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

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

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

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

A case of Clement and Scully's type II uterine tumor resembling ovarian sex cord tumors (UTROSCT) occurring in a 21-year-old woman is presented. Grossly, a 10 cm-sized fundic myometrial tumor, which was projecting into the endometrial cavity, was excised. Histologically, most parts of tumor showed the morphology of sex cord-like differentiation, including solid anastomosing cords or tubules, solid nests, and trabeculae arranged in a plexiform pattern. The sex cord elements were studied immunohistochemically with markers of sex cord, steroid cell differentiation (inhibin, O13, and A103), or both. The tumor cells were found to be diffusely immunoreactive for O13 (MIC2, CD99) and very focally positive for inhibin. There were also constant immunoreactivity for vimentin and hormone receptors and relatively rare positivity for desmin, actin, and cytokeratin. These findings provide strong evidence for the presence of true sex cord elements, the derivation of which seems to derive from the capacity for divergent differentiation of uterine stroma. This report demonstrates immunohistochemically true sex cord differentiation in UTROSCT.
Actins ; Cell Differentiation ; Desmin ; Female ; Humans ; Inhibins ; Keratins ; Vimentin ; Young Adult*

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

PURPOSE: This study was done to evaluate postoperative patient satisfaction, vaginal bleeding, and sexual function in women after laparoscopic supracervical hysterectomy (LSH). METHODS: A retrospective study was conducted using a questionnaire mailed to 131 women who underwent LSH between 2008 and 2011at the Department of Obstetrics &Gynecology, D University Hospital in Chungnam province. Indication for LSH was uterine myoma. The questionnaire contained questions on overall postoperative satisfaction, influence on quality of life of vaginal bleeding, and sexual satisfaction following surgery. Data were collected from March to July 2013 and 109 (83.2%) patients returned the questionnaire. RESULTS: Most women reported being very satisfied (90.8%) or satisfied (7.3%), but 2 women (1.8%) were not satisfied with LSH. Four patients (3.4%) reported experiencing vaginal bleeding but with no negative influence on quality of life. Of sexually active women, 82 patients (90.1%) reported improvements in sexual function, 8 patients (8.8%) reported "no change", and one patient (1.1%) reported a deterioration. CONCLUSION: Results of this study indicate that LSH is associated with a high degree of patient satisfaction, no negative influence on quality of life from vaginal bleeding, and improvement in sexual function to a minimum 2 years after the procedure.
Chungcheongnam-do ; Female ; Humans ; Hysterectomy* ; Leiomyoma ; Obstetrics ; Patient Satisfaction* ; Postal Service ; Quality of Life ; Questionnaires ; Retrospective Studies ; Uterine Hemorrhage*