PURPOSE: Epilepsy is generally defined as a chronic condition characterized by recurrent unprovoked seizure. It is still controversial whether the long-term antiepileptic drugs(AED) treatment will be necessary in children with first unprovoked seizure. Cognitive and behavioral side effects of AEDs are especially important in developing children. Therefore the rationale of AED treatment in the children with first unprovoked seizure depends upon the seizure recurrence rate and presence of risk factors related with seizure recurrence. We are going to evaluate the risk of seizure recurrence and risk factors after a first unprovoked seizure in children. METHODS: One hundred fifty eight patients presented with a first unprovoked seizure from July, 1994 to June, 1999 were prospectively followed by regular epilepsy clinic visit or telephone interview for a mean of 27 months. We analyzed overall recurrence risk and risk factors of seizure recurrence(EEG finding, etiology of seizure, seizure type, history of prior febrile convulsions, neurodevelopmental status prior to first seizure, presence of a Todd's paresis, family history of seizures, a seizure occuring while asleep, and duration of seizure) by Cox's proportional hazards model and Kaplan-Meier survival analysis. RESULTS: In 158 patients with first unprovoked seizure, 61 (39%) patients experienced subsequent seizure. The cumulative risk of seizure recurrence was 28.5, 37.6, and 42.3% at 6, 12, and 18 months. The median time to recurrence was 3 months, with 72% of recurrence occurring within 6 months, 92% within 1 year, and 100% within 2 years. On univariate analysis, risk factors for seizure recurrence included an etiology of seizure and abnormal EEG. In idiopathic cases, the risk factor was an EEG abnormality. CONCLUSION: Many of the children with a first unprovoked seizure will not have recurrences. The recurrence risk of a first unprovoked seizure in children have statistically correlated with the etiology of seizure(cryptogenic and symptomatic) and abnormal EEG. Children with an idiopathic first seizure and a normal EEG have a particularly favorable prognosis.
Ambulatory Care ; Child ; Electroencephalography ; Epilepsy ; Humans ; Interviews as Topic ; Paresis ; Prognosis ; Proportional Hazards Models ; Prospective Studies* ; Recurrence* ; Risk Factors ; Seizures* ; Seizures, Febrile

No abstract available.
Clonorchiasis*

Intrinsic plus deformity, which results in severe functional impairment of the hand, is caused by contracture of intrinsic muscles. This deformity can be resulted from many causes such as ischemic damage, spasm of intrinsic muscles, thermal injury, and so on. The surgical release of tightened intrinsic muscles, may be the only solution to make usable hand, especially for severe cases. Sixty five digits in 22 patients who were operated on from 1982 to 1992, were evaluated retrospectively, to analyse the effects of surgery for intrinsic plus hand. Among 65 digits, 13 were thumbs and 52 fingers. The mean age of the patients was 26 years and 8 months and 17 cases were males and 6 females. The causes were ischemic damage by laceration or crushing injuries in 11 patients, compartment syndrome in 5, cerebral palsy in 5, and burn in one. Involved digits were thumb only in 4 patients, thumb and fingers in 9, and fingers in nine. All the digits were classified preoperatively by Zancolli's classification. In 13 thumbs retropulsion contracture was 4 and adduction-antepulsion contracture was nine. All of the thumbs were treated by intrinsic release and Z plasty(or rotational flap). Other procedures including arthrolysis, arthrodesis and tendon reconstruction were combined in 9 thumbs. In 52 fingers, in addition to distal release, arthrolysis was combined in 12 fingers, and arthrolysis plus volar plate release were combined in 4 fingers. For the assessment, our criteria, based on subjective satisfaction of the patient and range of motion, was used. The duration of follow up was from one year to 9 years with the average of 26 months. In 14 thumbs the results were excellent in 2, 6 good, 4 fair, and one poor. In 52 fingers excellent was 12, 24 good, 13 fair, and 3 poor. In summary we could improve the function of intrinsic plus deformity by appropriate sugery, and their results were good.
Arthrodesis ; Burns ; Cerebral Palsy ; Classification ; Compartment Syndromes ; Congenital Abnormalities ; Contracture ; Female ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Lacerations ; Male ; Muscles ; Range of Motion, Articular ; Retrospective Studies ; Spasm ; Tendons ; Thumb

Although the goal of fracture treatment is alive bony union with anatomical reduction, prosthetic replacement is indicated for some complicated femoral neck fracture. However it is not defined until now which one is selected between hemiarthroplasty and total hip replacement for the delayed or complicated femoral neck fracture. In order to get the criteria which one is better for this patient when indicated, we reviewed the result of 39 endoprosthetic and 16 total hip replacement patients at Seoul National University Hospital between June of 1975 to June of 1980. Both methods of endoprosthesis and total hip replacement showed satisfactory results of 72% and 90% respectively. Considering two points of the pain-relief and walking ability, total hip replacement is believed to be far better than endoprosthesis, especially for those patients who are over 50 years of age and have had more active living conditions before fracture.
Arthroplasty, Replacement, Hip ; Femoral Neck Fractures ; Femur Neck ; Femur ; Hemiarthroplasty ; Humans ; Joints ; Seoul ; Social Conditions ; Walking

3 cases of giant cell tumor in the distal femur or upper tibia were treated by curettage and acrylic cement packing between October 1978 and May 1981. All were females. The postoperative courses were satisfactory with no recurrence or malignant change for periods of 16 months to 30 months. In one case, acrylic cement reinforced with tantalum wire was used because it is superior to acrylic cement alone in mechanical properties. The adventages of this method are: 1. The cautery effect of setting cement. 2. Avoidence of the need for large quantities of cancellous bone 3. The possibility of incorporating a prosthesis if the lesion is extensive. 4. Rapid mobilization. 5. Ease of early diagnosis of recurrence.
Cautery ; Cementation ; Curettage ; Early Diagnosis ; Female ; Femur ; Giant Cell Tumors ; Giant Cells ; Humans ; Methods ; Prostheses and Implants ; Recurrence ; Tantalum ; Tibia

We reviewed clinically the 56 patients, who had anterior interbody fusion of the cervical spine due to various causes, from 1975 to 1984. The result of the studies are as follows; 1. Inawaisting sign of the grafted level is the one of the most important prognostic factors which indicates the favorable fusion. 2. The mechanism of the inwaisting sign is not confirmed, however plausible explanation is the flexure drift law, which cause the inwaisting phenomena. 3. The time of clinical, radiological union and the appearance of the inwaisting sign of the grafted bone in the fusion of the lower cervical spine are displayed earlier than in the upper cervical spine. 4. Fusion at the one level is obtained one or two weeks earlier than the two level fusion. At the two level fusion, one large bone block operation achieved the earlier bony union than the two separate bone blocks fusion; it could shorten the fusion time by 4 weeks radiologically, although there were no significant difference in clinical aspect and inwaisting sign. 5. In the anterior interbody fusion of the cervical spine, clinical fusion took place in 6–7 weeks, and radiological one in 10-14 weeks after the fusion operation. And it was not influenced by the type of injury or neurological complications. The inwaisting sign appeared from the 4th to 7th week postoperatively. 6. There are no problems in the case of posterior instability initially. The reason is that we have performed the cervical traction and absolute bed rest for 4 to 6 weeks before the anterior interbody fusion in order to take the healing of the poterior ligament complex.
Bed Rest ; Clinical Study ; Humans ; Jurisprudence ; Ligaments ; Spine ; Traction ; Transplants

Supracondylar fracture of the humerus is the most common fracture of the elbow in children. Early accurate reduction is very important to obtain good results. Authors tried to reduce the fracture accurately under the concept of intact hinge mechanism. Forty-five displaced supracondylar fractures which were not able to be reduced by closed method were admitted for open reduction at our department from April 1981 to October 1985. They were analysed clinically. The result are as follows: 1. The patient age ranged from 3 to 14 years; 16.2% were between 7 and 8 years. 70.3% were boys Left humerus was affected in 70.3% of all cases. 2. The most common cause of fracture was falling down from height. 94.6% of fractures were extension type. The severity of displacement in 34 patients(90.2%) were grade III or 1V of Holmberg classification. 3. Only in 2 patients cubitus varus deformity was observed as residua and among the patients who were followed more than one year, only 2 had about 10 degrees of limitation of elbow motion. 4. In Holmberg's grade II, III, IV group, 22 cases(100.0%) of the both side pinned and 12 cases (80.0%) of one side pinned showed excellent or good results. Therefore, both side pinning could have contributed in obtaining more accurate reduction. 5. According to Mitchell and Adams' Criteria, 34 cases(91.9%) had satisfactory results.
Accidental Falls ; Child ; Classification ; Clinical Study ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Methods

No abstract available.

No abstract available.
Catheters*

Twenty four hyperlipidemic patients, consist of 13 males and 11 females, were administration a new hypolipidemic agents, Pantethine, and blood lipid level were checked sereally for 16 weeks. The following results are obtained. 1. The serum high density lipoprotein-cholesterol are markedly increased by 11.8%. 2. The serum cholesterol level are reduced mildly by 4.8% & it seems to be insignificant. 3. The serum triglyceride level are moderately reduced by 10.7%. 4. In 11 female patients, pantethine are more than effect on male patients. 5. Pantethine has been well tolerated in most patients. With a consideration of remakable safety, it is promising that pantethine are effective in reducing cholesterol, Triglyceride and increasing high density lipoprotein-cholesterol level.
Cholesterol ; Female ; Humans ; Hypolipidemic Agents ; Male ; Triglycerides