• Title/Summary/Keyword: Late-onset

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Diffusion-Weighted MR Imaging of Intracerebral Hemorrhage

  • Bo Kiung Kang;Dong Gyu Na;Jae Wook Ryoo;Hong Sik Byun;Hong Gee Roh;Yong Seon Pyeun
    • Korean Journal of Radiology
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    • v.2 no.4
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    • pp.183-191
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    • 2001
  • Objective: To document the signal characteristics of intracerebral hemorrhage (ICH) at evolving stages on diffusion-weighted images (DWI) by comparison with conventional MR images. Materials and Methods: In our retrospective study, 38 patients with ICH underwent a set of imaging sequences that included DWI, T1-and T2-weighted imaging, and fluid-attenuated inversion recovery (FLAIR). In 33 and 10 patients, respectively, conventional and echo-planar T2* gradient-echo images were also obtained. According to the time interval between symptom onset and initial MRI, five stages were categorized: hyperacute (n=6); acute (n=7); early subacute (n=7); late subacute (n=10); and chronic (n=8). We investigated the signal intensity and apparent diffusion coefficient (ADC) of ICH and compared the signal intensities of hematomas at DWI and on conventional MR images. Results: DWI showed that hematomas were hyperintense at the hyperacute and late subacute stages, and hypointense at the acute, early subacute and chronic stages. Invariably, focal hypointensity was observed within a hyperacute hematoma. At the hyperacute, acute and early subacute stages, hyperintense rims that corresponded with edema surrounding the hematoma were present. The mean ADC ratio was 0.73 at the hyperacute stage, 0.72 at the acute stage, 0.70 at the early subacute stage, 0.72 at the late subacute stage, and 2.56 at the chronic stage. Conclusion: DWI showed that the signal intensity of an ICH may be related to both its ADC value and the magnetic susceptibility effect. In patients with acute stroke, an understanding of the characteristic features of ICH seen at DWI can be helpful in both the characterization of intracranial hemorrhagic lesions and the differentiation of hemorrhage from ischemia.

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Serotype Distribution of Invasive Group B Streptococcal Diseases in Infants at Two University Hospitals in Korea (영아에서의 침습 B군 사슬알균 감염증 및 혈청형 분석: 2개 대학병원 연구)

  • Cho, Hye-Kyung;Nam, Hye Na;Cho, Hye Jung;Son, Dong Woo;Cho, Yong Kyun;Seo, Yiel-Hea;Kim, Yae-Jean;Eun, Byung Wook
    • Pediatric Infection and Vaccine
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    • v.24 no.2
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    • pp.79-86
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    • 2017
  • Purpose: This study was aimed at analyzing the serotypes of group B streptococcus (GBS) isolated from Korean infants with invasive disease and evaluating their association with disease manifestation. Methods: Data were retrospectively collected from invasive GBS infections at Gachon University Gil Medical Center from January 2006 to June 2012 and at Samsung Medical Center from April 2010 to November 2012. Serotypes were determined by slide agglutination test. Results: A total of 37 cases were identified, which included 22 full-term infants and 15 preterm infants. Fifteen cases (40.5%) were early-onset, 19 (51.4%) was late-onset, and three (8.1%) was very late-onset. Early-onset diseases among preterm infants were higher than those among full-term infants (60.0% [9/15] vs. 27.3% [6/22], P=0.17). The most common manifestation was bacteremia (70.3%), followed by meningitis and septic arthritis. Among 24 isolates retrievable for serotyping, serotype III (41.7%) was most common, followed by V (16.7%), Ia, Ib, and II (12.5%, respectively), and non-typeable (4.2%). Serotype III was more common in isolates from full-term infants (10/22) than from preterm infants (0/15), whereas serotype V was more common in isolates from preterm infants (4/15) than from full-term infants (0/22) (P=0.002). No penicillin-resistant strain was detected, and resistance to erythromycin and clindamycin were both 64.9%. Conclusions: GBS is an important pathogen in both preterm and full-term infants, and serotype distribution of GBS causing invasive diseases can differ between preterm and full-term infants. It is necessary to monitor the nationwide epidemiology of GBS diseases, including in preterm infants, in order to prepare preventive measures without underestimating early-onset diseases.

Clinical Correlates of Subcortical Hyperintensities on Magnetic Resonance Imaging in Patients with Bipolar Disorder : Preliminary Study (양극성장애 환자의 뇌자기공명영상에서 보이는 피질하 고신호광도의 임상적 상관변수에 관한 예비적 연구)

  • Yoon, Dae Hyun;Kwon, Jun Soo;Han, Moon Hee;Chang, Kee Hyun
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.60-66
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    • 1997
  • Objective : Accumulating evidence suggests a greater number of subcortical hyperintensities in the brain of patients with bipolar disorder. We studied the Clinical correlates of subcortical hyperintensities on magnetic resonance imaging in patients with Bipolar Disorder : Methods : Magnetic resonance images of the brain were obtained for 32 patients with bipolar disorder. The presence and location of hyperintensities were assessed. We compared clinical variables between patients with subcortical hyperintensities and patients without them. Results : Seven patients(21.8%) had subcortical hyperintensities, but among 8 patients who were 40 years or older, 5 patients(62%) had them. Age and age at onset of patients with subcortical hyperintensities were significantly older than patients without them. Psychotic symptoms were more frequent in patients with hyperintensities. Patients without hyperintensities had more familial loadings. Conclusion : Given the limitations of the study, our results should be seen as preliminary. This study, however, provides preliminary evidence supporting the notion that the onset, clinical feature and course of some bipolar disorders of late onset may be determined by underlying subcortical abnormalities, with such abnormalities being the consequence of factors related to aging or neurodegeneration(such as impaired cerebral circulation) rather than genetic factors which predispose to early-onset bipolar disorders.

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Hemodynamics in Korean Hemorrhagic Fever (한국형(韓國型) 출혈열(出血熱)에서의 혈류역동학적(血流力動學的) 연구(硏究))

  • Han, Jie-Young;Lee, Jung-Sang;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.8 no.1_2
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    • pp.1-11
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    • 1974
  • The author in an attempt to evaluate hemodynamic changes in the clinical stages of Korean hemorrhagic fever measured plasma volume, cardiac output and effective renal plasma flow utilizing radioisoto es during various phases of the disease. Cardiac output was measured by radiocardiography with external monitoring method using RIHSA. Effective renal plasma flow was obtained from blood clearance curve drawn by external monitoring after radiohippuran injection according to the method described by Razzak et al. The study was carried out in thirty-eight cases of Korean hemorrhagic fever and the following conclusions were obtained. 1. Plasma volume was increased in the patients during the oliguric-and hypertensive diuretic phases, while it was normal in the patients during the normotensive-diuretic phase. 2. Cardiac index was increased in the patients during the oliguric phase and was slightly increased in the patients at the hypertensive diuretic phase. It was normal in the other phases. 3. Total peripheral resistance was increased in the hypertensive patients during diuretic phase, while it was normal in the rest of phases. 4. Effective renal plasma flow was significantly reduced in the patients during the oliguric and diuretic phases as well as at one month after the oliguric onset. There was no significant difference between the oliguric and the early diuretic phases. Renal plasma flow in the group of patients at one month after the oliguric onset was about 45% of the normal, however, it returned to normal level at six months after the onset. 5. Clinical syndrome of relative hypervolemia was observed in some patients during the oliguric phase or hypertensive diuretic phase. Characteristic hemodynamic findings were high cardiac output and normal to relatively increased peripheral resistance in these cases. Relatively increased circulating blood volume due to decreased effective vascular space was suggested for the mechanism of relative hypervolemia. 6. Cardiac hemodynamic alteration returned to normal during late stage of the diuretic phase, while renal hemodynamic changes were normalized at six months after the onset.

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Clinical improvement in a case of atypical infantile onset Pompe disease with enzyme replacement therapy (효소 보충 치료로 호전을 보인 비전형적 영아형 Pompe 병 1례)

  • Jeon, You Hoon;Eun, Baik-Lin;Son, Chang Sung;Lee, Dong Hwan
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.213-217
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    • 2007
  • Pompe disease is a genetic disorder caused by a deficiency of acid ${\alpha}$-glucosidase (GAA). Infantile onset Pompe disease is uniformly lethal. Affected infants generally present in the first few months of life with hypotonia, generalized muscle weakness, and a hypertrophic cardiomyopathy, which is rapidly followed by death, usually by the age of one. The late-onset form is characterized less severe symptoms and prognosis. Therapy for Pompe disease is intended to directly address the underlying metabolic defect via intravenous infusions of recombinant human GAA to replace the missing enzyme. We report a case of atypical infantile-onset Pompe disease that presented symptoms in infancy but had less severe clinical manifestations and improved after GAA enzyme replacement ($Myozyme^{(R)}$, Genzyme Co., MA, USA) therapy. It is very important that pediatricians become aware of signs and symptoms of Pompe disease, such as a nasal voice or a waddling gait at an early stage so that these patients can benefit from appropriate GAA replacement therapy as soon as possible.

TREATMENT OF FIRST BRANCHIAL CLEFT CYST (TYPE I);A CASE REPORT (우측 경부에 발생한 제1 새열낭종(Type I)의 치험례)

  • Kim, Il-Kyu;Lee, Seong-Jun;Ha, Soo-Yong;Chu, Young-Chae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.1
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    • pp.180-186
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    • 1990
  • This is a case report of first branchial cleft cyst in 56 year old male patient, which was tentatively diagnosed as acute right submandibular abscess resulted from the periapical lesion of the lower right second molar. The results are as follows, 1. The accompanying ipsilateral inflammatory swelling resulted from the periapical lesion of lower right second molar tooth makes the diagnosis difficult. 2. The onset of this case was very late in comparison to the mean discovering age of branchial cleft cysts. 3. The plain radiography using contrast media is helpful for the diagnosis of cystic lesions within soft tissues. 4. This case in a first branchial cleft cyst(Type I) which occurs less than 1% of all branchial cleft anomalies.

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Surgical Treatment of Acute Active Endocarditis (급성 활동성 심내막염의 수술적 치료)

  • 김성호
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.759-763
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    • 1994
  • Between November 1990 and December 1993, 9 patients underwent surgical intervention for acute active endocarditis at Gyeongsang National University Hospital. All the patients were operated on within the first six weeks after onset of symptoms for various reasons. Surgical indications for early surgery were heart failure, systemic septic emboli, new murmur and growing vegetation. Most common infecting organism was Staphylococcus[55 %], and the others were Streptococcus, anaerobes, Candida and unknown in 1 case. The infection was in the mitral valve in 5 patients, the aortic valve in 2, the aortic and mitral in 1, and the aortic and pulmonary in 1. There was one operative death[11 %] and no late death. Preoperative Functional Class were II in 4 patients, III in 5 and after surgery all the patients improved to Class I. We conclude that early surgical intervention in acute active endocarditis is effective in most instances.

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Prevention of Invasive Candida Infections in the Neonatal Intensive Care Unit (신생아 집중치료실에서 침습 칸디다 감염의 예방)

  • Kim, Chun Soo
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.15-22
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    • 2011
  • Invasive Candida infections (ICI) have become the third most common cause of late-onset infection among premature infants in the neonatal intensive care unit (NICU). Risk factors include birth weight less than 1,000 g, exposure to more than two antimicrobials, third generation cephalosporin exposure, parenteral nutrition including lipid emulsion, central venous catheter, and abdominal surgery. Candida colonization of the skin and gastrointestinal tract is an important first step in the pathogenesis of invasive disease. Strict infection control measures against the infection should be done in the NICU. The following practices are likely to contribute to reducing the rate of ICI: (1) restriction of broad-spectrum antibiotics, antacids and steroid; (2) introduction of early feeding and promoting breast milk. Fluconazole prophylaxis may be an effective control measure to prevent Candida colonization and infections in individual units with high incidence of fungal infection. In addition, there is a need of further data including the development of resistant strains and the effect on long-term neurodevelopmental outcomes of infants exposed to drugs before the initiation of routine application of antifungal prophylaxis in the NICU.

Horizontal and vertical profiles of PCBs in sediments from southeastern coastal areas of Korea

  • Kim, Sang-Soo;Moon, Hyo-Bang;Lee, Pil-Yong;Choi, Hee-Gu
    • Journal of the korean society of oceanography
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    • v.36 no.4
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    • pp.93-100
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    • 2001
  • The concentrations of 20 congeners of PCBs were determined in surficial and dated sediments from Jinhae, Busan, Ulsan and Yeongil Bay of Korea to assess current distributions as well as historical trends. The concentration ranges of total CBs in sediments were nd-138.60 ng/g dry wt. The concentrations of total CBs were significantly different among bays in the southeastern coastal areas (Kruskal-Wallis Test, p=0.036), Showing the Order Of Busan>Ulsan>Yeongil>Jinhae Bay. Predominant PCB homologues were penta-, hexa- and hepta-CBs. The down-core distributions of PCBs showed that the highest concentrations occurred in the late 1960s, coinciding with the onset of industrialization of Korea. The compositions of PCB congeners in sediment among bays were uniform, suggesting that major sources were not changed over time.

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Report on the Case of Treatment of Child Guillain-Barre Syndrome (소아(小兒) Guillain-Barre 증후군(症候群) 치험례(治驗例) 보고(報告))

  • Lee, Jae-Won;Koo, Eun-Jeong
    • The Journal of Korean Medicine
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    • v.18 no.2
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    • pp.137-147
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    • 1997
  • The writers have treated in hospital a two-year and 4 month boy child with Guillain-Barre syndrome whose chief complaints are flaccid tetraparalysis and hypesthesia for about three months from December 2, 1996. In the early stage, the principles and methods of treatment such as wind expelling and removal of dampness(?風濕) and obstruction in meridians and collaterals(通經活絡) were used and in the late stage the principles and methods of treatment to invigorate the spleen, replenish Ki(健脾益氣), and nourish the liver and kidneys(滋補肝腎) were applied, together with acupuncture, indirect moxibustion and massotheraphy. Since then, the symptom has gradually improved. Six months after onset, the boy child was recovered to a nearly normal condition. Therefore, this case of treatment is reported, together with consideration of literature.

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