Cognitive impairment associated with childhood-onset epilepsy is an important consequence in the developing brain owing to its negative effects on neurodevelopmental and social outcomes. While the cause of cognitive impairment in epilepsy appears to be multifactorial, epilepsy-related factors such as type of epilepsy and underlying etiology, age at onset, frequency of seizures, duration of epilepsy, and its treatment are considered important. In recent studies, antecedent cognitive impairment before the first recognized seizure and microstructural and functional alteration of the brain at onset of epilepsy suggest the presence of a common neurobiological mechanism between epilepsy and cognitive comorbidity. However, the overall impact of cognitive comorbidity in children with epilepsy and the independent contribution of each of these factors to cognitive impairment have not been clearly delineated. This review article focuses on the significant contributors to cognitive impairment in children with epilepsy.
Brain ; Child ; Cognition ; Comorbidity ; Epilepsy* ; Humans ; Seizures

OBJECTIVE: To evaluate the association of maternal age with occurrence of fetal chromosomal abnormalities in Korean pregnant women of advanced maternal age (AMA). METHODS: A retrospective review of the amniocentesis or chorionic villous sampling (CVS) database at Gangnam and Bundang CHA Medical Centers, between January 2001 and February 2012, was conducted. This study analyzed the incidence of fetal chromosomal abnormalities according to maternal age and the correlation between maternal age and fetal chromosomal abnormalities in Korean pregnant women > or =35 years of age. In addition, we compared the prevalence of fetal chromosomal abnormalities between women of AMA only and the others as the indication for amniocentesis or CVS. RESULTS: A total of 15,381 pregnant women were selected for this study. The incidence of aneuploidies increased exponentially with maternal age (P<0.0001). In particular, the risk of trisomy 21 (standard error [SE], 0.0378; odds ratio, 1.177; P<0.001) and trisomy 18 (SE, 0.0583; odds ratio, 1.182; P=0.0040) showed significant correlation with maternal age. Comparison between women of AMA only and the others as the indication for amniocentesis or CVS showed a significantly lower rate of fetal chromosomal abnormalities only in the AMA group, compared with the others (P<0.0001). CONCLUSION: This study demonstrates that AMA is no longer used as a threshold for determination of who is offered prenatal diagnosis, but is a common risk factor for fetal chromosomal abnormalities.
Amniocentesis ; Aneuploidy ; Chorion ; Chromosome Aberrations ; Down Syndrome ; Female ; Humans ; Incidence ; Maternal Age ; Odds Ratio ; Pregnant Women ; Prenatal Diagnosis ; Prevalence ; Retrospective Studies ; Risk Factors ; Trisomy

No abstract available.
Stevens-Johnson Syndrome*

OBJECTIVE: To report the pregnancy which was made by in vitro fertilization using recombinant follicle stimulating hormone and gonadotropin releasing hormone antagonist. MATERIAL AND METHOD: Case report. RESULTS: Six oocytes were retrieved and all were fertilized by intracytoplasmic sperm injection. Six embryos were transferred and the pregnancy was confirmed. CONCLUSION: It is envisaged that the availability of recombinant gonadotropins and gonadotropin releasing hormone antagonists will ultimately lead to shorter, cheaper and safer treatments, using reduced dosages.
Pregnancy ; Female ; Humans

No abstract available.
Child* ; Humans

BACKGROUND: The product of oxygen-free radicals inf1ict oxidative injuries on healthy cells. Antioxidants such as superoxide dismutase(SOD), glutathione peroxidase, and reduced glutathione(GSH) are present in almost all cells and play important roles in metabolism, transport, and cellular protection. We measured blood GSH levels in healthy controls and patients with non insulin dependent diabetes mellitus(NIDDM) for evaluation of the clinical usefulness of GSH. METHODS: Erythrocyte GSH levels were measured in fifty healthy controls and thirty NIDDM patients with diabetic retinopathies by Beutler's method. We also tested within-run precision, between-run precision, linearity and recovery rate to evaluate this method measuring erythrocyte GSH levels. RESULTS: The GSH levels (mean +/-SD) of NIDDM patients (5.03+/-0.67mumo1/Hb) were significantly lower than those of healthy control group (6.46+/-0.85mumo1/Hb)(P<0.001). The results of within-run precision and between-run precision when stored at 4degrees Cwere excellent (coefficient of variation were 2.79% and 2.42%, respectively), however, when stored at the room temperature the GSH levels were sharply declined. The linearity and recovery rate were acceptable. CONCLUSIONS: The prescision, linearity, and recovery rate of GSH measurement were excellent. The GSH levels in NIDDM patient group were reduced, and this probably contributes to the defective defense mechanism against increased oxidative stress. Additional measurement of other antioxidants such as superoxide dismutase and glutathione Peroxidase may be required to clarify the pathologic significance of glutathione metabolism in various diseases.
Antioxidants ; Diabetes Mellitus, Type 2 ; Diabetic Retinopathy ; Erythrocytes* ; Glutathione Peroxidase ; Glutathione* ; Humans ; Insulin ; Metabolism ; Oxidative Stress ; Superoxide Dismutase ; Superoxides

No abstract available.
Preimplantation Diagnosis*

PURPOSE: To compare functional recovery and clinical outcome for internal fixation and hemiarthroplasty groups over eighty years old for basal intertrochanteric fracture. MATERIALS AND METHODS: Forty-two cases among 62 treated from Aug. 1997 to May 2001 (22 internal fixation-group A and 20 hemiarthroplasty-group B) were retrospectively evaluated to assess walking level, activity of daily living, mental status, dementia, chronic illness and complications after at least a one year follow up. RESULTS: Partial weight bearing was started at a postoperative 14.5 and 9.5 days and full weight bearing at 10 and 3 weeks in group A and B, respectively. Walking level changed from 3.5 to 2.2 in group A, from 3.0 to 2.5 in group B, and the daily living activity scale from 4.8 to 7.9, and from 4.6 to 6.2. Mental status reduced from 22.8 to 18.2, and from 22.8 to 19.7 in each group. Newly developed dementia occurred in 6 and 5, and the index of chronic illness increased from 2.09 to 2.27, and from 2.05 to 2.25 in each group. Other postoperative complications showed no significant difference between the groups. CONCLUSION: The authors suggest bipolar hemiarthroplasty shows better functional recovery in terms of walking level, activity of daily living, and mental status, but same recovery for dementia, postoperative delirium and chronic illness compared to the internal fixation group. Therefore, the authors suggest that bipolar hemiarthroplasty in an effective surgical method in the over eighties.
Activities of Daily Living ; Chronic Disease ; Delirium ; Dementia ; Femur ; Follow-Up Studies ; Hemiarthroplasty* ; Postoperative Complications ; Retrospective Studies ; Walking ; Weight-Bearing

Abrupt progression of renal scarring associated with vesicoureteral reflux (VUR) is rare in males over 2 years old of age. We report a 5 year old boy with sustained unilateral high grade VUR who experienced abrupt progression of renal scarring; he had a relative renal radionuclide uptake of 38% at 2 years of age that dropped to 8% after three years. Per his parent's wishes, he took prophylactic antibiotics for 25 months after his first febrile urinary tract infection (UTI) at 4 months old without surgical management. One episode of recurrent breakthrough infection occurred at the age of 2 years. This observation reminds us that a recommending surgical management for sustained high grade VUR associated with renal scarring might be needed. Close follow up of DMSA for renal scanning, and long term follow up of patients after the first febrile UTI are important.
Anti-Bacterial Agents ; Cicatrix ; Follow-Up Studies ; Humans ; Male ; Succimer ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: This study evaluated the shortening and rotational deformity after closed intramedullary nailing of femur shaft fracture according to Winquist-Hansen classification type. MATERIALS AND METHODS: This study was based on 98 cases who received cloased intramedullary fixation about their femur shaft fractures between January 2000 and October 2005 with minimum 12 months follow up. The rotational deformity was analysed by Yang's method (45 cases) preoperatively and postoperatively, and the shortening by orthoradiogram (55 cases). Furthermore we analysed other complications, for example nonunion, infection, and metal failure. RESULTS: We found more than 15 degrees anteversion difference of both femurs in 10 cases. Among them, 9 cases were classified to type 3, 4. According to Winquist-Hansen classification, rotational deformity ranged from 3.7° (Type 1) to 8.9° (Type 4). More than 2 cm leg length discrepancy (LLD) was found in 9 cases, all of them were classified as Winquist-Hansen classification type 3, 4. In the type 1, LLD was checked as 3.2 mm and type 4, 14.2 mm. CONCLUSION: To prevent the shortening and rotational deformity after intramedullary fixation of Winquist-Hansen classification type 3, 4 femur shaft fracture, intraoperatively the exact contralateral femoral anteversion and length should be checked.
Classification* ; Congenital Abnormalities* ; Femur* ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Leg ; Methods