No abstract available.
Lymphoma, T-Cell, Cutaneous*

PURPOSE: To study the effectiveness of chondrocyte and periosteum-derived cell transplantation in preventing bar formation in growth plate injuries. MATERIALS AND METHODS: Thirty immature rabbits were grouped according to site of growth plate damaged (distal femur or proximal tibia on the medial side) and type of cell and material inserted (chondrocytes plus agar, periosteum-derived cells plus agar, periosteum-derived cells plus Gelfoam, agar alone, or Gelfoam alone). Radiograms were taken for 16 weeks to measure the changes in varus angle of the distal femur and proximal tibia. Transformation of inserted cells was observed histologically. RESULTS: Rabbits inserted with agar alone showed more severe genu varum compared to those inserted with chondrocytes plus agar. Rabbits inserted with periosteum-derived cells plus agar or Gelfoam showed similar deformities compared to those inserted with agar or Gelfoam alone. Some inserted periosteum-derived cells began transformation into chondrocytes. All rabbits showed gradual bar formation and ultimate fusion of the growth plate. CONCLUSION: Cell-based therapy of growth plate injury still has obstacles to overcome. Further study will be required on how to maintain the inserted chondrocytes, or chondrocytes differentiated from the inserted periosteum-derived cells, and to prevent them from changing into osteoid formation cells.
Agar ; Cell Transplantation ; Chondrocytes* ; Congenital Abnormalities ; Femur ; Gelatin Sponge, Absorbable ; Genu Varum ; Growth Plate* ; Rabbits* ; Tibia ; Transplants

OBJECTIVES: Delayed sleep phase syndrome (DSPS) is characterized by difficulties in falling asleep and waking up at a desired time. Dawn simulation is a technique using a light that gradually increases in intensity before awakening in the morning, to imitate a natural sunrise. It has been found to be effective in decreasing both morning drowsiness and difficulty in awakening as well as treating symptoms of seasonal affective disorder. The aim of this study was to determine whether dawn simulation is helpful in decreasing difficulty in morning awakening and daytime sleepiness in adolescents with DSPS. METHODS: Twelve adolescents with DSPS participated in a 2-week dawn simulation trial. Each subject self-assessed level of difficulty in awakening, morning drowsiness and daytime sleepiness during a 2-week baseline period and a following 2-week trial period with dawn simulator. Subjects used Stanford Sleepiness Scale (SSS) for measuring morning drowsiness and Epworth Sleepiness Scale (ESS) for measuring daytime sleepiness. Difficulty in awakening was assessed by a single-item questionnaire. RESULTS: Dawn simulation trial decreased morning drowsiness (p=0.016) and daytime sleepiness (p=0.013) significantly compared to baseline. It also seemed to improve difficulty in awakening, but the effect was not statistically significant (p=0.092). CONCLUSION: Dawn simulation may help waking up in the morning and may improve daytime functioning by deceasing both morning drowsiness and daytime sleepiness in adolescents with DSPS.
Adolescent* ; Humans ; Surveys and Questionnaires ; Seasonal Affective Disorder ; Sleep Disorders, Circadian Rhythm* ; Sleep Stages

PURPOSE: This study was aimed to investigate the psychiatric manifestations in children with epilepsy and the associations with seizure-related variables. METHODS: The Korean version of the Child Behavior Checklist (K-CBCL) and the ADHD Rating Scale (K-ARS) were used to assess the psychopathology of 78 children with epilepsy (39 boys, mean age: 9.8+/-3.26 years-old) and 78 healthy comparisons matched for age and sex. RESULTS: Compared with healthy comparisons, children with epilepsy showed differences in the social, school, total competence scale, withdrawn, somatic complaints, social problems, thought, attention problems, aggressive behavior, internalizing and externalizing problem, and total behavior problem scores in the K-CBCL. Significant differences in the social, school, total competence scale, withdrawn, social problems, attention, and total behavior problem scales were found between groups in clinical spectrum and nonclinical spectrum. The inattentive, hyperactive/impulsive, and total scores of the K-ARS between groups were significantly different. In addition, the total scores of the K-ARS between subjects in clinical spectrum and nonclinical spectrum were different. The more the number of antiepileptic drugs, the higher significance of the score for aggressive behavior, sex problem, somatic complaints in the K-CBCL, and the inattentive scales in the K-ARS. In addition, the withdrawn, anxious/depressed and somatic complaints in the K-CBCL were correlated with sex, onset age and seizure type, respectively. CONCLUSIONS: Children with epilepsy may experience more various and serious psychiatric problems than healthy children. Responsiveness to antiepileptic drugs and seizure itself can be risk factors of psychiatric manifestations in epileptic children.
Age of Onset ; Anticonvulsants ; Checklist ; Child Behavior ; Child* ; Epilepsy* ; Humans ; Mental Competency ; Psychopathology ; Risk Factors* ; Seizures* ; Sexual Behavior ; Social Problems ; Weights and Measures

PURPOSE: Children under 3 years old with medulloblastoma (MB) or supratentorial primitive neuroectodermal tumor (SPNET) have a poor prognosis. They are more susceptible to the deleterious effects of craniospinal radiation (CSR). This study was undertaken to determine the survival rates and prognostic factors of currently used treatment. METHPDS: Retrospective review of 19 children (MB 16, SPNET 3) who were newly diagnosed as MB or SPNET at Seoul National University Children's Hospital from April 1996 to August 2000 was done. Eligible Patients were treated with postoperative induction chemotherapy using Children's Cancer Group (CCG) 9921A or 9931. Patients over 3 year of age received CSR as well. RESULTS: Three Patients with SPNET are all alive without disease. However, 6 patients under 3 years old at diagnosis with MB were all dead whereas only one patient had an event among 10 patients over 3 years old at diagnosis. Among patients with MB, age under 3 years at diagnosis or residual tumors after induction chemotherapy correlated with poor outcome. Metastasis at diagnosis, postoperative residual disease or extent of excision did not have a significant effect on survival statistically. Three-year event-free survival (EFS) of patients with MB was 53%. Three-year EFS of patients over 3 years old at diagnosis with MB was 85.7% and 1-year EFS of under 3 years old at diagnosis with MB was 16.7%. CONCLUSION: The combined use of chemotherapy and CSR in the treatment of MB and SPNET improved survival in children over 3 years old, whereas any treatment failed to improve survival in children under 3 years old. So, there's a need for a new treatment modality to improve survival of children under 3 year of age.
Child ; Child, Preschool ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Induction Chemotherapy ; Medulloblastoma* ; Neoplasm Metastasis ; Neoplasm, Residual ; Neuroectodermal Tumors, Primitive* ; Prognosis ; Retrospective Studies ; Seoul ; Survival Rate*

BACKGROUND/AIMS: Adefovir dipivoxil (adefovir) effectively inhibits both wild-type and lamivudine-resistant hepatitis B virus (HBV) replication. The development of adefovir resistance is both delayed and infrequent compared with lamivudine resistance. The aim of this study was to characterize the serologic, biochemical, and virologic response to adefovir, and to explore the factors affecting initial virologic response (IVR, defined as a decrease in serum HBV below 4 log10copies/mL after 6 month of treatment) and adefovir resistance in lamivudine resistant HBV-infected patients. METHODS: This study population comprised 76 patients with lamivudine-resistance who had received adefovir for more than 12 months between March 2004 and December 2006. The adefovir-resistant mutant was assayed at 6 months and 12 months during adefovir administration. Restriction-fragment mass polymorphism analysis was used for detecting YMDD and adefovir mutants. RESULTS: After adefovir administration, an IVR was observed in 31% of the patients with lamivudine resistance. Factors associated with an IVR were HBeAg negativity (P=0.04) and the presence of liver cirrhosis (P=0.04). Age, sex, pretreatment levels of alanine aminotransferase and aspartate aminotransferase, pretreatment HBV DNA levels, presence of precore mutation, and type of YMDD mutants were not related to an IVR during adefovir treatment. The prevalence of adefovir resistance was 5% and 13% at 6 months and 12 months after therapy, respectively. Mixed infection of the precore mutant was a risk factors for the emergence of adefovir resistance (P=0.01). CONCLUSIONS: Lamivudine-resistant HBV patients exhibiting HBeAg negativity and liver cirrhosis were more likely to achieve an IVR after adefovir therapy. Adefovir resistance was associated with mixed infection of the precore mutant.
Adenine/*analogs & derivatives/therapeutic use ; Adult ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; Aspartate Aminotransferases/blood ; DNA, Viral/blood ; Drug Resistance, Viral/genetics ; Female ; Hepatitis B e Antigens/metabolism ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Mutation ; Phosphonic Acids/*therapeutic use ; Polymorphism, Restriction Fragment Length

OBJECTIVE: To clarify the biological behavior and prognostic factors of brain stem gliomas, the authors reviewed 48 patients with brain stem gliomas treated between 1980 and 1996. PATIENTS AND METHOD: The clinical presentation, tumor location, pathology, and treatment modalities were correlated with the prognosis of these tumors. Male to female ratio was 1.1:1, with the median age of 12.5 years. Thirty patients(63%) were below 15 years old, and 18 patients(38%) were of adult ages. Mean follow up period was 21.8 months. RESULTS: Focal tumors were in 22 cases and diffuse tumors were in 26. All nine midbrain tumors were focal type. Twenty-two(92%) cases among 24 potine tumors were diffuse type and two cases were focal type as dorsally exophytic tumor. Eleven(73%) cases among 15 medullary and cervicomedullary tumors were focal type and four(27%) cases were diffuse type. Pathologically, there were 14 anaplastic astrocytomas, 11 low grade astrocytomas, 4 glioblastomas, 3 oligodendrogliomas, and 1 ganglioglioma. Fifteen tumors were diagnosed only radiologically without histologic verification. Surgery was done in 33 patients(gross total or subtotal removal in 8, biopsy or partial removal in 15, stereotactic biopsy in 10). Radiation therapy was given in 41 patients(conventional in 29, hyperfractionated in 12). Chemotherapy was done in four patients. CONCLUSION: Statistically significant prognostic factors were symptom duration prior to diagnosis(p=0.0004), cranial nerve palsy(p=0.0206), extent of tumor growth(p=0.0219), contrast enhancement(p=0.0226), intratumoral cyst(p=0.047), histopathological grading(p=0.0304), surgery in patients with focal tumors(p=0.0018), and radiation therapy(p=0.0149).
Adolescent ; Adult ; Astrocytoma ; Biopsy ; Brain Stem Neoplasms ; Brain Stem* ; Cranial Nerves ; Drug Therapy ; Female ; Follow-Up Studies ; Ganglioglioma ; Glioblastoma ; Glioma* ; Humans ; Male ; Oligodendroglioma ; Pathology ; Prognosis ; Survival Rate

BACKGROUND AND OBJECTIVES: Plasma B-type natriuretic peptide (BNP) can be increased in patients with renal insufficiency (RI). The aim of this study was to evaluate the diagnostic value of BNP for systolic heart failure (HF) in patients with moderate to severe RI. SUBJECTS AND METHODS: Between Aug 2002 and May 2004, 433 patients found to have systolic HF or moderate to severe RI were included. The patients were divided into 3 groups (group I; only HF, group II; only RI, group III; HF and RI). The severity of RI was graded according to the calculated creatinine clearance (Ccr); moderate 30< or =Ccr<60, severe 15< or =Ccr<30 or end stage renal disease (ESRD) Ccr<15 mL/min. RESULTS: The mean age of the patients was 67.6+/-12, and 49% were male. There were significant differences in the mean BNP levels between group III and the other two groups (p<0.001); group I (n=65, 837.3+/-884), group II (n=137, 1049.4+/-1332) and group III (n=231, 1738.3+/-1501 pg/mL). A weak negative correlation was note between BNP and Ccr (r=-0.335, p<0.001) in patients with RI. As the renal function deteriorated, the mean BNP of groups II and III was found to be elevated (moderate 625.5+/-574, 1183.0+/-1056; severe 760.5+/-1211, 2205.4+/-1470; ESRD 2157.6+/-1831, 3209.9+/-1900 pg/mL, p<0.05), with the mean BNP of group III being higher than that of group II for each grade (p<0.05). From the ROC curve, the optimal cut-off point of BNP for the diagnosis of systolic HF in patients with RI was 829 pg/mL (accuracy 68%, sensitivity 66% and specificity 70%, p<0.001). CONCLUSION: In the case of patients with moderate to severe RI, a higher BNP cut-off point for the diagnosis of systolic HF and a relatively lower diagnostic accuracy of BNP should be considered.
Creatinine ; Diagnosis ; Heart Failure ; Heart Failure, Systolic* ; Humans ; Kidney Failure, Chronic ; Male ; Natriuretic Peptide, Brain ; Plasma ; Renal Insufficiency* ; ROC Curve ; Sensitivity and Specificity

PURPOSE: To evaluate mortality and morbidity of very low birth weight infants(VLBW infants) born in the Busan area from 1996 to 2005. METHODS: A total of eight neonatal intensive care units (4 university hospitals and 4 general hospitals) in Busan participated in this study. A total of 1,414 VLBW infants were divided into three groups: period I, 1996 to 2000; period II, 1999 to 2002; period III, 2003 to 2005, based on date of birth. We performed a retrospective review of medical records of VLBWinfants and compared the survival rate, morbidity and mortality over the three periods. RESULT: The number of VLBW infants admitted to 8 NICUs in 1996-2005 was a total of 1,414 (1.3% incidence, mean gestational age 29.1+/-2.7 wk, mean birth weight 1158+/-235 g), including 361 (24.7%) extremely low birth weight infants (ELVW infants) who were less than 1,000 g at birth weight. Overall survival rate of VLBW infants was 66.1%. The survival rate of VLBW infants increased significantly over the three periods (period I:57.6%, period II:67.8%, period III:75.7%, P<0.01). Overall survival rate of ELBW infants was 33.8%, and increased from 26.4% in period I to 44.2% in period III (P<0.01). The incidence of respiratory distress syndrome was 45.1%; patent ductus arteriosus, 16.4%; bronchopulmonary dysplasia, 13.1%; blood culture positive sepsis, 12.7%; necrotizing enterocolitis, 6.6%; severe intracranial hemorrhage, 6.5%; and severe retinopathy of prematurity, 5.9%. The main causes of death were respiratory distress syndrome and sepsis. CONCLUSION: Overall survival rate of very low birth weight infant in Busan area during the last 10 years was 66.1%, and increased significantly over the three periods.
Birth Weight ; Bronchopulmonary Dysplasia ; Busan* ; Cause of Death ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Gestational Age ; Hospitals, University ; Humans ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care Units, Neonatal ; Intracranial Hemorrhages ; Medical Records ; Mortality ; Parturition ; Retinopathy of Prematurity ; Retrospective Studies ; Sepsis ; Survival Rate