No abstract available.
Lung*

PURPOSE: Seizure outcomes are more complicated in terms of repeated remission and relapse in the course of epilepsy. We aim to investigate the different patterns of evolution in new-onset pediatric epilepsy and the seizure outcome of different types of epilepsy syndromes. METHODS: We examined the evolution pattern of remission and relapse in the course of epilepsy in 326 children who were less than 15 years of age, with new-onset epilepsy. Different remission-relapse patterns were determined in each patient and according to epilepsy syndromes. The probability of repeated remission and relapse were analyzed with Markov process. RESULTS: During follow-up (mean+/-SD: 79+/-25 months) of 326 patients, early remission, defined as remission within the first year of treatment, was seen in 288 patients (88.4%), and late remission was achieved in 21 patients (6.4%). 17 patients (5.2%) never achieved remission. 94.8% of the cohort experienced at least one remission, with first relapse, second relapse, and third relapse occurring in 115 patients (35.3%), 61 patients (18.7%), and 28 patients (8.6%), respectively. At the end of follow-up period, 281 patients (86.2%) were in terminal remission. 194 patients (59.6%) showed a continuous remitting course, and 87 patients (26.7%) showed a remitting-relapse course. 45 patients (13.8%), including worsening courses in 28 patients (8.6%) and drug resistant courses in 17 patients (5.2%), did not show terminal remission. Markov process disclosed that children with epileptic encephalopathy and symptomatic partial epilepsy were less likely to show remission than children with idiopathic partial or generalized epilepsy (P<0.001). CONCLUSION: Only 13.8% of children with new-onset epilepsy have poor seizure outcome in terms of never achieving remission or persistent seizure after achieving at least one remission. The etiology of epilepsy syndrome is an important factor determining seizure outcome.
Child ; Cohort Studies ; Epilepsies, Partial ; Epilepsy ; Epilepsy, Generalized ; Follow-Up Studies ; Humans ; Markov Chains ; Natural History ; Recurrence ; Seizures

STUDY DESIGN: This is a retrospective clinical study. OBJECTIVES: To know how the associated foot or ankle fracture influences the fracture pattern in the thoracolumbar burst fractures caused by falls from height. SUMMARY OF LITERATURE REVIEW: There were few studies on how the foot or ankle fracture influences the thoracolumbar fracture caused by falls from height. MATERIALS AND METHODS: We reviewed 46 subjects, who underwent surgery due to burst fracture of the thoracic or lumbar region, caused by fall accidents, from May 2004 to October 2008. Among them, we defined 19 cases that had associated foot or ankle fractures as group A, and the other 27 cases as group B. We analyzed the differences of radiological and clinical findings, and functional outcomes between the two groups. RESULTS: The falling heights were higher in group A than in group B (P<0.01). Thoracolumbar junction (T11-L2) was the most common location involved in both groups, but group A had more fractures on the lower lumbar region (L3-5), relatively (p=0.03). Kyphotic deformity was more severe in group B (p=0.01) but there were no significant differences in the wedge angle, amount of canal compromise, compression rate of anterior column between both groups (p=0.08, 0.46, 0.76). More segments were fused in group B (P=0.04). Neurologic deficit was more common in group B (p=0.03), but there were many complications related with foot or ankle fractures in group A (38%).There was no significant difference in the final clinical outcome between both groups (Pain scale p= 0.48, Work scale p=1.00). CONCLUSIONS: In patients who had burst fractures in the thoracic or lumbar region associated with foot or ankle fractures, there was a tendency to increase the incidence of lower lumbar fracture, relatively. The neurologic deficits were less common in this group of patients, but there was no difference in the functional outcome.
Animals ; Ankle ; Congenital Abnormalities ; Foot ; Humans ; Incidence ; Lumbosacral Region ; Neurologic Manifestations ; Retrospective Studies

No abstract available.
Veins*

PURPOSE: To evaluate the effectiveness of new management policies on the incidence of invasive Candida infections METHODS: This observational study involved a retrospective analysis of the patients' medical records. In total, 99 very low birth weight infants, who were admitted to the neonatal intensive care unit at Ajou University Hospital from January 2010 to December 2011, were enrolled for the study. Period I, defined as the period before the revision of management policies, comprised 57 infants; whereas, period II, defined as the period after the implementation of new management policies, comprised 42 infants. The new management policies entailed a reduction in antibiotic and histamine type 2 receptor blocker (H2 blocker) use, duration of central venous catheterization, and duration of endotracheal intubation. RESULTS: There was a significant overall decrease in the use of antibiotics including 3rd generation cephalosporin and H2 blockers (P<0.05), and a significantly lower incidence of invasive Candida infections in period II as compared to period I (0/42 vs. 6/57, respectively; P=0.037). Comparison between infants with invasive Candida infections (n=6) and those without (n=93) showed that gestational age (odds ratio [OR], 0.909; 95% confidence interval [CI], 0.829 to 0.996; P=0.042) and the duration of 3rd generation cephalosporin use (OR, 1.093; 95% CI, 1.009 to 1.183; P=0.029) were statistically significant risk factors. CONCLUSION: The new management policies effectively decreased overall use of antibiotics, especially 3rd generation cephalosporin, and H2 blockers, which led to a significantly lower incidence of invasive Candida infections.
Anti-Bacterial Agents ; Candida ; Candidiasis, Invasive ; Catheterization, Central Venous ; Central Venous Catheters ; Cross Infection ; Gestational Age ; Histamine ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Medical Records ; Retrospective Studies ; Sepsis

PURPOSE: The purpose of this study was to evaluate clinical and radiological results after osteosynthesis of distal phalangeal nonunion with bone defect by using matchstick-shaped bone graft. MATERIALS AND METHODS: Fifteen distal phalangeal nonunions were treated with osteosynthesis using matchstick-shaped bone graft from September, 2009 to October, 2010. The mean age of patients was 36.1 years (range: 15 to 56 years). This study included 4 women and 10 men. The mean duration of follow-up was 16.8 months (range: 12 to 20 months). We evaluated radiographs, and measured postoperative visual analogue scale (VAS) score and pinch power. RESULTS: Union was achieved in all cases at a mean of postoperative 5.5 weeks (range: 4 to 6 weeks). The mean VAS score improved from 7.25 (range: 5 to 9) to 1.0 (range: 0 to 2) postoperatively. The mean postoperative pinch power was 7.75 lbs (range: 4 to 13 lbs) compared to opposite pinch power of 9.63 lbs (range: 5 to 15 lbs). There was no scar problem, pinch pain and other complication. CONCLUSION: Steosynthesis of distal phalageal nonunion with bone defect by using matchstick-shaped bone graft is technically feasible and simple in that it does not need volar incision and debridement. It is considered as an effective treatment option in distal phalangeal nonunion with bone defect.
Bone Transplantation ; Cicatrix ; Debridement ; Female ; Follow-Up Studies ; Humans ; Male ; Transplants

PURPOSE: The objective of this study was to evaluate clinical results of dual miniplate fixation for comminuted or periarticular fractures of the hand. MATERIALS AND METHODS: Twenty cases in 18 patients who had comminuted or periarticular fractures of metacarpal or phalangeal bones were treated with dual miniplate fixation from April, 2007 to May, 2009. The mean followed up period was 14.7 months. Our study included comminuted or periarticular fractures which were difficult to keep the fixation by pining or single plating. We evaluated radiologic bony union, angular or rotational deformity, extensor tendon irritaion and total arc of motion. RESULTS: Bony union was achieved successfully after primary dual miniplate fixationin in 12 cases. In 7 cases with a nonunion following previous operative fixation, bony union was obtained by dual miniplate fixation and bone grafting. In one case who had received primary dual plate fixation, nonunion occurred due to massive bone defect. Bony union was obtained by secondary dual plate fixation and bone grafting. Postoperative rotational deformity, angular deformity and irritation symptom were not observed in all cases. Functionally acceptable range of active motion was restored by way of early active motion. CONCLUSION: The dual miniplate fixation is one of the useful method for comminuted metacarpal or phalangeal fractures which cannot obtain firm fixation by other methods.
Bone Transplantation ; Congenital Abnormalities ; Fractures, Comminuted ; Hand ; Humans ; Tendons

PURPOSE:In idiopathic central precocious puberty(CPP), characterized by premature but otherwise normal puberty, the early onset of the pubertal growth spurt with increased height velocity results in premature epiphyseal closure with reduced final height. We examined the growth and growth-determining factors in female patients with CPP treated with a long-acting luteinizing hormone-releasing hormone analogue(Tryptorelin). METHODS:Ten female patients who were diagnosed as idiopathic precocious puberty were treated with Tryptorelin(0.06mg/kg, IM every 4 weeks) for 2 years. We evaluated the patients into two groups(Group A, 4 cases, predicted adult height before treatment were less than 150cm; Group B, 6 cases, predicted adult height before treatment were 150cm or greater), and analysed the growth and its determing factors. RESULTS:In total patients, the growth velocity during the second year were decreased to 4.1+/-1.9 from 5.7+/-2.2/yr during the first year(p>0.05) and no significant difference was found in predicted adult height(PAH) before and after 2 years of treatment(152.3+/-6.7 vs. 1453.9+/-6.8cm). The difference between the PAH before and after 2 years of treatment was not correlated with age, bone age, PAH, height standard deviation score(Ht SDS) before treatment, but correlated with difference between the PAH before and after 1 year of treatment(r=0.89310, P=0.0005). The mean Ht SDS for bone age in group A were significantly lower than those in group B(P<0.05). In group A, the mean PAH increased from 147.0+/-1.9 to 153.7+/-3.7cm during two years of treatment, but no difference in PAH was found in group B. So PAH were similar in two groups(154.1+/-8.7 vs. 153.7+/-3.7cm) after second year. The mean difference between bone age and chronological age decreased from 4.5+/-1.3 to 3.0+/-1.3 years in group A(P<0.05). CONCLUSION: Long-term Tryptorelin treatment is more effective in girls with idiopathic central precocious puberty, whose PAH before treatment were below 150cm. If PAH before treatment is 150 cm or greater or increase in PAH during the first year of treatment is poor, this treatment modality might be useless in terms of improved growth.
Adolescent ; Adult ; Female* ; Gonadotropin-Releasing Hormone* ; Humans ; Lutein* ; Puberty ; Puberty, Precocious*

No abstract available.
Arteriovenous Fistula ; Renal Dialysis

OBJECTIVES: The purpose of this study was to evaluation the effect of administration of postpartumtonic agent(MMQ) on postpartum anemia during puerperal period, obesity control and uterine involution. SUBJECTS AND METHODS: From June 2002 to November 2002, twenty women who underwent spontaneous vaginal delivery at department of obstetrics and gynecology, college of medicine, Pochon CHA University ghopital were included in this study. All women were randomly assigned to receive postpartum tonic agent(MMQ, Albiomed Co.Ltd) or placebo two times a day after each meal for four weeks. They were assessed obesity test(BMI), hematologic examination(CBC, reticulocyte count), liver function test(AST/ALT) and ultrasound test at first day and 28th days after delivery. RESULTS: There was no statistically significant difference between the two group in demographic characteristics. No statistically significant difference were found in this study between the two group in hemoglobin, hematocrit, BMI and the size of uterus. There was no adverse effect to the tested drug. CONCLUSION: There was no significant difference in efficacy and safety between MMQ and placebo in the effect of postpartum anemia, obesity control and reduction of recovery perod. The following limitations have to be considered; Iron supplement, variable diet, seaweed ingestion, consumption of herb and small sample ize. Therefore, a extensive prospective study with control of these variables should be required.
Administration, Oral* ; Anemia* ; Diet ; Eating ; Female ; Gynecology ; Hematocrit ; Humans ; Iron ; Liver ; Meals ; Obesity* ; Obstetrics ; Postpartum Period* ; Reticulocytes ; Seaweed ; Ultrasonography ; Uterus