1.Supportive Care in Pediatric Oncology.
Korean Journal of Pediatrics 2004;47(Suppl 2):S476-S489
No abstract available.
2.Rectal prolapse.
Dae Yune JEONG ; Chul Jae PARK ; Soo Tong PAI
Journal of the Korean Surgical Society 1991;40(5):653-660
No abstract available.
Rectal Prolapse*
3.Clinical Effects of Photodynamic Therapy on Carcinoma In Situ of the Skin.
Hye Nam LEE ; Jeong Deuk LEE ; Seung Chul BAEK ; Dae Gyoo BYUN ; Dong HOUH
Korean Journal of Dermatology 1998;36(3):407-414
BACKGROUND: Photodynamic therapy(PDT) is a type of photochemotherapy that is designed to kill targeted tumor cells. OBJECTIVE: The Clinical effects of PDT were analysed for response rates, post-treatment healing and adverse effects on several cutaneous carcinoma in situ. METHOD: PDT with topical 5-aminolevulinic acid-based irradiation of corresponding 630+5nm light was performed in 6 carcinoma in situ patients who had actinic keratosis, Bowen' disease or cutaneous squamous cell carcinoma. RESULT: In all patients the clinical results were exellent with respect to initial complete responses and cosmetic outcome. CONCLUSION: PDT might be chosen as a first line treament for cutaneous carcimoma in situ.
Carcinoma in Situ*
;
Carcinoma, Squamous Cell
;
Humans
;
Keratosis, Actinic
;
Photochemotherapy*
;
Skin*
4.Pharmacotherapy in Childhood Anemia.
Journal of the Korean Medical Association 2007;50(2):170-174
Anemia is one of the important causes compromising normal growth, development, and immune function in children. In outpatient clinics, we can see patients with anemia caused by various etiologies, whether congenital or acquired. Most cases of childhood anemia are caused by incomplete supplements of nutrients for erythropoiesis, despite the improved socioeconomic situation. Sometimes we need to treat the underlying diseases to correct the anemia. Also, we have to evaluate the etiology of anemia according to age, and consider medical treatments on the basis of the underlying causes. In this article, the author reviews pharmacotherapy in childhood anemia.
Ambulatory Care Facilities
;
Anemia*
;
Child
;
Drug Therapy*
;
Erythropoiesis
;
Humans
5.Allogeneic Bone Marrow Transplantation Experience for Children with Severe Aplastic Anemia and Refractory Leukemia.
Journal of the Korean Pediatric Society 1996;39(1):97-105
PURPOSE: We reviewed the result of allogeneic bone marrow transplantation(BMT) from HLA-identical sibling donors in children with refractory stem cell disorder along with future implication. METHODS: Forty-two children with refractory stem cell disorder received BMT from HLA-identical sibling donors between Nov. 1983 and Feb. 1995. Out of 42 children, 23 cases were severe aplastic anemia(SAA) and 19 cases were refractory leukemias. There were 20 male and 22 female with median age of 13 years (range, 2-17) and median follow-up of 36 months (range, 4-139 months). RESULTS: 1) The overall survival rate of all patients was 73.8%. The survival rate for SAA cases was 87.0%, while that for leukemia was 57.9%. 2) Acute GVHD(> or = grade II) was observed in 16.7% of all patients, 8.7% of SAA patients and 26.3% of leukemia patients, respectively. Chronic GVHD developed in 9.5% of all patients, 4.8% of limited type and 4.8% of extended type. No death was directly attributable to GVHD. 3) The causes of death after allogeneic BMT were graft rejection(7.1%), relapse of leukemia(7.1%), thrombotic thrombocytopenic purpura(4.8%), veno-occlusive disease, sepsis and CMV pneumonia respectively 2.4%. 4) The most common complication except death after allogeneic BMT was herpes zoster(26.2%). The other complications were hemorrhagic cystitis(7.1%), bronchiolitis obliterans and measles respectively 2.4%. CONCLUSIONS: We confirmed that allogeneic BMT is the curable treatment for children with refractory stem cell disorder. The most important factors that influence the result of transplantation are interval between diagnosis and transplantation in severe aplastic anemia and remission state at transplantation in leukemia.
Anemia, Aplastic*
;
Bone Marrow Transplantation*
;
Bone Marrow*
;
Bronchiolitis Obliterans
;
Cause of Death
;
Child*
;
Diagnosis
;
Female
;
Follow-Up Studies
;
Humans
;
Leukemia*
;
Male
;
Measles
;
Pneumonia
;
Recurrence
;
Sepsis
;
Siblings
;
Stem Cells
;
Survival Rate
;
Tissue Donors
;
Transplants
6.Regulatory T Cells and Allogeneic Transplantation.
Korean Journal of Pediatrics 2004;47(9):919-925
Allogeneic organ or hematopoietic stem cell transplantation(HSCT) is the treatment of choice for end-stage organ diseases or various hematologic disorders. The induction of alloantigen specific T cell tolerance and its maintenance are critical for preventing immune responses, including graft rejection or graft-versus-host disease(GVHD) in allogeneic transplantation. CD4+ T cells are classified as immune functions : Th1 CD4+ cells for cellular immunity, Th2 for humoral immunity, Th3 for suppressive effect against activated T cells, Tr1 for regulation of immune response. Some CD4+ regulatory T cells have a major role in controlling immune response to alloantigen. A minor population of CD4+ T cells, which co-express the interleukin-2 receptor(IL-2R) alpha-chain(CD25), is crucial for the control of autoreactive T cells and for peripheral tolerance in allogeneic transplantation. CD4+CD25+ regulatory T cells express high level of cytotoxic T lymphocyte associated antigen 4(CTLA 4), as cell-contact mechanism, and secret immunomodulating cytokines, as IL-10 or TGF-beta, as independent cell contact. High expression of CTLA 4 on CD4+CD25+ T cells may contribute to deliver suppressive signals into T cells via CD28. Immature dendritic cells have low expression of major histocompatibility(MHC) and co-stimulatory signals, and few secretion of IL-12. CD4+CD25+ T cells are developed by immature myeloid dendritic cells, which are controlled under vitamin D3 or IL-10. In kidney transplantation, graft survival in recipients with donor specific transfusion(DST) showed longer than without DST. DST may induce antigen specific CD4+CD25+ T cells, and these cells play a role for central or peripheral tolerance against immune cells. In allogeneic HSCT, donor CD4+CD25+ T cells suppress lethal GVHD in MHC mismatched pairs, and also may possess graft-versus-leukemia effect in early infusion with HSC. We need more study for cytotoxic effect of CD4+CD25+ T cells, which have Fas-FasL interaction, although these cells in cancer patients suppress autoreactive T cells against tumor. Recently, many trials have investigated treatment for intractable disease using various types of cells, including mesenchymal stem cells, dendritic cells. We have to consider ex vivo expansion of CD4+CD25+ T cells for induction of immune tolerance in allogeneic transplantation. Now, we have to study or understand immunoregulatory cells for allogeneic transplantation or immune control.
7.Ifosfamide and Etoposide in Relapsed Refractory Childhood Acute Lymphoblastic Leukemia.
Shung Shin KIM ; Bin CHO ; Dae Chul JEONG ; Hack Ki KIM
Korean Journal of Pediatric Hematology-Oncology 1997;4(1):90-97
BACKGROUND: The prognosis for children with relapsed acute lymphoblastic leukemia remains dismal. Ifosfamide has previously been shown to be active as a single agent and in combination with doxorubicin, etoposide, and teniposide in pediatric solid tumors, recurrent acute lymphoblastic leukemia and adult acute leukemia. We assessed the efficacy and the toxicity of the drug combination with ifosfamide and etoposide in patients with relapsed refractory acute lymphoblastic leukemia. METHODS: Between April 1995 and May 1996, twenty children aged 1 to 14 years with ALL in Catholic Medical Center, all heavily pretreated and in bone marrow relapse, were enrolled in this study. Drugs were given intravenously each day for 5 days at the following doses ; ifosfamide 1.8 g/m2/day, etoposide 100 mg/m2/day and mesna 1440 mg/ m2/day(as a uroprotectant) ; Cycles were repeated every 28 days for two cycles. RESULTS: 1) Twenty heavily pretreated patients were entered on study. At study entry, seventeen patients were in first relapse, two were in second relapse and one was in third relapse. 2) Six patients(30%) achieved complete remission, and eight patients(40%) achieved partial remission. Overall response rate was 70%. 3) Duration of remission ranged from 30 days to 230 days. 4) The toxicity of the regimen was tolerated. Moderate or severe toxicity evaluated on a per cycle basis included : neutropenia 52.5%, thrombocytopenia 45%, hemorrhagic cystitis 12.5% and mucositis 2.5%. 5) Two patients went on to bone marrow transplantation with histocompatibility matched sibling donors while in remission. CONCLUSION: The combination of ifosfamide and etoposide with mesna uroprotection has significant activity in relapsed refractory childhood lymphoblastic leukemia with tolerable toxicity. We recommended bone marrow transplantation after successful reinduction because of short remission duration of this regimen.
Adult
;
Bone Marrow
;
Bone Marrow Transplantation
;
Child
;
Cystitis
;
Doxorubicin
;
Etoposide*
;
Histocompatibility
;
Humans
;
Ifosfamide*
;
Leukemia
;
Mesna
;
Mucositis
;
Neutropenia
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
;
Prognosis
;
Recurrence
;
Siblings
;
Teniposide
;
Thrombocytopenia
;
Tissue Donors
8.Effect of Desferrioxamine Therapy in Patients with Transfusional Hemosiderosis Due to Severe Aplastic Anemia.
Jung Hyun LEE ; Bin CHO ; Dae Chul JEONG ; Hack Ki KIM
Korean Journal of Pediatric Hematology-Oncology 1997;4(1):62-69
BACKGROUND: This study was carried out to evaluate the efficacy of desferrioxamine as a chelating agent in iron overloaded patients with severe aplastic anemia due to multiple transfusion. METHODS AND MATERIALS: From Oct. 1995 to Aug. 1996, 15 patients with aplastic anemia, diagnosed from May 1995 to Jan. 1996 at St. Mary's Hospital, who had a transfusional hemosiderosis were included in this study. They received 19 courses of high-dose desfer-rioxamine therapy for 6 days(20 to 30 mg/kg daily as a 24-hour intravenous infusion) . Before and after treatment, we measured serum ferritin, iron, TIBC, 24-hour urinary excretion of iron. RESULTS: 1) The range of iron load before treatment was between 4.5 and 20.0 gram. 2) Because of limit of detection(1,800 microgram/L), it was difficult to compare the changes of serum ferritin level after therapy to those of before therapy. 3) There was no significant differences between the levels of serum iron before and after therapy(214.3+/-62.8 vs 220.0+/-53.3). And there was no significant differences between TIBC before and after therapy(235.8+/-64.6 vs 259.4+/-60.1). 4) Iron/TIBC ratios were significantly deceased after desferrioxamine treatment compared to those of before therapy(0.90+/-0.04 vs 0.85+/-0.04, P<0.001) and mean urinary excretions of iron were increased by high-dose desferrioxamine compared to those by test dose(6.5+/-7.6 vs 29.1+/-14.3, P<0.001) CONCLUSION: High-dose desferrioxamine therapy is very effective for chelating and excretion of iron in iron overloaded patients with severe aplastic anemia due to multiple transfusion. A repeat administration of desferrioxamine is necessary for the iron overloaded patient to eliminate the risk of a transfusional hemosidersis.
Anemia, Aplastic*
;
Deferoxamine*
;
Ferritins
;
Hemosiderosis*
;
Humans
;
Iron
;
Iron Overload
9.Assessment of Disease Activity in Juvenile Idiopathic Arthritis.
Journal of Rheumatic Diseases 2014;21(6):289-296
Juvenile idiopathic arthritis (JIA) is a chronic inflammation of joints in pediatric patients. Assessment of JIA disease activity is very difficult, because children cannot definitely describe their pain by themselves due to development of cognitive function during the pediatric period. Assessment of JIA disease activity is useful for quantitative measurement of patient status, monitoring therapeutic response, and disease course over time. This article reviewed objective assessment tool for JIA disease activity and described differences in assessment between adult rheumatoid arthritis and JIA.
Adult
;
Arthritis, Juvenile*
;
Arthritis, Rheumatoid
;
Child
;
Humans
;
Inflammation
;
Joints
10.A Case of Becker's Nevus Associated with Smooth Muscle Hamartoma.
Hong Seong JEONG ; Chul Ho YOO ; Dae Gyoo BYUN ; Joon Mo YANG ; Yu Sin LEE
Korean Journal of Dermatology 1987;25(6):832-836
We report a case of Becker's nevus associated with smooth muscle hamartoma, in a 21-year-old male patient, which shows clinically match-head sized, flat topped, round to oval, grouped papules with hairs on the outer surface of the right arm, and microscopically reveals numerous bundles of smooth muscle fiber in the dermis.
Arm
;
Dermis
;
Hair
;
Hamartoma*
;
Humans
;
Male
;
Muscle, Smooth*
;
Nevus*
;
Young Adult