Bacterial meningitis results in significant neurologic dificits despite in spite of much effort in the treatment of the disease. This study was performed to determine the incidence of caustive organisms and to correlate between the organisms and computed tomographic (CT) findings with clinical outcome of bacterial meningitis in newborns and infants. We analyzed the brain CT and clinical records of 15 infants who had been diagnosed as bactrial meningitis by CSF culture. We found that the most common organisms were Group B streptococcus in neonates withou no neurologic complications in all but one and Hemophilus influenza in infants whose clinical outomes were poor in all except one. CT findings related with poor prognosis in this study were cerebral edema, basal cistermal obliteration & enhancement, and cerebral infarction on initial CT and ventriculomegaly on follow-up CT. We concluded that CT diagnosed intracranial complications of bacterial meningitis well and could contributed to better treatment of bacterial meningitis.
Brain ; Brain Edema ; Cerebral Infarction ; Follow-Up Studies ; Haemophilus ; Humans ; Incidence ; Infant* ; Infant, Newborn* ; Influenza, Human ; Meningitis ; Meningitis, Bacterial* ; Prognosis ; Streptococcus

PURPOSE: To evaluate the spatial distribution of various proton metabolites in the human brain with use of water-suppressed in vivo 1H MR spectroscopic imaging (MRSI) technique MATERIALS AND METHODS: All of water-suppressed in vivo 1H MRSI were performed on 1.5 T whole-body MRI/MRS system using Stimulated Echo Acquisition Method (STEAM) Chemical shift Imaging (CSI) pulse sequence. T1 -weighted MR images were used for CSl Field Of View (FOV; 24 cm). Voxel size of 1.S cm3 was designated from the periphery of the brain which was divided by 1024 x 16 x 16data points. RESULTS: Metabolite images of N-acetylaspartate (NAA), creatine/phosphocreatine (Cr) + choline/phosphocholine (Cho), and complex of gamma-aminobutyric acid (GABA) -I- glutamate (Glu) were obtained on the human brain. CONCLUSION: Our preliminary study suggests that in vivo 1H MRSl could provide the metabolite imaging to compensate for hypermetabolism on Positron Emission Tomography (PET) scans on the basis of the metabolic informations on brain tissues. The unique ability of in vivo 1H MRSI to offer noninvasive informations about tissue biochemistry in disease states will stimulate on clinical research and disease diagnosis.
Biochemistry ; Brain* ; Diagnosis ; gamma-Aminobutyric Acid ; Glutamic Acid ; Humans* ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Protons

No abstract available.
Gamma Cameras* ; Head*

No abstract available.
Female ; Pregnancy ; Pregnancy, Abdominal* ; Ultrasonics*

PURPOSE: In this study, we developed a new software tool for the analysis of renal scintigraphy which can be modified more easily by a user who needs to study new clinical applications, and the appropriateness of the results from our program was studied. MATERIALS AND METHODS: The analysis tool was programmed with IDL5.2 and designed for use on a personal computer running Windows. For testing the developed tool and studying the appropriateness of the calculated glomerular filtration rate (GFR), 99mTc-DTPA was administered to 10 adults in normal condition. In order to study the appropriateness of the calculated mean transit time (MTT), 99mTc-DTPA and 99mTc-MAG3 were administered to 11 adults in normal condition and 22 kidneys were analyzed. All the images were acquired with ORBITOR, the Siemens gamma camera. RESULTS: With the developed tool, we could show dynamic renal images and time activity curve (TAC) in each ROI and calculate clinical parameters of renal function. The results calculated by the developed tool were not different statistically from the results obtained by the Siemens application program (Tmax: p=0.68, Relative Renal Function: p=1.0, GFR: p=0.25) and the developed program proved reasonable. The MTT calculation tool proved to be reasonable by the evaluation of the influence of hydration status on MTT. CONCLUSION: We have obtained reasonable clinical parameters for the evaluation of renal function with the software tool developed in this study. The developed tool could prove more practical than conventional, commercial programs.
Adult ; Gamma Cameras ; Glomerular Filtration Rate ; Humans ; Kidney ; Microcomputers ; Nuclear Medicine* ; Radionuclide Imaging ; Running ; Technetium Tc 99m Mertiatide

No abstract available.
Adrenal Glands* ; Ganglioneuroma* ; Hyperplasia*

This study was done to evaluate transvaginal ultrasonographic measurement of cervical length at 20 to 24 weeks and 37 weeks as a predictor of prolonged pregnancy (defined as a pregnancy that extended beyond 41+2 weeks of gestation [289 days]) in nulliparous women. This prospective observational study enrolled 149 consecutive nulliparous women with singleton gestation at 37 weeks. Cervical length was measured by transvaginal ultrasonography at 20 to 24 weeks and 37 weeks. Cervical length at 37 weeks, but not at 20 to 24 weeks, was significantly longer in women delivered at >41+2 weeks than in those delivered at < or =41+2 weeks (p<0.005). There was a significant correlation between cervical length at 37 weeks and gestational age at delivery (Pearson correlation coefficient, r=0.387, p<0.0001). In the receiver operating curve, the best cut-off value of cervical length at 37 weeks for the prediction of prolonged pregnancy was 30 mm, with a sensitivity of 78% and a specificity of 62%. Cervical length assessed by transvaginal ultrasonography at 37 weeks can predict the likelihood of prolonged pregnancy in nulliparous women. However, there is no association between cervical length at 20 to 24 weeks and the occurrence of prolonged pregnancy.
Vagina ; ROC Curve ; Prospective Studies ; Pregnancy, Prolonged/*diagnosis ; Pregnancy ; Humans ; Gestational Age ; Female ; Cervix Uteri/*anatomy & histology/*ultrasonography ; Adult

BACKGROUND AND PURPOSE: Low-dose topiramate (TPM) monotherapy has recently been found effective for seizure control in newly diagnosed epilepsy. In higher dosages, TPM has been associated with relatively high rates of adverse cognitive effects; similar side effects have been seen after rapid titration or polytherapy. However, its cognitive effects during low-dose monotherapy have not been established. We evaluated the cognitive effects of low-dose TPM compared with oxcarbazepine (OXC), a drug that does not appear to affect cognitive function. METHODS: Cognitive tests and subjective complaints of 30 patients with low-dose TPM monotherapy (50-200 mg/day) were retrospectively compared with those of 30 patients with OXC monotherapy at 1 year of medication. The two groups did not differ with respect to epilepsy-relevant variables, nor on baseline neuropsychological tests. RESULTS: The TPM group showed a significant difference in the performance of delayed word recall (P<0.05), backward digit span (P<0.01), and verbal fluency (P<0.05) compared with the OXC group. The TPM group showed worse performances of digit span and verbal fluency. The OXC group showed better performances of delayed word recall. The incidence of cognitive complaints was higher in the TPM group (50%) than in the OXC group (20%) (P<0.05). These cognitive effects shown in the TPM group were dose-related. The cognitive dysfunction was trivial with patients taking 50 mg/day TPM. CONCLUSIONS: Even at low-dose, TPM has a negative effect on working memory and verbal fluency compared with OXC. It can be demonstrated at 1 year of treatment.
Cognition ; Epilepsy* ; Humans ; Incidence ; Memory, Short-Term ; Neuropsychological Tests ; Retrospective Studies ; Seizures

The aims of this study were to determine whether sonographically measured cervical length is of value in the identification of microbial invasion of the amniotic cavity in women with preterm premature rupture of membranes (PPROM) and to compare its performance with maternal blood C-reactive protein (CRP), white blood cell count (WBC), and amniotic fluid (AF) WBC. This prospective observational study enrolled 50 singleton pregnancies with PPROM. Transvaginal ultrasound for measurement of cervical length was performed and maternal blood was collected for the determination of CRP and WBC at the time of amniocentesis. AF obtained by amniocentesis was cultured and WBC determined. The prevalence of a positive amniotic fluid culture was 26% (13/50). Patients with positive amniotic fluid cultures had a significantly shorter median cervical length and higher median CRP, WBC, and AF WBC than did those with negative cultures. Multiple logistic regression indicated that only cervical length had a significant relationship with the log odds of a positive AF culture. Transvaginal sonographic measurement of cervical length is valuable in the identification of microbial invasion of amniotic cavity in women with PPROM. Cervical length performs better than AF WBC, maternal blood CRP, and WBC in the identification of a positive amniotic fluid culture.
Adult ; Amniocentesis/methods ; Amniotic Fluid/*microbiology ; Bacterial Infections/*complications ; C-Reactive Protein/metabolism ; Cervix Uteri/*ultrasonography ; Female ; Fetal Membranes, Premature Rupture/etiology/*ultrasonography ; Gestational Age ; Humans ; Leukocyte Count ; Logistic Models ; Maternal Age ; Pregnancy ; Pregnancy Complications, Infectious/blood/etiology/ultrasonography ; Prospective Studies ; Risk Factors ; Ultrasonography/methods

No abstract available.
Brain* ; Evaluation Studies as Topic* ; Photic Stimulation* ; Tomography, Emission-Computed, Single-Photon*