An Unusual Case of Traumatic Cervical Epidural Hematoma in an Infant.

Spinal epidural hematoma (SEH) is exceedingly rare, especially in children. Acute cervical epidural hematoma presents suddenly, with progressive neurologic deficits. However, it is difficult to diagnose in infants, which results in delayed diagnosis. We report a case of rapid diagnosis of traumatic cervical epidural hematoma in an infant with successful hematoma evacuation. An 11-month-old patient was brought to the emergency department after falling backward from a o30cm-high bed. The child, who previously was able to stand without support, could not stand alone and frequently fell prone when he sat down. The brain magnetic resonance imagingshowed no abnormalities. On the spinal MRI, an acute epidural hematoma located at the C3-T1 level and pressed against the spinal cord was confirmed. Three months after surgical evacuation, the Korean version of the Bayley Scales of Infant and Toddler Development -III (K-Bayley-III) assessment was performed, and a developmental quotient (DQ) of 95 or higher was demonstrated for all parameters, including motor functions. This report described an exceedingly rare case of acute cervical epidural hematoma in an infant, induced by trauma. The diagnosis and treatment were performed within one day of injury. This process was significantly faster than other reported infantile cases of cervical epidural hematoma, which were diagnosed within 4 days to 2 months.

Incidence of Febrile Seizures in Children with COVID-19.

The coronavirus disease 2019 (COVID-19) has become a common cause of febrile seizures (FS), especially after the Omicron surge. This study aimed to determine the incidence of COVID-19-associated FS in children. The number of confirmed COVID-19 cases in patients aged below five years residing in the Jeonbuk province from January 2020 to June 2022 was obtained from official data provided by the Ministry of Public Administration and Security. During the same period, data on FS patients with COVID-19 were obtained from all local hospitals capable of FS treatment and were analyzed retrospectively. The number of children under five years of age in Jeonbuk was 62,772, of which 33,457 (53.2%) were diagnosed with COVID-19 during the study period. Of these, 476 patients (1.4%) required hospitalization, and 64 (0.19%, 44 boys; 68.8%: 20 girls; 31.2%) developed FS. All patients with FS presented with symptoms after the Omicron surge. Before the Omicron variant, 23.4% of the patients (89 of 381) required hospitalization; however, no children with COVID-19 were hospitalized for FS. Twenty-five patients (39.1%) had complex FS while one (1.6%) presented with febrile status epilepticus. Forty-two patients (65.6%) experienced first-time FS with an average of 1.5 convulsive events.

Effect of Oxcarbazepine on Language Function in Patients With Newly Diagnosed Pediatric Epilepsy.

BACKGROUND AND PURPOSE: This study aimed to determine the effects of oxcarbazepine (OXC) on the language function of patients with pediatric epilepsy. METHODS: We assessed the language abilities of patients aged 5-17 years with newly diagnosed focal epilepsy and the same number of age-matched healthy children using the Test of Problem Solving (TOPS) and the Receptive and Expressive Vocabulary Test-Receptive (REVT-R). The Mean Length of Utterance-words (MLU-w) was used to estimate linguistic productivity before and after OXC initiation. All patients received OXC monotherapy with a starting dosage of 10 mg/kg/day for 1 week, which in some cases was increased to 30 mg/kg/day (or 1,200 mg/day). RESULTS: The study finally included 41 pediatric patients (22 males and 19 females; age 9.9±3.0 years, mean±standard deviation). All language parameters of the TOPS improved significantly after initiating OXC (determining cause, 12.5±4.8-13.7±4.1 [p=0.016]; making inference, 15.6±5.6-17.4±6.4 [p<0.001]; and predicting, 9.8±5.0-11.6±4.5 [p=0.001]). However, patients who received OXC did not exhibit a significantly extended MLU-w (determining cause, p=0.493; making inference, p=0.386; and predicting, p=0.341). Receptive language scores also significantly increased after taking OXC (REVT-R: 121.0±43.1-129.4±43.8, p=0.002), but the percentage of development age to chronological age did not vary (REVT-developmental quotient: p=0.075). CONCLUSIONS: Our results suggest that OXC is safe and preserves language function in patients with pediatric epilepsy.

Clinical significance of asymmetric hypointense signals in minimum intensity projections of brain magnetic resonance imaging in children with primary headache.

PURPOSE: This study aimed to observe the changes of venous continuity using the susceptibility weighted imaging-minimum intensity projection (SWI-MinIP) images in children with primary headache. METHODS: The headache types were classified following the International Headache Society's diagnostic criteria. Patients with secondary headaches were excluded. The presence of asymmetric vasculature in SWI-MinIP images was visually assessed. Moreover, the relationship between headache patterns and asymmetric hypointense signals was analyzed. RESULTS: In this single-center, retrospective study from 2016 to 2020, among 251 cases of primary headache (male/female, 108/143; mean age, 11.4 ± 4.0 years), 137 (54.6%), 75 (29.9%), and 39 (15.5%) patients had migraine, tension-type headache, and other primary headaches, respectively. On SWI-MinIP images, 14 (5.6%) patients showed an asymmetric venous pattern. All patients with SWI-MinIP asymmetry were included in the migraine group, accounting for 10.2% of patients with migraine. Five (35.7%) and nine (64.3%) patients were included in the aura and non-aura groups, respectively, without a significant difference in the frequency of asymmetric hypointense signals between the two groups (p = 0.325). All 14 patients with asymmetric hypervascularity had brain MRI within 12 h of headache onset. Ten (71.4%) of the 14 patients showed consistency between the laterality of headache and the hemisphere of predominant vascularity in SWI-MinIP. CONCLUSION: Patients with migraine had increased cerebral venous perfusion in the most involved region of the headache on the SWI-MinIP view on a 3.0 T scanner, which can be used as a qualitative indicator with low sensitivity and high specificity for the diagnosis of primary headache in the acute phase (< 12 h).

Clinical significance of asymmetric venous vasculature on minimum-intensity projection in patients with moyamoya disease.

This study analyzed the clinical significance and characteristics of asymmetric venous blood flow in patients with Moyamoya disease (MMD) using minimum intensity projection (minIP) susceptibility-weighted imaging. The minIP views of 30 patients diagnosed with MMD were retrospectively analyzed using clinical features, brain magnetic resonance angiography, electroencephalography, and brain single-photon emission computed tomography (SPECT). Simultaneously, differences between patients with acute cerebral infarction and non-MMD causes were analyzed. Twelve (40.0%) of the 30 patients had asymmetrical venous flow, which is usually seen in patients with acute cerebral infarction (P = .146). They also had significantly higher Suzuki stages than symmetric patients (P = .014), with five (41.7%) and three (25.0%) of them in stages 4 and 5, respectively. When the Suzuki stages of both hemispheres were different, more veins were found in the stenotic hemisphere (88.9%). Brain SPECT showed more severe hypoperfusion on the side with prominent vascularity in the minIP view (100.0%). Additionally, asymmetric blood flow was observed in 66.7% of the patients with cerebral infarction caused by MMD, whereas only 11.1% of the children with cerebral infarction caused by non-MMD had asymmetry (P = .005). Patients with MMD showed asymmetric hypointensity of the cortical veins with a minIP appearance. The venous structure showed greater signal loss on SWI and was more prominent in the hemisphere where stenosis was advanced or infarction occurred in other examinations. Cerebral infarction in patients with MMD tended to occur with asymmetrically prominent venous patterns with damaged areas in minIP images, which had distinct characteristics from those of patients without MMD.

Fludrocortisone in Pediatric Vasovagal Syncope: A Retrospective, Single-Center Observational Study.

BACKGROUND AND PURPOSE: The purpose of this study was to determine the effect of fludrocortisone in patients with pediatric vasovagal syncope (VVS). METHODS: This retrospective observational single-tertiary-center study based on chart reviews included 74 patients who were newly diagnosed with VVS in the head-up tilt-table test (HUTT). Some of the patients had been treated with fludrocortisone. All patients were assessed using a brain and cardiac workup before treatment to rule out the syncope being due to other causes, which resulted in seven of them being excluded: two for epilepsy and five for brain pathologies. The remaining 67 patients were analyzed. The effect of fludrocortisone was evaluated based on the results of a follow-up HUTT, with a response to the treatment considered to be present if there was a negative change at the follow-up HUTT. Univariate logistic regression were used for statistical analyses, with the criterion for significance being p<0.05. RESULTS: There were no significant differences in the characteristic of the patients between the no-medication (n=39) and fludrocortisone (n=28) groups, including age, sex, and duration of treatment. The recurrence rate of syncopal or presyncopal events was significantly lower in the fludrocortisone group (39.3%, 11 of 28) than in the no-medication group (64.1%, 25 of 39) (p=0.044), as was the rate of negative change at the follow-up HUTT: 57.1% (16 of 28) and 28.2% (11 of 39), respectively (p=0.017). CONCLUSIONS: Our findings suggest that fludrocortisone is more effective than no medication in pediatric patients with VVS.

A Comparative Analysis of Clinical Screening Test and Language Specific Test in Language Delay Children.

The aim of this study was to investigate the usefulness of a clinical screening test [the Korean Infant and Child Developmental Test (KICDT)] compared to language specific tests: the sequenced language scale for infant (SELSI) and the Preschool Receptive-Expressive language Scale (PRES) in children with delayed language development. A retrospective chart review was conducted on 615 children who visited the Department of Pediatrics at Chonbuk National University Hospital from January 2013 to December 2016. All patients were evaluated with KICDT as a clinical screening test and SELSI or PRES as a language specific test. Language Developmental Quotients (LDQs) from the KICDT were compared with the Receptive Language Quotient (RLQ) and expressive language quotient (ELQ) from the SELSI or PRES. The sensitivity, specificity and predictive values of LDQ of KICDT were calculated by comparing with SELSI/PRES. Language DQs from the KICDT were significantly correlated with the RLQ (r=0.706), ELQ (r=0.768), and total language quotient (TLQ) (r=0.766) from the SELSI/PRES (p<0.05). In cross tabulation, the patients belonging to the retardation groups in both KICDT and SELSI/PRES were 417 (67.8%). Otherwise, patients belonging to the normal group in KICDT but not in SELSI/PRES were 151 (24.6%). Sensitivity and specificity of LDQ of KICDT relative to SELSI/PRES were 72.3% and 92.2% respectively (p<0.05). Our data suggests that clinical screening tests alone, not cumbersome language specific tests, can determine language developmental delays in children.

Effects of Lamotrigine on Problem-Solving Abilities in Newly Diagnosed Pediatric Patients with Epilepsy.

BACKGROUND AND PURPOSE: This study aimed to determine the effects of lamotrigine (LTG) on language unction, including problem-solving abilities, in newly diagnosed pediatric epileptic patients. METHODS: This study included 112 newly diagnosed epileptic patients treated with LTG [69 males and 43 females aged 9.6±2.7 years (mean±SD)]. Repeated neurologic examinations, electroencephalography, neuroimaging studies, and standard language tests including the Test of Problem Solving (TOPS), mean length of utterance in words (MLU-w), Receptive and Expressive Vocabulary Test (REVT), and Urimal Test of Articulation and Phonology were performed before and after initiating LTG treatment. The starting LTG dosage was 1 mg/kg/day (maximum: 25 mg/day) for the first 14 days, which was increased to 2 mg/kg/day for the subsequent 14 days and then up to 7 mg/kg/day (or 200 mg/day) for maintenance. RESULTS: Problem-solving skills as assessed by TOPS scores significantly improved after initiating LTG treatment (33.5±14.5 vs. 35.7±14.25, p<0.01). Scores in the "determining causes" category (11.9±4.7 vs. 12.9±4.8, p<0.01), "making inferences" category (12.9±6.2 vs. 13.6±6.0, p<0.05), and "predicting" category (8.9±5.4 vs. 9.7±5.6, p<0.01) significantly improved after LTG treatment. The MLU-w score did not decrease after LTG treatment (4.7±1.9 vs. 5.0±2.1). There was a significant improvement in receptive language function as assessed using the REVT score (9.4±3.4 years vs. 9.9±3.3 years, p<0.01). Precise articulation also improved after initiating LTG treatment (97.8% vs. 98.5%). CONCLUSIONS: Language function including problem-solving skills improved after LTG treatment, suggesting that LTG can be administered without causing significant negative effects on language function in pediatric patients.

Real-Life Effectiveness and Tolerability of Perampanel in Pediatric Patients Aged 4 Years or Older with Epilepsy: A Korean National Multicenter Study.

BACKGROUND AND PURPOSE: The US Food and Drug Administration approval for perampanel has only recently been expanded to patients as young as 4 years, and so there have been few real-life studies of the effects of perampanel in pediatric patients. The aim of this study was to determine the long-term efficacy, factors affecting treatment response, and tolerability of perampanel as an add-on therapy in pediatric patients aged 4 years or older with epilepsy. METHODS: This multicenter retrospective observational study collected data from pediatric epilepsy centers of four Korean national universities. Changes in the seizure frequency from baseline, adverse events, and retention rates were obtained at 3, 6, and 12 months. Adverse events and discontinuation profiles were obtained to assess tolerability. RESULTS: This study included 220 children and adolescents (117 males and 103 females) aged 4 to 20 years. The overall response rate was 43.6%, and the seizure-freedom rate was 17.7%. Factors affecting a good treatment response were the absence of intellectual disability, small number of concomitant antiepileptic drugs, and low baseline seizure frequency. Eighty-eight patients (40%) experienced adverse events, but they mostly were of mild severity and resolved after the dose reduction or discontinuation of perampanel. The retention rates at 3, 6, and 12 months were 85.0%, 71.8%, and 50.5%, respectively. CONCLUSIONS: Adjunctive treatment with perampanel was efficacious and tolerated in pediatric patients aged 4 years or older with epilepsy. Early perampanel treatment may help to reduce the burden of their seizures and improve their quality of life.

Language-Related White-Matter-Tract Deficits in Children with Benign Epilepsy with Centrotemporal Spikes: A Retrospective Study.

BACKGROUND AND PURPOSE: Benign epilepsy with centrotemporal spikes (BECTS) is one of the most common pediatric epilepsies, and it generally has a good prognosis. However, recent research has indicated that the epileptic activity of BECTS can cause cognitive defects such as language, visuospatial, and auditory verbal memory deficits. This study assessed language-delivery deficits in BECTS patients using diffusion-tensor magnetic resonance imaging (DTI). METHODS: T1-weighted MRI, DTI, and language tests were conducted in 16 BECTS patients and 16 age-matched controls. DTI data were analyzed using the TRActs Constrained by Underlying Anatomy tool in FreeSurfer 5.3, and 18 major white-matter tracts were extracted, which included 4 language-related tracts: the inferior longitudinal fasciculus, superior longitudinal fasciculus-parietal terminations, superior longitudinal fasciculus-temporal terminations, and uncinate fasciculus (UNC). Language tests included the Korean version of the Receptive and Expressive Vocabulary Test, Test of Problem-Solving Abilities (TOPS), and the mean length of utterance in words. RESULTS: The BECTS group exhibited decreased mean fractional anisotropy and increased mean radial diffusivity, with significant differences in both the superior longitudinal fasciculus and the left UNC (p<0.05), which are the language-related white-matter tracts in the dual-loop model. The TOPS language test scores were significantly lower in the BECTS group than in the control group (p<0.05). CONCLUSIONS: It appears that BECTS patients can exhibit language deficits. Seizure activities of BECTS could alter DTI scalar values in the language-related white-matter tracts.

Acute blindness as a presenting sign of left atrial myxoma in a pediatric patient: A case report and literature review.

RATIONALE: Central retinal artery occlusion (CRAO) due to cardiac myxoma primarily occurs in elderly individuals. Early detection and surgical resection of myxoma are extremely important because CRAO causes complete blindness in most cases. However, due to the extremely low incidence of CRAO caused by cardiac myxoma in the pediatric age group, such condition is rarely reported. PATIENT CONCERNS: A 16-year-old female patient visited our hospital due to sudden onset of vision loss in the left eye, dysarthria, and right-sided hemiplegia. DIAGNOSES: She was diagnosed with CRAO via fundoscopy. Results showed a cherry-red spot, indicating CRAO. Brain magnetic resonance imaging (MRI) revealed multifocal diffusion-restricted foci, particularly in the left frontal lobe. Echocardiography revealed a left atrial mass measuring 4.21 cm × 2.25 cm. The mass was attached to the interseptum and moved along the inflow of the mitral valve. Cardiac computed tomography (CT) revealed an enhanced mass measuring 3 cm × 2.2 cm × 3 cm and with irregular margin on the anterior wall of the left atrium and the border of the fossa ovalis. INTERVENTIONS: The patient underwent surgical excision under general anesthesia. Intraoperative finding showed a huge, jelly-like, and extremely friable mass. Pathological examination confirmed myxoma. OUTCOMES: During a follow-up of 2 years after diagnosis, she did not present with other neurological deficits and no residual mass was observed on echocardiography. However, visual impairment of the left eye persisted. LESSONS: Most patients with CRAO may present with other mild symptoms that are often be neglected before CRAO development. We recommend that patients who present with frequent syncopal attack or symptoms of transient ischemic attack should undergo echocardiography.

Clinical Significance of Asymmetric Minimum Intensity Projection Images of Brain Magnetic Resonance Imaging in Children.

BACKGROUND AND PURPOSE: The susceptibility-weighted imaging form of brain MRI using minimum intensity projection (mIP) is useful for assessing traumatic brain injuries because it readily reveals deoxyhemoglobin or paramagnetic compounds. We investigated the efficacy of using this methodology in nontraumatic patients. METHODS: We retrospectively analyzed the asymmetric mIP findings in nontraumatic patients. Asymmetric mIP images were first verified visually and then using ImageJ software. We enrolled patients with a difference of >5% between hemispheres in ImageJ analysis. All patients underwent detailed history-taking and EEG, and asymmetric mIP findings were compared. RESULTS: The visual analysis identified 54 pediatric patients (37 males and 17 females) with asymmetric mIP findings. Ten patients were excluded because they did not meet the ImageJ verification criteria. The 44 patients with asymmetry comprised 36 with epilepsy, 6 with headache, and 2 with cerebral infarction. Thirty-one of the 36 epileptic patients showed definite partial seizure activities in semiology, while the remaining patients did not demonstrate a history of partial seizure manifestations. The MRI findings were normal in all patients except for five with periventricular leukomalacia unrelated to seizure symptoms. There was agreement between mIP images and semiology in 29 (93.5%) of the 31 epileptic patients with focal signs, while the other 2 demonstrated discordance. Twenty (64.5%) of the 31 patients showed consistent EEG abnormalities. CONCLUSIONS: Our data suggest that asymmetric mIP findings are an excellent lateralizing indicator in pediatric patients with partial epilepsy.

Experimental Applications of in situ Liver Perfusion Machinery for the Study of Liver Disease.

The liver is involved in a wide range of activities in vertebrates and some other animals, including metabolism, protein synthesis, detoxification, and the immune system. Until now, various methods have been devised to study liver diseases; however, each method has its own limitations. In situ liver perfusion machinery, originally developed in rats, has been successfully adapted to mice, enabling the study of liver diseases. Here we describe the protocol, which is a simple but widely applicable method for investigating the liver diseases. The liver is perfused in situ by cannulation of the portal vein and suprahepatic inferior vena cava (IVC), with antegrade closed circuit circulation completed by clamping the infrahepatic IVC. In situ liver perfusion can be utilized to evaluate immune cell migration and function, hemodynamics and related cellular reactions in each type of hepatic cells, and the metabolism of toxic or other compounds by changing the composition of the circulating media. In situ liver perfusion method maintains liver function and cell viability for up to 2 h. This study also describes an optional protocol using density-gradient centrifugation for the separation of different types of hepatic cells, allowing the determination of changes in each cell type. In summary, this method of in situ liver perfusion will be useful for studying liver diseases as a complement to other established methods.

Increased Prevalence of Thalassemia in Young People in Korea: Impact of Increasing Immigration.

BACKGROUND: Thalassemia is highly prevalent in Southeast Asia but is rare in Korea; however, Southeast Asian immigrant population is recently rising in Korea. We investigated the prevalence of thalassemia in Korea in the context of increasing immigration. METHODS: This prospective, observational, multicenter study was conducted between September 2015 and August 2017. A total of 669 subjects <30 years living in Korea were grouped into the multiethnic (N=314) and Korean (N=355) groups. Hb electrophoresis and complete blood count (CBC) were performed. If low mean corpuscular volume with high red blood cell distribution width coefficient of variation or a high fetal Hb (HbF) or Hb alpha 2 (HbA2) level was observed, genetic testing of the α- and ß-globin genes was performed. In addition, the number of potential thalassemia carriers in Korea was estimated by multiplying the prevalence of thalassemia in a specific ethnicity by the number of immigrants of that ethnicity. RESULTS: Twenty-six multiethnic and 10 Korean subjects showed abnormal results for Hb electrophoresis and CBC. Eighteen multiethnic subjects and four Korean subjects were tested for α-globin and ß-globin gene mutations. Within the multiethnic group, five subjects (1.5%) were α-thalassemia carriers, and six (1.9%) were ß-thalassemia minor. The SEA deletion in HBA1 and HBA2, and c. 126_129delCTTT (p.Phe42Leufs*19) mutation of HBB were the dominant inherited mutations. CONCLUSIONS: The prevalence of thalassemia in young people in Korea is increasing due to the increasing number of Southeast Asian immigrants.

The clinical characteristics and prognosis of subgaleal hemorrhage in newborn.

PURPOSE: Subgaleal hemorrhage (SGH) is a rare but potentially fatal condition in newborns; however, few studies have reported on this condition. We aimed to identify the clinical characteristics and prognostic factors of SGH. METHODS: We retrospectively reviewed the medical records of 20 neonates diagnosed with SGH between January 2000 and June 2017. Enrolled neonates were clinically diagnosed when they had tender fluctuant scalp swelling that crossed the suture lines. RESULTS: Among 20 neonates with SGH, 12 were boys and 7 were girls; median hospitalization duration was 9.7±6.9 days. Fourteen neonates (70%) were born via vacuum-assisted vaginal delivery, and 4 via vacuum-assisted cesarean section. Of the neonates enrolled, half of them initially showed unstable vital signs, including apnea, desaturation, and cyanosis. Ten neonates had acidosis and 3 had asphyxia (pH<7.0). Intracranial lesions associated with SGH were observed in 15 neonates (75%), including subdural hemorrhage (50%), subarachnoid hemorrhage (15%), intraventricular hemorrhage (5%), cerebral infarct (15%), skull fracture (30%), and cephalohematoma (20%). Twelve neonates (60%) required transfusion, 5 (25%) had seizures, and 3 (15%) died. Eight neonates (40%) had hyperbilirubinemia (mean total bilirubin, 13.1±7.4). The mean follow-up period was 8.4±7.5 months. At follow-up, 10 neonates (58.8%) were healthy with normal development, whereas 7 (41.2%) had neurological deficits. CONCLUSION: The morbidity rate was 41.2% due to severe metabolic acidosis. Anemia, hyperbilirubinemia, low Apgar scores, and subdural hemorrhage did not affect the prognosis. The long-term outcomes of neonates with SGH are generally good. Only arterial blood pH was significantly associated with death.

Effects of Antiepileptic Drugs on Language Abilities in Benign Epilepsy of Childhood with Centrotemporal Spikes.

BACKGROUND AND PURPOSE: This study is to assess the responsiveness of electroencephalography (EEG) abnormalities and their effects on language ability after initiating different types of antiepileptic therapy in children with newly diagnosed benign epilepsy of childhood with centrotemporal spikes (BECTS). METHODS: The records of patients newly diagnosed with BECTS (n=120; 69 males) were reviewed retrospectively. The patients were randomly treated with lamotrigine, oxcarbazepine, or topiramate monotherapy, and underwent at least two EEG and standardized language tests. Effects were compared using Pearson's chi-square tests and paired t-tests. RESULTS: The recurrence rates for seizures in the lamotrigine, topiramate, and oxcarbazepine groups were 19.4%, 21.7%, and 11.4%, respectively, while complete or partial recovery (as indicated by EEG) occurred in 32%, 39%, and 16% of the patients. Patients in the lamotrigine group showed significant improvements in all parameters assessed by the Test of Language Problem Solving Abilities, except for 'determining cause.' Patients in the oxcarbazepine group also showed improvements, except for 'making inferences' (p<0.05). Most linguistic index scores were worse in the topiramate group except for Mean Length of Utterance in Words. Patients in the lamotrigine and oxcarbazepine groups showed significant improvements in the receptive language test (p<0.05). EEG improvements were not related to language ability. CONCLUSIONS: The improvements in language and problem-solving performance in children with BECTS were greater for lamotrigine and oxcarbazepine than for topiramate. However, EEG remission did not imply that language function would be improved after the treatments.

Carrier Transport Properties of MoS2 Asymmetric Gas Sensor Under Charge Transfer-Based Barrier Modulation.

Over the past few years, two-dimensional materials have gained immense attention for next-generation electric sensing devices because of their unique properties. Here, we report the carrier transport properties of MoS2 Schottky diodes under ambient as well as gas exposure conditions. MoS2 field-effect transistors (FETs) were fabricated using Pt and Al electrodes. The work function of Pt is higher than that of MoS2, while that of Al is lower than that of MoS2. The MoS2 device with Al contacts showed much higher current than that with Pt contacts because of its lower Schottky barrier height (SBH). The electrical characteristics and gas responses of the MoS2 Schottky diodes with Al and Pt contacts were measured electrically and were simulated by density functional theory calculations. The theoretically calculated SBH of the diode (under gas absorption) showed that NOx molecules had strong interaction with the diode and induced a negative charge transfer. However, an opposite trend was observed in the case of NH3 molecules. We also investigated the effect of metal contacts on the gas sensing performance of MoS2 FETs both experimentally and theoretically.

Influence of valproate on language functions in children with epilepsy.

The aim of the current study was to assess the influences of valproate (VPA) on the language functions in newly diagnosed pediatric patients with epilepsy. We reviewed medical records of 53 newly diagnosed patients with epilepsy, who were being treated with VPA monotherapy (n=53; 22 male patients and 31 female patients). The subjects underwent standardized language tests, at least twice, before and after the initiation of VPA. The standardized language tests used were The Test of Language Problem Solving Abilities, a Korean version of The Expressive/Receptive Language Function Test, and the Urimal Test of Articulation and Phonology. Since all the patients analyzed spoke Korean as their first language, we used Korean language tests to reduce the bias within the data. All the language parameters of the Test of Language Problem Solving Abilities slightly improved after the initiation of VPA in the 53 pediatric patients with epilepsy (mean age: 11.6±3.2years), but only "prediction" was statistically significant (determining cause, 14.9±5.1 to 15.5±4.3; making inference, 16.1±5.8 to 16.9±5.6; prediction, 11.1±4.9 to 11.9±4.2; total score of TOPS, 42.0±14.4 to 44.2±12.5). The patients treated with VPA also exhibited a small extension in mean length of utterance in words (MLU-w) when responding, but this was not statistically significant (determining cause, 5.4±2.0 to 5.7±1.6; making inference, 5.8±2.2 to 6.0±1.8; prediction, 5.9±2.5 to 5.9±2.1; total, 5.7±2.1 to 5.9±1.7). The administration of VPA led to a slight, but not statistically significant, improvement in the receptive language function (range: 144.7±41.1 to 148.2±39.7). Finally, there were no statistically significant changes in the percentage of articulation performance after taking VPA. Therefore, our data suggested that VPA did not have negative impact on the language function, but rather slightly improved problem-solving abilities.