Zonisamide was administered to 20 patients with refractory epileptic seizures. The mean duration of the administration was 6 months, and the mean dosage was 7.2 mg/kg/day. The efficacy of zonisamide was rated remarkable in 15% of the cases, improvement in 40%, and no change in 45%. The response rates of zonisamide were 62.5% for myoclonic seizures, 50% for tonic-clonic seizures, 80% for atonic seizures and 33.3% for atypical absence seizures. There was no correlation between the clinical response and dose or serum concentration of the drug. The adverse effects were observed in 35% of the cases which were drowsiness, dizziness, ataxia, nausea, and vomiting. In all cases, however, the administration of zonisamide could be continued.
Ataxia ; Child* ; Dizziness ; Epilepsy* ; Epilepsy, Absence ; Humans ; Nausea ; Seizures ; Sleep Stages ; Vomiting

No abstract available.
Biomarkers* ; Carcinoma, Hepatocellular* ; Hepatitis B* ; Hepatitis* ; Humans ; Korea* ; Prevalence*

A 47-year-old woman with stage IV chronic kidney disease developed a fistula between common carotid artery (CCA) and internal jugular vein (IJV) during central catheterization of the right IJV. The patient was treated with a self-expandable graft stent, which achieved successful closure of the carotid-jugular fistula. As demonstrated in our case, self-expandable graft stents could be a feasible treatment option for CCA-IJV fistulas without additional interventional procedures such as balloon angioplasty.
Angioplasty, Balloon ; Carotid Artery, Common* ; Catheterization, Central Venous ; Female ; Fistula* ; Humans ; Jugular Veins* ; Middle Aged ; Renal Insufficiency, Chronic ; Stents* ; Transplants*

PURPOSE: This study was conducted to compare the cumulative survival rates (CSRs) and the incidence of postloading complications (PLCs) between a bone-level internal connection system (ICS-BL) and an external connection system (ECS). METHODS: The medical records of patients treated with either a ICS-BL or ECS between 2007 and 2010 at Asan Medical Center were reviewed. PLCs were divided into two categories: biological and technical. Biological complications included >4 mm of probing pocket depth, thread exposure in radiographs, and soft tissue complications, whereas technical complications included chipping of the veneering material, fracture of the implant, fracture of the crown, loosening or fracture of the abutment or screw, loss of retention, and loss of access hole filling material. CSRs were determined by a life-table analysis and compared using the log-rank chi-square test. The incidence of PLC was compared with the Pearson chi-squared test. RESULTS: A total of 2,651 implants in 1,074 patients (1,167 ICS-BLs in 551 patients and 1,484 ECSs in 523 patients) were analyzed. The average observation periods were 3.4 years for the ICS-BLs and 3.1 years for the ECSs. The six-year CSR of all implants was 96.1% (94.9% for the ICS-BLs and 97.1% for the ECSs, P=0.619). Soft tissue complications were more frequent with the ECSs (P=0.005) and loosening or fracture of the abutment or screw occurred more frequently with the ICS-BLs (P<0.001). CONCLUSIONS: Within the limitations of this study, the ICS-BL was more prone to technical complications while the ECS was more vulnerable to biological complications.
Chungcheongnam-do ; Crowns ; Dental Implant-Abutment Design ; Dental Implants ; Humans ; Incidence* ; Medical Records ; Retrospective Studies ; Survival Rate

BACKGROUND: The interest of patients with chest pain and normal coronary arteries has been increased since 1960. From the year 1973, the syndrome representing these characteristics has been classified as syndrome X. Treadmill test and exercise TI-201 SPECT are important in the diagnosis of syndrome X. This study was designed to evaluate the clinical value of exercise TI-201 SPECT and the difference of clinical characteristics between exercise TI-201 SPECT positive(Group A) and negative (Group B) in patients with chest pain and normal coronary angiogram. METHODS: Twenty seven patients with chest pain and normal coronary angiogram underwent echocardiogram and exercise TI-201 SPECT. Patients received 2 mCi of thallium intravenously during exercise, redistribution images were performed 4 hour later and second dose of 1 mCi of thallium was injected at rest immediately thereafter. These three sets of image(stress, redistribution and reinjection) were analyzed. RESULTS: 1) 12 of 16 patients in Group A, none of 11 patients were positive on exercise treadmill test(p<0.005). 2) The incidence of systemic hypertension in Group A was significant greater than Group B(p<0.05). 3) The left ventricular end diastolic pressure was significantly higher in Group A than in Group B (p<0.05). CONCLUSION: The exercise TI-201 SPECT is a useful method to evaluate the patients with chest pain and normal coronary angiogram and the reversible perfusion defects on the exercise TI-201 SPECT might be related to systemic hypertension and elevated left ventricular end diastolic pressure.
Blood Pressure ; Chest Pain* ; Coronary Vessels ; Diagnosis ; Exercise Test ; Humans ; Hypertension ; Incidence ; Perfusion ; Thallium ; Thorax* ; Tomography, Emission-Computed, Single-Photon*

Objectives: Ovarian suppression using Gonadotropin releasing hormone (GnRH)-agonist in premenopausal women with breast cancer has been known to improve disease-free survival and overall survival. However, long-term effect of ovarian suppression on lipid metabolism has not been studied yet. In this retrospective cohort study, we aimed to investigate cholesterol changes during medical ovarian suppression. Methods: and Materials: We reviewed medical records and blood test results of 152 women who have been diagnosed as breast cancer and started GnRH-agonist every 12 weeks therapy for more than 24 weeks in Asan Medical Center between 2018.1.1 and 2020.12.31. Patients who had previously diagnosed dyslipidemia or diabetes, or newly received lipid-lowering agents during study period were excluded from the cohort. Age at diagnosis and preoperative Body Mass Index (BMI) were investigated as baseline demographics. Generalized additive mixed model was applied to analyze the relationship between duration of GnRH-agonist and cholesterol changes. Results: The age was distributed as 42.5±5.2 years old (mean±SD), and preoperative BMI was 23.0±3.6 kg/m2 (mean±SD). Duration of GnRH agonist therapy ranged from 5.6 to 37.7 months, with mean of 19.3. Total cholesterol was 171 mg/dL before starting GnRH-agonist, whereas 181 mg/dL on last check, which was significantly higher than initial value (p=0.03). Duration of GnRH-agonist did not affect total cholesterol level until 19.3 months, while significantly increased by 1.8 mg/dL for each month thereafter (p=0.011). There was no significant effect of age, preoperative BMI and GFR on total cholesterol. Conclusion While long-term use of GnRH-agonist is applied, patients should be monitored for dyslipidemia after 19 months of treatment and lipid-lowering agents may be considered especially when indicated.

Objectives: To investigate the changes in cholesterol levels during medical ovarian suppression. Methods: We reviewed the medical records and blood test results of 187 female patients with breast cancer who underwent gonadotropin-releasing hormone (GnRH)-agonist therapy for > 24 weeks at our hospital between 1 January 2018 and 31 December 2020.The study excluded patients in this cohort who had previously been diagnosed with dyslipidemia, diabetes, or had recently received lipid-lowering agents, resulting in a final sample size of 152 participants. The age at diagnosis and preoperative body mass index (BMI) were included as baseline demographics. A generalized additive mixed model was applied to analyze the relationship between the duration of GnRH-agonist treatment and changes in cholesterol levels. Results: The study participants had a mean age of 42.5 ± 5.2 years and a mean preoperative BMI of 23.0 ± 3.6 kg/m2 ; the mean GnRHagonist therapy duration was 19.3 months (range: 5.6–37.7 months); and the total cholesterol level before GnRH-agonist treatment was 171 mg/dL that was significantly higher at 181 mg/dL (P = 0.03) during the most recent measurement. The total cholesterol level was unaffected by the GnRH-agonist therapy until 19.3 months after which it significantly increased by 1.28 mg/dL per month (P = 0.011).There was no significant effect of age, preoperative BMI, or the glomerular filtration rate on the total cholesterol levels. Conclusions Long-term GnRH agonist therapy for > 19 months can cause a significant increase in the serum cholesterol levels. To prevent complications, patients receiving the treatment should be informed and monitored for the possible progression of dyslipidemia.

OBJECTIVES: The purpose of this study was to get the clinical significance of urinary ocncentration of epidermal growth factor (EGF) of the patients with benign and malignant gynecologic tumors comparked to normal conterol group. METHODS: We studied the urinary EGF levels in 73 patients with gynecologic tumors at MIn-joong General Hospital of konkuk univ. the colleted samples were treated by radioimmnunoassay thechnique. chi-square analysis and STudent's t-test were used. significance was determined at the level of p < 0.05. RESULT: in 73 cases, benign gynecologic tumors were 54cases and gynecologic cancer were 19case (cervical cancer 8, ovarian cancer 8, other gynecologic cancer 3). the old in gynecologic cancers. The mean urinary EGF levels of the patients with benign gynlogic cancers. The mean urinary EGF levels of the patients with bengin gynecologic tumors was 16.4 +/- 6.6ng/mg. creatinie, and 16.1 +/- 4.7ng/mg. creatinine in gynecologic cancers (15.3 +/- 4.3ng/mg. creatinine in cervical cancer, 16.4 +/- 3.7ng/mg. cretinine in ovarian cancer), 16.7 +/- 3.7ng/mg. creatinine in normal control grop. There was no sinificant difference in urinary EGF levels between control group and the patients with gynecologic tumors. There was no significant difference in urinary EGF levels between benign gynecologic tumors and gynecologic cancers. CONCLUSION: Our data suggest that urinary EGF may not be useful as a marker of gynecologic turmor.
Creatinine ; Epidermal Growth Factor* ; Hospitals, General ; Humans ; Ovarian Neoplasms ; Uterine Cervical Neoplasms

OBJECTIVES: The purpose of this study was to get the clinical significance of urinary ocncentration of epidermal growth factor (EGF) of the patients with benign and malignant gynecologic tumors comparked to normal conterol group. METHODS: We studied the urinary EGF levels in 73 patients with gynecologic tumors at MIn-joong General Hospital of konkuk univ. the colleted samples were treated by radioimmnunoassay thechnique. chi-square analysis and STudent's t-test were used. significance was determined at the level of p < 0.05. RESULT: in 73 cases, benign gynecologic tumors were 54cases and gynecologic cancer were 19case (cervical cancer 8, ovarian cancer 8, other gynecologic cancer 3). the old in gynecologic cancers. The mean urinary EGF levels of the patients with benign gynlogic cancers. The mean urinary EGF levels of the patients with bengin gynecologic tumors was 16.4 +/- 6.6ng/mg. creatinie, and 16.1 +/- 4.7ng/mg. creatinine in gynecologic cancers (15.3 +/- 4.3ng/mg. creatinine in cervical cancer, 16.4 +/- 3.7ng/mg. cretinine in ovarian cancer), 16.7 +/- 3.7ng/mg. creatinine in normal control grop. There was no sinificant difference in urinary EGF levels between control group and the patients with gynecologic tumors. There was no significant difference in urinary EGF levels between benign gynecologic tumors and gynecologic cancers. CONCLUSION: Our data suggest that urinary EGF may not be useful as a marker of gynecologic turmor.
Creatinine ; Epidermal Growth Factor* ; Hospitals, General ; Humans ; Ovarian Neoplasms ; Uterine Cervical Neoplasms

BACKGROUND: The catheter ablation usin radiofrequency(RF) energy in patients with atrioventricular nodal reentrant tachycardia(AVNRT) and atrioventricular reentrant tachycardia(AVRT) ahs been proved as a safe and effective nonpharmacologic therapeutic modality. The purpose of our study was to evaluate the success rate and complications of the initial experience and to determine the extent of myocardial damage of RF catheter ablation. METHODS: Electrophysiologic study was performed with the standard technique. Twenty five patinents(M:F=16:9, mean age:42 years old) underwent RF catheter ablation in St. May's Hospital from April to December in 1994. The RF generator in this study was RFG-3D model and catheters were 6F or 7F steerable catheters with 4mm kistal tip. In order to evaluate the extent of myocardial damage the WBC count, LDH, CK, and CK-MB fraction were checked before and after RF catheter ablation and the Tc99m myocardial scintigraphy was performed within 72 hours of the porcedure. RESULTS: Six of twenty five patients had AVNRT, in which the success rate of selective ablation of the slow pathway was 83.8%. Nineteen patients with AVRT had one accessory pathway. The ablation success rate of 14 accessory pathways in left free wall location was 85.7%, and that of 3 in left posteroseptal location was 66.6%. Two right sided accessory pathways were not ablated successfully. The level of CK-MB fraction after ablation was within normal limit. Only one case revealed grade 2 of hot spot in Tc99m myocardial scintigraphy. CONCLUSION: The RF catheter ablation in patients with AVNRT and AVRT is a safe and effective nonpharmacologic therapeutic modality. But right sided accessory pathways are more difficult to ablate than left sided accessory pathways, requiring more experiences and better technique. The extent of myocardial damage after RF catheter ablation reveals relatively minimal by cardiac enzyme study and Tc99mmyocardial scintigraphy.
Catheter Ablation* ; Catheters ; Humans ; Myocardial Perfusion Imaging ; Radionuclide Imaging ; Tachycardia, Supraventricular*