No abstract available.
Facial Asymmetry*

No abstract available.
Glomerular Filtration Rate*

No abstract available.
Zygoma*

We evaluated the feasibility of the transradial coronary intervention (TRCI) in 85 consecutive patients with chronic total occlusion (CTO). Clinical, angiographic and procedural factors were compared between the success and failure groups. An overall success rate of 65.5% (57 of 87 lesions) was achieved with TRCI, and the most common cause of failure was an inability to pass the lesion with a guidewire. A multivariate analysis demonstrated that the most significant predictor of failure was the duration of occlusion (OR 1.064 per month, 95% CI 1.005 to 1.126, p = 0.03). The procedural success rate improved with use of new-generation hydrophilic guidewires. The 6 Fr guiding catheters were used in the majority of the 70 cases (81%). Five cases were crossed over to a femoral artery approach due to engagement failure of the guiding catheter into the coronary ostium because of severe subclavian tortuosity and stenosis in two cases, radial artery looping in one case, and poor guiding support in two cases. There were no major entry site complications. In conclusion, the radial artery might be a feasible vascular route in coronary interventions for CTO, with comparable procedural success and no access site complications.
Treatment Outcome ; Radial Artery/surgery ; Intraoperative Complications ; Humans ; Feasibility Studies ; Coronary Disease/diagnosis/*therapy ; Angioplasty, Transluminal, Percutaneous Coronary/adverse effects/*methods

OBJECTIVE: Various lesions including tumors occupying in the presellar and suprasellar regions have been traditionally removed by the transcranial approach. The new modified transsphenoidal approaches(TSAs) have been proposed to avoid the craniotomy and to get better surgical view. MATERIALS AND PATIENTS: The sellar floor and presellar anterior cranial fossa were removed through the sublabial transseptal transsphenoidal technique in the "transsphenoidal supradiaphragmatic intradural approach". One tuberculum sella meningioma and a suprasellar Rathke's cleft cyst confined to the pituitary stalk were removed via this approach. RESULTS: The dissection of the anterior intercavernous sinus, diaphragma sella, and arachnoid membrane allowed a wide surgical field of pre- and suprasellar areas and facilitated a safe removal of lesions without significant surgical complications in our cases. CONCLUSION: From the authors' limited experience, the advantages of this technique are as follows: 1) it can be easily applicable through a minor modification of the standard TSA, 2) excellent anatomical exposure of the structures located in the supradiaphragmatic suprasellar cistern, and 3) might be suitable to remove small lesions located in the presellar and adjacent to the pituitary stalk region.
Arachnoid ; Cranial Fossa, Anterior ; Craniotomy ; Humans ; Membranes ; Meningioma ; Pituitary Gland

PURPOSE: To evaluate the long-term therapeutic efficacy and durability of lamivudine in Korean children with chronic hepatitis B. METHODS: A total of 48 children (31 male and 17 female; age, 1~18 years, mean, 8 years) with chronic hepatitis B who received lamivudine for at least six months from March 1999 to September 2004 were followed for a mean period of 29 months (8~66 months) at Department of Pediatrics, Kyungpook National University Hospital in Korea. Response to treatment was defined as the normalization of ALT and HBV DNA levels, and HBeAg seroconversion after the initiation of treatment. RESULTS: Twenty nine (60%) among the 48 children treated with lamivudine responded and nine (19%) children lost HBsAg during therapy. ALT and HBV DNA level had normalized in 94% one year after the initiation of treatment. Kaplan-Meier estimates of cumulative HBeAg seroconversion rates over the years were 13% (0.5 year), 34% (1 year), 50% (1.5 years), 68% (2 years), 79% (2.5 years) and 90% at 3 years respectively. Above all, among the 22 children treated before the age of seven, loss of HBsAg occurred in eight (36%), which showed superior rate of HBsAg loss (p=0.002 vs age >7). CONCLUSION: Long-term treatment of lamivudine improved the rate of HBeAg seroconversion in Korean children with chronic hepatitis B. After three years' observation, most of treated children have sustained HBeAg clearance. We believe that lamivudine should be tried as the first therapeutic option for children with chronic hepatitis B in immune clearance phase.
Child* ; DNA ; Female ; Gyeongsangbuk-do ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Korea ; Lamivudine* ; Male ; Pediatrics

Since urachal abnormalities are uncommon and have various clinical manifestations such as umbilical discharge, periumbilical pain, recurrent urinary tract infection and abdominal mass according to its structure, it is not easy to diagnose. We report our experience of a patient with urachal remnant abscess who presented with gross hematuria initially, and improved after the management with intravenous antibiotics and percutaneous drainage of abscess.
Abscess ; Anti-Bacterial Agents ; Child ; Drainage ; Hematuria ; Humans ; Urinary Tract Infections

BACKGROUND AND OBJECTIVES: Despite the proven benefit of cholesterol- lowering therapy in patients with CAD, there is no consensual opinion on guideline of cholesterol-lowering therapy in patients with CAD in Korea. The aim of this study is to evaluate the risk of CAD according to the cholesterol level and to consider current guideline of cholesterol-lowering therapy for the secondary prevention in patients with CAD. MATERIALS AND METHODS: Consecutive 600 patients were assigned into two groups - coronary artery disease group (364 patients) and normal coronary artery group (236 patients) - depending on the coronary angiographic findings. Lipid profiles (total cholesterol, Triglyceride, HDL-cholesterol, LDL-cholesterol) were obtained and the odd ratio of CAD was evaluated according to the national cholesterol education program treatment guideline (NCEP: LDL cholesterol > or = 130 mg/dl) and the national heath insurance treatment guideline (NHI: total cholesterol > or = 220 mg/dl) by multi-variate logistic regression analysis. RESULTS: According to the NHI and NCEP guideline, the proportion of patients with CAD indicated on cholesterol-lowering therapy were 25%, 36.5% respectively and the odd ratio of CAD was 1.00 (95% CI 0.52 - 1.89, p=0.99), 4.89 (95% CI 2.78 - 8.60, p< 0.01) respectively . CONCLUSIONS: Our data showed that LDL-cholesterol > or = 130 mg/dl only reflected the risk of CAD in both guidelines and more proportion of the patients were indicated on cholesterol-lowering therapy in NCEP guideline than in NHI guideline.
Cholesterol ; Cholesterol, LDL ; Coronary Artery Disease* ; Coronary Vessels* ; Education ; Humans ; Insurance ; Korea ; Logistic Models ; Secondary Prevention ; Triglycerides

BACKGROUND: Childhood vitiligo is a distinct subset of vitiligo and somewhat different from adulthood vitiligo. However, there are a few published studies that have investigated the clinical aspects of childhood vitiligo in Korea. OBJECTIVE: The purpose of this study was to evaluate the clinical aspects of childhood vitiligo in Korea. METHODS: This clinical investigation was made on 134 outpatients with childhood vitiligo who had visited Department of Dermatology, Our Lady of Mercy Hospital, from January 1992 to December 1999. RESULTS: The results are summarized as follows; 1. Male to female ratio was approximately 1: 1. The mean ages of onset and first visiting were 5 and 6.7 years respectively, and the mean duration of disease was 1.7 years. 2. Only seven patients had vitiligo and one patient had premature graying of hairs among their parents and siblings. 3. There was no known precipitating factor in most cases(93.3%) except in 9 patients. 4. The associated skin diseases were atopic dermatitis(20.9%), poliosis(6.0%), alopecia areata(1.5%), halo nevus(1.5%), and so on. 5. The most common clinical type was localized(51.5%), and then generalized(26.1%), segmental (20.9%), and acrofacial(1.5%) in decreasing order. 6. The sites of frequent involvement were head and neck(56.7%), trunk(42.5%), upper extremity(17.2%), and lower extremity(17.9%). 7. The average 4% of body surface area was involved. During recent 3 months the lesions increased in number and size in 66 patients(49.3%), whereas the lesions were stable in 57 patients(42.5%). 8. The most common clinical differential diagnosis of childhood vitiligo is nevus depigmentosus in 47 patients(35.1%). 9. Twenty-seven patients had past history of previous treatment including topical application of steroid and topical PUVA. CONCLUSION: Based on these clinical findings, childhood vitiligo seems different from adult vitiligo clinically.
Adult ; Alopecia ; Body Surface Area ; Dermatology ; Diagnosis, Differential ; Female ; Hair ; Head ; Humans ; Korea ; Male ; Nevus ; Outpatients ; Parents ; Precipitating Factors ; Siblings ; Skin Diseases ; Vitiligo*

This study was conducted to investigate the etiology, the clinical characteristics and prognosis of acute necrotizing encephalopathy (ANE) in Korean children. Six children (1 yr to 7 yr) patients with ANE were enrolled. They were diagnosed by clinical and radiological characteristics and their clinical data were retrospectively analyzed. In a search of clinically plausible causes, brain MRI in all patients, mitochondrial DNA studies for mitochondrial encephalomyopathy, lactic acidosis, and strokelike episodes (MELAS) and myoclonus epilepsy and ragged red fibers (MERRF) in four patients, and genomic typing on HLA DRB/HLA DQB genes in three patients were performed. All had precedent illnesses and the main initial symptoms included mental change (83%), seizures (50%), and focal deficits (50%). MRI revealed increased T2 signal density in the bilateral thalami and/or the brainstem in all patients. Mitochodrial DNA studies for MELAS and MERRF were negative in those children and HLA-DRB1*1401, HLA-DRB3*0202, and HLA-DQB1*0502 seemed to be significant. A high dose steroid was given to all patients, which seemed to be partly effective except for 2 patients. In conclusion, ANE is relatively rare, but can result in serious neurological complication in children. Early detection and appropriate treatment may lead to a better neurological outcome.
Child ; Child, Preschool ; Female ; HLA-DQ Antigens/metabolism ; HLA-DQ beta-Chains ; HLA-DR Antigens/metabolism ; HLA-DRB1 Chains ; HLA-DRB3 Chains ; Humans ; Infant ; Korea ; Leukoencephalitis, Acute Hemorrhagic/diagnosis/etiology/*pathology/*physiopathology ; MELAS Syndrome/pathology/physiopathology ; MERRF Syndrome/pathology/physiopathology ; Magnetic Resonance Imaging ; Male ; Prognosis ; Retrospective Studies