BACKGROUND: Vascular dementia is common cause of dementia, second to the dementia of Alzheimer desease. However in Asia and many developing countries, the incidence of vascular dementia exceeds that of Alzheimer's disease. Though many stroke-related factors related the nature of vascular injury, e.g. infarction and hemorrhage, have not assessed yet. Clarifying the difference of electroencephalograpy and clinical prognosis between infarction and hemorrhage, the aim of this study was to elucidate the role of nature of vascular injury. METHODS: to reduce confounding factors, the study population was restricted to the patients of single hemispheric striatocapsular infarction and hemorrhage saving cortex. On admission, we checked the KMMSE and FIM scores and using quantified EEG, we analyzed occipital peak frequency and the relative background alpha, theta and delta spectra power taken from 16 derivations by averaging twenty-2 -sec epoch in infarction, hemorrhage patients and elderly controls. After 6 months follow up, we compare the MMSE, FIM score between infarction and hemorrhage group. RESULTS: 1) Compared with infarction group, hemorrhage groups had a significantly bilateral lower occipital peak freqauency and background bilateral alpha spectra power. 2) In hemorrhage group, there is lower tendency in K-MMSE after 6 month follow up compared to infarction group. CONCLUSION: This study suggests that hemorrhage show more bilateral electrophysiological dysfunction than infarction group and possible grave prognosis for vascular dementia compared to infarction group.
Aged ; Alzheimer Disease ; Asia ; Dementia ; Dementia, Vascular ; Developing Countries ; Electroencephalography* ; Follow-Up Studies ; Hemorrhage* ; Humans ; Incidence ; Infarction* ; Prognosis* ; Vascular System Injuries

Nesidioblastosis, also known as persistent hyperinsulinemic hypoglycemia of infancy(PHHI) or familial hyperinsulinsm, is the most common cause of recurrent severe hypoglycemia in infancy. It is an autosomal recessive disorder characterized by irregular insulin secretion leading to inappropriately raised plasma insulin concentration compared to blood glucose levels. Recently, mutations in the sulfonylurea receptor(SUR) have been described in association with PHHI. The mainstay of medical treatment is glucose infusion and diazoxide or long acting somatostatin. If medical treatment fails in preventing hypoglycemia, near total pancreatectomy is recommended. We report one case of nesidioblastosis cured by near total pancreatectomy with brief review of literatures.
Blood Glucose ; Congenital Hyperinsulinism* ; Diazoxide ; Glucose ; Humans ; Hypoglycemia ; Infant, Newborn* ; Insulin ; Nesidioblastosis* ; Pancreatectomy ; Plasma ; Somatostatin

PURPOSE: To determine the significance of anomalous position of the gallbladder. MATERIALS AND METHODS: Sixteen patients with anomalous position of the gallbladder were evaluated for analysis. The diagnosis was confirmed by ultrasonography(15 patients) and oral cholecystography(1patient). Among those, six patients underwent CT scan and a patient had 99mTc-DISIDA scan. The images were analysed with respect to the location of the GB and configuration and associated abnormality of the liver and hepatobiliary systems. Medical records of each patient were also reviewed. RESULTS: Among 16 patients having an anomalous position of the gallbladder, nine had retrodisplaced gallbladder, four had left-sided gallbaldder, two had suprahepatic gallbladder, and one had floating gallbladder. Except for one patient, fifteen had abnormality in the liver such as focal atrophic or hypoplastic change and liver cirrhosis. Intrahepatic stones were demonstrated in 6 patients. CONCLUSION: Our results showed that anomalous position of the gallbladder was commonly associated with atrophy or hypoplasia of the liver rather than congenital in origin. The possiblity of an anomalous location of gallbladder should be kept in mind when GB is not in its normal location.
Atrophy ; Diagnosis ; Gallbladder* ; Humans ; Liver ; Liver Cirrhosis ; Medical Records ; Technetium Tc 99m Disofenin ; Tomography, X-Ray Computed

No abstract available.
CA-125 Antigen* ; Female ; Pregnancy ; Pregnancy, Ectopic*

Radiosurgery is a highly precise form of radiation therapy for the treatment of vascular lesions, certain primary or metastatic neoplasms, or functional disorders. Either intracranial or extracranial, which are inaccessible or unsuitable for surgical or other management. As the basis of radiation physics for radiosurgery, this article introduces radiation history, the method of radiation production, interaction mode of radiations with human, transfer of radiation energy to the tissue, and dose planning to generate a desirable dose distribution on the target site. Biologically, the goal of radiosurgery is to cause a precise damage only to the limited tissue within the target volume without exceeding the acceptable rate of complications. As the therapeutic ratio is a function of the volume irradiated, the total dose and dose per fraction used, and the level of acceptable risk, radiation oncologists or practitioners should consider various radiobiologic factors when using radiosurgery to obtain the maximum therapeutic ratio.
Humans ; Radiobiology ; Radiosurgery

Succinylcholine-induced prolonged neuromuscular blockade may occur in patients with either a low level of plasma cholinesterase activity or genotypically abnormal form of that enzyme. We experienced a case of succinylcholine-induced prolonged apnea due to a low level of plasma cholinesterase activity. A 31-year-old woman, full term primigravida, underwent cesarean section for breech presentation under general anesthesia. Familial and past medical history were nonspecific and preoperative physical and laboratory findings were within normal range. After operation, delayed apnea was detected and lasted for about one hour. We performed controlled and assisted ventilation for two and half hours. Plasma cholinesterase activity measured 30.00 IU/L (colorimetric method, normal value: 1130~1960 IU/L) at the first postoperative day. She was discharged on 7th postoperative day without any sequelae. From follow-up study after six months, it measured 1.02 U/ml (EIA, normal value: 7~9 U/ml).
Adult ; Anesthesia, General ; Apnea* ; Breech Presentation ; Cesarean Section* ; Cholinesterases* ; Female ; Follow-Up Studies ; Humans ; Neuromuscular Blockade ; Plasma* ; Pregnancy ; Reference Values ; Ventilation

PURPOSE: The pharmacologic effect of atropine on HPS can be considered to control pyloric muscle spasm. Therefore, we studied the effects of intravenous atropine sulfate on the clinical course of HPS, and periodically observed the ultrasonographic appearance of the pyloric muscles after atropine treatment. METHODS:From April 1998 to May 1999, 14 infants who were diagnosed with HPS were treated with intravenous atropine sulfate. Intravenous atropine sulfate was administered at an initial dose of 0.04mg/kg/day, which was divided into 8 equal doses. The daily dose was increased by 0.01 mg/kg/day until vomiting was controlled for an entire day while infants received unrestricted oral feeding. Ultrasonographic examinations were performed during hospitalization and repeated at least every 2 months until normalization of pyloric muscles was confirmed. RESULTS: Intravenous atropine was effective in 12 of 14 infants with HPS and the conditions of 9 of them improved. Two infants who were not free from vomiting despite a week of intravenous atropine sulfate treatment underwent pyloromyotomy. A series of ultrasonographic examinations were done after vomiting had improved with intravenous atropine sulfate. The ultrasonographic findings showed good passage of gastric contents through pyloric canals despite thickening of the pyloric muscles. CONCLUSION: Intravenous administration of atropine sulfate is an effective therapy for HPS and can be an alternative to pyloromyotomy. (J Korean Pediatr Soc 2000;43:763-768)
Administration, Intravenous ; Atropine* ; Hospitalization ; Humans ; Infant ; Muscles ; Pyloric Stenosis, Hypertrophic* ; Spasm ; Vomiting

Kallmann syndrome is characterized by hypogonadotropic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia. We experienced two cases of Kallmann syndrome with abnormal brain MRI findings(olfactory bulb aplasia) & secondary sexual dysfunction.
Brain ; Gonadotropin-Releasing Hormone ; Hypogonadism ; Kallmann Syndrome* ; Magnetic Resonance Imaging ; Olfaction Disorders

Kallmann syndrome is characterized by hypogonadotropic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia. We experienced two cases of Kallmann syndrome with abnormal brain MRI findings(olfactory bulb aplasia) & secondary sexual dysfunction.
Brain ; Gonadotropin-Releasing Hormone ; Hypogonadism ; Kallmann Syndrome* ; Magnetic Resonance Imaging ; Olfaction Disorders

BACKGROUND: Alzhiemeranjx disease (AD) and vascular dementia (VD) are common types of dementia. As a result of the development of new specific agents for AD, and because vascular dementia is a potentially preventable dementia, differentiating these diseases is of great importance. The role of EEG spectral analysis in the differential diagnosis between Alzheimer type and vascular dementia is still controversial. Since there have been few studies concerning the differential diagnosis of dementia by EEG, the present study has focused on this aspect. Usefulness of EEG in differen-tial diagnosis of dementia will be elucidated by clarifying relationship between type of dementia and spectral profile of EEG. METHODS: We analyzed the power spectra taken from 16 derivations and spectral profile was constructed by averaging twenty 2 sec epochs in three study groups (normal controls, AD and VD). Spectral profile was divided into three groups; (I) type A, showing a dominant 6.5-12 Hz peak (ii) type B, lacking a dominant peak in the 6.5-12 Hz (iii) type C, corresponding to a flat, low voltage, spectrum. To elucidate the relationship between spectral profile and other factors including diagnosis, statistical test was done. RESULTS: (1) In AD, type C profile was statistically more prevalent than in VD and type A profile was reversed. (2) In AD, Mini-Mental State Examination (MMSE) score was statistically lower in type C profile. (3) Spectral profile was not associated with age, age of symptom onset, and symptom duration. CONCLUSIONS: This study suggested that spectral profile is a useful tool for the differential diagnosis of dementia (AD and VD) and correlated with the severity of disease in AD.
Dementia ; Dementia, Vascular* ; Diagnosis ; Diagnosis, Differential* ; Electroencephalography*