No abstract available.

PURPOSE: A number of drugs are capable of changing body weight as a side effect. A number of neurotransmitter systems acting in several hypothalamic nuclei are pivotal to the storage regulation of body fat. Leptin is a protein encoded by the ob gene that is expressed in adipocyte. It regulates eating behavior by activating the action to the satiety center in the hypothalmus. The purpose of this study is to investigate the changes of serum leptin in children with epilepsy. METHODS: Serum leptin levels were measured in 43 epileptic patients (30 males, 13 females) receiving valproate or carbamazepine by radioimmunoassay. Thirty patients (19 males, 11 females, 10.0+/-5.0 years of age) were treated with valproate (VPA group) and 13 patients (11 males, 2 females, 9.1+/-4.0 years of age) were treated with carbamazepine (CBZ group). Obesity index and body mass index were calculated before and during anticonvulsant medications. RESULTS: 1) Body mass indices were significantly increased after VPA or CBZ medication; from 17.24+/-2.74 to 18.47+/-2.60 in VPA group, from 16.77+/-1.69 to 17.43+/-3.01 in CBZ group. 2) Obesity indices were increased without statistical significance after medication in both group. 3) Serum leptin levels were significantly higher in VPA group (4.54+/-4.77ng/ml) than CBZ group (2.47+/-2.26ng/ml). CONCLUSION: Body weight gain after VPA medication in susceptible individual might be related to a certain mechanism that elevates serum leptin level.
Adipocytes ; Adipose Tissue ; Body Mass Index ; Body Weight ; Carbamazepine ; Child* ; Epilepsy ; Feeding Behavior ; Female ; Humans ; Leptin* ; Male ; Neurotransmitter Agents ; Obesity ; Radioimmunoassay ; Valproic Acid ; Weight Gain

Meralgia paresthetica is a syndrome consisting of numbness, pain, tingling, burning and/or a variety of other paresthesias on the distribution of the lateral femoral cutaneous nerve (LFCN) of the thigh. We report a case of meralgia paresthetica in a 41-year-old woman who complained of the symptoms of pain, burning sensation, and dysesthesia which occurred whilst standing up without any other constitutional symptoms. The authors suspect that frequent. and persistent squatting may play a role in the development of the present symptoms.
Adult ; Burns ; Female ; Humans ; Hypesthesia ; Paresthesia ; Sensation ; Thigh

Epiblepharon is frequently encountered n oriental eyelid, especially in children. It is characterized by a horizontal fold of redundant skin and abundant orbicularis muscle near lid margin, which the lashes vertically, or posteriorly towards the eye. Surgical therapy of epiblepharon in correcting the trichiasis includes lid bracing sutures, burried sutures, skin resection, a Hotz procedure or its modification, and a Jones procedure. In our opinion, these procedures are not sufficient, because these procedures will not correct the epicanthal folds. Epicanthal folds have been a one of the characteristics of Asian over 50 percents of population in Japan and South Korea, and it either reduce the aesthetic result of the double-eyelid procedure or make the correction of the entropion and epiblepharon difficult. Although many surgical procedures are available to eliminate epicanthal folds, scarring on the medial canthus is in still and obstacle for surgeons to overcome. From January of 1998 to October of 1998, we used half z-plasty procedures in 5 cases to correct epicanthal folds in epiblepharon. There were few complications in our series. We believe that half z-plasty can get a good result in the correction of epibolepharon and oriental epicanthal folds.
Asian Continental Ancestry Group ; Braces ; Child ; Cicatrix ; Entropion ; Eyelids ; Humans ; Japan ; Korea ; Skin ; Sutures ; Trichiasis

Purpose: To report the surgical skills needed, and the clinical results of, minimally invasive hip surgery with dynamic hip screws and the comparison with the classical technique in stable pertrochanteric fractures of the femur. Materials and Methods: Thirty-two patients with pertrochanteric fractures of the femur who were treated with dynamic compression hip screws between April 1999 and March 2004, and were evaluated retrospectively, and were followed up for more than 12 months. 16 cases were treated with a classical dynamic hip screw technique and 16 cases with a minimally invasive technique in random order. The mean age was 73.2 years, and there were 11 males and 21 females. The operative times, total hemovac bleeding loss, functional scores, and average hemoglobin decrease ratios were evaluated. The clinical assessments were performed with the Harris Hip Score (HSS) and bony union was evaluated with serial follow-up plain radiographs. Results: The average operative time was 63.9 minutes with the classical technique and 42.5 minutes with the minimally invasive technique. The total average hemovac blood loss was 640 cc with the classical technique and 143 cc with the minimally invasive technique. Clinically, the HHS was an average of 85.9 and 89.2 in groups 1 and 2, respectively, by the last follow-up and there were no statistically significant differences between the two groups (P <0.05) The hemoglobin decrease ratio was the same in both groups and there was no nonunion. Conclusion: Minimally invasive dynamic hip screw insertion was useful in stable pertrochanteric fractures, because it decreased blood loss and operative times; and there were no changes in fracture healing and functional outcomes.
Female ; Femur ; Follow-Up Studies ; Fracture Healing ; Hemorrhage ; Hip* ; Humans ; Male ; Operative Time ; Retrospective Studies ; Surgical Procedures, Minimally Invasive

It is challenging to treat ventriculitis with parenteral treatment alone in some cases because of the difficulty involved in maintaining an appropriate level of antibiotics in cerebrospinal fluid (CSF). We report two cases of ventriculitis who did not respond to intravenous (IV) antibiotics but were successfully treated with intraventricular antibiotics using IV agents. The first case was a four-month-old male patient with X-linked hydrocephalus.He showed ventriculitis due to Klebsiella pneumoniae not producing extended-spectrum β-lactamase and susceptible to third-generation cephalosporins and gentamicin, following ventriculoperitoneal (VP) shunt. His condition did not improve during the 47 days of treatment with IV cefotaxime and meropenem. We achieved improvement in clinical presentation and CSF profile after three times of intraventricular gentamicin injection. The patient was discharged from the hospital with antiepileptic drugs. The second case was a six-month-old female patient with a history of neonatal meningitis complicated with hydrocephalus at one month of age, VP shunt at two months of age, followed by a methicillinresistant coagulase-negative staphylococci (CoNS) shunt infection with ventriculitis after the shunt operation. CoNS ventriculitis recurred four weeks later. We failed to treat intractable methicillin-resistant CoNS ventriculitis with IV vancomycin for ten days, and thus intraventricular antimicrobial treatment was considered. Five times of intraventricular vancomycin administration led to improvement in clinical parameters. There were only neurological sequelae of delayed language development but no other major complications. Patients in these two cases responded well to intraventricular antibiotics, with negative CSF culture results, and were successfully treated for ventriculitis without serious complications.

A rare case of carpal tunnel syndrome caused by a thrombosed persistent median artery is presented here. The diagnosis was delayed due to the overlapping cervical radiculopathy. Acute severe pain and nocturnal paresthesia were chief complaints. Ultrasonography, magnetic resonance imaging, and computed tomography angiography revealed that the median nerve was compressed by the occluded median artery. Instead of surgery, conservative therapy was tried. It worked well for six months. The importance of using modalities for decision making of diagnosis and treatment is emphasized in this report.

PURPOSE: To correlate signal intensities of hepatocellular carcinomas on MR images with applied field strength, tumor vascularity, history of transarterial chemoembolization, and their histopathologic findings. MATERIALS & METHODS: Twenty-two tumors in 18 patients with histologically proved hepatocellular carciomas were examined by MRI at 0.5T(14), 1.5T(5), or 2.0T(3). Tumor size ranged from 1 cm to 10 cm. We analyzed the signal intensities, presence of pseudocapsule and mosaic pattern of hepatocellular carcinomas on TI-, T2- and heavily T2-weighted images, and correlated them with histologic type and grade, as well as tumor vascularity on hepatic arteriography. RESULTS: Signal intensities of the tumors were hyperintense(6), isointense(11), or hypointense(5) on Tl-weighted images, hyperintense(21) or isointense(1) on T2-weighted images, and hyperintense(15) or isointense(3) on heavily T2-weighted images. There were hypointense tumors(3/13) on Tl-weighted MR images at 0.5 T, whereas they were absent at 2.0 T(0/4). Only one tumor was avascular which was hyperintense on Tl-weighted images. Capsules were present in 13 cases and Tl-weighted images depicted them in 10 cases, while T2-weighted images depicted them in 8 cases. Mosaic patterns with inhomogeneous signal intensity were present in 15 cases, and were seen in 7 cases on Tl-weighted images whereas 11 cases on T2-weighted images. Mixed trabecular and pseudoglandular patterns of histologic growth were seen in 5 tumors. On MR images, trabecular portion was seen as hypointense area on Tl-weighted images and hyperintense on T2-weighted images. Pseudoglandular portion was seen as isointense or hyperintense area on Tl-weighted images and as marked hyperintense and on T2-weighted images. Mixed cytologic feature of classic and clear cell was found in 4 tumors and three of these 4 cases were hyperintense on Tl-weighted images. Four of the six tumors with grades I-II were hyperintense on Tl-weighted images. Tumors with grades II-Ill, Ill-IV were 14 cases, and only two of these cases showed hyperintensity on Tl-weighted images. Peliotic change was present in one case, and was seen as hyperintense foci on T2, & heavily T2-weighted images. CONCLUSION: Pathologic correlation suggest that hyperintensity on Tl-weighted images might be due to pseudoglandular pattern, low grade of malignancy or clear cell portion of hepatocellular carcinoma. Marked hyperintensity on T2-weighted images may be due to pseudoglandular pattern or peliotic change.
Angiography ; Capsules ; Carcinoma, Hepatocellular* ; Humans ; Magnetic Resonance Imaging*

From January 1989 to December 1994, 105 cases of Macrosugical tubal reversal were performed and 87 cases of them were followed up for more than 1 year postoperatively in the Department of Obstetrics and Gynecology, Pohang St. Mary's Hospital. The result were as follows;1. The mean age of the patients was 31.7 years and 93.1% of them had been sterilized by laparoscopic sterilization. 2. Average inteval between sterilization and tubal reversal was 43.3 months. 3. The reasons for requesting reversal of sterilization were remarrigae 41.5%, chagne of attitude 33.3%, loss of children 25.2%. 4. The distributions of the site of tubal anastomosis were isthmic-ampullar 58.6%, isthmic-isthmic 24.1%, cornual-isthmic 8.1%. 5. The postoperative tubal length was 5.0 cm or more in 78.0%. 6. The overall pregnancy rate after tubal reversal was 68.9% and the outcome of the pregnancy was as follows; term pregnancy 74.6%, premature delivery 1.8%, opontaneous abortion 10.9%, ectopic pregnancy 9.1%, pregnancy state 3.3%.
Child ; Female ; Gyeongsangbuk-do ; Gynecology ; Humans ; Obstetrics ; Pregnancy ; Pregnancy Rate ; Pregnancy, Ectopic ; Sterilization

Phytolacca americana poisoning is a benign plant intoxication that causes gastrointestinal symptoms, including abdominal cramps, vomiting, diarrhea, and gastrointestinal bleeding. Other signs and symptoms include diaphoresis, salivation, visual disturbance, and seizures or mental changes. We report two cases of patients who experienced confusion and abdominal pain, vomiting, and hematemesis after oral ingestion of pokeweed. A 60-year-old female with confusion and a 67-year-old female with abdominal pain, vomiting, and diarrhea were admitted to the emergency department after pokeweed poisoning. After supportive treatment of hydration and gastrointestinal medication, the two patients showed full recovery within 24 h and were discharged from the hospital.
Abdominal Pain ; Aged ; Colic ; Diarrhea ; Eating ; Emergencies ; Female ; Hematemesis ; Hemorrhage ; Humans ; Middle Aged ; Phytolacca ; Phytolacca americana ; Plant Poisoning ; Plants ; Salivation ; Seizures ; Vomiting