OBJECTIVE: Activation of one or more serotonin (5-HT) receptors may play a role in mediating the antidepressant effects of serotonergic antidepressants. The serotonin 2C (5HT 2C) receptor is known to be associated with antidepressant action and weight gain. We sought to determine whether the 5-HTR 2C receptor -759C/T polymorphism was associated with weight gain and treatment response to mirtazapine in major depressive disorder (MDD) patients. METHODS: The 5-HT 2C receptor -759C/T polymorphism was analyzed in 323 MDD patients. All patients were evaluated using the 21-item Hamilton Depression Rating Scale at the beginning of the study and at 1, 2, 4, and 8 weeks of mirtazapine treatment. RESULTS: There was no significant difference in the 5-HT 2C receptor -759C/T genotype distribution between responder and non-responder groups. The 5-HT 2C receptor -759C/T polymorphism was not associated with weight change over time after mirtazapine administration. CONCLUSION: The 5-HT 2C receptor -759C/T polymorphism does not appear to be a predictor of treatment response to mirtazapine. This polymorphism was not associated with weight change after 8 weeks of mirtazapine treatment. Further investigation on other polymorphisms of the 5-HT 2C gene is required to determine whether the 5-HT 2C gene influences treatment response and weight change after mirtazapine administration in patients with major depressive disorder.
Antidepressive Agents ; Depression ; Depressive Disorder, Major ; Genotype ; Humans ; Mianserin ; Negotiating ; Receptor, Serotonin, 5-HT2C ; Serotonin ; Weight Gain

As younger preterm infants are able to survive, more extremely preterm infants are at risk of developing retinopathy of prematurity (ROP). To investigate the incidence, progression and risk factors of ROP in extremely preterm infants in Korea, the medical records of infants born before 25 weeks gestation were retrospectively reviewed. The criteria for laser treatment agreed with type 1 ROP as defined by the Early Treatment for Retinopathy of Prematurity study. Of the 121 infants included in the analysis, 119 (98.4%) infants developed any stage ROP, including 78 infants (64.5%) with type 1 ROP. The mean postmenstrual age (PMA) at the onset of any ROP and type 1 ROP were 33.5 and 36.1 weeks, respectively. All but one infant developed type 1 ROP after 31 weeks PMA. Univariate analysis showed that duration of total parenteral nutrition and onset of any ROP (PMA) were associated with the development of type 1 ROP. In conclusion, this study shows high incidence of ROP in extremely preterm infants and suggests that, although current screening protocols are feasible for most preterm infants born before 25 weeks gestation, earlier screening before 31 weeks PMA may be necessary in infants with an unstable clinical course.
Asian Continental Ancestry Group ; Birth Weight ; Female ; Gestational Age ; Humans ; Incidence ; Infant, Extremely Premature ; Infant, Newborn ; Intensive Care Units, Neonatal ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Republic of Korea/epidemiology ; Retinopathy of Prematurity/*epidemiology/mortality ; Retrospective Studies ; Risk Factors ; Severity of Illness Index

There are a number of situations where the oral mucosa can be sucked or pressed to produce relatively banal but clinical distinctive changes. The labial and buccal mucosa and tongue may develop protuberances in areas where a tooth is missing or extra space is present. The mucosa is pressed and sucked into these spaces, thus leading to the development of a fibrous hyperplasia. This case report describes the management of fibrous hyperplasia in oral mucosa. Fibrous hyperplasia can be formed by habitual pressure or suction in oral mucosa. Treatment of fibrous hyperplasia consists of simple excision and, if feasible, elimination of the cause. And habit control is a important factor for preventing recurrence.
Hyperplasia ; Mouth Mucosa ; Mucous Membrane ; Recurrence ; Suction ; Tongue ; Tooth

An outbreak of rapidly progressive renal failure was observed in Belgium in 1993 and was related to a slimming regimen involving Chinese herbs. Extensive interstitial fibrosis with atrophy and tubular loss was the major histological lesion. Aristolochic acid has been suspected to be responsible for nephrotoxicity. The use of Chinese herbal medicines is very popular in Korea. We report the presence of a nephrotoxic compound in herb medications, which led to end-stage renal failure in a patient with complete remission state of minimal change disease. The typical and sequential pathologic changes in our patient following the consumption of herbs suggest possible relationship to herbal medicines, and end-stage renal disease, despite the fact that a cause-and-effect relationship cannot be automatically inferred.
Asian Continental Ancestry Group* ; Atrophy ; Belgium ; Fibrosis ; Humans ; Kidney Failure, Chronic* ; Korea ; Nephrosis ; Nephrosis, Lipoid* ; Renal Insufficiency

It is known that CD95 (APO-1/Fas) is expressed on the cell surface, and apoptotic cell death can be induced by the CD95 ligation in the cultured, proliferating human retinal pigment epithelial (RPE) cells. However, little is known about CD95 on the non-proliferating RPE cells. In this study, human RPE cells were cultured up to 4 weeks after they reached the confluence, to simulate the non-proliferating RPE cells in situ. There was no significant difference in CD95 expression on the cell surface between the predominantly proliferating, preconfluent cells and predominantly non-proliferating, postconfluent cells in flow cytometric assays. However, unlike proliferating cells, no cellular death occurred in the predominantly non-proliferating cells after the treatment of agonistic anti-CD95 antibody with cycloheximide, pretreated with interferon-gamma. Our results suggest that the CD95/CD95L system probably plays a physiologic role in vivo to remove the abnormal, proliferating RPE cells, and factors other than the surface expression of CD95 may determine the sensitivity to the CD95 signals.
Antigens, CD95/*pharmacology ; Apoptosis/*physiology ; Cells, Cultured ; Human ; Pigment Epithelium of Eye/cytology/*drug effects/*physiology ; Sensitivity and Specificity

The interstitial lung diseases(ILD) comprises a large, heterogeneous group of disorders characterized by derangement of alveolar walls and alveolar capillary unit causing restrictive pulmonary dysfunction and disordered gas exchange. It is rare, especially in children, and the opinions on investigation and treatments are controversial. The classification of adult ILD is applied to that of children. But considering occurrence during the developing state of lung and immune systems, we should be more cautious because the clinical manifestations and prognosis will be different from those of adults. In 1995, Katzenstein named a unique type of ILD, chronic pneumonitis of infancy (CPI) for the first time. CPI is characterized by marked alveolar septal thickening, striking type II pneumocyte hyperplasia, and eosinophilic alveolar exudate containing numerous macrophages. We report a 14 month-old girl, who had continuing respiratory difficulty and cyanosis after upper respiratory infection, could not sustain oxygen saturation and was finally diagnosed as CPI by histologic examination.
Adult ; Capillaries ; Child ; Classification ; Cyanosis ; Eosinophils ; Exudates and Transudates ; Female ; Humans ; Hyperplasia ; Immune System ; Infant ; Lung ; Lung Diseases, Interstitial* ; Macrophages ; Oxygen ; Pneumocytes ; Pneumonia* ; Prognosis ; Strikes, Employee

This disease predominantly affects infants and young children living in Japan and Taiwan, and manifests itself as acute encephalopathy following viral infections. The hallmark of this encephalopathy is multifocal, symmetric brain lesions affecting bilateral thalamus, brainstem tegmentum, cerebral periventricular white matter and cerebellar medulla, which can be visualized by computed tomography and magnetic resonance imaging. Both the gray and white matter are involved, with neuropathological evidence of local breakdown of the blood-brain barrier. The prognosis was poor in the 1980s, but has improved recently. A characteristic combination of focal neurologic signs is often recognized as the sequelae. We experienced a case of a 7-month-old male infant who had been transferred to our hospital for comatous mentality and clonic seizure of both arms and legs. We report this case with a review of the related literatures.
Arm ; Blood-Brain Barrier ; Brain ; Brain Stem ; Child ; Humans ; Infant ; Japan ; Leg ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Prognosis ; Seizures ; Taiwan ; Thalamus

Branchio-oto-renal(BOR) syndrome is an autosomal dominant disorder. The pathophysiology of this syndrome is unknown. BOR syndrome has a wide range of clinical manifestations affecting the branchial, auditory and renal systerns. Associated abnormalities of the face, lacrimal duct, palate and ureters have also been described. However, the major clinical findings associated and/ or ear pits, and renal anormaly. We experienced a case of a 15-day-old rnale newborn who had visited our hospital for deformed auricle and atresia of external auditory canal found at birth. We report this case with a review of the related literatures.
Branchial Region ; Branchio-Oto-Renal Syndrome* ; Ear ; Ear Canal ; Humans ; Infant, Newborn ; Palate ; Parturition ; Ureter

PURPOSE: Adenoviral respiratory infection can develop a life threatening condition similar to severe bacterial pneumonia. Despite adequate intensive care, this infection progresses to acute respiratory distress syndrome and causes permanent lung damage in some patients. In this study, we analyzed clinical features and long-term follow-up clinical data of this infection in children. METHODS: Forty-seven cases of inpatients were diagnosed as adenoviral respiratory tract infection by viral culture of nasal aspirates or histopathological diagnosis at Samsung Medical Center during the period from February 1995 to July 1998. We reviewed medical records retrospectively. RESULTS: During this study, 1301 cases of acute respiratory tract infection were investigated, of which 47 cases were confirmed as adenoviral infection. Age ranged from 2 months to 6 years. Initial symptoms were productive cough(100%), fever(91%), dyspnea(62%), diarrhea(40%), and conjunctival injection(30%). Thirty-nine cases(83%) were pneumonia and 7 cases(15%) were bronchiolitis. The radiologic findings were pneumonic consolidation(60%), effusion(36%), infiltration(19 %), and atelectasis(13%). Five cases developed acute respiratory distress syndrome and 3 cases expired. In 31 cases of recovered patient, follow-up evaluation was done at a minimum of 3 months(mean duration 9.9+/-9.3 months). Under the follow-up evaluation, 13 patients(42%) showed physical and radiologic findings that consisted with bronchiolitis obliterans or bronchiectasis. CONCLUSION: Because of severe clinical manifestations and pulmonary complications, early diagnosis, adequate management, and long-term follow-up are needed for adenoviral respiratory tract infection.
Adenoviridae ; Bronchiectasis ; Bronchiolitis ; Bronchiolitis Obliterans ; Child* ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Inpatients ; Critical Care ; Lung ; Medical Records ; Pneumonia ; Pneumonia, Bacterial ; Respiratory Distress Syndrome, Adult ; Respiratory Tract Infections ; Retrospective Studies

BACKGROUND AND OBJECTIVE: Specific IgE to food allergen is associated with atopic dermatitis, but it does not always show good clinical correlation. It has been suggested that IgG may be partly involved in allergen-induced reaction. This study was designed to investigate the clinical significance of specific IgG antibody to egg white (EW) in atopic dermatitis patients who showed improvement with egg elimination diet. METHOD: Eleven atopic dermatitis patients who responded to egg elimination diet were selected. They were classified into two groups; group I (n=5) with positive specific IgE to EW and group II (n=6) with normal levels of serum specific IgE. Two volunteers with no allergic diseases were enrolled in the control group. EW-specific IgG western blotting was performed with patient's serum and purified protein extracted from EW. RESULTS: IgG western blotting to EW in group I showed bands at 51.8 kD in two patients and bands at 35 kD in the others. In group II, two showed bands at 51.8 kD, and diffuse bands at 35 kD~51.8 kD were found in four patients. There were no bands in the control group. CONCLUSION: Regardless of the presence of specific IgE, specific IgG to EW was detected by western blotting in patients with egg-associated atopic dermatitis, suggesting that specific IgG may play a role in the pathogenesis of atopic dermatitis.
Blotting, Western* ; Child* ; Dermatitis, Atopic* ; Diet ; Egg White ; Humans ; Immunoglobulin E ; Immunoglobulin G* ; Ovum* ; Volunteers