Epilepsy can be defined as a paroxysmal, neuronal discharge within the brain originating from either corticalor sugcortical regions. The incidence of epilepsy is increasing possibly due to the survival of persons who shouldhave died of brain injuries or other cerebral abnormalities acquired in earlylife. the use of abtibiotics andimprovement in the medical care have saved many children who might have died of meningitis, brain abscess,encephalitis, severe head injuries, etc. CCT scan is new radiologic procedure for defining cranial andintracranial structures and also an useful procedure for evaluation and follow-up(FU) of patient with focalseizure disorder. Recently we experienced nodules which were isodense or hypodense on initial noncontrasted CT(NECT) and scans became hyperdense of the enhancement in 4 cases of focal epileptic seizures. Nearly completedisappearance or regression of the epileptic foci occurred on the FU CT scans in 2 cases. Operation was performedin 2 cases. The tissue specimen obtianed from the CT nodule revealed cerebral edema in one case and localizedgliosis and congestion in the other. All the patients showed marked clinical improvement when the CT noduleimporved. Review of literature failed to disclose any previous report on such observation.
Brain ; Brain Edema ; Brain Injuries ; Child ; Craniocerebral Trauma ; Epilepsy ; Estrogens, Conjugated (USP) ; Humans ; Incidence ; Meningitis ; Neurons ; Tomography, X-Ray Computed

The purpose of this study was to analyse the various patterns of calcification demonstrated in the anteriorand lateral neck roentgenograms of 213 unselected patients with thyroid enlargement. The patterns of thyroidcalcifications were correlated with clinical, surgical and histological findings. The results were as follows: 1.Of 213 cases of thyroid enlargement, 180 cases were benign and 168 cases were female. 2. The calcification ratewas high in the chronic thyroid enlargement. 3. The incidence of calcification was 30.2% in the malignancy and17.2% in the benign disease. There was no clacification in the Hashimoto's disease. 4. The nodular calcificationwas demonstrated in the both benign and malignant disease but curvilinear calcifiation was predominantly seen inbenign disease.
Female ; Hashimoto Disease ; Humans ; Incidence ; Neck ; Thyroid Gland

An accurate preoperative evaluation of lymph nodes(LNs) in gastric cancer is a prerequisite for successful surgery and favorable prognosis. We retrospectively analyzed the Ct accuracy in perigastric LN localization and LN staging of gastric cancer as well as the size criteria for the metastasized LN in 64 patients who hed undergone a surgery for gastric cancer. The results of perigastric LNs evaluation by CT are as follows; sensitivity 67%(64/95), specificity 90%(839/929), accuracy 88%(903/1024). Of 95 pathologically metastasized LN groups, 66 could be retrospectively identified on Ct scans(69%). In LN staging, CT was correct in 60%(38/64), overstaged in 32%(21/64), and understaged in 8%(5/64). The perigastric LN groups which were easily localized on CT were #3, 7, 8, and 13. The mean size of metastasized LNs on CT according to the I.N group was #3 (13mm), #4(9mm), #6 (10mm), #7(10.5mm), #8 (10mm), #9 (11mm), #13 (9mm).
Humans ; Lymph Nodes* ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms*

Various surgical methods including soft tissue procedures and bone procedures are commonly used to treat knee flexion and contracture deformity. However, several complications such as, neurovascular injury and skin necrosis were reported because of rapid correction. We aim to report good results from gradual correction using Ilizarov following supracondylar osteotomy in a 24-year-old man suffering from fused knee flexion and valgus deformity, a complication developed by septic arthritis.
Arthritis, Infectious ; Congenital Abnormalities* ; Contracture ; Humans ; Knee Joint ; Knee* ; Necrosis ; Osteotomy ; Skin ; Young Adult

OBJECTIVES: The aim of this study was to investigate the attitudes toward complementary and alternative medicine among 1,490 residents(339 households) in Suwon city. METHODS: All respondents were asked about types, frequency, effects, side-effects, views, and cost of complementary or alternative medicine through a questionnaire from July 24th to 27th. Six therapies were investigated: diet; acupuncture/ massage/ chiropractic etc.; mind control such as Ki/ Yoga/ spiritual therapy/ relaxation therapy etc.; nutritional supplements, cultural remedies; and Herb medications. RESULTS: The results of this survey were as follows: 35.6% of respondents had experiences with at least one or more types of complementary and alternative medicine. The average number of different types of therapies used was 3.4. More experience with various types of therapies were found among those respondents of higher education, older age group, higher income, married group, religious group than among the opposite groups of respondents. Herb medications were used most frequently(39.8%), followed by minor grains(37.9%), Ginseng(23.8%), Boshintang(21.5%), acupuncture(20.3%), Gaesojou (15.3%), Gingko nut(12.0%), mushroom(11.5%), Cupping therapy(10.2%), and black goat(0.0%). Acupuncture and Herb medications were used for treatment of hypertension the most frequently; minor grains or silkworm for treatment of diabetic mellitus; vegetables for treatment of obesity; acupuncture, Cupping Therapy, Herb medications for treatment of rheumatism; and acupuncture, Herb medications, or exercises for treatment of Cerebro Vascular Accident(CVA). The average costs of treatment were 108,000 Won for hypertension, 87,200 Won for diabetic mellitus, 16,800 Won for obesity, 68,800 Won for rheumatism, and 87,500 Won for CVA. Among 10.9% of respondents, there were 13 cases of side-effects with acupuncture, Herb medications, and Gaesojou. Among the cases of side-effects, majority was due to Herb medications. Respondents reported that Cupping Therapy was the most effective, followed by acupuncture, Ginseng, Gingko nut, Boshintang, black goat, minor grains, Gaesojou, Herb medications, vegetables, and mushroom. In response to the views of complementary and alternative medicine which they had used, they recommended minor grains first, followed by Ginseng, acupuncture, Gingko nut, Cupping Therapy, vegetables, Boshintang, black goat, mushroom and Herb medications. In contrast, they did not recommend Herb medications, acupuncture, nor Gaesojou. CONCLUSIONS: These findings indicate that many people use various complementary and alternative medicine without any guidelines for treatment of serious chronic diseases not even to invigorate themselves. It is, therefore, suggested that medical doctors or scientists verify the true effects or side-effects from the most common complementary or alternative therapies through experiments. Also medical doctors should provide a comfortable atmosphere for discussion among doctors and patients who would like to try these therapies.
Acupuncture ; Agaricales ; Atmosphere ; Bombyx ; Edible Grain ; Chiropractic ; Chronic Disease ; Complementary Therapies* ; Surveys and Questionnaires ; Diet ; Education ; Exercise ; Ginkgo biloba ; Goats ; Gyeonggi-do* ; Humans ; Hypertension ; Nuts ; Obesity ; Panax ; Surveys and Questionnaires ; Relaxation Therapy ; Rheumatic Diseases ; Vegetables

PURPOSE: To assess the efficacy of open debridement and polyethylene exchange (ODPE) combined with proper antibiotic therapy in strictly selected patients with infection after total knee arthroplasty (TKA) and analyze factors associated with treatment failure. MATERIALS AND METHODS: From January 2010 to January 2014, 25 cases that underwent ODPE under the diagnosis of infection within four weeks after TKA or acute hematogenous infection within five days of symptom onset were reviewed in this study. RESULTS: Treatment was successful in 22 out of 25 cases (88.0%). Factors associated with failure were accompanying infection (periprosthetic infection in the ipsilateral foot, cervical parotid abscess, and masticator space abscess) and diagnosis of rheumatoid arthritis (RA) before TKA. Resistant bacteria did not entail a risk. On clinical results, the mean postoperative Lysholm score and Korean Knee score were 81.4 and 79.4, respectively, the knee range of motion was 115.4°±12.9°, and duration of hospitalization was 32.3±8.4 days. On radiographic results, 3.47±1.56 mm joint line elevation and a valgus change of 0.61°±2.35° in knee alignment were observed. CONCLUSIONS: ODPE combined with appropriate antibiotics therapy could be a useful treatment method for infection after TKA if the procedure is performed within a symptom duration of five days or less in the absence of accompanying infection in patients whose indication for TKA was not RA.
Abscess ; Anti-Bacterial Agents ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Bacteria ; Debridement ; Diagnosis ; Foot ; Hospitalization ; Humans ; Joints ; Knee ; Methods ; Polyethylene ; Range of Motion, Articular ; Treatment Failure

OBJECTIVES: Primary IgA nephropathy(IgAN), currently recognized as the most prevalent form of glomerular disease in the world, has tendency toward end stage renal failure at a rate of 20-30% in patients after a long-term follow-up of more than 20 years. But its etiology and pathophysiology is not fully understood. This study was designed to evaluate the pattern of histocompatibility antigens(HLA) and its association with poor prognostic factors in patients with IgAN. METHODS: Study population comprised the 69 patients with IgAN which was diagnosed by clinical and pathological findings, and control groups were 202 healthy Korean people. We evaluated the HLA class I serologic typing by standard microlymphocytotoxic technique and the HLA class II genotypes by the two-step polymerase chain reaction. RESULTS: 1. HLA-A was not associated with IgAN. 2. The phenotype frequency of HLA-B55 was 6.1% in patient group and 1.7% in normal control group. HLAB55 was associated with IgAN(relative risk 3.47, P<0.05). 3. HLA-DQB1*04 was also associated with IgAN (relative risk 3.57, P<0.05). 4. There was no significant difference in the distribution of HLA in IgAN patients according to histologic grading, blood pressure, renal function and proteinuria. CONCLUSIONS: Frequencies of HLA-B55, HLA-DQB1 *04 are higher in Korean patients with IgAN compared to general population. But we could not observe the significant relationships between HLA type and poor prognostic factors. Further study using larger population with IgAN may be necessary to identify the association of HLA locus with poor prognostic factors and progress decline in renal function in patients with IgAN.
Blood Pressure ; Genotype ; Glomerulonephritis, IGA* ; Histocompatibility Antigens* ; Histocompatibility* ; HLA-A Antigens ; Humans ; Immunoglobulin A* ; Phenotype ; Polymerase Chain Reaction ; Proteinuria ; Renal Insufficiency

Prostaglandin(PG) E has been shown to affect renal function by influencing renal blood flow and perfusion pressure and to have immunosuppressive properties. Positive effects of PG-E on kidney allograft hemodynamics and function have previously been, but not without controversy. This study was therfore designed to evaluate the long-term effect of misoprostol on blood pressure, CsA level, graft survival, renal function and histological change in first- time renal transplant recipients treated with cyclosporine. Eighty kidney transplant(KT) recipients were randomly se parated into three groups according to the duration of misoprostol treatment. Group C(n=50) was control; group M1(n=13) recieved misoprostol for less than 6 months and group M2(n=17) for more than 6 months after KT. The results were as follows. 1)Serum CsA levels at 24 months after KT were not significantly different among the three groups [groupC 167+/-58ng/ml; group M 163+/-75ng/ml (group M1 171+/-70ng/ml, group M2 155+/-81ng/ml)]. Group M2 required higher dosage of CsA than group C or M1 to maintain the proper serum levels (group M2 4.27+/-1.07mg/kg/day vs. group C 4.04+/-0.90mg/ kg/day or group M1 4.08+/-1.03mg/kg/day). But these results were not statistically significant. 2) Mean arterial pressures at 24 months after KT were not different among the groups[group C 101+/-11 mmHg; group M 103+/-10mmHg(group M1 108+/-11 mmHg, group M2 100+/-7mmHg)]. 3) Incidence of acute rejection was no different between group C(10 cases; 20%) and group M(12 cases; 40%). 4) Serum creatinine levels at 24 months after KT were not significantly different among the groups [group C 1.30+/-0.37mg/dl; group M 1.43+/-0.41mg/dl (group M1 1.51+/-0.47mg/dl, group M2 1.36+/-0.37mg/ dl)]. 5) Routine biopsy of transplanted kidney performed at 2 weeks after KT showed more abnormal findings in group C(9 cases; 49%) than group M(4 cases; 28.5%), but there was no statistical significance. In conclusion, long-term misoprostol treatment in renal transplant recipients was not effective in preventing the acute rejection, maintaining the renal fucntion, and decreasing blood pressure. Still, studies in patients receiving CsA are needed to determine the effect of misoprostol in CsA bioavaility and the histologic change of graft kidney.
Allografts* ; Arterial Pressure ; Biopsy ; Blood Pressure* ; Creatinine ; Cyclosporine* ; Graft Survival ; Hemodynamics ; Humans ; Incidence ; Kidney ; Kidney Transplantation ; Misoprostol ; Perfusion ; Renal Circulation ; Transplantation ; Transplants

The activation of c-fos protein (FOS) in ventrol- ateral preoptic neuron (VLPO) induces sleep (Science 271; 216-219, 1996). Although sleep disturbance are very common in patients with chronic renal failure, its mechahanism of sleep disturbance is not clear. The purpose of this study was to evaluate sleep dissturbance and expression of FOS in VLPO of chronic uremic rats. Chronic uremic rats were induced by 5/6 nephrectomized rnodel. After 4 weeks, blood urea nitrogen and serum creatinine in uremic rats (n=14 were higher than in control (n=17) (blood urea nitrogen; 73.6+/-24.8 mg/dl vs. 23.3+/-2.9 mg/dl, P<0.001 serum creatinine', 1.49+/-0.42 mg/dl vs. 0.66+/-0.12 mg/dl, P<0.001). General activity was counted with infrared during day time (08:00-20:00) and night time (20:00-08:00). Rats were killed at 10:00 or 16:00 during day time (uremic rats 7, control 9) and at 22:00 during night time (uremic rats 7, control 7). The expression of FOS in VLPO was examined with immunohistochernical method. The number of day tirne general activity in uremic rats was significantly higher than in control (458+/-185 vs. 222+/-41, P<0.001), and the number of night time general activity in uremic rats was lower than in control (949+/- 430 vs. 1618+/-261, P<0.001). During day time, the number of FOS immunoreactive cell in uremic rats was lower than in control (18.4+/-5.3 vs. 42.8+/-6.3, P<0.001), but there was no difference between 2 groups at night time (10.8+/-8.4 vs 12.5+/-5.1, P=0.62). There was strong negative correlation between the number of activity and the number of FOS immunoreactive cell in control (r= -0.93, P<0.001), but there was no correlation in uremic rats. This study shows that sleep disturbance in chronic uremic rats might be related to decrease of expression of FOS in VLPO.
Animals ; Blood Urea Nitrogen ; Creatinine ; Humans ; Hypothalamus* ; Kidney Failure, Chronic ; Neurons ; Nitrogen ; Rats* ; Urea ; Uremia

It was already reported in else where that a standard linear accelerator, with only slight modification can function in a manner similar to Leksell's Gamma unit device in the treatment of inoperable deep seated intracranial lesions. Using collimated narrow beams, a localization system and special computer programs for precise patient positioning and a high concentration of irradiation dose within the lesions, eleven patients with AVMs and brain tumor have now been treated since 1988. The 6 MeV linear accelerator and Hitchcock stereotactic frame was used of the all procedures. In 10 of the 11 patients, no side effects occurred. The first 7 patients, who could be observed 3 months or longer have been studied radiologically and clinically. In 6 patients marked decrease in contrast enhancement and sometimes dramatic clinical improvement was achieved. In one case a marked increase of the surrounding brain edema occurred 7days after radiosurgery, who was operated on. The radiantion dose was based on the volume, location and radiosensitivity of the lesion which ranged 15-40 Gy.
Brain Edema ; Brain Neoplasms ; Humans ; Particle Accelerators* ; Patient Positioning ; Radiation Tolerance ; Radiosurgery*