PURPOSE: There has been no adequate measure of health-related quality of life specifically for children with epilepsy. The aim of this study was 1) to develop a Korean version of the QOLCE, an epilepsy-specific HRQOL, 2) to confirm its reliability and validity. METHODS: The QOLCE was adapted to Korean language through a translation-backtranslation procedure. The subjects were 219 children (M:F=117:102) with epilepsy (age 4-17 years) and their guardians. They completed a questionnaire of 42-items covering five domains:physical function, emotional well-being, cognitive function, social function, and behavior. We assessed internal consistency and test-retest reliability. Construct validity was assessed by correlating scales of the K-CBCL, Korean version of Child Behavior Checklist. RESULTS: The internal consistency reliability estimated by Cronbach's a coefficient was 0.86 (ranged 0.77-0.94) for adequate reliability (p<0.05). To assess the convergent and discriminant item validities, correlations between each of the 15 subscales in the QOLCE were obtained. Each scale highly correlated with theoretically similar scales but correlation between theoretically dissimilar subscales was not high (p<0.01). For construct validity, a comparison was made between QOLCE subscales and the CBCL subscales. QOLCE subscales were significantly related to the CBCL subscales (p<0.05) CONCLUSIONS: This study demonstrated that the Korean version of the QOLCE was a reliable and valid measure at a level of comparable with the original version. These results indicate that this new instrument may be a feasible medical or surgical outcome measure for children with epilepsy.
Checklist ; Child ; Child Behavior ; Epilepsy* ; Humans ; Outcome Assessment (Health Care) ; Quality of Life* ; Surveys and Questionnaires ; Reproducibility of Results ; Weights and Measures

PURPOSE: Twenty percent or more of children with epilepsy may have attention deficit hyperactivity disorder (ADHD). The treatment of ADHD with epilepsy has been an important clinical issue. The aim of this study is to investigate the efficacy and safety of methylphenidate in children with epilepsy and ADHD. METHODS: The subjects were 38 children with ADHD accompanied by epilepsy diagnosed at Department of Pediatrics and Epilepsy Center, Sanggye Paik Hospital. They were examined with IQ testing and Conners scales at baseline before using methylphenidate, and follow-up study was repeated 1 year after methylphenidate. Efficacy was determined by Conners scales and IQ score results. Safety was determined by measuring changes in seizure frequency, and electroencephalographic findings. RESULTS: According to their parents and teachers' reports, methylphenidate improved ADHD symptoms in 24 children (63.2%). Three of them (7.9%) showed significant improvement in IQ scores and 7 children (18.4%) revealed significant improvement in cognitive function with rising IQ scores between 10 and 15 points. There were no worsening in seizure frequency, and electroencephalographic findings after methylphenidate. CONCLUSION: Methylphenidate is effective and safe treatment in children with epilepsy and ADHD, showing significant benefit on children's behavior and academic improvement in many cases.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Epilepsy* ; Follow-Up Studies ; Humans ; Methylphenidate* ; Parents ; Pediatrics ; Seizures ; Weights and Measures

Species that belong to Penicillium section Sclerotiora are commonly found in various terrestrial environments, but only a few have been reported in marine environments. Because the number of Penicillium species reported in marine environments is increasing, we investigated the diversity of Penicillium section Sclerotiora in marine environments in Korea. Based on sequence analyses of β-tubulin and calmodulin loci, 21 strains of section Sclerotiora were identified as P. bilaiae, P. daejeonium, P. exsudans, P. herquei, P. cf. guanacastense, P. mallochii, P. maximae, and P. viticola. Three of them were confirmed as new to Korea: P. exsudans, P. mallochii, and P. maximae. Here, we have provided detailed morphological descriptions of these unrecorded species.
Calmodulin ; Korea ; Penicillium ; Phylogeny ; Sequence Analysis

Tumor necrosis factor alpha (TNFalpha) is a multifunctional cytokine that is elevated in inflammatory diseases such as atherosclerosis, diabetes and rheumatoid arthritis. Recent evidence has suggested that beta2 adrenergic receptor (beta2AR) activation in osteoblasts suppresses osteogenic activity. In the present study, we explored whether TNFalpha modulates betaAR expression in osteoblastic cells and whether this regulation is associated with the inhibition of osteoblast differentiation by TNFalpha. In the experiments, we used C2C12 cells, MC3T3-E1 cells and primary cultured mouse bone marrow stromal cells. Among the three subtypes of betaAR, beta2 and beta3AR were found in our analysis to be upregulated by TNFalpha. Moreover, isoproterenol-induced cAMP production was observed to be significantly enhanced in TNFalpha-primed C2C12 cells, indicating that TNFalpha enhances beta2AR signaling in osteoblasts. TNFalpha was further found in C2C12 cells to suppress bone morphogenetic protein 2-induced alkaline phosphatase (ALP) activity and the expression of osteogenic marker genes including Runx2, ALP and osteocalcin. Propranolol, a beta2AR antagonist, attenuated this TNFalpha suppression of osteogenic differentiation. TNFalpha increased the expression of receptor activator of NF-kappaB ligand (RANKL), an essential osteoclastogenic factor, in C2C12 cells which was again blocked by propranolol. In summary, our data show that TNFalpha increases beta2AR expression in osteoblasts and that a blockade of beta2AR attenuates the suppression of osteogenic differentiation and stimulation of RANKL expression by TNFalpha. These findings imply that a crosstalk between TNFalpha and beta2AR signaling pathways might occur in osteoblasts to modulate their function.
Alkaline Phosphatase ; Animals ; Arthritis, Rheumatoid ; Atherosclerosis ; Bone Morphogenetic Proteins ; Durapatite ; Mesenchymal Stromal Cells ; Mice ; Osteoblasts ; Osteocalcin ; Propranolol ; Receptor Activator of Nuclear Factor-kappa B ; Receptors, Adrenergic ; Tumor Necrosis Factor-alpha

Objective: To compare the performance of the deep learning-based lesion detection algorithm (DLLD) in detecting liver metastasis with that of radiologists. Materials and Methods: This clinical retrospective study used 4386-slice computed tomography (CT) images and labels from a training cohort (502 patients with colorectal cancer [CRC] from November 2005 to December 2010) to train the DLLD for detecting liver metastasis, and used CT images of a validation cohort (40 patients with 99 liver metastatic lesions and 45 patients without liver metastasis from January 2011 to December 2011) for comparing the performance of the DLLD with that of readers (three abdominal radiologists and three radiology residents). For per-lesion binary classification, the sensitivity and false positives per patient were measured. Results: A total of 85 patients with CRC were included in the validation cohort. In the comparison based on per-lesion binary classification, the sensitivity of DLLD (81.82%, [81/99]) was comparable to that of abdominal radiologists (80.81%, p = 0.80) and radiology residents (79.46%, p = 0.57). However, the false positives per patient with DLLD (1.330) was higher than that of abdominal radiologists (0.357, p < 0.001) and radiology residents (0.667, p < 0.001). Conclusion DLLD showed a sensitivity comparable to that of radiologists when detecting liver metastasis in patients initially diagnosed with CRC. However, the false positives of DLLD were higher than those of radiologists. Therefore, DLLD could serve as an assistant tool for detecting liver metastasis instead of a standalone diagnostic tool.

Objective: To compare the performance of the deep learning-based lesion detection algorithm (DLLD) in detecting liver metastasis with that of radiologists. Materials and Methods: This clinical retrospective study used 4386-slice computed tomography (CT) images and labels from a training cohort (502 patients with colorectal cancer [CRC] from November 2005 to December 2010) to train the DLLD for detecting liver metastasis, and used CT images of a validation cohort (40 patients with 99 liver metastatic lesions and 45 patients without liver metastasis from January 2011 to December 2011) for comparing the performance of the DLLD with that of readers (three abdominal radiologists and three radiology residents). For per-lesion binary classification, the sensitivity and false positives per patient were measured. Results: A total of 85 patients with CRC were included in the validation cohort. In the comparison based on per-lesion binary classification, the sensitivity of DLLD (81.82%, [81/99]) was comparable to that of abdominal radiologists (80.81%, p = 0.80) and radiology residents (79.46%, p = 0.57). However, the false positives per patient with DLLD (1.330) was higher than that of abdominal radiologists (0.357, p < 0.001) and radiology residents (0.667, p < 0.001). Conclusion DLLD showed a sensitivity comparable to that of radiologists when detecting liver metastasis in patients initially diagnosed with CRC. However, the false positives of DLLD were higher than those of radiologists. Therefore, DLLD could serve as an assistant tool for detecting liver metastasis instead of a standalone diagnostic tool.