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

It is well known that the merit of total hip replacement is to provide rather satisfactory range of motion with relief of pain among reconstructive procedures. Therefore it is presumed that the ankylosed hip could gain range of motion by reconstruction of artificial joint, it the muscles around the hip is adequate. Furthermore when the patient has some problems in the back or knee secondary to ankylosed and deformed hip, any kind of reconstructive surgery, maybe total hip replacement is necessary which gives range of motion and correct deformity of the hip. Our result total hip replacements for fifteen ankylos d hips of twelve patients that were followed more than one year is gratifying to all patients with relief of pain and relatively satisfactory range of motion.
Arthroplasty, Replacement, Hip ; Congenital Abnormalities ; Hip ; Humans ; Joints ; Knee ; Muscles ; Range of Motion, Articular

BACKGROUND AND AIMS: When acute gastric anisakiasis is clinically suspected, endoscopic removal of larva is the only definite treatment method. However, there has been little known for endoscopic findings of gastric anisakiasis. METHODS: In 39 patients with gastric anisakiasis, the ingested species of marine products and clinical findings were investigated. The form of larvae, the mucosal changes of the insertion site, close and distant area were also analysed during endoscopic examination. RESULTS: Twelve patients (30.8%) ate raw Astroconger myriaster solely, and the most frequent mucosal insertion site of larvae was around the greater curvature of the body (59.5%). Endoscopic findings of erosion (33.3%), hemorrhagic erosion (33.3%) and redness of the mucosa (11.9%) were observed at the insertion site. The adjacent mucosal changes were edema and fold enlargement. All patients were treated medically. CONCLUSIONS: When acute gastric anisakiasis is suspected, the careful endoscopic examination of larva was necessary for confirmatory diagnosis and definite treatment of the disease.
Anisakiasis* ; Diagnosis ; Edema ; Humans ; Incheon* ; Larva ; Mucous Membrane

No abstract available.
Acrocephalosyndactylia* ; Hypertelorism* ; Orbit*

PURPOSE: Patency of the arteriovenous fistula remains the most important support for patients with end stage renal disease. Prosthetic materials have been used only when autogenous arteriovenous fistula procedure is not feasible, because of the relatively low patency in prosthetic arteriovenous fistula. We designed this study to determine the appropriateness of primary prosthetic arteriovenous fistula. METHOD: Twenty-one consecutive patients who underwent prosthetic arteriovenous fistula formation on the arm in Chosun university hospital from Mar. 1998 to Feb. 2001 were retrospectively analysed. RESULT: The median patency in radio-antecubital fistula, brachio-antecubital fistula, and brachio-axillary fistula was 9.6, 11.4, and 16.6 months, respectively. The primary assisted patency rates in radio-antecubital fistula and brachio-antecubital fistula were 44.9% and 70.0% at the first year, respectively (P=0.03). The secondary patency rates in radio-antecubital fistula and brachio-antecubital fistula were 71.4% and 80.0% at the first year and 28.6% and 48.0% at the second year, respectively (0.02). CONCLUSION: The patency rates according to the site of prosthetic arteriovenous fistula were statistically significant in the radio-antecubital fistula and brachio-antecubital fistula groups. Nevertheless, the patency rates of the brachio-axillary fistula group were statistically insignificant. Primary brachio-antecubital fistula with PTFE creation showed favorable patency rates and many other benefits. Therefore, we suggest primary brachio-antecubital fistula with PTFE as the appropriate arteriovenous access in patients with poor vessel condition.
Arm ; Arteriovenous Fistula* ; Fistula ; Humans ; Kidney Failure, Chronic ; Polytetrafluoroethylene ; Retrospective Studies

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.
Facial Nerve*

No abstract available.
Durapatite* ; Dust* ; Rabbits* ; Transplants*