Childhood epilepsy which has high prevalence rate and inception rate is one of the commonest problem encountered in pediatrician. In contrast with epilepsy of adult, in childhood epilepsy, more variable and varying manifestations are found because the factors of age, growth and development exert their influences in the manifestations and the courses of childhood epilepsy. Moreover epilepsy children have associated problems such as physical and mental handicaps, psychological disorders and learning disability. For these reasons pediatrician who deals with epileptic children experiences difficulties in making diagnosis and managing them. In order to improve understanding and management of childhood epilepsy, authors reviewed 103 cases of epileptic patients seen at pediatric department of Yeungnam University Hospital retrospectively. The patients were classified according to the type of epileptic seizure. Suspected causes of epilepsy, associated conditions of epileptic patients, age incidence and the findings of brain CT were reviewed. Large numbers of epileptic patients (61.2%) developed their first seizures under the age of 5. The most frequent type of epileptic seizure was generalized tonic-clonic, tonic, clonic seizure (49.5%), followed by simple partial seizure with secondary generalization (17.5%), simple partial seizure (7.8%), atypical absence (5.8%) and unclassified seizure (5.8%). In 83.5% of patients, we could not find specific cause of it, but in 16.5% of cases, history of neonatal hypoxia (4.9%), meningitis (3.9%), prematurity (1.9%), small for gestational age (1.0%), CO poisoning (1.0%), encephalopathy (1.0%) were found. 30 cases of patients had associated diseases such as mental retardation, hyperactivity, delayed motor milestones or their combinations. The major abnormal findings of brain CT performed in 42 cases were cortical atrophy, cerebral infarction, hydrocephalus and brain swelling. This review stressed better designed classification of epilepsy is needed and with promotion of medical care, prevention of epilepsy is possible in some cases. Also it is stressed that childhood epilepsy requires multidisciplinary therapy and brain CT is helpful in the evaluation of epilepsy with limitation in therapeutic aspects.
Adult ; Anoxia ; Atrophy ; Brain ; Brain Diseases ; Brain Edema ; Cerebral Infarction ; Child ; Classification ; Diagnosis ; Epilepsy* ; Generalization (Psychology) ; Gestational Age ; Growth and Development ; Humans ; Hydrocephalus ; Incidence ; Intellectual Disability ; Learning Disorders ; Meningitis ; Poisoning ; Prevalence ; Retrospective Studies ; Seizures

We studied the effects of the acute intermittent peritoneal dialysis in severe acute renal failure of 1 newborn infant and 2 young infants during 18 months period from February 1985 to April 1986. The predisposing illnesses were severe acute gastroenteritis with dehydration. Reye's syndrome, and bilateral nephrolithiasis with hyperuricemia. The concomitant illnesses were severe hypernatremia, hyponatremia, hyperkalemia, hypocalcemia, hypoglycemia, DIC (disseminated intravascular coagulopathy). Paralytic ileus, metabolic acidosis and gastrointestinal bleeding. As a dialysate, Imperinol solutionR, 1.5% was used in all cases. The cycles of dialysis were 8, 16, and 41 times in each cases. Observed complications during dialysis were leakage, and abdominal wall and scrotal swelling in 2 cases, hyperglycemia in 1 case, and peritonitis in 1 case. Acinetobacter calcoaceticus was cultured in peritoneal fluid of peritonitis. These complications were treated by stopping dialysis in leakage and abdominal wall swelling, insulin therapy in hyperglycemia, and intraperitoneal and systemic antibiotics therapy in peritonitis. We experienced improvements of severe acute renal failure with variable concomitant illnesses by acute intermittent peritoneal dialysis despite of the treatable complications of dialysis in all cases.
Abdominal Wall ; Acidosis ; Acinetobacter calcoaceticus ; Acute Kidney Injury* ; Anti-Bacterial Agents ; Ascitic Fluid ; Dacarbazine ; Dehydration ; Dialysis ; Gastroenteritis ; Hemorrhage ; Humans ; Hyperglycemia ; Hyperkalemia ; Hypernatremia ; Hyperuricemia ; Hypocalcemia ; Hypoglycemia ; Hyponatremia ; Infant* ; Infant, Newborn* ; Insulin ; Intestinal Pseudo-Obstruction ; Nephrolithiasis ; Peritoneal Dialysis* ; Peritonitis ; Reye Syndrome

The purpose of this study is to analyze degree of geographic maldistribution of physicians and changes in the distributional pattern in Korea over the years 1980-1985. In assessing the degree of distribution and in identifying changes in the distribution pattern, the Gini index of concentration was used. The geographical units selected for computation of the Gini index in this analysis are districts (Gu), cities (Si), and counties (Gun). Locational data for 1980 and 1985 were obtained from the population census data in the Economic Planning Board and regular reports of physicians in the Korean Medical Association. The rates of physician located countries to whole physicians were 10.4% in 1980 and 9.6% in 1985. In term of the ratio of physicians per 100,000 population, rural area had 9.18 physicians in 1980 and 12.95 in 1985, 7.13 general practitioner in 1980 and 7.29 in 1985, and 2.05 specialists in 1980 and 5.66 in 1985. Only specialists of general surgery and preventive medicine were distributed over 10% in county and distribution of every specialists except chest surgery in county increased in 1985, comparing with that rates of 1980. The Gini index computed to measure inequality of physician distribution in 1985 indicate as follows; physicians 0.3466, general practitioners 0.5479, and specialists 0.5092. But the Gini index for physicians and specialists fell -15.40% and -10.42% from 1980 to 1985, indication more even distribution. The changes in the Gini index over the period for specialists from 0.3639 to 0.4542 for districts, from 0.2510 to 0.1949 for cities, and 0.5303 for countries indicate distributional change of 24.81%, -22.35%, and 10.65% respectively. The Gini indices for specialists of neuro-surgery, chest surgery, plastic surgery, ophthalmology, tuberculosis, preventive medicine, and anatomical pathology in 1985 were higher than Gini indices in 1980.
Censuses ; General Practitioners ; Humans ; Korea ; Ophthalmology ; Pathology ; Preventive Medicine ; Rural Population ; Socioeconomic Factors ; Specialization ; Surgery, Plastic ; Thorax ; Tuberculosis

No abstract available.
Cheek* ; Rhabdomyosarcoma*

Fractures of the ankle joint that involve the tibial plafond result from axial compression and rotational forces causing variable degrees of rnetaphyseal disruption, articular damage, and malleolar displacement. Management of these fractures has been described as difficult and often discouraging. Recommended treatments have included manipulation and cast application, calcaneal traction using pins in plaster or external fixators, vertical transarticular pin fixation, percutaneous pinning of large fragments and immobilization in a plaster cast, fibular stabilization alone, limited open reduction of so-called key fragments, immediate motion with the foot in traction, primary arthrodesis, and even immediate amputation. But, the best results of treatment reported for this fracture have followed early open reduction and rigid internal fixation to restore length, reconstruction of the plafond, primary cancellous bone grafting, tibial buttress plates, early motion, and prolonged non-weight-bearing. We reviewed 40 cases of tibial plafond fractures treated at the Department or Orthopaedic Surgery, Yonsei University, Wonju College of Medicine, during 7 years from January 1980 to December, 1986. The longest duration of follow-up was 5 years and 4 months, the shortest one was 6 months, and the average was 2 years. The results were as follows: 1. Of the 40 cases, male were 32, female were 8. 2. The major causes of the injury of the ankle were fall down and traffic accident. 3. The tibial plafond fractures were classified into 5 types, according to the degree of displacement of the plafond, articular comminution, and metaphyseal disruption. Our cases were relatively in even distribution. 4. Regardless of the types of the fracture, better results were obtained by treatment with open reduction and rigid internal fixation than by any other ones. 5. Complications including superficial wound infection (4 cases), osteomylitis. (2 cases), delayed union (2 cases), non-union (2 cases) were observed. 6. This study suggest that the important variables that influenced the clinical result were the type of fracture, the method of treatment, and the quality of the reduction.
Accidents, Traffic ; Amputation ; Ankle ; Ankle Joint ; Arthrodesis ; Bone Transplantation ; Casts, Surgical ; Clinical Study ; External Fixators ; Female ; Follow-Up Studies ; Foot ; Gangwon-do ; Humans ; Immobilization ; Male ; Methods ; Traction ; Wound Infection

No abstract available.
Child* ; Headache Disorders* ; Humans

No abstract available.
Carcinoma, Squamous Cell* ; Cell Line* ; Suramin*

No abstract available.
Femoral Fractures* ; Hip Dislocation* ; Hip*

To evaluate the effect of a new topical anesthetic cream (EMLA : Eutectic mixture of local anesthetics) on reducing pain associated with DPT vaccination, we conducted a clinical observation on eighty infants who were brought to well baby clinic of Yeungnam University Hospital for DPT vaccination. 80 Infants, who were between 2 months and 8 months in age, were divided into two groups. EMLA treated group and control group. Male to femle sex ratio was 1.4 to 1. EMLA cream was applied 60 minutes before DPT vaccination, the effect of reducing pain was assessed by using McGrath's face scale, Oucher pain scale and modified behavioral pain scale (MBPS) and also evaluated by measuring the duration and time of crying (the time of the first crying after iniection, duration of the first crying, total duration of crying). The scores of those scales were lower in EMLA treated group than in control group significantly (P<0.01 in McGrath's face scale. MBPS and p<0.05 in Oucher pain scale). There was no difference in the time of the first crying after vaccination in both groups. The duration of the first crying was shorter in EMLA treated group than control group of crying was also shorter in EMLA treated group (EMLA treated group 9.0±12.5 sec, p<0.05). Transient skin erythema was noted in 5 infants after EMLA application, but no other adverse effects were observed. We conclude that the application of EMLA cream before vaccination seems to be an effective and safe way to reduce the pain from vaccination, but it takes usually 60 minutes to get the anesthetic effect of EMLA and it is expensive, so EMLA cream can not be recommended in routine vaccination in infants now.
Anesthetics ; Crying ; Erythema ; Humans ; Infant ; Male ; Sex Ratio ; Skin ; Vaccination* ; Weights and Measures

No abstract available.
Acne Conglobata* ; Acne Vulgaris* ; Steroids*