No abstract available.
Doxycycline*

No abstract available.
Constriction, Pathologic*

PURPOSE: The purpose of this study was to analysis of effectiveness between cognitive function assessment scores and gaming cognitive rehabilitation system in children with intellectual impairment. METHODS: Five children (male=5, age=10.00±0.80) with intellectual impairment participated in this study and were randomly assigned to the experiment that played (received) gaming cognitive rehabilitation system (Neuroworld). The children were applied 2 times a week for 30 minutes during 3 months. The children were assessed K-WSIC-VI (Korean-Wechsler intelligence scale for children-fourth edition) and recorded that gained score in gaming cognitive rehabilitation system before and after intervention. K-WSIC-VI contained five primary index scores: verbal comprehension index, visual spatial index, fluid reasoning index, working memory index, and processing speed index. Gaming cognitive rehabilitation system scoring was composed visual recall, target recall, sequence recall, selective attention, continuous attention, and exploration. RESULTS: In the intelligence quotient (IQ) of K-WSIC-VI, there were significant increased in all children. The visual recall item was highest effective in all children. However, sequential recall showed the lowest improvement in all children. The performance speed of selective attention item was decreased, this means that children's skills have improved. Also, their ability to explore has improved significantly. CONCLUSION: In conclusion, gaming cognitive rehabilitation system was significant effectiveness in cognitive function in some categories for children with intellectual impairment. However, the visual recall and performance speed don't represent of all cognitive function. Therefore, further studies will need to verify by applying more subject and longer duration.
Child* ; Cognition* ; Comprehension ; Humans ; Intellectual Disability* ; Intelligence ; Memory, Short-Term ; Rehabilitation

PURPOSE: Although adjuvant chemotherapy after resection of gastric cancer is a popular practice in Korea, there are still controversies about the effectiveness of the treatment. The fact that the relatively less effective drugs have been used and the rarity of large-scaled controlled studies may be partially responsible for the controversies. FP(5-FU, Cisplatin) combination is one of the most active regimen against advanced gastric cancer, consistently showing a response rate of 50~60%. We tried the FP chemotherapy as an adjuvant treatment for high-risk patients after curative resection of gastric cancer. MATERIALS AND METHODS: Between February 1992 and June 1996, 35 patients with completely resected high-risk gastric cancer(postoperative stage III or IV except thase with M1) received six courses of FP chemotherapy. Endpoints were toxicities of treatment, relapse free survival, and overall survival. RESULTS: With a median follow-up time of 17.1 months, Kaplan-Meier estimates of 2-year overall survival was 63.3% and relapse free survival estimates was 49%. There were no differences between stage III and IV patients in terms of overall survival or relapse free survival. Hematologic and non-hematologic toxicities were tolerable for most of the patients. CONCLUSION: Postoperative FP combination chemotherapy was tolerable for patients with high-risk(stage III and IV) gastric cancer. It is too early to determine the long term survival rates for this patients, but 2-year overall and relapse free survival were comparable to that of historical non-cisplatin containing regimens. Randomized phase III studies are warranted.
Chemotherapy, Adjuvant ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Fluorouracil* ; Follow-Up Studies ; Humans ; Korea ; Recurrence ; Stomach Neoplasms* ; Survival Rate

Autoimmune thrombocytopenia and autoimmune hemolytic anemia occur in 10-26% of patients with systemic lupus erythematosus(SLE). These hematological manifestations may be the sole presenting sign and can precede the appearance of diagnosable SLE in 5 to 23% of cases. The conventional treatment for SLE associated with these disorders includes corticosteroid therapy and splenectomy, but autoimmune thrombocytopenia or autoimmune hemolytic anemia may be refractory to both treatments. We experienced a case of a SLE patient complicated by severe autoimmune thrombocytopenia. Therapy with intravenous immunoglobulin and corticosteroids failed. She responded to danazol and remission of thrombocytopenia(platelet >100,000/mm3) was observed 7 days after starting danazol. Danazol therapy seems to be a useful and well tolerated treatment for refractory autoimmune thrombocytopenia associated with SLE.
Adrenal Cortex Hormones ; Anemia, Hemolytic, Autoimmune ; Danazol* ; Humans ; Immunoglobulins ; Lupus Erythematosus, Systemic* ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy

PURPOSE: Nipple discharge is a disturbing symptom due to the fear of breast cancer, although approximately 95% of incidents of nipple discharge arise from benign causes. This study was designed to determine a proper approach for referrals with nipple discharge. METHODS: One hundred and ten patients who underwent surgery due to nipple discharge were included in the study. Clinical parameters, including age, characteristics of nipple discharge, clinical breast examination findings, mammographic findings and ultrasonographic findings were analyzed in association with the pathologic diagnosis of malignancy. A chi-square test and logistic regression test were used to assess the statistical significance of the results. RESULTS: The mean age of the patients was 44.8 year-old (range: 19-84). The most common cause diagnosed was intraductal papilloma of 58 (52.7%), followed by 18 fibrocystic changes (16.4%), 17 infiltrating ducal carcinomas (15.5%), 14 intraductal carcinomas (12.7%) and 3 duct ectasias (2.7%). The number of incidences of malignancy was 31 (28.2%). Bloody nipple discharge, nipple discharge with accompanying mass, abnormal mammographic finding and abnormal ultrasound finding were associated with malignancy in 43.2%, 55.6%, 50% and 66.7%, respectively, as compared with 11.5% in serous discharge, 22.6% in discharge without accompanying mass, 21.9% in normal mammographic finding and 52.9% in normal ultrasonographic finding, respectively. In a multivariate analysis of factors predicting malignancy, nipple discharge with accompanying mass and bloody nipple discharge were the independent risk factors. CONCLUSION: Triple examinations including physical examination, mammogram and ultramammography would be necessary for the complete evaluation of nipple discharge and surgical excision is mandatory in cases with suspicion of cancer.
Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Dilatation, Pathologic ; Humans ; Incidence ; Logistic Models ; Multivariate Analysis ; Nipples* ; Papilloma, Intraductal ; Physical Examination ; Referral and Consultation ; Risk Factors ; Ultrasonography

BACKGROUND/AIMS: The prevalence and clinical characteristics of entecavir (ETV) resistance is not well known. The aim of this study was to determine the frequency of genotypic resistance in nonresponders and virologic breakthrough (VBT) patients. METHODS: The medical records of 76 chronic hepatitis B patients treated for a least 6 months from October 2006 to October 2008 were reviewed retrospectively. We divided patients into two groups: nucleoside analogue (NA)-naive patients (n=38) and LAM experienced patients (n=38). NA-naive and LAM experienced patients received ETV at 0.5 and 1.0 mg/day, respectively. The virologic response and VBT were investigated in both groups. We used the multiplex restriction fragment mass polymorphism (RFMP) method to test genotypic resistance at the rtI169, rtT184, rtS202, rtM204, and rtM250 sites. RESULTS: Age, gender, serum ALT, and HBV DNA level before treatment did not differ between the groups. Neither VBT nor nonresponse was observed in the NA-naive group, whereas VBT and nonresponse were observed in three patients each in the lamivudine (LAM)-experienced group; all six patients had YMDD mutation at study enrollment, all three patients with VBT had genotypic resistance to ETV, but the three nonresponse patients did not have genotypic resistance to ETV. CONCLUSIONS: We suspect that VBT is mostly associated with genotypic resistance to ETV. However, nonresponse might be associated with the continuance or reselection of the YMDD mutant in LAM-experienced patients.
Adult ; Antiviral Agents/*therapeutic use ; Drug Resistance, Viral/genetics ; Female ; Genotype ; Guanine/*analogs & derivatives/therapeutic use ; Hepatitis B/genetics ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Lamivudine/therapeutic use ; Male ; Middle Aged ; Mutation ; Polymorphism, Restriction Fragment Length ; RNA-Directed DNA Polymerase/genetics ; Retrospective Studies

Intramural pregnancy implanting in the previous cesarean section scar is one of the rarest form of an ectopic pregnancy and probably the most dangerous form because of its risk of rupture and hemorrhage. For its sonographic diagnosis, the gestational sac should be in the anterior wall of uterine isthmic portion, there should be no myometrium between bladder and gestational sac, and it should be verified that uterine cavity and cervix should be isolated from gestational sac. For young patients who wish to maintain their fertility, an earlier diagnosis and more conservative treatment are desirable. We have recently experienced a case of intramural pregnancy implanting in the scar of cesarean section, treated with systemic methotrexate injection. So, we report this case with a brief review of the literature.
Animals ; Cervix Uteri ; Cesarean Section* ; Cicatrix* ; Diagnosis ; Female ; Fertility ; Gestational Sac ; Hemorrhage ; Humans ; Methotrexate* ; Mice ; Myometrium* ; Pregnancy* ; Pregnancy, Ectopic ; Rupture ; Ultrasonography ; Urinary Bladder

Gastritis cystica polyposa was diagnosed in three patients with ages of 49, 56 and 66 years. All patients had been operated on for gastric cancer 1 to 5 years earlier, with Billroth II gastroenteric anastomose being made at that time. The lesions were diagnosed by regular follow-up endoscopic examination without any presenting symptoms. Macroscopically, all lesions were located on the gastric side of the anastomosis, with polypoid growth of 1.5x1.0, 2.0x1.5, and 0.5x0.5 cm in size respectively. The surfaces of the lesions were coarsely nodular and brittle, and one of them protruded into the anastomosis lumen. Histologic examination revealed polypoid mucosal changes associated with functionally active, hyperplastic and cystic dilatation of the glands which had infiltrated to into the underlying submucosa. An endoscopic polypectomy was performed in two patients, and all has gone well, without evidence of a recurrent tumor 6 & 18 months after polypectomy. The other patients refused a polypectomy. Gastritis cystica polyposa should be differentiated from a stump carcinoma to avoid a further unnecessary surgical intervention. Awareness of the entity will lead to better diagnosis of gastritis cystica polyposa.
Diagnosis ; Dilatation ; Follow-Up Studies ; Gastritis* ; Gastroenterostomy ; Humans ; Stomach Neoplasms

PURPOSE: Renal cystic diseases comprise a mixed group of heritable, developmental and acquired disorders. Recently the use of imaging modalities such as ultrasonography and radionuclide scanning has increased the detection rate of renal cystic diseases. We studied to review the clinical features and treatment of renal cystic diseases in children. METHODS: This study was performed in 95 children with renal cystic diseases in the Department of Pediatrics, Asan Medical Center from October 1989 to June 2001. RESULTS: In 95 patients, there were 55 cases(58.0%) with multicystic dysplastic kidney(MCDK), 19 cases(20.0%) with simple renal cysts, 13 cases(13.7%) with hereditary polycystic kidney diseases(7 with autosomal recessive type, 5 with autosomal dominant type, 1 with undetermined), 6 cases(6.3%) with renal cysts in tuberous sclerosis and 1 case(1.0%) with medullary cystic disease. All MCDK patients had no renal dysfunction and hypertension during the follow-up period. Three out of 13 with polycystic kidney diseases had progressed to end-stage renal disease during the follow-up period. One case with a simple cyst underwent laparoscopic malsupialization for decompression. CONCLUSION: Renal cystic diseases have diverse clinicopathologic features and variable prognosis. We emphasize that routine follow-up should be performed to prevent and to detect early treatable complication in renal cystic diseases. Therefore, their natural history and treatment need further investigation and long term follow-up is required.
Child* ; Chungcheongnam-do ; Decompression ; Follow-Up Studies ; Humans ; Hypertension ; Kidney Failure, Chronic ; Natural History ; Pediatrics ; Polycystic Kidney Diseases ; Prognosis ; Tuberous Sclerosis ; Ultrasonography