PURPOSE: There are few rigorous studies about the side effects of antiepileptic drugs(AEDs) according to age. This study is to analyze differences of the side effects of AEDs in epileptic children according to age. METHODS: Sample are 368 children who had received AEDs for at least 1 month during January 1995 to June 1999. We reviewed their medical records including age, sex, AEDs and side effects, and analyzed these data by X2-test. RESULTS: Side effects were observed in 86(23.4%) of 368 patients. There was no difference in the frequency of overall side effects according to age. But significant differences existed in each side effect(p<0.05). The most common side effect according to age were hematologic side effect(75.0%) under 2 months, gastro intestinal side effect(41.7%) between 2 months and 1 year, CNS side effect(42.1%) between 1 year and 5 years, CNS side effect(41.5%) over 5 years. Hepatotoxicity, the increase of AST/ALT due to valproate, occurred significantly more frequently in children younger than 2 years(p<0.05). Drug eruption and post-carbamazepine leukopenia had no differences according to age. Under 1 year, valproate group had significantly more side effects in CNS. But carbamazepine, phenobarbital, and vigabatrin groups had no differences. CONCLUSION: There was significant difference in the side effects of AEDs among each system according to age. It is recommended to use valproate as monotherapy in children younger than 2 years, and pay more attention to CNS side effect in children older than 1 year.
Anticonvulsants* ; Carbamazepine ; Child* ; Drug Eruptions ; Humans ; Leukopenia ; Medical Records ; Phenobarbital ; Valproic Acid ; Vigabatrin

PURPOSE: The purpose of this study is to estimate the side effects of antiepileptic drug(AED) in children. METHODS: Subjects were 267 children who had received AED for at least 1 month during January 1995 to July 1998. We reviewed their sex, age at start of seizure onset, age at medication, class and number of AED, developmental delay, type and cause of seizure according to the presence of side effect. We analyzed data using Student's t-test and X2-test. RESULTS: Side effects were observed in 61 of 267(22.8%) patients. There were no significant differences in their characteristics according to the presence of side effect. There were 112 episodes of complications in 61 patients. In decreasing order, CNS(38.4%) > digestive(25.9%) > hematologic(22.3%) > skin and connective tissue(7.1%) > others(6.3%). There were 12 episodes in 11 patients who should have been taken off AED due to drug eruption, drowsiness, nausea and so on. Side effects were observed in 16 of 123(6.0%) patients in monotherapy compared with 45 of 144(16.8%) patients in polytherapy, which showed significantly fewer side effects in monotherapy(P<0.05). In monotherapy, mean age at seizure onset and medication start were older(4.63+/-3.83, 5.85+/-3.86 years, respectively) than in polytherapy(2.69+/-3.06, 3.69+/-3.58 years, respectively) (P<0.05). CONCLUSION: In the data, CNS is the most common side effect(43 episodes, 38.4%) and there were significantly fewer side effects in monotherapy compared with polytherapy. Accordingly, we concluded that monotherapy is preferred over polytherapy in reducing the side effects of AED.
Child* ; Drug Eruptions ; Humans ; Nausea ; Seizures ; Skin ; Sleep Stages

BACKGROUND: Control of seizure inducing factors (SIFs) is essential in the management of epilepsy. We suggest that avoiding of SIFs may prevent first attak of seizure in patients with risk factors or family history of epilepsy. We observed SIFs, clinical features associated with SIFs on their first seizure attack in patients diagnosed as epilepsy to help the prevention or management of the childhood epilepsy. SUBJECTS AND METHODS: A retrospective study was undertaken the analysis of 339 epileptic children visited to the pediatric Department of Pusan National University hospital from November, 1992 to July, 1998. RESULTS: 1) The 168 of 339 patients (49.5%) are associated with SIFs on first seizure attack. 2) Mean Age on their first seizure attack in the group with SIFs is 4.08+/-3.63 year-old and without SIFs is 2.80+/-3.34 year-old.3) The factors were febrile state (32.7%), sleepy state (29.0%), acute illness (8.3%), emotional stress (5.8%), fatigue (5.3%), hypoxia (4.7%), during watching TV or playing game (3.5%), head trauma (3.5%), bathing (2.8%), infection of central nervous system (2.3%), sleep deprivation (1.1%), vaccination (0.5%), hyperventilation(0.5%). 4) The types of seizure in patients with SIFs were as following : generalized tonic, clonic, tonic-clonic seiuzre was 140(90.9%), partial seiuzre 14(9.1%). 5) The family history of seizure disorders were not associated with SIFs. And 14(8.3%) of patients with SIFs had developmental delay, 24 (14.0%) of patients without SIFs. 6. Mean duration of control seizure was 1.52+/-2.65 years in the group with SIFs, 0.84+/-1.30 years in the group without SIFs. CONCLUSION: Early detection and education of the possible SIFs in each epileptic patients is considered as an important therapeutic modality in managing the epileptic patients in childhood.
Anoxia ; Baths ; Busan ; Central Nervous System ; Child ; Craniocerebral Trauma ; Education ; Epilepsy* ; Fatigue ; Humans ; Precipitating Factors* ; Retrospective Studies ; Risk Factors ; Seizures* ; Sleep Deprivation ; Stress, Psychological ; Vaccination

PURPOSE: Lumbar puncture is an essential and commonly practiced diagnostic tool and post-lumbar puncture headache and post-lumbar puncture back pain are common neurological complications. The aim of this study is to identify the factors that might cause post-lumbar puncture back pain and to reduce those complaints by eliminating the causes. METHODS: From June 5, 2013 to July 29, 2013, we studied 155 patients, male and female between the age 1 and 18,who received diagnostic or therapeutic lumbar puncture at Pusan National University Hospital and Pusan National University Yangsan Hospital. We collected data of variable aspects that may influence post-lumbar puncture back pain, by reviewing the medical records retrospectively. The independent variables were sex, age, symptoms, diagnosis, number of trials to successful lumbar puncture, year of the resident who carried out the procedure, opening pressure of cerebrospinal fluid(CSF), spinal level of punctured site, duration of strict bed rest, and use of sedatives for the procedure. RESULTS: Among the 155 patients whounderwent lumbar puncture, 36 (23.2%) experienced back pain after the procedure. Back pain subsided within 48hours in 24 ofthe 36 patients. Only one patient suffered from post-lumbar puncture back pain for more than 5days. There is no clear causality between the occurrence rate of post-lumbar puncture back pain and the independent variables which includeage, sex, duration of bed rest, symptoms, diagnosis, number of trials, skill, opening pressure, anatomic location, and use of sedatives. CONCLUSION: Back pain was a frequent complication of lumbar puncture. Various factors we expected to influence on the incidence of post-lumbar puncture back pain had no statistical significance. Further studies should be performed to investigate the causes and risk factors of post-lumbar puncture back pain.
Back Pain* ; Bed Rest ; Busan ; Child* ; Diagnosis ; Female ; Gyeongsangnam-do ; Humans ; Hypnotics and Sedatives ; Incidence ; Male ; Medical Records ; Post-Dural Puncture Headache ; Punctures* ; Retrospective Studies ; Risk Factors ; Spinal Puncture

Central pontine myelinolysis(CPM) is rare, with fewer than 30 cases reported in children. It is characterized by demylinated regions throughout the brain and which are most prominent in the pons. The original patients studied were all chronic alcholics, but subsequently the condition has been found in children and in other patients with electrolyte abnormalities, most notably hyponatremia which had been corrected rapidly. CPM symptoms include spastic quadriparesis, pseudobulbar palsy, and acute changes in mental status leading to altered levels of consciousness, coma, or death. This condition was originally thought to be uniformly fatal, but there have been recent reports of survival accompanied by varying degrees of residual neurologic deficit. We experienced a case of central pontine myelinolysis in a 1-year-old girl in 1998. On admission, she had right hemiphegia and developmental delay. She suffered from hyponatremia a year prior to admission. We performed brain MRI and other studies. She was diagnosed with CPM though brain MRI.
Brain ; Child ; Coma ; Consciousness ; Female ; Humans ; Hyponatremia ; Magnetic Resonance Imaging ; Muscle Spasticity ; Myelinolysis, Central Pontine* ; Neurologic Manifestations ; Pons ; Pseudobulbar Palsy ; Quadriplegia

Central pontine myelinolysis(CPM) is rare, with fewer than 30 cases reported in children. It is characterized by demylinated regions throughout the brain and which are most prominent in the pons. The original patients studied were all chronic alcholics, but subsequently the condition has been found in children and in other patients with electrolyte abnormalities, most notably hyponatremia which had been corrected rapidly. CPM symptoms include spastic quadriparesis, pseudobulbar palsy, and acute changes in mental status leading to altered levels of consciousness, coma, or death. This condition was originally thought to be uniformly fatal, but there have been recent reports of survival accompanied by varying degrees of residual neurologic deficit. We experienced a case of central pontine myelinolysis in a 1-year-old girl in 1998. On admission, she had right hemiphegia and developmental delay. She suffered from hyponatremia a year prior to admission. We performed brain MRI and other studies. She was diagnosed with CPM though brain MRI.
Brain ; Child ; Coma ; Consciousness ; Female ; Humans ; Hyponatremia ; Magnetic Resonance Imaging ; Muscle Spasticity ; Myelinolysis, Central Pontine* ; Neurologic Manifestations ; Pons ; Pseudobulbar Palsy ; Quadriplegia

Behcet's disease consists of a triad of relapsing inflammatory disease of the eye (iridocyclitis) with painful and recurrent oral and genital ulcerations. Arthritis, thrombophlebitis, neurologic abnormalities, fever, and colitis are associated clinical manifestations. The disease affects predominantly young adults and is very rare in children, especially those under 10 years of age. The proportion of Behcet's colitis in Behcet's disease is about 12%. Ulcerations are localized or diffuse, with the majority occuring in the ileocecal region. Extension to the serosal surface may result in perforation. The frequent complaints are abdominal pain, nausea, vomiting, diarrhea, hematochezia, loss of appetite, loss of weight gain, distention and palpable abdominal mass. The disease is complicated by intestinal obstruction, perforation, fistula formation, abscess formation and hemorrhage. We experienced a case of Behcet's colitis in a 9-year-old boy showing symptoms of abdominal pain, tenderness, and diarrhea. Thus, we report a case of Behcet's colitis with brief review of related literatures.
Abdominal Pain ; Abscess ; Appetite ; Arthritis ; Child* ; Colitis* ; Diarrhea ; Fever ; Fistula ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intestinal Obstruction ; Male ; Nausea ; Thrombophlebitis ; Ulcer ; Vomiting ; Weight Gain ; Young Adult

In this paper, a new superimposition scheme using a computer vision system was proposed with pairs of skull and ante-mortem photographs, which were already identified through other tests and DNA fingerprints at the Korea National Institute of Scientific Investigation. In this computer vision system, an unidentified skull was caught by video-camcoder with the MPEG and the other ante-mortem photograph was scanned by scanner. These two images were processed and superimposed using pixel processing. This recognition of individual identifications by anatomical references can be performed on the two superimposed images for many big cases like as Guam KAL accident in 1997.
Artificial Intelligence ; DNA Fingerprinting ; Guam ; Korea ; Skull

Adenoid basal carcinoma of the uterine cervix is uncommon neoplasia mostly occurring in postmenopausal women. It has excellent prognosis and a favorable clinical course. In addition, adenoid basal carcinoma is differentiated from adenoid cystic carcinoma by histologic and cellular morphologies, and immunohistochemistry. In this paper, we present the case of a 22 year old Korean female. She initially had a high-grade squamous intraepithelial lesion (HSIL) on Pap smear and a subsequent cervical loop electrosurgical excision procedure (LEEP) specimen revealing adenoid basal carcinoma. The lesion showed the histologic characteristics of adenoid basal carcinoma. Because of the lesion's low potential for recurrence and metastasis, the young primipara had a conization procedure performed and has been under close observation.
Adenoids* ; Carcinoma, Adenoid Cystic ; Cervix Uteri* ; Conization ; Female ; Humans ; Immunohistochemistry ; Neoplasm Metastasis ; Prognosis ; Recurrence

Uterine leiomyoma is one of the most common gynecological tumor, whereas acute torsion of the uterine leiomyoma is very rare. We report a case of subserosal leiomyoma that was first detected by ultrasonography, and further confirmed as torsion of subserosal leiomyoma by laparoscopic surgery.
Laparoscopy ; Leiomyoma* ; Torsion Abnormality ; Ultrasonography ; Uterine Neoplasms