PURPOSE: Successful management of epileptic patients requires complete control of seizures without adverse effect. The purpose of this study is to evaluate the hematologic effect and hepatic enzyme change of antiepileptic drugs in epileptic children and compare the changes of these values according to serum drug level. METHODS: The study included 89 epileptic children with antiepileptic drugs such as phenobarbital, valproate, and carbamazepine from May 1990 to July 1999. We classified these patients into 3 groups according to the drug they had taken; group 1 : patients treated by phenobarbital, group 2 : valproate, group 3 : carbamazepine. Baseline screening tests before the start of therapy for all patients included complete blood count(CBC) and differential, platelet count, serum alanine aminotransferase(ALT), aspartate aminotransferase(AST). The tests wee repeated at follow-up visits in 2nd week, 4th week, 6th week, 12th month on the new drug. We compared their mean hematologic and liver enzyme values, which were examined before and after taken the medications, such as white blood cell counts(WBC), red blood cell(RBC), platelets, hemoglobin(Hgb), hamatocrit(Hct), mean corpuscular volume(MCA), mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), AST, and ALT. Statistically significant change of each value was observed according to drug blood levels. RESULTS: No significant differences were found between before and after medication on AST, ALT, Hgb, MCHC in all the groups. The WBC count diminished after medication of carbamazepine, significantly. But the correlation between WBC count and serum carbamazepine level was no statistically significant. The mean platelet count diminished significantly after medication of phenobarbital and valproate, and the correlation of maximum serum valproate level with the degree of platelets count was statistically significant. Statistically significant changes were found on MCV and MCH values before and after the medication in 3rd group. But it did not depend on carbamazepine blood level. CONCLUSION: Statistically significant correlations was found between the platelet count and the plasma valproate level. Significant increase of MCV and MCH, and decrease WBC count was observed after the medication of carbamazepine.
Alanine ; Anticonvulsants* ; Aspartic Acid ; Carbamazepine ; Child* ; Erythrocyte Indices ; Follow-Up Studies ; Humans ; Leukocytes ; Liver* ; Mass Screening ; Phenobarbital ; Plasma* ; Platelet Count ; Seizures ; Valproic Acid

No abstract available.
Graves Disease* ; Insulin*

Stroke is a leading cause of long-term disability in ischemic survivors who are suffering from motor, cognitive, and memory impairment. Previously, we have reported suppressing LPA5 activity with its specific antagonist can attenuate acute brain injuries after ischemic stroke. However, it is unclear whether suppressing LPA5 activity can also attenuate chronic brain injuries after ischemic stroke. Here, we explored whether effects of LPA5 antagonist, TCLPA5, could persist a longer time after brain ischemic stroke using a mouse model challenged with tMCAO. TCLPA5 was administered to mice every day for 3 days, starting from the time immediately after reperfusion. TCLPA5 administration improved neurological function up to 21 days after tMCAO challenge. It also reduced brain tissue loss and cell apoptosis in mice at 21 days after tMCAO challenge. Such long-term neuroprotection of TCLPA5 was associated with enhanced neurogenesis and angiogenesis in post-ischemic brain, along with upregulated expression levels of vascular endothelial growth factor. Collectively, results of the current study indicates that suppressing LPA5 activity can provide long-term neuroprotection to mice with brain ischemic stroke.

Malignant tumors of the maxilla represent about 3-4% of head and neck malignant neoplasm and the origins are maxillary gingiva, hard palate and maxillary sinus. We are to investigate clinical features and results according to various treatment modalities of maxillary malignant tumor to get information for better treatment results. Sixty patients with malignant maxillary tumors treated at Yonsei medical center from 1992 to 1997 were studied retrospectively. They are evaluated according to clinical signs & symptoms, stages at first diagnosis, primary site, histopathologic features, treatment method, recurrence and survival rate with clinical records, biopsy results and CT radiograph. The most common primary site was maxillary sinus and most common histopathology was squamous cell carcinoma. The local recurrence rate was 18% at 5 years, neck failure was 3% and distant metastasis was 18%. Overall survival rate was 78% at 2 years and 69% at 5 years. Failure at primary site is the main problem in the curative treatment. So, to improve survival in these patients efforts should be directed toward improvement of local control.
Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Gingiva ; Head ; Humans ; Maxilla* ; Maxillary Sinus ; Neck ; Neoplasm Metastasis ; Palate, Hard ; Recurrence ; Retrospective Studies ; Survival Rate

OBJECTIVES : A neural circuit including amygdala, the hippocampal complex and prefrontal cortex was associated with deficits in facial processing in schizophrenia. These deficits have a significant impact on social functioning in schizophrenia. Both neuropsychological deficits and brain structural abnormalities in first-degree relatives of schizophrenia patients suggest that they may also have the deficit in facial information processing as genetic factors. The purpose of this study was to explore the dysfunction of facial information processing in first-degree relatives of schizophrenia patients using functional magnetic neuroimaging (fMRI). METHODS : Ten non-affected siblings of schizophrenic patients and 10 normal comparison subjects having no schizophrenic siblings underwent fMRI during the d ynamic facial change procedure consisting of presentations of facial emotion and gender discrimination stimuli. The emotion discrimination condition consisted of the presentation of 12 happy faces and 12 disgust/fear faces. The gender discrimination condition consisted of the presentation of 12 male faces and 12 female faces. Condition-specific brain activations were compared between non-affected siblings and normal comparison subjects RESULTS : The facial information processing related brain regions including fusiform gyrus, several areas of frontal, temporal, occipital, and cerebellar regions exhibited more activation during gender discrimination than emotion discrimination tasks in each group. During gender discrimination task, siblings of schizophrenic patients showed less activation in right fusiform gyrus, both middle and superior frontal gyrus, left cuneus, and left inferior frontal gyrus, compared with normal comparison subjects. CONCLUSION : Dysfunctional facial information processing, such as a deficit in gender discrimination, might be an endophenotype of schizophrenia.
Amygdala ; Automatic Data Processing ; Brain ; Discrimination (Psychology) ; Endophenotypes ; Female ; Humans ; Magnetic Resonance Imaging ; Magnetics ; Magnets ; Male ; Neuroimaging ; Prefrontal Cortex ; Schizophrenia ; Siblings

PURPOSE: Most men with benign prostatic hyperplasia (BPH) have bothersome lower urinary tract symptoms (LUTS). This study aimed to investigate the safety and efficacy of high-performance system (HPS) laser photoselective vaporization of the prostate (PVP) for the treatment of BPH in men with detrusor underactivity (DU). MATERIALS AND METHODS: From March 2009, 371 patients with BPH were divided into 2 groups according to the findings of preoperative urodynamic study: 239 (64.4%) patients with bladder outlet obstruction (BOO) and 132 (35.6%) patients with bladder outlet obstruction with detrusor underactivity (BOO+DU). 120 W HPS laser PVP was performed to resolve the BOO. The perioperative data and postoperative results at 1 month and 12 months, including the International Prostate Symptom Score (IPSS), maximum urinary flow (Qmax), and postvoid residual urine (PVR) values, were evaluated. RESULTS: Compared with the preoperative parameters, significant improvements in IPSS, Qmax, and PVR were observed in each group at 1 and 12 months after the operation. In addition, IPSS, Qmax, and PVR were not significantly different between the BOO and BOO+DU groups at 1 and 12 months after the operation. CONCLUSIONS: Surgery to relieve BOO in the patients with BPH seems to be an appropriate treatment modality regardless of the existence of DU.
Humans ; Laser Therapy ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostatic Hyperplasia ; Urinary Bladder Neck Obstruction ; Urodynamics ; Volatilization

No abstract available.
Bronchopulmonary Sequestration*

PURPOSE: To report a case of orbital aspergillosis with third nerve palsy. CASE SUMMARY: A 75-year-old male presented with abrupt onset of visual impairment, extraocular movement limitation, and ptosis. The patient previously experienced rhinolalia and headache and was diagnosed with sinusitis 2 months prior, and was treated with oral antibiotics for 1 week. Orbital magnetic resonance imaging revealed a mass with bone erosion including the nasal cavity, ethmoid bone, and left orbit suggestive of fugal sinusitis. Aspergillus was detected histopathologically in the mass which was removed by endoscopic surgery. Amphotericin B was administered intravenously for 7 days along with voriconazole. There was no recurrence during the follow-up period. Extraocular movement limitations and ptosis were recovered postoperatively. CONCLUSIONS: The present study results indicate that visual impairment and third nerve palsy can develop in a patient with orbital aspergillosis.
Aged ; Amphotericin B ; Anti-Bacterial Agents ; Aspergillosis* ; Aspergillus ; Ethmoid Bone ; Follow-Up Studies ; Headache ; Humans ; Magnetic Resonance Imaging ; Male ; Nasal Cavity ; Oculomotor Nerve Diseases* ; Orbit* ; Recurrence ; Sinusitis ; Speech Disorders ; Vision Disorders

PURPOSE: To report a case of visual field defect and optic atrophy in a patient with periventricular leukomalacia. CASE SUMMARY: A 22-year-old woman was referred to our hospital for further glaucoma evaluation. She was diagnosed with normal tension glaucoma by her local ophthalmologist. Best corrected visual acuity and intraocular pressure were 1.0 and 16 mm Hg in both eyes, respectively. Fundus examination showed a cup disc ratio of 0.36 in the right eye and 0.34 in the left eye. However, the optic disc had temporal pallor. Red-free photograph and optical coherence tomography showed supratemporal retinal nerve fiber layer atrophy. Visual field examinations revealed inferior visual field defect in both eyes. The patient was born at 34 weeks of gestation with a birth weight of 1600 g. Brain magnetic resonance imaging (MRI) showed periventricular leukomalacia. CONCLUSIONS: The author presents a case of periventricular leukomalacia with inferior visual field defect and optic atrophy in a patient who was previously diagnosed with glaucoma. If non-specific clinical features that differ from typical glaucomatous clinical features are observed in a patient with a history of prematurity, a brain MRI can aid the diagnosis.
Atrophy ; Birth Weight ; Brain ; Eye ; Female ; Glaucoma ; Humans ; Infant, Newborn ; Intraocular Pressure ; Leukomalacia, Periventricular ; Low Tension Glaucoma ; Magnetic Resonance Imaging ; Nerve Fibers ; Optic Atrophy ; Pallor ; Pregnancy ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields

OBJECTIVE: Many studies have showed that excess or lack of sexual hormones, such as prolactin and testosterone, induced the sexual dysfunction in humans. Little, however, is known about the role of sexual hormones showing normal range in, especially, the basal state unexposed to any sexual stimulation. We hypothesized sexual hormones in the basal state may affect sexual behavior. METHODS: We investigated the association of the sexual hormones level in the basal hormonal state before visual sexual stimulation with the sexual response-related brain activity during the stimulation. Twelve heterosexual men were recorded the functional MRI signals of their brain activation elicited by passive viewing erotic (ERO), happy-faced (HA) couple, food and nature pictures. Both plasma prolacitn and testosterone concentrations were measured before functional MR scanning. A voxel wise regression analyses were performed to investigate the relationship between the concentration of sexual hormones in basal state and brain activity elicited by ERO minus HA, not food minus nature, contrast. RESULTS: The plasma concentration of prolactin in basal state showed positive association with the activity of the brain involving cognitive component of sexual behavior including the left middle frontal gyrus, paracingulate/superior frontal/anterior cingulate gyri, bilateral parietal lobule, right angular, bilateral precuneus and right cerebellum. Testosterone in basal state was positively associated with the brain activity of the bilateral supplementary motor area which related with motivational component of sexual behavior. CONCLUSION: Our results suggested sexual hormones in basal state may have their specific target regions or network associated with sexual response.
Brain ; Cerebellum ; Dopamine ; Heterosexuality ; Humans ; Magnetic Resonance Imaging ; Male ; Plasma ; Prolactin ; Reference Values ; Sexual Behavior ; Testosterone