The effect of growth hormone treatment on craniofacial growth in short stature children / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to analyze the effect of growth hormone treatment (GHT) on craniofacial growth in children of short stature. METHODS: Nineteen untreated children of short stature were referred from the Pediatric Department, Yeungnam University Hospital as a subject group. All subjects had lateral cephalograms taken before, after 1 year and after 2 years of growth hormone treatment. As a reference group, we selected 19 normal children with paired sampling who matched the subjects' age and sex, from the Department of Orthodontics, Kyungpook National University Hospital. RESULTS: Before GHT, anterior cranial base length and upper posterior facial height, posterior total facial height, mandibular ramus length, and mandibular corpus length were significantly smaller in the reference group. In angular craniofacial measurements, saddle angle and mandibular plane angle were larger. SNA and SNB were smaller in the reference group. After two years of GHT, growth hormone accelerated growth in several craniofacial components. The posterior total facial height, the anterior, posterior cranial base length, and the mandibular ramus length were increased. And the difference in mandibular plane angle and ANB values compared with the reference group was decreased. CONCLUSIONS: GHT over 2 years leads to a craniofacial catch-up growth tendency, which is pronounced in interstitial cartilage and condylar cartilage.

Successful Conversion Arterial Switch Operation after Palliative Senning Operation / 대한흉부외과학회지

Six year-old female having TGA, VSD with severe PHT which was considered inoperable for anatomical correction, received palliative Senning procedure. During follow-up, she was given prostacyclin and at the age of 21, she received Senning takedown, arterial switch and VSD closure after a reevaluation of the hemodynamic status. Significant reduction in PHT was found and she is doing well without complication 3 months after the operation.

Trends in Malocclusion Patients of Yeungnam University Hospital / 영남의대학술지

BACKGROUND: This study was done to better understand patterns, trends and local distribution patterns of malocclusion so that we can provide adequate information to patients, to help make the appropriate diagnosis and therapeutic plans, and to assess the future directions of malocclusion treatment. MATERILAS AND METHODS: Malocclusion patterns, distribution and trends of visiting patients were examined in 993 malocclusion patients who had been evaluated and diagnosed at the Department of Dentistry, Yeungnam University Hospital over a 10-year period from 1995 to 2004. RESULTS: The number of visiting patients per year showed an increasing trend and the visit rate was 1.28 time-higher in females(56.1%) than in males(43.9%). Age distribution showed that the 7-12 year-old group was the largest (36.7%). Geographic distribution showed the majority of patients were from the Dalseo district(28.2%). Angle's malocclusion classification revealed that class III was the largest(38.4%). Crowding was the chief complaint in the highest percentage of patients(33.9%). The therapeutic method used was the fixed appliance in 61% of cases and a combination with extraction in 30.8%. CONCLUSIONS: The availability of dental services can accommodate orthodontic needs adequately as well as obtain reliable quantitative information regarding the characteristics of orthodontic patients.

Cell Viability and Proliferation Activity of Peripheral Lymphocytes in Patients with Alzheimer's Disease / 신경정신의학

OBJECTIVES: There are evidences of apoptotic neuronal cell death in Alzheimer's disease (AD). Recent studies suggested AD pathogenesis in the central nervous system as well as in peripheral lymphocytes. The object of this study is to compare the cell viability and the proliferation activity in AD patients with healthy normal control by using peripheral lymphocytes. METHODS: We analyzed the cell viability and the proliferation activity of phytohemagglutinin (PHA)-activated lymphocytes from 73 AD patients and 31 normal contols. The cell viability and the proliferation activity were measured at baseline (T0), 24 hours (T24), 48 hours (T48), 72 hours (T72), 96 hours (T96), by the tryphan blue method and the BrdU proliferation activity method, respectively. RESULTS: The cell viability of PHA-activated peripheral lymphocytes in AD patients was significantly decreased at T72, T96 compared with healthy controls (F=8.034, p<0.001). In AD patients, the decline of proliferation activity appeared in earlier than healthy normal controls. CONCLUSION: This study suggests that there is a decreased cell viability and the proliferation activity of peripheral lymphocytes in AD patients. These finding may be related with the increased apoptosis in Alzheimer's disease.

A Survey on Petition and Process for the Extension of Hospitalization in Mental Hospital / 신경정신의학

OBJECTIVES: The authors performed this survey to find out current status of petition and process for the extension of hospitalization of patients who were hospitalized more than 6 months. METHODS: Authors designed a questionnaire named 'Questionnaire for Survey of Current Status and Process of Petition for Extension of Hospitalization of Psychiatric Patients' and distributed it to 242 psychiatric facilities with closed wards for psychiatric patients. The psychiatric facilities includes 4 categories;psychiatric department of university hospital, psychiatric department of general hospital, psychiatric hospital and small sized private clinic. The period of survey was from Jan. 1 to Dec. 31 of 2002. RESULTS: Among 84 psychiatric facilities responded, 2,615 petitions for extension of hospitalization were submifted to the Local Mental Health Tribunal, and the dissent rate was 4.1%. The most of petitions were from psychiatric hospitals (2,265). The psychiatric departments of general hospitals favored the discharge-readmission method rather than applying extension by due process of the Mental Health Act when further admission was needed after 6 months hospitalization (280 vs. 106). The main reason for the petitions for extension of hospitalization was "no improvement" (72.7%) than "dangerousness to self or others" (14.7%). Against doctor's recommendation for discharge agter improvement, many patients couldn't be discharged becanse of guardians' refusal or cut off from caregiver or guardian. In cluded were these patients applied petitions for extension of hospitalization. CONCLUSION: This study suggests that hospitalization of some patients are extended improperly in view of the spirif of the Mental Health Act. The authors proposea new system of ambulatory treatment, reinforcement of psychiatric rehabilitation, legal control of the neglected patient by guardians.

Dysregulation of Cell Cycle Regulating Proteins in Peripheral Lymphocytes from the Patients with Alzheimer's Disease / 대한정신약물학회지

OBJECTIVE: Extensive neuronal death occurring in the Alzheimer's disease (AD) may be related with the apoptosis. Recent studies have suggested that regulatory failure of cell cycle appeared to be very early event of AD pathogenesis in neuronal cells as well as in peripheral lymphocytes. We compared the change of cyclin dependent kinases (Cdks), which is related with G1/S phase transition in the cell cycle, between AD patients and normal controls using peripheral lymphocytes. METHODS: We obtained Cdks from peripheral lymphocytes of 37 AD patients and 18 age-matched normal subjects. Cells in first culture were considered to be G-zero (G0) cells. We measured Cdk2, Cdk4, and Cdk6 at baseline (T0). Thereafter, we observed Cdks 24 hours later after using PHA (phytohemaglutinin) (N24). Meanwhile, we observed Cdks 24 hours later again with rapamycin treatment (T24). RESULTS: At baseline (T0), Cdk2 and Cdk6 were increased in AD patients compared to the control group (p< 0.001, p=0.038, respectively). Cdk2 was increased in AD patients more than control group after using PHA (T24, p=0.007). After rapamycin treatment for 24 hours (N24), Cdk2, Cdk4, and Cdk6 were increased in the patients compared to the controls (p=0.002, p=0.022, p=0.011, respectively). CONCLUSION: This results showed that the cell cycle regulating proteins in AD patients, which are related with G1/S phase transition, were increased in peripheral lymphocytes compared to those in normal controls. We provide the clue which demonstrate the cell cycle dysregulation in the patients with Alzheimer's disease.

The Standardization of the Ge riatric Quality of Life s cale-Dementia(GQOL-D)

Objectives : We developed the instrument to assess the quality of life(QOL) for demented patients, 'Geriatric Quality of Life-Dementia(GQOL-D)'. The purpose of this study was to standardize the GQOL-D and to introduce administration results in Korean demented patients. METHODS: The normal subjects were 340 elderly people, aged over 55 years old, who were physically and cognitively normal. And the patient group was consisted of 69 demented patients. RESULTS: Both in normal group and in patient group, the internal consistency, Cronbach's = 0.87, 0.90, respectively, and item-total correlation was acceptable. And the test-retest reliability revealed the stability across time by r=0.86, 0.77, respectively. Criterion validity was found to be a high correlation between each itemand overall QOL' item, and adequate correlations between the GQOL-D and scales assessing cognition, psychological wellbeing, behavior and activities of daily living convinced convergent validity. In the result of factor analysis, 2 factors with a variance percentage of 37.7% were extracted. The mean score and standard deviation of items of the GQOL-D for two groups and differences in items such as memory, recreation/leisure, self esteem, general health, and mobility between groups were presented. CONCLUSION: It was confirmed that there is no difficulty for old people to carry out the GQOL-D. As it was suggested that there is enough room for intervening in dementia patients' emotional and behavioral difficulties, the GQOL-D will be useful in research and clinical practice for the patients with dementia.

CREB Expression in Peripheral Lymphocyte and Antidepressant Response / 대한정신약물학회지

OBJECTIVE: The molecules related with the intracellular signal transduction system are one of the main targets for the mode of mechanisms of antidepressant treatment in depressive patients. In vivo and in vitro studies have provided the evidence that the transcription factor, CREB (c-AMP response element binding protein) is the key mediator of the therapeutic response to antidepressants. We investigated the relationship between the treatment response to fluoxetine for 6 weeks and the change of CREB immunoreactivity in peripheral T lymphocyte. METHODS: CREB-expression and phosphorylation were quantified via western blot, and binding activity between transcription factor and CRE-oligonucleotide via electrophoretic mobility shift assay (EMSA) in nuclear extracts from 14 normal controls and 31 depressed patients at 0 and 6th week during fluoxetine treatment (20 mg/day). Responder was defined as the > or =50% of reduction or < or =7 of HAM-D score. We compared the changes of CREB during 6 weeks of fluoxetine treatment between drug responders and non-responders using SPSS11.0. RESULTS: After six weeks of treatment with fluoxetine, the drug responders showed a significant increase in CREB (p=0.024 by t-test) and p-CREB (p=0.045 by Mann-Whitney U test) compared with the non-responders. The change of CREB immunoreactivity was positively correlated with the change of p-CREB (r=0.770, p=0.000 by Spearman's rho), and the change of p-CREB was also positively correlated with CRE-DNA binding (r=0.753, p=0.000 by Spearman's rho). CONCLUSION: These results suggest that CREB response in peripheral lymphocyte may reflect and mediate the response to antidepressant treatment in depressed patients.

Surgical Repair of the Congenital Aneurysm of the Rght Atrium / 대한흉부외과학회지

The four most common types of congenital malformations involving the right atrium(RA) and the coronary sinus(CS) are congenital enlargement of the RA, single RA diverticulum, multiple diverticula of the RA, and aneurysm of the RA or CS. A previously healthy 6year-old child was presented with signs of upper respiratory tract infection. Chest X-ray and echocardiogram revealed a severely isolated right atrial enlargement. The abnormally dilated right atrim was widely resected under cardiopulmonary bypass. Pathology revealed multifocal myocardial loss associated with mild fibrotic changes of the endocardium and epicardium. Our experience on this rare congenital disease is presented along with a review of the literature.

Surgical Repair of the Congenital Aneurysm of the Rght Atrium / 대한흉부외과학회지

The four most common types of congenital malformations involving the right atrium(RA) and the coronary sinus(CS) are congenital enlargement of the RA, single RA diverticulum, multiple diverticula of the RA, and aneurysm of the RA or CS. A previously healthy 6year-old child was presented with signs of upper respiratory tract infection. Chest X-ray and echocardiogram revealed a severely isolated right atrial enlargement. The abnormally dilated right atrim was widely resected under cardiopulmonary bypass. Pathology revealed multifocal myocardial loss associated with mild fibrotic changes of the endocardium and epicardium. Our experience on this rare congenital disease is presented along with a review of the literature.

CT Findings of Inverted Papilloma and Aspergiollosis in Sinonasal Cavities: CT differentiation

PURPOSE: To describe the characteristic CT findings of inverted papilloma (IP) and aspergillosis involving sinonasal cavities and to differentiate between them on CT. MATERIALS AND METHODS: We retrospectively reviewed CT images in 22 cases of pathologically confirmed IP and 16 of aspergillosis; these were classified as one of four types, according to location. We also analyzed infundibular widening, displacement of the maxillary medial wall, the presence of air in the maxillary ostium, elevation of ethmoidom axillary plate (EMP), calcification within a lesion, reactive hyperostosis and CT density. RESULTS: Four cases were type I, which was seen only in aspergillosis (4/16, 25%); five were type IV, and all were IP (5/22, 22.7%), with a characteristic growing vector. Type II was seen in nine cases of IP and 11 of aspergillosis, and type III in eight cases of IP and one of aspergillosis. In types II and III (17 of 22 cases of IP; 12 of 16 of aspergillosis), five of 22 cases of IP (22.7%) and nine of 16 of aspergillosis (56.3%) showed infundibular widening, which was more severe in aspergillosis. Maxillary medial wall displacement was seen in five of 22 cases (22.7%) of IP, four of which showed lateral displacement and in five of 16 cases (31.3%) of aspergillosis, all of which showed medial displacement. Air in the maxillary ostium was seen in seven of 22 cases of IP (31.8%). Elevation of EMP was seen in two cases of IP (9.1%) and three of aspergillosis (18.8%), which showed oblique elevation. Calcification was detected in nine cases of aspergillosis (56.3%) but in only one of IP. Reactive hyperostosis was seen in 13 cases of aspergillosis (81.3%) and two of IP (9.1%). CONCLUSION: Although it is hard to differentiate between IP and aspergillosis involving sinonasal cavities, the findings of calcification, infundibular widening, air in the maxillary ostium,displacement of the maxillary medial wall, an elevated EMP pattern and reactive hyperostosis combined with duration of symptom may be helpful.