Successful Treatment of Intractable Hiccups with Benztropine / 대한소아신경학회지

In general, intractable hiccups are uncommon. Various drugs and interventions have been reported, but there is no consensus on the treatment of intractable hiccups. We report a patient with meningitis and rhombencephalitis who presented with intractable hiccups that were resolved following treatment with benztropine. A 17-year-old boy was admitted to another hospital with a two-week history of fever and headache. A cerebrospinal fluid (CSF) test showed an increased white blood cell (WBC) count (290/muL, monocytes 100%). He was diagnosed with meningitis and treated with ceftriaxone. Two days after admission, hiccups started and lasted for eight days, despite treatment with phenobarbital, diazepam, haloperidol, phenytoin, and chlorpromazine. He was transferred to our hospital for further evaluation and treatment. He was clinically diagnosed with rhombencephalitis based upon the findings of brain magnetic resonance imaging (MRI). The fever and headache disappeared one day later. However, the hiccups persisted, despite symptomatic treatment with chlorpromazine, gabapentin, and metoclopramide. The hiccups disappeared after one day of adding benztropine without relapse. Benztropine can be considered in the treatment of intractable hiccups.

Evaluation of Cardiac Function in Children with Solid Tumors, who Underwent Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation / 임상소아혈액종양

BACKGROUND: Even though the five year survival rate and prognosis of childhood solid tumors have been improved through the introduction of dose-escalation using tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT), changes in cardiac function have not yet been studied. We therefore evaluated cardiac function after tandem HDCT/auto-SCT. METHODS: This study retrospectively analyzed 56 pediatric patients who were diagnosed with solid tumors and who underwent tandem HDCT/auto-SCT at Samsung Medical Center. We investigated the cardiac function of these patients using echocardiography to evaluate the parameters of the left ventricular ejection fraction, e/e', and left ventricular Tei index. RESULTS: The mean left ventricular ejection fraction, e/e', and left ventricular Tei index at one year after the second HDCT/auto-SCT were 65.7%, 0.32, and 8.6, respectively. When compared those with before the first tandem HDCT/auto-SCT, there were no significant negative changes. We evaluated the changes in cardiac function in different subgroups, based on doxorubicin, radiotherapy involving heart, and the age of the patient at diagnosis. There were no significant changes of cardiac function after the treatment in any of the subgroups. Clinical heart failure did not develop in any of the patients. CONCLUSION: This study showed no significant negative changes in cardiac function at one year after tandem HDCT/auto-SCT. However, long-term follow-up studies of cardiac function in survivors and further studies of cardiac function are needed.

Evaluation of Cardiac Function in Children with Solid Tumors, who Underwent Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation / 임상소아혈액종양

BACKGROUND: Even though the five year survival rate and prognosis of childhood solid tumors have been improved through the introduction of dose-escalation using tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT), changes in cardiac function have not yet been studied. We therefore evaluated cardiac function after tandem HDCT/auto-SCT.METHODS: This study retrospectively analyzed 56 pediatric patients who were diagnosed with solid tumors and who underwent tandem HDCT/auto-SCT at Samsung Medical Center. We investigated the cardiac function of these patients using echocardiography to evaluate the parameters of the left ventricular ejection fraction, e/e', and left ventricular Tei index.RESULTS: The mean left ventricular ejection fraction, e/e', and left ventricular Tei index at one year after the second HDCT/auto-SCT were 65.7%, 0.32, and 8.6, respectively. When compared those with before the first tandem HDCT/auto-SCT, there were no significant negative changes. We evaluated the changes in cardiac function in different subgroups, based on doxorubicin, radiotherapy involving heart, and the age of the patient at diagnosis. There were no significant changes of cardiac function after the treatment in any of the subgroups. Clinical heart failure did not develop in any of the patients.CONCLUSION: This study showed no significant negative changes in cardiac function at one year after tandem HDCT/auto-SCT. However, long-term follow-up studies of cardiac function in survivors and further studies of cardiac function are needed.

The Effects of Steroids and Nonsteroidal Antiinflammatory Agents on Proliferation of Human Ocular Fibroblast

Corticosteroid, 5-fluorouracil and Mitomycin C(MMC) have been used to suppress proliferation of subconjunctival connective tissue. However, the various complication and undesirable side effects associated with the use of these drugs have prompted the search for alternative drugs with less toxicity. In present study, I have evaluated the effect of corticosteroid(dexamethsone sodium phophate), cyclooxygenase inhibitor(diclofenac sodium) and lipoxygenase inhibitor(nordihydroguaratic acid, NDGA) to inhibit human pterygial fibroblast proliferation in tissue culture. Human pterygial fibroblast were cultured and exposed to various concentration of each drug for 1, 2 and 3 days. Cell viability was measured using MTT assay. There was no different in antiproliferative activity between nonsteroidal antiinflammatory agents(NSAIDs) and steroid. Dexamethasone caused inhibition of proliferation with LD 50 of 0.5mM by day 2, NDGA of 0.5mM by day 3 and diclofenac sodium of 1.0mM by day 3. These results suggest that NSAIDs may be useful as both antiproliferative and less toxicity agents.

The Effect of Mitomycine C (MMC) on Inhibition of Pterygial Fibroblast Proliferation

The purpose of this study is to investigate that the biological effect of mitomycin C(MMC) in cellular metabolic activity and morphological change on the ptreygium fibroblast in vitro by MMC concentration and duration of exposure used clinically. Human pterygial fibroblasts were exposed for threeminute and five-minute to MMC 0.002%, 0.004%, 0.01%, 0.02%, 0.04%, and DMEM(control). MTT based colorimetric assay was performed to assess the metabilic activity, inhibition of fibroblast proliferation on the MMC concentration and exposure time. The higher the concentration of MMC, and longer the duration of exposure time, the absorbance of spectrometer are decreased. The metabolic activity of fibroblasts were inhibited by 50% at least only over MMC 0.02% for five-minute expoure time. In histological findings, the higher the concentration and longer the duration of MMC exposure time, the enlargement of many mitochondira and rough endoplasmic reticulum without nuclear damage were more distinctly appeared. Especially, the ptergial fibroblast has more severe cytoplasmic damage at a five-minute exposure to MMC 0.02% than a three-minute exposure to MMC 0.04%. For inhibition of fibroblast proliferation, in case of using MMC should be at least over 0.02% concentration for five-minute exposure time. Arthors think that the experimental and clinical research on the duration of MMC exposure time as well as the concentration MMC, should be need to evaluate the effect on inhibition of cellular proliferation.

Successful Transplantation of 3 Cases of Oligomeganephronia

"We retrospectively reviewed the results of 1,850 fine needle aspiration cytology (FNAC) of thyroid nodules performed from 1990 to 1991 in the Department of Pathology, Seoul National University Hospital. Among 1,528 cases and 322 cases aspirated by clinicians and a pathologist, 465 cases (30.4%) and 13 cases (4.0%) of the aspirates were inadequate, respectively. In 227 cases, correlation of the FNAC diagnosis and histologic diagnosis was done. Excluding the inadequate cases, the sensitivity for the detection of neoplasm (malignancy together with follicular adenoma) was 86.4% and the specificity was 70.7%. The overall diagnostic accuracy was 79.0%. There were 16 false-positive cases (7.0%), and 19 false-negative cases (8.4%). The predictive value of each cytologic diagnosis was 92% in papillary carcinoma, and 100% in Hashimoto's thyroiditis. The expectancy of malignancy was 52.8% in ""suspicious malignancy"" and 26.7% in ""atypical lesion""."