Although oxcarbazepine (OXC)-induced hyponatremia is usually asymptomatic, it can lead to serious complications. We reports two cases of symptomatic hyponatremia induced by OXC. First case was 39-year-old female with partial epilepsy who developed the exceeding tiredness, headache, and seizures under OXC with a serum sodium level of 121 mEq/L. After the discontinuation of OXC, serum sodium was normalized and the clinical symptoms disappeared. Second case was 48-year-old female with partial epilepsy who complained of the fluctuating tiredness and fatigability, and then eventually developed seizures after OXC was increased in dosage. At that time, serum sodium was 121 mEq/L. She remained asymptomatic with normal level of serum sodium even if OXC was maintained with topiramate. Our cases may suggest that symptomatic hyponatremia is not rare unlike the results from previous studies. Therefore, clinician should be alert to mild symptoms such as headache, lethargy, and tiredness in patients treated with OXC.
Adult ; Epilepsies, Partial ; Female ; Headache ; Humans ; Hyponatremia* ; Lethargy ; Middle Aged ; Seizures ; Sodium

Fifty-two patients of meniscal injury were studied in the Department of Orthopedic Surgery, Seoul National University Hospital for 5 years and 6 months from January, 1973 to June, 1978. The results were as follows: 1. Male was more affected than female (M:F = 1.4:1). And the injury of meniscus was most frequently occurred in the age group between 11 and 30 years old (65.2%). 2. Thirteen patients denied the history of trauma (25.2%). 3. Over-all positive rate of Memurray sign was 85% and arthrography was 74%. 4. Lateral meniscus was more frequently affected than medial meniscus. The most frequent type of lesion was peripheral longitudinal tear (11 cases). Discoid meniscus was found in 14 patients. 5. In follow-up study, satisfactory results were obtained in 84.3%.
Arthrography ; Clinical Study ; Female ; Follow-Up Studies ; Humans ; Male ; Menisci, Tibial ; Orthopedics ; Seoul ; Tears

The object of treatment of Legg-Calve-Perthes disease (L.C.P.D.) is to shorten the clinical course and minimize, or prevent residual deformity, This is accomplished by placing the femoral head deeply within the acetabulum, so that its articular surface is completely contained and maintaining a full range of motion, thereby preventing lateral extrusion of head, concentrated vertical loads and collapse. The purpose of this study was to determine the predicting value of prognosis and correlation of three different evaluating methods, when examining an identical series of radiographs to assess the effect of treatments, and to determine whether the result obtained by femoral osteotomy gave better result than those by non-surgical means. During the past ten years prior to writing, 89 patients with L.C.P.D. were treated by authors. Seventy eight (87.6%) patients were boys and 11 (12.4%) girls. Their ages at the time of initial visit ranged from 2 to 13 years. Twelve (13.5%) patients had bilateral and 77 had unilateral involvement for a total of 101 hips. They were analysed according to Catteralls classification, and also comparative study was done for 32 patients who were followed up over 15 months. The longest follow-up was 5 years and 2 months. They were divided into 2 groups: clildren in group A were treated by rest and abduction brace,. followed over 3 years and 3 months in average, and children in group B were treated, by intertro-chanteric osteotomy, followed over 2 years and 6 months in average. End results for 32 cases were evaluated at each follow-up time by Length/Width Index (L/W.I.) of femoral neck (Robichon, 1974), Migration Index (M.I.) and Spherical quotient (S.Q.) of capital femoral epiphysis (Edsberg et al, 1979). L/W.I.,M.I, S.Q. were used not only as the method of evaluation, but also were used as a predicting the prospective clinical course during the treatment by regular measurement whether it takes the good course or not. Results obtained were as follows: 1. 21(20.8%) were classified as group I, 30(29.7%) as group Il. 31(30.7%) as group III and 19 (18.8%) as group IV. 43 children (42.6%) on their initial visit were found to have this diasbling hip condition at stage II (necrosis and early fragmentation stage). 2. Regardless of the type of treatment, good results were obtained in younger children under age of 7 years, and in mild form as in group I, and lI. Also good, results were obtained in the cases who had treatment at early stage of the disease. No difference was found in the end results between girls and boys when they had same degree of head involvement. 3. In 14 surgically-treated patients, the good results were obtained in 9(64.3%) when assessed by L/W I. 10(75.4%) by M.I., and 7(50%) by S.Q., while in 18 conservatively treated patients good results were obtained in 8(44.4%) when assessed by L/W I. in 6(33.3%) by M.I., and 7(38.7%) by S.Q.. This fact means that S.Q. under-estimates the results of well-treated cases, while M.I. seemingly over-estimates them. 4. when X-rays of the hips were taken in different position's, different L/W Indices were unexpectedly obtained; these deviations in assessment may be listed as a drawback. Migration Index can prognosticate the healing process of the disease during treatment, if the index together with medial joint space is measured repeatedly with certain intervals. Also it is difficult to obtain accurately the S. Q. by measurements because of difficulty locating the center of fragmentary head, but it is considered the best method assessing the end-result at the healed stage. S.Q. expresses the head spherocity, while the M. I. expresses the degree of head coverage and the neck L/W.I. expresses the indirectly amount of neck deformity. 5. When the clinical course is assessed by three evaluating methods, occasionally these three results contradict to each other and do not show similar prognostic tendency or trend. The reason is that neck L/W Index and Spherical quotient indicate directly the progress of the disease while Migration Inex receases only the state of femoral head containment and there by indirectly indicates ensuing prospective course when containment is good, and do not indicate the state of severity of the involved head. 6. In this study, the result of surgically treated patients were superior to those of conservatively treated patients.
Acetabulum ; Braces ; Child ; Classification ; Congenital Abnormalities ; Containment of Biohazards ; Epiphyses ; Female ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Legg-Calve-Perthes Disease ; Methods ; Neck ; Osteotomy ; Prognosis ; Prospective Studies ; Range of Motion, Articular ; Writing

Isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament has been thought very rare. We also had experienced only nine cases of above injury in our center during 5.5 years from January, 1976 to June, 1981. Eight cases of them were followed for an average of the thirteen months, but one of them was eliminated from the study because follow-up study was impossible for the case. The purposes of this paper are to present eight cases of isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament and to discuss the causes and mechanisms of the injury and the method of screw fixation for the avulsed fracture fragment. Seven were injured by traffic accident and one by fall on the knee. All cases seemed to be injured by the force directed against the flexed knee which violently stroke the anterior surface of the proximal end of the tibia or inferior portion of the knee and drove it backwards. We found the tear of posterior capsule only in one patient who was seeming injured by extensive force. All cases were treated operatively by means of screw fixation, and excellent results were obtained in five cases, good in two, and fair in one case.
Accidents, Traffic ; Follow-Up Studies ; Humans ; Knee ; Methods ; Posterior Cruciate Ligament ; Stroke ; Tears ; Tibia

It is well known that early diagnosis and early treatment is very important for the patient with congenital dislocation of the hip joint to provide a favorable function in the whole life. The goal of treatment, which is either conservative or operative, is to replace the dislocated hip into the socketand restore its anatomical position. If the head is reduced lately, it may subluxate or redislocate. As a result, secondary osteoarthritis will be complicated in such hips at a laterdate The most cases of congenital dislocation of hip have a increased anteversion and vaglus deformity. It is known that these deformity are cause of redislocation or subluxation, and should be corrected by varus or derotational varus osteotomy to restore for normal cephalocotyloid relationship. We analized 18 residual subluxation of hips which had been treated by derotational varus osteotomy. The results obtained are as follows. 1. Regardless of the age at the time of osteotomy and the amount of varization, the neck-shaft angle corrected to nearly normal in all cases within 3 years after the osteotomy. 2. Acetabular development, indicated by acetabular index, was satisfactory when the osteotomy was done before 4 years, but unsatisfactory in the cases after 4 years of age. 3. Coxa valga epiphysialis of the subluxated head corrected spontaenously after osteotomy in all cases. 4. Subluxated head, indicated by C-E angle and migration percentage, reduced in the cases who had by the derotational varus osteotomy in patients below age of 4 years, but it persisted without further luxation in the cases over 4 years of age.
Acetabulum ; Congenital Abnormalities ; Coxa Valga ; Dislocations ; Early Diagnosis ; Head ; Hip Joint ; Hip ; Humans ; Osteoarthritis ; Osteotomy

In order to compare the effects of the flexible external fixations with the rigid one on fracture healing, rabbits tibiae were fractured surgically and each fracture were immobilized with external devices using graphites (the group I), plastics (the group II) and stainless steel (the group III). At six weeks after fracture, clinical and radiological union rates in group I, II and III were 91% 73% and 60% respectively. The rabbits tibiae were load in 4-point bending test to determine the mechanical properties of the fracture healing. The means and standard errors of maximum bend moment of the fractured tibiae were 11. 30±2.33kg.f. cm., 8.55±2.02kg.f. cm. and 9.79±2.09kg.f. cm. in group I, II and III respectively. These data may suggest that a certain amount of the flexibility (ex, graphite) or motion is better than the rigidity (ex, stainless steel) in fracture healing by the method of the external immobilization).
Fracture Healing ; Graphite ; Methods ; Plastics ; Pliability ; Rabbits ; Stainless Steel ; Tibia

PURPOSE: To describe the magnetic resonance (MR) findings of pigmented villonodular synovitis(PVNS) of the knee, and to evaluate the clinical value of MR in the diagnosis of PVNS. MATERIALS AND METHODS:MR imagings of seven patients with PVNS were studied. The type of lesion, presence of bony erosion, the signal intensity, and the relationship between contrast enhancement and signal intensity on T2-weighted images were analyzed, retrospectively. RESULTS: The lesion was mainly villous in three patients and nodular in four, and bony erosion was seen in one patient. On T2-weighted image, the signal intensity of the villous form was mixed iso- and hypointense in two, hypointense in one, and that of the nodular form was heterogeneous with hypo-, iso-, and hyperintensities. The hypointense portion on T2-weighted image showed poor contrast enhancement, which may suggest hemosiderin deposition or advanced fibrosis. The iso- or hyperintense portion on T2-weighted image showed strong enhancement, which suggest active cellular proliferation. CONCLUSION:MR imaging could be a very useful modality in the diagnosis as well as prediction of histological findings of the PVNS.
Cell Proliferation ; Diagnosis ; Fibrosis ; Hemosiderin ; Humans ; Knee* ; Magnetic Resonance Imaging* ; Retrospective Studies ; Synovitis, Pigmented Villonodular*

PURPOSE: To describe the MR characteristics of giant cell tumor of bone. MATERIALS AND METHODS: MR iraagings of 15 cases of pathologically proved giant cell tumor were retrospectively analyzed. Signal intensity and homogeneity, involvement of articular surface, low signal intensity rim around the tumor, cortical disruption and soft tissue involvement were evaluated. RESULTS:Tumor showed low signal intensity on T1 weighted images(93%), inhomogenous high signal on T2 or T2* weighted images(93%) and inhomogeneous enhancing pattern(88%). In 11 cases of giant cell tumor of long bones, all cases showed involvement of articular margin and 10 cases(90%) showed rim of low signal intensity between tumor and normal marrow. Disruption of cortical bone(25%) and soft tissue involevement(7%) were also demonstrated. CONCLUSION: We concluded that giant cell tumor showed characteristic MR findings could be helpful in making correct diagnosis.
Bone Marrow ; Diagnosis ; Giant Cell Tumor of Bone ; Giant Cell Tumors* ; Giant Cells* ; Retrospective Studies

PURPOSE: Smoking cessation interventions are important because university students are vulnerable to smoking and good health practices during their university lives greatly affects their health status. The purpose of this study is to investigate the factors affecting smoking cessation success among the university students who participated in the 4-week smoking cessation program. METHODS: This study was conducted with 101 university student smokers. To identify the factors affecting the success of smoking cessation, a logistic regression analysis was performed. RESULTS: In Model 1, without the smoking cessation aids variable, when the frequency of face-to-face counseling was greater, the success rate of smoking cessation was 1.70 times higher. In Model 2, including the smoking cessation aids variable, when the nicotine dependence score was higher, the success rate of smoking cessation was 0.72 times lower, and when the number of smoking cessation aids used was greater, the success rate of smoking cessation was 1.40 times higher. CONCLUSION: Smoking cessation aids are essential to increase the success of short-term smoking cessation, and face-to-face counseling and telephone counseling should be provided continuously to maintain long-term smoking cessation.
Counseling ; Humans ; Logistic Models ; Smoke* ; Smoking Cessation* ; Smoking* ; Telephone ; Tobacco Use Disorder

Clinical observation was done on 302 cases of cerebrovascular accidents admitted at Sung-Sim hospital, Chung-Ang University from January, 1968 to August, 1976. 1) Of 302 cases of cerebrovascular accidents, the incidence of cerebral hemorrhage was 28.8, cerebral thrombosis 47,7 Subarachnoid hemorrhage 20.2% and cerebral embolism 3.3%. 2) The peak age incidence was in the fifth decade in cerebral hemorrhage, subarachnoid hemorrhage, whereas in cerebral thrombosis, it was in the sixth decade. 3) The most frequent predisposing factor in cerebral hemorrhage and subarachnoid hemorrhage were physical activity and emotional stress, whereas in thrombosis and embolism, it was rest. 4) Among disease preceding the onset of cerebrovascular accidents, hypertension were presented 65.4% in cerebral hemorrhage, 63.6% in cerebral thrombosis, 56.6% in subarachnoid hemorrhage and valvular heart disease was presented 40.0% in cerebral embolism. 5) Serum cholesterol level over 200mg% was seen in 33.0% of cerebrovascular accidents. 6) Leukocytosis was seen 58.6% of cerebrovascular accidents which was predominantly found in the hemorrhagic group. 7) The pressure of cerebrospinal fluid was elevated in 61.7% of cerebrovascular accidents, predominantliny the hemorrhagic group. 8) The peak duration of admission was present in 51.7% of cerebrovascular accidents within 7 days and mortality rate during hospitalization was 38.0% in cerebral hemorrhage, 10.4% in cerebral thrombosis and 27.8% in subarachnoid hemorrhage. 9)The mortality rate during hospitalization was 35.3% in all cerebrlavascular accidents within 24 hours.
Causality ; Cerebral Hemorrhage ; Cerebrospinal Fluid ; Cholesterol ; Embolism and Thrombosis ; Heart Valve Diseases ; Hospitalization ; Hypertension ; Incidence ; Intracranial Embolism ; Intracranial Thrombosis ; Leukocytosis ; Mortality ; Motor Activity ; Stress, Psychological ; Stroke ; Subarachnoid Hemorrhage