Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and restricted, repetitive patterns of behavior and interest. Sleep problems are not uncommon in children with autism spectrum disorders. Symptoms of insomnia are the most frequent sleep problems in individuals with ASD. Sleep problems can cause significant difficulties in the daily life of children with ASD and their families. Genetic factor, deregulations of melatonin synthesis, extraneous environmental stimuli and psychiatric and medical conditions may cause sleep problems. The first line treatment of sleep problems in ASD includes managements for potential contributing factors and parent education about sleep hygiene care for child and behavioral therapy. Supplementation with melatonin may be effective before considering other medications, such as risperidone, clonidine, and mirtazapine.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Clonidine ; Education ; Genetics ; Humans ; Hygiene ; Melatonin ; Parents ; Risperidone ; Sleep Initiation and Maintenance Disorders

No abstract available.

No abstract available.
Lymphomatoid Papulosis* ; Pregnancy*

Reconstruction of the auricle is one of the most fastidious fields in plastic and reconstructive facial surgery, because the ear is made up of complex cartilage framework arid its thin skin envelope. Insertion of carved rib cartilage is the most popular method for framework fabrication. But it has some disadvantages such as donor site morbidity, lesser flexibility of rib cartilage, difficulty in carving structure and distortion of cartilage after calving. Furthermore surgeon's talent and sufficient practice are necessary for a satisfactory result. So we introduced the concept of perichondral graft to improve the framework fabrication. In 1972 Skoog and associates reported that free perichondral grafts could be used to produce new cartilage. And several other reports supported the chondrogenesis of free perichondral graft. We molded the human ear using silicone rubbed impression material. And the eat mold was wrapped up in perichodrium of rabbit ear and placed in a subcutaneous pocket in formes of graft and flap. Six and eight weeks later, rabbits were sacrified and the newly formed cartilage framework was harvested. Grossly it showed the same appearance as the human eat and elastic property of normal cartilage. In histologic examination, it showed mature structure of normal cartilage; large lacunae containing spherical chondrocytes surrounded by well defined capsule.
Aptitude ; Cartilage ; Chondrocytes ; Chondrogenesis ; Ear ; Ear Cartilage* ; Fungi ; Humans ; Plastics ; Pliability ; Rabbits ; Ribs ; Silicones ; Skin ; Tissue Donors ; Transplants*

We report a case of a skin problem induced by a visual display t rminal in a 24-year-old female. The patient had erythematcn.is rashes, crusts on both zygomatic areas and upper eyelids with itching, burning and pain sensations after she had been exposed to her visual display terminal. After the cassation of exposure, her skin lesions were markedly improved. A proioction test with her own visual display terminal was positive.
Burns ; Exanthema ; Eyelids ; Female ; Humans ; Pruritus ; Sensation ; Skin* ; Young Adult

PURPOSE: To evaluate the frequently of low ahetenuation area in enhanced CT scans of non-Hodgkin lymphoma(NHL) and to find out if there is any pertinent relationship between this and the histopathologic classification. MATERIALS & METHODS: The authors reviewed CT scans in the newly diagnosed 53 patients with NHL. We defined the-low attenuation area as the one with CT attenuation value lower than that of the muscle, surrounding lesion, or other lymph nodes after contrast enhancement. NHL with the low attenuation areas were correlated with the histopathologic findings according to the classification based on the Working Formulation and the frequency of the lesion was evaluated. RESULT: Of the 53 patients, the low attenuation area was found in 13 patients (25%) at CT. The histopathologic classification could be made in 12 patients, among whom one patient was classified as low grade, six as intermediate grade, and five as high-grade. Concerning the specific cell typing, the diffuse large cell type was most common in intermediate-grade NHL seen in five patients and the large cell, immunoblastic type was most common in high-grade NHL seen ih three patients. CONCLUSION: The authors concluded that the low attenution area within lymphoma is not an infrequent finding at CT, and there was no stastistically significant correlation between this finding and the prognostic grading of the Working Formulation.
Classification ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Tomography, X-Ray Computed

We analyzed ninety one fractures of femoral neck treated with surgery and followed for more than 2 years at Seoul National University from January 1977 to June 1983. Of these, 45(49%) were treated with internal fixation(compression hip screw or Knowles' pinning), 26(29%) with primary endoprosthesis, 20(22%) with total hip replacement arthroplasty. The criteria for internal fixation were fresh fracture that could be reduced satisfactorily and the age of the patient were under 65 years. The criteria for endoprosthesis were displaced subcapital or transcervical type or severe osteoporosis with intact acetabular cartilage. The criteria for total hip replacement arthroplasty were neglected fractured patients with significant medical problems, including cardiovascular, pulmonary, and renal disease, that posed significant risks for a second operation, and patients who had previous hip disease such as degenerative arthritis or rheumatoid arthritis. Following results were obtained. 1. In our series, the most frequent occurrence of femoral neck fractures was in the 7th decade(34 %), and the most common cause was fall down(72.6%). 2. In fresh fractures less than 3 weeks after injury, transcervical type (73%) according to anatomical classification and Garden's type III(44%) according to displacement were the most common type, respectively. 3. After internal fixation, 11% of avascular necrosis and 9% of non-union occurred. After endoprosthesis, 4% of acetabular protrusion, 8% of loosening and 12% of loosening and 12% of painful hip occurred. After total hip replacement arthroplasty, 10% of dislocation and 10% of loosening occurred. 4. Functional end results of excellent 56%, good 22%, fair 6% and poor 16% in internal fixation group, excellent 31%, good 38%, fair 12% and poor 19% in endoperosthesis group, and excellent 45%, good 30%, fair 10% and poor 15% in total hip replacement arthroplasty group were obtained.
Acetabulum ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Cartilage ; Classification ; Clinical Study ; Dislocations ; Femoral Neck Fractures ; Femur Neck ; Hip ; Humans ; Necrosis ; Osteoarthritis ; Osteoporosis ; Seoul

Soft-tissue sarcomas are derived from mesodermal tissues and with few exceptions are located in deeper planes of the musculoaponeurotic structures. Despite differences in histogenesis, the rate of locsl recurrence snd distant metastasis of these sarcomas reveals that their rstes are almost the same. These soft-fissue sarcomas do not respond well to chemotherpy or radiotheraphy. And soft-tissue sarcomas located on different anatomical sites, so the surgical approach to them located centrally is difficult than the approach to them located peripherally. The authors reviewed 75 cases of soft-tissue sarcoma, which were confirmed by pathological reports, and also analysed the results of some kinds of surgery on 60 cases of that tumor at the Department of Orthopedidic Surgery, Seoul National University Hospital during the period from January 1976 to Decomber 1985, and following results were obtained. 1. There were 54 males and 21 females, and the age incidence wss highest in 5th decade. There was no special age-peak. 2. Malignant fibrous histiocytomas accounted for 26.7% of the tumors in this study. Liposarcoma, rhabdomyosarcoma, and synovial sarcoma were the next common tumors. 3. The lower extremity was the most common anatomicsl site of malignant soft-tissue sarcomas, which acconted for 46.7% in this study. There showed low incidence below the wrist and ankle joints. 4. Enneking's stage II B was the most common tumor, which accounted for 41.7%. 5. When we decided the prognosis at 2 years postoperatively, in the inadequately treated group the local recurrence rate was 97.1%, distant metastasis rate was 80.0%, and 2 YSR was 28.6%. In the adequately treated group the local recurrence rate was 20.0%, distant metastasis rate was 24.0%, and 2 YSR was 84.0%. 6. The most common site of distant metastasis was the lungs, which accounted for 82.4%. So the significant factors affecting the prognosis of soft-tissued sarcomas were the location of sarcomas and the adequacy of sugical procedure.
Ankle Joint ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Incidence ; Liposarcoma ; Lower Extremity ; Lung ; Male ; Mesoderm ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Rhabdomyosarcoma ; Sarcoma ; Sarcoma, Synovial ; Seoul ; Wrist

BACKGROUND: Pilomatricoma(Benign calcifying epithelioma of Malherbe) is a uncommon benign tumor with differentiation toward hair cortex cells. It commonly manifests itself as a firm, deep seated nodule with normal Overlying skin, However, anetodermic cutaneous changes have also been described in the literature since 1943. Although the authors hypothesized this phenomenon as a chronic mechanical irritation or a step of transepidermal elimination of the tumoral mass, distinctive elucidation of pathomechanism of it remained. OBJECTIVE: The purpose of this study was to characterize the clinical and histopathologic features of 25 cases with pilomatricoma and to elucidate pathomechanism of the anetodermic cutaneous changes through the comparison of the anetodermic pattern of overlying skin with the changes of the tumoral mass or collagen and elastic fibers in the dermis. METHODS: Twenty-five cases with pilomatricoa have been collected at Chunganam National University Hospital and Kongju Medical Center during 15 years and 5 years, respectively, And we studied the clinical and histopathological characteristics of patients and tried to reveal the relationship between the cutaneous manifestations and the histologic changes through the test for independence. RESULTS: 1. In the age distribution, the patients lesser than 30 years old was 23 cases(92%). The mean age was 18.9 years old. The ratio of males to females was 1 : 2.6. 2. The duration of lesions was from 2 months to 7 years, with the mean duration of 11 months. The predilection sites were arm(40%), face(28%), neck(12%), shoulder(8%), scalp(4%) and back(4%) in order. All lesions were hard in consistency, and were from bean to walnut sized. Clinically, 10 cases (40%) showed reddish discoloration and/or anetodermic cutaneous changes. 3. Histopathologically, the typical patterns of pilomatricoma were commonly located at the dermis (23 cases) and consisted of the shadow cells predominantly(21 cases). Calcium deposits(21 cases, 84%) were noted within the shadow cells. Eight cases(32%) had the tumoral maese demarcated with fibrous capsules, and the foreign body reaction with giant cells and chronic mononuclear cell infiltrations around the shadow cells ruptured the fibrous capsules in 17 cases(68%). 4. When we compared the relationship between the inflammatory cell infiltrations around the tumoral mass and the changes of dermal collagen and elastic fibers, we observed that the changes of dermal fibers and foreign body reaction and mononuolear cell infiltrations were statistically co-related. When compared the cutaneous changes with the inflammatory cell infiltrations of the tumoral masses, we could also reveal that the anetodermic cutaneous changes of the overlying skin might be influenced by the foreign body reactions with chronic mononulcer cell. Based on the status of foreing body reaction, the average of onset was inversely proportional to the average of age. CONCLUSION: Pilomatricomas are slowly growing, firm, deep seated benign tumor which occurs commonly on the arm, face and neck. However, they often showed the anetodermic changes on the overlying skin. Anetodermic cutaneous changes or discoloration may be correlated with the degree of foreign body reactions without the evidences of transepidermal elimination histopathologically.
Adult ; Age Distribution ; Arm ; Calcium ; Capsules ; Carcinoma ; Chungcheongnam-do ; Collagen ; Dermis ; Elastic Tissue ; Female ; Foreign Bodies ; Foreign-Body Reaction ; Giant Cells ; Hair ; Humans ; Juglans ; Male ; Neck ; Pilomatrixoma* ; Skin

The Y-chromosome, as with other chromosomes in the cell, is subject to mutations. However, unlike autosomal genes, the Y chromosome does not undergo recombination, and therefore individuals from different geographical regions may have differing distribution patterns with respect to Y-chromosome mutations. More detailed knowledge and information regarding Y-chromosome mutations might therefore provide insights into phylogenetic history and personal identification. Here, we describe a case study involving genotype-phenotype discrepancy in an Indian male individual. We found that the mistyping in sex determination was caused by a deletion in the amelogenin Y (AMEL Y) gene. Furthermore, on examining the short tandem repeat (Y-STR) loci using the PowerPlex(R) Y23 System, we found four more deleted loci on Yp11.2 (DYS576, DYS481, DYS570, and DYS458) in this sample. We performed deletion mapping for this sample, and we propose that the microdeletion on the Yp11.2 locus occurred approximately in the 6.44 Mb to 9.75 Mb region. Previous studies have reported that the AMEL Y deletion is a common mutation in the Indian population. Taking into account regional differences, we also analyzed several area-specific Y-chromosome mutations.
Amelogenin ; DNA* ; Humans ; Male ; Microsatellite Repeats ; Recombination, Genetic ; Y Chromosome*