No abstract available.
Biliary Atresia*

The authors carried out various treatment modalities in 74 consecutive patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage and were admitted to the Department of Neurosurgery. Konkuk University Hospital, from Jan. 1991 to Dec. 1993. A variety of prognostic factors that influence mortality were observed. The locaton of hematoma was at the basal ganglia in 47 cases and at the thalamus in 27 cases. The prognosis gets poorer as the hematoma extended wider and deeper. The prognosis was unfavorable when the hematoma was over 30cc(P<0.001). The mortality rate was higher in cases with IVH than in cases without IVH(P<0.005). In cases with IVH, 19 cases(26%) showed dilated 4th ventricular hemorrage and higher mortality rate(P<0.001). Cases in which the GCS were less than 9 on admission showed higher mortality rate(P<0.0001). The mortality rate was also higher if the midline shift was more than 10mm on the initial brain CT scan(P<0.005). THe group where the unilateral or bilateral pupillary light reflex was unreactive(35cases) showed poorer prognosis than the group where the bilateral pupillary light reflex was reactive(P<0.0001). The ventriculocranial ratio(VCR), hydrocephalus, surrounding edema edema around the heamtoam, and treatment modality were not related to the prognosis. The significant prognostic factors in patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage were location and type of hematoma, whether or not the volume of hematoma is more than 30cc, IVH, dilated 4th ventricular hemorrhage, Graeb's score of more than 7, GCS of less than 9, midline shift of more than 10mm, and reactivity of pupillary light reflex.
Basal Ganglia ; Brain ; Cerebral Hemorrhage* ; Edema ; Ganglion Cysts* ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Prognosis ; Reflex ; Thalamus

BACKGROUND: It has been reported that the association between blood pressure and cognitive impairment could be modified by factors such as gender, education, and Apo E genotypes. This study was aimed to investigate whether `age' could also be a modifier of the association. METHODS: The study group consisted of 489 participants aged 65 years or over who lived in Namwon, Korea. The presence of hypertension was ascertained by the measurement of their resting blood pressure. A cognitive impairment was considered to be present when a Korean Mini-Mental State Examination score was less than 19 (30th percentile). RESULTS: A higher systolic blood pressure was significantly associated with cognitive impairment, after an adjustment for age, gender, education, and occupation. However, the significance was lost in subjects aged 71 or over. CONCLUSIONS: High systolic blood pressure is a factor strongly associated with cognitive impairment in an aged population. However, in the subjects with far advanced age, the association is not significant. Further studies are required to elucidate whether blood pressure lowering strategies should be differentiated according to age in order to reduce cognitive impairment.
Adult* ; Aged* ; Apolipoproteins E ; Blood Pressure* ; Education ; Genotype ; Humans ; Hypertension ; Jeollabuk-do ; Korea ; Occupations

BACKGROUND: In Korea, the proportion and absolute number of old people are increasing very rapidly. And the concern about the quality-of-life of elderly is to increase more and more among health care workers. The quality-of-life of elderly is affected by chronic medical conditions in some part. The purpose of this study is to evaluate the association between eight chronic medical conditions and health-related quality of life among the community-based elderly. METHODS: Target areas were 22 dongs in Dong-gu,Kwangju and 2 dongs in Buk-gu. Six hundreds subjects were randomly sampled from target ares. Interview survey was performed for chronic medical conditions by check list and health-related quality of life by COOP chart. Actual subjects were 568 elderlies. RESULTS: The results are followed ; 1) Compared with other domains of health-related quality of life, overall health was the most associated with chronic medical conditions, and social activity the least associated. 2) Stroke were significantly associated with every domain. And also back problems/joint problems were except the domain of social activity. Compared with other disease, stroke was the most associated with health-related quality of life except the domain of pain. 3) Migraine/chronic headache, gastroduodenal problems, and heart conditions were significantly associated with overall health, bodily pain, and one or two domains. 4) Hypertension and diabetes mellitus were signi ficantly associated with only one domain; overall health 5) Asthma and chronic bronchitis was not associated with any domains. CONCLUSION: Generally, health-related quality of life was highly associated with mobility limiting diseases such as back problems/joint problems stroke. And also moderately associated with pain relation disease such ans migraine/chronic headache, gastroduodenal problems, and heart condition.
Aged ; Asthma ; Bronchitis, Chronic ; Chronic Disease* ; Delivery of Health Care ; Diabetes Mellitus ; Headache ; Heart ; Humans ; Hypertension ; Korea ; Quality of Life* ; Stroke

PURPOSE: In spite of many reports about Helicobacter pylori infection in children with functional gastrointestinal disorders, there are few reports about the influence of H. pylori infection to functional dyspepsia and gastric motility. Therefore, we studied the influence of H. pylori infection on gastric myoelectrical activity in children with functional dyspepsia. METHODS: Between August 2006 and December 2008 upper gastrointestinal endoscopies with biopsies, the rapid urease test and/or 13C urea breath test, and electrogastrography (EGG) were performed on 63 patients with histologic chronic gastritis; patients with chronic disorders were excluded. Comparisons about gastric myoelectrical activities were made between H. pylori-positive children (n=25) and H. pylori- negative children (n=38). RESULTS: The percentage of pre- and post-prandial normogastria was relatively lower in H. pylori-positive children than H. pylori-negative children (80% vs. 65%, and 80% vs. 68%, respectively). Compared to H. pylori-negative children, H. pylori-positive children had lower postprandial predominant power (8.18+/-22.36 dB and 32.20+/-24.18 dB, respectively; p<0.01) and a lower power ratio (deltaP; delta1.28+/-6.18 vs. +.62+/-5.93, respectively; p<0.01). CONCLUSION: It was suggested that the gastric myoelectrical activity in children with chronic gastritis can be influenced by H. pylori infection. Thus, this study indicates that H. pylori infection may be predictable in children with functional dyspepsia through analyzing the EGG parameters, and treatment may be considered in H. pylori-positive children with impaired gastric activity, especially in the lower prevalence area.
Adolescent ; Biopsy ; Breath Tests ; Child ; Dyspepsia ; Endoscopy, Gastrointestinal ; Gastritis ; Gastrointestinal Diseases ; Helicobacter ; Helicobacter pylori ; Humans ; Ovum ; Prevalence ; Urea ; Urease

OBJECTIVES: The purpose of this study was to examine daytime sleepiness-related factors, including sleeping patterns and daytime activities, in shift and non-shift workers. METHODS: One hundred and twenty two shift workers, and two hundred and fifty four non-shift workers, were selected and identified in terms of their general characteristics, such as age, tenure, educational level, marital status and religion. Screening questionnaires were composed of the Epworth Sleepiness Scale (ESS) for evaluation of daytime sleepiness, the Multidimensional Fatigue Scale (MFS) for fatigue, and the Korean version of the National Institute for Occupational Safety and Health (NIOSH) for sleeping patterns. RESULTS: The shift worker group reported significantly higher rates of sleep disturbance and higher fatigue scores compared with the non-shift workers (all p<0.01). The prevalence of daytime sleepiness was higher in the shift workers (19.7%) than the non-shift workers (10.6%) (p<0.05). The significant daytime sleepiness-related factors were found to be shift work, tenure and difficulties in falling back to sleep once woken (p<0.05). Shift work was proved to be an important factor in workers aged less than 40 years (p<0.05). However, this association was not evident in workers aged 40 years and over. CONCLUSIONS: The shift workers showed a significantly higher prevalence of daytime sleepiness compared with the non-shift workers. The present study suggests a need for the implementation of sleeping and fatigue management programs for shift workers in order to improve working efficiency and control safety accidents during shift work.
Adult* ; Fatigue* ; Humans ; Male* ; Marital Status ; Mass Screening ; National Institute for Occupational Safety and Health (U.S.) ; Prevalence ; Questionnaires

PURPOSE: Most malignant peritoneal or pleural effusions caused by advanced malignancy are unresponsive to systemic chemotherapy except for chemotherapy sensitive tumors, and they are equally ineffective to regional therapy or radiotherapy. Thus, for the purpose of palliating the symptoms related to malignant effusion and to reduce fluid reaccumulations, we evaluated the therapeutic feasibility and efficacy of intracavitary ' Ho-CHICO (chito- san complex) instillation for intractable malignant effusions. MATERIALS AND METHODS: Thirty one patients with cytologically or pathologically proven malignant effusions underwent intracavitary 166Ho-CHICO therapy from May 1996 to March 1998 at Ajou University Hospital. The subjective and objective responses were evaluated 4 weeks after the treatment, including the changes of symptoms, weight, abdominal girth, doses of diuretics, frequencies and amounts of repeat aspirations for fluid reaccumulations, and imaging studies of chest radiograph and ultrasounds. RESULTS: The response rates treated with Ho-CHICO were 50% in patients with peritoneal effusion and 46% in patients with pleural effusion (overall 49%). The response rates between 166Ho-CHICO doses of 50-80 mCi and 90-100 mCi were similar (50% vs 47%). Response rate of 70% was noted in patients with even distribution of radioisotope on the post-therapy scan, but, the response rate was lower in cases with focal (44%) and uneven (29%) distribution pattern. There was no difference in response by the effusion sites. All patients tolerated intracavitary 166Ho-CHICO instillation well, although the majority of patients experienced Grade I/II side effects such as pain, fever, weakness and dyspnea. But, no serious complications of Grade lII or IV degree were observed with 166Ho-CHICO therapy. CONCLUSION: Intracavitary 166Ho-CHICO instillation was clinically efficacious in controlling malignant effusions without a significant toxicity seen with conventional sclerotic therapy. The therapeutic modality appeared to offer similar benefits obtained with the conventional intracavitary therapy.
Ascitic Fluid ; Aspirations (Psychology) ; Chitosan* ; Diuretics ; Drug Therapy ; Dyspnea ; Fever ; Holmium* ; Humans ; Pleural Effusion* ; Radiography, Thoracic ; Radiotherapy ; Ultrasonography

Leucine-rich repeat kinase 2 (LRRK2) mutations are the most common genetic cause of Parkinson's disease (PD). LRRK2 contains a functional kinase domain and G2019S, the most prevalent LRRK2 pathogenic mutation, increases its kinase activity. LRRK2 regulates mitochondria morphology and autophagy in neurons. LPS treatment increases LRRK2 protein level and mitochondrial fission in microglia, and down-regulation of LRRK2 expression or inhibition of its kinase activity attenuates microglia activation. Here, we evaluated the direct role of LRRK2 G2019S in mitochondrial dynamics in microglia. Initial observation of microglia in G2019S transgenic mice revealed a decrease in mitochondrial area and shortage of microglial processes compared with their littermates. Next, we elucidated the molecular mechanisms of these phenotypes. Treatment of BV2 cells and primary microglia with LPS enhanced mitochondrial fission and increased Drp1, a mitochondrial fission marker, as previously reported. Importantly, both phenotypes were rescued by treatment with GSK2578215A, a LRRK2 kinase inhibitor. Finally, the protein levels of CD68, an active microglia marker, Drp1 and TNF-α were significantly higher in brain lysates of G2019S transgenic mice compared with the levels in their littermates. Taken together, our data suggest that LRRK2 could promote microglial mitochondrial alteration via Drp1 in a kinase-dependent manner, resulting in stimulation of pro-inflammatory responses. This mechanism in microglia might be a potential target to develop PD therapy since neuroinflammation by active microglia is a major symptom of PD.
Animals ; Autophagy ; Brain ; Down-Regulation ; Mice ; Mice, Transgenic ; Microglia* ; Mitochondria ; Mitochondrial Dynamics* ; Neurons ; Parkinson Disease ; Phenotype ; Phosphotransferases*

PURPOSE: The purpose of our study was to evaluate the outcome of intensified induction therapy using the Vanderbilt regimen in patients with a poor prognosis non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS: We retrospectively analyzed the results of two pilot studies, which enrolled the patients aged 60 years or less, with a previously untreated NHL of intermediate grade on the Working formulation, having 2 or 3 adverse prognostic factors on the age- adjusted International Prognostic Index. Patients received an intensified induction, with the regimen described by the Vanderbilt group. RESULTS: Thirty-five patients were analyzed. After induction, 29 patients (83%) achieved more than partial response (PR): 22 (63%) complete response (CR) and 7 (20%) PR. Three of the PRs were subsequently converted to CR following consolidation therapy. The overall CR rate, following the completion of treatment, was 71%. The 3-year overall survival (OS) rate of all patients was 53%. In the univariate analysis, age (50 years) was the only factor affecting the OS. The 3-year disease-free survival (DFS) rate of patients with CR was 68%. In the univariate analysis, age and bone marrow involvement were the factors affecting the DFS. Two patients died from the treatment-related toxicity of the induction therapy: one due to sepsis and the other due to congestive heart failure. CONCLUSION: Although the CR rate was relatively high, the OS or DFS of patients with a poor prognosis NHL, who had received the intensified induction using the Vanderbilt regimen, were no different from those that had received the conventional chemotherapy, as reported by the International Prognostic Index Project. However, the OS or DFS in the young patient groups were encouraging. To test the hypothesized benefits of our approach in the young patient groups, a larger cohort of patients aged 50 years or less should be studied.
Bone Marrow ; Cohort Studies ; Disease-Free Survival ; Drug Therapy ; Heart Failure ; Humans ; Lymphoma, Non-Hodgkin* ; Pilot Projects ; Prognosis ; Retrospective Studies ; Sepsis

Extraskeletal Ewing's sarcomas (EES) are rare. Recently, Ewing's sarcoma of the bone, primitive neuroectodermal tumor (PNET), Askin tumor and EES have been included into the family of Ewing's tumors, due to the overlapping features relating to their clinico-pathological and cytogenetic appearance. We experienced a case of an EES arising from the duodenum in a 14-year-old girl who presented with hematemesis and epigastric discomfort. A duodenal biopsy specimen revealed the infiltration of small round cells and rich vasculatures, with immunohistochemical finding of MIC-2 (CD99) (+), vimentin (+), CD56 (NCAM) (+), LCA (-), T-cell (-), B-cell (-), CD43 (-) and CD68 (-). She was treated with several cycles of multiagent chemotherapy, and achieved an initial partial response, but rapid progression of tumor followed, so she was treated with surgical excision. This is the first case report of an EES arising from the duodenum in the literature.
Adolescent ; B-Lymphocytes ; Biopsy ; Cytogenetics ; Drug Therapy ; Duodenum* ; Female ; Hematemesis ; Humans ; Neuroectodermal Tumors, Primitive ; Sarcoma ; Sarcoma, Ewing* ; T-Lymphocytes ; Vimentin