PURPOSE: Meningitis is an acute childhood infection caused by viral or bacterial infection. The purpose of the present study is to analyze the differences between enteroviral meningitis and non-enteroviral aseptic meningitis. METHODS: From January 2013 to December 2016, we retrospectively reviewed the medical records of a total of 303 aseptic meningitis patients who visited Wonju Severance Christian Hospital. We examined demographics of all patients and analyzed serologic and cerebrospinal fluid tests, clinical symptoms, and outcomes. RESULTS: Of a total of 303 patients, 197(65.0%) were male, and the most cases occurred from June to November (91.8%). The most common pathogen of meningitis was found to be enterovirus (65.0%). According to the etiology, the enteroviral meningitis group had significantly more headache and enteric symptoms (P=0.0003 and P=0.0013, respectively). Furthermore, the non-enteroviral meningitis group showed pleocytosis in the cerebrospinal fluid and a significantly higher rate of seizure at 1 to 4 years (P=0.0360 and P=0.0002, respectively). CONCLUSION: In this study, enteroviral meningitis was the most common and the prognosis was good. When compared between two groups, neurological symptoms were frequent in patients with non-enteroviral meningitis in groups 1 to 4 years.
Bacterial Infections ; Cerebrospinal Fluid ; Child ; Demography ; Enterovirus* ; Gangwon-do ; Headache ; Humans ; Leukocytosis ; Male ; Medical Records ; Meningitis* ; Meningitis, Aseptic ; Prognosis ; Retrospective Studies ; Seizures

Poststroke depression is very common and has been reported in as many as 40~50% of poststroke patients. The fluoxetine is one of the most frequently prescribed drugs for the treatment of poststroke depression. This serotonin selective reuptake inhibitor, known as generally safe and well tolerated drug, has been recently reported to induce mania. We report a case of fluoxetine-induced mania. A 64 year-old male, who has taken 10 mg of fluoxetine daily due to poststroke depression, presented elevated mood, hyperactivity, regressed behavior, excessive planning, sleep deterioration, and talkativeness abruptly. We were suspicious of fluoxetine- induced manic state and discontinued immediately fluoxetine without prescription of mood stabilizer. His symptoms had been ceased over two weeks.
Bipolar Disorder ; Depression ; Fluoxetine ; Humans ; Male ; Prescriptions ; Serotonin

Autonomic dysfunction is a common manifestation in Guillain-Barre syndrome (GBS), but it rarely persists. We report a case involving a 22-year-old man who presented with glove-and-stocking type sensory loss, symmetric weakness, urinary distension, orthostatic hypotension, decreased perspiration, and the syndrome of inappropriate secretion of antidiuretic hormone. He was subsequently diagnosed as having GBS with autonomic failure that persisted for more than six months, despite regaining muscle strength. Orthostatic hypotension progressively improved after rehabilitation and administration of midodrine and fludrocortisone. Extensive evaluation and management should be performed in patients with GBS because severe autonomic dysfunction is a major source of disability.
Fludrocortisone ; Guillain-Barre Syndrome ; Humans ; Hypotension, Orthostatic ; Midodrine ; Muscle Strength ; Young Adult

Objectives: This study investigated the effects of mouthwashes containing cetylpyridinium chloride and zinc acetate on oral health. Methods: A total of 60 participants were included in the study. Fifty-three participants (27 and 26 participants in the experimental and control groups, respectively) were retained, excluding seven candidates who dropped out. The mouthwash used for the study was spat out after 10-15 ml of mouth-washing for 3 s in the oral cavity after breakfast, lunch, and dinner. Oral examination indices included the gingival (gingival index, PMA index), the patient hygiene performance (PHP index, Turesky plaque index), and the bad breath (BB checker, Oral chroma) indices. Five measurements were taken after 2, 4, 6, 8, and 12 weeks and compared. Results: Measurements of the gingival index showed a statistically significant difference between the experimental and the control groups after 4 weeks, and the PMA index from eight weeks (P<0.05). Measurements of the PHP and Turesky plaque indices showed a significant difference in the experimental and control groups after 4 weeks (P<0.05). Compared to the PHP index before the experiment, that of the experimental group showed a significant index decrease after 2 weeks (P<0.05). Results of measuring bad breath through a BB checker showed a statistically significant difference between the experimental and control groups after 4 weeks (P<0.05). Conclusions Oral mouthwash products containing cetylpyridinium chloride and zinc acetate relieves gingivitis, removes bacterial plaque, and reduces bad breath.

Objectives: The aim of this study was to investigate the infection rates of bacteria associated with dental caries among children and adolescents in Korea. Methods: Oral examinations were conducted in 146 students. The numbers of bacteria associated with dental caries, such as Streptococcus mitis , Streptococcus mutans , Streptococcus sobrinus , and Lactobacillus casei , in the subjects’ oral cavity were counted by real-time PCR, and infection rates for those bacteria were additionally investigated. Results: The infection rate of Streptococcus mitis , Streptococcus mutans , Streptococcus sobrinus , and Lactobacillus casei was 99.3% (145/146), 63.0% (92/146), 1.4% (2/146), and 25.3% (37/146), respectively. The amounts of Streptococcus sobrinus and Lactobacillus casei did not differ with the participants’ age. However, the number of Streptococcus mutans was 537.6 for primary school students, 5698.2 for middle school students, and 19037.5 for high school students. The mean number of oral bacteria increased with age (P<0.05). The mean bacterial numbers of the infected subjects indicated significant differences in the numbers of Streptococcus mitis and Streptococcus mutans (P<0.05). Conclusions The infection rates of Streptococcus mitis and Streptococcus mutans were distinct in children and adolescents. Efforts to control the bacteria associated with dental caries are needed to prevent dental caries.

Humeral shaft fracture sustaining arm wrestling is rare, but occurs intermittently. We treated 15 cases of humeral shaft spiral fractures occurred during arm wrestling for fun since 2007. Average age was 22.47±2.69 years, average body mass index was 22.67±2.06 kg/m2. There was no prominent tendency for the fractures to occur at a certain phase of the match. Fractured level and length of each case were measured in the plain radiographs and compared with those of previous reports. Eight cases (53.3%) had an associating medial butterfly fragment, and the time taken until the fracture occurred was longer than that of simple spiral fracture (15.62±9.03 seconds vs. 7.85±2.67 seconds, p=0.048). Fractures were distributed mid to distal one third of humerus, the length of fracture was 7.93±2.69 cm and involved 25.43%±8.24% of humeral length. All cases except one treated surgically using plate and screws and returned their full activities within postoperative 3 months. Although arm wrestling is a simple and joyful sport, participants should be aware of the risks of injury during arm wrestling, especially for the amateur players.
Arm* ; Body Mass Index ; Butterflies ; Humans ; Humeral Fractures ; Humerus ; Male* ; Sports ; Wrestling*

Cholangiocarcinoma is a malignant disease originating from the epithelium of the biliary tract, and its prognosis is dismal due to distant metastasis in its early stages. The most common metastatic sites are the intra-abdominal organs, lymph nodes, and lungs. A patient was diagnosed with intrahepatic cholangiocarcinoma and underwent surgical resection. During the follow-up period, metastases were detected at the remnant liver and both lung fields. Eleven months after resection, the patient complained of severe headache. An approximately 5-cm cystic mass was found at the left occipital lobe of the cerebrum, and metastatic malignant cells were present on cerebrospinal fluid cytology. The patient underwent whole-brain radiotherapy. We herein report a rare case of cholangiocarcinoma with cystic brain metastasis together with a review of the relevant literature.
Biliary Tract ; Brain ; Cerebrum ; Cholangiocarcinoma ; Epithelium ; Follow-Up Studies ; Headache ; Humans ; Liver ; Liver Neoplasms ; Lung ; Lymph Nodes ; Meningeal Carcinomatosis ; Neoplasm Metastasis ; Occipital Lobe ; Prognosis

Precursor B-cell lymphoblastic lymphoma (B-LBL) is an uncommon high-grade neoplasm of immature B cells. It occurs predominantly in childhood with extranodal involvement such as skin and bone. Therefore, primary cutaneous involvement in elderly adults is a very rare manifestation of B-LBL. Here, we report a 78-year-old man with B-LBL presenting as a single cutaneous lesion which was immunohistochemically positive for leukocyte common antigen (LCA), CD79a, paired box 5 (PAX5), B cell lymphoma-2 (bcl-2), and terminal deoxynucleotidyl transferase (TdT) staining, but was without systemic involvement. The patient was treated using cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP), and achieved complete response (CR) at the first response assessment conducted after 3 CHOP cycles. After an additional cycle of CHOP treatment, radiotherapy was administered at a total dose of 3,600 cGy over 4 weeks. At the 21-month follow-up, he had maintained CR.
Adult ; Aged ; Antigens, CD45 ; B-Lymphocytes ; Cyclophosphamide ; DNA Nucleotidylexotransferase ; Doxorubicin ; Follow-Up Studies ; Humans ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Precursor Cells, B-Lymphoid ; Prednisolone ; Skin ; Vincristine

Saphenous mononeuropathy is an uncommon neuropathy in clinical condition, which may incur from various surgical procedures, direct trauma, or entrapment, and most frequently involves at the adductor canal, or Hunter's canal. A 17-year old female, who was majoring in ballet, visited our rehabilitation clinic for numbness in the medial aspect of the left lower leg for the previous 9 months, without weakness. The electrodiagnostic study revealed only a delayed small potential in the left saphenous nerve. MRI examination showed soft tissue swelling in the medial side of the left knee. Accordingly, we diagnosed the patient with saphenous mononeuropathy around the knee, without lumbar plexopathy or femoral neuropathy. We report a case of saphenous mononeuropathy which developed after repetitive compression on the medial side of the knee without any other iatrogenic injury, and include a review of the relevant literature.
Female ; Femoral Neuropathy ; Humans ; Hypesthesia ; Knee ; Leg ; Mononeuropathies

OBJECTIVE: To analyze the hospitals related rehabilitation, which were designated for industrial accident compensation insurance, focusing faculties and facilities by administrative district. METHOD: Total 1,031 hospitals having more than 30 beds were included. We investigated the numbers of hospital beds, medical departments, medical doctors, nurses, physical therapists, and occupational therapists of each hospital with official document of industrial accident compensation insurance. And we classified and analyzed all data by administrative district. RESULTS: The average of each objects were estimated as following orders: total number of hospital beds (131.5); medical departments (5.8); medical doctors (11.2); nurses (33.8); physical therapists (4.2); occupational therapists (0.9). The percentage of hospitals with department of rehabilitation medicine was 28.4% in total, 26.7% in hospital and 35.3% in general hospital. Mean numbers of hospital beds, medical departments, medical doctors, nurses and physical therapists did not showed disparity among the administrative districts. However, the percentages of hospitals with department of rehabilitation medicine and of hospitals with occupational therapists showed disparity among the administrative districts. The regional distribution of hospitals with department of rehabilitation medicine showed similar distribution, as that of occupational therapists. CONCLUSION: These results demonstrate faculties and facilities of hospitals under the industrial accident compensation insurance which are related with rehabilitation treatment. We believe that these results would be helpful for constructing certification system of rehabilitation hospital and for further research about rehabilitation treatment associated with industrial accident compensation insurance.
Accidents, Occupational ; Certification ; Compensation and Redress ; Hospitals, General ; Humans ; Insurance ; Physical Therapists