PURPOSE: The objective of this prospective study is to assess changes in body mass index(BMI, weight in kilograms/height in meters2) according to age and dosage on epileptic children treated with topiramate. METHODS: From January 2006 to December 2008, prospective studies have been performed on 63 children with epilepsy aged below 15 old who had been treated with topiramate. Patients were classified into 3 groups according to age: 2-5 years as a group 1; 6-10 years as a group 2; 11-15 years as a group 3;, and classified into 2 groups according to dosage: from 2 to 5 mg/kg/day as group A, more than 5 mg/kg/day to 8 mg/kg/day as group B. We have checked BMI of patients four times and evaluated the changes in BMI of each group. RESULTS: BMI at initial presentation and follow-up periods of 6, 12, and 24 months is as follows: 16.3+/-1.25, 14.3+/-1.8, 14.2+/-2.4, and 15.7+/-2.1 in the group 1, 18.5+/-1.23, 15.2+/-1.24, 14.8+/-2.27, and 16.8+/-2.5 in the group 2, 21.6+/-2.31, 16.5+/-2.17, 15.4+/-2.56, and 15.1+/-1.3 in the group 3. Comparing with group A and B is as follows: 19.3+/-2.35 and 18.1+/-1.89 at initial presentation, 15.5+/-2.45 and 15.1+/-1.15 at 6 months, 14.9+/-2.15 and 14.7+/-1.91 at 12 months, 15.9+/-1.28 and 16.0+/-1.12 at 24 months. CONCLUSION: The effect of topiramate on changes of BMI shows difference according to age. In groups of 2-10 years old, BMI was rebounded from lowest value after 12 months, however, in the group of 11-15 years old, BMI kept decreasing at 24 months. And dosage of topiramate does not affect to BMI significantly.
Aged ; Body Mass Index ; Child ; Epilepsy ; Follow-Up Studies ; Fructose ; Humans ; Prospective Studies

Medical students’ career choices hold significant importance at both individual and national levels. Therefore, Chungnam National University College of Medicine aimed to systematize its revised career fair in 2022, basing its efforts on a career planning process model. Chungnam National University College of Medicine sought to formalize the design process by utilizing the ADDIE model (analysis design, development, implementation, evaluation model) in developing programs for the career fair program. Throughout the entire process, the student support center and student council actively collaborated, striving to incorporate students’ requests and opinions. They designed and developed a program for all stages of the career planning process. However, a new stage (“review & reflection”) was added to the existing 4-phase model, creating a transformed framework where this stage interacts with the original 4 phases. Each stage involved portfolios, career aptitude tests, career-related lectures, posters with introductory information about majors, and booths for each major. The revised career fair attracted double the expected participants (N=589). The program evaluation survey showed overall positive responses (N=135). Additionally, some factors in the Specialty Indecision Scale showed significant differences between before and after the career fair. The success of the newly developed career fair at Chungnam National University College of Medicine can be attributed to its systematic framework and the active involvement of students throughout the process. However, for aspects with long-term implications, such as “understand yourself” and “choose your specialty,” there may be a need for supplementary programs.

The urachus is a normal embryonic remnant of the primitive dome. It generally exists as a fibrous cord extending from the dome of the bladder to the umbilicus. Disorders of the urachus are developed as a result of its incomplete regression. The urachal cyst is the most common urachal anomaly, and is usually asymptomatic in infancy and childhood. However, when the cysts are large or accompanied with secondary infection, they may be detected in its early stage. A sonography or CT scan may be helpful to confirm the diagnosis of urachal cyst. The managements of infected urachal cyst are varied from simple drainage to radical excision. Here, we report an unusual case of urachal cyst infection that occurred during corticosteroids therapy in a girl with IgA nephropathy.
Adrenal Cortex Hormones ; Coinfection ; Drainage ; Glomerulonephritis, IGA ; Humans ; Immunoglobulin A ; Umbilicus ; Urachal Cyst ; Urachus ; Urinary Bladder

BACKGROUND: It is important to evaluate the right ventricular (RV) function intraoperatively for optimal management of patients undergoing cardiac surgery. The clinical relevance of thermodilution method to tranesophageal echocardiography (TEE) for the measurements of RV function during off-pump coronary artery bypass surgery (OPCAB) was evaluated in this study. METHODS: Fifty patients undergoing OPCAB were included. RV function was assessed with both thermodilution method and TEE after anesthesia induction (T1), 10 min after leg elevation (T2), 10 min after returning to the supine position (T3), 10 min after Y-graft formation started (T4), 10 min after sternum closure (T5) and 10 min after applying 5 cmH2O of positive end expiratory pressure (T6). Fractional area change (FAC) and tricuspid annular plane systolic excursion ratio (TAPSE) were measured by TEE and compared to RV ejection fraction (RVEF) measured by thermodilution technique. RV end diastolic area (EDA) derived from TEE was compared to RV end diastolic volume index (EDVI) derived from thermodilution technique. RESULTS: There was no significant correlation between echocardiographic data and thermodilution data by linear regression analysis. However, only in patients with right coronary artery stenosis less than 90%, TAPSE and FAC were significantly correlated with RVEF (P = 0.008 and 0.01, respectively) and EDA was significantly correlated with EDVI (P = 0.013) only at T4. CONCLUSIONS: RV performance measured by thermodilution technique did not correlate well with TEE finding in severe coronary artery disease patients. The correlation was significant during hemodynamically stable period (during Y-graft formation) in patients without severe right coronary artery disease.
Anesthesia ; Coronary Artery Bypass, Off-Pump ; Coronary Artery Disease ; Coronary Stenosis ; Echocardiography* ; Echocardiography, Transesophageal ; Humans ; Leg ; Linear Models ; Positive-Pressure Respiration ; Sternum ; Supine Position ; Thermodilution* ; Thoracic Surgery ; Ventricular Function, Right*

BACKGROUND: This study was designed to compare the effect of low-molecular 6% hydroxyethyl starch (HES) 130/0.4 on hemostasis and hemodynamic efficacy with that of medium-molecular 6% HES 200/0.5 in patients undergoing off-pump coronary artery bypass surgery. METHODS: Forty-eight patients were randomized to receive up to 33 ml/kg of either 6% HES 130/0.4 or 6% HES 200/0.5. Hemodynamic variables and blood tests including thromboelastography were measured 10 min after induction (baseline value, T0), 5 min after acute loading of HES 10 ml/kg (T1) in hypovolemic patients, after sternum closure (T2), and 16 hr after intensive care unit (ICU) arrival (T3). Chest tube drainage was recorded until 16 hours after ICU arrival. RESULTS: Hemodynamic variables were similar in both groups. Chest tube drainage at 16 hr after surgery was higher in HES 200/0.5 group than that in HES 130/0.4 group. Maximum clot firmness was decreased in HES 200/0.5 group at sternal closure but not in HES 130/0.4 group. CONCLUSIONS: Both HES 200/0.5 and HES 130/0.4 were equally efficient in maintaining stable hemodynamics during off-pump coronary artery bypass surgery. However, HES 130/0.4 may reduce postoperative blood loss compared to that of HES 200/0.5 at the same dose of 33 ml/kg.
Blood Coagulation ; Chest Tubes ; Coronary Artery Bypass, Off-Pump* ; Drainage ; Fluid Therapy ; Hematologic Tests ; Hemodynamics* ; Hemostasis* ; Humans ; Hypovolemia ; Intensive Care Units ; Postoperative Hemorrhage ; Starch* ; Sternum ; Thrombelastography

BACKGROUDN: Docetaxel is a highly effective chemotherapeutic agent with proven efficacy for non-small cell lung cancer (NSCLC). However, myelosuppression can be a substantial concern when docetaxel is administered every 3 weeks. Weekly administration of low-dose docetaxel has demonstrated a comparable efficacy together with a distinct toxicity profile with reduced myelosuppression. We conducted a phase II study of weekly administration of docetaxel and cisplatin or carboplatin in patients with advanced NSCLC to evaluate efficacy and safety. METHODS: Twenty-nine patients with advanced or metastatic NSCLC who had not received prior treatment were enrolled in the study. The patients received intravenous infusions of docetaxel (35 mg/m2 on days 1, 8, 15) and cisplatin (75 mg/m2 on day 1) or carboplatin (AUC 6), followed by a week of rest. RESULTS: Twenty-six patients were assessable for efficacy and all patients were assessable for toxicity determination. The overall response rate of the regimen was 44.8%. The median survival was 11.3 months, and the 1-year survival rate was 37%. Of the hematologic toxicities, grade 3/4 neutropenia were observed in 12.6% of the patients, but there were no episodes of neutropenic fever. Non-hematologic toxicities were mild. CONCLUSIONS: With this weekly dosing regimen, although efficacy is comparable, myelosuppression is substantially less, and the overall tolerability profile is better than with dosing every 3 weeks.
Carboplatin ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin ; Fever ; Humans ; Infusions, Intravenous ; Neutropenia ; Platinum* ; Survival Rate