BACKGROUND: The clinical characteristics of seizures in adults with localization-related epilepsy have been clearly described and classified. But few researches and data are available in childhood intractable epilepsy. METHODS: We analyzed 334 videotaped seizures from 41 pediatric patients who underwent epilepsy surgery at Dong San Medical Center between 1993 and 1997. Twenty- one of 41 patients had temporal lobe epilepsy, and the remaining 20 patients had extratemporal lobe epilepsy. We divided the patient sample into two groups : (a) those with total cases, (b) those with good outcome (seizure-free or more than 90% reduction of seizures after surgery). We compared temporal lobe epilepsy (TLE) with extratemporal lobe epilepsy (ETE) by clinical symptoms and initial ictal symptoms. In addition, we analyzed the lateralizing value of ictal dystonia, head turning, head deviation and automatism. RESULTS: The aura and head deviation of TLE and the motor arrest, head deviation and dystonic posture of ETE were observed more frequently in total group (P<0.05). In contrast, the vocalization and secondary generalization of TLE and the motor arrest, dystonic posture and dysarthria of ETE were observed more frequently in good outcome group (P<0.05). In cases of the initial ictal symptoms, the aura and hand automatism of TLE and the motor arrest and dystonic posture of ETE were observed more frequently in both groups (P<0.05). Of the ictal motor phenomena, ipsilateral hand automatism and contralateral dystonic posture were useful in lateralizing the seizure focus (P<0.05). CONCLUSION: The clinical ictal manifestations in children are very helpful to localize or lateralize the epileptic focus, like in adults case. Because of the lack of younger age group in our study, however, we suggest more rigorous studies based on more comprehensive data.
Adult ; Automatism ; Child ; Dysarthria ; Dystonia ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Temporal Lobe ; Generalization (Psychology) ; Hand ; Head ; Humans ; Posture ; Seizures* ; Temporal Lobe*

The mechanism of apoptosis was first discovered at the end of the 19th century, but it was only recently that its importance was recognized. Not only in a pathologic environment but also in a normal environment, apoptosis has an important role in homeostasis. The number of cells is restricted by apoptosis which is controlled by several SlgBS lll VlVO. In pregnancy, the placenta regulates the maternal-fetal exchange of molecules and functions as a barrier for the protection of the fetus. As the pregnancy proceeds, changes occur in the number and components of placental cells. Observing the placental tissues, apoptosis was found in the syncytiotrophoblasts of early and late pregnancy. In particular, the fact that apoptosis observed in the placenta of late pregnancy supports the hypothesis that pmgrammed cell death is a normal sequence. Pregnancy-induced hypertension is usually accompanied by abnormal placenta and intrauterine growth restriction. In this study, using the TdT-FragEL DNA fragmentation detection kit, the changes in the nucleus by apoptosis in the placental tissues of 23 to 40 gestational weeks in preeclampsia and eclampsia were compared with normal placenta. Apoptosis was observed in the normal term placenta and in pregnancy-induced hypertension patients, regardless of whether vasculopathy was observed in Doppler ultrasound or confirmed by pathology, more apoptoses were observed aside from the number of gestational weeks.
Apoptosis ; Cell Death ; DNA Fragmentation ; Eclampsia ; Female ; Fetus ; Homeostasis ; Humans ; Hypertension, Pregnancy-Induced* ; Maternal-Fetal Exchange ; Pathology ; Placenta* ; Pre-Eclampsia ; Pregnancy ; Trophoblasts ; Ultrasonography

OBJECTIVES : Adenotonsillar hypertrophy is one of the principal causes associated with snoring, sleep apnea, and restless sleep. These sleep-disordered breathing (SDB) is associated with hyperactivity, rebellious behavior, aggressiveness, enuresis, inattention, social withdrawal, and learning difficulties. The purpose of this study was to assess the impact of adenotonsillar hypertrophy on attention deficit hyperactivity symptoms and sleep-related symptoms in children by standard tests. METHODS : Children aged 5 through 15 years old, a total of 65 who were scheduled for Tonsillectomy and Adenoidectomy, were studied. The control group consisted of 30 healthy children of the same age. In both groups, attention-deficit hyperactivity dis-order (ADHD) was evaluated by Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). The degree of inattention, hyperactivity and sleep-related symptoms was evaluated by Korean ADHD Rating Scales (K-ARS), ADHD diagnostic system (ADS) and pediatric sleep questionnaire. The K-ARS and sleep questionnaire were completed by the parents of the children. RESULTS : Acording to K-SADS-PL, 23 subjects out of 65 subjects in the patient group and 2 subjects out of 30 subjects in the control group were diagnosed with ADHD. According to sleep questionnaires, the patient group reported significantly more problems than the control group. The patients had significantly higher cumulative questionnaire scores than the control group. In linear regression analysis, the cumulative score of sleep questionnaire was associated with inattention subscale scores, hyperactivity/impulsivity subscale scores and the total score of K-ARS, and also with the response time and the standard deviation of response time of ADS. In relation to ADHD, the patient group had significantly higher ADHD scores in K-ARS inattention subscale and significantly slower response time in ADS compared to the control group. Comparing SDB children without ADHD and the control group without ADHD by excluding ADHD children in both groups, SDB children without ADHD did not show significantly higher scores in K-ARS but did show significantly slower ADS response time. CONCLUSION : Children with adenotonsillar hypertrophy are associated with increased SDB and ADHD symptoms. Therefore they may need intensive treatment such as surgical intervention.
Adenoidectomy ; Aged ; Child ; Enuresis ; Humans ; Hypertrophy ; Learning ; Linear Models ; Mood Disorders ; Parents ; Surveys and Questionnaires ; Reaction Time ; Sleep Apnea Syndromes ; Snoring ; Tonsillectomy ; Weights and Measures

OBJECTIVES : Adenotonsillar hypertrophy is one of the principal causes associated with snoring, sleep apnea, and restless sleep. These sleep-disordered breathing (SDB) is associated with hyperactivity, rebellious behavior, aggressiveness, enuresis, inattention, social withdrawal, and learning difficulties. The purpose of this study was to assess the impact of adenotonsillar hypertrophy on attention deficit hyperactivity symptoms and sleep-related symptoms in children by standard tests. METHODS : Children aged 5 through 15 years old, a total of 65 who were scheduled for Tonsillectomy and Adenoidectomy, were studied. The control group consisted of 30 healthy children of the same age. In both groups, attention-deficit hyperactivity dis-order (ADHD) was evaluated by Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). The degree of inattention, hyperactivity and sleep-related symptoms was evaluated by Korean ADHD Rating Scales (K-ARS), ADHD diagnostic system (ADS) and pediatric sleep questionnaire. The K-ARS and sleep questionnaire were completed by the parents of the children. RESULTS : Acording to K-SADS-PL, 23 subjects out of 65 subjects in the patient group and 2 subjects out of 30 subjects in the control group were diagnosed with ADHD. According to sleep questionnaires, the patient group reported significantly more problems than the control group. The patients had significantly higher cumulative questionnaire scores than the control group. In linear regression analysis, the cumulative score of sleep questionnaire was associated with inattention subscale scores, hyperactivity/impulsivity subscale scores and the total score of K-ARS, and also with the response time and the standard deviation of response time of ADS. In relation to ADHD, the patient group had significantly higher ADHD scores in K-ARS inattention subscale and significantly slower response time in ADS compared to the control group. Comparing SDB children without ADHD and the control group without ADHD by excluding ADHD children in both groups, SDB children without ADHD did not show significantly higher scores in K-ARS but did show significantly slower ADS response time. CONCLUSION : Children with adenotonsillar hypertrophy are associated with increased SDB and ADHD symptoms. Therefore they may need intensive treatment such as surgical intervention.
Adenoidectomy ; Aged ; Child ; Enuresis ; Humans ; Hypertrophy ; Learning ; Linear Models ; Mood Disorders ; Parents ; Surveys and Questionnaires ; Reaction Time ; Sleep Apnea Syndromes ; Snoring ; Tonsillectomy ; Weights and Measures

Sialocele formation is a recognised complication of parotid surgery. Most cases resolve after conservative therapy consisting of pressure dressing, fasting, and repeated aspiration. However, some cases are resistent to such treatment and require further intervention. In this report, we present the method of botulinum toxin (BTX) injection into the parotid gland under ultrasonographic guidance along with atropine injection. A 63-year-old female underwent excision of a pleomorphic adenoma abutting an accessory parotid gland. Sialocele formation persisted after almost 3 weeks of conservative therapy. BTX A was given under ultrasonographic guidance and the sialocele disappeared after two doses of treatment. BTX injection under ultrasonographic guidance was thus a safe and effective method for treating persistent sialocele.
Adenoma, Pleomorphic ; Atropine ; Bandages ; Botulinum Toxins* ; Botulinum Toxins, Type A* ; Fasting ; Female ; Humans ; Methods ; Middle Aged ; Parotid Diseases ; Parotid Gland

The purpose of this study was to demonstrate corticospinal tract compression that was due to a hematoma by using diffusion tensor tractography (DTT) and functional MRI (fMRI) in a patient with an intracerebral hemorrhage (ICH). A 23-year-old right-handed woman presented with severe paralysis of her right extremities at the onset of a spontaneous ICH. Over the first three days from onset, the motor function of the affected upper and lower extremities rapidly recovered to the extent that she was able to overcome applied resistance to the affected limbs, and her limbs regained normal function 3 weeks after onset. The tract of the right hemisphere originated from the primary sensori-motor cortex (SM1) and it passed through the known corticospinal tract pathway. However, the tract of the left hemisphere was similar to that of the right hemisphere except that it was displaced to the antero-medial side by the hematoma at the cerebral peduncle. Only the contralateral SM1 area centered on the precentral knob was activated during affected (right) or unaffected (left) hand movements, respectively. In conclusion, fMRI and DTT demonstrated a corticospinal tract compression due to hematoma in this patient. We conclude that the combined use of these two modalities appears to improve the accuracy of investigating the state of the corticospinal tract.
Spinal Cord Compression/complications/*diagnosis/pathology ; Pyramidal Tracts/*pathology ; *Magnetic Resonance Imaging ; Humans ; Hematoma/complications/*diagnosis/pathology ; Female ; Diffusion Magnetic Resonance Imaging/*methods ; Cerebral Hemorrhage/complications/*diagnosis/pathology ; Adult