PURPOSE: The development of the corpus callosum occupies the entire period of cerebral formation. The myelination pattern on magnetic resonance imaging (MRI) is very useful to evaluate neurologic development and to predict neurologic outcome in high risk infants. The thickness of the corpus callosum is believed to depend on the myelination process. It is possible to calculate the length and thickness of the corpus callosum on MRI. Thus, we can quantitatively evaluate the development of the corpus callosum. We investigated the clinical significance of measuring various portions of the corpus callosum in neonate with neurologic disorders such as hypoxic brain damage and seizure disorder. METHODS: Forty-two neonates were evaluated by brain MRI. We measured the size of the genu, body, transitional zone, splenium, and length of the corpus callosum. Each measurement was divided by the total length of the corpus callosum to obtain its corrected size. The ratio of corpus callosal length and the anteroposterior diameter of the brain was also measured. RESULTS: There was no statistical significance in the sample size of each part of the corpus callosum. However, the corrected size or the ratio of body of the corpus callosum correlated with periventricular leukomalacia and hypoxic ischemic encephalopathy. CONCLUSION: There was no statistical significance in the sample size of each part of the corpus callosum. However, the corrected size or the ratio of body of the corpus callosum correlated with periventricular leukomalacia and hypoxic ischemic encephalopathy.
Brain ; Corpus Callosum ; Epilepsy ; Humans ; Hypoxia, Brain ; Hypoxia-Ischemia, Brain ; Infant ; Infant, Newborn ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging ; Myelin Sheath ; Nervous System Diseases ; Sample Size

No abstract available.
Reye Syndrome*

No abstract available.
Hemorrhagic Fever with Renal Syndrome* ; Humans ; Proteinuria*

Objectives: Psychiatry in North Korea is still poorly understood. Therefore, it is necessary to study the psychopathology and diagnostic classification of North Korean psychiatry. This study examined North Korea’s psychopathology and diagnostic classification system and how it differs from international standards. Methods: This study reviewed North Korean medical books and medical journals available at the Information Center on North Korea. This literature review and qualitative content analysis examined 15 medical books and 227 medical articles. Results: North Korea’s psychiatric diagnostic classification is based on the International Classification of Diseases, 10th edition (ICD-10), but with some modifications to reflect the circumstances of North Korea. While the research journals mainly used the ICD-10 diagnostic criteria, North Korea has its own diagnostic criteria, which it refers to as the “existing diagnostic criteria.” ‘Neurotic disorders’ were the most common, both in the classification in the medical books and the list of disorders covered in the medical journals. There was an interest in ‘organic mental disorders,’ such as postconccusional syndrome and ‘mental disorders due to encephalic parasitism,’ but relatively little research on mood disorders. There were no studies on suicide and a view that alcohol is abused in capitalist countries. Conclusion This study examined the diagnostic classification system of North Korean psychiatry.Further analyses of the characteristics of the psychopathology used in North Korea can be used to understand North Korean society.

PURPOSE: To evaluate outer retinal tubulation (ORT) found in chronic central serous chorioretinopathy (CSC) using color fundus photography and spectral domain optical coherence tomography (SD-OCT). METHODS: ORT identified in patients with chronic CSC was examined using color fundus photography, fundus autofluorescence image, fluorescein angiography, indocyanin green angiography, and SD-OCT. The images were analyzed for morphological features, location, and size of ORT in the retinal layers. RESULTS: ORT was detected in 3 of 342 (0.88%) chronic CSC patients. Color fundus photography revealed circular or ovoid shape with hollow lumen and deep yellowish border mainly appearing at the affected retinal pigment epithelium layer in the macular area. SD-OCT B-scan revealed hyperreflective material observed inside the hyporeflective internal space with hyperreflective border. ORT had circular or ovoid shape on the SD-OCT C-scan. ORT was primarily located on the outer nuclear layer in the retina, emanating to the inner nuclear layer and was not greater than 170 x 170 microm in size when measured with SD-OCT B-scan image. CONCLUSIONS: ORT was identified in patients with chronic CSC which was observed using color fundus photography and circular or ovoid structure was observed using a SD-OCT C-scan.
Angiography ; Central Serous Chorioretinopathy* ; Fluorescein Angiography ; Humans ; Photography ; Retina ; Retinal Pigment Epithelium ; Retinaldehyde* ; Tomography, Optical Coherence

Transient hyperammonemia in a newborn is an overwhelming disease manifested by hyperammonemic coma. The majority of affected newborns are premature and have mild respiratory syndrome. The diagnosis may be difficult to determine. This metabolic disorder is primarily characterized by severe hyperammonemia in the postnatal period, coma, absence of abnormal organic aciduria and normal activity of the enzymes of the urea cycle. Hyperammonemic coma may develop within 2-3 days of life, although its etiology is unknown. Laboratory studies reveal marked hyperammonemia (>4,000 micromol/L). The degree of neurologic impairment and developmental delay in this disorder depends on the duration of hyperammonemic coma. Moreover, the infant may succumb to the disease if treatment is not started immediately and continued vigorously. Hyperammonemic coma as a medical emergency requires dialysis therapy. Here, we report a case of severe transient hyperammonemia in a preterm infant (35 week of gestation) presented with respiratory distress, seizure, and deep coma within 48 hours and required ventilatory assistance and marked elevated plasma ammonia levels. He survived with aggressive therapy including peritoneal dialysis, and was followed 2 years later without sequelae.
Ammonia ; Coma ; Dialysis ; Emergencies ; Humans ; Hyperammonemia ; Infant ; Infant, Newborn ; Infant, Premature ; Peritoneal Dialysis ; Plasma ; Seizures ; Urea

PURPOSE: This study was launched to classify subjects of the CSF examination and improve early diagnosis of meningitis and its treatment in children who have had a first febrile seizure. METHODS: From March 1995 to September 2003, children aged 3 months to 5 years who had had treatment for febrile seizure were analyzed as to their age at first seizure, type of seizure, CSF examination, and prevalence of meningitis. RESULTS:The largest age group distribution among the 780 children was 356(45.6%) children who were under 18 months. One hundred ninteen(15.3%) patients received the CSF examination, and out of those 68(19.1%) were less than 18 months old. Twenty five(3.2%) children were diagnosed with meningitis; those less than 18 months old were 15(4.2%). Two(0.2%) were diagnosed as bacterial meningitis. Out of 780 patients 599(76.8%) were simple febrile seizure patients. Out of 32(5.3%) who received the CSF examination, nine were diagnosed as meningitis. In complex febrile seizure, 86(52.1 %) out of 165(21.2%) received CSF examinations and 16(9.7%) of those were diagnosed as meningitis. Thus, there was a higher prevalence of meningitis in children presenting complex febrile seizure. CONCLUSION: To diagnose meningitis with the CSF examination in the first febrile seizure, the patient's general condition, such as clinical symptoms and types of seizure, are more important than the ages of the patients. We suggest that experienced physicians should be concerned with doing an early diagnosis of meningitis and thus reduce the number of CSF examinations of children with febrile seizures.
Cerebrospinal Fluid ; Child ; Early Diagnosis ; Humans ; Infant ; Meningitis ; Meningitis, Bacterial ; Prevalence ; Seizures ; Seizures, Febrile*

The occurrence of the colonic obstruction secondary to colorectal carcinoma (CRC) has been reported in 7~30% of the CRC patients. It is generally believed that obstructive CRC is associated with a poor prognosis with respect to operative mortality and five-year survival. A series of 1064 cases of the CRC treated surgically at Asan Medical Center from June 1989 to December 1996 has been analyzed to compare clinicopathological findings between obstructive and non-obstructive CRC and to evaluate surgical treatment options in obstructive CRC. Complete obstruction was present in 49 cases (4.6%). There were no differences between obstructive and non-obstructive CRC in tumor location, size, Dukes' stage, and differentiation. In forty-nine obstructive CRC cases, primary resections were performed in 29 cases after peri-operative bowel decompression. In this group, right colon cancer was more prevalent than staged operation group (45% vs. 5%, P<0.05) and hospital stay was significantly short (16 days vs. 38 days, P<0.05). Postoperative complication rate was higher in staged operation group (65% vs. 28%, P=0.01). It may be due to stoma related wound complication. In obstructive left colon cancer, there was a significant difference in complication rate between primary resection and staged operation (P<0.05). Overall 5-year survival rate were 66% and 53% in non-obstructive and obstructive group, respectively. Survival rate according to the Dukes' B and C stages did not show statistical differences, either. Conclusively, primary resection is preferred to the obstructive CRC when supportive care, preoperative bowel decompression, and intraoperative colonic irrigation were performed adequately.
Chungcheongnam-do ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Decompression ; Humans ; Length of Stay ; Mortality ; Postoperative Complications ; Preoperative Care ; Prognosis ; Survival Rate ; Wounds and Injuries

Permanent vascular access is a prerequisite for successful treatment of patients with chronic hemodialysis. Although a number of strategies including native and synthetic arterio-venous fistulae are performed to create vascular access, they are often not available due to peripheral vascular diseases which are common in patients with diabetes and elderly patients. So, in spite of technical advance, vascular access for hemodialysis remains a significant problem confronting the nephrologists. Recently, Permcath(R) (double lumen silicone rubber catheter) has been introduced and can provide temporary access in patients whose native fistulas have not yet matured and permanent access in patients who have difficulty in creating a arterio-venous fistula. We investigated the availability and the clinical outcome of use of Permcath(R) as temporary or permanent vascular access. Total 16 catheters were placed in 14 patients who were admitted in Chung-Ang University Hospital between April, 1993 to March, 1996. Clinical course of the patients and outcome of the catheters were observed, retrospectively. The mean age of the 14 patients was 56 9 (39-67) years. The indications were exhausted peripheral access, poor vascular system for conventional access operation, and limited life expectancy. The median survival of the catheters was 80 weeks with a range of one week to 113 weeks. The one-year actuarial catheter survival rate was 67% and 44% at 2 year. The most common complication during use of Permcath(R) was infection, occurred in 5 patients (31.2%). The 5 catheters were removed because of complications of catheter such as infection or malfunction. We suggest that the Permcath(R) is a safe and durable temporary vascular access for patients with poor vascular system anticipating a long duration for arterio-venous fistula maturation and permanent access for patients who have exhausted peripheral access sites.
Aged ; Catheters ; Fistula ; Humans ; Life Expectancy ; Peripheral Vascular Diseases ; Renal Dialysis ; Retrospective Studies ; Silicone Elastomers ; Survival Rate

PURPOSE: Febrile seizure affects 2 to 5% of children, but 30 to 40% of the children who already had febrile seizure experience another febrile seizure. We researched to define a high risk group of recurrent febrile seizures through investigating several risk factors. METHODS: We evaluated 342 patients who were admitted to our hospital or treated in the emergency room for their first febrile seizure from March, 1995 to August, 2001. We assessed various risk factors, such as age, the type of seizure, body temperature, serum sodium concentration, sex, neurologic abnormalities, and family history of febrile seizure or epilepsy. RESULTS: Age at the first febrile seizure(< or =18 months) and family history of febrile seizure were significant risk factors for recurrence of febrile seizure. The study showed that 21.9% of the children who had none of these risk factors, 36.4% of the children who had one, and 57.1% of the children who had both factors had recurrent febrile seizures. Thus, the recurrence rates clearly increase as the number of these factors increase. CONCLUSION: Two major risk factors for recurrent febrile seizures were identified:early onset(< or =18 months) and family history of febrile seizure. The risk of recurrent febrile seizures increased with the number of these risk factors increased. Consequently, children with both risk factors were considered to belong to a high risk group of recurrent febrile seizures.
Body Temperature ; Child ; Emergency Service, Hospital ; Epilepsy ; Humans ; Recurrence ; Risk Factors* ; Seizures ; Seizures, Febrile* ; Sodium