PURPOSE: A number of drugs are capable of changing body weight as a side effect. A number of neurotransmitter systems acting in several hypothalamic nuclei are pivotal to the storage regulation of body fat. Leptin is a protein encoded by the ob gene that is expressed in adipocyte. It regulates eating behavior by activating the action to the satiety center in the hypothalmus. The purpose of this study is to investigate the changes of serum leptin in children with epilepsy. METHODS: Serum leptin levels were measured in 43 epileptic patients (30 males, 13 females) receiving valproate or carbamazepine by radioimmunoassay. Thirty patients (19 males, 11 females, 10.0+/-5.0 years of age) were treated with valproate (VPA group) and 13 patients (11 males, 2 females, 9.1+/-4.0 years of age) were treated with carbamazepine (CBZ group). Obesity index and body mass index were calculated before and during anticonvulsant medications. RESULTS: 1) Body mass indices were significantly increased after VPA or CBZ medication; from 17.24+/-2.74 to 18.47+/-2.60 in VPA group, from 16.77+/-1.69 to 17.43+/-3.01 in CBZ group. 2) Obesity indices were increased without statistical significance after medication in both group. 3) Serum leptin levels were significantly higher in VPA group (4.54+/-4.77ng/ml) than CBZ group (2.47+/-2.26ng/ml). CONCLUSION: Body weight gain after VPA medication in susceptible individual might be related to a certain mechanism that elevates serum leptin level.
Adipocytes ; Adipose Tissue ; Body Mass Index ; Body Weight ; Carbamazepine ; Child* ; Epilepsy ; Feeding Behavior ; Female ; Humans ; Leptin* ; Male ; Neurotransmitter Agents ; Obesity ; Radioimmunoassay ; Valproic Acid ; Weight Gain

We evaluated MR imaging of spondylolytic spondylolisthesis degenerative spondylolisthesis and retrolisthesis in 14, 9 and 20 patients respectively. Sagittal and axial spin echo and gradient echo images were obtained with 25-30cm FOV and 5mm/0.5mm thickness/gap by using spine surface coil. Sagittal images showed defects of pars interarticularis just inside of the pedicles of spines in all the cases of spondylolytic spondylolisthesis with relatively variable signal intensity. Displaced vertebrae were commonly observed at L5 (8/14) in spondylolytic spondylolisthesis, at L4 (5/9) in degenerative spondylolisthesis and at variable locations in retrolisthesis. The mean length of displacement of vertebrae in spondylolytic spondylolisthesis was about 7mm and less displacement was onserved in degenerative spondylolisthesis and retrolisthesis. Seven, four and six cases of pseudobulging of disk at displaced level were observed in cases of spondylolytic spondylolisthesis, degenerative spondylolisthesis and retrolisthesis respectively. Seven, five and 14 cases of true disk lesions were onserved in cases of spondylolytic spondylolisthesis, degenertive spondylolisthesis and retrolisthesis respectively. Grade II neural foraminal stenoses (obliteration of one half epidural fat of neural foramen) were commonly (8/14) seen in spondylolytic spondylolisthesis, however the other two types showed less severe neural foraminal stenosis. In conclusion, MR imaging is a highly accurate method for the diagnosis and evaluation of spondylolisthesis and associated lesions of spine and disks.
Constriction, Pathologic ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Methods ; Spine ; Spondylolisthesis*

PURPOSE: Persistence of urgency in women after anti-incontinence surgeries is a distressing problem. We compared post-operative outcome of urgency according to clinical factors and urodynamic findings. And we evaluated the effects of post-operative persistent or de novo urgency on patient satisfaction. MATERIALS AND METHODS: Medical records of 279 consecutive women who had undergone modified fascial sling operation were reviewed. Motor urge defined as urgency with detrusor instability, and patients with urgency but no demonstrable detrusor instability on urodynamic study were diagnosed as sensory urge. Post-operative symptoms and satisfaction were assessed by questionnaire. RESULTS: Of the 279 patients, 53 with motor urge and 115 with sensory urge had pre-operative urgency. Cure or improvement in urgency occurred in 45 (84.9%) and 5 (9.4%) of the motor urge, and 70 (60.9%) and 23 (20.0%) of sensory urge cases, respectively (p<0.05). 105 (84.0%) of 125 patients with cure or improvement of urgency were satisfied for the operation, however, de novo urgency was noted in 8 patients (2.9%) and only 34 (66.7%) of 51 patients with persistent urgency or de novo urgency were satisfied (p<0.05). CONCLUSIONS: Our results suggest that we can predict cure or improvement of urgency with resolution of stress urinary incontinence after sling operation in many patients, and patients with motor urge are more likely to have urgency resolution after sling operations than those with sensory urge. Among various factors, post-operative outcome of urgency has a considerable effect on patient satisfaction.
Female ; Humans ; Medical Records ; Patient Satisfaction* ; Surveys and Questionnaires ; Urinary Incontinence* ; Urodynamics

BACKGROUND: The presence of cardiac metastasis from cervical cancer is very rare. Due to the rarity of this condition, clinical characteristics of the patients with cardiac metastasis from cervical carcinoma is not well known. This study is to investigate the clinical profiles and outcomes of patients with cardiac metastasis from the carcinoma of the uterine cervix. MATERIALS AND METHODS: From Jan. 1990 to May 1999, 4 patients with cardiac metastasis from cervical cancer during the course of the disease were registered in Korea Cancer Center Hospital. The clinical characteristics of these patients were reviewed retrospectively. RESULTS: Mean age of patients was 49 years, and median interval from initial diagnosis to recurrence was 27 months. Histologically, all 4 cases were squamous cell type carcinoma. The stage distribution is two patients with FIGO stage II, one with stage I and one with stage III. Clinical symptoms of patients were dyspnea and facial edema in 2 patients, facial edema in one patients, and dyspneas only in one patient. All patients were confirmed histologically by pericardiocentesis. Synchronous metastatic lesions were supraclavicular lymph node, lung parenchyme and paraaortic, mediastinal lymph node. Following pericardiocentesis or pericardiodesis, all patients were improved clinically and survived for mean interval of 5.3 months. CONCLUSIONS: The patients with pericardial metastasis from cervical carcinoma showed a short survival time, but could be managed by pericardiocentesis or pericardiodesis with improvement of clinical symptoms.
Cervix Uteri ; Diagnosis ; Dyspnea ; Edema ; Female ; Humans ; Korea ; Lung ; Lymph Nodes ; Neoplasm Metastasis* ; Pericardiocentesis ; Recurrence ; Retrospective Studies ; Uterine Cervical Neoplasms*

OBJECTIVES: This non-randomized retrospective study was to investigate the clinical characteristics and to evaluate the actual 5-year survival rate of the patients with invasive cancer of the cervix. METHODS: 489 evaluable patients with invasive cancer of the cervix were treated at Korea Cancer Center Hospital from January to December 1992. In this retrospective study, we studied the clinico-pathologic characteristics(age, FIGO stage, histologic type, nodal metastasis) and treatment modalities by the review of medical records. Especially, the survival was confirmed by the support of the police and government office. RESULTS: The most common subsets of patients were found in the group of FIGO stage IIb(32.5%) and age between 51 and 60(33%). Surgery was the main treatment in stage Ib/IIa(65%) and radiation in stage IIb or more(97%). Nodal metastasis were surgically identified in 6% of stage Ib, 29% of stage IIa and 36% of stage IIb. Overall actual 5-year survival rate was 72.2%; stage Ia(100%), Ib(94%), IIa(82%), IIb(63%), IIIa(36%), IIIb(47%), and IV(0%). The five-year survival rate according to LN status in surgically confirmed FIGO stage Ib-II patients were 91.9% in negative patients and 73.1% in positive patients respectively. Five-year survival rate was significantly different according to stage(P < 0.02) and nodal metastasis(p < 0.01). However, age and histologic type did not show any significant differences in survival. CONCLUSION: Overall actual five-year survival rate of 489 evaluable patients with invasive cancer of the cervix who were treated at Korea Cancer Center Hospital from January to December 1992 was 72.2%. Five-year survival rate was different according to stage and nodal metastasis.
Humans ; Korea ; Medical Records ; Neoplasm Metastasis ; Police ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

OBJECTIVES: To investigate clinicopathologic findings of patients with small cell carcinoma of uterine cervix, and to evaluate the recurrence pattern and prognosis of patients with small cell carcinoma of the uterine cervix. Methods: From Jan. 1990, to Dec. 1997, 23 patients with small cell carcinoma of the uterine cervix were registered and followed-up at Korea Cancer Center Hospital. Clinical characteristics, survival of these patients were studied retrospectively. RESULTS: Among the 23 cases of small cell carcinoma of uterine cervix, 17 cases(74%) were of the neuroendocrine type (NE group), and 6 cases(26.0%) of the squamous cell type (SCC group). The median age, FIGO stage, and treatment modality were not significant difference between two groups. Pelvic lymph node metastases were found 53% in NE group, and 33% in SCC group, but there were not significant difference between two groups(p>0.05). Three patients showed distant metastases in NE group(bone 18%, bladder 9%), but there was no distant metastasis in SCC group. The 3 year survival rate was 50.0% in SCC group and 32.1% in NE group, but there were not statistical significance(p>0.05). Six patients showed recurrence after treatment (4/17 cases in NE group, 2/6 cases in SCC group). Recurrence sites were liver (3/6, 50%), and lung (2/6, 33%), brain (2/6, 33%), retroperitoneum (1/6, 17%), and axillae lymph node (1/6, 17%). CONCLUSION: This study showed neuroendocrine small cell carcinoma may have more aggressive than squamous small cell carcinoma, but there were not significant difference in prognosis between the two groups. Because of limitation of number of patients, further large scaled multicenter studies are needed.
Axilla ; Brain ; Carcinoma, Small Cell* ; Cervix Uteri* ; Female ; Humans ; Korea ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Uterine Cervical Neoplasms

Carcinosarcoma is a rare malignant neoplasm consisting of both epithelial and nonepithelial components, that is, carcinoma and sarcoma in the same tumor. Since Queckenstedt reported the case of carcinosarcoma of the stomach in 1904, only 30 cases have been reported. We present a case of carcinosarcoma and adenocarcinoma of the stomach in 63-year-old man with the review of the literature.
Adenocarcinoma* ; Carcinosarcoma* ; Humans ; Middle Aged ; Sarcoma ; Stomach*

Elevation of aspartate aminotransferase (AST), alanine aminotransferase(ALT),and bilirubin levels was noted incidentally in patients who received laparoscopic cholecystectomy(LC). This study was attempted to investigate the elevation of liver enzymes and bilirubin levels after LC and its clinical significance. Twenty patients who showed normal levels of preoperative liver function test were entered into this study, and blood was collected at 24hours, 72hours and 7days after operation for measurement of AST, ALT, alkaline phosphatase(ALP), and bilirubin levels. In AST, a mean 2.76-fold postoperative increase was observed in 18 patients(90%) and 12 patients(60%) showed an elevation rise above normal limits. In ALT, a mean 2.14-fold postoperative increase was observed in 16 patients(80%) and 10 patients(50%) showed an elevation rise above normal limits. A mean 1.42-fold and a mean 2.12-fold increase were observed in total and direct bilirubin level respectively and elevation above normal limits occured in 7 patients(35%) and 4 patients (20%) respectively. The patients with an elevation of AST, ALT and bilirubin levels did not show any related clinical problem, and the elevations were transitory and returned to normal value within several days without any specific treatment.. Although the exact causes of these elevations need further investigation, theys appear to have no obvious clinical significance.
Alanine ; Aspartate Aminotransferases ; Bilirubin* ; Cholecystectomy, Laparoscopic* ; Humans ; Liver Function Tests ; Liver* ; Reference Values

Tuberous sclerosis is a complex neurocutaneous disease in which facial angiofibroma, mental retardation, seizures, renal tumor and phakoma of the retina are particularly frequent, in which renal tumors are usually angiomyolipomas and they are usually small, bilateral and not combined with symptom. We report a case of bilateral renal angiomyolipomas in association with facial angiofibroma, which resulted in spontaneous rupture and massive retroperitoneal hemorrhage.
Angiofibroma ; Angiomyolipoma* ; Hemorrhage ; Intellectual Disability ; Kidney ; Retina ; Rupture, Spontaneous ; Seizures ; Tuberous Sclerosis*

PURPOSE: To evaluate the relationship between urethral hypermobility and Valsalva leak point pressure (VLPP), subjective symptom degree in women with stress urinary incontinence. MATERIALS AND METHODS: 229 patients who were diagnosed as stress urinary incontinence and had undergone all of standing cystourethrogaphy, urodynamic study including VLPP, and recording questionnaire of incontinence were included in this study. The subjective degree of stress urinary incontinence was graded to 3 grades by Stamey classification, and urethral mobility more than 2.0 cm on standing cystourethrography was determined as the urethral hypermobility. And patients were stratified 3 groups according to the VLPP of less than 60, 60 to 90 and greater than 90 cmH2O. Correlation between urethral hypermobility and VLPP, subjective symptom degree were evaluated. RESULTS: According to the VLPP of less than 60, 60 to 90 and greater than 90 cmH2O, urethral hypermobility was noted in 49.4%, 86.6%, 92.4%, respectively. The rate of urethral hypermobility increased according to VLPP does with statistical significance (p<0.05). And in subjective symptom grade I, II, III urethral hypermobility was noted in 75.0%, 79.7%, 61.0%, respectively. There was not significant correlation between urethral hypermobility and subjective symptom degree (p=0.15). CONCLUSION: Our results suggest that there is significant correlation between urethral hypermobility and VLPP. And in some of patients with stress urinary incontinence urethral hypermobility and intrinsic sphincter deficiency are coexist. However, we suggest that the preoperative evaluation for urethral hypermobility and intrinsic sphincter deficiency is needed to assess the surgical outcome more exactly in the patients with stress urinary incontinence.
Classification ; Female ; Humans ; Surveys and Questionnaires ; Urinary Incontinence ; Urodynamics