We experienced 2-cases of epileptic seizures aggravated by CBZ, of one which was 15-year old frontal lobe epileptic and the other was 8-year old occipital lobe epileptic. Their seizures were disappeared by withdrawal of CBZ. In conclusion, if a child or adult is noted to have more seizures or to have a new type of seizure when CBZ is added. One should consider the possibility that the seizures are drug-induced rather than part of the natural course of a progressive epilepsy and promptly withdraw CBZ.
Adolescent ; Adult ; Carbamazepine* ; Child ; Epilepsy ; Frontal Lobe ; Humans ; Occipital Lobe ; Seizures*

BACKGROUND: Total body irradiation (TBI) has been traditionally used as a conditioning regimen prior to hematopoietic stem cell transplantation (HSCT) in patients with pediatric leukemia. However, TBI can cause late sequelae such as growth impairment, cataract, hormone abnormalities, infertility, neurocognitive effects, and secondary malignancy in pediatric patients.METHODS: This single center retrospective study included 22 patients with acute lymphoblastic leukemia who were aged <18 years and underwent HSCT between May 1999 and December 2014; seven patients received a TBI-based regimen and 15 received a non-TBI regimen.RESULTS: The overall survival and event-free survival rates in the TBI group were not significantly different from those in the non-TBI group (overall survival rate 71% vs. 73%, respectively; P=0.906; event-free survival rate 71% vs. 73%, respectively P=0.923).CONCLUSION: Our results indicate that non-TBI conditioning regimens can be an alternative treatment option of the treatment of pediatric acute lymphoblastic leukemia undergoing HSCT.
Cataract ; Child ; Disease-Free Survival ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Infertility ; Leukemia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies ; Survival Rate ; Whole-Body Irradiation

PURPOSE: The anthracyclines (AC) are widely used chemotherapeutic agents for pediatric cancers. However, the therapeutic use of these agents is limited by their cardiotoxicity. The aim of the present study was to investigate the usefulness of plasma B-type natriuretic peptide (BNP) levels as a marker for AC-induced cardiotoxicity compared to echocardiography in Korean children with cancer. METHODS: Fifty-five pediatric cancer patients who had received chemotherapy including AC were enrolled. The cumulative AC doses, clinical symptoms, and two echocardiography parameters, left ventricular fractional shortening (LVFS) and left ventricular ejection fraction (LVEF), were studied and compared with plasma BNP levels. RESULTS: In 55 patients, plasma BNP levels were measured 115 times and echocardiographies were performed 64 times. The median cumulative dose of AC was 325 mg/m2 (range 120-600; mean 345) and the median plasma BNP level was 10 pg/mL (range 5-950; mean 31). The cumulative AC doses correlated significantly with the plasma BNP levels (P=0.002). The plasma BNP levels correlated significantly with LVFS (P=0.018) and LVEF (P=0.025). Dilated cardiomyopathies were identified in three patients. LVFS and LVEF decreased and plasma BNP levels increased in a patient with acute dilated cardiomyopathy and in that with symptomatic chronic dilated cardiomyopathy. However, LVFS, LVEF and plasma BNP levels were normal in a patient with asymptomatic chronic dilated cardiomyopathy. CONCLUSION: The results of this study demonstrated that plasma BNP levels could be used as a marker for AC-induced cardiotoxicity; they showed good correlation with echocardiography findings in pediatric cancer patients. Plasma BNP levels may be used for the detection and management of AC-induced cardiotoxicity in Korean children with cancer.
Anthracyclines ; Cardiomyopathy, Dilated ; Child* ; Drug Therapy ; Echocardiography ; Humans ; Natriuretic Peptide, Brain* ; Plasma* ; Stroke Volume

No abstract available.

To eveluate the risk factors which are related to recurrence of ischemic stroke, we selected subjects who were admitted to YNUH due to recurrent stroke and compared their risk factors with non-recurred group- who suffered from single ischemic stroke. In the subjects, 55 of them are men and 22 were women and in the non-recurred groups, 84 of them were men and 40 were women, Subject's age ranged from 29 to 86 years(Mean 62. 5years), and non-recurred group's age ranged from 27 to 90 years(Mean 60.7years), Peak incidence of ischemic stroke is in the 7th decade in both groups. Age and sex are not statistically significant for recurrence of ischemic stroke. The patient's history of diabetes mellitus, myocardial infarction, atrial fibrillation, transient attack and type or site of ischemic stroke had no significant effect statistically on the recurrent ischemic stroke. However, when the patient had previous history of hypertension or systolic blood pressure more than 160mmHg and diastolic more than 95mmHg, there was substantial difference (P<0.05) between the two group in the recurrence of ischemic stroke. According to the above results, hypertension is most likely significang risk factor of the recurrence of ischemic stroke within 2yeats after initial one. Therefore, adequate treatment of the hypertension is impertant for the prevention of ischemic stroke. Further study is required for searching other risk factors.
Atrial Fibrillation ; Blood Pressure ; Diabetes Mellitus ; Female ; Humans ; Hypertension ; Incidence ; Male ; Myocardial Infarction ; Recurrence ; Risk Factors* ; Stroke*

Hepatitis C is transmitted via parenteral routes and has commonly chronic course with progression to liver cirrhosis and hepatocellular carcinoma. The seroprevalence of HCV in Korea is about 1%, but in leprosy patients it is not well-known. So, the study was performed on anti-HCV seroprevalence and its epidemiologic survey in leprosy patients. The leprosy patients were 619 subjects(M:343, F:276) who were hospitalized in Catholic Skin Clinic from 1997 to 2001. Serum anti-HCV was checked by MEIA(Microparticle Enzyme Immunoassay) method, as well as HBsAg, HBsAb and alanine aminotransferase(ALT) value. In addition, age, sex, residency, duration of leprosy, and the frequency of liver problems were reviewed by medical records. The results were as follows; 1. The mean age of subjects was 68.3+/-9.2 years with ranging from 28 to 94 years. 2. The anti-HCV seropositivity among 619 leprosy patients was 39.3% and it showed increasing trend with aging(p<0.05), whereas it was insignificantly associated with sex(p>0.05). 3. The residency of anti-HCV positive subjects were Gyeongbuk(40.7%), Gyeongnam(35.4%), Daegu(19.4%), and other areas(28.9%) in order. 4. The seropositivities of HBsAg and HBsAb were 4.5% and 11.8% respectively. Only 6(2.5%) patients were positive on both HBsAg and anti-HCV. 5. In 563 leprosy patients excluding unknown type(56 subjects), the anti-HCV seropositivities in leprosy type were 41.2%(163/396) in lepromatous leprosy(LL), 35.0%(14/40) in borderline leprosy(BB), 31.5%(40/127) in tuberculoid leprosy(TT) respectively with insignificant correlation(p>0.05). The HBsAg seropositivities were 4.8% in LL, 5.0% in BB, 3.1% in TT respectively, with insignificant correlation(p>0.05). 6. There were significant relationships between the seroprevalence of anti-HCV and the duration of leprosy in the well-recorded 433 leprosy patients (p<0.05). 7. The anti-HCV seropositivity in the elevated ALT(> or =40U/L) group was significantly higher than in normal group(<40U/L)(58.3% vs 37.2%, p<0.05). Of the 6 anti-HCV and HBsAg positive patients, ALT value was elevated in one patient. Comparatively, the anti-HCV positives were likely to have a higher incidence of liver problems. In conclusion, the seropositivity of anti-HCV in leprosy patients(39.3%) was high. There were significant relationship of the seropositivity of anti-HCV with age, duration of leprosy, residency, ALT value, and the frequency of liver problems, but not associated with sex, HBV markers and types of leprosy. Therefore check-up of routine biochemical screen of anti-HCV and the evaluation for the possible transmission routes (such as transfusion, drug abuse, sexual/household contact, shared needles, folk remedies, acupunctures, tattoos, etc.) are needed to set-up the precautionary measures in leprosy patients.
Alanine ; Carcinoma, Hepatocellular ; Hepatitis B Surface Antigens ; Hepatitis C* ; Hepatitis* ; Humans ; Incidence ; Internship and Residency ; Korea ; Leprosy* ; Liver ; Liver Cirrhosis ; Medical Records ; Medicine, Traditional ; Needles ; Seroepidemiologic Studies* ; Skin ; Substance-Related Disorders

Inflammatory pseudotumors, which clinically mimic neoplasms, are space-occupying collections of inflammatory cells, histiocytes, and fibroblasts. They are most often found in the orbits and lungs, but rarely in the head and neck region, and hardly ever in the nasal septum. Here we report on a 71-year-old woman with pseudotumor cerebri and an inflammatory pseudotumor of the nasal septum. This case demonstrates that inflammatory pseudotumor can cooccur in the brain and nasal septum.
Aged ; Brain ; Female ; Fibroblasts ; Granuloma, Plasma Cell* ; Head ; Histiocytes ; Humans ; Lung ; Nasal Septum* ; Neck ; Orbit ; Pseudotumor Cerebri

BACKGROUND: Invasive fungal infections (IFIs) are a life-threatening problem in immunocompromised patients. Despite timely diagnosis and appropriate antifungal therapy, clinical outcomes of IFIs remain unsatisfactory, necessitating treatment with a combination of antifungal agents. Therefore, childhood leukemic patients treated with voriconazole plus caspofungin were evaluated for the safety and efficacy of the combination antifungal therapy to treat IFIs. METHODS: In this retrospective study, medical records were retrieved for patients admitted to the Pediatric Department of Yeungnam University Hospital, Daegu, South Korea, between April 2009 and May 2013. Medical records of 22 patients were analyzed. RESULTS: Of the 22 patients studied, nine (41%) had been diagnosed with probable IFI, and 13 (59%) with possible IFI. All patients, except one, were already receiving antifungal monotherapy for the treatment of neutropenic fever. After a diagnosis of IFI was confirmed, antifungal monotherapy was replaced with combination therapy. The study's overall response rate was 90.9%, with complete responses in 86.3% of the patients. Two patients experienced a side effect of a small increase in liver enzyme levels. CONCLUSION: Voriconazole plus caspofungin combination therapy is an effective and safe treatment for serious IFI in pediatric patients with acute leukemia.
Antifungal Agents ; Aspergillosis ; Child* ; Daegu ; Diagnosis ; Echinocandins ; Fever ; Humans ; Immunocompromised Host ; Korea ; Leukemia* ; Liver ; Medical Records ; Retrospective Studies ; Voriconazole*

BACKGROUND AND OBJECTIVES: The demand for rhinoplasty has been high for both men and women over the years; recently, however, it is rapidly increasing for men as their interest in aesthetics has heightened. This study investigated the psychological characteristics of male patients who underwent rhinoplasty through questionnaire-guided consultation. In addition, we investigated the difference between patients and surgeons regarding their aesthetic concerns for rhinoplasty. SUBJECTS AND METHOD: Of the male patients who underwent rhinoplasty from January 2006 to December 2012, 124 patients who had completed the questionnaires were included. The questionnaire for rhinoplasty asked about the basic personality traits of patients, patients' complaints about their nose, reasons for receiving the operation and expectation for postoperative change. RESULTS: Patients responded most to the item, “I have high expectations for the surgery” for the question regarding personality characteristics, followed by the response, “I am concerned about my health.” Regarding questions about reasons for rhinoplasty, complaints about their dorsum were high; among these patients, they were most concerned about the appearance of the ‘crooked nose’ when viewed from the front. On the other hand, the concern for the ‘poorly defined nasal tip’ was not high, whereas it was defined as one of the problems mentioned by the surgeons. CONCLUSION: These results show differences regarding aesthetic concerns between the patients and the surgeon, especially regarding the nasal tip. It would be helpful for both patient and surgen to plan the surgery after careful consultation based on the questionnaire, accurate understanding of the patients' complaints and expectations to obtain satisfactory results for both.
Anxiety ; Esthetics ; Female ; Hand ; Humans ; Male* ; Methods ; Nose ; Psychology ; Rhinoplasty* ; Surgeons

Incidence of nontuberculous mycobacterium (NTM) pulmonary disease is increasing with the wider recognition and development of diagnostic technology. Mycobacterium kansasii is the second most common pathogen of NTM pulmonary disease in human immunodeficiency virus (HIV)-infected patients. However in Korea, the incidence of M. kansasii pulmonary disease is relatively low, and there has been no report of M. kansasii pulmonary disease with bronchial involvement in HIV patients, to the best of our knowledge. We report a case of M. kansasii pulmonary disease presenting with endobronchial lesions in an HIV-infected patient complaining of chronic cough with bilateral enlargements of hilar lymph nodes on chest X-ray.
Bronchial Diseases ; Cough ; HIV ; Humans ; Incidence ; Korea ; Lung Diseases* ; Lymph Nodes ; Mycobacterium kansasii* ; Mycobacterium* ; Nontuberculous Mycobacteria ; Thorax