Dubin-Johnson Syndrome is a form of benign, familial idiopathic jaundice presenting with chronic intermittentconjugated hyperbilirubinnmia and a melamin-like pigment has been found in the parenchymal liver cells. This disorder is rarely diagnosed in the neonatal period. We report a case of Dubin-Johnson syndrome presenting with neonatal cholestasis.
Cholestasis ; Jaundice ; Jaundice, Chronic Idiopathic* ; Liver

Dubin-Johnson Syndrome is a form of benign, familial idiopathic jaundice presenting with chronic intermittentconjugated hyperbilirubinnmia and a melamin-like pigment has been found in the parenchymal liver cells. This disorder is rarely diagnosed in the neonatal period. We report a case of Dubin-Johnson syndrome presenting with neonatal cholestasis.
Cholestasis ; Jaundice ; Jaundice, Chronic Idiopathic* ; Liver

The accidental swallowing of foreign body is a common problem in the children. We describe the case of 37-month-old girl in whom a gastric ulcer was caused by the ingestion of three magnets. This case report demonstrates that if more than one magnet were swallowed, they should be removed even if there are no sharp edges and small size. Because the magnets will attract each other and hold the intestinal walls between them, causing necrosis and resulting in intestinal perforation or a fistula.
Child ; Child, Preschool* ; Deglutition ; Eating* ; Female* ; Fistula ; Foreign Bodies ; Humans ; Intestinal Perforation ; Necrosis ; Stomach Ulcer*

Bacterial endophthalmitis is an ocular emergency that requires rapid diagnosis and therapeutic decision making. The introdection of intravitreal injection of antibiotics has been a major advancement because it has resulted in a marked improvement in visual outcome. The intravitreal injection of steroids may be potentially useful in the treatment of endophthalmitis and other ocular inflammatory diseases. Forty eyes of pigmented rabbits were used, and divided into two groups. Group I was eyes without vitrectomy. In the right eye, 100 microliter of 1mgvancomycin, 400 microliter amikacin and 400 microliter dexamethasone injected was done. Group II was eyes with vitrectomy and lensectomy. At 2 weeks after lens and vitreous removal, rabbit eyes received an injection of a combination of 1mg vancomycin, 400 microliter amikacin and 400 microliter dexamethasone in right eye and BSS in left eye. The effect of combination injection was examined by light and transmission, scanning electron microscope at 3 days, 1 week, 2 weeks and 6 weeks following injection. The injection of combination without vitrectomy produced no toxicity. After injections of either combination or BSS after vitrectomy, macrophages were observed on the surface of retinal pigment epithelium and disorganized outer segments. This finding seems to be produced by vitrectomy procedure rather than drug toxicity. These results supports the hypothesis that the injection of these combinations is not toxic to aphakic/vitrectomized eyes.
Amikacin ; Anti-Bacterial Agents ; Decision Making ; Dexamethasone* ; Diagnosis ; Drug-Related Side Effects and Adverse Reactions ; Emergencies ; Endophthalmitis ; Intravitreal Injections ; Macrophages ; Rabbits ; Retinal Pigment Epithelium ; Steroids ; Vancomycin ; Vitrectomy*

PURPOSE: To report a case of non-arteritic anterior ischemic optic neuropathy (NAION) in a patient on hemodialysis. CASE SUMMARY: A 59-year-old female undergoing intravenous hemodialysis developed sudden blurred vision for 2 days. Chronic hypotension and anemia may have been persisted for approximately 6 months before the onset of symptoms. Her corrected visual acuity in both eyes was 0.7 and visual field test showed superior arcuate defect in the left eye. Fundus photography showed inferonasal optic disc swelling and fluorescein angiography revealed hyperfluorescence of the disc in the late phase which was probably attributable to NAION. After 3 weeks, corrected visual acuity was 0.7 in the left eye and fundoscopic finding of the left eye was improved. CONCLUSIONS: Hemodialysis can cause a hypotensive event and anemia which may be associated with NAION. Avoiding acute hypotension and anemia should be advised to prevent development of NAION in dialysis patients.
Anemia ; Dialysis ; Female ; Fluorescein Angiography ; Humans ; Hypotension ; Middle Aged ; Optic Neuropathy, Ischemic* ; Photography ; Renal Dialysis* ; Visual Acuity ; Visual Field Tests

PURPOSE: This study was performed to know the mothers' recognition of childhood obesity because the mothers' role is essential for management in childhood. METHODS: Seven hundred and seventy two mothers who visited pediatrics clinics in five regional cities(Daegu, Kumi, Waekan, Kyungsan and Youngchun) were include in a questionnaire survey concerning childhood obesity. The questionnaire was anonymous and filled in by the mothers themselves. RESULTS: Most of the mothers perceived childhood obesity as a serious disease. Sources of acquisition of knowledge about obesity were health programs on TV or radio(70.3%), advertisements in newspapers or magazines(44.0%) and from neighbors or relatives(20.0%) and hospitals or clinics(3.0 %). Mothers wish to acquire more knowledge about childhood obesity by health programs on TV or radio(43.8%) and hospitals or clinics(35.9%). The most common apprehensions of mothers carring out their childrens' obesity management program was psychologic stress(63.6%). If children were obese, almost all mothers wanted to treat them by various methods. CONCLUSION: For the more efficient management of childhood obesity, doctors' role in consultation and management should be emphasized.
Anonyms and Pseudonyms ; Child ; Gyeongsangbuk-do ; Humans ; Mothers ; Periodicals ; Obesity ; Pediatric Obesity* ; Pediatrics ; Surveys and Questionnaires

Phospholipase D (PLD) is an enzyme involved in signal transduction and widely distributed in mammalian cells. The signal transduction pathways and role for phospholipid metabolism during hormonal response in cortical collecting duct remain partly undefined. It has been reported that dexamethasone increases transepithelial transport in M-1 cells that are derived from the mouse cortical collecting duct. We investigated the expression and activity of PLD in M-1 cells. Basal PLD activity of M-1 cells cultured in the presence of dexamethasone (5 microM) was higher than in the absence of dexamethasone. Dexamethasone and ATP activated PLD in M-1 cells but phorbol ester did not stimulate PLD activity. Vasopressin, bradykinin, dibutyryl cyclic AMP, and ionomycin were ineffective in activating PLD of the cells. The PLD2 isotype was detected by immunoprecipitation but PLD1 was not detected in M-1 cells. Addition of GTPgammaS and ADP-ribosylation factor or phosphatidylinositiol 4,5-bisphosphate to digitonin-permeabilized cells did not augment PLD activity. In intact cells PLD activity was increased by sodium oleate but there was no significant change between dexamethasone treated- and untreated cells by oleate. These results suggest that at least two types of PLD are present in M-1 cells and PLD plays a role in the corticosteroid-mediated response of cortical collecting duct cells.
Animal ; Biological Transport/drug effects ; Dexamethasone/pharmacology* ; Dose-Response Relationship, Drug ; Drug Interactions ; Glycerophospholipids/analysis ; Isoenzymes/drug effects ; Kidney Cortex/cytology ; Kidney Tubules, Collecting/drug effects* ; Kidney Tubules, Collecting/cytology ; Mice ; Mice, Transgenic ; Oleic Acid/pharmacology ; Phospholipase D/drug effects*

BACKGROUND: Results of automated clinical chemistry tests are affected by many factors including analytical variability. In 1976, the College of American Pathologists (CAP) Conference on the analytical goals in clinical chemistry recommended that analytical variability should be less than 1/4 of the appropriate biological variability to improve distinction between normal and diseased populations. This study is conducted to evaluate whether automated clinical chemisty analyses performed in our laboratory is in conformance with the CAP's recommendation. METHODS: Routine chemistry and electrolyte tests were performed using Hitachi 747 automatic analyzer on 22 healthy volunteers. Blood samples were obtained from the volunteers' same vein twice in one week interval to study the total variability. Serum samples from 12 subjects were tested in duplicate immediately after blood collection for within-run analytical variability; and samples from another 10 subjects were repeated after 6 hours for within-day analytical variability. Within-run analytical variability plus within-day analytical variability make total analytical variability. Biological variability was defined as the difference between total variability and the analytical variability. Finally, ratios of analytical and biological variabilities were calculated. RESULTS: The ratios of analytical and biological variabilities of uric acid, glucose, and K were less than 0.25. But ratios of BUN, PO4, alkaline phosphatase, total bilirubin, AST, cholesterol, ALT, Cl, and protein exceeded 0.25. The ratios of Na, Ca, albumin, CO2, and creatinine could not be calculated. CONCLUSIONS: It is suggested that the analytical processes of the automated clinical chemistry tests be improved so as to be in conformity with the CAP's recommendation.
Alkaline Phosphatase ; Bilirubin ; Chemistry ; Chemistry, Clinical* ; Cholesterol ; Clinical Chemistry Tests* ; Creatinine ; Glucose ; Healthy Volunteers ; Uric Acid ; Veins

PURPOSE: Recently, there has been a marked increase in childhood obesity, and that has aroused social concern. Obesity increases several metabolic disease such as hypertension, diabetes, fatty liver, heart disease and the mortality rate. Complications of obesity are more closely related with the accumulation of visceral fat. Therefore, fundamental treatment of obesity Should be the reduction of body fat. Exercise is the best way to reduce body fat, especially to consume the free fatty acid released from adipocytes. However, it is anticipated that children's response to exercise could differ from adult's. This research was done to find the difference adaptations of energy metabolisms in exercises between children and adults. METHODS: Sprague-Dawley male rats were divided into a young group(two-three months old), adult group(six months old) and an old group(fifteen months old). At fed ad libitum, O2 consumption and CO2 production were measured before and after the exercise. Before and after fasting for 24 hours, O2 consumption and CO2 production were measured. After fasting for 24 hours, the blood was taken to analyse the plasma glucose and free fatty acid. RESULTS: The fasting oxygen consumption decreased only in young rats compared with that of the fed state. The fasting respiratory quotient was decreased in the young and adult rats compared with those of the fed state. The post exercise oxygen consumption was increased in the young and adult rats but not in the old rats. The post-exercise respiratory quotient was decreased only in the young rats. There was no significant change of plasma glucose and free fatty acid between fed and fasting state in the young rats, while the fasting glucose levels were increased in the adult and old rats. CONCLUSION: These results mean that the responses to fasting and exercise differ among rats of different age groups and young rats can burn fat more easily during exercise and fasting than those of the adult and old rats because of the better metabolic flexibility of young rats.
Adipocytes ; Adipose Tissue ; Adult ; Animals ; Blood Glucose ; Burns ; Child ; Energy Metabolism ; Exercise ; Fasting* ; Fatty Liver ; Glucose ; Heart Diseases ; Humans ; Hypertension ; Intra-Abdominal Fat ; Male ; Metabolic Diseases ; Mortality ; Obesity ; Oxygen Consumption ; Pediatric Obesity ; Pliability ; Rats* ; Rats, Sprague-Dawley

PURPOSE: To report a case of sudden orbital cellulitis presenting 2 weeks after strabismus surgery in a patient who had previously undergone retinal surgery for rhegmatogenous retinal detachment. CASE SUMMARY: A 45-year-old male visited the ophthalmology clinic with a 3-day history of left eye pain and lid swelling which suddenly developed 2 weeks after left lateral rectus muscle recession surgery for secondary sensory exotropia. The patient had undergone trans pars plana vitrectomy twice, scleral encircling, oil injection and removal for rhegmatogenous retinal detachment 1.3 years prior. His best corrected visual acuity was 0.2 in his left eye and physical examination revealed eyelid edema, chemosis, and subconjunctival hemorrhage of the left eye. The next day, eye movements were moderately restricted. Computed tomography scanning with contrast enhancement demonstrated diffuse periorbital soft tissue swelling and enhanced fat stranding suggesting left orbital cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. He was discharged after a 5-day course of intravenous antibiotic treatment, but readmitted for symptom aggravation and purulent discharge from the left conjunctival fornix. Culture of conjunctival fornices revealed penicillin-resistant staphylococcus aureus. Intravenous anitibiotics were maintained for 11 days additionally and left eye swelling, tenderness and ocular movement restrictions were improved. The patient was discharged from the hospital with a best corrected visual acuity of 0.2.
Anti-Bacterial Agents ; Edema ; Exotropia ; Eye ; Eye Movements ; Eye Pain ; Eyelids ; Hemorrhage ; Humans ; Male ; Muscles ; Ophthalmology ; Orbit ; Orbital Cellulitis ; Physical Examination ; Retinal Detachment ; Retinaldehyde ; Staphylococcus aureus ; Strabismus ; Visual Acuity ; Vitrectomy