The goal of therapy of epileptic children is to control of seizures with minimal side effects of antiepileptic drug (AED). The relationship between side effects, serum levels and doses of AED were examined prospectively in 72 epileptic children who received monotherapy with phenobarbital, phenytoin, valproate, or carbamazepine for 6 to 26 months. Our results were as follows: 1) Side effects were observed in 59.7% of all patients; in decreasing order, behavioral (41.6%)>digestive (25.0%)>others (22.2%)>neurologic (11.1%). 2) The most common side effects in children treated with phenobarbital (PB) was behavioral (54.2%); these included hyperactivity, drowsiness, sleeping in decreasing order and there was significant relationship between drowsiness and serum level of PB(P<0.05). 3) Common side effects in patients receing carbamazepine (CBZ) were behavioral (52.0%) and digestive (52.2%); behavioral disorders included drowsiness and sleeping which showed significance with dosage of CBZ (P<0.01), digestive disorders were abdominal pain which showed significance, with dosage of CBZ (P<0.05) and weight gain. Other side effects were dizziness, headache, diplopia, tremor pallor, durg eruption, alopecia, aggravated acne etc. 4) The most common side effect in children treated with valproate (VPA) was pallor which showed significance with dosage of VPA (P<0.05). Abdominal pain had<0.05 significance with serum level of VPA, and Other side effects were anemia and weight gain. 5) In 83.3% of all patients, they had no side effects or could tolerate mild side effects. But in 12.5% of patients, the side effects disappeared when dosages were reduced, and AED had to be withdrawn in only 4.2% of patients.
Abdominal Pain ; Acne Vulgaris ; Alopecia ; Anemia ; Anticonvulsants* ; Carbamazepine ; Child* ; Diplopia ; Dizziness ; Headache ; Humans ; Pallor ; Phenobarbital ; Phenytoin ; Prospective Studies ; Seizures ; Sleep Stages ; Tremor ; Valproic Acid ; Weight Gain

No abstract available.
Korea* ; Measles* ; Vaccination*

Medroxyprogesterone acetate(MPA) is one of the most commonly used hormonal agents for the treatment of advanced or recurrent endometrial adenocarcinoma. However, the progesterone receptor content of endometrial carcinoma varies directly to the degree of differentiation and inversely with stage of the tumor. Thus one would predict that MPA therapy would be less effective in advanced and poorly differentiated tumors. In addition, MPA has been shown to reduce progesterone receptor content of both normal and malignant endometrial cells, which could result in loss of hormone responsiveness. Tamoxifen, which is often used in breast cancer therapy, has also been used in the treatment of patients with advanced and recurrent endometrial carcinoma. Tamoxifen is known to have some estrogenic effects at low concentration and one of these effects is induction of progesterone receptor both in normal and malignant endometrium. This property has focused interest on sequential or simultaneous use of tamoxifen and MPA in the therapy of endometrial carcinoma. The growth inhibitory effects of MPA and tamoxifen were tested on six longestablished endometrial carinoma cell line(HEC-1-A, HEC-1-B, RL 95-2, AN3CA, KLE) and on SCHE-1, a new endometrial carcinoma cell line established in our laboratory. MPA and tamoxifen were used in growth experiments either alone, simultaneously or sequentially. The MCF-7 breast cancer cell line was used as a control. Only 20% reduction in cell number was achieved after 10 days of exposure to the drug, even with the highest MPA concentration tested(10micronm) in endometrial carcinoma cell lines. But in MCF-7 cells, 60% reduction in cell number was achieved with the same concentration of MPA(10um). Ten days of feeding with 5micronm tamoxifen produced a 96% reduction in cell number in MCF-7, a 91% reduction in HEC-1-A, a 88% reduction in HEC-1-B, a 98% reduction in AN3CA and a 71% reduction in KLE cultures. In SCHE-1 cultures a 83% reduction in cell growth was seen and no viable cells remainde in RL 95-2 cultures after 10 days of feeding with a 5uM tamoxifen. In AN3CA cultures, simultaneous exposure to 5um tamoxifen and 5um MPA resulted in partial reversal of the tamoxifen-induced growth inhibition. In RL 95-2, HEC-1-A and HEC-1-B cultures, simultaneous use of these drugs had the same effect as tamoxifen alone, whereas in KLE and SCHE-1 cultures a slight additive growth effect was observed. All six endometrial carcinoma cell lines resumed logarithmic growth when medium containing tamoxifen of logarithmic growth under these conditions was slower than that in the other endometrial carcinoma cultures. Our results show that MPA does not have growth inhibitory effects in these endometrial carcinoma cell cultures, whereas tamoxifen has been shown to have potent endometrial carcinoma cells. These findings are of special importance since patients who are most likely to need adjuvant therapy for advanced or recurrent endometrial carcinoma are those with estrogen receptor and progesterone receptor negative tumors.
Adenocarcinoma ; Breast Neoplasms ; Cell Count ; Cell Culture Techniques ; Cell Line* ; Endometrial Neoplasms* ; Endometrium ; Estrogen Receptor Modulators* ; Estrogens ; Female ; Humans ; MCF-7 Cells ; Medroxyprogesterone ; Receptors, Progesterone ; Tamoxifen*

Most instances of choriocarcinoma of the ovary are gestational in origin. In contrast, nongestational choriocarcinoma of the ovary is an exceedingly rare primary germ cell neoplasm that has worse prognosis than gestational neoplasm. We report a case of pure nongestational choriocarcinoma of the ovary in view of the rarity of its kind. The patient was a 35-year-old Korean unmarried woman who had suffered from vaginal bleeding and feeling of abdominal inflation for two months. The X-ray studies and CT scanning revealed a child head sized cystic mass on the right pelvic cavity and multiple nodular densities in both lung fields and the liver. The mass in pelvic cavity was excised and histologically confirmed to be a nongestational pure choriocarcinoma, arising from the right side ovary.
Child ; Male ; Female ; Humans

80 patients, 40 patients without preexisting EKG abnormality (group 1) and 40 patients with preexisting abnormalities of EKG (group 2), receiving general anesthesia in the operating room were monitored continously with electrocardioscope, Servomed SMK 155-1 and were recorded. 1) 7 cases(17.5%) of group 1 developed a variety of arrhythmia, and 13 cases (32.5%) of group (32.5%) of group 2 developed a variety of arrhythmia. 2) The most common arrhythmia was premature ventricular contraction including bigeminies (13 cases, 60% of the total arrhythemia) and the most serious arrhythmia was seen 1 case of rapid ventricular tachycardia without artrial activity. 3) Continous cardiac monitoring is valuable, easy and practical in virtually all instance during anesthesia and surgery.
Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac* ; Electrocardiography ; Humans ; Operating Rooms ; Perioperative Period* ; Tachycardia, Ventricular ; Ventricular Premature Complexes

This study was conducted to assess the bone mineral density (BMD) and the anthropometric measurements, life style, and other environmental factors affecting BMD in Korean adolescents. Subjects were 167 high school students (83 male students, 84 female students) in Seoul. BMD was measured in the lumbar spine (LS), femoral neck (FN), femoral trochanter (FT), and Ward's triangle (WT) by dual energy x-ray absorptiometry (DEXA). The questionnaire was used to assess the anthropometric measurements, life style, and other environmental factors. Bone mineral density of LS, FN, FT and WT were 0.967, 0.960, 0.795, 0.761 g/cm2. The BMD of LS was not different by sex but the male students's BMD of FN, FT and WT were higher significantly than the female students (LS: 0.976 vs. 0.958, FN: 1.040 vs. 0.880, FT: 0.842 vs. 0.749, WT: 0.827 vs. 0.695 g/cm2) Female students's BMD of LS, FN, WT, and FT was positively correlated with weight but male students's BMD of WT was not correlated with weight. The factors such as the life style, activity and exercise have significant influence on BMD. This study confirms that the major factor affecting BMD was body weight and the factors such as the life style, activity and exercise is related to accumulation of BMD. The classification of sexual characteristics is needed for further studies on BMD of adolescents.
Absorptiometry, Photon ; Adolescent* ; Body Weight ; Bone Density* ; Classification ; Female ; Femur ; Femur Neck ; Humans ; Life Style* ; Male ; Seoul ; Spine ; Surveys and Questionnaires

No abstract available.
DNA, Recombinant* ; Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Yeasts*

PURPOSE: School-age children spend more than half of the day at school and teachers or school nurses are responsible for managing students with asthma during school hours. Thus, the teachers' knowledge about asthma is very important for the care of asthmatic school children. METHODS: Total 159 teachers were asked to fill out questionnaire on their knowledge about asthma and their personal profiles. The survey was administered by mail. The questionnaire includes 17 items about pathophysiology, symptoms, precipitating factors, treatment, care and prognosis, which were to be answered by either 'true' or 'false'. The correct or incorrect answers were examined data was statistically analyzed by SPSS. RESULTS: Most teachers were in their thirties (54.7%) and years of teaching experience were from six to fifteen years (50.4%). The teachers who experienced asthma students were 23.6%, and 12.6% were either asthma patients or had asthma patients in their family. They had knowledge about precipitating factors of asthma, but, the knowledge was not correct in detail. Only 34% teachers knew what to do and where to contact in case of asthma attack among the students. Teachers' demographic and professional factors did not affect the knowledge about asthma, except their working experience as school nurses and/or with school nursing asthmatic students. CONCLUSION: The survey results demonstrated that their teachers' knowledge about asthma was not sufficient enough to take good care of the asthmatic students at school including emergency management. Asthma education for the school teachers is required and efficient educational programs for the teachers should be developed.
Asthma ; Child ; Education ; Emergencies ; Humans ; Postal Service ; Precipitating Factors ; Prognosis ; Surveys and Questionnaires ; School Nursing

PURPOSE: During the past two decades in Korea, the prevalence rate of childhood asthma has been increased, and also there has been a significant evolution in the management of asthma. In 1994, a guideline for the diagnosis and treatment of asthma was established. This study was designed to investigate a real picture of clinical practice in the management of childhood asthma. METHODS: This survey was conducted with data on 24 items of questionnaires from pediatricians working in private clinics, general hospitals, and university hospitals. We investigated the age distributions, severity of asthma, educational levels, management of asthma, and current trends of medication. RESULTS: 1) In age distribution, childhood asthma was most prevalent in 3-5 years old age group (30-40%), followed by 2 years old age group, and was least prevalent in 10-15 years old age group. 2) The number of patients with cough variant asthma was about 10% of all childhood asthma. 3) A period of 5-10 minutes was the most common period consumed for the explanation of child asthma during each medical practice. Cases recording symptom diary and cases monitoring PEFR (using peak flow meter) were less than 10% each. 4) With regard to the use of beta2 agonist in the treatment of acute asthmatic attack, rate of using oral drugs and nebulizer or inhalers of beta2 agonist are similar in the university hospitals, but the rate of using oral drugs was over 80% in private clinics. 5) With regard to the use of anti-inflammatory drugs in the management of chronic asthma, nebulizer or inhaler therapy was the first-line choice in the university hospitals (rate over 60-90%), oral drugs were main therapy in private clinics. The administration of anti-allergic medication as a preventive measures was recommended in about 40-50%, and ketotifen was used most frequently. 6) Immunotherapy was being performed in about 10% of childhood asthma patients. CONCLUSION: Childhood asthma was most prevalent in the age group under 5 years and severity was mostly mild. For the management of childhood asthma, the education and control for asthma are still insufficient and previously published guidelines have been inappropriately used in practical field.
Age Distribution ; Asthma* ; Child ; Child, Preschool ; Cough ; Diagnosis ; Education ; Hospitals, General ; Hospitals, University ; Humans ; Immunotherapy ; Ketotifen ; Korea ; Nebulizers and Vaporizers ; Peak Expiratory Flow Rate ; Prevalence ; Surveys and Questionnaires

PURPOSE: Airway inflammation is a characteristic feature of asthma. Sputum analysis can be used as a non-invasive tool to assess severity of the airway inflammation. This study was performed to compare relationships between sputum eosinophils to other parameters of airway inflammation and to evaluate the clinical utility of sputum eosinophils and ECP in childhood asthma. METHODS: Twenty one ashtmatic children and age matched control subjects without history of allergy were enrolled in this study. Their age was from 21 months to 15 years old. The study was performed from January to April of 2001. Ultrasonically nebulized hypertonic saline was used to induce sputum from children. The children were pre-treated with bronchodilator and peak expiratory flow rate (PEFR) was monitored thought-out the procedure. Sample were analysed for total cell count, differential cell count and for concentrations of eosinophil cationic protein (ECP). RESULTS: Asthmatic subjects had a significantly higher proportion of blood eosinophils than the control subjects (279.8+/-187.7/mm3 and 26.5+/-18.5/mm3, P<0.01). Correspondingly, percentages of eosinophil and concentration of ECP were 5.10+/-8.79% and 99.85+/-70.10 microL/L in asthmatic and 0.20+/-0.42% and 1.02+/-2.54 microL/L in control subjects (P<0.01 and P<0.01). Serum eosinophils have no correlation with sputum eosinophils or sputum ECP. There was no correlation between sputum eosinophils and ECP either. CONCLUSION: This study suggests that the proportion of eosinophils and the level of ECP in induced sputum may be sensitive and accurate means of assessing the airway inflammation in childhood asthma, and their relationships with serum eosinophils or serum ECP are to be studied further.
Adolescent ; Asthma* ; Cell Count ; Child ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Hypersensitivity ; Inflammation ; Peak Expiratory Flow Rate ; Sputum*