OBJECTIVES: Attention deficity hyperactive disorder is known to be a disease with a high genetic trait. Recently the relationship between alleles frequency distribution and ADHD has been actively researched. In Korea, the relationship between the genetic type and alleles for dopamine transporter gene has been studied in ADHD patients. METHODS: Thirty five patients diagnosed with ADHD according to the DSM-IV diagnostic criteria were selected for study. The diagnosis and clinical features were confirmed by korean version Child behavior check list, korean version Conner's parent rating scale, Attention deficit Diagnostic System, korean version Spielberger state-trait anxiety scale etc. For the control group, the parents of patients were chosen. Blood samples were taken from the 105 subjects. DNA was extracted from blood lymphocytes, PCR was performed for dopamine transporter gene. RESULTS AND CONCLUSION: In comparing the ADHD transmitted group and the not transmitted group, significant difference was seen between the DAT1 genetic type and alleles distribution. As a result, it is viewed that there is relationship between ADHD and the dopamine transporter gene. Follow up studies with larger patient or pure subgroups are expected.
Alleles ; Anxiety ; Attention Deficit Disorder with Hyperactivity ; Child ; Child Behavior ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Follow-Up Studies ; Humans ; Korea ; Lymphocytes ; Parents* ; Polymerase Chain Reaction

Cardiac organoids have emerged as invaluable tools for assessing the impact of diverse substances on heart function.This report introduces guidelines for general requirements for manufacturing cardiac organoids and conducting cardiac organoid-based assays, encompassing protocols, analytical methodologies, and ethical considerations. In the quest to employ recently developed three-dimensional cardiac organoid models as substitutes for animal testing, it becomes imperative to establish robust criteria for evaluating organoid quality and conducting toxicity assessments. This guideline addresses this need, catering to regulatory requirements, and describes common standards for organoid quality and toxicity assessment methodologies, commensurate with current technological capabilities. While acknowledging the dynamic nature of technological progress and the potential for future comparative studies, this guideline serves as a foundational framework. It offers a comprehensive approach to standardized cardiac organoid testing, ensuring scientific rigor, reproducibility, and ethical integrity in investigations of cardiotoxicity, particularly through the utilization of human pluripotent stem cell-derived cardiac organoids.

Since 1920, when Harvey Cushing first used radiofrequency in electrosurgery, the procedural technique has developed rapidly. Even though this procedure is minimally invasive and safer than other neurodestructive procedures, it is still not free of complications. A 72-year-old female patient had constant facial pain, despite several operations and radiotherapies for her maxillary cancer. The region innervated ophthalmic branch and maxillary branch of the trigeminal nerve was involved, with radiofrequency procedure of the gasserian ganglion for pain control also performed at the area. After the procedure, her blood pressure became elevated and she complained of a headache, and six hours later, she became irritable and distracted. Bacterial meningitis was diagnosed by a spinal tap, with third-generation cephalosporin administered as the treatment. The following day, her symptoms had improved and the pain was also reduced. She was discharged from hospital after 14 days, without any sequelae.
Aged ; Blood Pressure ; Electrosurgery ; Facial Pain ; Female ; Headache ; Humans ; Meningitis ; Meningitis, Bacterial* ; Radiotherapy ; Spinal Puncture ; Trigeminal Ganglion ; Trigeminal Nerve

PURPOSE: Smoking elicits airway inflammation and airflow obstruction in patients with asthma, even after smoking cessation. The aim of this study was to examine the effects of smoking cessation on lung function and quality of life (QOL) in asthmatic patients. METHODS: Thirty-two patients with asthma who were active smokers were recruited. After education on the effects of smoking on asthma, 22 patients continued to smoke, and 10 quit smoking. All patients were treated with inhaled fluticasone propionate (1 mg/day) for 3 months. We compared forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity (FVC), forced expiratory flow between 25 and 75% FVC (FEF(25-75%)), and scores on a QOL questionnaire at baseline, 1, 2, and 3 months. RESULTS: Quitters showed a greater percent change in FEV1 (19.1+/-6.3 vs. 7.9+/-2.4%, P=0.024) and FEV1/FVC (6.5+/-4.14 vs. 3.5+/-1.5%, P=0.05) than smokers. Both quitters and smokers showed improved QOL scores after 1, 2, and 3 months of fluticasone treatment. CONCLUSIONS: Patients with asthma who quit smoking showed less airway obstruction, suggesting that smoking cessation is crucial in the management of asthma.
Airway Obstruction ; Androstadienes ; Asthma ; Diethylpropion ; Forced Expiratory Volume ; Humans ; Inflammation ; Lung ; Quality of Life ; Smoke ; Smoking ; Smoking Cessation ; Vital Capacity ; Fluticasone ; Surveys and Questionnaires

PURPOSE: The aim of this study was to evaluate long-term oncologic outcomes after concurrent chemoradiation treatment for anal cancer. MATERIALS AND METHODS: Between January 1979 and December 2008, the records of 50 consecutive patients with anal cancer and who were treated by chemoradiation or radiation only with a curative intent were retrospectively reviewed. The oncologic outcomes and the risk factors for recurrence were analyzed. RESULTS: Of the 50 patients, 49 underwent concurrent chemoradiation and one underwent radiation only. After these definitive treatments, 43 (86.0%) achieved a clinical complete response. During the median follow-up of 60 months (range: 2-202 months), the 5-year overall survival, disease-free survival, and locoregional recurrence-free survival were 84.2%, 72.7%, and 69.9%, respectively. Multivariate analysis revealed that the performance status (p=0.031) and a clinical complete response (p=0.039) were the independent predictors for overall survival; lymph node involvement (p=0.031) was the only independent predictor for disease-free survival. CONCLUSION: The performance status and a clinical complete response may be reliable predictors of survival after chemoradiation for anal cancer. The addition of irradiation to the inguinal area may not be significantly associated with the outcomes.
Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms/*drug therapy/*radiotherapy ; Chemoradiotherapy/*methods ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Recurrence ; Time Factors ; Treatment Outcome

Congenital hemangioma (CH), which is already fully formed at birth, is a rare clinical entity that is distinctly different from the common postnatally-occurring hemangioma of infancy (HOI). These two forms of CH have been described according to their clinical courses: apart from the clinical features of presentation at birth, there is the rapidly involuting congenital hemangioma (RICH) with rapid involution shortly after birth and the noninvoluting congenital hemangioma (NICH) with neither postnatal enlargement nor spontaneous involution. It is important to recognize this uncommon disease entity NICH in the early period because it has no tendency for spontaneous regression, so timely therapeutic intervention is needed, which is in contrast to that of HOI. We present 3 patients who were 1-, 3- and 13-year-old girls with red-stippled blue to blue gray vascular lesion. They all showed their lesions since birth and the lesions remained unchanged with no subjective symptoms. Doppler ultrasonography demonstrated a well-defined fast-flowed vascular lesion confined to the dermis and subcutis. The histology commonly showed lobular growth of capillaries, centrilobular irregular and often stellate vessels, extralobular large vessels and more conclusively, negative staining for GLUT-1, which is unlike HOI.
Adolescent ; Capillaries ; Dermis ; Hemangioma ; Humans ; Iodine Compounds ; Negative Staining ; Parturition ; Ultrasonography, Doppler

BACKGROUND: Idiopathic pulmonary fibrosis(IPF) is a fatal progressive fibrous disease of the lung of unknown etiology. Recently it has been classified into several distinct entities of the basis of pathologic and clinical characteristics, ie : usual interstitial pneumonia(UIP), desquamative interstitial pneumonia(DIP), acute interstitial pneumonia(AIP), bronchiolitis obliterans with organizing pneumonia(BOOP), and nonspecific interstitial pneumonia(NSIP). IPF is now applied only for UIP, which has the worst prognosis. The previous reports of 3-5 year median survival apears to be overoptimistic because other types with better prognosis like NSIP or BOOP might have been included. Therefore, this study was performed to determine the clinical course and the prognostic factors of UIP as diagnosed by surgical lung biopsy. METHODS: The subjects were 72 UIP patients (age 58.2±11.6 years, M:F=45:27, median follow up period:18.1 months (0.7-103.6) diagnosed by surgical lung biopsy at the Asan Medical Center (68 patients) and the Paik Hospital in Seoul (4 patients). Clinical scores (level of dyspnea:1-20 points), radiologic score (honey-combing : HC score 0-5 points, ground glass : GG score 0-5 points), and physiologic scores (FVC:1-12 points, FEV1:0-3 points, TLC:0-10 points, DDLC:0-5 points, AaDO2:0-10 points) were summed into a total CRP score. RESULTS: 1) The one year survival rate was 78.3%, while the rate for three year survival was 58.1%, and the median survival period was 42.5 months. 2) Short term (1 year) prognosis : The patients who died within one year of diagnosis (14 patients) had the higher initial total CRP score (28.6±8.3 vs. 16.6±9.7) than those who lived longer than one year (46 patients). The difference in the total CRP score was attributed to the symptom score (8.4±2.1 vs. 5.7±3.9) and the physiologic score (15.7±7.1 vs. 6.7±5.7) including FVC, DLCO, and AaDO2. 3) Long-term (3 year) prognosis : The total CRP score (12.2±6.7 vs. 28.7±7.9:including symptom score, FVC, DLCO, and AaDO2) at the time of diagnosis were also different for the long-term survivors and those who lived less than 3 years. 4) Cox regression analysis showed LCO (≥60%) (Hazard ratio:4.56, 95% CI:2.30-16.04) was the independent prognostic factors of UIP (P<0.05). CONCLUSION: These results suggest that DLCO at the time of diagnosis seem to be a prognostic markers of biopsy-proven UIP.
Biopsy ; Bronchiolitis Obliterans ; Chungcheongnam-do ; Cryptogenic Organizing Pneumonia ; Diagnosis ; Follow-Up Studies ; Glass ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung ; Prognosis ; Seoul ; Survival Rate ; Survivors

Periorbital edema is a rare manifestation of systemic lupus erythematosus (SLE). We describe here a patient with bilateral periorbital edema as a presenting symptom of SLE. A 23-year-old woman was admitted for a sudden onset of severe periorbital edema that developed 7 days previously. On the basis of the malar rash, arthritis of the right hand and left wrist, leukopenia, proteinuria and the positive anti-nuclear and anti-dsDNA antibodies, she was diagnosed with SLE. Kidney biopsy revealed lupus nephritis (WHO class IV). After treatment with high dose of steroids, intravenous cyclophosphamide and daily hydroxychloroquine, her symptoms resolved, including the periorbital edema. She was discharged with prescriptions for prednisolone and hydroxychloroquine and she remains well.
Antibodies ; Arthritis ; Biopsy ; Cyclophosphamide ; Edema ; Exanthema ; Female ; Hand ; Humans ; Hydroxychloroquine ; Kidney ; Leukopenia ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Prednisolone ; Prescriptions ; Proteinuria ; Steroids ; Wrist ; Young Adult

BACKGROUND: Isolated leukopenia is rare, but it has important clinical implications during antituberculosis treatment. Inadvertent discontinuation of short-course regimen drugs for fear of leukopenia inevitably will extend the duration of treatment, and the treatment completion rate will decrease completion of treatment will be delayed. However no guidelines concerning proper management for leukopenia during antituberculosis treatment have been presented. So we performed this Therefore, this study in order was performed to confirm whether or not it is possible to continue evaluate the possibility of continuing the same short-course regimen in case of the development of if a mild-to-moderate degree of isolated leukopenia was to develop during antituberculosis treatment. METHOD: Thirty-six patients who had been prescribed a short-course antituberculosis regimen between January 1997 and August 1999, had newly developed, mild-to-moderate degree, isolated leukopenia during medication, and who had continued the same drug regimen in spite of despite leukopenia were enrolled. One patient had been lost to was not available for the follow-up, so the remaining thirty-five (twenty-five prospectively and ten retrospectively) patients were analyzed. Patients who had other known causes of leukopenia were excluded. A mild-to-moderate degree of isolated leukopenia was arbitrarily defined as having a peripheral blood leukocyte count between 2,000 and 3,499 mm3 and no evidence of coexisting hematologic abnormalities. RESULTS: 1) All thirty-five patients could were able to complete short-course anti-tuberculosis treatment without complication or a further decrease of leukocytes count to less than 2,000/mm3 in spite of despite continuous treatment with the same regimen. 2) The mean duration from start of antitituberculosis medication to detection of leukopenia was 6465 days. 3) The mean leukocyte count was 5,0351,583/mm3 before treatment, and the its lowest count was 2,908390/mm3 during treatment. Leukopenia recovered after completion of treatment (4,2831,269/mm3). 4) The main component of leukopenia was a the decrease in neutrophil count ( 3,361 1,732 vs. 1,512 423 mm3, p<0.05). CONCLUSION: In a case of a For mild-to-moderate degree of isolated leukopenia (2,000/mm3 WBC < 3,500/mm3) developed (,) developing during short-course antituberculosis treatment, it is suggested that we can continue the short-course antituberculosis regimen may be continued without complications.
Follow-Up Studies ; Humans ; Leukocyte Count ; Leukocytes ; Leukopenia* ; Neutrophils ; Prospective Studies ; Tuberculosis

BACKGROUND: Despite the physical disfigurement, bothersome symptoms and psychological problemsfrom the proliferative scarring process of keloids and hypertrophic scars, there is currently no consensus regarding the best management of these lesions. OBJECTIVE: The purpose of this study was to determine the therapeutic efficacy and safety of intralesional corticosteroid injection combined with 5-fluorouracil (5-FU) and/or pulsed dye laser (PDL) in Koreans with keloids or hypertrophic scars. METHODS: Twenty-five patients with keloids and/or hypertrophic scars over 2 cm in size or who had more than 3 separated lesions were included in this study. Each scar was divided equally into 2 or more segments and these were treated with 1 of the following 3 different modalities: (1) intralesional injection of triamcinolone acetonide (TCA: 20 mg/ml weekly), (2) intralesional injection of TCA 0.1 ml (40 mg/ml) mixed with 5-FU 0.9 ml (50 mg/ml) weekly and (3) treatment #2 combined with PDL (585 nm, 5~7.5 J/cm2) at baseline and at the 3rd and 7th weeks. We estimated the change of the height, the erythema, the pliability, the pruritus, the pain/tenderness scores, the patient-self assessment and the complications. This study was an 8-week prospective study and the assessment of relapse was done at 4 and 12 weeks after the last treatment. RESULTS: There was a statistically significant improvement of the clinical signs and symptoms in all the treated groups. However, the 5-FU-treated groups had more sustained effects compared to the group that underwent TCA monotherapy with respect to flattening and pliability. Complications such as ulcerations, crusts and hyperpigmentation were more frequent in the 5-FU-treated groups. CONCLUSION: Although 5-FU may be preferable to TCA for improving the symptoms of keloids and hypertrophic scars, we believe it is prone to induce more complications in Koreans.
Cicatrix ; Cicatrix, Hypertrophic ; Consensus ; Erythema ; Fluorouracil ; Humans ; Hyperpigmentation ; Injections, Intralesional ; Keloid ; Lasers, Dye ; Pliability ; Prospective Studies ; Pruritus ; Recurrence ; Triamcinolone Acetonide ; Ulcer