OBJECTIVES: In oder to investigate the cognitive and cortical functions of patients with conduct disorder, the present study was carried out with the neuropsychological test battery and Event-Related Potentials(ERPs:P300). METHODS: The subjects were consisted of 18 patients with conduct disorder who fulfilled DSM-IV criteria and 18 normal controls. For all subjects the neuropsychological test battery and ERPs were administered. The neuropsychological test battery consisted of attention tests, memory tests and Card Sorting Test which is used to evaluate the problem-solving and hypothesis-testing. The P300 was measured by oddball paradigm in which 1,000Hz tone was served as standard stimulus and 2,000Hz tone as target stimulus. The task of the subject was to press response-button whenever the target stimulus was presented. K-WAIS was administered in order to control the intelligence of the subjects. RESULTS: The results were as follows: 1) Among subtests of the neuropsychological test battery, only the result of Card Sorting Test showed significant difference between conduct disorder group and control group. The conduct disorder group showed significant low hit-rate compared with control group. 2) The conduct disorder group showed decreased P300 amplitude compared with control group on Fz and Cz. Among 18 patients with conduct disorder, 12 patients showed negative potentials on Fz. 3) The conduct disorder group showed prolonged P300 latency compared with control group on Fz. CONCLUSION: These results indicate that the patients with conduct disorder seem to have retarded functions of problem-solving and hypothesis-testing, and this retardation seems to be related to the frontal dysfunction.
Conduct Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Evoked Potentials ; Humans ; Intelligence ; Memory ; Neuropsychological Tests

No abstract available.
Child* ; Endoscopy* ; Gastrointestinal Diseases* ; Humans

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Echocardiography* ; Pulmonary Valve Stenosis*

Wegener's granulomatosis is a disease of unknown etiology that is characterized by the clinicopathologic complex of necrotixing granulomatous vasculitis of the upper and lower respiratory tract, glomerulonephritis, and variable degrees of small vessel vasculitis. Recently Antineutrophil Cytoplasmic Antibody (ANCA) has been reported to be a highly specific test for the diagnosis of Wegener's granulomatosis. We have experienced a patient of Wegener's granulomatosis in a 11 year old girl who was admitted with complaints f arthralgia, hematuria, convulsion and associated with otitis media and sinusitis. Serologic test of C-ANCA was positive and histologic findings of the kidney showed crescentic glomerulonephritis with sclerosis and surrounding infiltration of multinucleated giant cells. Patient was treated with pulse methylprednisolone without improvement. The clinical course progressed rapidly and expired due to the renal failure, gastrointestinal bleeding and status epilepticus. A brief review of literatures was made.
Antibodies, Antineutrophil Cytoplasmic* ; Arthralgia ; Child ; Diagnosis ; Female ; Giant Cells ; Glomerulonephritis ; Hematuria ; Hemorrhage ; Humans ; Kidney ; Methylprednisolone ; Otitis Media ; Renal Insufficiency ; Respiratory System ; Sclerosis ; Seizures ; Serologic Tests ; Sinusitis ; Status Epilepticus ; Vasculitis ; Wegener Granulomatosis*

PURPOSE: The purpose of this study was to evaluate the prevalence of leg length discrepancy (LLD) in hemiplegic cerebral palsy and to assess the gait pattern of hemiplegic patients with LLD. MATERIALS AND METHODS: 189 patients with hemiplegic cerebral palsy were included in this study. We evaluated the prevalence of LLD of more than 1.5 cm and compared the results of 3-dimensional gait analysis of a group with LLD (Group I) and a group without LLD (Group II). RESULTS: A leg length discrepancy exceeding 1.5 cm was noted in 25 patients (13.2%). In spastic type, the prevalence of LLD was highest in Winter type IV patients (30.8%) than any other type (6.7-13.0%), and the prevalence in patients older than 12 years of age (27.5%) was higher than that in younger patients (8.0%). According to 3-dimensional gait analysis, there were significant decreases in the range of motion of the hip and ankle in the sagittal plane of Group I compared with Group II, and the muscles of the Group I were affected more severely than those of Group II. CONCLUSION: Prevalence of LLD in hemiplegic tcerebral palsy was higher than that in the normal population, and the discrepancy increased with skeletal maturity. When muscles were affected more severely, the prevalence of LLD increased.
Ankle ; Cerebral Palsy* ; Gait* ; Hemiplegia ; Hip ; Humans ; Leg* ; Muscle Spasticity ; Muscles ; Paralysis ; Prevalence* ; Range of Motion, Articular

PURPOSE: To understand the relationship between the gait patterns in transverse plane and the torsional deformities (TD). MATERIALS AND METHODS: We evaluated the clinical, radiological, and three-dimensional gait analysis data of 55 spastic hemiplegics with TD. We define the TD as follows: 1) femoral anteversion > or =30degrees, 2) thigh foot angle < or = -5degrees or > or =25degrees, 3) severe foot deformities that could affect the foot progression angle (FPA). RESULTS: There were 35 males and 20 females with an average age of 8.4 years. 49 patients (89.1%) showed pelvic compensation (PC). In the PC group, 27 patients (55.1%) showed physiologic FPA. However, 22 patients (44.9%) still showed in-toeing (19 patients) or out-toeing (3 patients) gait. Out of the 6 patients (10.9%) who did not showed PC, we could observe in-toeing, out-toeing gait, and physiologic FPA from 3, 2, and 1 patients, respectively. 51 patients (92.7%) had increased femoral anteversion. There were 11 patients (19.6%) with an internal (2 patients) or an external tibial torsion (9 patients), and 30 patients (54.5%) with foot deformities. CONCLUSION: We classified the gait patterns and analyzed the relationship between each gait pattern and types of torsional deformities.
Cerebral Palsy ; Compensation and Redress ; Congenital Abnormalities* ; Female ; Foot ; Foot Deformities ; Gait* ; Hemiplegia* ; Humans ; Male ; Muscle Spasticity* ; Thigh

In order to investigate the level of anxiety, depression and repression, and the coping style in response to the stress of the delinquent adolescents, we examined 158 delinquent adolescents and 60 student adolescents using anxiety scale, depression scale, repression sensitivity scale and coping scale. Data were processed by IBM PC AT computer using SPSS program and were statistically analyzed by ANOVA. The level of anxiety, depression and repression of delinquent adolescents was significantly higher and the score of maladaptive coping scale was significantly higher than those of student adolescents. In conclusion, delinquent adolescents were more anxious, depressive, repressive, and more maladaptive than student adolescents.
Adolescent* ; Anxiety* ; Depression* ; Humans ; Repression, Psychology*

A 7-yr-old girl presented with progressive shortening of the right upper arm and limitation of shoulder motion. Pseudohypoparathyroidism associated with Albright's hereditary osteodystrophy was diagnosed by biochemical, hormonal and radiographic studies. Her condition was complicated by severe humerus varus on the right side. Proximal humeral valgization osteotomy and concomitant humeral lengthening resulted in an improvement of the shoulder joint motion and activity in daily life.
Bone Diseases/*complications/*diagnosis ; Bone Diseases, Developmental/diagnosis ; Bone Lengthening ; Child ; Female ; Foot/radiography ; Hand/radiography ; Humans ; Humerus/*radiography ; Joint Deformities, Acquired/diagnosis ; Osteotomy ; Pseudohypoparathyroidism/*complications ; Time Factors

PURPOSE: The purpose of this study was to evaluate the safety and efficacy of intravenous patient-controlled analgesia (PCA) with fentanyl and ketorolac for postoperative pain management in patients with cerebral palsy. MATERIALS AND METHODS: Sixty patients were categorized based on operation complexity into either a minor operation group or a major operation group, and then subdivided based on the analgesic methods used, i.e., intravenous PCA with fentanyl and ketorolac or intravenous pethidine injection. Pain intensity was assessed using the Wong-Baker's faces pain scale. RESULTS: In the major operation group, patients that received PCA had significantly lower pain scores than those who received intravenous pethidine injection, while no significant differences in pain scores were observed in the minor operation group. Moreover, the side effects of these two analgesic methods did not differ significantly. CONCLUSION: Intravenous PCA with fentanyl and ketorolac is effective and safe for moderate to severe postoperative pain control in pediatric patients with cerebral palsy.
Analgesia, Patient-Controlled* ; Cerebral Palsy* ; Fentanyl ; Humans ; Ketorolac ; Meperidine ; Pain, Postoperative* ; Passive Cutaneous Anaphylaxis

PURPOSE: The purpose of this study was to evaluate the post-operative changes and to determine the factors affecting results obtained after surgical correction of spastic equinus deformity. MATERIALS AND METHODS: Among cerebral palsy patients who had received Tendo Achilles Lengthening (TAL) or the Strayer procedure, eighty nine patients (114 cases: TAL, 78 cases and Strayer, 36 cases) were included in this study. We evaluated clinical assessment data, kinematic data, and kinetic data pre- and post-operatively, according to the geographic type of cerebral palsy, age at operation, and sex. RESULTS: Clinically, equinus deformities were corrected with an increased passive range of motion of the ankle in both groups. Accord-ing to the kinematic results, both groups showed a normal ankle motion pattern with an increased dynamic range of motion. Kinetic results revealed that peak plantarflexor moment and power generation (A2) increased in both groups and that this increase was statisti-cal significant in TAL group. CONCLUSION: Both the TAL and Strayer procedures corrected the spasticity and equinus deformity, and resulted in an increased dynam-ic range of motion of the ankle joint without compromising the triceps power. However, care must be taken not to decrease power gen-eration when TAL is performed in diplegic cases older than 13 years of age.
Ankle Joint ; Ankle* ; Cerebral Palsy ; Equinus Deformity* ; Humans ; Muscle Spasticity* ; Range of Motion, Articular