Common Features of Attention Deficit Hyperactivity Disorder and Epileptic Disorder in Childhood and Early Adolescence / 정신신체의학

OBJECTIVES: We conduct this study to investigate the common features between Attention Deficit Hyperactivity Disorder(ADHD) and epileptic patients compared to normal control. METHODS: Epileptic patients were recruited from the department of pediatic in Jesus Hospital. ADHD patients were recruited from the department of neuropsychiatry in Jesus Hospital. We excluded mental retardation or brain organic pathology. We use ADHD Diagnostic System and Korean-Child Behavior Checklist(K-CBCL) to assess features of ADHD. Electroencephalogram(EEG) of ADHD, epileptic patients and normal control were analyzed and compared. RESULTS: Compared to normal control group, inattention, reaction time deviation were increased in both ADHD and epilepsy group. EEG abnormalities(control 13.8%, epilepsy 97.1%, ADHD 40%) in three groups were reported. CONCLUSION: There are common features of ADHD and epileptic patients.

Subintimal Stent Placement in Patients with Long Segment Occlusion of the Iliac Artery

PURPOSE: We evaluated the technical feasibility and clinical efficacy of subintimal stent placement for long segment occlusion of the iliac artery. MATERIALS AND METHODS: From March 2003 to February 2007, subintimal stent placement for long segment occlusion of the iliac artery of 24 limbs in 22 patients was analyzed retrospectively. Endovascular access was performed via the ipsilateral femoral artery in 7 cases, via the contralateral femoral artery in 6 cases, via both femoral arteries in 10 cases and via the brachial artery in one case. The SAFARI (subintimal arterial flossing with antegrade-retrograde intervention) technique using a microcatheter was performed to recannalize iliac artery occlusion in three cases. Medical records were reviewed for the collection of follow-up data. The stent patency rate was analyzed by use of the Kaplan-Meier method. RESULTS: Subintimal stent placement was technically successful in 23 of 24 procedures (95.8%). The mean ankle-brachial index (ABI) increased from 0.26 to 0.82. The Fontaine classification was improved after stent placement in all patients. Major complications occurred in four procedures: three distal embolizations and one arterial rupture. All of the complications were successfully treated by endovascular intervention. The primary stent patency rates at 6-months, 1-, 2- and 3-years were 95%, 88%, 88% and 88%, respectively. CONCLUSION: Subintimal stent placement is a safe and effective treatment for long segment occlusion of the iliac artery.

Intractable Postpartum Bleeding: A Comparison of the Retrospective Analysis of Angiographic Findings and Transcatheter Arterial Embolization According to Delivery Pattern

PURPOSE: We evaluated the technical aspect and efficacy of transcatheter arterial embolization (TAE) in cases of intractable postpartum bleeding by comparing the angiographic findings women patients according to their delivery pattern. MATERIALS AND METHODS: Between July of 2003 and March of 2008, 55 female patients were enrolled in this study. Of the 55 patients, 36 underwent a vaginal delivery (group 1), whereas 19 underwent a cesarean section delivery (group 2). We retrospectively evaluated the angiographic findings and the embolization technique between groups, using a Pearson Chi-Square test. Medical records and telephone interview findings were also reviewed to evaluate the efficacy of TAE and the outcome of fertility. RESULTS: Significantly greater positive angiographic findings were found in group 2 (63.2%) relative to group 1 (30.6%). For positive angiographic findings, except for AVM, the embolization was performed using coil or glue with gelfoam. For the negative angiographic findings or AVM, the gelfoam was the only embolic agent used. In all patients except for one, bleeding stopped after embolization. Major complications occurred in 2 patients only, and included uterine synechia and perforation. All patients except for one recovered after menstruation. In total, four patients became pregnant and one patient delivered a healthy infant. CONCLUSION: Positive angiographic findings requiring embolization with coil or glue, as well as gelfoam, were more commonly encountered in group 2 than in group 1. Based on the outcome of the study group, TAE is a safe and effective treatment for intractable postpartum bleeding and is also useful for preserving fertility.

Two Cases of Enlarged Vestibular Aqueduct Syndrome / 대한이비인후과학회지

A large vestibular aqueduct, an isolated anomaly of temporal bone, is relatively rare and its association with sensorinerual hearing loss in childhood is known as the enlarged vestibular aqueduct syndrome. Using MRI, we found enlarged endolymphatic ducts and sacs in four ears of our two patients. Signal intensity of enlarged endolymphatic sac that is detected higher than that of CSF in Fluid Attenuated Inversion Recovery (FLAIR) image may indicate poor prognisis with respect to bone conduction threshold in pure tone audiogram.

A Case of Orbital Apex Syndrome Caused by Paranasal Sinusitis / 대한이비인후과학회지

Acute visual loss may occur in association with sinusitis either as a complication of orbital cellulitis or, less frequently, as a part of the orbital apex syndrome. Originally, an orbital apex syndrome is associated with an affection of the vessels and nerves passing through the superior orbital fissure and the optic foramen. A classical feature of orbital apex syndrome is presented with visual loss and ophthalmoplegia, but with minimal or no signs of orbital inflammation such as proptosis, chemosis, or lid edema. We present a case of male patient with alternating bilateral visual loss with ophthalmoplegia secondary to paranasal sinusitis.

A Case of Arteriovenous Malformation of the Parotid Gland / 대한이비인후과학회지

Arteriovenous malformation is a part of the spectrum of vascular malformations that involve shunting of blood from the arterial vessel directly into the venous system. The most frequent locations, in order of incidence, are the extremities, the lungs, and the head and neck. However, arteriovenous malformation of the parotid gland is rare, The "turkey wattle" sign describes the enlargement of a facial mass in dependency of the head, and when present, it is pathognomonic of hemangioma or vascular malformation. The treatment of choice is to complete removal of the mass by surgery to stop their progress. We report a recent encounter with a case of arteriovenous malformation of the parotid gland in a 43-year-old female patient. This disorder was successfully removed by total parotidectomy with the preservation of the facial nerve.