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.
Nails

During the last 18 years only a small number of successful replantation of lower extremities severed by trauma have been reported. In this paper we report the first successful case of replantation of completely amputated thigh In Korean literature. A 31-year-old man was admitted to Kyung Hee Unlversity Hospital on February 27th 1976, approximately 1 hour after accident in which the left thigh was completely amputated 15 cm above the knee joint. Circulation was restored 6 hours after amputation through anastomosis of the femoral vein, artery, great saphenous vein, profunda femoris artery and vein. The continuity of sciatic nerve was reestablished by secondary furnicular suture 7 week after injury. About 4 years and 7 months after injury the patient could walk without pain and returned to his occupation. Thre was a almost complete return of motor and sensory function of the posterior tibial nerve.
Adult ; Amputation ; Arteries ; Femoral Vein ; Humans ; Knee Joint ; Lower Extremity ; Microsurgery ; Occupations ; Replantation ; Saphenous Vein ; Sciatic Nerve ; Sensation ; Sutures ; Thigh ; Tibial Nerve ; Veins

The PCL is the strongest ligament in the knee joint. And it gives the posterior stability to the knee joint and act on rotation of knee joint. The many authors reported the surgical approaches for PCL. But none of them was satisfactory for exposure for PCL. Authors report the approach for repair and reconstruction on PCL injury The purpose of this report is to get the more satisfactory exposure of operation field for anatomical repair of injuried PCL. 1. PCL injury combined with MCL injury. a) MCL injury at its femoral attachment area. Detach the injuried MCL from femoral attachment completely, continue with anteromedial incision, and can observe both femoral and tibial attachment of PCL and ACL. b) MCL injury at its tibial attachment area. Retract the injuried MCL, medial meniscus, joint capsule superiorly, and through between medial meniscus and tibial proximal protion, also can observe the tivial attachment of PCL. 2. Isolated PCL injury. a) at tibial attachment(avulsion fracture) Through posterior approach or straight anteromedial approach, incised the posteromedial joint capsule, and can observed the tibial attachment of PCL. b) at substance level. Detach the MCL from its femoral attachment with bone-block and apply the knee valgus force. And can observe the entire length of PCL. Also reinforce the repaired site of PCL by reconstruction using a semitendinosus tendon.
Joint Capsule ; Knee Joint ; Knee ; Ligaments ; Menisci, Tibial ; Posterior Cruciate Ligament ; Tendons

The authors performed a study of 32 patients who had undergone anterior lumbar interbody fusion using allograft with posterior pedicular instrumentation. The clinical outcomes were evaluated and the radiographs were analyzed with respect to graft subsidence, interspace collapse, graft collapse, sagittal angle and fusion status. In 71% of the levels there was a loss of disc space height during the follow-up, with 18% of the levels being narrower than their preoperative height at late follow-up. Significant(more than 3mm) subsidence and collapse were noted in three and four levels respectively. Approximately 84% of the 32 patients had satisfactory results and a radiological fusion was obtained in 88.2% of the 34 levels. We consider the pedicle screw fixation improves the retention of interspace distraction and the fusion rate of allograft in anterior lumbar interbody fusion.
Allografts* ; Follow-Up Studies ; Humans ; Spine ; Transplants

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

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

OBJECTIVE: The object of this study is to determine whether there is any association between birth to placenta weight ratio and oxidative stress. 34 pregnant women (who gave birth after 36 weeks of pregnancy by cesarean section without labor) were divided into three groups according to their birth to placenta weight ratio. The degree of lipid peroxidation in the placenta and the activity of superoxide dismutase which removes peroxide products were compared in three groups METHODS: In the 34 women who gave birth through cesarean section before labor, we classified the patients to three groups ; the first group (n=13) women whose birth to placenta weight ratio was equal to or above 5.0. The second group (n=14) whose ratio was between 4.3 and 5.0. The third group (n=7) whose ratio was less than 4.3. We measured malondialdehyde (MDA) as a indicative marker of lipid peroxidation through a Thibarbituric Acid (TBA) method, and the activity of superoxide dismutase (SOD) as a antioxidant defense system through a Bioxytech SOD-525 kit (OxisResearch, USA). Data were analyzed statistically using ANOVA test (SPSS for Windows 10.0) and students's t-test. RESULTS: In a group consisting of preeclampsia and FGR, the birth to placenta weight ratio had no significant difference. The mean MDA concentration of group 1 was 7.38+/-6.6 nmole/mg protein, which was significantly lower than both mean of group 2 (17.39+/-12.54 nmole/ mg protein) and group 3 (19.89+/-8.69 nmole/mg protein), There were no significant differences between group 2 and 3. The MDA/SOD ratio of group 1 was 1.01+/-0.97, which was significantly lower than those of group 2 and 3, which were 2.79+/-2.92 and 3.29+/-2.18, respectively. However, there were no significant differences between group 2 and 3. CONCLUSIONS: It is possible to assume that oxidative stress participates in the mechanism of decreased birth to placental weight ratio. Th decreased ratio is probably due to excessive lipid peroxides in placenta. To evaluate the association of birth to placental weight ratio with oxidative stress.
Cesarean Section ; Female ; Humans ; Lipid Peroxidation ; Lipid Peroxides ; Malondialdehyde ; Oxidative Stress ; Parturition ; Placenta ; Pre-Eclampsia ; Pregnancy ; Pregnant Women ; Superoxide Dismutase ; Superoxides

OBJECTIVE: To compare the clinical results between laparoscopic assisted vaginal hysterectomy (LAVH) and laparoscopic supracervical hysterectomy (LSH) in women with uterine leiomyoma. METHODS: One hundred four women underwent laparoscopic hysterectomy for the treatment of uterine leiomyoma between July 2008 and December 2009. A total of 60 women decided to undergo complete hysterectomy with removal of uterine cervix (LAVH group) and 44 women wished to preserve the uterine cervix (LSH group). Outcome measures including patient's characteristics, operating time, blood loss, rate of complications, were assessed and compared between groups. RESULTS: The women in the LAVH group were significantly older as compared with the LSH group, 45.16+/-0.84 years versus 42.41+/-0.62 years respectively. There were no significant differences in patient's characteristics (body mass index, parity, prior surgery) between the two groups. The mean operating time was 64.07+/-2.37 min. for LAVH group and 69.76+/-2.01 min. for LSH group; the mean hemoglobin change was 1.62+/-0.13 g/dL for LAVH group, 1.83+/-0.14 g/dL for LSH group, no significant differences were noted between two groups respect to the mean operating time and the mean hemoglobin change. There is no post-operative complications in both LAVH and LSH group. CONCLUSION: Based on our results, in women with uterine leiomyoma, LAVH and LSH seem to be the preferred hysterectomy techniques. The mean age was younger in LSH group, but did not appear to offer any significant benefits over LAVH. LAVH proved to be a valid alternative to LSH, and appropriate method for laparoscopic hysterectomy.
Cervix Uteri ; Female ; Hemoglobins ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Leiomyoma ; Outcome Assessment (Health Care) ; Parity

OBJECTIVE: To report our clinical outcome on 160 cases of laparoscopically assisted vaginal hysterectomy (LAVH) and to evaluate the efficacy and safety of LAVH. METHODS: From May, 1998 to April 2004, 160 patients were performed LAVH at the Department of Obstetrics and Gynecology, Dankook University Hospital. We retrospectively analyzed the results with regard to age, parity, height, weight, previous operation history, preoperative indication, combined operation, operation time, uterine weight, change of hemoglobin, hospitalization, convert to total abdominal hysterectomy (TAH), and complication. RESULTS: The mean age was 44.63 +/- 6.79 years, The mean parity was 2.34 +/- 1.18. The common previous operations were tubal ligation (54%) and appendectomy (17%). The common preoperative indications were myoma (75%) and adenomyosis (10%). The most common combined operation was unilateral salpingoophorectomy (39%). The mean operation time was 97.81 +/- 29.90 minutes, and the mean uterine weight was 215.59 +/- 89.97 g. The mean hemoglobin change was 2.08 +/- 1.34 g/dL, and the mean hospitalization was 4.45 +/- 0.71 days. The complications were bladder injury (1 case), rectum injury (1 case), subcutaneous hematoma (2 cases), hemoperitoneum (1 case). CONCLUSION: LAVH is effective and safe alternative to TAH in many cases of gynecologic surgery. LAVH has been possible to replace TAH with improvement of surgical skill and laparoscopic instruments.
Adenomyosis ; Appendectomy ; Female ; Gynecologic Surgical Procedures ; Gynecology ; Hematoma ; Hemoperitoneum ; Hospitalization ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Myoma ; Obstetrics ; Parity ; Rectum ; Retrospective Studies ; Sterilization, Tubal ; Urinary Bladder