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

The endoscopic variceal ligation(EVL) has been adopted as a new treatment for acute hemorrhage from esophageal varices that ranks the highest mortality rate in upper gastrointestinal tract bleedings. This treatment method has good effects for the urgent treatment and eradication of varices from acute variceal bleeding in repeated sessions. We enrolled 34 patients with an acute or chronic variceal bleeding episode at the time of admission in this study from Apr. 8, 1992 to June. 2, 1994. Among 34 patients, there were 31 males and 3 females, at ages between 45-66(mean: 52 years). The incidence of symptoms on admission was 10 in tarry stool, 9 in hematemesis 8 in ascites, 4 in hepatic encephalopathy and 3 in nonspecific symptoms. Varices were eradicated or reduced to grade I in 30(88.2%) of the 34 patients by 4-25 bands (mean: 10.8 bands) in 1-7 EVL sessions(mean: 3.1 sessions). After EVL, there are complicated by active bleeding in 3 patients, dysphagia in 3 patienta and transient chest discomfort in 5 patients but subsided during 24 hours. These results indicated that EVL is a safe method for treatment of bleeding from esophageal varices.
Ascites ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Female ; Hematemesis ; Hemorrhage* ; Hepatic Encephalopathy ; Humans ; Incidence ; Ligation* ; Male ; Mortality ; Thorax ; Upper Gastrointestinal Tract ; Varicose Veins

BACKGROUND: The growth of elderly population increased the need for oral health care. Elderly patients with poor teeth alignment needs more attention with orthodontic treatment METHODS: Elderly patients visiting department of orthodontics, Kangdong Sacred Heart Hospital between 2000-2004 were treated with fixed appliances in one or both dental arches. Treatment plans were different from than that of younger patients and included uncommon and strategic removals of teeth and prosthesis. RESULTS: There was decrease in orthodontic treatment forces with increasing age, and the observation made from this study was favorable in the patients' as well as in the orthodontist's, point of view. It was possible to move the remaining teeth considerably, and the retention was made with various fixed appliances. CONCLUSIONS: Orthodontic treatment is not limited by patient age. However, it is wise not to extend treatment goals too far beyond the patients' objective needs
Aged* ; Dental Arch ; Heart ; Humans ; Oral Health ; Orthodontics ; Prostheses and Implants ; Tooth

Darier's disease is an autosomal dominant disorder with altered keratinization of the epidermis, but many cases are sporadic and presumably represent new mutation. Multiple discrete, keratotic, asymptomatic or mild pruritic papules are present at not only the seborrheic areas but also oral mucosa, palm and sole. The histologic characteristic changes in Darier's disease are formation of corps ronds and grains, suprabasal acantholysis and villi. We experienced a case of Darier's disease with preceding lesions of palm and sole, so reported this case with literature review.
Acantholysis ; Edible Grain ; Darier Disease* ; Epidermis ; Mouth Mucosa

Multiple dermatofibromas are rare and some case reports show this disease has been related to generalized defective immune function: autoimmune disease and altered immunity, such as AIDS and systemic lupus erythematosus(SLE), can be treated with immunosuppressive agents. But there are no specific reports of this disease developing in healthy people. We describe a case of multiple dermatofibromas in a 38-year-old healthy man who showed no abnormality of the immune function.
Adult* ; Autoimmune Diseases ; Histiocytoma, Benign Fibrous* ; Humans ; Immunosuppressive Agents

In Albright's hereditary osteodystrophy (AHO) including the syndromes of pseudohypoparathyroidism (PHP) and pseudopseudohypoparathyroidism (PPHP), multiple areas of intracutaneous ossification are often encountered. The characteristic features are short stature, round face, short neck, obesity, cutaneous ossifications, and various skeletal anomalies including short metacarpal and metatarsal bones, curve of radius, and brachydactyly. The patient was a 10-month-old male infant. He presented slightly depressed erythematous hard plaques on the left upper chest and left thigh. We had taken biopsies from both skin lesions, confirming cutaneous ossification or bone formation. He also had the characteristic features of AHO. He had a history of admission due to patent ductus arteriosus and atrial septal defect. The laboratory results showed slightly decreased calcium, increased phosphorus and PTH levels. The patient received no specific corrective measures because his calcium and phosphorus levels were not far from normal values until newly developed similar skin lesions appeared.
Biopsy ; Brachydactyly ; Calcium ; Ductus Arteriosus, Patent ; Heart Septal Defects, Atrial ; Humans ; Infant ; Male ; Metatarsal Bones ; Neck ; Obesity ; Osteogenesis ; Phosphorus ; Pseudohypoparathyroidism* ; Pseudopseudohypoparathyroidism ; Radius ; Reference Values ; Skin ; Thigh ; Thorax

No abstract available.
Malaria*

We report two cases of vulvar syringorna in a 40-year-old women and a 28-year-old woman who had 2-3mm sized, brownish papules on both valvar areas an l-3rnm sized, yellow-brownish papules on both vulvar ares with yellowish milia-like lesion the surface, respectively. Microscopically the lesions revealed characteristic findings of syrinzoiza However the second case showed a small cystic duct in the papillary dermis, which is lineilly a stratified epithelium and filled with concenteric lamellae of keratin.
Adult ; Cystic Duct ; Dermis ; Epithelium ; Female ; Humans ; Syringoma* ; Vulva

No abstract available.
Scalp* ; Skin* ; Transplants*

Currently several modalities are available for performing intracorporeal lithotripsy including ultrasound, electrohydraulic and laser procedures. We report our initial clinical experience with a new and unique technology for performing intracorporeal lithotripsy, namely the Swiss Lithoclast. 35 patients were performed for removal of ureteral stone. This device successfully fragmented 31 of 35 ureteral calculi (89%). Complications of stone removal were gross hematuria (3 cases), high fever (2 cases). All complications were treated successfully with conservative management. In conclusion, we have found the ability of the Swiss Lithoclast to fragment stones safely and without significant complications.
Fever ; Hematuria ; Humans ; Lithotripsy ; Ultrasonography ; Ureter* ; Ureteral Calculi ; Urinary Calculi