PURPOSE: Epilepsy is one of the most important morbidities in childhood, but its underlying causes can not be found even though extensive studies have been done. Advances in diagnostic modalities, including neuroimaging such as MRI reveal the apparent underlying causes of epilepsies. Therefore, we evaluated specific causes of symptomatic epilepsy and compared clinical features with idiopathic epilepsy. METHODS: Three hundred nine epileptic children visited the Pediatric Department of Pusan National University Hospital from January, 1991 to June, 1998. Of these, 79 patients were determined as symptomatic epilepsy and the analysis of various clinical features was undertaken retrospectively, according to the presence or absence of underlying causes. RESULTS: Two hundred and thirty two patients(75.1%) were idiopathic and 79 patients(24.9%) were symptomatic, the ratios of male to female and the ages at the onset of first seizure were 1.28 : 1, 1.48 1 and 3.24+/-5.65, 2.40+/-2.86 years(p>0.05, p<0.05), respectively. Causes of symptomatic epilepsy in order of frequency were birth asphyxia(29.9%), CNS malformation(27.3%), CNS infection(22.1%) and others(20.7%). The ratios of male to female and onset age of birth asphyxia, CNS malformation, CNS infection were 2.83 : 1, 1.91+/-2.64, 0.75:1, 2.35+/-2.92 and 1.43 : 1, 2.74+/-2.56, respectively. Seizure types in symptomatic group were classified as partial seizure in 22.1%, generalized seizure in 71.4% and unclassified in 6.5%, compared with those of idiopathic group classified as 46.6%, 51.7%, 1.7%, respectively. Intervals between medication start and seizure control in idiopathic and symptomatic groups were 146.5+/-148.7 days and 246.1+/-247.6 days, repectively(p<0.05). According to their etiology of birth asphyxia, CNS malformation and CNS infection were 364.5+/-315.0 days, 175.4+/-181.6 days, 199.9+/-215.3 days, respectively(p<0.05). CONCLUSION: CNS malformation, birth asphyxia, CNS infection were main causes of symptomatic epilepsy in childhood. In symptomatic epilepsy, generalized seizures was more common and occurred at a younger age. It takes more time to control seizure of symptomatic epilepsy.
Age of Onset ; Asphyxia ; Busan ; Child ; Epilepsy* ; Epilepsy, Generalized ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Neuroimaging ; Parturition ; Retrospective Studies ; Seizures

No abstract available.
Amantadine* ; Benztropine* ; Double-Blind Method*

No abstract available.
Hyperthyroidism*

Primary hyperparathyroidism is a rare endocrine disease in children. It involves bone and joint, urinary tract, gastrointestinal tract and cardiovascular system. The main cause of these involvement is high level of PTH in serum, resulting in hypercalcemia.An 11 years old male patient who had complained of limping gait since last 18 months, showed typical laboratory and radiological findings of primary hyperparathyroidism. At the ultrasonography, computed tomography and radionuclide scanning, a well defined mass(10 X 15mm) was found on the posterior aspect of the right thyroid lobe. The mass was confirmed histologically as adenoma of parathyroid gland. The patient was successfully treated with subtotal parathyroidectomy and temporal administration of calcium and vitamin D.We report this case of primary hyperparathyroidism with brief review of the literatures.
Adenoma ; Calcium ; Cardiovascular System ; Child ; Endocrine System Diseases ; Gait ; Gastrointestinal Tract ; Humans ; Hyperparathyroidism, Primary ; Joints ; Male ; Parathyroid Glands ; Parathyroidectomy ; Thyroid Gland ; Ultrasonography ; Urinary Tract ; Vitamins

PURPOSE: Periventricular leukomalacia(PVL) is associated with various neurologic sequelae such as cerebral palsy and cortical blindness. The aim of this study was to analyse the correlation between the degree of PVL on MRI and clinical features or its severity. METHODS:Thirty-eight children with PVL on MRI among children brought to Pusan National University Hospital between January 1996 and August 1999 with development delay, cerebral palsy or epilepsy were included into the study group. We reviewed medical records of the patients including the gestational age, birth weight and neurologic sequelae. The grade for PVL was divided into 1 to 3, and it was based on abnormally increased signal intensity in periventricular white matter or a reduced amount of periventricular white matter or both, and compensatory focal ventricular enlargement. We analysed the relationship of the grade of PVL and various clinical findings. RESULTS: The age ranged from 11 months to 13 years old with a mean of 42 months. History of cesarean delivery and ventilator care were significantly frequent for the severe grade of PVL. Birth weight was significantly lower according to grade of PVL. Gestational age was lower according to the grade of PVL, but was not significant statistically. Incidence of cerebral palsy was significantly higher on the severe grade of PVL. Incidence of epilepsy and mental retardation were 34.2Yo and 23.9M, not associated with the grade of PVL. CONCLUSION: Incidence of cerebral palsy was associated with the severe grade of PVL, so we think MRI can be helpful in predicting neurodevelopmental outcome. (J Korean Pediatr Soc 2000;43 798-805)
Adolescent ; Birth Weight ; Blindness, Cortical ; Brain* ; Busan ; Cerebral Palsy ; Child ; Epilepsy ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Intellectual Disability ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging* ; Medical Records ; Ventilators, Mechanical

PURPOSE: The periventricular leukomalacia(PVL) tends to increase the risk of developing motor neurologic sequelae, delayed cognitive development, visual impairment, and epilepsy. Although several developmental screening test methods are being used, one of the oldest and best known developmental screening test was restandardized and revised as Denver Development Screening Test II(Denver II). The objective of this study is to analyse the correlation between the degree of PVL on MRI and the results of Denver II. METHODS: Among the children brought into Pusan National University Hospital between January 1996 and August 1999 with developmental delay, all of the 36 children with PVL on MRI were selected for the study. Denver II was checked in all these patients for screening of developmental delay with the review of medical records. Depending on the grade of PVL, total sample was classified into three groups, and it was based on abnormally increased signal intensity in periventricualr white matter or a reduced amount of periventricular white matter or both, and compensatory focal ventricular enlargement. We analysed the relationship of the grade of PVL and the results of Denver II. RESULTS: The 36 total patients were composed of 22 boys and 14 girls, with the age distribution between 11 to 72 months and the mean of 34.4 months. Delayed occurrence of gross motor sector were 5 cases(44.4%) in group 1, 16 cases(80.0%) in group 2, 7 cases(100.0%) in group 3. Incidence of delay was significantly higher in the high grade PVL group. Delayed rate of other sectors(fine motor-adaptive, personal-social) were higher in the high grade PVL group. But it was not statistically significant. Delayed rate of language sector has no correlation with grade of PVL on MRI. CONCLUSION: Incidence of dealy of gross motor sector was significantly higher in the high grade PVL group. However, language sector has no correlation with grade of PVL on MRI.
Age Distribution ; Brain* ; Busan ; Child ; Epilepsy ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Mass Screening* ; Medical Records ; Vision Disorders

PURPOSE: The purpose of this study was to determine the degree of undergraduate nursing student adaptation to college life and investigate the factors that influenced that adaptation. METHODS: First-year (undergraduate) students attending three nursing colleges were surveyed from November 24 through December 5, 2014; and data from 206 respondents were analyzed. For data analysis, multiple regression analysis was performed using the SPSS WIN 18.0 program. RESULTS: The findings showed that age (p=.002), emotional intelligence (p<.001), and self-efficacy (p<.001) were significant variables that influenced first-year undergraduate nursing student adaptation to college life. Undergraduate nursing student adaptation was explained by self-efficacy (beta=.327, p<.001), emotional intelligence (beta=.222, p=.001), satisfaction with education in their academic major (beta=-.217, p<.001), and academic achievement (beta=.136, p=.018); and, the explanatory power of these variables was 41.2%. CONCLUSION: To facilitate undergraduate nursing student adaptation to college life prior to clinical practice, developing and apply programs to improve self-efficacy, emotional intelligence, satisfaction with education in their major, and academic achievement is deemed necessary.
Surveys and Questionnaires ; Education ; Emotional Intelligence ; Humans ; Nursing ; Statistics as Topic ; Students, Nursing*

We retrospecively analyzed MRI findings of 14 patients with intracranial tuberculosis according to the disease process before anti-tuberculous medication. We also analyzed the correlativity between these findings and the clinical outcome after anti-tuberculous medication in 8 patients who had taken follow-up MR imaging. MR imaging was performed with either a 0.5T(1 patients) or 1.0T(13 patients) superconducting system with spinecho pulse sequences. Abnormalities on MRI were seen in 87%(12/14) of the patients. MRI findings consisted of meningeal enhancement(n=10), parenchymal tuberculoma(n=6), hydrocephalus(n=5), and infarction(n=5). Most of them were found within 3 months from symptom-onset. Parenchymal tuberculomas were found after 1 month of symptom-onset. All cases of hydrocephalus and infarction were associated with meningeal enhancement. On follow-up MRI after anti-tuberculous medication, changes of MR imaging did not correlate with clinical outocome in 4(50%) of 8 patients. Improvement of MRI findings were observed in patient treated for more than 3 weeks. In conclusion, MRI is a good modality in the diagnosis of intracranial tuberculosis, however, the MRI findings are not always correlated with clinical outcome after, anti-tuberculous medication.
Diagnosis ; Follow-Up Studies ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Imaging* ; Tuberculoma ; Tuberculosis*

No abstract available.
Thoracoplasty*

PURPOSE: Weight gain is a known side effect of valproic acid(VPA), which is associated with change of serum total cholesterol(TC) level. However, there are controversies on the correlation between VPA and serum TC. This investigation was undertaken to evaluate the change of TC level in children with epilepsy on long-term VPA monotherapy and the related factors. METHODS: Epileptic patients on VPA monotherapy for more than one year were recruited at the Department of Pediatrics, Pusan National University Hospital. The body mass index (BMI) and TC before and after VPA treatment were obtained from all patients. We analyzed the change of serum TC according to dosage of VPA, serum drug level and other clinical data such as gender, age at start of treatment, type of seizure, etiology of seizure, duration of VPA medication and BMI. which could affect the serum TC. RESULTS: 82 children(49 male and 33 female) were included in this study. Mean serum TC of pre- and post-VPA medication was 153.5+/-31.0 mg/dL and 158.1+/-30.2 mg/dL(P>0.05), respectively. There were no clinically significant changes of serum TC level according to dosage of VPA, serum drug level and other clinical data such as gender, age at start of treatment, seizure type, etiology of seizure, duration of VPA medication and BMI(P>0.05). CONCLUSION: Our results suggest that long-term VPA medication does not affect serum TC, and overweight at pre-VPA medication is not a risk factor.
Body Mass Index ; Child ; Cholesterol ; Epilepsy ; Humans ; Male ; Overweight ; Pediatrics ; Seizures ; Valproic Acid ; Weight Gain