A study was made on 50 cases of epileptic children who had been observed at the pediatric department of Chungnam National University Hospital Taejeon Eul Ji Hospital during the period from July, 1986 to June, 1991. The result are as follows: 1) Epilepsy was most frequent in children from 1 year to 10 year of age (80%). Epilepsy was commoner in female children compare to male representing male to female ratio, 1:1.2. 2) Intractable cases with VPA were 40%, and male to female ratio was 1.2:1. Intractable cases were most common between 1 and 5 years (65%). 3) The most common epileptic type was generalized tonic clonic seizure (38%). 4) The clinical effect of valproic acid was the worst in severely abnormal EEG finding. 5) The mean plasma VPA level was significantly lower for the polytherapy (57.7microgram/ml) than for the monotherapy (69.5microgram/ml). The VPA dose of steady-state was significantly higher for polytherapy (27.9mg/kg/d) than for the monotherapy (20.9mg/kg/d). VPA level: dose ratio was reduced in the polytherapy (2.1) as compared to monotherapy (3.3). 6) The plasma VPA level increased according to dosage. In the same dose, plasma level of monotherapy was significantly higher than polytherapy. 7) The VPA dose of stead-state was highest under 1 year (monotherapy: 24.8mg/kg/day, polytherapy: 33.4mg/kg/day). The VPA dose decreased in accordance with an increase of the age. 8) There was no correlation between EEG change and plasma concentration of VPA. 9) There was linear correlation between clinical affect and plasma VPA level, and plasma concentration of VPA reached 51 to 100microgram/ml at that time. 10) The clinical effect was good in abscence seizure, simple partial seizure, myoclonic seizure, and generalized tonic clonic seizure in decreasing order. 11) The incidence of side effect were gastrointestinal disturbance, behavior disorder, laboratory abnormality, neurologic abnormality in order of frequency. The frequency of overall side effects observed was 40% but toxic effects were generally mild.
Child* ; Chungcheongnam-do ; Daejeon ; Electroencephalography ; Epilepsy ; Female ; Humans ; Incidence ; Male ; Plasma ; Seizures ; Valproic Acid*

No abstract available.

No abstract available.

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

PURPOSE: Occupational stress can have a negative effect on the worker such as physical, emotional, and psychological health. Although it is well reported that health service staff tend to have a high level of minor psychiatric disorder, only a few studies have been reported in Korea. Intern and Residency (residents) are very vulnerable periods of stress and other psychiatric disorders. In this study, we describe occupational stress of interns and residents and relationship between occupational stress and depression. METHODS: The participants of this study were interns and residents trained in a tertiary hospital in Korea. The occupational stress scale was used for measurement of occupational stress. In addition, the Korean version of the Beck depression scale was used to evaluate the prevalence of depression. Statistical analyses were performed using SPSS v. 18.0; p-value less than 0.05 was considered statistically significant. RESULTS: Female doctors showed higher occupational stress than male. Interns and chief residents demonstrated higher occupational stress than other grades. Astonishingly, most participants showed depressive mood. Compared with the general population, job demand and culture of the workplace are in the first upper quartile. It is indicated that compared with general populations, physicians have a higher workload and patience is required in order to cope with the harsh culture of the workplace. Depressive mood was evaluated with various factors and only occupational stress was statistically significant. CONCLUSION: Overwhelming occupational stress of residents could result in both medical and social problems. Therefore, recognition of occupational stress is essential and aggressive interventions are required.
Burnout, Professional ; Depression ; Female ; Health Services ; Humans ; Internship and Residency ; Korea* ; Male ; Prevalence ; Seoul* ; Social Problems ; Tertiary Care Centers*

OBJECTIVE: To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH). METHOD: 60 of LAVH cases and 60 of TAH cases, which were performed at Dankook university hospital from April 1998 to December 2000. We analyzed the results with regard to patient's characteristics, indication of hysterectomy, weight of uterus, operation time, blood loss, hospital stay and complications. RESULTS: Total 120 of hysterectomy cases (60 LAVH, 60 TAH) were enrolled in this study. All operations, LAVH and TAH, were performed by same surgeon. There were no significant differences in patient's characteristics (age, height, weight, parity) between the two groups. The main preoperative indication was myoma uteri, followed by adenomyosis, CIN III, for both LAVH and TAH. The mean uterine weight of TAH cases was larger than LAVH (214.8+/-88.1 gm for LAVH, 377.1+/-269.0 gm for TAH, p<0.05) cases. The operation time was longer in LAVH operation (114.3+/-31.4 min for LAVH, 93.7+/-30.2 min for TAH, p<0.05). The blood loss was not significantly different between the two groups (185.5+/-53.3 ml for LAVH, 205.8+/-65.8 ml for TAH, p>0.05). The hospital stay of LAVH was significantly shorter than TAH (4.9+/-0.6day for LAVH, 7.5+/-1.9day for TAH, p<0.05). CONCLUSION: In the comparison of LAVH and TAH operation, we conclude that LAVH can be considered as the first choice when determining hysterectomy method, unless contraindication prevents it. LAVH has advantages of shorter hospitalization and the acceptable complication rate.
Adenomyosis ; Female ; Hospitalization ; Hysterectomy* ; Hysterectomy, Vaginal* ; Length of Stay ; Myoma ; Uterus

OBJECTIVE: This study was designed to determine the clinical significance of serum CA 125 and CA 19-9 levels in preoperative differential diagnosis of benign ovarian tumors. METHODS: 104 patients who visited the department of Obstetrics and Gynecology of Dankook University Hospital from February 1999 to December 2001, and who were diagnosed as adnexal mass and underwent surgery, and free of other medical diseases, were enrolled as subjects. An analysis of preoperative serum CA 125, CA 19-9 levels of patients was performed in correlation with the postoperative histologic diagnoses. The histologic diagnoses were grouped as mature cystic teratoma, endometrioma, mucinous cystadenoma, serous cystadenoma, benign cystic tumor group, adnexal inflammatory disease group. Study group was defined as endometrioma, adnexal inflammatory disease in CA 125, and mature cystic teratoma, endometrioma in CA 19-9, and the others were defined as control group. Statistical analysis with Chi square test was done on the number of cases who showed CA 125 or CA 19-9 increment over cut off value between study group and control group. Study group was compared with control group in the mean value of serum tumor marker level and the mean value of elevated serum tumor marker level over cut off value. RESULTS: The number of cases who showed serum CA 125 increment over cut off value (35 U/ml) was significantly higher in endometrioma and adnexal inflammatory disease group (p<0.05), and the number of cases who showed serum CA 19-9 increment over cut off value (37 U/ml) was significantly higher in endometrioma and mature cystic teratoma group (p<0.05). The mean value of serum tumor marker level and the mean value of elevated serum tumor marker level over cut off value in those groups showed no significant difference in comparison with those of the other groups. CONCLUSION: In this study, increment of CA 19-9 in endometrioma and CA 125 and CA 19-9 in mature cystic teratoma showed statistically significant higher frequency than other groups. We concluded that checking the preoperative serum level of CA 125 and CA 19-9, combined with transvaginal ultrasonography, may be helpful in differential diagnosis of benign ovarian tumors and in discriminating benign ovarian tumors from malignant ovarian tumors, if any other condition that may cause serum level elevation of CA 125 and CA 19-9 is excluded.
Cystadenoma, Mucinous ; Cystadenoma, Serous ; Diagnosis ; Diagnosis, Differential ; Endometriosis ; Female ; Gynecology ; Humans ; Obstetrics ; Teratoma ; Biomarkers, Tumor* ; Ultrasonography

Varicocele has been implicated as a cause of infertility in adult men, but little has been known on the significance of varicocele in adolescents. We created experimental varicoceles by partial ligation of the left renal vein in rats at 4 weeks, 7 weeks and 12 weeks of age to understand the effects of varicocele on testis in different stages of development ; preadolescence, adolescence and adulthood. Effects of varicocele on testis were studied with observation of the changes of testicular weights and testicular histology 4 weeks and 8 weeks after creation of varicocele. The experimental groups in which varicoceles were induced at 4 weeks and 12 weeks of age showed minimal testicular weight changes and minimal histologic changes. The experimental group of 7 weeks of age showed the marked changes on testis ; mean weight of the left testis was significantly reduced in experimental group (1.03+/-0.31) compared with control group (1.51+/-0.12g) (p<0,05). Histologic changes such as degeneration of germinal epithelium, tubular atrophy, Sertoli cell hyperplasia and interstitial edema were more frequently observed in this group. We measured the mean seminiferous tubular diameter as a means of quantitative evaluation of spermatogenesis and found it decreased significantly in this group (219+/-37 micrometer) compared with control group (270+/-141 micrometer) (p<0.05). Above results suggest that varicocele which occurred in adolescence has the most damaging effects on testis.
Adolescent* ; Adult ; Animals ; Atrophy ; Edema ; Epithelium ; Evaluation Studies as Topic ; Humans ; Hyperplasia ; Infertility ; Ligation ; Male ; Rats* ; Renal Veins ; Spermatogenesis ; Testis* ; Varicocele* ; Weights and Measures

Reviewing the radiologic studies of the 402 patients with infravesical obstructive lesions, we studied the pattern of upper urinary tract change in children and adults. The following results were obtained. 1. The upper tract dilatation was shown in 68 patients : 9 of 11 posterior urethral valve patients(82 percent), 22 of 280 benign prostatic hyperplasia patients(7.9 percent), 11 of 57 urethral stricture patients(19 percent), 26 of 54 neurogenic bladder patients(48 per cent). 2. Upper tract dilatation in infravesical obstructive diseases occurred on one side in 32 percent of the cases : 24 percent in children and 38 percent in adults. 3. Of 68 patients with upper tract dilatation, 40 patients had voiding cystourethrography. Vesicoureteral reflux was observed in 30 of 69 dilated kidney units : 25 of 49 kidney units (51 percent) in children and 5 of 20 kidney units(25 percent) in adults. Vesicoureteral reflux was more frequently occurred in children than in adults.
Adult ; Child ; Dilatation ; Humans ; Kidney ; Prostatic Hyperplasia ; Urethral Stricture ; Urinary Bladder, Neurogenic ; Urinary Tract* ; Vesico-Ureteral Reflux

No abstract available.
Tuberculosis* ; Tuberculosis, Lymph Node*