Factors Predictive of Response to Interferon-alpha Therapy in Children with Chronic Hepatitis B

PURPOSE: The efficacy and safety of interferon-alpha (IFN-alpha) therapy in children with chronic hepatitis B (CHB) is similar to that of adults. However, little information is available about the predictive factors of response to this therapy in children. The aim of this study was to determine the predictive factors for responsiveness to IFN-alpha therapy in children with CHB. METHODS: The basal parameters were studied in 35 children with CHB treated with IFN-alpha (300MU/m2 of body surface area subcutaneously, 3 times weekly for 6 months). HBsAg, anti-HBs, HBeAg, anti-HBe, HBV DNA and aminotransferase levels were assessed serially. Pretreatment liver biopsies were performed in 16 patients and modified histologic activity index(HAI) was determined respectively. Responder was defined as disappearance of HBeAg and HBV-DNA after cessation of therapy. We analyzed the predictive factors of response to IFN-alpha therapy. RESULTS: Serum HBeAg and HBV DNA became negative in 16 children (46%) among 35 treated children at the time of cessation of therapy. In the univariate analysis, HAI, ALT level and maternal HBsAg were associated with the response. In multivariate analysis, HAI was the best factor for predicting response (sensitivity : 80% and specificity : 100%). CONCLUSION: Factors predictive of response in children with CHB are similar to those reported in adult, and may help identify those children with a better chance of responding.

Effects of Somatostatin Analogue Pretreatment on Ovarian Response to Ovulation Induction in Patients with Polycystic Ovarian Syndrome / 대한산부인과학회잡지

OBJECTIVE: To determine whether the somatostain analogue, octreotide, pretreatment before ovulation induction with human menopausal gonadotropin (hMG) affects ovarian response, and ovulation induction outcome in infertile patients with polycystic ovarian syndrome (PCOS) resistant to clomiphene citrate (CC) METHODS: From November 1998 to June 1999, 30 infertile patients with PCOS unresponsive to CC were randomly allocated either octreotide pretreatment (treatment group) (n = 15) or hMG alone (control group) (n = 15) groups. In the treatment group, 100 g of octreotide were administered daily for 7 days after progesterone injection for withdrawal bleeding, and then hMG was administered for ovulation induction. RESULTS: There were no differences in the total number of hMG ampules required and the duration of hMG administration between the two groups. The number of follicles of 10-14 mm diameter on the day of hCG injection was significantly less in the treatment group than that in the control group (4.3 +/- 2.5 vs. 9.6 +/- 4.4, p < 0.001). The serum estradiol (E2) level on the day of hCG injection was significantly lower in the treatment group, with 1579.2 +/- 421.0 pg/ml compared with 2120.3 +/- 512.7 pg/ml in the control group (p < 0.001). The hematocrit level on the day of hCG injection was also significantly lower in the treatment group than that in the control group (36.9 +/- 2.1% vs. 40.8 +/- 2.9%, p < 0.05). The incidence of severe ovarian hyperstimulation syndrome (OHSS) seemed to be lower in the treatment group, but the difference did not achieve significance (6.7% vs 20.0%). CONCLUSION: This study suggests that octreotide pretreatment before ovulation induction could improve hormonal milieu compared to hMG alone, and therefore may be effective in ovulation induction for patients with PCOS resistant to CC.

The fetal therapy of congenital cystic adenomatoid malformation of the lung in - utero : Two cases of thoracoamniotic shunting using a basket - shaped catheter / 대한산부인과학회잡지

No abstract available.

A Case of Congenital Myotonic Dystrophy Diagnosed by Molecular Genetics / 대한소아신경학회지

Congenital myotonic dystrophy is an inherited, autosomal dominant disease that results in a progressive wasting of the skeletal muscle, and sometimes heart and smooth muscles in human. In the newborn period, an affected infant is profoundly weak, has difficulty in sucking and swallowing, and may have severe respiratory difficulties. Myotonia is not a feature of the condition at this stage. Motor development is usually delayed in these children, and they may show some signs of mental retardation. Generally, the condition improves through the early years but deteriorates during late childhood and adolescence, when the 'adult' features of the disease gradually emerge. The gene defect responsible for myotonic dystrophy has proved to be a region of unstable fragment of DNA on chromosome 19. An expansion of a CTG(cytosinethymine-guanine) repeat in the 3'-untranslated region of a protein kinase gene contributes to the development of myotonic dystrophy. We have diagnosed and experienced a case of congenital myotonic dystrophy in a neonate with the chief complaint of respiratory difficulty and apnea. So we report the case and the brief review of related literatures.

A Case of Ceftriaxone-induced Pseudocholelithiasis

Ceftriaxone, a third-generation cephalosporin, is a very potent, broad spectrum antibiotic commonly used in patients with meningitis, osteomyelitis, pyelonephritis, Lyme disease and many other severe infectious diseases. Up to 46% of those receiving this antibiotic develop gallbladder sludge. Most of them are asymptomatic, but a small proportion may develop right upper quadrant pain, nausea, vomiting and even cholecystitis. We report a case of ceftriaxone-induced pseudocholelithiasis in a 5-year-old boy. We also emphasize the fact that surgical interventions such as cholecystectomy is not necessary, because the condition may resolve spontaneously after cessation of the drug.