No abstract available.

We obtained successful functional and esthetic results by grafting of iliac marrow-cancellous bone in 2 cases of alveolar-palatal cleft patients. Bone graft of alveolar-palatal clefts provide bony support to adjacent teeth of cleft area, prevented from relapse of orthodontic arch expansion, closure of oroantral fistula and improvement of speech problem. 1. In one case, extraction of upper right central incisor that was little bone support, alignment of rotated teeth and expansion of collapsed arch segment were done with pre-orthodontic treatment. The other case. Bone grafting was done after removal of prosthesis with no pre-orthodontic treatment. 2. After mucoperiosteal incision in cleft area, the mucosal flap of labial area, palate and nose were separation and the raised nasal mucosa was sutured for closure of oroantral fistula. Then, the iliac marrow-cancellous bones were grafted to cleft site. 3. After 6 months of operation, we had seen the new bone deposition to cleft site in dental radiograph and prosthetic treatment of missing teeth were done.
Bone Transplantation* ; Humans ; Incisor ; Nasal Mucosa ; Nose ; Oroantral Fistula ; Palate ; Prostheses and Implants ; Recurrence ; Tooth ; Transplants

PURPOSE: Febrile seizure, the most common seizure disorder in children between 6 months and 5 years of age, is mostly caused by viral infections, except severe CNS infection. It can also be caused by disorders in organic acid metabolism, especially accompanied by fever. Therefore we decided to investigate the relationship between children with febrile seizures and disorders in organic acid metabolism. METHODS: We examined 54 children with febrile seizure who visited Chunchon Sacred Heart Hospital Emergency Department from February 2002 to January 2004. We conducted urine organic acid analysis, CBC, urine analysis, serum ammonia and gas analysis. RESULTS: Thirteen(24.1%) patients showed ketonuria, eight(14.8%) patients showed lactic aciduria and ketonuria, two(3.7%) patients showed pyruvic aciduria, and one(1.8%) showed mandelic aciduria. CONCLUSION: Twenty four of 54(44.4%) showed abnormal findings in urine organic acid analysis. Most results are ketonuria or lactic aciduria with ketonuria. They may show in fasting, severe infection or ketolytic defect(ex, 3-ketothiolase deficiency). Patients with 3-ketothiolase deficiency, can develop seizures during fever, and fasting state. Therefore further evaluation is necessary.
Acetyl-CoA C-Acyltransferase ; Ammonia ; Child ; Emergency Service, Hospital ; Epilepsy ; Fasting ; Fever ; Gangwon-do ; Heart ; Humans ; Ketosis ; Lactic Acid ; Metabolism ; Seizures ; Seizures, Febrile*

Cyclosporine A is the most frequently used immunosuppressive agent for prevention of graft versus host disease (GVHD) and treatment of frequently relapsing nephrotic syndrome in childhood. Some adverse effects such as hepatic and renal toxicity, have been frequently encountered. But central nervous system toxicity caused by cyclosporine A is rare, and the incidence of encephalopathy among patients recieving cyclosporine A is unknown. Brain magnetic resonance imaging is an essential tool for diagnosis of cyclosporine A neurotoxicity. It typically demonstrates nonenhancing symmetric subcortical, and sometimes deep white matter changes resembling edema with posterior hemisphere predominance. We report a child with nephrotic syndrome who developed encephalopathy during cyclosporine A therapy. Based on this study, we emphasize that careful follow up of patient's neurological finding is very important to prevent serious life-threatening complications.
Brain ; Central Nervous System ; Child* ; Cyclosporine* ; Diagnosis ; Edema ; Follow-Up Studies ; Graft vs Host Disease ; Humans ; Incidence ; Magnetic Resonance Imaging ; Nephrotic Syndrome*

PURPOSE: This study was performed to investigate the change of weight and body composition, and lipid profiles in the idiopathic epileptic children treated with valproate. METHODS: We measured the weight, height, left arm circumference, left triceps skinfold thickness of 30 idiopathic epileptic children treated with valproate before, at 1 month and 4 months of treatment. We also analyzed the serum lipid profiles of the patients before and at 4 months of treatment. We analyzed the change of Body Mass Index (BMI), Arm Muscle Area(AMA), Arm Fat Area(AFA), and the serum lipid profiles. Two-way analysis of variance, chi-square test and paired-t test were used for statistical analysis. RESULTS: There was no statistically significant change in BMI, AFA, AMA of the patients. But the weight of 13(44.3%) children increased greater than 10% with valproate treatment. AMA were not changed, but AFA were significantly increased, 791.2+/-209.6 mm2 before treatment, 858.1+/-246.6 mm2 at 1 month, 1051.7+/-393.2 mm2 at 4 months, in 13 patients, whose weight gain were greater than 10%(P<0.05). There was no change in cholesterols, low density lipoproteins, high density lipoproteins of the 30 children. CONCLUSION: The increase of the weight in the children treated with valproate resulted from the increase body fat. So the weight gain may be a risk factor of obesity
Adipose Tissue ; Arm ; Body Composition ; Body Mass Index ; Child* ; Cholesterol ; Humans ; Lipoproteins, HDL ; Lipoproteins, LDL ; Obesity ; Risk Factors ; Skinfold Thickness ; Valproic Acid* ; Weight Gain*

BACKGROUND: We sought to examine the use and outcomes with early intraaortic balloon couterpulsation(IABP) combined early reperfusion therapy in patients presenting with cardiogenic shock complicating acute myocardial infarction. The use of IABP in patients with cardiogenic shock is widely accepted. however, there is a paucity of information on the use of this technique in patients with cardiogenic shock who are treated with reperfusion therapy in Korea. MATERIALS AND METHODS: Twenty-eight Patients presented with cardiogenic shock were classified into two groups: the early IABP group (insertion within 12 hours after AMI onset time) and late IABP group (insertion after 12 hours). We compared In-hospital mortality in two group (early IABP group vs late IABP group). RESULTS: Two groups show no significant difference at clinical feature and coronary angiographic results. Among total 28 patients, 7 patients were treated with thrombolytic therapy and 21 patients with PTCA. Insertion site bleeding, fever, thrombocytopenia were reported as some of the complications of IABP insertion. In-hospital mortality of early IABP group and late IABP group were 4 patients(25%) and 8 patients(66%), respectively(p<0.05). Early IABP insertion and early PTCA showed lower hospital mortality rates. There was significant difference in the time to PTCA after AMI onset between the to groups(p<0.05). CONCLUSION: IABP appears to be useful in patients presenting with cardiogenic shock unresponsive medical therapy. Early IABP insertion and early Reperfusion therapy may reduce In-hospital mortality rates in PostMI Cardiogenic shock patients.
Fever ; Hemorrhage ; Hospital Mortality ; Humans ; Korea ; Myocardial Infarction ; Reperfusion* ; Shock, Cardiogenic* ; Thrombocytopenia ; Thrombolytic Therapy

PURPOSE: Since 1997, the quantification of organic acids in urine has become possible in Korea. This helped to diagnose a great variety of inborn errors of metabolism. However, we still don't know the normal value of organic acids in amniotic fluid, therefore it is impossible for doctors to make a correct diagnosis of inborn errors of metabolism in prenatal care. We tried to confirm the normal value of organic acid in amniotic fluid. METHODS: From Jan. 1998 to Dec. 2001, we carried out amniocentesis and were able to obtain 43 samples of amniotic fluid from between 16 and 20 weeks of gestation, and quantified 82 organic acids to come up with a normal value. Organic acid concentrations were quantified with gas chromatography, and the individual acids were identified with mass spectrometry. To isolate organic acids from amniotic fluid, we used a solvent extraction method with ethylacetate. Derivatization was done with MSTFA(N-methy-N-trimethylsilylfluoroacetamide). RESULTS: The results of this study showed that when organic acid concentrations in amniotic fluid were compared with those in urine, TCA cycle intermediates(lactate, pyruvate, malate, 2-ketoglutarate, citrate etc) and ketone body(3-hydroxybutyric acid, acetoacetate etc) were found at significantly higher levels. CONCLUSION: Because TCA cycle intermediate in amniotic fluid is found at high concentrations, we could expect that diagnosis of mitochondria disorder is difficult. Organic acids other than TCA cycle intermediates were undetectable in amniotic fluid. Therefore, prenatal diagnosis of organic acidemias is possible. In our study, the prenatal diagnosis of methylmalonic acidemia could be made by using the measurement of methylmalonic acid in the amniotic fluid taken at high risk pregnancy with a family history of methylmalonic acidemia.
Amniocentesis ; Amniotic Fluid* ; Chromatography, Gas ; Citric Acid ; Diagnosis ; Female ; Humans ; Korea ; Mass Spectrometry ; Metabolism, Inborn Errors ; Methylmalonic Acid ; Mitochondria ; Pregnancy ; Pregnancy, High-Risk ; Prenatal Care ; Prenatal Diagnosis* ; Pyruvic Acid ; Reference Values

Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, worldwide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs. The group researched all articles and major foreign CPGs published in English until December 2015 using several search engines. Based on these articles, levels of evidence and grades of recommendations were determined by our society as well as by other related Quality Control Committees from neurointervention, neurology and rehabilitation medicine. The Korean version of the CPGs for aSAHs includes risk factors, diagnosis, initial management, medical and surgical management to prevent rebleeding, management of delayed cerebral ischemia and vasospasm, treatment of hydrocephalus, treatment of medical complications and early rehabilitation. The CPGs are not the absolute standard but are the present reference as the evidence is still incomplete, each environment of clinical practice is different, and there is a high probability of variation in the current recommendations. The CPGs will be useful in the fields of clinical practice and research.
Aneurysm ; Brain Ischemia ; Cerebrovascular Disorders ; Diagnosis ; Disease Management ; Hydrocephalus ; Intracranial Aneurysm ; Mortality ; Neurology ; Quality Control ; Rehabilitation ; Risk Factors ; Search Engine ; Subarachnoid Hemorrhage ; Surgeons