PURPOSE: To evaluate the efficacy of interferon alpha therapy with or without prednisolone in children with chronic hepatitis B. METHODS: Twenty-eight children (22 boys, 6 girls, mean age 130 months) had seropositive results for HBsAg, HBeAg and HBV DNA; 11 had chronic persistent hepatitis and 17 had chronic active hepatitis. The patients were divided into two groups depending upon their inflammatory activity on liver biopsy, pretreatment serum ALT levels and HBV DNA levels. Fourteen children (group 1: chronic active hepatitis, ALT > or = 100 IU/L and HBV DNA < or = 100 pg/300 microliter) received interferon alpha 2a 5 MU/m2 of body surface three times weekly for 6 months. Fourteen children (group 2: chronic persistent hepatitis or chronic active hepatitis with ALT < 100 IU/L or HBV DNA > 100 pg/300 microliter) received prednisolone in decreasing daily doses of 60 mg/m2, 40 mg/m2, and 20 mg/m2, each for 2 weeks, followed after 2 weeks by interferon alpha 2a on the same schedule. At the end of therapy, 3 end points were analyzed: HBeAg seroconversion, serum ALT normalization rate and clearance of serum HBV DNA. RESULTS: At the end of treatment, HBe antigen-to antibody seroconversion was higher but not more significant in group 1 than group 2 (71.4% vs. 50.0%). Only one patient in group 2 who lost HBeAg, also cleared HBsAg. ALT normalization was similar in both groups (64.3% in group 1 vs. 55.6% in group 2). Clearance of serum HBV DNA was observed in 78.6% of patients in group 1 and 64.3% in group 2, but no significant differences. Complete response was similarly achieved in both groups (57.1% in group 1 vs. 50.0% in group 2). Interferon alpha therapy with prednisolone priming was well tolerated and all children finished therapy. CONCLUSION: The combined therapy with prednisolone followed by interferon alpha may be safe and effective in inducing a serological and biochemical remission of the disease in approximately 50% of children with chronic hepatitis B and with a high level of viral replication and less active disease. However, a controlled study should be performed to confirm these results.
Appointments and Schedules ; Biopsy ; Child* ; DNA ; Female ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons ; Liver ; Prednisolone*

No abstract available.
Jaundice

BACKGROUND: Patients with obstructive sleep apnea syndrome (OSAS) have some deficits in attention and frontal functions. The pathophysiology of the cognitive dysfunction is still controversial. We investigated the cognitive performances of OSAS patients, and the relationship of cognitive functioning and nocturnal respiratory findings and daytime sleepiness. METHODS: Neuropsychological testing, the Beck Depression Inventory and the Epworth sleepiness scale (ESS) were administered to 35 patients with OSAS and to 31 normal controls. RESULTS: Compared to the controls, OSAS patients had significant impairment on the Korean mini mental state examination (K-MMSE), semantic and phonemic fluency, the time and number of correct on the Korean Stroop color word test, the Digit cancellation test and delayed response on the Seoul verbal learning test (SVLT). ESS was significantly correlated with K-MMSE, trail making A, the time and number of correct on the Korean Stroop color word test, delayed recall of SVLT and Rey figure test and number of fulfilled categories on the Wisconsin card sorting test in OSAS patients. The Apnea-hypopnea index (AHI) was significantly correlated with the copy of the Rey figure test. Arousal index, total time slept with oxygen saturation below 90% and the lowest oxygen saturation were not correlated with any neuropsychological parameters. CONCLUSIONS: Patients with OSAS have cognitive impairment concerning attention, executive function and retrieval of memory. The cognitive impairment may be attributed not to nocturnal hypoxemia, but to subjective daytime sleepiness.
Anoxia* ; Arousal ; Depression ; Executive Function ; Humans ; Memory ; Neuropsychological Tests ; Oxygen ; Polysomnography ; Semantics ; Seoul ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Verbal Learning ; Wisconsin

Sjogren's syndrome(SS) is an autoimmune disease characterized by inflammation induced chronic dysfunction of the exocrine glands. Neurologic manifestations occurs in 30% of patients. We report a 55-year-old woman with primary SS, who presented with subacute aseptic meningitis combined with an unnoticed polyneuropathy. SS was confirmed by dry eyes and Schirmer's test, salivary scintigraphy and serum autoantibodies. We suggest SS as a cause of subacute aseptic meningitis in an elderly female patient with dry eyes and mouth.
Aged ; Autoantibodies ; Autoimmune Diseases ; Exocrine Glands ; Female ; Humans ; Inflammation ; Meningitis, Aseptic ; Middle Aged ; Mouth ; Neurologic Manifestations ; Peripheral Nervous System* ; Polyneuropathies ; Radionuclide Imaging ; Sjogren's Syndrome*

Parkinson’s disease is a neurodegenerative disease compromising progressive motor and non-motor features for a long disease course. Although many drugs controlling parkinsonian symptoms were discovered, treatment with disease-modifying or halting effect was not developed to date. The exploration of reliable biomarkers would be helpful for better predicting disease progression and thereby successful development of disease-modifying therapy. In this review, we will review the clinical biomarkers in the prodromal stage and biomarkers using biological tissue in Parkinson’s disease.

The present study was aimed to determine whether nitric oxide (NO) plays a role in the regulation of aquaporin (AQP) channels in the kidney. Male Brattleboro rats (250~300 g body weight) were used. The experimental group was treated with N(G)-nitro-L-arginine methyl ester (L-NAME, 100 mg/L drinking water) for 1 week, and cotreated with indomethacin (5 mg/kg, twice a day, i.p.) for the last two days. Control groups were treated with either L-NAME for 1 week, indomethacin for 2 days, or without any drug treatment. The abundance of AQP1, AQP2 and AQP3 proteins in the kidney was determined by Western blot analysis. Indomethacin downregulated AQP channels, whereas L-NAME by itself showed no significant effects on them. The indomethacin-induced downregulation of AQP2 and AQP3 was significantly blunted in L-NAME-treated rats, while that of AQP1 was not affected. These results suggest that endogenous NO, when stimulated, may downregulate AQP channels that are specifically regulated by AVP/cAMP pathway in the kidney.
Animals ; Aquaporin 3 ; Aquaporins* ; Blotting, Western ; Down-Regulation* ; Drinking ; Humans ; Indomethacin ; Kidney ; Male ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Rats* ; Rats, Brattleboro

Iodinated contrast media (CM) can cause immediate and late reactions. We treated a patient with a recurrent generalized maculopapular rash and a fever that occurred within two days of exposure to iodinated CM, iopromide (Ultravist(R)), for chest computed tomography. We performed skin testing including prick tests, intradermal tests, and patch tests. Our findings indicated a late skin reaction to Ultravist(R) in addition to cross-reactions to other iodinated CM such as ioversol (Optiray(R)), iohexol (Iobrix(R)), and iobitridol (Xenetix(R)). In this study, we report the case of a patient diagnosed with a late adverse reaction to Ultravist(R) in addition to cross-reactions to other iodinated CM.
Contrast Media ; Exanthema ; Fever ; Humans ; Intradermal Tests ; Iohexol ; Patch Tests ; Skin ; Skin Tests ; Thorax ; Triiodobenzoic Acids

Drug hypersensitivity syndrome (DHS) has rarely been reported in association with vancomycin treatment. Here, we describe an 11-year-old girl who developed fever and a maculopapular rash on day 18 of intravenous vancomycin for treatment of infective endocarditis. The patient presented with fever, a maculopapular skin rash, hepatitis, and acute renal failure caused by vancomycin-induced DHS. The symptoms resolved in less than 24 h after withdrawal of vancomycin and treatment with corticosteroids. We present this case of DHS associated with vancomycin.
Acute Kidney Injury ; Adrenal Cortex Hormones ; Child ; Drug Hypersensitivity ; Endocarditis ; Exanthema ; Fever ; Hepatitis ; Humans ; Hypersensitivity ; Vancomycin

PURPOSE: This study was conducted to investigate the pulmonary cellular profiles and IL-8 levels in patients with post-measles wheezing. METHODS: Twelve previously healthy infants with a minimum of three episodes of wheezing after measles pneumonia(Measles wheezing, median age, 1.3 years) were recruited by a retrospective examination of hospital records. They underwent bronchoalveolar lavage(BAL) with flexible bronchoscopy, and high-resolution computed tomography(HRCT) with a mean six(1-15) months interval. Comparisons were made with seven normal controls(Control, median age: 7.4 years). BAL cell counts and differentials were determined. IL-8 levels also were measured by ELISA. RESULTS: The BAL cellular profiles were characterized by a significantly increased percentage of neutrophils in the Measles wheezing group(median 16.0%) compared to the control group(median 3.8%)(P<0.01). IL-8 levels were markedly increased in the Measles wheezing group(mean+/-SD, 512.7+/-324.0 pg/mL) compared to the control group(41.7+/-67.7 pg/mL)(P<0.01). Furthermore, IL-8 levels correlated significantly(r=0.816, P=0.001) with neutrophil percentages in BAL fluids in the Measles wheezing group. Abnormal HRCT findings were mosaic perfusion, bronchiectasis, bronchial wall thickening, and decreased vascularity. CONCLUSION: These results suggest that pulmonary neutrophils and IL-8 may play an important role in the pathogenesis of the post-measles wheezing.
Bronchiectasis ; Bronchoalveolar Lavage ; Bronchoscopy ; Cell Count ; Enzyme-Linked Immunosorbent Assay ; Hospital Records ; Humans ; Infant ; Interleukin-8* ; Measles ; Neutrophils ; Perfusion ; Respiratory Sounds* ; Retrospective Studies

BACKGROUND: Migraine can cause suffering and reduce functioning and productivity. Migraine is usually suboptimally treated, with many migraineurs not being satisfied with the applied acute treatment. Migraine-ACT is a four-item assessment tool used by clinicians to identify patients who require a change in their acute treatment. The objective of this study was to determine validity and reliability of the Korean Migraine-ACT. METHODS: Participants who visited Hallym University Sacred Heart Hospital neurology clinic for headache were recruited. The survey employed SF-36, HIT-6, and Migraine-ACT. Headache diagnosis was assigned on ICHD-II after completing a semistructured diagnostic interview. RESULTS: A total of 52 migraine patients aged 38.7+/-14.7 years (mean+/-SD) were recruited. There was a positive correlation between general summary scores on SF-36 and Migraine-ACT (Spearman's correlation coefficient=0.39, p<0.05) and a negative correlation between HIT-6 scores and Migraine-ACT scores (Spearman's correlation coefficient=.0.52, p<0.05). Cronbach's alpha of Migraine-ACT was 0.78. CONCLUSIONS: These results indicate that Korean Migraine-ACT is a valid and reliable instrument to identify migraine patients who require a change in their acute treatment.
Aged ; Efficiency ; Headache ; Heart ; Humans ; Migraine Disorders ; Neurology ; Reproducibility of Results ; Stress, Psychological