Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

PURPOSE: The purpose of this study was to describe depression, caregiving burden and the correlation of the two variables in the families of patients with amyotrophic lateral sclerosis (ALS) and to clarify factors predicting caregiving burden. METHODS: A descriptive and cross-sectional study was conducted with 139 family members who provided care to patients with ALS. The characteristics of patients and families, Korean-Beck Depression Inventory (K-BDI), Korean version of Zarit Burden Interview (K-ZBI) and Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised (K-ALSFRS-R) were used as study measures. RESULTS: The mean score for K-BDI was 19.39 out of 63 suggesting sub-clinical depression and 38.2% of the family members exhibited depression. The mean score for K-ZBI was 66.03 out of 88. The predictors for K-ZBI were K-BDI, age of family member, length of time spent per day in caring, relationship to patient and K-ALSFRS-R. CONCLUSION: The results of this study suggest that levels of depression and caregiving burden are high among family members caring for patients with ALS. As depression is associated with caregiving burden, screening and emotional supports should be provided to reduce the burden of care for these family. Support programs to alleviate the care burden are also needed, considering family demographics, time per day in caring giving and K-ALSFRS-R.
Adult ; Aged ; Amyotrophic Lateral Sclerosis/pathology ; Caregivers/*psychology ; Cross-Sectional Studies ; Depression/etiology/*psychology ; Family ; Female ; Humans ; Male ; Middle Aged ; Psychiatric Status Rating Scales ; Quality of Life ; Surveys and Questionnaires

In glaucoma, we need an accurate, highly reproducible analysis method for the purpose of early detection of fine glaucomatous optic nerve head change. Nowadays many investigations using confocal laser tomographic scanner (Heidelberg Retinal Tomograph ; HRT) are actively undertaken. We analyzed the optic nerve head of 479 normal eyes(male:308, female:171) with HRT, and got the mean value of each parameter in HRT. We compared the difference between men and women. We also observed the distribution of the value of each parameter in normal adult. In addition, for the parameter of rim/disc area ratio, we got the mean value in 6 divisions of optic nerve head. The range of distribution of disc area was from 1.139 mm2 to 4.512 mm2, cup area ranged from 0.104 mm2 to 2.667 mm2, and rim area was from 0.760 mm2 to 2.925 mm2. The parameter which showed difference between men and women was height variation contour. For rim/disc area ratio, the mean value of each 6 divisions were as follows: nasal inferior, 0.909; nasal, 0.908; nasal superior, 0.860; temporal inferior, 0.763; temporal 0.519; temporal superior 0.738. We can make good use of the normal parameters of HRT in Koreans for diagnosis and treatment of glaucoma.
Adult ; Diagnosis ; Female ; Glaucoma ; Humans ; Male ; Optic Disk* ; Optic Nerve* ; Retinaldehyde

PURPOSE: The present study was designed to analyze the relationship between vascular endothelial growth factor (VEGF) and p53, and their impact on clinical outcome in squamous cell carcinoma of the cervix treated with radiation therapy. MATERIALS AND METHODS: This immunohistochemical study involved 23 patients with available paraffin blocks among 46 patients who were treated during the period from 1994 to 1997 in Eulji University Hospital in Korea. Anti-VEGF mouse monoclonal antibody and DO-7 anti- p53 mouse monoclonal antibody were used as the primary antibodies. Antibody binding was detected with a LSAB kit. Staining was defined as positive for VEGF and p53, when more than 10% and 5% of the tumor cells were stained out of 500 cells counted, respectively. RESULTS: FIGO stage (p=0.05) and tumor size (p=0.04) were significant prognostic factors for survival. p53 expression was present in 17 (77%) cases. There was no significant relationship between p53 staining and the clinicopathologic factors, such as FIGO stage (p=0.98), tumor size (p=0.43), lymph node status (p=0.82), parametrial invasion (p=0.96), and age (p=0.18). The five year survival rates according to the p53 expression status were 80% for the p53 negative group and 66% for the p53 positive group (p=0.58). Positive VEGF expression was observed in 11 (47%) of the total of 23 patients. Statistical evaluation of VEGF expression according to stage (p=0.36), tumor size(p=0.11), lymph node status (p=0.82), parametrial invasion (p=0.49), and age (p=0.55) revealed no significant difference in any of these parameters. The five year survival rates according to the VEGF expression status were 89% for the VEGF negative group and 41% for the VEGF positive group (p=0.07). CONCLUSION: We suggest that VEGF expression may have an effect on the prognosis of cervix cancer patients treated with radiation therapy, and further evaluation with a large sample size is warranted.
Animals ; Antibodies ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Humans ; Korea ; Lymph Nodes ; Mice ; Paraffin ; Prognosis ; Radiotherapy ; Sample Size ; Survival Rate ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

Coronary restenosis is still regarded as Achilles' Hill of interventional cardiology despite relentless efforts of many investigators. Recent experimental and clinical studies have suggested that both gamma and beta radiation can be reduce restenosis after angioplasty. Currently, intracoronary brachytherapy for the prevention of restenosis has become a new evolving treatment modality in interventional cardiology. This report discusses a physical aspect of gamma and beta radiation, initial clinical results and delivery systems used in intracoronary brachytherapy. We shall take a brief overview of methods and their advantages in intracoronary brachytherapy. Future work should provide further insight for the best way of treating restenosis.
Angioplasty ; Beta Particles ; Brachytherapy ; Cardiology ; Coronary Restenosis ; Humans ; Research Personnel

BACKGROUND: Recently, Doppler echocardiography has been widely used to evaluate left ventricular(LV) diastolic filling. However, There are only limited date about the influence of LV systolic function on the pattern of left ventricular diastolic filling. METHODS: To evaluate the changes of Doppler echocardiographic parameters of left ventricular filling induced by variations in left ventricular systolic function in dilated cardiomyopathy(DC) with heart failure(HF), 25 patients(M : F=14 : 11) with DC and HF, and 21 age-matched normal subjects(M : F=13 : 8) were examined by ECG, phonocardiography and echocardiography. From the Doppler recording, A2D(time from second heart sound to the onset of early diastolic mitral flow), peak velocity at early diastole(E) and late diastole(A), ratio of E to A velocity(E/A) and flow velocity integral(FVI) were measured. RESULTS: In 22 patients with DC and HF without mitral regurgitation(MR), A2D was significantly prolonged(119.5+/-12.7 vs 92.4+/-14.1msec, p<0.01), and early diastolic peak velocity and E/A velocity ratio were decreased as compared with the normal subjects(E=0.39+/-0.08 vs 0.57+/-0.12m/sec, p<0.01, E/A : 0.87+/-0.19 vs 1.33+/-0.19 vs 1.33+/-0.18, p<0.05). There were significant correlations between A2D and FVI(r=+0.73, p<0.01), and between E/A velocity ratio and FVI(r=-0.78, p<0.01). However, in 3 patients with MR, A2D(88.7+/-12.1msec), E(0.56+/-0.05m/sec), and E/A(1.32+/-0.12) were similar to those in normal subjects, despite of decreased FVI(12.0+/-0.9cm). CONCLUSIONS: These data show that a change of left ventricular systolic function in patients without MR may influence a diastolic filling pattern of left ventricle but not in patient with MR, and suggest that MR masks left ventricular distolic filling abnormalities.
Cardiomyopathy, Dilated* ; Echocardiography ; Echocardiography, Doppler* ; Electrocardiography ; Heart ; Heart Sounds ; Heart Ventricles ; Humans ; Masks ; Phonocardiography ; Ventricular Function, Left*

BACKGROUND AND PURPOSE: It has been suggested that oxidative stress is one of the pathomechanisms underlying amyotrophic lateral sclerosis (ALS), and thus antioxidants such as uric acid (UA) that could reduce oxidative stress might be beneficial in the prevention or treatment of this disease. The objective of this study was to prospectively investigate serum UA levels in Korean ALS patients and to relate them to disease progression. METHODS: ALS patients and healthy controls who were individually well-matched for sex, age, and body mass index (BMI) underwent blood testing for serum UA levels, and analyzed whether UA levels were correlated with the disease status of the patients, as defined by the ALS Functional Rating Scale-Revised (ALSFRS-R). RESULTS: The study included 136 ALS patients and 136 matched controls. The UA level was lower in the ALS patients (4.50+/-1.17 mg/dL, mean+/-SD) than in the controls (5.51+/-1.22 mg/dL; p<0.001). Among the ALS patients, the level of UA acid was inversely correlated with the rate of disease progression (decrease in ALSFRS-R score). Kaplan-Meier analysis revealed that a better survival rate was more strongly correlated with top-tertile levels of serum UA than with bottom-tertile levels (log-rank test: p=0.035). CONCLUSIONS: ALS patients had lower serum UA levels than did healthy individuals. UA levels in ALS were negatively correlated with the rate of disease progression and positively associated with survival, suggesting that UA levels contribute to the progression of ALS. UA levels could be considered a biomarker of disease progression in the early phase in ALS patients.
Amyotrophic Lateral Sclerosis* ; Antioxidants ; Body Mass Index ; Disease Progression ; Hematologic Tests ; Humans ; Kaplan-Meier Estimate ; Oxidative Stress ; Prognosis ; Prospective Studies ; Survival Rate ; Uric Acid*

BACKGROUND: The evaluation of behavioral and psychological symptoms (BPS) in ALS is important because its existence may serve as a prognostic factor and suggest a shared pathology with frontotemporal dementia (FTD) in ALS. In this study, we sought to identify the prevalence of the BPS of ALS patients and evaluate its relationship with the clinical profiles and survival of ALS patients. METHODS: One hundred sixty-six patients were enrolled in a cross-sectional cohort analysis from September 2008 to February 2012. All patients had sporadic ALS without a genetic mutation and were collected clinical profiles. The t-test and chi-square test were used to assess differences in the clinical characteristics and caregiver-administered neuropsychiatric inventory (CGA-NPI) scores. The Kaplan-Meier method and Cox proportional hazard model were used for the survival analysis. RESULTS: Forty-two patients had clinically significant BPS (42/166, 25.3%). ALS patients with BPS had worse clinical dementia rating (CDR), ALS Functional Rating Scale-Revised (ALSFRS-R) score, and progression rate of disease than those without BPS. Among CGA-NPI subscales, depression, irritability, apathy, and agitation were higher prevalent than the others. There was a trend for ALS patients with BPS having short survival time than those without BPS in the Kaplan-Meier analysis (p=0.006). However, in the Cox proportional hazard model, BPS in ALS patients were not associated with poor survival. CONCLUSION: These results support the presence of an overlapping spectrum between ALS and FTD and emphasize the importance of neuropsychiatric evaluations in ALS. Although the association between BPS and prognosis are not explained clearly, these results could be used to stratify ALS patients according to neuropsychiatric symptoms and help investigators to evaluate the BPS in ALS patients.
Amyotrophic Lateral Sclerosis* ; Apathy ; Cohort Studies ; Dementia ; Depression ; Dihydroergotamine ; Frontotemporal Dementia ; Humans ; Kaplan-Meier Estimate ; Pathology ; Prevalence ; Prognosis ; Proportional Hazards Models ; Research Personnel

BACKGROUND AND PURPOSE: The increasing recognition that deficits in social emotions occur in amyotrophic lateral sclerosis (ALS) is helping to explain the spectrum of neuropsychological dysfunctions, thus supporting the view of ALS as a multisystem disorder involving neuropsychological deficits as well as motor deficits. The aim of this study was to characterize the emotion perception abilities of Korean patients with ALS based on the recognition of facial expressions. METHODS: Twenty-four patients with ALS and 24 age- and sex-matched healthy controls completed neuropsychological tests and facial emotion recognition tasks [ChaeLee Korean Facial Expressions of Emotions (ChaeLee-E)]. The ChaeLee-E test includes facial expressions for seven emotions: happiness, sadness, anger, disgust, fear, surprise, and neutral. RESULTS: The ability to perceive facial emotions was significantly worse among ALS patients performed than among healthy controls [65.2±18.0% vs. 77.1±6.6% (mean±SD), p=0.009]. Eight of the 24 patients (33%) scored below the 5th percentile score of controls for recognizing facial emotions. CONCLUSIONS: Emotion perception deficits occur in Korean ALS patients, particularly regarding facial expressions of emotion. These findings expand the spectrum of cognitive and behavioral dysfunction associated with ALS into emotion processing dysfunction.
Amyotrophic Lateral Sclerosis* ; Anger ; Facial Expression ; Frontotemporal Dementia ; Happiness ; Humans ; Neuropsychological Tests ; Perception

BACKGROUND AND PURPOSE: The increasing recognition that deficits in social emotions occur in amyotrophic lateral sclerosis (ALS) is helping to explain the spectrum of neuropsychological dysfunctions, thus supporting the view of ALS as a multisystem disorder involving neuropsychological deficits as well as motor deficits. The aim of this study was to characterize the emotion perception abilities of Korean patients with ALS based on the recognition of facial expressions. METHODS: Twenty-four patients with ALS and 24 age- and sex-matched healthy controls completed neuropsychological tests and facial emotion recognition tasks [ChaeLee Korean Facial Expressions of Emotions (ChaeLee-E)]. The ChaeLee-E test includes facial expressions for seven emotions: happiness, sadness, anger, disgust, fear, surprise, and neutral. RESULTS: The ability to perceive facial emotions was significantly worse among ALS patients performed than among healthy controls [65.2±18.0% vs. 77.1±6.6% (mean±SD), p=0.009]. Eight of the 24 patients (33%) scored below the 5th percentile score of controls for recognizing facial emotions. CONCLUSIONS: Emotion perception deficits occur in Korean ALS patients, particularly regarding facial expressions of emotion. These findings expand the spectrum of cognitive and behavioral dysfunction associated with ALS into emotion processing dysfunction.
Amyotrophic Lateral Sclerosis* ; Anger ; Facial Expression ; Frontotemporal Dementia ; Happiness ; Humans ; Neuropsychological Tests ; Perception