The aim of this study was to evaluate the clinicopathologic characteristics of the colorectal polyps in people under 50 years old.

From January to August 2001, the colonoscopic finding and pathologic reports of 527 patients under 50 years old who underwent colonoscopy were reviewed retrospectively. The advanced polyp was defined as an adenoma more than 10mm in diameter or with the histology of villous or high grade dysplasia.

Total 94 colonic polyps(17.8%) were analyzed. On age distribution, 65 cases(69.1%) were in forth decade, 25 cases(26.6%) in third decade. Abdominal pain(29.8%) was the most common cause of taking the colonoscopic examination followed by rectal bleeding(18.1%), asymptomatic screening(12.7%). Rectosigmoid area was the most common site of polyps in 63.8%. On the pathologic review, adenoma was found 55.1%, inflammatory polyp 38.5% and hyperplastic polyp 6.4%. Advanced adenomas were 17.9%(17/156) and adenomas with focal carcinomatous changes were 1.9%(3/156). Patients who had symptoms of abdominal pain or rectal bleeding, multiple polyps or familial history of colorectal cancer had a higher prevalence of advanced adenoma than that of non-advanced adenoma(p<0.05).

This study showed that major symptoms of patients with advanced polyps under 50 years old were abdominal pain and rectal bleeding. The symptoms, multiplicity of polyp and family history were important indicator of advanced polyps. Further study was needed for reasonable indication and cost effectiveness for colonoscopic examination in young age people.

Stable gene transfer to human pluripotent hematopoietic stem cells is an attractive strategy for the curative treatment of many genetic hematologic disorders. In clinical tral, the level of gene transfer to this cell population have generally been low.

In this study we have evaluated the efficiency of gene transfer to human umbilical cord blood(UCB) CD34+cells using vesicular stomatitis virus glycoprotein G(VSV-G) pseudotyped HIV-1 vector.

High titers of replication-defective VSV-G pseudotyped HIV-1 based vector encoding the enhanced yellow fluorescent protein were produced by transient transfection. Human CD34+cells purified from UCB were incubated with pseudotyped HIV supernatants for 24-48 hours. The transduction efficiency were measured by marker gene expression under the microscopy and flow cytometry.

Transduction rates into CD34+ were low at 0 and 24 hours, reflecting 4.7±2.4% at 24 hours, they were increased to 5.7±2.7% at 48 hours.

We demonstrate efficient transduction of purified human UCB CD34+ by HIV vectors pseudotyped with VSV-G. The results extend the lentiviral vector to clinical gene therapy using human pluripotent hematopoietic stem cells.

Chronic subdural hematoma(CDH) is collection of encapsulated ligified hematoma in subdural space and familiar with neurosurgens. 50 patients of CDH were treated using burr holes and closed-system drainage. The study is a retrospective clinical analysis and reviewed of the surgical method.

Between 1995 and 2001, 50 patients with CDH had surgical treatments, using burr holes and closed-system drainage technique at the department of neurosurgery, Ewha Uninversity Medical Center, Mok-Dong hospital. Mean age was 61 years with a range 35-82 years. The male/female ratio is 41/9. Diagnosis of CDH was confirmed by CT scans. The author divided into 2 groups ; traumatic group and atraumatic group. Retrospectively the author analysed the clinical data regarding age group, sex ratiso, etiology, neurologic grade at admission, post-operative outcomes and outcomes according to neurologic grade at admission. These clinical data compared the traumatic group with atraumatic group.

The number of patients were 27 in traumatic group and 23 in atraumatic groups. The mean age in traumatic and atraumatic groups was 60 years respectively. These lesions generally occur in elderly with the average 61 years. The male/female ratio 21/6 in traumatic group and 20/3 in atraumatic group. Generally it was predominent in male patients. The causes in atraumatic group were hypertension(2 patients), CVA(3 patients) and the others remain unknown. The neurologic grade at admission ; 0 grade 26(male/female=21/5, 1 grade) 7(m/f=6/1), 2 grade 14(m/f=11/3). The outcome scale according to glasgow scale ; 5 scale 31(m/f=24/7), 4 scale 15(m/f=13/2) and 3 scale 4(m/f=4/0). The outcome scale according to neurologic grade at admission was that the more neurologic grade is good, the more outcome is better.

The burr holed and closed system drainage technique is simple, mininal risk, and results in good recovery with short days of admision. This technique is considered as first choice for the evacuation of hematoma of CDH.

Chronic hydrocephalus is a frequent occurrence after aneurysmal subarachnoid hemorrhage. 14 patients with chronic hydrocephalus and treating with shunting procedure were retrospectively reviewed. Chronic hydrocephalus after aneurysmal subarachnoid hemorrhage was usually recognized when gradual deterioratsm of consciousnes, unexplanied aggrvation of occuring neurologic defists, especially urinary incontinence.

Two-hundred consecutive patients with aneurysmal SAH were admitted to the neuro-surgical department Ewha Womans university Mok-Dong Hospital between fanuary 1994 and fanuary 2001, in all the patients aneurysms clipping was carried out. Among then 14 patient to chronic hydrocephalus following aneurysmal SAH and treating with shunting procedure were reviewed according to consionsnes level(Hunt-Hess classification), amonts of SAH(grading system of Fisher), sites and incidence. The chronic hydrocephalus was diagnosed CT findings in the clinical findings ; deterioration of level of consiousness, aggravation of neurologic deficits and urinary incontinence.

The average age of patients was 51 and predominant in women(man : woman=4 : 10). The incidence of chronic hydrocephalus was 7% and the aneurysmal sites were followings : posterior communicating artery(7), anterior communicating artery(4), and internal carotid artery bifuncation, middle cerebral artery and superior cerebellar artery were 1 respectiviy. According Hunt-Hess Grades were following ; grade I, II, III and IV=1, 6, 3 and 4. The number of patients according to Fisher's grading system were following ; grade 2, 3, and 4=6, 7, and 1. The outcomes by Glasgow assessment were the followings ; Score 5 and 4=9 and 5.

The response to shunting procedure in symptomatic patients of Chronic hydrocephalus following aneurysmal SAH. good in all patients.

It is now generally accepted that lead low doses may influence behavioral and attentional problems in children. The selection of a treatment approach depends on a proper assessment of the cause of the problem. This study was carried out to investigate the relationship between exposure to lead and behavioral and attentional problems in attention deficit hyperactivity disorder(ADHD).

The participants were 62 boys, 6 to 12 years of age with ADHD. Children with probable causes of attentional or behavioral problems other than lead contamination were excluded from the study. Various aspects of behavioral problems were measured using questionnaires for parents and teachers. Attentional problems were measured with TOVA(The Test Of Variability of Attention). As an assessment of body lead burden, lead concentration in blood was measured.

Mean lead concentration in blood was 3.39 1.32µg/dl. Correlations between lead concentration in blood and the possible confounding factors were not significant. The results were same as that of lead concentration in attentional and behavioral problems. Lead concentration was significantly correlated with the scores of TOVA : omission error(r=0.34, p<0.1) ; commission error(r=0.43, p<0.05) ; and variation(r=0.34, p<0.1). Correlations between lead concentration and social withdrawal subscale of CBCL were significant(r=0.33, p<0.01).

It appears that some link between low-level exposure to lead and performances exist.