This clinical trial was undertaken on 32 infants and chhildren who had G-I symptoms caused by a few diseases, such as meningitis, parenteral infection and intestinal infection. Out of 32 patients, six had vomiting only, caused by meingitis and habitual vomiting, eighteen had vomiting and diarrhea both which caused by parenteral infection and rest of them (8) had diarrhea only, caused by intestinal infection. Polybutine syrup, which 5.0 ml contain 24 mg of trimebutine, was given to these patients as follows; 2.5 ml twice a day at 6 months of age, 5.0 ml twice a day at 6 months to one year and 10 ml three times a day at 1-5 years of age. In ten of 24 patients, who had vomiting only (6), vomiting and diarrhea (18), the symptoms were improved within 48 hours, and rest of them (10) was also shown the improvement of their symptoms within 5 days after medication. In comparison of polybutine treated group and not treated group, the effectiveness of polybutine treatment for the symptoms was statistically meaningful.
Diarrhea ; Humans ; Infant ; Meningitis ; Trimebutine ; Vomiting

Hydrops fetalis is diagnosed when abnormal fluid collections are manifest in two or more fetal compartments, including abdominal ascites, pleural effusions, pericardial effusions, skin edema, polyhydroamniosis and placental edema. Although fetal hydrops was hystorically most commonly associated with Rh blood group isoimmunization, the availability of Rh immunoglobulin has increased the proportion of fetuses affected due to nonimmune etiologies. We have experienced a case of nonimmune hydrops fetalis at 32 weeks of gestation in a 27-year-old woman and reported that with brief review of related literatures.
Adult ; Ascites ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Immunoglobulins ; Pericardial Effusion ; Pleural Effusion ; Pregnancy ; Skin

No abstract available.
Atrial Fibrillation* ; Mitral Valve Stenosis*

PURPOSE: Gastric stump cancer is defined as a cancer that develops in the stomach after a resection in cases of non-malignant or malignant gastric disease. The interval between the gastrectomy and the detection of gastric stump cancer must be over 5 years. Since duodenogastric reflux gastritis is a precancerous condition and one of the most important factors inducing gastric stump cancer, we compared the bile-acid content of gastric juice between gastric stump cancer patients and controls. MATENRIALS AND METHODS: To evaluate retrospectively the surgical treatment of patients with gastric stump cancer, we reviewed the cases histories of 1016 stomach cancer patients who had been operated on at the Department of General Surgery, Kosin University Gospel Hospital, between 1995 and 1998. The gastric juice was collected during the operations on the gastric stump cancer patients by using a needle puncture of the fundus of the stomach and during the endoscopic examinations of the control subjects. The samples were analyzed for various bile acids (gas chromatography/mass spectrometry). RESULTS: The 6 gastric stump cancer cases accounted for 0.6% of all gastric cancer patients; 5 patients were first operated on for a peptic ulcer and the remaining one for an adenocarcinoma of the stomach. All of the cases were men. The reconstruction method after the initial gastrectomy was a Billroth II in all cases. The sites of the gastric stump cancer were the anastomotic sitein 2 patients, the upper body in 2, the fundus in 1 and the cardia in 1. The operative methods were 3 total gastrectomies, 2 subtotal gastrectomies with Roux en Y anastomosis, and 1 partial gastrectomy with lymph node dissection and had a curative intention in all patients. All of the patients were still surviving at the time of this report. The gastric juices of 4 gastric stump patients showed significantly higher contents of cholic acid (36.42microgram/ ml) compared to the gastric juices of 35 control subjects (12.82microgram/ml)(p< or =0.0001). Chenodeoxycholic acid and lithocholic acid were not significantly different. CONCLUSION: The gastric juice of gastric stump cancer patients contained a significantly higher cholic acid content. At the time of the initial gastrectomy, an operative method that prevents duodenogastric reflux may prevent or minimize the development of gastric stump cancer, and more aggressive surgical treatment may improve survival.
Adenocarcinoma ; Anastomosis, Roux-en-Y ; Bile Acids and Salts ; Cardia ; Chenodeoxycholic Acid ; Cholic Acid ; Duodenogastric Reflux ; Gastrectomy ; Gastric Juice ; Gastric Stump* ; Gastritis ; Gastroenterostomy ; Humans ; Intention ; Lithocholic Acid ; Lymph Node Excision ; Male ; Needles ; Peptic Ulcer ; Precancerous Conditions ; Punctures ; Retrospective Studies ; Stomach ; Stomach Diseases ; Stomach Neoplasms

Renal biopsy is an essential diagnostic tool for detecting acute and chronic kidney rejection as well as recurrent and de novo nephropathies in renal allograft recipients. However, a well-known complication of percutaneous renal biopsy is arteriovenous fistula (AVF). Most post-biopsy AVFs are asymptomatic and regress spontaneously but some AVFs result in hypertension, hematuria, and renal insufficiency. Whether post-biopsy AVF superimposed on transplant renal artery stenosis (TRAS) also regresses spontaneously is unknown. We present a case of acute renal insufficiency in a 51-year-old female renal allograft recipient with post-biopsy AVF and TRAS. Percutaneous angioplasty with stent implantation was performed for the TRAS and transcatheter arterial coil embolization therapy applied for AVF. The patient's renal function returned to baseline levels and is currently being followed up for 6 months.
Acute Kidney Injury ; Angioplasty ; Arteriovenous Fistula ; Biopsy ; Female ; Hematuria ; Humans ; Hypertension ; Kidney ; Rejection (Psychology) ; Renal Artery ; Renal Artery Obstruction ; Renal Insufficiency ; Stents ; Transplantation, Homologous ; Transplants

Acute fulminant invasive fungal sinusitis in an immunocompromised host and bacterial rhinosinusitis with intracranial or orbital extension is challenging to manage. And it sometimes constitutes true otolaryngologic emergencies. In the absence of rapid diagnosis and treatment, these diseases can be fatal. A 57-year-old female was admitted for chills and headache, who received a deceased donor renal transplantation 3 months ago. Paranasal sinus CT showed enhanced soft tissue density and MRI showed low-signal with hyperintense signal of around paranasal sinus cavity. The histological investigation revealed invasive aspergillosis of paranasal sinuses. Clinical improvement occurred after endoscopic sinus surgery and post-operative systemic antifungal therapy with amphotericin B and voriconazole.
Amphotericin B ; Aspergillosis ; Chills ; Emergencies ; Female ; Headache ; Humans ; Immunocompromised Host ; Kidney ; Kidney Transplantation ; Middle Aged ; Orbit ; Paranasal Sinuses ; Pyrimidines ; Sinusitis ; Tissue Donors ; Triazoles

Dexamethasone converts pluripotent pancreatic AR42J cells into exocrine cells expressing digestive enzymes. In order to address molecular mechanism of this differentiation, we have investigated the role of mitogen-activated protein (MAP) kinase pathway and gene expressions of p21(waf1/cip1)and nuclear oncogenes (c-fos and c-myc) during AR42J cell differentiation. Dexamethasone markedly increased the intracellular and secreted amylase contents as well as its mRNA level. However, cell growth and DNA content were significantly decreased. With these phenotypic changes, AR42J cells induced transient mRNA expression of p21(waf1/cip1)gene, which reached maximal level by 6 h and then declined gradually toward basal state. In contrast to p21(waf1/cip1), c-fos gene expression was transiently inhibited by 6 h and then recovered to basal level by 24 h. Increased c-myc expression detected after 3 h, peaked by 12 h, and remained elevated during the rest of observation. Dexamethasone inhibited epidermal growth factor-induced phosphorylation of extracellular signal regulated kinase. Inhibition of MAP kinase pathway by PD98059 resulted in further elevation of the dexamethasone-induced amylase mRNA and p21(waf1/cip1)gene expression. These results suggest that p21(waf1/cip1)and nuclear oncogenes are involved in dexamethasone-induced differentiation and inhibition of MAP kinase pathway accelerates the conversion of undifferentiated AR42J cells into amylase-secreting exocrine cells.
Amylases/genetics ; Animals ; Cell Differentiation/*drug effects ; Cell Division/drug effects ; Cell Line, Tumor ; Cyclins/genetics/*metabolism ; Dexamethasone/*pharmacology ; Gene Expression Regulation/drug effects ; Genes, fos/genetics ; Genes, myc/genetics ; MAP Kinase Signaling System/*drug effects ; Mitogen-Activated Protein Kinases/*metabolism ; Pancreas/cytology/*drug effects/enzymology/metabolism ; RNA, Messenger/genetics/metabolism ; Rats ; Support, Non-U.S. Gov't

Transplant renal artery stenosis (TRAS) is an important cause of hypertension, allograft dysfunction, and graft loss. Patient and allograft survival rates are lower in patients with TRAS. Causes of TRAS include acute rejection, cytomegalovirus infection, calcineurin inhibitor toxicity, atherosclerosis of recipient, and/or donor. Technical problems due to surgery are a common cause of early TRAS. A 62-year-old male in end stage renal disease received kidney transplant surgery. There was 5/6 mismatch of human leukocyte antigen and the panel reactive antibody of patient was class I 0% and class II 0%. End to side anastomosis was done between the graft's renal artery and the patient's common iliac artery. His serum creatinine was measured at 6.4 mg/dL before transplantation but his serum creatinine level did not fall below 2.6 mg/dL at 5 days postoperative. His blood pressures was 160/90~180/100 mmHg. There was a significant TRAS (about 80% luminal narrowing) at the arterial anastomosis site on the renal magnetic resonance angiography. We performed percutaneous transluminal angioplasty (PTA) for the stenotic lesion. The balloon angioplasty was done with a 5 mm balloon and low pressure (8 mmHg, nominal pressure was 10 mmHg) at the stenotic lesion. The arterial pressure gradient was 8 mmHg (recipient's common iliac arterial pressure, 147/73 mmHg; poststenotic segmental renal arterial pressure, 139/70 mmHg) just before the balloon angioplasty. After PTA, the arterial pressure gradient became 3 mmHg (recipient's common iliac arterial pressure, 157/66 mmHg; poststenotic segmental renal arterial pressure, 154/65 mmHg). The arterial size and blood flow recovered to within normal range and serum creatinine level was normal after PTA. PTA using low pressure and a small balloon was safe and effective modality in treating early TRAS.
Allografts ; Angioplasty ; Angioplasty, Balloon* ; Arterial Pressure ; Atherosclerosis ; Calcineurin ; Creatinine ; Cytomegalovirus Infections ; Humans ; Hypertension ; Iliac Artery ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Leukocytes ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Phenobarbital ; Reference Values ; Renal Artery Obstruction* ; Renal Artery* ; Survival Rate ; Tissue Donors ; Transplants