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

PURPOSE: To evaluate the advantages and complications of triamcinolone acetonide (TA)-assisted pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: We retrospectively examined 110 eyes with vitreous hemorrhage or tractional retinal detachment resulting from a PDR after surgery. The TA-assited PPV [TA(+)] consisted of 58 eyes, and the conventional PPV[TA(-)]group consisted of 52 eyes. The improvement in vision, residual vitreous cortex (VC) pattern, and postoperative complications were studied. RESULTS: The residual VC pattern was divided into 3 groups: the focal type in 34 eyes (58.6%): the diffuse type in 22 eyes (37.9%): and no residual VC, seen in 2 eyes (3.4%). The TA (+) group had a lower incidence of rebleeding (p=0.0149) and of a preretinal membrane (p=0.0138) than the TA (-) group. No apparent persistant ocular hypertension occurred in any eyes. CONCLUSIONS: Triamcinolone-assisted PPV appears to be potentially useful to remove residual VC and to protect from postoperative complications.
Diabetic Retinopathy* ; Incidence ; Membranes ; Ocular Hypertension ; Postoperative Complications ; Retinal Detachment ; Retrospective Studies ; Traction ; Triamcinolone Acetonide ; Vitrectomy* ; Vitreous Hemorrhage

No abstract available.
Humans ; Noninvasive Ventilation* ; Weaning*

Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.
Abdominal Muscles ; Abdominal Pain ; Abdominal Wall ; Aged ; Cough ; Epigastric Arteries ; Hematoma* ; Humans ; Pregnancy ; Renal Insufficiency, Chronic* ; Risk Factors ; Rupture

There has been no report about hereditary and clinical features of retinitis pigmentosa (RP) in Koreans. To evaluate these, data were collected from 365 RP patients including age, gender, visual acuity (VA), spherical equivalent (SE) of refractive errors, funduscopic findings, color vision test, visual field score (VFS) obtained from Goldmann perimetry, and the inheritance patterns from pedigrees. Simplex RP was the most common inheritance pattern (61.9%); followed by autosomal recessive RP (17.3%), autosomal dominant RP (12.1%) and X-linked recessive RP (8.8%). Myopia was the most common refractive errors (77.5%) including 16.1% of high myopia. The most common cataract type was posterior subcapsular cataract (25.8%). Observed retinal findings included changes of retinal pigment epithelium (88.8%), bony spicule-like pigmentation (79.7%), attenuation of retinal vessel (76.2%), waxy disc pallor (12.6%), golden ring around optic disc (2.2%), epiretinal membrane (0.8%) and cystoid macular edema (0.5%). Corrected VA and refractive errors did not show any significant difference between the inheritance patterns. VFS was significantly worse in autosomal recessive RP than in autosomal dominant RP. Color vision defect was noted in 66.1% on Hardy-Rand-Rittlers color vision test. In conclusion, Korean RP patients have the indigenous hereditary and clinical features as well as the ordinary ones.

OBJECTIVE: To report successful cases of extubation from invasive mechanical ventilation at our institution using pulmonary rehabilitation consisting of noninvasive ventilation (NIV) in neuromuscular patients with experience of reintubation. METHODS: Patients who experienced extubation failure via the conventional weaning strategy but afterwards had extubation success via NIV were studied retrospectively. Continuous end-tidal CO₂ (ETCO₂) and pulse oxyhemoglobin saturation (SpO₂) monitoring were performed. Extubation success was defined as a state not requiring invasive mechanical ventilation via endotracheal tube or tracheotomy during a period of at least 5 days. RESULTS: A total of 18 patients with ventilatory failure who initially experienced extubation failure were finally placed under part-time NIV after extubation. No patient had any serious or long-term adverse effect from NIV, and all patients left the hospital alive. CONCLUSION: NIV may promote successful weaning in neuromuscular patients with experience of reintubation.
Humans ; Neuromuscular Diseases* ; Noninvasive Ventilation* ; Oxyhemoglobins ; Rehabilitation ; Respiration, Artificial ; Retrospective Studies ; Tracheotomy ; Weaning*

To report a case of Boucher-Neuhauser syndrome, which is an autosomal recessive disorder characterized by the triad of spinocerebellar ataxia, chorioretinal dystrophy, and hypogonadotropic hypogonadism. An 18-year-old man was seen for visual problems, which had been diagnosed as retinitis pigmentosa at the age of 12 years. His puberty was delayed. At 16 years of age, the patient experienced progressive deterioration of his balance and gait disturbance. Then he was referred to our clinic because Boucher-Neuhauser syndrome was suspected. He had no specific family history; his visual acuity was 0.04 in both eyes. We observed broad retinal pigment epithelium atrophy and degeneration in both fundi. Both fluorescein and indocyanine green angiography showed choriocapillaris atrophy in the posterior pole area and midperiphery. Macular optical coherence tomography showed thinning of the neurosensory retina. An electroretinographic examination showed no photopic or scotopic responses. The Boucher-Neuhauser syndrome should be included in the differential diagnosis of patients with retinitis pigment epithelium atrophy and degeneration.
Adolescent ; Atrophy ; Cerebellum/pathology ; Coloring Agents/diagnostic use ; Electroretinography ; Fluorescein Angiography ; Humans ; Hypogonadism/*diagnosis/genetics ; Indocyanine Green/diagnostic use ; Magnetic Resonance Imaging ; Male ; Photoreceptor Cells, Vertebrate/physiology ; Retinal Degeneration/*diagnosis/genetics ; Retinal Pigment Epithelium/*pathology ; Retinitis Pigmentosa/*diagnosis/genetics/physiopathology ; Spinocerebellar Degenerations/*diagnosis/genetics ; Syndrome ; Tomography, Optical Coherence

PURPOSE: We evaluated whether lipoic acid as antioxidant could inhibit expression of VEGF and STAT3 in experimental diabetic rat retina. METHODS: Diabetes was induced chemically by injection of streptozotocin in 12 rats of 18 Sprague-Dawley rats. After induction of diabetes, lipoic acid was injected into the peritonium in 6 rats. So all rats were divided into 3 groups, normal group (n=6), diabetes mellitus (DM) group (n=6), lipoic acid treated group (n=6). The ocular tissue of the rats were collected on 8 weeks after diabetes induction. Difference of VEGF and STAT3 expression was investigated by immunohistochemistry, RT-PCR, western blot. The change of VEGF and STAT3 in lipoic acid treated group were evaluated in these experimental model. RESULTS: The VEGF and STAT3 expression was elevated in diabetic rat retina. The active form STAT3, phosphorylated STAT3 was also elevated. The VEGF and STAT3 expression in lipoic acid treated group was lower than DM group. CONCLUSIONS: The lipoic acid could inhibit the VEGF and STAT3 expression in diabetic rat retina.
Animals ; Blotting, Western ; Diabetes Mellitus ; Diabetic Retinopathy ; Immunohistochemistry ; Models, Theoretical ; Rats* ; Rats, Sprague-Dawley ; Retina* ; Streptozocin ; Thioctic Acid* ; Vascular Endothelial Growth Factor A*

PURPOSE: Rotavirus is one of the most important causes of nosocomial infections among children. The aim of this study is to determine the risk of nosocomial rotavirus infections and to evaluate the effectiveness of breast-feeding and probiotics in the prevention of nosocomial rotavirus infections. METHODS: This study was carried out on admitted children without diarrhea between March 1, 2003 and February 29, 2004. Three hundred ninety patients aged 4 days to 13 years during this study were available. We examined the feces of all children for rotavirus by latex agglutination on admission, during hospital, and after discharge, to see whether they developed diarrhea or not. RESULTS: Nosocomial rotavirus infections was significantly increased with children under 12 months of age(P=0.008). The monthly attack rate was great between December and March(P=0.046). Prolonged hospital stay was associated with an increased attack rate of nosocomial rotavirus infections (P=0.003). The risk of nosocomial rotavirus infections was not associated with the number of roommates and whether or not they were breast-fed or fed on probiotics. CONCLUSION: Nosocomial rotavirus infections are significantly more likely to occur in children under 12 months of age, admitted between December and March, and with prolonged hospital stays. Prompt identification and isolation of children with nosocomial rotavirus infections, even without diarrhea, may decrease rates of nosocomial rotavirus infections.
Agglutination ; Child* ; Cross Infection ; Diarrhea ; Feces ; Humans ; Latex ; Length of Stay ; Probiotics ; Risk Factors* ; Rotavirus Infections* ; Rotavirus*

PURPOSE: To assess the ability of a mechanical in-exsufflator (MI-E), either alone or in combination with manual thrust, to augment cough in patients with neuromuscular disease (NMD) and respiratory muscle dysfunction. MATERIALS AND METHODS: For this randomized crossover single-center controlled trial, patients with noninvasive ventilator-dependent NMD were recruited. The primary outcome was peak cough flow (PCF), which was measured in each patient after a cough that was unassisted, manually assisted following a maximum insufflation capacity (MIC) maneuver, assisted by MI-E, or assisted by manual thrust plus MI-E. The cough augmentation techniques were provided in random order. PCF was measured using a new device, the Cough Aid. RESULTS: All 40 enrolled participants (37 males, three females; average age, 20.9±7.2 years) completed the study. The mean (standard deviation) PCFs in the unassisted, manually assisted following an MIC maneuver, MI-E-assisted, and manual thrust plus MI-E-assisted conditions were 95.7 (40.5), 155.9 (53.1), 177.2 (33.9), and 202.4 (46.6) L/min, respectively. All three interventions significantly improved PCF. However, manual assistance following an MIC maneuver was significantly less effective than MI-E alone. Manual thrust plus MI-E was significantly more effective than both of these interventions. CONCLUSION: In patients with NMD and respiratory muscle dysfunction, MI-E alone was more effective than manual assistance following an MIC maneuver. However, MI-E used in conjunction with manual thrust improved PCF even further.
Cough* ; Female ; Humans ; Insufflation ; Male ; Neuromuscular Diseases ; Respiratory Muscles*