Patients with human immunodeficiency virus (HIV) infection have a higher burden of seizures, but few studies have examined seizures in HIV-infected individuals in Korea. A retrospective study was conducted to determine the epidemiology and clinical characteristics of seizures in patients with HIV infection. Among a total of 1,141 patients, 34 (3%) had seizures or epilepsy; 4 of these individuals had epilepsy before HIV infection, and the others showed new-onset seizures. Most patients exhibited moderate (200 to 500, n = 13) or low (below 200, n = 16) CD4 counts. The most common seizure etiology was progressive multifocal leukoencephalopathy (n = 14), followed by other HIV-associated central nervous system (CNS) complications (n = 6). Imaging studies revealed brain lesions in 21 patients. A total of 9 patients experienced only one seizure during the follow-up period, and 25 patients experienced multiple seizures or status epilepticus (n = 2). Multiple seizures were more common in patients with brain etiologies (P = 0.019) or epileptiform discharges on EEG (P = 0.032). Most seizures were controlled without anticonvulsants (n = 12) or with a single anticonvulsant (n = 12). Among patients with HIV infection, seizures are significantly more prevalent than in the general population. Most seizures, with the exception of status epilepticus, have a benign clinical course and few complications.
Adult ; Aged ; Anticonvulsants/therapeutic use ; Causality ; Comorbidity ; Electroencephalography/*statistics & numerical data ; Female ; HIV Infections/diagnosis/*epidemiology ; Humans ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk Factors ; Seizures/*diagnosis/*epidemiology/prevention & control ; Treatment Outcome

No abstract available.
Ischemia* ; Skin*

Traditionally, radical hysterectomy is the main surgical method for the treatment of early cervical carcinoma and always results in the loss of fertility. But, large numbers of young women are recently being diagnosed with cervical carcinoma and fertility preservation has become a concern. So, there has been a move towards more conservative approaches for the treatment of cervical carcinoma in recent years. Radical trachelectomy, which allows preservation of uterus but removes the cervix, parametrium and upper one third of the vagina, is a conservative but locally radical procedure. We performed radical abdominal trachelectomy with pelvic lymphadenectomy for two cases of invasive cervical carcinomas, which may be the first report in korea. One patient was 37 years old single women who had stage Ib cervical cancer and was disease free for 17 months after treatment. The other patient was 19 years old student who was also single and had stage IIa cervical cancer and was disease free for 14 months after treatment. We report the first two cases and review the literature on radical trachelectomy.
Adult ; Cervix Uteri ; Female ; Fertility ; Fertility Preservation ; Humans ; Hysterectomy ; Korea ; Lymph Node Excision* ; Uterine Cervical Neoplasms ; Uterus ; Vagina ; Young Adult

PURPOSE: Laparoscopic common bile duct exploration (LCBDE) has more advantages than conventional common bile duct surgery, but the use of this route for stone removal and biliary drainage remains controversial. The goal of this study was to investigate the usefulness of LCBDE in patients who had been failed in the endoscopic stone extraction. METHODS: From November 2005 to August 2008, 52 patients underwent LCBDE due to failure of endoscopic stone extraction in Chungnam National University Hospital. Clinical data were collected and analyzed retrospectively. RESULTS: Duodenal diverticulum (23 cases, 44.2%) was the most common cause in failure of endoscopic stone extraction and large common bile duct stone 12 cases (23.1%), previous upper gastrointestinal operation 10 cases (19.2%) were followed. Twenty four patients did not have preoperative biliary drainage, such as PTBD, ENBD, PTGBD. Forty-five patients (86.5%) of the 52 participating patients underwent LCBDE successfully, but 7 cases resulted in open surgery for the following reasons: 3 cases of severe intraabdominal adhesions, 3 cases of stone impaction in ampulla portion, and 1 case of a remnant stone. External biliary drainage was performed in 41 cases with T-tube (31 cases, 68.9%), PTBD (7 cases, 15.6%), ENBD (3 cases, 6.7%). The stone clearance of LCBDE was 95.6%. Remnant stone weredetected in 2 cases (4.4%) and removed with choledochoscope via external biliary drain. Postoperative complications happened in 5 cases (9.5%). Procedure related complications happened in 2 cases (3.8%). CONCLUSION: LCBDE is useful technique in patients with failed endoscopic stone extraction, and biliary drainage may be necessary for detection and removal of latent remnant CBD stones.
Common Bile Duct ; Dioxolanes ; Diverticulum ; Drainage ; Fluorocarbons ; Humans ; Postoperative Complications

Familial idiopathic basal ganglia calcification(FIBGC) is an inheritable neurological condition characterized by calcium deposits in the basal ganglia and extra-basal ganglia areas. The condition manifests as parkinsonism and other variable neuropsychiatric symptoms. FIBGC is a rare condition, and its pathophysiology has not yet been fully elucidated. Here we report the results of a clinical study of two related patients diagnosed with FIBGC.
Basal Ganglia* ; Calcium ; Ganglia ; Humans ; Parkinsonian Disorders

OBJECTIVE: A prospective, randomized, controlled clinical study is performed to verify the effectiveness of epidural dexamethasone-soaked gelatin sponges to reduce postoperative pain following lumbar microdiscectomy. METHODS: Twenty-three patients (10 men and 13 women) undergoing lumbar microdiscectomy were included. Five pieces of gelatin sponge measuring 1 x 1 cm (Gelfoam; Pharmacia & Upjohn, Kalamazoo, MI, USA), soaked with either 5mg dexamethasone or an equal amount (2 mL) of saline, were left on the decompressed nerve root after unilateral hemilaminectomy, flavectomy and discectomy. RESULTS: Subjective visual analog scale(VAS) scores of leg pain in the dexamethasone group on the first, third and fifth postoperative days (2.5, 2.5, 1.7, respectively) were significantly lower than in the control group (5.0, 4.8, 3.6) ( P<0.05). No side effects related to the dexamethasone-soaked gelatin sponges were observed. CONCLUSION: The intraoperative application of dexamethasone-soaked gelatin sponges during lumbar microdiscectomy can provide effective postoperative analgesia without complications.
Analgesia ; Dexamethasone ; Diskectomy ; Gelatin* ; Humans ; Leg ; Male ; Pain, Postoperative ; Porifera* ; Prospective Studies

No abstract available.
Hemangioma* ; Polyhydramnios*

Low bone mineral density (BMD) is common in HIV-infected patients. We aimed to describe the prevalence of low BMD and risk factors in Korean HIV-infected patients and to assess the effects of antiretroviral therapy (ART) on BMD. We retrospectively evaluated 224 HIV infected-patients. The prevalence of osteopenia and osteoporosis were 41.5% and 12.9%. These were much higher in 53 patients aged 50 yr and older (52.8% and 34.0%). Older age, lower body mass index, and ART > 3 months were independent risk factors for low BMD. Osteoporosis was more prevalent in patients on the abacavir-based regimen for < 1 yr than > or = 1 yr; however, it was more prevalent in patients on the zidovudine-based regimen for > or = 1 yr than < 1 yr (P = 0.017). Osteoporosis in patients on the abacavir-based regimen was more common in the spine than in the femur (P = 0.01). Given such a high prevalence of low BMD, close monitoring of BMD for HIV-infected patients on ART is required. The different prevalence of osteoporosis over time and affected areas between two regimens suggest they may play roles in different mechanisms in bone loss.
Adult ; Anti-HIV Agents/adverse effects/*therapeutic use ; Asian Continental Ancestry Group ; Body Mass Index ; *Bone Density ; Bone Diseases, Metabolic/*epidemiology/etiology ; Dideoxynucleosides/adverse effects/*therapeutic use ; Female ; HIV Infections/*drug therapy/epidemiology/pathology ; Humans ; Male ; Middle Aged ; Odds Ratio ; Osteoporosis/*epidemiology/etiology ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Zidovudine/adverse effects/*therapeutic use

BACKGROUND: Skin disorders are common in human immunodeficiency virus (HIV)-infected patients in Korea. However, introduction of highly active antiretroviral therapy (HAART) has changed the skin manifestations of HIV infection. OBJECTIVE: We evaluated the frequency of skin disorders and their immune status using CD4+ T lymphocyte counts in HIV infected patients. METHODS: A retrospective study of 134 HIV-infected patients who visited in our clinic was carried out from September 2008 to July 2011. All subjects underwent complete physical examination to detect their skin disorders as well as necessary diagnostic procedures by consultation with the dermatologist. RESULTS: Tinea infection (including tinea corporis, tinea pedis and onychomycosis) was the most common skin disorder identified. Patients with a CD4+ T lymphocyte count of less than 200 cells/mm3 showed a significantly higher prevalence of syphilis, oral candidiasis and drug eruption compared with patients with a CD4+ T lymphocyte count of over 200 cells/mm3. CONCLUSION: Numerous skin disorders were demonstrated in HIV-infected patients. Among them, tinea infection was the most common skin manifestation in 134 HIV-infected patients. Moreover, Syphilis, oral candidiasis and drug eruption were associated with low CD4+ T lymphocyte counts. Further evaluation is necessary to confirm the trend towards changes in skin manifestations in HIV infected patients.
Antiretroviral Therapy, Highly Active ; Candidiasis, Oral ; Drug Eruptions ; HIV ; HIV Infections ; Humans ; Korea ; Lymphocyte Count* ; Lymphocytes* ; Physical Examination ; Prevalence ; Retrospective Studies ; Skin Manifestations ; Skin* ; Syphilis ; Tinea ; Tinea Pedis

OBJECTIVE: In processing high dimensional clinical data, choosing the optimal subset of features is important, not only for reduce the computational complexity but also to improve the value of the model constructed from the given data. This study proposes an efficient feature selection method with a variable threshold. METHODS: In the proposed method, the spatial distribution of labeled data, which has non-redundant attribute values in the overlapping regions, was used to evaluate the degree of intra-class separation, and the weighted average of the redundant attribute values were used to select the cut-off value of each feature. RESULTS: The effectiveness of the proposed method was demonstrated by comparing the experimental results for the dyspnea patients' dataset with 11 features selected from 55 features by clinical experts with those obtained using seven other classification methods. CONCLUSION: The proposed method can work well for clinical data mining and pattern classification applications.
Data Mining ; Dyspnea