PURPOSE: Headache is a frequent symptom in pediatric practice, but the prevalence of chronic recurrent headache was estimated in several studies with wide variations, because of inadequate expression and differences in case definition in children. Headache classification of International Headache Society is usually used in adults, but the application of it to children is uncommon, so we tried to diagnosis children with headache by using International Headache Society Classification. METHODS: We analyzed the clinical pictures, physical examinations including neurologic examination, PNS series, EEG and CT or MRI in 53 children with nonprogressing recurrent headache over than one month, who visited to pediatric department of Dong-A University hospital from January, 1995 to Feburary, 1996 and diagnosed them by using International Headache Society Classification. RESULTS: 1) The sex ratio between male and female was 1:1.2. 2) Diagnosed groups consisted of children with migraines in 22 cases(41.5%), tension-type headache in 19 cases(35.9%), coexisting migraine and tension-type headaches in 5 cases(9.4%), miscellaneous headaches not associated with structual lesion in 1 case(1.9%), headache associated with vascular disorders in 2 cases(3.8%), headache associated with nonvascular intracranial disorder in 1 case(1.9%), headache due to facial pain in 3 cases(5.6%). 3) Of 22 migraine cases, 13 cases(59.1%) had migraine with aura, 8 cases(40.9%) have migraine without aura and of 19 tension-type headache cases, 8 cases(42.1%) have episodic type, 11(57.9%) cases have chronic type. 4) Of 53 cases with recurrent headache, 3 cases(6%) had abnormal findings in CT or MRI. 5) Of 53 cases with recurrent headache, 9 cases(17%) had abnormal findings in EEG. CONCLUSIONS: International Headache Society Classifications are useful, but the diagnostic criteria are too strict for children, especially in migraine and tension type headache.
Adult ; Child* ; Classification* ; Diagnosis ; Electroencephalography ; Facial Pain ; Female ; Headache* ; Humans ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura ; Neurologic Examination ; Physical Examination ; Prevalence ; Sex Ratio ; Tension-Type Headache

A technique radiogrequency localization and coagulation of articular nerves supplying the lumbar facets is described and reported from a series of 46 patients with clinical diagnosis of facet syndrome over a 4-year period. None of them had clinical or radiologic evidence of a lumbar disc hrniation, and all had exhausted conservative treatment. The literature reviewed for anatomical accuracies in denervation of the medial branch of posterior primary(dorsal) ramus. The technique of facet denervation is simple and safe and relief of pain was achieved in 78% of the patient, the morbidity remains quite low.
Denervation* ; Diagnosis ; Humans ; Low Back Pain*

The authors analyzed 52 cases of spinal cord tumor who had been operated upon at the department of neurosurgery of the Koryo General Hospital from 1983 to 1992. The results were summerized as followings: 1) The spinal cord tumor was most common in the 6th decade of age(52 cases, 28.8%) and the ratio of male to female was 1.26:1. 2) The pathologic diagnosis was neurogenic tumor in 25 cases(48.1%), metastatic tumor in 12 cases(23.1%), glial tumor in 6 cases(11.5%), and meningeal tumor in 3 case(5.7%) in order frequency. 3) The tumors were located most frequently in the thoracic area(19 cases, 36.5%) and in the intradural extramedullary space(28 cases, 53.9%). 4) The most common initial presentation was pain(27 cases, 51.9%) and on admission 14 cases(26.9%) showed paraparesis. 5) The rate of abnormality of the plain radiologic study was 59.6% and the most common positive finding was the pedicle erosion(15 cases, 28.8%). 6) The computed tomographic scanning with water soluble contrast media was useful in planning of operation to provide the exact relationship between the tumor, spinal cord and location of dura. 7) The total removal was possible in 27 cases(51.9%). 8) The follow-up results after 19.4 months of the mean follow-up duration in 46 cases were recovery in 29 cases(63.0%), improvement in 12 cases(26.0%), stationary state in 3 cases(6.5%), worse in 2 cases(4.3%). It was excellent particulary in cases of intradural-extramedullary tumor. 9) The incidence of metastatic tumor was 23.1%(12 cases) and the lung was most common primary focus. The follow-up result of metastatic tumor was poor than the other tumors.
Contrast Media ; Diagnosis ; Female ; Follow-Up Studies ; Hospitals, General ; Humans ; Incidence ; Lung ; Male ; Meningeal Neoplasms ; Neurosurgery ; Paraparesis ; Spinal Cord Neoplasms* ; Spinal Cord*

Compression of the left renal vein (LRV) between the superior mesenteric artery and the aorta has been termed the nutcracker syndrome. The entrapment of the left renal vein is not easily detectable by ordinary diagnostic procedures. We report 2 cases of the nutcracker syndrome with symptoms ( / ) diagnosed by phlebography and pressure measurement. In both cases, no remarkable findings were obtained from medical history and physical examination. Profuse collaterals from a left renal vein in one case with no symptom were observed in venous phase of renal angiography. In the other case, recurrent left flank pain and microscopic hematuria developed. In both cases, the diagnosis of "nutcracker phenomenon" was presumed by renal venography with measurement of pressure gradient between left renal vein and inferior vena cava. Awareness of the pathophysiology of the nutcracker syndrome ensures an early diagnosis. New diagnostic modalities are demanded for atypical cases.
Angiography ; Aorta ; Diagnosis ; Early Diagnosis ; Flank Pain ; Hematuria ; Mesenteric Artery, Superior ; Phlebography ; Physical Examination ; Renal Veins ; Vena Cava, Inferior

No abstract available.
Anxiety* ; Depression* ; Headache*

No abstract available.
DNA* ; Herpesvirus 4, Human* ; Nasopharyngeal Neoplasms* ; Polymerase Chain Reaction*

OBJECTIVE Licorice is used throughout the world as a traditional herbal remedy. Ac-cording to Chinese traditional medicine licorice alone can be used to treat inflammation.Although there have been some studies investigated the anti-inflammatory ingredients of licorice, but for the potency of flavonoid glycoside and their aglycones on inflammation are not evaluated.This study was designed to assess the contributions of licorice flavonoid glycosides and their aglycons to its anti-inflammatory and hypnotic effects. METHODS For the flavonoid aglycone's enrichment, the extract of licorice (EL) was fermented in submerged culture of the edible fungus Grifola frondosa HB0071 mycelia which can produce β-glucosidase and catalyze the flavonoid glycosides to aglycones.EL and fermented extract of licorice (FEL) were used in this study. The anti-inflammation test was carried out in arachidonic acid (AA)-induced ear edema model and the hypnotic test was performed by using electroencephalogram (EEG)analysis method in normal freely moving SD rats.The chemicals constituents were analyzed by HPLC.RESULTS During fermentation,the falvonoid glycosides of licorice were hydrolyzed by the time process.Along with fermentation time,the concentration of the major flavonoid glycosides,liquiritin and isoliquiritin were decreased obviously, and simultaneously their aglycons, liquiritigenin and isoliquiriti-genin were remarkably increased in FEL.Moreover,the content of another major constituent glycyrrhi-zic acid and glycyrrhetinic acid were not changed after the fermentation. In AA-induced mice ear ede-ma test,after topical application,FEL(effective dose range:5-20 μg·ear-1)showed more potent inhibito-ry activity than EL(effective dose range:25-100 μg·ear-1).On the other hand,oral administration of EL and FEL exhibited the same hypnotic potency and both enhanced the total sleep time including rapid eye movement (REM) sleep and non-REM sleep time. CONCLUSION These results suggested that the enrichment of flavonoid aglycons such as liquiritigenin and isoliquiritigenin enhanced the anti-inflam-matory potency of licorice extract,and this potentiation has nothing to do with glycyrrhizic acid or glycyr-rhetinic acid.In addition,enrichment of flavonoid aglycones did not alter the hypnotic effect of licorice.

Hemolytic uremic syndrome is an unusual and uncommon disease in adults but more common in children, which is defined by the triad of acute renal failure, thrombocytopenia, and microangiopathic hemolytic anemia. We report a 64-year-old man who developed hemolytic uremic syndrome after esophagectomy and esophagogastrostomy due to esophageal cancer. We treated him using continuous renal replacement therapy and plasmapheresis with large volume fresh frozen plasma transfusion for 9 days. We could not find the cause of hemolytic uremic syndrome, and so finally concluded that it is idiopathic. Bleeding continuously without a particular reason after an operation, it needs an early diagnosis and treatment with considering a possibility of the hemolytic uremic syndrome.
Acute Kidney Injury ; Adult ; Anemia, Hemolytic ; Child ; Early Diagnosis ; Esophageal Neoplasms ; Esophagectomy* ; Hemolytic-Uremic Syndrome* ; Hemorrhage ; Humans ; Middle Aged ; Plasma ; Plasmapheresis ; Renal Replacement Therapy ; Thrombocytopenia

OBJECTIVES: The trial was performed to obtain an unbiased comparison of the relative merits of endocervical and vaginal prostaglandin E2(PGE2) in the case of parous and nulliparous woman with favorable and unfavorable cervical features. This study was performed to determine the clinical usefullness of endocervical PGE2 comparing with the vaginal PGE2 in cervical ripening and induction of labor. METHOD: The randomized trial with 65 Participants was performed with sealed envelopes for parity and Bishop score (from March to september, 1998). PGE2 tablet(3mg Dinoprostone) was administrated intravaginally to the 32 pregnant women and endocervically to the 33 pregnant women every eight hours with maximum three times until the regular labor develped. RESULT: Outcomes of labor and delivery were clearly related to cervical score at trial entry. endocerval PGE2 had a more marked effect on cervical ripeness than did vaginal PGE2. There were no significant differences on age distribution, gestatioanal period, primiparity, cervical status, initial B-score in each group. There were no significant differences in cesarian section rate, fetal distress, uterine hyperstimulation, side effect and poor infant outcome between the groups The mean induction time was statistically shorter in cervical group with multiparous women than other group(p=0.0195). In the induction-active labor time, cervical with primi group was statistically shorter than other group(p=0.0245). Statistically significant differences were noted between the nulliparous woman and multiparous women in mean induction time, induction-active labor time, time to B-score 8. In the factor that effects induction-active labor, route was significantly better than other factor.(p=0.0001) CONCLUSION: edocervical PGE2 is more effctive than vaginal PGE2 in cervical ripening and induction of active labor. the endocervical PGE2 resulted in a significantly shorter induction to active labor time compared with vaginal PGE2 and has almost no side effect. Because differences in effectiveness between endocervical and vaginal PGE2 are marginal, preference of woman and clinicians can the choice between them.
Age Distribution ; Cervical Ripening ; Dinoprostone ; Female ; Fetal Distress ; Humans ; Infant ; Parity ; Pregnancy ; Pregnant Women

OBJECTIVES: This study was conducted to assess the current management status of the vestibular function test laboratories in Korea. METHODS: Questionnaire about the management status of the vestibular function test laboratories was sent by email to the entire members of the Korean Balance Society. The contents of questionnaire included situation of employees who perform the tests, the types of vestibular function tests and equipment, frequency of the test and types of dizziness related questionnaires. RESULTS: Forty-nine hospitals and clinics responded. All the 49 respondents answered that they have videonystagmography. Spontaneous nystagmus analysis by videonystagmogrphy was the most frequently tests for patients with dizziness. Questionnaires for dizziness were used by 27 respondents (55.1%) for initial evaluation of the dizziness patients. The Korean version of dizziness handicap inventory was the most frequently used dizziness related questionnaire. CONCLUSIONS: We analyzed the current management status of vestibular function test laboratories to comprehend the present condition of the vestibular function test. We think that these results will help to provide a standard for laboratory operations and prepare for the education, focusing on high-demand tests.
Dizziness ; Education ; Electronic Mail ; Humans ; Korea ; Surveys and Questionnaires ; Vertigo ; Vestibular Function Tests