PURPOSE: This study examined the effects of neuromuscular electrical stimulation (NMES) and horseback riding using a robotic device on the trunk muscle activity and gross motor function in children with spastic diplegia. METHODS: Children with spastic diplegia were divided into two groups: an experimental group (NMES and horseback riding using a robotic device [n=10]) and a control group (placebo NMES and horseback riding using a robotic device [n=10]). Each group received general physical therapy and occupational therapy. Each intervention involved the administration of NMES for 15 minutes and horseback riding using robotic device therapy for 15 minutes three times a week for 4 weeks. The evaluation included both the rectus abdominis muscles (RA), external oblique muscles (EO), thoracic paraspinal muscles (TP), and lumbar paraspinal muscles (LP) activity and GMFM. RESULTS: The RA, EO, TP, and LP muscle activity, GMFM C, D, and E were increased significantly in the experimental and control groups. A significant increase in both the TP muscle activity and GMFM D was observed in the experimental group compared to the control group. CONCLUSION: This study showed that horseback riding using a robotic device is an effective intervention for trunk muscle activity and GMFM in children with spastic diplegia. However, if NMES is added to the back muscles, it is possible to further increase the thoracic paraspinal muscle activity and standing ability.
Back Muscles ; Cerebral Palsy* ; Child* ; Electric Stimulation ; Humans ; Muscle Spasticity* ; Muscles ; Occupational Therapy ; Paraspinal Muscles ; Rectus Abdominis

BACKGROUND: As an attempt to develop a strategy to improve the protective immune response to GM-CSF-secreting CT26 (GM-CSF/CT26) tumor vaccine, we have investigated whether the apoptogenic treatment of GM-CSF/CT26 prior to vaccination enhances the induction of anti-tumor immune response in mouse model. METHODS: A carcinogen- induced mouse colorectal tumor, CT26 was transfected with GM-CSF gene using a retroviral vector to generate GM-CSF-secreting CT26 (CT26/GM-CSF). The CT26/GM-CSF was treated with gamma-irradiation or mitomycin C to induce apoptosis and vaccinated into BALB/c mice. After 7 days, the mice were injected with a lethal dose of challenge live CT26 cells to examine the protective effect of tumor vaccination in vivo. RESULTS: Although both apoptotic and necrotic CT26/GM-CSF vaccines were able to enhance anti-tumor immune response, apoptotic CT26/GM-CSF induced by pretreatment with gamma-irradiation (50,000 rads) was the most potent in generating the anti-tumor immunity, and thus 100% of mice vaccinated with the apoptotic cells remained tumor free for more than 60 days after tumor challenge. CONCLUSION: Apoptogenic pretreatment of GM-CSF-secreting CT26 tumor vaccine by gamma-irradiation (50,000 rads) resulted in a significant enhancement in inducing the protective anti-tumor immunity. A rapid induction of apoptosis of CT26/GM-CSF tumor vaccine at the vaccine site might be critical for the enhancement in anti-tumor immune response to tumor vaccine.
Animals ; Apoptosis ; Colony-Stimulating Factors* ; Colorectal Neoplasms ; Granulocyte-Macrophage Colony-Stimulating Factor ; Mice ; Mitomycin ; Vaccination ; Vaccines ; Zidovudine

BACKGROUND: Granulocyte-macrophage colony-stimulating factor (GM-CSF) gene- transduced tumor cell vaccines induce very potent systemic anti-tumor immunity in preclinical and clinical models. Our previous phase I clinical trial in patients with metastatic renal cell carcinoma (RCC) has demonstrated both immune cell infiltration at vaccine sites and T cell-mediated delayed-type hypersensitivity (DTH) response to whole tumor cell vaccines. METHODS: To investigate the immune responses to autologous genetically- modified tumor cell vaccines, tumor-specific CD8+ T cell lines were generated from peripheral blood lymphocytes (PBL) of a RCC patient 1.24 by repeated in vitro stimulation with either B7.1-transduced autologous RCC tumor cells or B7.1-transduced autologous tumor cells treated with interferon gamma (IFNgamma), and cloned by limiting dilution. RESULTS: Among several RCC-specific cytotoxic T lymphocytes (CTLs), a CD4+ /CD8+ double positive T cell clone (17/A2) appeared to recognize IFNgamma-treated autologous RCC restricted by HLA-B39. The 17/A2 also recognized other HLA-B39 positive RCC tumor cells after IFNgamma treatment. CONCLUSION: These results demonstrate that autologous RCC vaccination successfully generates the tumor-specific CTL 17/A2, and suggest that the presentation and recognition of the tumor antigen by the 17/A2 might be upregulated by IFNgamma.
Carcinoma, Renal Cell ; Cell Line ; Clone Cells ; Granulocyte-Macrophage Colony-Stimulating Factor* ; HLA-B39 Antigen ; Humans ; Hypersensitivity ; Interferons ; Lymphocytes ; T-Lymphocytes* ; T-Lymphocytes, Cytotoxic ; Vaccination ; Vaccines

BACKGROUNDS: Gamma band oscillatory activity is considered to be related to congnitive functions and illustrates that the concept of event-related oscillations bridges the gap between single neurons and neural assemblies. An event-related gamma oscillation is the time - locked responses of specific frequency, and can be identified by computing the amplitude frequency characteristics of the averaged event-related potentials(ERPs) after stimulation. OBJECTIVES: We purposed to present experimental paradigm to investigate @-band oscillation activities from the recording of ERPs by using auditory oddball paradigm and investigate the difference of @-band activity between schizophrenia and normal controls. METHODS: The ERPs resulting from auditory stimuli with oddball paradigm in a group of schizophrenics(n=11) and also a group of age-, sex- and handedness matched normal controls, were recorded by 128 channel EEG. The @-band oscillatory activities were calculated by using time-frequency wavelet decomposition of the signal between 20 and 80Hz. The @-band oscillatory activities of both groups were compared by t-test. RESULTS: The @-band oscillatory of the leads Fz,Gz and Pz of both groups were represented well in the time - frequency maps. Significant increases of the @-band activity in normal controls compared with schizophrenics were observed around 160 msec. 350msec. and 800 msec after stimulation. CONCLUSIONS: Our results suggested that the increment in @-band oscillatory activity during cognitive operations and decreased @-band activity in schizophrenics may be associated with the cognitive dysfunctions and the pathophyiology of the schizophrenia.
Electroencephalography ; Evoked Potentials* ; Functional Laterality ; Neurons ; Schizophrenia

BACKGROUND: Varix bleeding in children is infrequent but it is potentially fatal. It has characteristics different from adult age varix bleeding. But there was little clinical data about it. The purposes of this study is to detect its characteristics of varix bleeding in pediatric patients, and to help an emergency physician make a decision about the management. METHODS: We reviewed medical records of 32 patients who visit Seoul National University Hospital Pediatric Emergency center from Jan. 1, 1995 to Dec. 31, 1996. RESULTS: 1) The peak age was between 1 and 5 years of age, and the ration of males to females was 1: 1. 2) As a underlying cause, intrahepatic disease were more common than extrahepatic diseases(87.1%:12.9%). 3) 10 patients(31.3%) had URI symptoms as a precipitating factor. 4) Varix bleeding has a circardian rhythm, and occured more often during the night. 5) In Child Classification for the hepatic reserve fuction, Child C was the most common(75%). 6) Endoscopic eliminations were performed in 14 patients(43.8%). 7) According to shock classification. the ration of conservative to vasopressin treatment in class I and class II were 13(40.6%)/10(31.3%) and 6(18.8%)/3(9.4%), respectively. 8) Fever was the most common complication(43.8%), and the mortality rate was 3.1%. CONCLUSION: We suggest that the only conservative management can show a good result far pediatric varix bleeding compared to other treatment modalities.
Adult ; Child ; Classification ; Emergencies* ; Esophageal and Gastric Varices* ; Female ; Fever ; Hemorrhage* ; Humans ; Male ; Medical Records ; Mortality ; Precipitating Factors ; Seoul ; Shock ; Varicose Veins ; Vasopressins

BACKGROUND: Inflammatory mediators, including oxidants, play a important role in the systemic response to burn injury and cause a sepsis and subsequent multiple organ failure by lipid peroxidation of cell. It has been known that vitamin C has potent antioxidant effect and inhibits the lipid peroxidation. This study was designed to evaluate the inhibitory effect of vitamin C about lipid peroxidation in the early stage of bum injury. METHODS: 15 rats with second degree bum on 30-35% of body surface were divided into three groups. Only normal saline was injected into intraperitonial space on the control group , and vitamin C of 50 mg/kg of body weight was added on the low dose group (LDG), and vitamin C of 500 mg/kg of body weight on the high dose group (HDG). After 24 hours of bum damage, biochemical levels of malondialdehyde (MDA), superoxide dismutase (SOD) and catalase were measured in lung and liver tissue. The statistical methods used were Kruskal-Wallis test and Mann-Whitney test. RESULTS: MDA levels of LDG and HDG were significantly low compared to that of the control group (p<0.01). On the catalase activity, there was no significant difference when comparing the control group with LDG (p=0.015), but significant difference with HDG (p<0.01). There was no significant differences between three groups on the activities of SOD (p>0.01), except comparing the control group with HDG in lung tissue (p<0.01). CONCLUSION: Vitamin C therapy in the early stage of bun decreased the level of MDA and increased the catalase activity. It means that vitamin C inhibits the lipid peroxidation and has antioxidant effect. But vitamin C revealed the only partial effect on the SOD activity.
Animals ; Antioxidants* ; Ascorbic Acid* ; Body Weight ; Burns* ; Catalase ; Lipid Peroxidation ; Liver ; Lung ; Malondialdehyde ; Multiple Organ Failure ; Oxidants ; Rats* ; Sepsis ; Superoxide Dismutase ; Vitamins*

PURPOSE: The purpose of this study was to review our clinical experiences of acute mesenteric ischemic disease at the Masan Samsung hospital. METHOD: Retrospectively reviewed the medical records of 20 patients with acute mesenteric ischemic disease from 1998 through 2003 in terms of clinical characteristics, image findings, management and results. RESULT: The mean age of patients was 63.5 years and the male female ratio was 1.5:1. Coexisting diseases were atrial fibrillation (n=10), hypertension (n=9), myocardial infarction (n=2), DM (n=4). The clinical manifestations were abdominal pain, abdominal distension, peritoneal irritation signs, vomiting and melena. The presenting signs were nonspecific. Laboratory findings were nonspecific and not helpful for diagnosis of acute mesenteric ischemia. Abdominal CT and SMA angiography were accurate and sensitive diagnostic tools. Seventeen cases were SMA occlusion (1 case: SMA dissection) and 3 cases were SMV occlusion. Operative procedures were resection of bowel (12 cases) and thromboembolectomy (5 cases). Non operative procedure was anticoagulation (3 cases). One patient refused surgery. CONCLUSION: Both clinical and laboratory data were non-specific and delayed diagnosis was the main cause of the overall mortality rate of 35% (7 cases). The mortality rate for patients undergoing surgery for acute mesenteric ischemic disease was high, but early diagnosis and intensive care may be reduced mortality.
Abdominal Pain ; Angiography ; Atrial Fibrillation ; Critical Care ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis ; Embolism ; Female ; Humans ; Hypertension ; Ischemia* ; Male ; Medical Records ; Melena ; Mesenteric Vascular Occlusion ; Mortality ; Myocardial Infarction ; Retrospective Studies ; Surgical Procedures, Operative ; Thrombosis ; Tomography, X-Ray Computed ; Vomiting

OBJECTIVES: Although most of the functional and structural neuroimaging studies have reported the association of the that cognitive deficits in patients with schizophrenia with the pathophysiology of the prefrontal cortex, their findings vary considerably. Based on the precise parcellation methods, this study was designed to investigate substructural abnormalities of the prefrontal cortex in patients with schizophrenia. METHODS: The subjects consisted of twelve patients with schizophrenia and 12 age- and sexmatched normal volunteers. Magnetic resonance images were obtained in all subjects, and parceled into 8 frontal substructures using the topographic landmarks. The frontal substructural volumes were compared between the two groups, and their correlations with the schizophrenic symptom severity were analysed in the patient group. RESULTS: In the comparison of substructural volumes, most frontal substructures of the patient group tended to be smaller than those of the normal comparison group; particularly the right supplementary motor area was significantly smaller(p<0.003). Negative symptoms tended to be inversely correlated with the frontal substructural volumes, particularly with the right superior frontal gyral volume(gamma= -0.70, p=0.01). CONCLUSION: These findings suggest the possibility of structural defects related to 'hypofrontality' in schizophrenia. These frontal structural defects may be the basis of neurocognitive deficits and neural circuital dysfunction in schizophrenia.
Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Neuroimaging ; Prefrontal Cortex ; Schizophrenia*

Supernumerary derivative (22) syndrome is a rare genomic syndrome. It is characterized by severe mental retardation, microcephaly, failure to thrive, preauricular tag or sinus, ear abnormalities, cleft and/or high-arched palate, micrognathia, kidney abnormalities, congenital heart defects, and genital abnormalities in males. In 99% of the cases, one of the parents is a balanced carrier of a translocation between chromosome 11 and chromosome 22. To date, there have been about 100 case reports of supernumerary derivative (22) syndrome. In most of the cases, supernumerary derivative (22) syndrome was the result of 3:1 meiotic segregation in the maternal 11;22 translocation carrier. We now report a case of 47,XX, + der(22)t(11;22)(q23;q11.2) resulting from 3:1 meiotic segregation of the paternal translocation carrier.
Chromosomes, Human, Pair 11 ; Chromosomes, Human, Pair 22 ; Congenital Abnormalities ; Ear ; Failure to Thrive ; Heart ; Humans ; Intellectual Disability ; Kidney ; Male ; Microcephaly ; Palate ; Parents ; Trisomy

BACKGROUND AND OBJECTIVES: The transmission properties of the middle ear directly influence otoacoustic emissions (OAEs) which are transmitted from the cochlea to the ear canal via middle ear. The purpose of this study is to evaluate the effects of middle ear effusion (MEE) on detectability of various OAEs and to assess the potential applicability of DPOAE measurements in monitoring the middle ear status. MATERIALS AND METHOD: Spontaneous otoacoustic emissions (SOAEs), transiently evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) were recorded for 44 normal ears and 32 ears with MEE. DPOAEs were collected in two basic forms consisting of distortion product audiograms(DPgrams) and input-output (I-O) functions, elicited by two primary tones fl and f2 with varying geometric mean frequencies between 1-6 kHz. RESULTS: SOAEs were absent in 21 ears of 32 ears with MEE, TEOAEs were diminished in 28 ears with MEE, and DPgrams were eliminated in 17 ears with MEE. I-O function curves at 3 kHz and 4 kHz were significantly diminished by equal levels of fl and f2 primary tones of 45 & 55 dB SPL under the condition of MEE (p<0.05). CONCLUSION: The results suggest that MEE affects the detectability of various OAEs and that the DP I-O function curve measurement at 3 and 4 kHz may be valuable to monitor the middle ear status in pediatric patients.
Cochlea ; Ear ; Ear Canal ; Ear, Middle* ; Humans ; Otitis Media with Effusion* ; Otoacoustic Emissions, Spontaneous