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Purpose@#Acute promyelocytic leukemia (APL) is a rare disease in children and there are some different characteristics between children and adult. We aimed to evaluate incidence, clinical characteristics and treatment outcomes of pediatric APL in Korea. @*Materials and Methods@#Seventy-nine pediatric APL patients diagnosed from January 2009 to December 2016 in 16 tertiary medical centers in Korea were reviewed retrospectively. @*Results@#Of 801 acute myeloid leukemia children, 79 (9.9%) were diagnosed with APL. The median age at diagnosis was 10.6 years (range, 1.3 to 18.0). Male and female ratio was 1:0.93. Thirty patients (38.0%) had white blood cell (WBC) count greater than 10×109/L at diagnosis. All patients received induction therapy consisting of all-trans retinoic acid and chemotherapy. Five patients (6.6%) died during induction chemotherapy and 66 patients (86.8%) achieved complete remission (CR) after induction chemotherapy. The causes of death were three intracranial hemorrhage, one cerebral infarction, and one sepsis. Five patients (7.1%) suffered a relapse during or after maintenance chemotherapy. The estimated 4-year event-free survival and overall survival (OS) rates were 82.1%±4.4%, 89.7%±5.1%, respectively. The 4-year OS was significantly higher in patients with initial WBC < 10×109/L than in those with initial WBC ≥ 10×109/L (p=0.020). @*Conclusion@#This study showed that the CR rates and survival outcomes in Korean pediatric APL patients were relatively good. The initial WBC count was the most important prognostic factor and most causes of death were related to serious bleeding in the early stage of treatment.
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PURPOSE: To evaluate the diagnostic efficacy and complications of ultrasound-guided percutaneous renal biopsy using automatic biopsy gun in patients with pediatric diffuse renal disease. MATERIALS and METHODS: Using an 18G automatic biopsy gun, biopsies were performed on 97 pediatric patients with clinically suspicious diffuse renal disease. The acquired tissue specimens were analyzed by photomicroscopy, immunofluorescence, and electron microscopy to support the diagnosis. In the 97 biopsies, the success of the histologic diagnosis, number of glomeruli, and complication rates were retrospectively evaluated by analyzing the variable exams and clinical records. RESULTS: Adequate tissue for histologic diagnosis was obtained in 91 of 97 biopsies (94%) and the mean number of glomeruli was 9.6. Complications such as minute pain, gross hematuria, and small perirenal hematoma presented in 22 of the 97 biopsies (23%), all of which either improved within 5-72 hours or did not need specific treatment. CONCLUSION: Ultrasound-guided percutaneous renal biopsy using 18G automatic biopsy gun is an effective and safe method for the histologic diagnosis of pediatric diffuse renal disease without any major complication.
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Humanos , Biopsia , Diagnóstico , Técnica del Anticuerpo Fluorescente , Hematoma , Hematuria , Microscopía Electrónica , Estudios RetrospectivosRESUMEN
Direct approach of technically difficult or inoperable intracranial aneurysms many become possible using complete circulatory arrest with extracorporeal circulation and profound hypothermia and barbiturate cerebral protection. To avoid difficulties associated with closed chest method, open chest method was used by direct cannulation of the right atrium and aorta through the chest. 3 patients with posterior circulation aneurysms operated on with these techniques;1 large basilar bifurcation aneurysm and 1 irregular shaped vertebro-basilar junction aneurysm and 1 posterior cerebral artery aneurysm were operated on and all had excellent results. Careful attention was needed to the depth of hypothermia, duration of total circulatory arrest, and hemostasis which important factors in the success of these methods.
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Humanos , Aneurisma , Aorta , Cateterismo , Circulación Extracorporea , Atrios Cardíacos , Hemostasis , Hipotermia , Aneurisma Intracraneal , TóraxRESUMEN
The aim of this study is to investigate the end of filaments of the different toothbrushes in the market through the stereomicroscope and to evaluate the % of rounded-end filaments considered to be acceptable. 9 brands, total 11 type toothbrushes were tested. 2 toothbrushes of each type which is marked as roundedend filaments were tested. The toothbrushes which are not marked as rounded-end filaments were excluded. The domestic as well as foreign toothbrushes which are familiar to consumers were tested. 2 tufts of each toothbrushes were cut and examined by stereomicroscope using 40x magnification. The procedure was carried out with blind-technique, and the digital photographs were taken. Besides the % of rounded-end filaments, total tufts number, material of the tuft, stiffness, and other special characteristics were recorded. By the classification of Silverstone and Featherstone, rounded-end filaments were examined and counted. The results shows that there are different range of rounded-end filaments according to the toothbrush types(17.7%-91.2%). Atman toothbrush has the most rounded-end filaments(91.2%) among the observed toothbrushes, and the Advantage Plus(Oral-B) has the next(86.75%). E-Clean #411 has the least(17.70%) and E-Clean #410 of the same brand has also low % rounded-end filaments(20.60%). While G.U.M #409(Butler) has 67.90% rounded-end filaments, G.U.M #471 of the same brand has comparative low 41.83% rounded-end filaments. 4 types of total 11 have the rounded-end filaments over 80%, however other 4 types have under even 50%. Considering that the correct brushing habit with a toothbrush which has rounded-end filaments can protect the gingival injury and tooth abrasion, it is thought that we dentists need to give the correct information about toothbrush to the patients
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Humanos , Clasificación , Odontólogos , Abrasión de los DientesRESUMEN
Ursodeoxycholic acid(UDCA) is a hydrophilic gall bladder acid and has been used as a effective drug for liver disease related to immunity. This drug inhibits secretions of IL-2, IL-4, and IFN- ? from T-cells and production of immunoglobulin from B-cells. Also it has been reported that UDCA inhibits production of IL-1 related to the progression of periodontal disease and activation of collagenases. The purpose of the present study was to elucidate the effects of UDCA on inhibition of periodontal disease progression using clinical, microbiological and histometrical parameters. Twelve pure bred, 16 month-old-beagle dogs were used in the study. After ligature-induced periodontal diseases were formed, experimental drugs were applied twice a day and then the results of clinical, microbiological, and histometrical parameters were measured at baselie(initiation of experiment), 4weeks and 8weeks. The gel with UDCA(concentration 0.5%, 5% 3 dogs in each) was applied to experimental group, chlorhexidine to positive control group(3dogs) and the gel without UDCA(base) to negative control group. After induction of general anesthesia, the maxillary 2nd, 3rd premolars and 1st molar and the mandibular 2nd, 3rd-4th premolars and 1st molar were ligated in one side selected randomly and were not ligated in the opposite side. The plaque index(PI), gingival index(GI), pocket depth(PD) and gingival crevicular fluid(GCF) volum were measured clinically. The PI and GI were measured at 3 buccal points of all experimental teeth and the GCF was measured only at the 3rd premolar in the maxilla and the 4th premolar in the mandible. In the microbiological study, the samples extracted from the 3rd premolar of the maxilla and the 4th premolar of the mandible at the center of buccal surface were analyzed aerobics, anaerobics and Streptococcus colony forming units. After clinical and microbiological examination at 8weeks, the dogs were sacrificed by carotid artery perfusion. The samples were fixed and sectioned including interproximal area, and the distance from cementoenamel junction(CEJ) to alveolar crest was measured, The results were that PI, GI and PD increased until 4 weeks and decreased at 8 weeks in three groups but the differences between all the groups were not significant. The 0.5% UDCA in non-ligated group showed remarkable decrease of GCF. The experimental group applied 5% UDCA decreased the number of aerobics and anaerobics. The distance from CEJ to alveolar crest was greater in the negative control group on both ligated and non-ligated sides, but the differences were not significant stastically.