There has been a growing interest in sleep problems associated with attention deficit hyperactivity disorder (ADHD). In this paper, we reviewed the current literature on the underlying sleep problems associated with ADHD. Sleep problems are very common in children with ADHD. Patients with ADHD may have sleep difficulties including difficulty falling asleep, frequent night awakening, increased tiredness upon waking. Children with ADHD are associated to restless legs syndrome, periodic limb movement and sleep-disordered breathing. Screening for other psychiatric comorbidities and the side effects of medications, such as psychostimulants, is also necessary when considering sleep problems in ADHD. Sleep problems can cause a negative impact on the quality of life and emotional well-being both of children with ADHD and their parents. Many evidences suggest that assessment of sleep difficulties should be included in evaluating the patient of ADHD.
Attention Deficit Disorder with Hyperactivity ; Child ; Comorbidity ; Extremities ; Humans ; Mass Screening ; Parents ; Quality of Life ; Restless Legs Syndrome ; Sleep Apnea Syndromes

PURPOSE: Although most researchers agree that platelet-rich plasma (PRP) is a good source of autogenous growth factors, its effect on bone regeneration is still controversial. The purpose of this study was to evaluate whether increasing angiogenic factors in the human PRP to enhance new bone formation through rapid angiogenesis. MATERIAL AND METHODS: In vitro, the human platelets were activated with application of shear stress, 20 microgram/ml collagen, 2 mM CaCl2 and 10U thrombin/1 x 109 platelets. Level of vascular endothelial growth factor (VEGF) and platelet microparticle (PMP) in the activated platelets were checked. In the animal study, human angiogenic factors-enriched PRP was tested in 28 athymic rat's cranial critical bone defects with beta-TCP. Angiogenesis and osteogenesis were evaluated by laser Doppler perfusion imaging, histology, dual energy X-ray densinometry, and micro-computed tomography. RESULTS: In vitro, this human angiogenic factors-enriched PRP resulted in better cellular proliferation and osteogenic differentiation. In vivo, increasing angiogenic potential of the PRP showed significantly higher blood perfusion around the defect and enhanced new bone formation around acellular bone graft material. CONCLUSION: Angiogenic factor-enriched PRP leads to faster and more extensive new bone formation in the critical size bone defect. The results implicate that rapid angiogenesis in the initial healing period by PRP could be supposed as a way to overcome short term effect of the rapid angiogenesis.
Angiogenesis Inducing Agents ; Animals ; Blood Platelets ; Bone Regeneration ; Calcium Phosphates ; Cell Proliferation ; Collagen ; Durapatite ; Humans ; Intercellular Signaling Peptides and Proteins ; Osteogenesis ; Perfusion ; Perfusion Imaging ; Platelet-Rich Plasma ; Rats, Nude ; Transplants ; Vascular Endothelial Growth Factor A

No abstract available.
Zygoma*

No abstract available.
Zygoma*

A 16-year-old girl developed pyoderma gangrenosum without underlying disease at first. She was treated with local cutaneous dressing and systemic oral prednisolone and minocycline for 10 months, imtermittently. After that, acute leukemia, which was undeterminated type, was developed 4 years after first onset. Since pyoderma gangrenosum may be a preindication of underlying disease, continual follow up check for systemic disease is required.
Adolescent ; Bandages ; Female ; Follow-Up Studies ; Humans ; Leukemia* ; Minocycline ; Prednisolone ; Pyoderma Gangrenosum* ; Pyoderma*

Any type of urticaria may affect as many as 20% person during their lifetimes, yet the causes of this disorder is established in no more than 20% of cases. So, 308 patients with urticaria(acute ; 73, factitial; 120, chronic;115) were evaluated for results of historical and laboratory tests. The results were summerized as follows,' 1. The disesse primarily affected 2nd % 3rd decade(46.2%) with predominance of woman than man (M: F=1: 1.4). 2. Ninety-seven(31.5%) had at least one abnormal finding in the laboratory tests but, may be twenty-three(7.5%) would have causal relationship. 3. We sought serologic markers of Hepatitis B virus infection in serum from 8(14%) of 57 patients with urticaria. Of these, 4 were found to have abnormal liver function. 4. Sixty-five had taken at least one sort of drug previously or just before urticaria developed, but, may be forty-six(14.9%) would have a causal relationship and the predisposing drugs were analgesics, antibiotics, common cold medication & vitamin etc. 5. The predisposing conditions were as follows ; pulmory tuberculosis, viral hepatitis, hyperthyroidism, tonsillitis & ascariasis, etc. Of these, eleven(3.6%) of this patients were newly found to have underlying diseases. 6. This study showed inciting factors of urticaria in 27.2%(84/308).
Analgesics ; Anti-Bacterial Agents ; Ascariasis ; Common Cold ; Female ; Hepatitis ; Hepatitis B virus ; Humans ; Hyperthyroidism ; Liver ; Palatine Tonsil ; Tonsillitis ; Tuberculosis ; Urticaria* ; Vitamins

PURPOSE: With the process of neoangiogenesis being linked to the growth and metastasis of various tumors, anticancer therapeutics with a basis in the suppression of neoangiogenesis has recently been receiving attention. In this study, we tried to clarify the immunoreactivities of vascular endothelial growth factor (VEGF), major angiogenic inducer and thrombospondin-1 (TSP-1), major angiogenic inhibitor in human Wilms' tumor and its clinicopathological significance. MATERAILS AND METHODS: Utilizing immunohistochemical staining, we assessed the immunoreactivities of VEGF and TSP-1 in archival tissues of 29 Wilms' tumors and 25 normal kidneys. Also, we assessed the relationship between expression of each factor and clinicopathological parameters in 29 cases of Wilms' tumors. RESULTS: Immunoreactivities of VEGF and TSP-1 were detected mainly in the cytoplasm of the tubular cells in normal kidneys. In Wilms' tumors, whereas VEGF was detected in the cytoplasm of the tumor cells and peritumoral stromal tissues, but TSP-1 only in the peritumoral stromal tissues. Immunohistochemical expression patterns of each factor were divided into two groups according to the area of immunoreactivity (negative:<10%, positive: > OR =10%). VEGF immunoreactivity was detected in 25 (100%) normal kidneys and in 20 (69%) Wilms' tumors. However, TSP-1 immunoreactivity was detected in 24 (97%) normal kidneys and in 3 (10%) Wilms' tumors. Therefore, although no significant difference was observed between the expressions of VEGF and TSP-1 in normal kidney, the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors. A relatively higher rate of positive expression of TSP-1 was observed in the patients with no demonstrable lymph node metastasis. Also, as for the VEGF, maximal diameter of the tumor was larger in the positive expression group. However, it proved otherwise for TSP-1 as the negative expression group demonstrated tumors with larger maximal diameters. CONCLUSIONS: Our study demonstrated that the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors, and disease progression has a tendency to be found in the VEGF-positive cases and TSP-1 negative cases. We suggest that the growth and metastasis of Wilms' tumor may be influenced mainly by TSP-1 decrease rather than VEGF increase.
Cytoplasm ; Disease Progression ; Humans ; Kidney ; Lymph Nodes ; Neoplasm Metastasis ; Thrombospondin 1 ; Vascular Endothelial Growth Factor A* ; Wilms Tumor*

No abstract available.

OBJECTIVE: Neonatal blood pressure is one of the vital signs used to assess the general health of a newborn infant. But, it is difficult to measure and varies according to the model of sphygmomanometer, the used method, the postconceptional age, birth weight, asphyxia, postnatal age and activity. We have assessed the rnean value of blood pressure(BP) according to postconceptional age. Variations caused by the postconceptional age, birth weight, body surface area(BSA), postnatal age, and sex were analyzed to determine the rnost important factor influencing the neonatal BP. METHODS: This study included 448 normal fullterm infants and healthy preterm infants born from Jan. 1995 to Aug. 1997 at Ewha Dongdaemoon and Mokdong Hospital. The BP was taken on day 1, 3, 5 with the oscillometric device(Dinamap 1846 critikon Inc.), for premature infants BP was followed up every week afterward. RESULTS: The neonatal BP was related to the postconceptional age(R=0.204, P<0.05), BSA(R =0.191, P<0.05), birth weight(R=0.183, P<0.05) and the postnatal age in fullterm infants(R=0.022, P<0.05) but not with the sex of the infant. The postconceptional age was the most significant variable among those influencing the BP. The normal value of the systolic and the diastolic BP was expressed as mean+/-2SD according to the postconceptional age, less than 28 weeks(n=27) systolic/diastolic pressure 50.4+/-23.1mmHg/26.2+/-12.8mmHg, 28-32weeks(n= 63) 60.1+/- 30.6mmHg/33.6+/-16.7mmHg, 32-36weeks(n = 139) 63.2+/- 20.4mmHg/37.7+/- 19.8 mmHg, 36- 40weeks(n=543) 65.6+/-18.5mmHg/38.6+/-17.3mmHg, more than 40weeks(n= 136) 67.7+/-16,9mmHg/39.3+/- 15.8mmHg. The increase in blood prssure with the postconceptional age was statistically significant. CONCLUSION: The normal range of neonatal BP, especially preterm infants, was presented, and it would be much valuable for the evaluation of BP in neonate if standardized by postconceptional age.
Asphyxia ; Birth Weight ; Blood Pressure* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Parturition ; Reference Values* ; Sphygmomanometers ; Vital Signs

Adenoid cystic carcinoma (ACC) of the breast is an uncommon carcinoma accounting for less than 1% of the breast carcinoma. This type of carcinoma has a distinctive histology, such as cylindromatous, cribriform, glandlike space and solid pattern in the variable proportion. Prognosis is favorable with rare recurrence or metastasis and the guideline for therapy is not well established. We experienced a case of ACC of right breast in the 48 year-old woman. Cytologically, it showed numerous three-dimensional, well outlined cell clusters with central core of homogeneous, eosinophilic material. The mass was well demarcated, firm and measured 2.5 2.5 2 cm. Cut surface was yellowish white and granular with focal necrosis. Histologically, the tumor was composed of cylindromatous, adenoid and solid area with marked cellular atypia. Focal invasion was identified in the adipose tissue around the tumor. Histologic and nuclear grade was III by Kleer's grade. Nodal metastasis was not found.
Adenoids* ; Adipose Tissue ; Breast Neoplasms ; Breast* ; Carcinoma, Adenoid Cystic* ; Eosinophils ; Female ; Humans ; Middle Aged ; Necrosis ; Neoplasm Metastasis ; Prognosis ; Recurrence