59 children seen from Jan. 1990 to Jun. 1994 with epilepsy were retrospectively reviewed to evaluate the tendency of recurrence and the risk factors after the antiepileptic drug discontinuation. The population consisted of 59 children who were seizure free for more than 2 years and followed up for more than 1 year after the discontinuation via department of pediatrics, Yonsei University, Wonju College of Medicine. We analyzed risk factors of recurrence(age of seizure onset, seizure frequency before treatment, interval from seizure onset to start of treatment, duration from neurologic disorders, and EEG done just before discontinuation) between non-recurrent group(43 patients) and recurrent group(16 patients). The results were as follows: 1) In 59 patients with epilepsy, 16(27.1%) patients showed recurrence after the discontinuation and 14(87.5%) patients of those were developed during taperring and within less than 1 year. The probability of recurrent seizure by Kaplan-Meier curve at 12 and 24 months after discontinuation are 23.7% and 33.6% respectively. 2) There were significant differences on seizure frequency before treatement, duration from start of treatment to control (9.5months vs 31.1months), and associated neurologic disorders(11.6% vs. 56.2%) between non-recurrent and recurrent group. 3) There were no significant differences on age at seizure onset(70.6 months vs. 58.5months), interval from seizure onset to start of treatment(9.5months vs. 6.6months), length of seizure free(49.7months vs 39.3months), abnormal EEG finding done just before withdrawal(23.2% vs. 25.0% ) between non-recurrent and recurrent group.
Child ; Electroencephalography ; Epilepsy* ; Gangwon-do ; Humans ; Nervous System Diseases ; Pediatrics ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Seizures

PURPOSE: To evaluate the role of CT in early detection, location, and extent of osteochondritis dissecans (OCD) of the elbow joint. MATERIALS AND METHODS: We reviewed surgically proved 27 cases of 22 patients with osteochondritis dissecans in elbow joint retrospectively. We compared simple x-ray(elbow AP & lateral) with CT on the basis of staging of OCD of talus by simple x-ray. RESULTS: The frequency of location was as follows:fourteen cases of capitellum, 5 cases of olecranon tip, 5 cases of medial epicondyle, 2 cases of trochlea, and 1 case of olecranon base. Among the 4 cases of normal finding on simple x-ray, CT showed 1 case each of stage I, II, III, and IV OCD and among the 8 cases of stage I on simple x-ray, CT showed 2 cases of stage I, 1 case of stage II, and 5 cases of stage III. Among the 3 cases of stage II on simple x-ray, CT showed 1 case of stage II and 2 cases of stage III. Among the 5 cases of stage III on simple x-ray, CT showed 1 case of stage II, 2 cases of stage III, and 2 cases of stage IV, but it was difficult to detect the presence or absence of attachment between the articular cartilage of mother bone and osteochondral fragment. CT was more accurate than simple x-ray in detection of loose body. CONCLUSION: CT might be an useful imaging modality in early diagnosis of OCD and evaluation of its anatomic location and extent in elbow joint.
Cartilage, Articular ; Early Diagnosis ; Elbow Joint* ; Elbow* ; Humans ; Mothers ; Olecranon Process ; Osteochondritis Dissecans* ; Osteochondritis* ; Retrospective Studies ; Talus

Pulmonary histiocytosis X is a rare granulomatous disorder of unknown etiology that alters the interstitium of the lung. When confined to the lung, it is known as primary pulmonary histiocytosis X or eosinophilic granuloma of the lung. The chest radiograph shows characteristic nodular, reticular, and cystic abnormalities, which are most apparent in the upper and middle lung zones, but spare the costophrenic angles, The CT demonstrates innumerable small cysts with thin walls, and fine nodules. Recently we experienced pathologically proven primary pulmonary histiocystosis X in 35 years old male patients who had recurrent pneumothorax.
Eosinophilic Granuloma ; Histiocytosis, Langerhans-Cell* ; Humans ; Lung ; Male ; Pneumothorax ; Radiography, Thoracic

BACKGROUND: To study the prognosis of patients with lung cancer, many investigators have reported the methods to detect cell proliferation in tissues including PCNA, thymidine autoradiography, flow cytometry and Ki-67. PCNA, also known as cyclin, is a cell related nuclear protein with 36KD intranuclear polypeptide that is maximally elevated in S phase of proliferating cells. In this study, PCNA was identified by paraffin-embedding tissue using immunohistochemistry which has an advantage of simplicity and maintenance of tissue architecture. The variation of PCNA expression is known to be related with proliferating fraction, histologic type, anatomic(TNM) stage, degree of cell differentiation, S-phase fraction and survival rate. We analyzed the correlation between PCNA expression and S-phase fraction, survival. METHODS: To investigate expression of PCNA in primary lung cancer, we used immunohistochemical stain to paraffin-embedded sections of 57 resected primary non-small cell lung cancer specimen and the results were analyzed according to the cell type, cell differentiation, TNM stage, S-phase fraction and survival. RESULTS: PCNA expression was dMded into five group according to degree of staging(-, +, ++, +++,++++). Squamous cell type showed high positivity than in adenocarcinoma. Nonsignificant difference related to TNM stage was noticed. Nonsignificant difference related to degree of cell differentiation was noticed. S-phase fraction was increased wit advance of PCNA positivity, but t could not reach the statistic significance. The 2 year survival rate and median survival time were -50% 13 months, +75% 41.3 months, ++73% 33.6 months, +++67% 29.0 months, ++++25% 9 months with statistic significance (P<0.05, Kaplan-Meier, generalized Wilcox). CONCLUSION: From this study. PCNA expression was high positive n squamous cell cancer. And, there was no relationship between PCNA positivity and TNM stage, cellular differentiation or S-phase fraction. But, the patients with high positive PCNA staining showed poor survival rate than the patients with lower positive PCNA. It was concluded that PCNA immunostaining is a simple and useful method for survival prediction in paraffin embedded tissue of non-small cell lung cancer.
Adenocarcinoma ; Autoradiography ; Carcinoma, Non-Small-Cell Lung* ; Cell Differentiation ; Cell Proliferation ; Cyclins ; Flow Cytometry ; Humans ; Immunohistochemistry ; Lung Neoplasms ; Neoplasms, Squamous Cell ; Nuclear Proteins ; Paraffin ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Research Personnel ; S Phase ; Survival Rate* ; Thymidine

The Bcl-2 protein has been shown to block apoptosis induced by a variety of stimuli. We have performed the experiments which cell death can be blocked by the bcl-2 proto-oncogene under moderate(50-100mM) or high ethanol treatment(400-600mM). As a result of morphological changes, and MTT assay, cell death was blocked by Bcl-2 under 100mM ethanol. However, the results of DNA fragmentation and RT-PCR(ICE, and CPP32), immunoblotting(CPP32, and PARP) for SK-pcDNA3 cells(vector only) and SK-Bcl-2 cells(stably expressed bcl-2 gene) were showen to be no significant differences between two cell lines. These result suggested that cell death induced by ethanol was not followed by apoptosis mechanism, and was blocked by the bcl-2 proto-oncogene with moderate ethanol.
Apoptosis ; Cell Death* ; Cell Line ; DNA Fragmentation ; Ethanol* ; Ice ; Proto-Oncogenes*

No abstract available.
Education* ; Humans ; Internship and Residency* ; Korea*

BACKGROUND: Laryngeal mask airway (LMA) is a useful instrument for routine anesthesia. It permits spontaneous or positive pressure ventilation but its use in obstetric anesthesia has not been described. In this study, we evaluated the effectiveness and the side effects of the LMA during elective cesarean sections. METHODS: Institutional approval and patients' permission were obtained. One thousand sixty-seven patients scheduled for elective an cesarean section, that have been NPO for more than 6 (6-48) hours were evaluated. They were premedicated with an H2 receptor blocker (ranitidine 50 mg i.m.) 1 hour before the operation. They were anesthetized with penthotal sodium (3-4 mg/kg), vecuronium (1 mg/10 kg i.m.) and then a 3 or 4 LMA was inserted after the mask ventilation with 100% oxygen for 1 min. The cuff was inflated with air 15.3 +/- 2.6 ml. On auscultation, air entry was good in both lungs. Anesthesia was maintained by 50% oxygen in N2O with 0.7 - 1.0% enflurane. Analgesics (tramadol 30 mg i.v.) was given incrementally after delivery of the baby. Manual assisted ventilation was used throughout the procedure. The number of insertion attempts, cuff volume and the incidences of complications were evaluated. RESULTS: In 1051 patients, the LMA was inserted on the first attempt. In 16 patients more than 2 attempts were needed and change to endotracheal intubation were needed in 7 cases. The mean cuff volume was 15 +/- 2.6 ml at insertion and increased to 18.5 +/- 3.2 ml after removal. The average airway pressure was 20 cmH2O during positive pressure ventilation, above that pressure air leakage was detected in 16 cases. Complications noted were mild sore throat in 5 cases, and blood tinged after removal of LMA in 3 cases but gastric distention was not detected. No incidence of aspiration was noted. CONCLUSIONS: In this study, the LMA proved to be a useful tool for the management of patients presenting for elective an cesarian section. There is the remote possibility of aspiration which did not happen in our study.
Analgesics ; Anesthesia ; Anesthesia, Obstetrical ; Auscultation ; Cesarean Section* ; Enflurane ; Female ; Humans ; Incidence ; Intubation, Intratracheal ; Laryngeal Masks* ; Lung ; Masks ; Oxygen ; Pharyngitis ; Positive-Pressure Respiration ; Pregnancy ; Sodium ; Tolnaftate ; Vecuronium Bromide ; Ventilation

PURPOSE: To examine the effect of back massage on immune response, symptom distress, and mood state of patients undergoing allogeneic hematopoietic stem cell transplantation (allogeneic HSCT). METHODS: Subjects were thirty-seven patients undergoing sibling allogeneic HSCT (including 16 in the experimental group and 21 in the control group). Experimental subjects participated in an intervention group of back massage for 10 minutes, once a day and 5 times a week, from one week prior to the HSCT to the third week after the HSCT or a control group. A non-equivalent pretest-posttest design was used. t-test and Repeated measures ANOVA were used to examine group differences by using SAS. RESULTS: No significant group differences were found in Immune response (CD4+, CD8+,CD19+, CD56+) and symptom distress. The experimental group had significantly less mood state (anxiety, confusion) than the control group. CONCLUSION: The back massage for the patients undergoing allogeneic HSCT may be effective in altering the anxiety and confusion during hematopoietic stem cell transplantation. However, this study did not provide evidence in improving immune response and symptom distress.
Anxiety ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Massage ; Phenothiazines ; Siblings

Herba houttuyniae has been used as a constituent of herval medicine prescriptions for the treatment of inflammation, cancer, and other diseases. In the present study, we investigated the cellular effects of herba houttuyniae extract (HHE) and the signal pathways of HHE-induced apoptosis in HL-60 human promyelocytic leukemia cell line. HHE treatment caused apoptosis of cells as evidenced by discontinuous fragmentation of DNA, the loss of mitochondrial membrane potential, release of mitochondrial cytochrome c into the cytosol, activation of procaspase-9 and caspase-3, and proteolytic cleavage of poly(ADP-ribose) polymerase. Pretreatment of Ac-DEVD-CHO, caspase-3 specific inhibitor, or cyclosporin A, a mitochondrial permeability transition inhibitor, completely abolished HHE-induced DNA fragmentation. Together, these results suggest that HHE possibly causes mitochondrial damage leading to cytochrome c release into cytosol and activation of caspases resulting in PARP cleavage and execution of apoptotic cell death in HL-60 cells.
Apoptosis/*drug effects ; Caspases/*metabolism ; Cytochrome c Group/*metabolism ; Enzyme Activation/drug effects ; HL-60 Cells ; Human ; Medicine, Oriental Traditional ; Membrane Potentials/drug effects ; Mitochondria/*drug effects ; Plant Extracts/*pharmacology ; Plants, Medicinal/*chemistry

BACKGROUND: Immediate implant placement has become an acceptable treatment for the edentulous area. The advantages of the immediate implant placement include considerable decrease in time from tooth extraction to placement of the finial prosthesis, fewer surgical procedures, and better acceptance of the overall treatment plans. But the success is dependent on the quantity and quality of the extraction socket. The purpose of this study is to evaluate the success of the immediate implant placement. MATERIALS AND METHODS: Twenty-one sites in 16 patients were selected for the evaluation of the immediate implant placement. All of the cases were followed using clinical and radiographic examinations. Criteria of success were the absence of peri-implant radiolucency, mobility, and persistent pain or sign of infection. RESULTS: Of the 21 implants, 13 implants have been succeeded. Of the 13 implants, 10 implants were replaced for the periodontal disease and 3 implants were replaced for the trauma. CONCLUSION: The criteria of the success in immediate implant placement are as follows. 1) Implants placed into fresh extraction sockets have a high rate of survival. 2) Implant should be placed as close as possible to the alveolar crest. 3) Implant placed into available bone beyond the apex have a high success rate.
Humans ; Periodontal Diseases ; Prostheses and Implants ; Tooth Extraction* ; Tooth*