in chronic hyperproliferative skin diseases. Thus, we studied telomerase activity in skins from 10 patients with psoriasis and compared telomerase activity with the expression of Ki-67, a proliferation marker, using immunohistochemical staining. The effect of retinoic acid on the telomerase activity in HaCaT cells was also evaluated. Telomerase activity was detected in 7 (70%) of 10 lesional skins of psoriasis and none of the nonlesional skin. Telomerase activity in lesional skin was significantly associated with Ki-67 labelling index. Retinoic acid treatment on HaCaT cells inhibited telomerase activity, which correlated with inhibition of cell proliferation by the agent. The results of our study represent another example that shows telomerase activity correlates with cellular proliferation. Further studies on the regulation of the telomerase are needed to understand the cellular factors involved in controlling telomerase activity.
Cell Division/drug effects ; Cell Line ; Enzyme Inhibitors/*pharmacology ; Human ; Ki-67 Antigen/*analysis ; Psoriasis/*enzymology ; Skin/*enzymology ; Telomerase/antagonists & inhibitors/*metabolism ; Tretinoin/*pharmacology

BACKGROUND: The brain is a common site of a metastasis in lung cancer patients. If left untreated, the patients succumb to progressive neurological deterioration with a lower survival rate than with other metastases sites. Contrast-enhanced MR imaging in the absence of symptoms or clinical signs is not recommended for identifying a cerebral metastasis in lung cancer patients because of management effectiveness. This pilot study was performed to estimate whether or not limited brain MR imaging, which has a lower cost, could be used to replace conventional brain MR imaging. METHOD: Between April 1999 and March 2001, 43 patients with a primary lung cancer and the others (breast cancer, stomach cancer, colon cancer, malignant melanoma etc), who had neurological symptoms and signs, were examined using conventional brain MR imaging to examine brain metastases. The control group involved four patients who had no evidence of brain metastases the sensitivity, specificity and correlation of limited brain MR imaging were compared with conventional brain MR imaging. RESULTS: All the 43 patients who were examined with conventional brain MR imaging showed evidence of brain metastases, whereas limited brain MR imaging indicated that 42 patients had brain metastases(sensitivity=97.67%). One patient in whom limited brain MR imaging showed no brain metastasis had a metastasis in the cerebellum, as shown by the contrast-enhanced T1 weighted axial view using conventional brain MR imaging. The conventional brain MR imaging and the limited brain MI imaging of the 4 control patients both indicated no brain metastases (specificity=100 %). The Pearson Correlation of the two groups was 0.884(Confidence Interval : 99%) observed. CONCLUSION: Limited brain MR imaging can detect a brain metastasis with the same accuracy. In addition, it is cost-effective (229,000 won, 180$) compared to conventional brain MR imaging(529,000 won, 480$) when patients had neurological symptoms and signs or staging.
Brain* ; Cerebellum ; Colonic Neoplasms ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging* ; Melanoma ; Neoplasm Metastasis* ; Pilot Projects ; Stomach Neoplasms ; Survival Rate

BACKGROUND: Radiation pneumonitis(RP) is the major serious complication of thoracic irradiation treatment. In this study, we attempted to retrospectively evaluate the long-term prognosis of patients who experienced acute RP and to identify factor that might allow prediction of RP. METHODS: Of the 114 lung cancer patients who underwent thoracic radiotherapy between December 2000 and December 2002, We performed analysis using a database of 90 patients who were capable of being evaluated. RESULTS: Of the 44 patients(48.9%) who experienced clinical RP in this study, the RP was mild in 33(36.6%) and severe in 11(12.3%). All of severe RP were treated with corticosteroids. The median starting corticosteroids dose was 34 mg(30~40) and median treatment duration was 68 days(8~97). The median survival time of the 11 patients who experienced severe RP was significantly poorer than the mild RP group. (p=0.046) The higher total radiation dose(>or=60 Gy) was significantly associated with developing in RP.(p=0.001) The incidence of RP did not correlate with any of the ECOG performance, pulmonary function test, age, cell type, history of smoking, radiotherapy combined with chemotherapy, once-daily radiotherapy dose fraction. Also, serum albumin level, uric acid level at onset of RP did not influence the risk of severe RP in our study. CONCLUSION: Only the higher total radiation dose(>or=60 Gy) was a significant risk factor predictive of RP. Also severe RP was an adverse prognostic factor.
Adrenal Cortex Hormones ; Drug Therapy ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Prognosis ; Radiation Pneumonitis* ; Radiotherapy ; Respiratory Function Tests ; Retrospective Studies ; Risk Factors ; Serum Albumin ; Smoke ; Smoking ; Uric Acid

BACKGROUND: Unresectable non-small cell lung cancer has a poor response to chemotherapy and has an unfortunate prognosis. More effective and less toxic cytotoxic agents are needed to improve the outcome of these pa tients. The efficacy and safety of vinorelbine monotherapy in these advanced lung cancer patients was evaluated. METHODS: Sixteen patients with non-small cell lung cancer in stage III or IV, who received vinorelbine alone as an intial anticancer chemotherapy from June 1996 to December 2000 were enrolled in this study. Vinorelbine was given intravenously at a dose 30mg/m2 every weel. RESULTS: Among the sixteen patients, six had a partial response (38%) and the median survival was 16 weeks. The median response duration was 27 weeks (95% CI 6-47), and the time to progression was 16 weeks (95% CI 6-26). Among a ttal of 112 cycles, neutropenia (WHO grade 3 or 4) and anemia (grade 3) occurred in 9% and 3%, respectively. Only 1 patients required hospitalization for neutropenic fever. Non-hematologic toxicity was monor and was easily controlled. CONCLUSION: Vinorelbine monotherapy was well tolerated, and moderatly effective in patients with advanced non-small cell lung cancer.
Anemia ; Carcinoma, Non-Small-Cell Lung* ; Cytotoxins ; Drug Therapy ; Fever ; Hospitalization ; Humans ; Lung Neoplasms ; Neutropenia ; Prognosis