PURPOSE: The purpose of this study was to evaluate whether the therapeutic effects of topiramate differ according to the types of migraine. METHODS: We recruited 38 children and adolescents with migraine who had been treated with topiramate. The effect of topiramate was evaluated on the basis of the change in the frequency of migraine attacks after treatment. RESULTS: Among patients having migraine with aura, 85.7% showed complete recovery, 1 (7.1%) showed partial recovery, and 1 did not show any recovery. Among patients having migraine without aura, 47.1% showed complete recovery, 29.4 % showed partial recovery, and 23.5% showed no recovery. Among patients suspected with migraine, 1 (20%) showed complete recovery, 1 (20%) showed partial recovery, and 3 (60%) showed no recovery. CONCLUSION: Our results indicated that topiramate exhibited excellent therapeutic effects for migraine accompanied with aura, and it was effective in migraine without aura. However, the effect of topiramate in patients suspected with migraine was uncertain.
Adolescent ; Child ; Epilepsy ; Fructose ; Humans ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura

We report here a case of maternal 3-methylcrotonyl-coenzyme A carboxylase (3-MCC) deficiency in a Korean woman. Her 2 infants had elevated 3-hydroxyisovalerylcarnitine (C5-OH) on a neonatal screening test by liquid chromatography-tandem mass spectrometry (LC-MS/MS), but normal results were found on urine organic acid analysis. The patient was subjected to serial testing and we confirmed a maternal 3-MCC deficiency by blood spot and breast milk spot test by LC-MS/MS, serum amino acid analysis, urine organic acid and molecular genetic analysis that found c.838G>T (p.Asp280Tyr) homozygous mutation within exon 9 of the MCCB gene. Especially, we confirmed marked higher levels of C5-OH on breast milk spot by LC-MS/MS, in the case of maternal 3-MCC deficiency vs. controls.
Breast* ; Exons ; Female ; Humans ; Infant ; Infant, Newborn ; Mass Spectrometry ; Milk, Human* ; Molecular Biology ; Neonatal Screening

Multiple sclerosis (MS) is a demyelinating disorder that affects discrete areas of the CNS, including the optic nerves, in a quite variable relapsing-remitting fashion over a prolonged period of time. Although MS is usually considered to be a disease that affects peoples in early to middle adulthood, children do develop multiple sclerosis. The frequency of MS onset before the age of 15 years is 2.7-5% of all cases, while MS onset during infancy and early childhood was observed to be 0.2- 0.7% of all cases. We report here on a Korean case of a relapsing-remitting MS female child who was treated with four rounds of intravenous methylpredinsolone pulse therapy and preventive Interferon-beta-1b (Betaferon(R)).
Child ; Demyelinating Diseases ; Female ; Humans ; Interferons* ; Multiple Sclerosis* ; Optic Nerve ; Interferon beta-1b

PURPOSE: The purpose of this study was to evaluate the clinical course and prognosis of migraines in childhood and adolescence, and the influence of preventive therapy on them. METHODS: We recruited 110 children and adolescents with migraines who had been newly diagnosed and treated. Treatment was composed of observation after consultation, acute symptomatic treatment, and preventive therapy. We prescribed topiramate for preventive therapy. The recipients of preventive therapy were those patients who complained of disturbance in daily life due to severe headache. The clinical course was evaluated on the basis of changes in the frequency of migraine attack and was divided into three groups: complete recovery, partial recovery, and non-recovery. The prognosis of migraine was classified into those free from migraine attack, decreased, and persistant. RESULTS: Forty-six (41.8%) of 110 patients completely recovered, and 70 (63.6%) were free from migraine attack. In those suffering from migraines without aura, 38.3% of the patients completely recovered and 59.6% were free from migraine attack. Regarding migraines with aura, 58.5% of the patients completely recovered and 70.7% were free from migraine attack. With respect to cases of probable migraine, 18.2% completely recovered and 59.6% were free from migraine attack. In those receiving preventive treatment, 80.0% of all patients completely recovered and 85.0% were free from migraine. According to migraine type, 66.7% of patients with migraine without aura completely recovered and 80% were free from migraine. In those with migraine and aura, 88.8% of patients completely recovered and 88.8% were free from migraine attack. CONCLUSION: It was estimated that the clinical course and prognosis of migraine patients who were treated by pediatric neurologists were generally good. The clinical course was better in the preventive therapy group. In particular, the effect of preventive treatment and prognosis were optimal in patients with migraine with aura.
Adolescent ; Child ; Epilepsy ; Fructose ; Headache ; Humans ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura ; Prognosis ; Stress, Psychological

Pathologic splenic rupture is an uncommon finding associated with a long list of pathologic conditions, including infectious diseases, hematologic diseases, metabolic disorders, drug therapy, primary and secondary benign or malignant splenic tumors, acute or chronic pancreatitis, collagen disorders pregnancy, and others. In this report, we present a case study of a pathologic splenic rupture caused by metastasis from a previously undiagnosed gastric carcinoma.
Collagen ; Communicable Diseases ; Drug Therapy ; Hematologic Diseases ; Neoplasm Metastasis ; Pancreatitis, Chronic ; Pregnancy ; Splenic Rupture*

PURPOSE: The purpose of this study was to evaluate the attitudes of middle-school students about height and their behaviors related to height gain. METHODS: One thousand four hundred twenty two middle-school students were included. We requested that the students complete a battery of questionnaires asking about problems associated with height. RESULTS: There was a clear difference between real height and desired height. Most students (83.7%) had height dissatisfaction. Most students (91.1%) were concerned about their height. Few students made efforts to improve their height, even though most students had height dissatisfaction and were concerned about their height. Herbal medicine had a tendency to become popularized in treatments for height. Students generally did not judge their friends by height, but there was a small tendency to ignore shorter friends and to feel a sense of inferiority around taller friends. Most students had a greater desire to have a beautiful face than a good body, especially to be tall. Most students thought that there would be some handicaps in life if they had a short stature. CONCLUSION: The attitudes and concerns about height in adolescence should be understood, and recognized as one aspect of treatment for problems associated with height.
Adolescent ; Friends ; Herbal Medicine ; Humans ; Surveys and Questionnaires

PURPOSE: Leptin may play an important role in the pathophysiology of osteoarthritis. However, the effect of letpin on the anabolic and catabolic metabolisms in chondrocytes remains unclearly elucidated. Therefore, the purpose of this study was to investigate the effect of leptin on proliferation, anabolic and catabolic metabolism of chondrocyte using ATDC5 chondrogenic cell line. MATERIALS AND METHODS: The effects of leptin on chodnrocyte proliferation, anabolic and catabolic meatabolism were examined in ATDC5 cells treated with leptin at varying concentrations(10, 100, 300, 600 ng/ml) for 24, 48, and 72 hours. The cell proliferation was evaluated by MTT assay. The anabolic and catabolic activities were assayed by RT-PCR for transforming growth factor-beta(TNF-alpha), proteoglycan-4 (PRG4), type- I collagen (type- I Col) and tumor necrosis factor-beta(TNF-alpha), matrix metalloproteinase -2 (MMP-2), respectively. RESULTS: Leptin treatment did not influence cell proliferation of chondrocyte regardless of concentration. TGF-beta expression was increased until 48 hours of leptin treatment compared to controls. Especially, it was significantly increased in leptin of 10 ng/ml and 100 ng/ml (P<0.05). PRG4 expression was not different between letpin treatment and controls. Type-I Col expression was decreased in dose- and time-dependent manner. Leptin of 10ng/ml significantly inhibited MMP-2 and TNF-alpha expressions compared to controls (P<0.05). CONCLUSION: This study shows that leptin at low concentration increases TGF-beta expression, but inhibits the expression of TNF-alpha and MMP-2. Also this study shows that leptin do not affect the cell proliferation of chondrocytes. These results suggest that leptin at low or physiological level contributes to the prevention of cartilage damage by stimulating anabolic activity and inhibiting catabolic activity of chondrocyte rather than chondrocyte regeneration by increasing cell proliferation.
Cartilage ; Cell Proliferation ; Chondrocytes ; Collagen ; Leptin ; Necrosis ; Osteoarthritis ; Regeneration ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

PURPOSE: The purpose of this research is to evaluate the efficacy of early computed tomography in the diagnosis and treatment of bowel obstruction. METHODS: The medical records of 108 patients who underwent CT for clinically suspected bowel obstruction were reviewed retrospectively. We compared the emergency department (ED) stay time, the rate of emergent operation, and the days of hospital treatment between two groups. Group 1 have underwent CT within 3 hours, group 2 have done after 3 hours from arrival. RESULTS: After the abdominal CT, Mean ED stay time was shortened significantly. The mean ED stay time was 8.1 hours in Group 1 (n=58), and 18.0 hours in Group 2 (n=50). But We failed to reveal that the early CT is beneficial to emergent operation and total hospital time for bowel obstruction. CONCLUSION: In patients suspected bowel obstruction, Early CT is helpful for diagnosis, treatment and can shorten the ED stay time.
Diagnosis* ; Emergency Service, Hospital ; Humans ; Intestinal Obstruction ; Intestines ; Medical Records ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To evaluate the modified Ender nailing technique for the treatment of femoral intertrochanteric fractures in elderly patients. MATERIALS AND METHODS: 31 cases of femoral intertrochanteric fractures treated by modified Ender nailing from May 1997 to December 2004 were included in this study. We analyzed the method of the anesthesia, amount of intraoperative blood loss, operation time, number of used nail, postoperative ability of ambulation, postoperative complication, and the time for radiological union. RESULTS: 22 cases were operated under epidural anesthesia and 9 cases under general anesthesia. The average amount of intraoperative blood loss was 55 ml and average time for operation was 37 minutes. The average number of used nails were 3.1. The postoperative ambulatory ability was clinically recovered to the preoperative ambulatory ability in 23 cases, and decreased than before in 8 cases. Postoperative complications included knee joint pain or limitation of motion of the knee joint and distal migration of the nails. The average time for radiological bone union was 17.1 weeks postoperatively. CONCLUSION: The modified Ender nailing technique is the one of the proper method in elderly femoral intertrochanteric fractures with associated medical problems. This method reduce the operation time and the amount of intraoperative blood loss.
Aged ; Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Femur* ; Hip Fractures ; Humans ; Knee Joint ; Postoperative Complications ; Walking

The treatment of a thoracic aortic dissection is guided by prognostic and anatomical information. Stanford type A aortic dissection requires surgery, but the appropriate treatment of a Stanford type B aortic dissection has not been determined, especially in patients with visceral artery compromise associated with the aortic dissection due to the failure of surgery to improve the prognosis.We report a case of a 35-year-old man, with a Stanford type B aortic dissection, where the superior mesenteric artery was obstructed. This condition was successfully treated with stents inserted at the origin of the artery.
Adult ; Arteries* ; Humans ; Mesenteric Artery, Superior* ; Stents*