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Objectives@# Based on the results from the Korean Total Diet Study (KTDS), the sodium (Na) and potassium (K) intake of Koreans were estimated and compared with intake estimates from the Food & Nutrient Database (FNDB), as in the Korea National Health and Nutrition Examination Survey (KNHANES) to verify the validity of these estimates. @*Methods@# One hundred and thirty-four representative foods (RFs) covering 92.5% of the total food intake of Koreans were selected, and 228 pairs of corresponding ‘RF x representative cooking method’ were derived by reflecting the methods used mainly in terms of frequency and quantity in their cooking.RF samples were collected from three cities with a larger population size in three regions (nine cities) nationwide, and six composite samples were made for each RF, considering its regional and/or seasonal characteristics. One thousand three hundred and sixty-eight ‘RF x representative cooking method’ pair samples were prepared, and the Na and K contents were assessed using inductively coupled plasma atomic emission spectrometry (ICP-MS). The Na and K intake of the Korean population was estimated by linking the content with the food intake data from the 7th KNHANES. @*Results@# The mean Na and K intake of Koreans were 2,807.4 mg and 2,335.0 mg per person per day, respectively. A comparison with the Na and K intake from KNHANES, including only RFs of KTDS, showed comparable results with less than 5% variation. While the contribution and ranking of food items to Na intake were similar between KNHANES and KTDS, there were differences in K intake.This was attributed to the large discrepancies in the K content of rice and coffee between KTDS results and the values in the 9th Revision of the National Food Composition Table used in KNHANES. @*Conclusions@# The Na and K intake of Koreans estimated based on the KTDS, which performed nutrient analysis on samples prepared to a ‘table-ready’ state using foods of the representative collection, was similar and comparable with that of KNHANES. This supports the validity and usefulness of FNDB-based nutrient intake estimation at the population level. The list of nutrients studied in KTDS is expected to be expanded, allowing for intake estimation of nutrients with currently insufficient or absent information in the FNDBs in use.
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Background and Objectives@#There have been no reports in Korea regarding cochlear implant surgeries using Cochlear Nucleus Profile Slim Modiolar electrode [CI532 (Cochlear Ltd.)], as it has been recently released in Korea. We aimed to investigate the short-term results of CI532 and compare them with previous devices with perimodiolar or straight electrodes arrays from the same manufacturer.Subjects and Method From August 2018 to July 2019, 52 patients (26 adults; 26 children) who underwent cochlear implantation of CI532 were included. The intraoperative impedance and evoked compound action potential (ECAP) threshold in each electrode were analyzed and compared with the devices with a perimodiolar electrode array [Contour Advance® (Cochlear Ltd.)] and a lateral wall electrode array [CI422 and CI522 (Cochlear Ltd.)]. Postoperative changes of hearing thresholds at each frequency (250, 500, and 1000 Hz) and aided word recognition scores (WRS) were also compared. @*Results@#CI532 showed significantly lower intraoperative impedance in the basal regions compared to the lateral wall electrode array. The ECAP thresholds of CI532 in the apical electrodes were significantly lower than that in the other two groups. After implantation, CI532 showed a significant preservation of hearing thresholds at most frequencies and showed significantly higher preservation rates than the other electrodes. However, there was no difference between the three groups regarding the postoperative short-term aided WRS. @*Conclusion@#CI532 showed lower intraoperative impedances and ECAP thresholds, and better short-term hearing preservation outcomes compared to the other electrodes, suggesting that CI532 electrode might be a better option with less traumatic insertion. However, there was no significant difference in the aided WRS, and further studies with a longer follow-up are necessary to examine the difference of audiologic outcomes.
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Quarantine often provokes negative psychological consequences. Thus, we aimed to identify the psychological and behavioral responses and stressors of caregivers quarantined with young patients after a close contact to a coronavirus disease 2019 case at a children's hospital. More than 90% of the caregivers reported feelings of worry and nervousness, while some of them reported suicidal ideations (4.2%), and/or homicidal ideations (1.4%). Fear of infection of the patient (91.7%) and/or oneself (86.1%) were most frequently reported stressors. A multidisciplinary team including infection control team, pediatrician, psychiatrist, nursing staff and legal department provided supplies and services to reduce caregiver's psychological distress. Psychotropic medication was needed in five (6.9%), one of whom was admitted to the psychiatry department due to suicidality. Quarantine at a children's hospital makes notable psychological impacts on the caregivers and a multidisciplinary approach is required.
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Objectives@#. Cortical auditory evoked potentials (CAEPs) have been used to examine auditory cortical development or changes in patients with hearing loss. However, there have been no studies analyzing CAEP responses to the different sound stimulation by different stimulation sides. We characterized changes in normal CAEP responses by stimulation sides in normal-hearing adults. @*Methods@#. CAEPs from the right auditory cortex were recorded in 16 adults following unilateral (ipsilateral and contralateral) and bilateral sound stimulation using three speech sounds (/m/, /g/, and /t/). Amplitudes and latencies of the CAEP peaks in three conditions were compared. @*Results@#. Contralateral stimulation elicited larger P2-N1 amplitudes (sum of P2 and N1 amplitudes) than ipsilateral stimulation regardless of the stimulation sounds, mostly due to the larger P2 amplitudes obtained, but elicited comparable P2-N1 amplitudes to bilateral stimulation. Although the P2-N1 amplitudes obtained with the three speech sounds were comparable following contralateral stimulation, the /m/ sound elicited the largest P2-N1 amplitude in ipsilateral stimulation condition due to the largest N1 amplitude obtained, whereas /t/ elicited larger a P2-N1 amplitude than/g/ in bilateral stimulation condition due to a larger P2 amplitude. @*Conclusion@#. Spectrally different speech sounds and input sides are encoded differently at the cortical level in normal-hearing adults. Standardized speech stimuli, as well as specific input sides of speech, are needed to examine normal development or rehabilitation-related changes of the auditory cortex in the future.
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PURPOSE: Unplanned conversion is sometimes necessary during minimally invasive liver resection (MILR) of hepatocellular carcinoma (HCC). The aims of this study were to compare surgical outcomes of planned MILR and unplanned conversion and to investigate the risk factors after unplanned conversion.METHODS: We retrospectively analyzed 286 patients who underwent MILR with HCC from January 2006 to December 2017. All patients were divided into a MILR group and an unplanned conversion group. The clinicopathologic characteristics and outcomes were compared between the 2 groups. In addition, surgical outcomes in the conversion group were compared with the planned open surgery group (n = 505). Risk factors for unplanned conversion were analyzed.RESULTS: Of the 286 patients who underwent MILR, 18 patients (6.7%) had unplanned conversion during surgery. The unplanned conversion group showed statistically more blood loss, higher transfusion rate and postoperative complication rate, and longer hospital stay compared to the MILR group, whereas no such difference was observed in comparison with the planned open surgery group. There were no significant differences in overall and disease-free survival among 3 groups. The right-sided sectionectomy (right anterior and posterior sectionectomy), central bisectionectomy and tumor size were risk factors of unplanned conversion.CONCLUSION: Unplanned conversion during MILR for HCC was associated with poor perioperative outcomes, but it did not affect long-term oncologic outcomes in our study. In addition, when planning right-sided sectionectomy or central bisectionectomy for a large tumor (more than 5 cm), we should recommend open surgery or MILR with an informed consent for unplanned open conversions.
Subject(s)
Humans , Carcinoma, Hepatocellular , Disease-Free Survival , Informed Consent , Length of Stay , Liver , Postoperative Complications , Retrospective Studies , Risk FactorsABSTRACT
OBJECTIVES: Inflammation is a major mechanism underlying coronary heart disease (CHD) and C-reactive protein (CRP) is a marker of inflammation. When administered soon after menopause, menopausal hormone therapy (MHT) prevents CHD. This study was conducted to examine the impact of estrogen by administration route on CRP in postmenopausal Korean women using micronized progesterone (MP4) for endometrial protection. METHODS: This retrospective cohort study included 129 healthy women without CHD risk factors. Eighty-nine women took oral estrogen (conjugated equine estrogen, 0.625 mg/day or equivalent), and 40 women applied a 1.5-mg/day 0.1% percutaneous estradiol gel. MP4 was added in 82 women with an intact uterus. The CRP level was measured at baseline and three and six months after initiation of MHT. RESULTS: The baseline characteristics were comparable between the MHT groups except current age and age at menopause. After controlling for age, menopausal age, body mass index, and basal CRP, no significant change in CRP was observed in the oral estrogen group (n = 29). Follow-up CRP levels were also similar to the baseline in the percutaneous estrogen group (n = 18). However, three-month CRP was significantly lower than six-month CRP, and there was a significant time trend within the percutaneous estrogen group. However, the group difference did not reach statistical significance. CRP also did not differ by addition of MP4 in either group. CONCLUSIONS: In postmenopausal Korean women, no change in CRP was observed with oral estrogen, while percutaneous estrogen might decrease CRP. The estrogenic impacts were not influenced by adding MP4.
Subject(s)
Female , Humans , Body Mass Index , C-Reactive Protein , Cohort Studies , Coronary Disease , Drug Administration Routes , Estradiol , Estrogens , Follow-Up Studies , Hormone Replacement Therapy , Inflammation , Menopause , Postmenopause , Progesterone , Retrospective Studies , Risk Factors , UterusABSTRACT
BACKGROUND AND OBJECTIVES: There is a need for fast and reliable objective measures of cochlear implant (CI) performance, especially in young children. The aim of the study was to investigate the detection and characterization of cortical auditory evoked potentials (CAEP) of different types of sound stimulation in CI listeners using a commercially available system, HEARLab™. SUBJECTS AND METHOD: Sound field CAEPs were obtained from 10 CI listeners, using three natural speech sounds (/m/, /g/, and /t/) presented at 55, 65, and 75 dB SPL. Detection rates, the latencies and amplitudes of CAEP waves were analyzed and compared with those of the normal hearing (NH) group. RESULTS: It was possible to detect CAEP responses in all CI listeners. Of the three stimuli (/m/, /g/, /t/), /g/ was the most robust waveform, although this was not statistically significant. Latencies for the /m/ stimulus were relatively longer than those for /t/ and especially for /g/, suggesting that CI listeners hear high-frequency sounds better than low-frequency sounds. When compared to the NH group, CAEP of CI listeners tended to show smaller amplitudes of various waves and longer latencies especially at P1 wave. CONCLUSION: CAEP responses could be obtained in all CI listeners and normal adults successfully, indicating that CAEP can be applied clinically as an objective assessment tool of hearing. Further studies are needed for CI listeners especially in infants and toddlers using this protocol to assess its clinical usefulness.
Subject(s)
Adult , Child , Humans , Infant , Auditory Cortex , Cochlear Implants , Evoked Potentials, Auditory , Hearing , Methods , PhoneticsABSTRACT
OBJECTIVES: This study was conducted to examine the effects of hormone therapy on serum lipid levels in postmenopausal Korean women. METHODS: This retrospective cohort study included 154 healthy postmenopausal Korean women. Seventy-nine women took oral estrogen (conjugated equine estrogen 0.625 mg/day or equivalent), and 75 applied estrogen transdermally using 0.1% 17beta-estradiol gel. Micronized progesterone (MP) was added to 40 women of oral group and 49 women in transdermal group. Serum levels of triglyceride, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and lipoprotein (a) were measured before, 3 and 6 month after hormone therapy. RESULTS: At baseline, mean body mass index (BMI) were lower (22.76 vs. 23.74 kg/m2) and proportion of family history of cardiovascular disease (CVD) (61 vs. 39%) were higher in oral group. In oral group, LDL-C and lipoprotein(a) levels decreased, and triglyceride and HDL-C levels increased significantly after 3 and 6 months. There was no significant change in lipoprotein levels compared to the baseline in transdermal group. There were also no differences with additional MP. Changing pattern of HDL-C during 6 months was significantly different by the route of estrogen administration. CONCLUSION: Oral estrogen therapy might be more beneficial than transdermal estrogen in terms of lipid in postmenopausal Korean women. The estrogen effects are not influenced by adding MP.
Subject(s)
Female , Humans , Body Mass Index , Cardiovascular Diseases , Cholesterol , Cohort Studies , Drug Administration Routes , Estrogens , Hormone Replacement Therapy , Lipoprotein(a) , Lipoproteins , Progesterone , Retrospective Studies , TriglyceridesABSTRACT
PURPOSE: The aim of this study is to estimate total sugar intake and identify major food sources of total sugar intake in the diet of the Korean population. METHODS: Dietary intake data of 33,745 subjects aged one year and over from the KNHANES 2008-2011 were used in the analysis. Information on dietary intake was obtained by one day 24-hour recall method in KNHANES. A database for total sugar content of foods reported in the KNHANES was established using Release 25 of the U.S. Department of Agriculture National Nutrient Database for Standard Reference, a total sugar database from the Ministry of Food and Drug Safety, and information from nutrition labeling of processed foods. With this database, total sugar intake of each subject was estimated from dietary intake data using SAS. RESULTS: Mean total sugar intake of Koreans was 61.4 g/person/day, corresponding to 12.8% of total daily energy intake. More than half of this amount (35.0 g/day, 7.1% of daily energy intake) was from processed foods. The top five processed food sources of total sugar intake for Koreans were granulated sugar, carbonated beverages, coffee, breads, and fruit and vegetable drinks. Compared to other age groups, total sugar intake of adolescents and young adults was much higher (12 to 18 yrs, 69.6 g/day and 19 to 29 yrs, 68.4 g/day) with higher beverage intake that beverage-driven sugar amounted up to 25% of total sugar intake. CONCLUSION: This study revealed that more elaborated and customized measures are needed for control of sugar intake of different subpopulation groups, even though current total sugar intake of Koreans was within the range (10-20% of daily energy intake) recommended by Dietary Reference Intakes for Koreans. In addition, development of a more reliable database on total sugar and added sugar content of foods commonly consumed by Koreans is warranted.
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Adolescent , Humans , Young Adult , Agriculture , Asian People , Beverages , Bread , Carbonated Beverages , Coffee , Diet , Energy Intake , Food Labeling , Fruit , Korea , Nutrition Surveys , Recommended Dietary Allowances , VegetablesABSTRACT
PURPOSE: The reflux of pancreatic enzymes into the biliary tract is associated with chronic inflammation and increases cellular proliferation of the biliary epithelium, leading to biliary carcinoma. The aim of this study is to detect the incidence of occult pancreaticobiliary reflux (OPBR) in patients who underwent elective cholecystectomy. METHODS: Forty-seven patients with symptomatic gallstones who underwent cholecystectomy were recruited for this study. The gallbladder bile samples were obtained from the specimen of gallbladder and the amylase level was measured. The immunohistochemistry of p53, SMAD4 and Ki-67 were performed for the detection of metaplasia and dysplasia. RESULTS: Biliary amylase was higher than the serum amylase in 10 patients (group A, 15,402.66 +/- 33,592.43 IU/L; group B, 13.06 +/- 18.12 IU/L). The mean age was 67.2 years in group A and 51.2 in group B (P < 0.01). The ratio of male to female was 1:2.3 and 1:1.8 in group A and B, respectively (P = 0.297). Eight patients in group A and thirteen patients in group B had inflammation (P = 0.014). The positive results of the Ki-67 test were exhibited in five cases in each group (P = 0.024). CONCLUSION: Results from the study indicate that the age was older, degree of inflammation and positive rate of Ki-67 were higher when OPBR was suspected. In conclusion, the patients with OPBR would need long-term follow-up, because the OPBR can cause dysplasia and the reflux of pancreatic juice may be considered as a risk factor for extrahepatic bile duct carcinoma.
Subject(s)
Adult , Female , Humans , Male , Amylases , Bile , Bile Ducts, Extrahepatic , Biliary Tract , Cell Proliferation , Cholecystectomy , Epithelium , Gallbladder , Gallstones , Immunohistochemistry , Incidence , Inflammation , Ki-67 Antigen , Metaplasia , Pancreatic Juice , Risk FactorsABSTRACT
We have recently experienced an endometrial cancer 12 years after the diagnosis of colon cancer with Lynch syndrome. A 49-year-old Korean woman had a family history of colon cancer. Her mother had colon cancer at 56-year-old, and her brother had colon cancer at 48 years old. The patient received surgery for endometrial cancer at the same hospital 12 years after being treated for colon cancer. Immunohistochemistry showed that her endometrial tissue stained negative for MSH2. A microsatellite instability test was performed and showed the presence of instability high microsatellite instability. An hMLH2 gene mutation was detected at codon 629 codon of exon 12, in which a glutamine was replaced with an arginine (1886A>G [p.Gln629Arg]). To our knowledge, this is the first case of metachronous cancer in a Lynch syndrome family in Korea with a gap of more than ten years between cancer diagnoses.
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Female , Humans , Middle Aged , Arginine , Colon , Colonic Neoplasms , Colorectal Neoplasms, Hereditary Nonpolyposis , Diagnosis , Endometrial Neoplasms , Glutamine , Immunohistochemistry , Korea , Microsatellite Instability , Mothers , SiblingsABSTRACT
Pancreatic lipomas are commonly diagnosed based on radiologic images, although the prevalence of lipomas has not been established. Histologic confirmation of pancreatic lipomas is extremely rare because surgical treatment is unnecessary in most cases. Endoscopic ultrasound-guided fine-needle aspiration cytology has been suggested to avoid unnecessary surgery to distinguish between a lipoma and a well-differentiated liposarcoma; however, surgery would be needed when the tumor is associated with symptoms or difficult to distinguish from a liposarcoma. We present a case of a pancreatic lipoma in a 54-year-old male patient that was histologically-confirmed by subtotal pancreatectomy.
Subject(s)
Humans , Male , Middle Aged , Biopsy, Fine-Needle , Lipoma , Liposarcoma , Pancreas , Pancreatectomy , Prevalence , Unnecessary ProceduresABSTRACT
Stereotactic vacuum-assisted breast biopsy (VAB) has been used to evaluate microcalcifications or non-palpable breast lesions on mammography. Although stereotactic VAB is usually performed in a prone or upright position, an expensive prone table is necessary and vasovagal reactions often occur during the procedure. For these reasons, the lateral decubitus position can be applied for stereotactic VAB, and true lateral mammography can be used to detect the lesion. We report on 15 cases of lateral decubitus positioning for stereotactic VAB with true lateral mammography for non-palpable breast lesions or microcalcifications. The mean procedure time was approximately 30.1 minutes, and no complications occurred during the procedures. Fourteen cases had benign breast lesions and one case had a ductal carcinoma in situ. The lateral decubitus stereotactic VAB with true lateral mammography can be applied for microcalcifications or non-palpable breast lesions and helps to minimize anxiety and vasovagal reactions in patients.
Subject(s)
Humans , Anxiety , Biopsy , Breast , Carcinoma, Intraductal, Noninfiltrating , Mammography , Stereotaxic TechniquesABSTRACT
PURPOSE: Patients with breast cancer are at risk for developing psychological distress and psychiatric disorders such as depression. The aim of this study was to assess the depressive symptom related factors in women with breast cancer. METHODS: A total of 211 patients with breast cancer who had undergone an operation within 5 years participated in this survey with consent. Depressive symptoms in patients were measured using the 21-item Beck Depression Inventory (BDI) questionnaire in the outpatient clinic and sociodemographic, clinicopathologic factors of the patients were analyzed with a BDI score. The patients were divided into group A (BDI or =16, n=65). RESULTS: The mean age of the patients was 49.2 years and the mean follow-up period was 22 months. In the univariate analyses, postmenopausal status (p=0.014), tumor size (p=0.023) and presence of progesterone receptor (p=0.012) were significantly associated with depressive symptom. In multivariate analysis, only postmenopause (p=0.021) and tumor size (p=0.018) were related with depressive symptom. CONCLUSION: Depressive symptom is common in patients with breast cancer and a screening test for depression is needed in breast cancer patient who experienced menopause or has bigger tumor size.
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Female , Humans , Breast NeoplasmsABSTRACT
OBJECTIVES: There is a lack of data on bone loss in premenopausal patients with breast cancer after chemotherapy in Korea. In this study, we compared the bone mineral density of breast cancer patients after chemotherapy with normal control. MATERIALS AND METHODS: We used the data from the fourth Korea National Health and Nutrition Examination Survey (KNHNES) as normal control, and 119 women were enrolled who had surgery and chemotherapy due to breast cancer. They were under the age of 50 and premenopausal state according to their FSH level. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry.
Subject(s)
Female , Humans , Body Mass Index , Bone Density , Breast , Breast Neoplasms , Femur Neck , Hip , Korea , Nutrition Surveys , Premenopause , Prevalence , SpineABSTRACT
PURPOSE: Stage-related treatment has been recommended for gallbladder cancer (GBC). When patients with T2 tumors undergo an extended cholecystectomy, the 5-year survival rates have been reported to be 64~100%. But when patients with T2 tumors undergo simple cholecystectomy, the 5-year survival rates have been reported to be only 20~40%. The question may rise as to which patients benefit from simple cholecystectomy among patients with T2 GBC. We investigated the survivals and the facts leading to death or recurrence after simple cholecystectomy for T2 GBC. METHODS: Between Mar. 2001 and Dec. 2007, 13 patients had refused second radical operation for T2 GBC incidentally discovered after simple cholecystectomy. Survival analyses were evaluated by clinopathological factors. RESULTS: The 1-, 3- and 4-year overall survival rates were 84.6%, 76.2% and 38.1% and 1- and 3-year disease-free survival rates were 69.2%, 51.3%. The factors affected survival rates were low serum albumin titer and R1 resection (Lymph node metastasis or cystic duct involvement in microscopic finding) (P<0.05). CONCLUSION: Simple cholecystectomy is not a curative method of T2 GBC, because it reveals lower 5-year survival rates compared to those of extended cholecystectomy or radical surgery. But in the case when the patient refuses reoperation or it is difficult to undergo reoperation because of severe underlying disease, simple cholecystectomy with normal albumin titer or the absence of lymph node metastasis and absence of cystic duct involvement in microscopic findings may help the long-term survivals after simple cholecystectomy.
Subject(s)
Humans , Cholecystectomy , Cystic Duct , Disease-Free Survival , Gallbladder , Gallbladder Neoplasms , Lymph Nodes , Neoplasm Metastasis , Recurrence , Reoperation , Serum Albumin , Survival RateABSTRACT
PURPOSE: Oxcabarzepine (OXC), newly recommended antiepileptic drug, has been prescribed for patients with partial seizures and generalized tonic clonic seizures in Korea from 1999. There are limited reports about an efficacy of OXC therapy in epileptic children in Korea. This study evaluated the efficacy and safety of OXC in the light of our experience. METHODS: The patients, who had visited the pediatric neurology clinic of Korea University Guro Hospital from January 2001 to December 2006, were included. The data of 144 patients who were administrated OXC as monotherapy or polytherapy, was summarized retrospectively and we evaluated the efficacy and safety of OXC. RESULTS: After 6 months of OXC therapy, 77 patients (53.5%, n=144) achieved seizure freedom, 48 patients (33.3%) experienced >50% improvement. After 12 months of OXC therapy, cessation of seizure was observed in 88 patients (61.1%, n=133), and 27 patients (18.8%) manifested an improvement. Monotherapy group showed superior efficacy to polytherapy one. The frequent side effects of OXC were drowsiness (20.1%), headache (12.5%), dizziness (9.7%) and rash (8.3%). They did not related to patient's age or sex, and dosage of OXC. Twenty four patients (16.7%) experienced hyponatremia, but which were neither symptomatic nor significant one. CONCLUSION: The efficacy and safety of OXC in our patients were excellent and had less significant side effects than established international one. We expect this report contributes toward OXC therapy in epileptic children.
Subject(s)
Child , Humans , Carbamazepine , Dizziness , Exanthema , Freedom , Headache , Hyponatremia , Korea , Light , Neurology , Retrospective Studies , Seizures , Sleep StagesABSTRACT
PURPOSE: Herbal medicine is thought to be widely used by children with epilepsy, but there have been few studies. This study aimed to investigate the perceptions and the actual conditions of usage of herbal medicine by children with epilepsy. METHODS: From July to August 2007, three hundred seventy eight questionnaires were completed by parents of epileptic children who visited pediatric neurology clinic of Korea University hospital and Kwangmyung-Sungae hospital. Demographic data and patterns of usage of herbal medicine were investigated. RESULTS: Among 378 patients, sixty five (17.2%) reported using herbal medicine. Major reasons for using herbal medicine were 'to enhance general health' and 'belief that it has fewer side effects'. Majority of respondents did not notify their physician about using herbal medicine because 'they did not need to share this with doctor' and 'they thought their doctor would disapprove'. After taking herbal medicine, 33.3% of patients reported that it did not benefit their seizure but they felt healthier. Usage of herbal medicine was significantly related to number of AEDs (antiepileptic drugs), duration of AED treatment, association with psychosomatic disorders and motivation by other people or by mass media. CONCLUSION: Considerable numbers of epileptic children were using herbal medicine during treatment with AED and did not inform their physician about usage of it. Physicians should be aware of benefits and harms of herbal medicine and actively intervene in the usage of herbal medicine by epileptic patients.
Subject(s)
Child , Humans , Epilepsy , Herbal Medicine , Korea , Motivation , Neurology , Parents , Psychophysiologic Disorders , Surveys and Questionnaires , SeizuresABSTRACT
PURPOSE: In addition to epileptic seizures (ES), a variety of physiologic, organic and psychogenic disorders can manifest as paroxysmal behavioral events. Paroxysmal nonepileptic events (PNEs) are quite encountered in infants, young children, and adolescents. In a substantial proportion of cases, a careful history and examination will elucidate their nature. However, in other cases, it is necessary to differentiate PNEs from ES by video-electroencephalographic (EEG) monitoring. We report our experiences with PNEs in a group of children and adolescents who underwent video-EEG monitoring. METHODS: From September, 2004 to June, 2006, one hundred thirty patients were monitored in the Pediatric Epilepsy Monitoring Units of Korea University Guro and Ansan hospitals. Their hospital charts were reviewed and video records of these events were analyzed. We observed all patients after video- EEG monitoring for more than 3 months. RESULTS: Typical spells occurred during monitoring in 33 patients, not associated with a seizure pattern on EEG recordings. Two patients were diagnosed as frontal lobe epilepsy on basis of typical semiology and clinical characteristics, so 31 patients were documented to have PNEs finally. The mean age of patients was 7.2+/-5.8 years. The male to female ratio was 15 (48.4%) to 16 (51.6%). Among 31 patients, fifteen patients had associated disorders such as epilepsy, developmental delay, cerebral palsy, gastric ulcer, attention deficit hyperactivity disorder or depressive disorder. Somatoform disorder and factitious disorder was frequently seen in children more than 5 years old (P0.05). CONCLUSION: Our study suggests that video-EEG monitoring is an important diagnostic tool in the evaluation of paroxysmal behavioral events. With correct diagnosis of the PNEs, several unnecessary treatment could be avoided.
Subject(s)
Adolescent , Child , Female , Humans , Infant , Male , Attention Deficit Disorder with Hyperactivity , Cerebral Palsy , Depressive Disorder , Electroencephalography , Epilepsy , Epilepsy, Frontal Lobe , Korea , Seizures , Somatoform Disorders , Stomach UlcerABSTRACT
PURPOSE: Major chest wall reconstruction following radical excision of advanced breast cancer is remained a challenging treatment of oncoplastic surgeons. The aims of this study are to introduce a method of external oblique myocutaneous flap (EOMCF) and evaluate the effect of large chest wall reconstruction using external oblique myocutaneous flap. METHODS: A retrospective review of 17 patients who underwent chest wall reconstruction with external oblique myocutaneous flap from January of 2007 through May of 2008 was performed. The upper edge of external oblique myocutaneous flap was lower margin of defect. The medial edge was mid-line of abdomen by umbilicus, vertically along the linea alba. The lower edge was a lateral transverse line at the level of umbilicus. The flap was rotated clockwise in the left side chest wall defects and counterclockwise in the right. RESULTS: The mean chest wall defect was 360.8+/-137.8 cm2 and the mean flap size was 591.1+/-136.2 cm2. The mean reconstruction time was 41.5+/-7.9 min and patients were discharged on 8.8+/-1.2 postoperative day (mean). Three patients had superficial skin loss (<5%) and this lesions are healed with conservative therapy. CONCLUSION: We propose that the external oblique myocutaneous flap may be a safe and feasible method for reconstruction of large chest wall defects after radical mastectomy including all breast skin.