BACKGROUNDS: In adult, the clinical seizure characteristics of complex partial seizure(CPS) originated from temporal lobe are pretty stereotypic, and could be used as one of the important guidelines for the preoperative localization of the epileptogenic zone. Recently, surgical treatment for the intractable childhood temporal lobe seizure is frequently performed. However, most of the clinical studies to describe the seizure patterns of CPS in childhood included CPS of extratemporal lobe origin. There is still controversy about the typical pattern of temporal lobe seizure(TLS) in childhood. Therefore, we intend to investigate the clinical seizure patterns of CPS originated from temporal lobe, and the difference of seizure characteristics in different age group. SUBJECTS AND METHODS: On June 1996, 33 patients among 172 patients who presented CPS had CPS of temporal lobe origin, and were treated with antiepileptic drugs at the Pediatric Epilepsy Clinic of Ajou University Medical Center. We classified 33 patients according to age group; Group A(1-6 yr, 16 cases) and Group B(7-15 yr, 17 cases). We selected following criterias to determine CPS of temporal origin; focal spike in the temporal area with interictal or ictal EEG, mesial temporal sclerosis(MTS) or other epileptogenic lesion in the temporal area on brain MRI, and/or decreased rCBF in the temporal area on brain SPECT. We have analyzed the clinical seizure patterns with 24-48 hr Video-EEG monitoring in 3 patients, ictal EEG in 4 patients, and questionnaire or medical record in 26 patients. RESULTS: 1) Commonly observed ictal symptoms of TLS in children are versive movement(46%), motor phenomenon(42%), simple automatism(42%), complex automatism(24%), secondary generalization(21%), and dystonic posture(12%). If we analyzed the ictal symptoms of TLS according to age group, school age children showed relatively similar ictal symptom to those of adult. However, ictal symptoms in the preschool age group disclosed a significant differences to those of school age children as follows; frequent motor phenomenon(63%) and simple automatism(48%), but rarity of secondary generalization(6%) and complex automatism(0%). 2) Motor phenomenon of extremity, tonic posture, showed pretty different pattern; highly symmetric presentation in the preschool age group(78%) but always unilateral presentation in the school age group. 3) Commonly observed initial symptoms of TLS are aura(46%), behavioral arrest(30%), versive movement(12%), arousal response(9%), and motor phenomenon(3%). School age children always presented aura(70%) or behavioral arrest(24%) as an initial symptom. However, preschool age children showed variable initial symptoms as follows; behavioral arrest(37%), versive movement(19%), aura(19%), and arousal response(19%). 4) Aura was presented as initial symptom in 15 patients with TLS; visceral sensation in 7 cases, psychic symptoms in 5 cases, and cephalic symptoms in 3 cases. CONCLUSION: The clinical seizure characteristics of CPS originated from temporal lobe was similar to those of adult in the school age group, but quietly different in preschool age group. Preschool age children frequently showed behavioral arrest, versive movement, and arousal response as an initial symptom of TLS. Most frequent clinical characteristics of TLS in the preschool age group is symmetric tonic posture which we frequently observed in the frontal lobe epilepsy. Therefore, clinical seizure characteristics of CPS of temporal lobe origin could not be used as an important guideline for the preoperative localization of the epileptogenic zone in the young children.
Academic Medical Centers ; Adult ; Anticonvulsants ; Arousal ; Brain ; Child* ; Electroencephalography ; Epilepsy ; Epilepsy, Frontal Lobe ; Extremities ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Posture ; Surveys and Questionnaires ; Seizures* ; Sensation ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon

The flexor tendon injuries of the finger are very difficult to treat satisfactorily. Early treatment is desirable, but not always posaible. In addition, joint stiffness and limitation in gliding of the tendon caused by adhesion, make the problem more complex. From 1978 until 1988, 13 patients (14 eases) underwent operations for free tendon graft, and 10 patients (13 eases) for staged tendon graft at the Department of Orthopaedic Surgery, National Medieal Center. They have been followed up for clinical study, and the result was summarized as follows:1. Old flexor tendon injuries were common in the teen and twenties, especially in male. 2. They occurred in the index (10 Cases, 37.0%) and middle (8 cases, 29.6%) fingers most commony, especially zone II (62.9%). 3. The result was evalusted according to the method designed by Strickland and Glovac. In 19 out of 27 cases, satisfactory result (excellent and good) was yielded. 4. In cause, deep laceration by sharp object was better in the result than crushing injury. 5. The interval between the injury and the operation ranged from 1 month through 11 years, averaging 16 months, and is supposed to have little relation to the result. 6. The preoperative state is supposed to have much relation to postoperative result, judging from 100% of satisfactory result in Grade I compared with 40% in Grade V according to Boyes preoperative classification. 7. Little difference is seen in the result between free tendon graft and staged tendon graft. And 5 cases complicated by adhesion, rupture of grafted tendon and wound infection yielded poor result.
Adolescent ; Classification ; Clinical Study ; Fingers ; Hand ; Humans ; Joints ; Lacerations ; Male ; Methods ; Rupture ; Tendon Injuries ; Tendons ; Transplants ; Wound Infection

PURPOSE: We investigated the statistical methods to compose the functional brain map of human working memory and the principal factors that have an effect on the methods for localization. MATERIALS AND METHODS: Repeated PET scans with successive four tasks, which consist of one control and three different activation tasks, were performed on six right-handed normal volunteers for 2 minutes after bolus injections of 925 MBq H0 at the intervals of 30 minutes. Irnage data were analyzed using SPM96 (Statistical Parametric Mapping) imple-mented with Matlab (Mathworks Inc., U.S.A.). Images from the same subject were spatially registered and were normalized using linear and nonlinear transformation methods. Significant difference between control and each activation state was estimated at every voxel based on the general linear model. Differences of global counts were removed using analysis of covariance (ANCOVA) with global activity as covariate. Using the mean and variance for each condition which was adjusted using ANCOVA, t-statistics was performed on every voxel To interpret the results more easily, t-values were transformed to the standard (saussian distri-bution (Z-score). RESULTS: All the subjects carried out the activation and control tests successfully. Average rate of correct answers was 95%. The numbers of activated blobs were 4 for verbal memory I, 9 for verbal memory II, 9 for visual memory, and 6 for canjunctive activation of these three tasks. The verbal working memory activates predominantly left-sided slruetures, and the visual memory activates the right hernisphere. CONCLUSION: We conclude that rCBF PET imaging and statistical parametric mapping method were useful in the localization of the brain regions for verbal and visual working memory.
Brain Mapping* ; Brain* ; Electrons* ; Healthy Volunteers ; Humans ; Linear Models ; Memory ; Memory, Short-Term ; Positron-Emission Tomography*

No abstract available.
Osteoblasts*

No abstract available.

No abstract available.
Magnetic Resonance Imaging*

The success of Moore and Thompson endoprosthesis in arthroplasty of the hip during the past three decades has prompted their continued use with but few alterations. Recently, to reduce the intolerance of acetabular cartilage and bone to frictional shear forces, the conventional endoprosthesis was modified, so many types of bipolar arthroplasty were introduced and implanted. But, the movements of the two components and acetabular erosion are rather controversial still. Among the 51 cases of bipolar endoprosthesis those have been operated at department of orthopaedic surgery, National Medical Center from 1981 to 1986, we analysed 40 cases for acetabular erosion and 22 cases for motion study of two components under the fluoroscopy. Following results were obtained, 1. Among 40 cases, there was no true protrusio acetabuli and increased CE angle in 12 cases(30%), which were limited to cartilage. 2. Under the fluoroscopic study, we found motion at inner and outer bearing joint in 14 cases, inner bearing joint only in 6 cases and outer bearing only in 2 cases. 3. The CE angle was increased more in younger age group than older group. 4. According to indication of bipolar arthroplasty, CE angle was increased more in disease group than trauma group. 5. The CE angle was increased more in leg length discrepancy and head piece size discrepancy group than the other group. 6. The CE angle can be substituted for joint space measurement. 7. The CE angle was increased more in low Harris hip rating score group. 8. Harris hip rating score had no correlation to motion of two components.
Acetabulum ; Arthroplasty ; Cartilage ; Clinical Study ; Fluoroscopy ; Friction ; Head ; Hip ; Humans ; Joints ; Leg

PURPOSE: Cross-modality coregistration of positron emission tomography (PET) and magnetic resonance imaging (MR) could enhance the clinical information. In this study we propose a refined technique to improve the robustness of registration, and to implement more realistic visualization of the coregistered images. MATERIALS AND METHODS: Using the sinogram of PET emission scan, we extracted the robust head boundary and used boundary-enhanced PET to coregister PET with MR. The pixels having 10% of maximum pixel value were considered as the boundary of sinogram. Boundary pixel values were exchanged with maximum value of sinogram. One hundred eighty boundary points were extracted at intervals of about 2 degree using simple threshold method from each slice of MR images. Best affined transformation between the two point sets was performed using least square fitting which should minimize the sum of Euclidean distance between the point sets. We reduced calculation time using pre-defined distance map. Finally we developed an automatic coregistration program using this boundary detection and surface matching technique. We designed a new weighted normalization technique to display the coregistered PET and MR images simultaneously. RESULTS: Using our newly developed method, robust extraction of head boundary was possible and spatial regishation was successfully performed. Mean displacement error was less than 2.0mm. In visualization of coregistered images using weighted normalization method, structures shown in MR image could be realistically represented. CONCLUSION: Our refined technique could practically enhance the performance of automated three dimensional coregistration.
Brain* ; Head ; Magnetic Resonance Imaging ; Positron-Emission Tomography

A giant hydronephrosis caused by ureteropelvic junction stricture in a 16-month-old male infant was presented. After the size and volume of giant hydronephrosis were estimated by retrograde pyelography, nephrectomy was performed. We report this case with review of literatures.
Constriction, Pathologic ; Humans ; Hydronephrosis* ; Infant ; Male ; Nephrectomy ; Urography

The deformity of hallux valgus is associated with three hasic prohlems: a prominent rnedial eminence, contracted soft-tissue structures on the lateral side of the great toe, and an altered intermetatarsal angle between the first and second metatarsal. We retrospectively have reviewed the results for thirty-one patients(47 feet) in whom a hallux vaigus deformity had heen conected with the release of the distal soft tissues, excision of the medial eminence, plication of the medial part of the capsule, and proximal crescentic osteotomy of the first metatarsal. The patients were followed for an average of twenty months(range, twelve to twenty-eight months). There were nine cases with mild defoimity, twenty-nine cases with moderate deformity, nine cases with severe deformity. The preoperative hallux valgus angle averaged 38.1 degrees, and the immediate postoperative angle averaged 6.7 degrees. The preoperative intermetatarsal angle averaged 17.1 degrees, and the immediate postoperative angle, 7.6 degrees. At the latest follow-up, the hallux valgus angle averaged 19.3 degrees, the intermetatarsal angle averaged 9.9 degrees. We found that the more the deformity, the lesser the congruency. 74.5% of the patients were satisfied with the result of the procedure. They stated that, eiven the same circumstances, they would have the operation again. The most common complication was recurrence of the nallux valgus, which occurred in nine feet(five patients). The other complications included pain under a fibular sesamoid in one foot, severe hypoesthesia on the medial aspect ot the big toe in one foot, and superficial wound infection in one foot.
Congenital Abnormalities ; Follow-Up Studies ; Foot ; Hallux Valgus* ; Hallux* ; Humans ; Hypesthesia ; Metatarsal Bones* ; Osteotomy* ; Recurrence ; Retrospective Studies ; Toes ; Wound Infection