BACKGROUND: Juvenile myoclonic epilepsy(JME) is the most common idiopathic generalized epileptic syndrome which occurs mostly in the second decade of life. It is still frequently unrecognized and misdiagnosed. JME responds well to valproate, but is hardly controlled by other commonly used antiepileptic drug such as carbamazepine or phenytoin. We intended to Investigate the clinical symptoms and EEG findings of JME to support the diagnosis and treatment of JME. SUBJECTS AND METHODS: We retrospectively reviewed the medical record of 18 childrens with JME, from March 1991 to February 1997 We have analysed the clinical symptoms, seizure type, EEG findings including photosensitivity, and the effect of antiepileptic drug. RESULTS: 1) Seven patients were boys and eleven patients were girls(M : F=1 : 1.6). The seizure onset between 5 and 7 years of age were noted in 5 cases, that between 8 and 10 years in 5 cases, and in 8 cases seizures began after 11 years of age 2) Generalized convulsive seizures were noted in 16 cases(GTC 13, GC 2, GCTC 1), myoclonic seizures in 18 cases, absence seizures in 5 cases, and photoconvulsive seizures during video game were associated in 3 cases. 3) Epileptiform discharges at the diagnosis of JME were noted 12 cases(66.7%), and no epileptiform discharges were seen in 6 cases(33.3%). The background activities were normal in all cases. In all 12 cases that showed abnormal epileptiform discharge, generalized spike and wave discharges were obtained, and photosensitivies noted in 4 cases. 4) Follow up EEG obtained after treatment, showed normal EEG findings in 16 cases, and abnormal EEG findings were obtained in 2 cases. 5) Sixteen cases responded well to valproate monotherapy, and 2 other cases responded to valproate and ethosuximide combined therapy. In one case who received vigabatrin, the seizure was aggravated. 6) In 5 cases who discontinued antiepicoptic drug medication after 3 year seizure free duration, 3(60%) cases relapsed within 1 year, and 2(40%) cases remained seizure free for over 1 year. CONCLUSION: Juvenile myoclonic epilepsy is an epileptic syndrome with generalized convulsive seizure, myoclonic seizure, and absence seizure, and EEG findings showed generalized spike and wave discharge in 66.7%, and photosensitivity in 22.2%. JME responded well to valproate monotherapy or valproate and ethosuximide combined the rape, but not responded to other antiepileptic drugs.
Anticonvulsants ; Carbamazepine ; Child ; Diagnosis ; Electroencephalography ; Epilepsy, Absence ; Ethosuximide ; Follow-Up Studies ; Humans ; Medical Records ; Myoclonic Epilepsy, Juvenile* ; Phenytoin ; Rape ; Retrospective Studies ; Seizures ; Valproic Acid ; Video Games ; Vigabatrin

Burns is children result in the loss of precious life, or if the child survives, in much suffering from physical, emotional, social, and economic problems. These burn accidents to children happen in the bustle of family life and frequently without any warning. With this background information, this study was designed to identity types of burns in children and mother's attitudes towards, and knowledge of burn prevention, in order, to not only, in still a safety consciousness regarding the seriousness of burn accidents and the strengthening prevention, but also as basic data towards the development of an educational program aimed at prevention. From May 1 to May 25 in 1997, data were collected from the mothers of children attending five day care centers and kindergartens located in Seoul, which had been selected for the study. The tools used for the study, which were developed by the researchers, surveyed the type of burns suffered by children, mother's knowledge of burns and attitudes toward burn accidents. The data were analyzed through real numbers percentages and analysis was done using SPSS computer programs. The results of the study show that the most frequent type of burn accidents were those caused by hot water(55.4%) and these were frequently related to everyday habits that easily lead to danger. Further, the first aid treatment following a burn was weak. The majority of the mothers had not instructed their children on who to contact in the cape of a fire, first aid for burns, or how to take escape in the case of a fire. This left the children in a defenseless position in case of a fire. The mothers showed a lack knowledge, on what to do when a blaze is discovered, how to put out a fire, first aid for burns, escaping from a fire and appropriate water temperature, in that 50% of the time they answered incorrectly. From this study a prevention program, HIPP(Home Injury Prevention Program) could be developed that includes fire prevention habits and first aid for burns. This program can be used with kindergarten and elementary school children for group education fire prevention and can be used as a foundation for construction of a system of facilities and equipment to prevent fires and also prevent injury from fires.
Burns* ; Child* ; Consciousness ; Day Care, Medical ; Education ; Fires ; First Aid ; Humans ; Mothers ; Seoul ; United Nations ; Water ; Child Health

Serum creatine phosphokinase(CPK) levels were measured serially in 20 adults with closed tibial shaft fractures, CPK activity increased significantly after fracture(p < 0.01). High energy and delayed healing fractures had significantly higher levels of CPK than low energy and normally healing fractures, respectively. Thus, CPK determinations could be used to assess the severity of trauma and possible prognosis of the healing in tibial shaft fractures.
Adult ; Creatine Kinase ; Creatine ; Humans ; Prognosis

This study was carried out to clarify the effect of dietary calcium, casein, and suet on the accumulation of cadmium in mice. It was performed for 30 days, from April 11 to May 10 1988. 90 mice were divided into 4 experimental groups and control group with 6 mice each dietary group, and measured survival rate, body weight, and weight ratio of organ to body. The contents of cadmium in liver, kidney, spleen, muscle and skin with hair, and faces were analyzed by atomic absorption spectrophotometer after sacrifice by anesthesia. After 30 days, the survival rate of control group was 100%, but 66.7% in group IV(basal+Cd+Ca) with single dose of 100 microgram cadmium and with free-intake of water containing 50ppm cadmium, and group V(basal diet+Cd+suet) with free-intake of water containing 50ppm cadmium. The rate of weight gain in the case of single dose of 100 microgram cadmium was highest in group IV as 42.3% and lowest in group V as 26.0%, whereas in the cases of free intake group IV was highest as 24.0% and group II(basal diet+Cd) was lowest as 11.6%. The body weight, in the case of single dose of 100 microgram cadmium showed no increase until 5th day after acute poisoning. But in the case of free intake group, it showed very increase through all the breeding period. The weight ratio of organ to body were lowest in the liver of group II in both occasions. The most of cadmium administered were excreted through feces within 2 days after single dose of 100 microgram cadmium. The contents of cadmium in each group were significantly higher than those of control group. In the liver, kidney, spleen and muscle, group II showed the highest level in both occasions of 100 microgram single dose and free intake of water containing 50ppm cadmium. In the skin with hair, group II of the occasion with single dose of 100 microgram and group V with free intake showed the highest level. And the contents of cadmium in tissue were markedly higher in the occasion of free intake of water containing 50ppm cadmium. From the above results I would conclude that the addition of casein and calcium are effective in the inhibition of intension absorption of cadmium esp. by calcium.
Absorption ; Anesthesia ; Animals ; Body Weight ; Breeding ; Cadmium* ; Calcium ; Calcium, Dietary* ; Caseins* ; Feces ; Hair ; Kidney ; Liver ; Mice* ; Poisoning ; Skin ; Spleen ; Survival Rate ; Water ; Weight Gain

This study was designed to validate the usefulness of the near point of convergence(NPC)test in determination of dominant & non-domnant eyes in intermittent exotropia patients. We performed NPC test in 36 intermittent exotrpic patients, and then, determined the non-dominant eye which deviated outward beyond the NPC. The dominant eyes determined by the NPC were compared to those that were determined by amblyopia, sensory fusion and photophobia. Best corrected visual acuity was used to divide patients into two groups : 26 patients without amblyopia, and 10 with amblyopia. Among the amblyopia group, if the eyes with better visual acuity were taken as dominant eyes, then eight(80%)cases were identical with the NPC test and two(20%)cases were different. Ten patients had sensory anomaly, and among then, nine(90%)cases were identical with the NPC test and one(10%)case was different. Twenty six(64%)patients had photophobia in one eye and all(100%)cases were identical with the NPC test. In intermittent exotropia, determination of dominant eye by the NPC test showed high coincidence with other tests. Therefore, we suggest that the NPC test is an easy and accurate method in determining either the dominant or non-dominant eye for surgery.
Amblyopia ; Dominance, Ocular* ; Exotropia* ; Humans ; Photophobia ; Visual Acuity

In order to understand the role of mec regulator genes in the evolution of methicillin-resistant S. aureus (MRSA), the distribution of the mec regulator genes among the 66 clinical isolates of MRSA was analysed. And also the correlation between gene mutation and degree of phenotypic expression of resistance was studied. Fifty strains carried whole mec regulator region, while the mecI gene and nearly half of the 3'-end of the mecR#l gene were deleted in fifteen strains. The mecRl MS gene was detected among all of the mecA carried strains, but the mecRl PB gene was carried by 77% of the MRSA strains. At least a portion of the 5'-end region of the mecRl gene was carried by all MRSA strains tested. Forty-seven strains were finally confirmed to have mecI gene and each mecI gene of above strains was sequenced for identification of the relationship between repressor function of mecI gene on mecA transcription and MIC level of methicillin. Point mutations were detected in 11 strains of 47 strains. In 8 strains, there was one nucleotide substitution (C to T at position 202) that produced a new termination codon at position 201. In 3 strains, one nucleotide substitution from G to T at position 43 caused an amino acid substitution from Val to Phe. The MIC of methicillin of strains carrying mutated mecI genes ranged 256 ug/ ml to 1024 ug/ml. Transcription level of amplified cDNA corresponding to mecA was determined by the method of RT-PCR of extracted RNA. Total RNA was extracted from two strains with mutated mecI gene and a strain with intact mecI gene. Deletional loss or the mutational inactivation of the mecI gene did not affect the level of mecA transcription. Role of mecI gene as a strong repressor function on mecA gene seemed to be skeptical.
Amino Acid Substitution ; Codon, Terminator ; DNA, Complementary ; Genes, Regulator* ; Methicillin Resistance ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Point Mutation ; RNA

Malignant mixed mesodermal tumor (MMMT) of the ovary is endometrioid tumor containing epithelial and mesenchymal components. The mesenchymal component may be homologous, in which case the term carcinosarcoma is often used, or heterologous, containing cartilage, striated muscle, osteoid, bone, or fat, or combination of these elements. MMMT usually afflicts the postmenopausal woman and occurs more often in the nulliparous female. The disease is usually advanced (stage III) when diagnosed. Cliniopathologic data were presented for 3 cases of MMMT of the ovary with review of literatures. Clinical history substantiated previous reports in postmenopausal women wit this tumor. Symptoms were the same as for ovarian malignancy in general. All the patients presented wit stage II disease, according to the International Federation fo Gynecology and Obstetrics (FIGO) classification. Two patients died of tumor 4 and 10 months after operation, respectively. One patient had been alive at 2 months after operation. None of 3 cases demonstrate evidence of endometriosis in the remaining ovaries. Microscopically, periodic acid-Schiff (PAS)-positive, diastase-resistant hyaline droplets were found frequently in undifferentiated mesenchymal stroma and epithelial structures. The clinical significance and origin of the hyaline droplets in MMMT should be further explored.
Female ; Humans

A case of desmoplastic fibroma of mandible in a 18 years old woman is presented. She had complained progressive swelling of right mandible for 4 years. Radiographically, a multilocular radiolucent of right hemimandibulectomy showed multinodular external surface without cortical destruction. Cut surfaces revealed grayish white, fibrous homogeneous appearance with firm consistency, sparing head portion. The maximum diameter of the tumor was 13 cm. Microscopically, the tumor was composed of interlacing bundles of monomorphic spindle-shaped cells with abundant intercellular collagen. Ultrastructurally, most tumor cells were fibroblastic-like cells with abundant RER and cytoplasmic fibrils, but a few disclosed transition to myofibroblasts. However, no fully developed myofibroblasts were seen.
Female ; Humans

A case of desmoplastic fibroma of mandible in a 18 years old woman is presented. She had complained progressive swelling of right mandible for 4 years. Radiographically, a multilocular radiolucent of right hemimandibulectomy showed multinodular external surface without cortical destruction. Cut surfaces revealed grayish white, fibrous homogeneous appearance with firm consistency, sparing head portion. The maximum diameter of the tumor was 13 cm. Microscopically, the tumor was composed of interlacing bundles of monomorphic spindle-shaped cells with abundant intercellular collagen. Ultrastructurally, most tumor cells were fibroblastic-like cells with abundant RER and cytoplasmic fibrils, but a few disclosed transition to myofibroblasts. However, no fully developed myofibroblasts were seen.
Female ; Humans

Talus is an important structure of the ankle joint and its function is critical for ambulation and weight bearing. The talus fracture is rare, but the complications of fracture and dislocation are serious and resulting in avascular necrosis, osteoarthritis. So its treatment is carefully considered at initial status. Authors reviewed 11 cases of fracture and dislocation of the talus treated at Yeungnam university hospital from 1984 to 1991. The longest follow up was 8 years and shortest, 1 years. The results were as follows. 1. There were all males, the average age was 30 years old. 2. The most common cause was fall down (8 cases), and next traffic accident (2 cases), sports injury (1 case). 3. According to Marti-Weber classification, 1 case was type I, 1 in type II, 4 in type III and 5 in type IV. 4. The method of treatment were open reduction and internal fixation in 6 cases, the others were closed reduction in 5 cases. 5. Final results (by Hawkins grading system) were as follows, 3 cases were excellent, 4 cases were good, 1 case was fair and 3 cases were poor. 6. Complications were AVN in 2 cases, degenerative arthritis in 8 cases, malunion in 1 case. 7. The range of motion of the ankle joint was relatively preserved (74%), but in the subtalar joint it was decreased (43%)
Accidents, Traffic ; Ankle Joint ; Athletic Injuries ; Classification ; Dislocations ; Follow-Up Studies ; Humans ; Male ; Methods ; Necrosis ; Osteoarthritis ; Range of Motion, Articular ; Subtalar Joint ; Talus* ; Walking ; Weight-Bearing