OBJECTIVE : Bone mineral density is influenced by genetic, hormonal and exogenous factor that adversely affect peak mineral density include cigarette smoking, physical disability, poor calcium intake and certain medication include steroid and anticonvulsant drugs. We studied epileptic children receiving 6months above, to document change of bone mineral density by anticonvulsant drugs. METHODS: From July 1, 1996 to September 1, 1996 lumbar bone mineral density was measured by dual-energy X-ray absorptiometry in 27 children treated with anticonvulsant drugs 6months above (age ranged : 4-13 year) in Soonchunghyang University hospital. The subjects were classified into 3 groups : treated with carbamazepine alone, valproate alone and combined group. RESULTS: 1) Mean age of carbamazepine group was 10.2+/-2.42yrs(6-l4yr), duration of therapy was 22.1+/-13.9 months(6-44 months), mean value of bone mineral densities were 0.668+/-0.128g/cm2(0.548-0.927). Though it was lower than control group in 8, 9, 10, 12, 13 year, had not statistical significance. 2) Mean age of valproate group was 9.8+/-2.92yrs(6-l3yr), duration of therapy was 40.5 +/-22.2months(17-79month), mean value of bone mineral densities were 0.618+/-0.097g/cm2(0.516-0.788). Though it was lower than control group in 7, 10, 13 year, had not statistical significance. 3) Mean age of combined group was 7.9+/-3.2yrs(4-l4yr), duration of therapy was 37.5 +/-24.7months(12-88month), mean value of bone mineral densities were 0.602+/-0.109 g/cm2(0.552-0.807). Though it was lower than control group in 7, 8, 10 year, had not statistical significance. CONCLUSION: Because growing children is more sensitive than adult, in case of receiving long-term anticonvulsant therapy, it is important that early detection and prevention of abnormal bone mineralization by appropriate monitoring.
Absorptiometry, Photon ; Adult ; Anticonvulsants* ; Bone Density* ; Calcification, Physiologic ; Calcium ; Carbamazepine ; Child* ; Humans ; Smoking ; Valproic Acid

A 26-year-old Korean woman had a 5 month history of pruritic, keratotic papules on the scalp, trunk, and pubic area, which were accompanied by diffuse hair loss from the scalp, eyebrows and pubic area. She also had flat-topped violaceous papules on the scalp and pubic area, and white lace-like striae on the oral mucous and hard palate. Histopathologic study of the progressive stages of the disease revealed dilated follicles filled with horny material, hyperkeratosis, hypergranulosis and hydropic degeneration of the basal cell layer. Throughout the entire subepidermal region, there was an intense bandlike infiltration of mononuclear cells, which were most prominent at the lower pole of the hair follicles. The late stage of the disorder showed atrophy of the epidermis and atrophy of the hair follicles with fibrotic tracts, and mild mononuclear infiltrate at the sites of the former hair follicles. This is the first recorded case, to the best of cur knowledge, in Korea.
Adult ; Atrophy ; Epidermis ; Eyebrows ; Female ; Hair ; Hair Follicle ; Humans ; Korea ; Lichens* ; Palate, Hard ; Scalp

No abstract available.
Leukemia*

No abstract available.
Drug Therapy* ; Humans ; Uterine Cervical Neoplasms*

OBJECTIVES: The diagnosis of ASCUS(atypical squamous cells of undetermined significance) and LSIL(low-grade squamous intraepithelial lesion) was introduced in 1988 by the Bethesda system for reporting cervical/vaginal cytologies. A significant proportion of women referred for colposcopy with low grade cervical cytologic abnormalities(ASCUS and LSIL) will have high grade cervical intraepithelial neoplasia(CIN II or CIN III) and therefore require adequate management. The purposes of this study were to evaluate the usefulness of high risk type HPV(human papillomavirus) DNA detection using PCR(polyerase chain reaction) in patients with low grade cervical cytologic abnormalities in the prediction of high grade CIN and invasive cancer and to determine the clinical triage in the management of low grade cervical cytologic abnormalities. METHODS: We reviewed 18,942 cases of Papanicolau smears that were performed at our hospital from Jan. 1995 to Mar. 1999. Colposcopically directed biopsy or LLETZ(large loop excision of transformation zone) or hysterectomy were performed on 318 patients with abnormal PAP smears of low degree. HPV PCR testing of high risk types(16 and 18) was also performed on 115 patients. RESULTS: Histologic outcome of ASCUS included 43 cases(38.4%) of high grade CIN and invasive cancer, and that of LSIL included 65 cases(47.5%) of high grade CIN and invasive cancer. In cases of high risk HPV type, 19 patients(73.1%) were at age over 30 years. A highly significant correlation was found between a positive test for high risk types of HPV and finding of high grade CIN and invasive cancer. Among 51 women with ASCUS, a positive test for high risk type had a sensitivity and specificity of 40.0% and 86.1%, and positive predictive value(PPV) and negative predictive value(NPV) of 54.5% and 77.5%, respectively. In 64 women with LSIL, a positive high risk type test was associated with sensitivity and specificity of 30.0% and 94.1%, and PPV and NPV of 81.8% and 60.4%, respectively. CONCLUSION: Our results suggest that high risk type HPV may be positively predictive of and may act as a surrogate marker for high grade CIN and invasive cancer in women with low grade cervical cytologic abnormalities. The management of women with a low grade cervical cytologic abnormalities should be active such as colposcopically directed biopsies.
Biomarkers ; Biopsy ; Colposcopy ; Diagnosis ; DNA* ; Female ; Humans* ; Hysterectomy ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Triage

OBJECTIVE: The aim of this study was to identify human papilloma virus(HPV) infection in cervical lesions by using polymerase chain reaction in situ hybridization(PCR-ISH) and to compare the results of PCR-ISH with conventional in situ hybridization(ISH) METHODS: Forty-seven randomly chosen neutral-buffered formalhyde-fixed cervical biopsies in which cervical intraepithelial neoplasia and invasive cervical cancer had been diagnosed were tested for HPV DNA by PCR-ISH and ISH. The method of PCR-ISH includes deparaffinization of specimens, PCR amplification of DNA, in situ hybridization and detection of amplified products. RESULTS: The positivity rate of ISH was 36% for all biopsies and 26%, 40% for CIN and invasive cancer respectively. By using PCR-ISH the positivity was 80%, 84% respectively. All PCR-ISH positive cases were ISH positive and no ISH positive was PCR-ISH negative. CONCLUSION: In our study HPV DNA, undetectable by standard in situ hybridization, was detectable by PCR in situ hybridization. Our study shows that PCR in situ hybridization is highly sensitive method for detection of HPV in cervical neoplastic specimens with morphological evidence.
Adenomyosis ; Biopsy ; Cervical Intraepithelial Neoplasia ; DNA ; Endometriosis ; Female ; Humans ; In Situ Hybridization* ; Papilloma ; Polymerase Chain Reaction* ; Uterine Cervical Neoplasms

No abstract available.
Facial Bones*

PURPOSE:Craniopharyngioma is one of the most common causes of organic growth hormone deficiency leading to pituitary hormonal insufficiency. However, some growth hormone(GH)-deficient children with craniopharyngioma may grow normally or even show accelerated growth. This study was designed to evaluate several factors associated with growth of patients with craniopharyngioma. METHODS:Forty children operated on for craniopharyngioma were evaluated for their pituitary function, serum insulin like growth factor-I(IGF-I), serum insulin like growth factor binding protein-3(IGFBP-3) and serum prolactin levels. We also observed their growth status and corresponding changes with or without GH treatment. RESULTS:Among 40 patients, one had normal pituitary hormonal status and one had isolated GHD(GH deficiency). The other patients showed multiple pituitary hormone deficiency including GH(98%), LH, FSH(75%), TSH(65%), ACTH(62%), and ADH(38%) deficiencies. Patients with GHD were categorized into 2 groups. Group 1 consisted of children who showed normal growth, thus had not received GH treatment(n=14) and Group 2, those who showed subnormal growth(n=25). Patients in Group 2 were subdivided into Group 2A, when the patients had not received GH treatment in spite of subnormal growth(n=9) and Group 2B, when GH treatment had been added later on(n=16). There were no differences in the age at diagnosis of GHD, initial height standard deviation score(Ht SDS), body mass index(BMI), peak GH concentration between Group 1 and Group 2. Height velocities in Group 1, 2A, and 2B were 8.1+/-.2 cm/yr, 2.4+/-.2 cm/yr, 2.7+/-.2 cm/yr during the first year of endocrinologic follow-up, 7.1+/-.8 cm/yr, 1.2+/-.1 cm/yr, 7.6+/-.7 cm/yr during the second year, 5.9+/-.0 cm/yr, 2.8+/-.9 cm/yr, 7.3+/-.7 cm/yr during the third year, respectively. BMI changes during the first year of endocrinologic follow-up and postoperative prolactin levels were not significantly different between Group 1 and Group 2A. Postoperative IGF-I and IGFBP-3 levels in Group 1 were significantly higher than those in Group 2A(P<0.05). Both IGFBP-3 and prolactin levels correlated significantly with height velocity in Group 1 and 2A(P=0.004 r=0.64 and P= 0.035 r=0.74 , respectively). CONCLUSION: In this study, growth in children with craniopharyngioma was likely to be associated with IGF-I, IGFBP-3 and prolactin levels. Further studies are needed to unravel other growth promoting factors related to GH independent growth.
Child* ; Craniopharyngioma* ; Diagnosis ; Follow-Up Studies ; Growth Hormone ; Humans ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Prolactin

BACKGROUND: Chlamydia pneumoniae, a new species of the obligate intracellular Chlamydia, has been recognized as a significant pathogen that causes infection of the human respiratory tract and has recently been associated with coronary atherosclerosis. Diagnosis of infections with C. pneumoniae is problematic, because the syndrome usually presents few distinguishing features and culture of the organism is far more difficult than other Chlamydia species. To further improve the cell culture isolation and passage of C. pneumoniae organisms. we have studied several chemical and physical factors that might affect their viability and growth. METHODS: C. pneumoniae strain (TW-183) was obtained from the Centers for Disease Control, Atlanta. Ga. First we compared McCoy HeLa-229, and HEp-2 cells in the search for a more efficient and practical cell culture system. The growth rate of C. pneumoniae was assessed by the effects of diethylaminoethyl-dextrin, by the adequate centrifugation force and time, by the growth promoting effect of cycloheximide, and by the optimal incubation time. All of the results were evaluated by the indirect immunofluorescent stain using the genus-specific monoclonal antibody(HYMo 1-1) to Chlamydia. RESULTS: The HEp-2 cell was the most efficient for culturing C. pneumoniae and the inclusion bodies in monolayer were increased with DEAE-dextran pretreatment at 30microgram/ml. Also application of a centrifugal force of 1.500 xg for at least 15 minute during inoculation enhanced the growth of C. pneumoniae. The best concentration of cycloheximide in the culture medium for host cell cytostasis was 1microgram/ml. The yields of organisms were greater when the cultures were harvested at 48 hours. CONCLUSIONS: We suggest that this system may make it more practical for laboratories to culture for C. pneumoniae.
Cell Culture Techniques ; Centers for Disease Control and Prevention (U.S.) ; Centrifugation ; Chlamydia* ; Chlamydophila pneumoniae* ; Coronary Artery Disease ; Cycloheximide ; DEAE-Dextran ; Diagnosis ; Humans ; Inclusion Bodies ; Pneumonia ; Respiratory System

Takayasu's arteritis(arteritis syndrome) is an inflammatory disease process affecting primarily the aorta and its main branches. It's etiology and pathogenesis are unknown. Controversy exists in treatment. Segmental stenoses, occlusions, and aneurysmal degeneration of the aorta and the proximal arterial tree are frequent findings. Clinical presentations may include cerebrovascular ischemia, limb ischemia, aortic valvular insufficiency, heart failure, renovascular hypertension, or renal failure. Recently, we experienced a case of Takayasu's arteritis in a 24 years old female with severe dizziness, claudication in right upper extremity. Patient was treated by angioplasty of left vertebral artery and concomitant left subclavian-to-right axillary artery bypass surgery followed by percutaneous transluminal angioplasty with stent therapy of right vertebral artery to prevent cerebrovascular ischemia during the operation. Postoperative result was excellent and dizziness and claudication of right arm were completely relieved.
Aneurysm ; Angioplasty ; Aorta ; Arm ; Axillary Artery ; Constriction, Pathologic ; Dizziness ; Extremities ; Female ; Heart Failure ; Humans ; Hypertension, Renovascular ; Ischemia ; Renal Insufficiency ; Stents ; Takayasu Arteritis* ; Upper Extremity ; Vertebral Artery* ; Young Adult