PURPOSE: Beginning in the eighth week of fetal life the neuroblasts migrate from the midline to the periphery to form the gray matter of the cerebral cortex. Abnormalities of cell migration are characterized by ectopic location of neurons in the cerebral cortex. This broad group of anomalies include lissencephaly, schizencephaly, cortical dysplasia, gray matter heterotopia, and unilateral hemimegalencephaly. The purpose of this study was to correlate clinical data with anatomic data, which was evaluated by brain magnetic resonance imaging characteristics that are most useful in predicting clinical METHODS: The clinical records, EEG, and MRI findings of 20 patients with neuronal migration disorders were retrospectively reviewed. RESULTS: The 20 patients with neuronal migration disorders consisted of 11 with lissencephaly, 7 with cortical dysplasia, 2 with heterotopia, and 2 with schizencephaly. Clinically, seizure was the most common symptom in 85%, next developmental delay in 50%, and then delayed speech in 25%, motor deficit 15% in order. The main associated brain anomalies included absence of septum pellucidum in 20%, periventricular leukomalacia in 15%, and corpus callosal agenesis in 15% of Patients. Bilateral involvement of lesion in MRI was 60%, comparing to unilateral lesion in 40% of the patients. The most common involved lobes was frontoparietal region. An abnormality of EEG examination was showed in 11 cases of patients(68.7%). Patients with diffuse, bilateral lesion in MRI findings of neuronal migration disorders had significantly developmental delay than those with unilateral lesion(p=0.0007). Patients with unilateral lesion had significantly motor deficit than those with bilateral lesion(p=0.04). CONCLUSION: Seizures were the most common symptoms among neurological manifestations of neuronal migration disorders. Statistically significant correlations of delayed developement with bilateral lesion and motor deficit with unilateral lesion were found.
Brain* ; Cell Movement ; Cerebral Cortex ; Electroencephalography ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Lissencephaly ; Magnetic Resonance Imaging* ; Malformations of Cortical Development ; Neurologic Manifestations ; Neuronal Migration Disorders* ; Neurons* ; Retrospective Studies ; Seizures ; Septum Pellucidum

PURPOSE: Successful management of epileptic patients requires complete control of seizures without adverse effect. The purpose of this study is to evaluate the hematologic effect and hepatic enzyme change of antiepileptic drugs in epileptic children and compare the changes of these values according to serum drug level. METHODS: The study included 89 epileptic children with antiepileptic drugs such as phenobarbital, valproate, and carbamazepine from May 1990 to July 1999. We classified these patients into 3 groups according to the drug they had taken; group 1 : patients treated by phenobarbital, group 2 : valproate, group 3 : carbamazepine. Baseline screening tests before the start of therapy for all patients included complete blood count(CBC) and differential, platelet count, serum alanine aminotransferase(ALT), aspartate aminotransferase(AST). The tests wee repeated at follow-up visits in 2nd week, 4th week, 6th week, 12th month on the new drug. We compared their mean hematologic and liver enzyme values, which were examined before and after taken the medications, such as white blood cell counts(WBC), red blood cell(RBC), platelets, hemoglobin(Hgb), hamatocrit(Hct), mean corpuscular volume(MCA), mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), AST, and ALT. Statistically significant change of each value was observed according to drug blood levels. RESULTS: No significant differences were found between before and after medication on AST, ALT, Hgb, MCHC in all the groups. The WBC count diminished after medication of carbamazepine, significantly. But the correlation between WBC count and serum carbamazepine level was no statistically significant. The mean platelet count diminished significantly after medication of phenobarbital and valproate, and the correlation of maximum serum valproate level with the degree of platelets count was statistically significant. Statistically significant changes were found on MCV and MCH values before and after the medication in 3rd group. But it did not depend on carbamazepine blood level. CONCLUSION: Statistically significant correlations was found between the platelet count and the plasma valproate level. Significant increase of MCV and MCH, and decrease WBC count was observed after the medication of carbamazepine.
Alanine ; Anticonvulsants* ; Aspartic Acid ; Carbamazepine ; Child* ; Erythrocyte Indices ; Follow-Up Studies ; Humans ; Leukocytes ; Liver* ; Mass Screening ; Phenobarbital ; Plasma* ; Platelet Count ; Seizures ; Valproic Acid

A 17-year-old woman had an extensive nevus comedonicus affecting the left sides of the breast, trunk, axilla, and upper extremity. Her condition was complicated by episodes of re-current cyst formation, secondary infection, and atrophic scars. We performed various therapeutic approaches include topical keratolytic agents, manual extraction of comedones, excision of smaller lesions, and systemic antibiotics but the response was unsatisfactory. We tried systemic isotretinoin and minocycline and the pustulation of the lesions was reduced. Herein we report a rare case of linearly arranged extensive nevus comedonicus.
Adolescent ; Anti-Bacterial Agents ; Axilla ; Breast ; Cicatrix ; Coinfection ; Female ; Humans ; Isotretinoin ; Keratolytic Agents ; Minocycline ; Nevus* ; Upper Extremity

No abstract available.
Reticulocyte Count* ; Reticulocytes*

No abstract available.
Reticulocyte Count* ; Reticulocytes*

No abstract available.
Ligaments* ; Sutures*

Trachea is lined by a pseudostratified epithelium which usually expresses a complex mixture of stratified as well as simple epithelial-type cytokeratins. In the present work, the cytokeratin expressions was studied immunohistochemically in the tracheal epithelium and gland of human fetus at 14, 26 and 32 weeks of gestation. The primary antibodies used were CK7, 8, 10, 14, 18, AE8, 5D3, MNFl16 and AE3. In PAS-hematoxylin stain, the tracheal eithelium was composed of pseudostratified ciliated columnar type and consisted of surface, intermediate and basal layers regardless of gestational ages. The PAS positive cells, however, were decreased in number in proportion to gestational ages. The tracheal gland was not fully differentiated at 14 weeks of gestation, and had well differentiated secretory portions consisting mucous and serous cells at 26 and 32 weeks of gestation. The mucous cells and luminal border of the duct were positive for PAS stain. The tracheal eithelium showed different immunoreactivity between cartilageous and membranous portions. In general, CK7 and 5D3 were expressed in surface cells, AE8 in intermediate cells, and MNFl16 and AE3 in the cells of all layers. At 14 weeks of gestation, the tracheal epithelium immunoreacted for CK7, AE8, 5D3, MNFl16 and AE3. The premordium of tracheal gland was positive for 5D3, MNFl16 and AE3. The tracheal epithelium at 26 and 32 weeks of gestation showed same staining properties to those at 14 weeks of gestation. The duct cells at 26 weeks of gestation were immunoreactive for CK7, 8, 14, 18, AE8, 5D3, MNFl16 and AE3, and those at 32 weeks of gestation were immunoreactive for CK7, 14, 5D3, MNFl16 and AE3. The acinar cells at 26 and 32 weeks of gestation were positively stained for CK7, 8, 18, 5D3, MNFl16 and AE3. These results suggest that CK7 and 5D3 may serve as useful markers for mature cilated cells, AE8 (CKl3) for immature ciliated cells, and CKl4 for duct cells in tracheal epithelium and gland.
Acinar Cells ; Antibodies ; Epithelium* ; Fetus* ; Gestational Age ; Humans* ; Immunohistochemistry ; Keratins* ; Phenobarbital ; Pregnancy ; Trachea

No abstract available.

PURPOSE: Many neurologic and psychiatric behaviors can mimic epileptic seizures. Making a diagnosis of these nonepileptic paroxysmal disorders is very important to prevent inappropriate use of antiepileptic drugs. We studied the clinical characteristics of nonepileptic paroxysmal events in order to help differentiate them from true epileptic seizures. METHODS: We retrospectively reviewed 77 patients aged 2 months-15 years who visited the Pediatric Neurology clinic from January, 1990 to January, 1999 for evaluation of seizure disorders who were diagnosed as having nonepileptic paroxysmal disorders. RESULTS: Nonepileptic paroxysmal disorders were classified into 6 major groups as follows : movement disorders 19 cases (23.5%), respiratory disorders 16 (19.8%), loss of consciousness or tone 15 (18.5%), drug-induced dystonia 14 (17.3%), behavioral disorders 12 (14.8%), and perceptual disturbances 5 (6.1%). The final diagnoses of the 6 major groups were as follows : breath holding spell 16 cases (19.8%), syncope 14 (17.3%), drug-induced dystonia 14 (17.3%), pseudoseizure 6 (7.4%), sleep disorders 5 (6.1%), tics 4 (4.9%), headache 4 (4.9%), temper tantrum 4 (4.9%), sleep myoclonus 3 (3.7%), paroxysmal choreoathetosis 2 (2.5%), and masturbation 2 (2.5%). Five of the 77 patients also had idiopathic epilepsy. Breath holding spell is common in 2 months-6 years of age, syncope in 2-15 years, and pseudoseizure in 6-15 years. Monitoring in patients with pseudoseizure and abnormal eye movement with video EEG is helpful for diagnosis. CONCLUSION: Nonepileptic neurologic disorders are common and show a different incidence according to age group. The exact diagnosis of nonepileptic paroxysmal disorders using video EEG, is very important for preventing misdiagnosis and inappropriate use of antiepileptic drugs.
Anticonvulsants ; Breath Holding ; Diagnosis ; Diagnosis, Differential* ; Diagnostic Errors ; Dystonia ; Electroencephalography ; Epilepsy ; Eye Movements ; Headache ; Humans ; Incidence ; Masturbation ; Movement Disorders ; Myoclonus ; Nervous System Diseases ; Neurology ; Retrospective Studies ; Sleep Wake Disorders ; Syncope ; Tics ; Unconsciousness

No abstract available.