Ambulatory BP monitoring was performed in a patients with pheochromocytoma before and after removal of the tumor. Before surgery, it did not show any significant diurnal variation. But, after surgery the diurnal variation was restored.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Humans ; Pheochromocytoma*

Rupture of the sinuses of Valsalva is not common in childhood. It is frequently associated with other heart disease, most commonly with VSD. It is classified into four types, anatomically. The symptoms are differentiated as acute, gradual progression, and unruptured aneurysm. We experienced 2 cases of rupture of the sinuses of Valsala, which were corrected completely after operation. The patients were 14 year old boy with his chief complaint of dyspnea and chest pain, and an 11 year old girl with chief complaint of exertional dyspnea.
Adolescent ; Aneurysm ; Chest Pain ; Child ; Dyspnea ; Female ; Heart Diseases ; Humans ; Male ; Rupture*

PURPOSE: In this study we tried to look at the spreading, duration of colonization, and acquisition of new streptococci which were obtained in one geographical area, as well as the bacteriologic and molecular epidemiology of normal school children carrying group A streptococci and their clonal relationship through the combined application of the serotype of T antigen and Pulsed Field Gel Electrophoresis(PFGE). METHODS: A total of 88 strains of group A streptococci were isolated from 396 normal school children. All isolates were classified in groups by Streptex and serotyped by T. agglutination. Restriction enzyme digestion of DNA was taken using Sma I. DNA fragments were separated by PFGE. RESULTS: A total of 33 strains were allocated their epidemiologic characteristics. Four out of 33 strains were not restricted by enzyme(Sma I). Twenty nine strains out of 33 strains showed 12 subtypes with 8-12 fragments between 40kbp and 500kbp of DNA fragments on PFGE. Eight strains of NT and T6 war same fragment patterns on PFGE, respectively. Three strains out of 4 strains of T8/25 were not restricted and the other one showed different, unique patterns. One strain out of 8 stains of T12 was not restricted, and the others were classified as 5 different subtypes. Two strains of Tl were different patterns from each other, and 2 strains of T4 showed the samefragment pattern CONCLUSION: T serotypes with PFGE will be useful as a screening and molecular epidemiologic method in a country where anti-M antisera is not available, after recognizing the advantages and disadvantages of M and T serotyping.
Agglutination ; Antigens, Viral, Tumor ; Child* ; Colon ; Coloring Agents ; Digestion ; DNA ; Epidemiologic Methods ; Epidemiologic Studies* ; Humans ; Immune Sera ; Mass Screening ; Molecular Epidemiology ; Serotyping* ; Streptococcus pyogenes* ; Streptococcus*

Objective: We sought to determine if the links between and within the default mode network (DMN) and dorsal attention network (DAT) exhibited different conditions according to catechol-O-methyltransferase (COMT) gene polymorphism in relationship to attention-deficit hyperactivity disorder (ADHD) symptoms. Methods: Fifty-seven children with ADHD and 48 healthy controls (HCs) were administered an intelligence test, the Children’s Depression Inventory, the Korean ADHD rating scale, and continuous performance test. Resting-state brain functional MRI scans were obtained, and COMT genotyping was performed to distinguish valine carriers and methionine homozygotes. Results: Compared to controls, children with ADHD showed increased ADHD scale scores, increased visual commission errors, and increased functional connectivity (FC) within the DMN and DAT. Compared to all children with ADHD, children with the methionine homozygote and those who were valine carriers showed increased FC within the DMN and DAT and decreased FC between the DMN and DAT. FC within the DMN was also increased in HC valine carriers compared to HC children with the methionine homozygote, and in children with ADHD who were valine carriers compared to HC valine carriers. Conclusion We observed increased brain connectivity within the DMN and DAT and altered brain connectivity within and between the DMN and DAT associated with COMT polymorphism in children with ADHD.

BACKGROUND AND PURPOSE: Atrophy of the hippocampus is an important clinical diagnostic marker of Alzheimer's disease (AD), and so assessments of hippocampal activity and its subdivisions might provide invaluable information. This study compared the glucose metabolism of hippocampal subdivisions in mild-AD patients and healthy controls. METHODS: High-resolution T2*-weighted gradient-echo magnetic resonance imaging (MRI) images and ¹⁸F-fluorodeoxyglucose (FDG) positron-emission tomography (PET) images were acquired using 7.0-T MRI and high-resolution research tomograph FDG-PET, respectively, in 9 early-stage AD patients and 10 healthy subjects. The hippocampal body was divided into three equal parts (anterior, middle, and posterior), and in each part a region of interest (ROI) was drawn over the cornus ammonis (CA)1, CA2/3, CA4/dentate gyrus (DG), and subiculum. The standardized uptake values of the hippocampal subdivisions were calculated for each ROI as ratios relative to the pons standardized uptake value. Statistical analysis was conducted using the Mann-Whitney U test. RESULTS: Patients with early-stage AD patients showed significantly less metabolic activity than healthy controls focally in the middle (p=0.050) and posterior (p=0.034) CA2/3 regions of the right hippocampus, and significantly less activity throughout the left hippocampal body in the anterior CA2/3 (p=0.027) and CA4/DG (p=0.027) regions, the middle CA1 region (p=0.011), and the posterior CA1 (p=0.034), CA2/3 (p=0.007), and CA4/DG (p=0.014) regions. CONCLUSIONS: It was possible to use high-resolution PET-MRI fusion images to identify hippocampus subdivisions and assess glucose metabolism in the subfields. Reductions in metabolic activity were found to vary along the hippocampal axis in early-stage AD patients.
Alzheimer Disease* ; Atrophy ; Cornus ; Glucose* ; Healthy Volunteers ; Hippocampus ; Humans ; Magnetic Resonance Imaging* ; Metabolism ; Pilot Projects* ; Pons ; Positron-Emission Tomography

BACKGROUND AND PURPOSE: Early-onset Alzheimer's disease (EOAD) and late-onset Alzheimer's disease (LOAD) have different clinical and neuroimaging characteristics, but memory decline is usually present in both types. However, there have been few functional studies focused on the hippocampus in Alzheimer's disease. We therefore investigated the functional connectivity between the hippocampus and other brain regions using resting-state fMRI and compared the findings between EOAD and LOAD. METHODS: We recruited 13 patients with EOAD and 19 patients with LOAD at the early disease stage. Twenty-one young controls and ten old controls were also recruited. Each participant completed a standardized neuropsychological battery of tests and underwent T1-weighted structural MRI. fMRI data were acquired during the resting state using 3-T MRI. The functional connectivity to the hippocampus was calculated based on automated anatomical labeling templates. RESULTS: The functional connectivity from the hippocampus to other brain regions differed between patients with EOAD and LOAD. The LOAD patients showed decreased hippocampal connectivity to cortical regions, such as to the middle temporal cortex, orbitofrontal cortex, postcentral cortex, supramarginal cortex, and rolandic operculum. In contrast, EOAD patients showed smaller functional changes of the cortical regions connected to the hippocampus, such as the middle frontal cortex. CONCLUSIONS: EOAD and LOAD patients exhibited different hippocampal connectivity. The memory decline in EOAD may be due to brain areas other than the hippocampus.
Alzheimer Disease* ; Brain ; Frontal Lobe ; Hippocampus* ; Humans ; Magnetic Resonance Imaging ; Memory ; Neuroimaging ; Prefrontal Cortex ; Temporal Lobe

Meningiomas are typically diagnosed by their characteristic appearance on conventional magnetic resonance imaging (MRI). However, detailed image findings regarding peri- and intra-tumoral anatomical structures, tumor consistency and vascularity are very important in pre-surgical planning and surgical outcomes. At the 7.0 T MRI achieving ultra-high resolution, it could be possible to obtain more useful information in surgical strategy. Four patients who were radiologically diagnosed with intracranial meningioma in 1.5 T MRI underwent a 7.0 T MRI. Three of them underwent surgery afterwards, and one received gamma knife radiosurgery. In our study, the advantages of 7.0 T MRI over 1.5 T MRI were a more detailed depiction of the peri- and intra-tumoral vasculature and a clear delineation of tumor-brain interface. In the safety issues, all patients received 7.0 T MRI without any adverse event. One disadvantage of 7.0 T MRI was the reduced image quality of skull base lesions. 7.0 T MRI in patients with meningiomas could provide useful information in surgical strategy, such as the peri-tumoral vasculature and the tumor-brain interface.
Humans ; Magnetic Resonance Imaging* ; Meningioma* ; Radiosurgery ; Skull Base

BACKGROUND: Alterations in blood cell count are well recognized features of bacteremia. The study objective was to determine the hematologic changes predictive of bacteremia. METHODS: We retrospectively studied febrile adult patients with neutrophilia and included patients were either bacteriologically proven cases or those who had clinically suspected bacterial infections. Hematologic findings derived from basic hematologic tests were compared between patients with and those without bacteremia. RESULTS: Of the 624 patients, 143 (22.9%) had significant bacteremia. The following items were significantly different between patients with and those without bacteremia by univariate analysis: absolute neutrophil count, neutrophil differential, absolute lymphocyte count, lymphocyte differential, platelet count and band-associated parameters such as absolute band neutrophil count (ABC). Multivariate analysis revealed platelet count, lymphocyte differential and ABC as independent predictors (P<0.0001, each). Platelet count, the most potent predictor of bacteremia, showed area under the curve (AUC) of 0.685. Analysis according to the primary diagnosis indicated that the most potent predictors of bacteremia in patients with respiratory tract, urinary tract and hepatobiliary system infections were platelet count (P=0.002, AUC=0.697), ABC (P=0.002, AUC=0.681) and neutrophil differential (P=0.0001, AUC=0.822), respectively. CONCLUSIONS: Simple variables obtained from basic hematologic tests were associated with bacteremia even in febrile patients with neutrophilia. In particular, very high neutrophil differential was highly predictive of bacteremia in patients with hepatobiliary system infections and its clinical usefulness needs to be elucidated in a prospective study.
Adult ; Bacteremia ; Bacterial Infections ; Blood Cell Count ; Hematologic Tests ; Humans ; Lymphocyte Count ; Lymphocytes ; Multivariate Analysis ; Neutrophils ; Platelet Count ; Respiratory System ; Retrospective Studies ; Urinary Tract

Thymic carcinoma is a rare malignant neoplasm of the thymic epithelium, distinguished from benign or invasive thymoma by the presence of malignant cytology and a greater incidence of local invasion and embolic metastases. The true incidence of this neoplasm is unknown. Nearly three fourth of their patients had symptoms of an anterior mediastinal mass, including cough, chest pain, and superior vena cava syndrome. These patients rarely have myasthenia gravis or other thymoma-associated paraneoplastic syndromes. The treatment of thymic carcinoma remains a controversial matter. We report eight cases of thymic carcinoma treated in our institution from 1990 to 1997.
Chest Pain ; Cough ; Epithelium ; Humans ; Incidence ; Mediastinum ; Myasthenia Gravis ; Neoplasm Metastasis ; Paraneoplastic Syndromes ; Superior Vena Cava Syndrome ; Thymoma*

PURPOSE: Taking an accurate and rapid body temperature can give a valuable information when taking care of neonates. The purpose of this study is to compare the reliability of taking rapid and less complicated means of measuring body temperature at tympanic membrane by infrared tympanic thermometer(Thermoscan IRT 1020, type 60005711, home model) with the standard method of taking body temperature at axilla and rectum by mercury thermometer. METHODS: Simultaneous rneasurements of tympanic membrane and axillary temperatures were taken followed by rectal temperatures within 5 minutes by 2 different investigators from 107 term infants One investigator measured tympanic membrane temperature by infrared tyrnpanic thermometer for 3 times and took the highest temperature as a final measurement and the other investigator took the axillary temperature for at least 5 minutes and rectal temperature for at least 2 minutes on each patient. RESULTS: Total of 107 term infants including 57 males and 50 females were subjects, The average body temperatures were 36.7+/-0.3degree, 37.0+/-0.4degree, 36.6+/-0.3degree for axillary, reactal and tympanic membrane, respectively. The correlation coefficients between axillary, rectal and tympanic temperature measurements were high at r=0.746- 0.804 and were statistically significant at P<0.001. CONCLUSION: We have shown from this study that taking tympanic membrane temperature can be used as an altemative and reliable means of taking body temperature in place of taking axillary and rectal temperature in neonates.
Axilla ; Body Temperature ; Female ; Humans ; Infant ; Infant, Newborn* ; Male ; Rectum ; Research Personnel ; Thermometers* ; Tympanic Membrane