No abstract available.

No abstract available.
Child ; Epilepsy ; Humans

We have treated total 37 cases of femoral neck fracture in children who were under the 16 years old in age at the Catholic University Medical College since 1985, followed them for average 21 months to analyse their types of fracture and treatment, complications and prevention of complications, and obtained the following results. 1. According to the Delbet's classification, type I was 1 case, II were 18(49%), most common, III were 10 and IV were 8 cases. Their ages were average 8.2 years and boys were predominant in 27 cases. 2. Thirty-six cases were treated with open reduction and internal fixation within 1-13 days after fracture, but only one type IV was treated with closed reduction, followed by hip spica cast for 6 to 9 weeks in all. 3. The fixation devises were removed at average 8.7 months after operatio. 4. fifteen complications were observed in 11 cases(37%), that were AVN(3 cases), early physeal closure(8 cases), coxa vara(3 cases), coxa valga and limb shortening(each 1 case), and their causes were severe fracture displacement(2 cases), penetration of fixation devices to physis(8 cases), incomplete reduction and loss of initial reductio (1 case) etc, but were not correlated with their method of fracture treatment. Conclusively, the femur neck fracture in children could favorably be treated with open reduction and internal fixation to reduce their complications. Physeal early closures due to penetration of screws and pin were most common cause of complications, and their long-term follow-up should be necessary.
Child ; Classification ; Coxa Valga ; Extremities ; Femoral Neck Fractures ; Femur Neck ; Femur ; Follow-Up Studies ; Hip ; Humans ; Methods

BACKGROUND AND OBJECTIVES: Candesartan cilexetil (Atacand ), a selective type I angiotensin II receptor blocker, has recently been introduced as a new antihypertensive agent. We evaluated its anti-hypertensive effect and safety in mild to moderate hypertensive patients. MATERIALS AND METHODS: Candesartan cilexetil, 8 mg or 16 mg, was administered once a day over 8 weeks period in the patients with mild to moderate hypertension (25 male, 26 female, mean age: 53.5+/-1.2 years). For safety evaluation, laboratory tests were performed before and after treatment with candesartan cilexetil. Changes in blood pressure, heart rate and electrocardiogram were also observed. RESULTS: 1) The mean blood pressures in the sitting position were systolic 164.1+/-2.1 mmHg and diastolic 106.3+/-0.8 mmHg before treatment, which were lowered to 135.4+/-2.0 mmHg and 89.1+/-1.1 mmHg, repectively after 8 weeks of treatment (p<0.05). 2) Candesartan cilexetil had a significant dose-dependent antihypertensive effect for diastolic pressure in 35 patients (8 mg: 97.8+/-0.9 mmHg, 16 mg: 91.3+/-1.1 mmHg, p<0.05). 3) Heart rate was not significantly changed before and after treatment during the treatment with candesartan cilexetil (72.2+/-1.2/min vs. 72.0+/-1.3/min: p>0.05). 4) Laboratory tests revealed no significant abnormality by the treatment with candesartan cilexetil. 5) Left ventricular hypertrophy by ECG criteria detected in 3 cases disappeared after treatment with candesartan cilexetil. 6) No significant side effects were observed during the treatment period. CONCLUSION: Candesartan cilexetil, 8 mg or 16 mg, once a day is an effective and well tolerated antihypertensive treatment. It has a significant dose-dependent antihypertensive effect.
Blood Pressure ; Electrocardiography ; Female ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Male ; Receptors, Angiotensin

Infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA) has become a worldwide concern. We present a case of a 12-year-old child with IE of the native mitral valve due to MRSA infection after an invasive dental procedure. Based on the clinical symptoms and the presence of cerebrospinal fluid pleocytosis, the patient was initially diagnosed with presumed bacterial meningitis and treated with empiric antibiotics. On the third day of hospitalization, MRSA was cultured from the initial blood samples and vegetation was observed on the mitral valve during an echocardiogram, findings which are compatible with a diagnosis of IE. The revised guidelines for antibiotic prophylaxis for the prevention of IE advise that IE prophylaxis for dental procedures is reasonable only for patients with underlying cardiac conditions, who are at the highest risk of adverse outcomes from IE. However, in this case, the patient had no high risk factors indicative of IE prophylaxis, except for mitral valve prolapse. She had no recurrence of IE over a follow-up period of 12 months.
Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Cerebrospinal Fluid ; Child ; Diagnosis ; Endocarditis* ; Follow-Up Studies ; Hospitalization ; Humans ; Leukocytosis ; Meningitis* ; Meningitis, Bacterial ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Mitral Valve ; Mitral Valve Prolapse ; Recurrence ; Risk Factors

OBJECTIVE: It is well-known that antipsychotics are widely used in the treatment of bipolar disorder. So, the aim of this study was to examine the subjective response to antipsychotics in acute manic patients. METHODS: Data were gathered through the study for feasibility testing of Korean Medication Algorithm for Bipolar Disorder (KAMP-BP), which 17 nationwide clinical centers were entered into the study. A total 126 bipolar patients were enrolled and then 92 were treated according to the treatment algorithm. The data of 58 patients were completely recorded from baseline to 2 weeks of treatment and were entered into analysis. Drug Attitude Inventory-10 (DAI-10) was used for evaluating patient's subjective response to antipsychotics and patients were grouped as subjective non-dysphoric and dysphoric as the total score of DAI-10. For assessing the clinical status, Young Mania Rating Scale (YMRS), Clinical Global Impression- Severity scale (CGI-S), Hamilton Rating Scale for Depression (HAM-D), Global Assessment of Functioning (GAF) and Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS) were used. RESULTS: Dysphoric group was younger and has more females in sex distribution than non-dysphoric group. YMRS and CGI-S were severer in dysphoric group. The prescription patterns were not different between two groups: Combinations of mood stabilizers and antipsychotics were administered to all patients and atypical antipsychotics were prescribed over 90% of the patients. At 2 weeks of treatment, more patients were turned into remission in non-dysphoric group. Dysphoric patients showed more changes of positive subjective response in DAI-10 from baseline and more patients turned toward the non-dysphoric group. CONCLUSION: Although the subjective response to antipsychotics using DAI-10 was not typically characterized in acute manic patients, it seems that atypical antipsychotics may have a role in determining the subjective feelings of the acute bipolar manic patients.
Antipsychotic Agents* ; Bipolar Disorder ; Depression ; Female ; Humans ; Prescriptions ; Sex Distribution

Primary cardiac lymphoma is an uncommon malignancy, accounting for 1.3% of primary cardiac tumors and 0.5% of extranodal lymphomas. However, secondary involvement of the heart is seen in 8.7-27.2% of the documented clinical cases of lymphoma. A 66-year-old man was referred to us for evaluation of dyspnea. A tumor mass was detected by transthoracic and transesophageal echocardiogram in the right atrium. The tumor was surgically resected. The pathologic diagnosis was a malignant lymphoma(diffuse large B cell type) had associated with intracavitary involvement of the right atrium. But acute mediastinitis was developed and then the patient was expired due to sepsis and bleeding at postoperative 9 days.
Aged ; Diagnosis ; Dyspnea ; Heart ; Heart Atria* ; Heart Neoplasms ; Hemorrhage ; Humans ; Lymphoma* ; Mediastinitis ; Sepsis

STUDY DESIGN: Twenty patients with spinal infection(tuberculous+pyogenic) in the lumbar spine were evaluated according to the surgical treatment methods using posterior instrumentation(pedicle screw) and conventional anterior curettage and interbody fusion method without posterior instrumentation. OBJECTIVE: The purpose of this study is to evaluate the efficacy of the method consisting of posterior instrumentation using pedicle screw and anterior lumbar interbody fusion. SUMMARY OF LITERATURE REVIEW: It has been reported that patients ended up with kyphosis had a higher incidence of back pain. MATERIALS AND METHODS: Twenty patients with spine infection in the lumbar spine divided into two groups depending on their use of posterior instrumentation in surgical treatment methods. One group consisted of 10 cases which were treated by conventional anterior curettage and anterior lumbar interbody fusion only(Group A) and the other groups consisted of 10 cases were treated by conventional anterior curettage and anterior lumbar interbody fusion with posterior instrumentation using pedicle screw(Group B) by a single surgeon. The clinical outcomes were evaluated using Macnab's classification and the radiographys were analyzed with respect to fusion status and sagittal angle. RESULTS: A solid bony fusion was obtained in Group B. But in Group A, 2 cases of bony resorption were occurred. The preoperative, immediate postoperative, and final follow-up sagittal angle in both groups were -7.4degree/ - 0 . 8degree, -19.0degree/ - 1 2 . 4degreeand -5.9degree/ - 8 . 6degree, respectively. There is a significant statistical difference in loss of sagittal angle correction between two groups(P<0.05). There is no complication related to the posterior instrumentation, but only 1 case of superficial infection was occurred. The clinical outcome which was evaluated by Macnab's method, there was no significant statistical difference between two groups(P>0.05), but exellent result was more common in Group B. CONCLUSION: This method which consist of conventional curettage and anterior lumbar interbody fusion with posterior instrumentation appears to be effective in stabilizing the vertebrae, and restoration and maintenance of physiologic lumbar lordosis. we would suggested this method for the surgical treatment in infection of lumbar spine.
Animals ; Back Pain ; Classification ; Curettage ; Follow-Up Studies ; Humans ; Incidence ; Kyphosis ; Lordosis ; Spine*

Primary tumors of the heart are rare, three-quarters of the tumors are benign, and nearly half of the benign heart tumors are myxomas. Cardiac myxoma usually originate in the left atrium about 75 percent, but, only 3 to 4 percent of myxoma are detected in the left ventricle. Cardiac myxoma is histologically benign, but may be lethal because of their position. We reported a case of 65-year-old man with left atrium myxoma associated with inferior vena caval thrombi and pulmonary embolism. After the operation of myxoma, the Budd-Chiari syndrome developed and the patient died due to hepatic failure.
Aged ; Budd-Chiari Syndrome* ; Heart ; Heart Atria* ; Heart Neoplasms ; Heart Ventricles ; Humans ; Liver Failure ; Myxoma* ; Pulmonary Embolism* ; Thrombosis*