No abstract available.
Funnel Chest*

No abstract available.
Pneumothorax* ; Thoracotomy*

PURPOSE: Cerebral palsy or hearing disability of hyperbilirubinemic complication was reduced by blood exchange transfusion(BET) and phototherapy(PT). But in spite of these treatment, abnormal Auditory Brainstem evoked Response(ABR) finding after BET or PT and neurodevelopmental defect due to chronic bilirubin encephalopathy were observed. So we have studied risk factors and outcome of chronic bilirubin encephalopathy after BET, and treatment of hyperbilirubinemia. METHODS: We have analyzed clinical characteristics, the finding and change of ABR after BET in 17 hyperbilirubinemic neonates, and in 8 hyperbilirubinemic neonates who were treated by phototherapy and 15 normal control neonates. RESULTS: 1) Mean bilirubin concentraion were 27.5+/-4.1mg/dL in BET group and 22.1+/-2.3 mg/dL in PT group. There were no difference of clinical findings between BET and PT group. 2) Change of ABR (1) Wave I loss resulted in 4 neonates, wave III loss in 3 neonates, and wave V loss in 2 neonates in BET group(P<0.05). (2) Wave I peak latency and hearing threshold in BET group were significantly increased more than normal control group(P<0.01). 3) In 10 neonates(58.8%) among 17 BET group, 4 neonates(50%) in 8 PT group were observed abnormal initial ABR finding after jaundice treatment. Age at treatment and duration of jaundice(interval between onset of jaundice and treatment) in abnormal ABR group were significant prolongation compared with normal ABR group(P<0.05). 4) Chronic bilirubin encephalopathy(CBE) was observed in 3 neonates(17.6%) among 17 BET group and showed higher of bilirubin level than normalized group after BET (31.1mg/dL vs 26.6mg/dL), other clinical findings showed no significant differences. CONCLUSION: Bilirubin level was significantly elevated in CBE more than in BET group and duration of jaundice, age at treatment were longer in abnormal ABR group than in normal ABR group. So not only bilirubin level but also duration of jaundice shoud be considered at jaundice treatment, and ABR has a potential utility in detection of acute brain toxicity of bilirubin and follow up evaluation of bilirubin encephalopathy.
Bilirubin ; Brain ; Brain Stem ; Cerebral Palsy ; Follow-Up Studies* ; Hearing ; Humans ; Hyperbilirubinemia ; Infant, Newborn* ; Jaundice ; Kernicterus ; Phototherapy* ; Risk Factors

BACKGROUND: The electrophysiological effects of purinergic receptor agonists, adenosine triphosphate(ATP) and adenosine were examined using conventional microelectrode technique in rat atrial muscle fibers under superfused with a normal or a simulated ischemic(hypoxic, hyperkalemic and acidotic) physiologic salt solution(PSS) in vitro. METHODS: Action potential parameters, such as maximal diastolic potential(MDP), action potential amplitude(APA), rate of phase 0 depolarization(dv/dtmax) and action potential duration(APD90) were measured in electrically paced, physiologic salt solution(Tyrode's) superfused left rat atrium. In the experiment of ischemic simulation in vitro, normal physiologic salt solutions(NPSS0 were modified(MPSS) and superfused in substitute for normal Tyrode's solution. To investigate the effects of purinergic receptor agonists, ATP or adenosine was added to the superfused tyrode's solutions(NPSS or MPSS) in molar concentration. RESULTS: Under superfused with normal PSS, ATP(10(-3), 10(-4)M) elicited slight hyperpolarization in MDP, and both ATP(10(-6)-10(-3)M) and adenosine(10(-6)-10(-3)M) shortened the duration of normal action potential in a dose-dependent manner. The other paramaters were not affected by the drugs. Superfusion with ischemic PSS caused reductions in MDP as well as APA, dv/dtmax and, especially, APD90. The effects produced by the initial 10 minutes of superfusion with ischemic PSS almost completely disappeared during a subsequent period of continued superfusion with normal PSS, but, those by the initial 20 min lasted in some degree. Both ATP(10(-4)M) and adenosine(10(-4)M) attenuated the reduction in the rate of phase 0 depolarization and the amplitude of the action potential amplitude produced by the ischemic PSS. CONCLUSION: Purinergic receptor agonists, ATP and adensoine, caused a concentration-dependent shortening of the action potential duration in rat atrial muscle fibers and they attenuated the reductions in the rate of phase 0 depolarization and action potential amplitude in fibers superfused with ischemic PSS.
Action Potentials ; Adenosine ; Adenosine Triphosphate ; Animals ; Ischemia ; Microelectrodes ; Molar ; Purinergic Agonists* ; Rats ; Receptors, Purinergic

Luteal phase defect (LPD) is an ovulatory disorder of considerable clinical importance that leads to delayed endometrial maturation and inadequate endometrium for blastocyst implantation. This disorder is implicated in infertility and recurrent spontaneous abortion. We analyzed the endometrial histological maturation, and the estrogen receptor(ER) and progesterone receptor(PR) status in patients with unexplained delayed ovulation, and in patients with ovulation induction by clomiphen citrate. The purpose of this study was to determine whether the length of the follicular phase influences the endometrial histological maturation and the hormonal receptor status, and to know the effect of clomiphen citrate on the endometrium. In the delayed ovulation group, the endometrium was characterized by an irregular outpouching and dilated lumina of the glands, a decreased secretory activity and predecidualization, and a decreased number of granulocytes in the stroma. In the clomiphen citrate-ovulation induction group, glandular proliferation was markedly diminished with poorly convoluted and narrow glands, secretory activity was decreased, stroma was undecidualized, and there was an absence of granulocytes. ER expression was increased in the glandular epithelium in the delayed ovulation group, and both ER and PR expressions were markedly decreased in the glandular epithelium and stromal cells in the ovulation induction group. Endometrial maturation and differentiation may be diminished by increased estrogenic and relatively deficient progesterone effects in patients with delayed ovulation. The hormonal receptor status might also be influenced by hormonal changes. Clomiphen citrate successfully induced ovulation in patients with delayed ovulation, however, endometrial proliferation and maturation were markedly suppressed. This might be related to the lower pregnancy rate and higher abortion rate in patients with clomiphen citrate induced ovulation.
Pregnancy ; Female ; Humans

No abstract available.
Humans ; Nurseries*

No abstract available.
Diabetes Mellitus, Type 1* ; Echocardiography*

No abstract available.
Pierre Robin Syndrome*

No abstract available.
Hypereosinophilic Syndrome*

The results of Brain CT in 93 children with seizure and or other neurologic problems are evaluated in relation to the age of onset, patients' history, final diagnosis & EEG. The overall incidence of abnormal scans were 78.5% in our series. Analysis of CT results showed that the incidence of abnormal scan was closely related to the following criteria. 1. Patients with onset of neurologic problems during the age of 1 year, have a higher incidence of abnormal CT scans(87.5%), particularly if the onset was below 1 month of age. (93.8%), Also the results of CT were markedly different between the age under the 6 years and the age above the 6 years. In the former group of paients, brain atrophy and hydrocephalus were the most common cause of abnormal findings and in the latter group, brain tumor and vascular lesions. 2. Patients with a first attack of seizure have a higher incidence of abnormal scans than that of recurrent attacks(87%, 75%). 3. CT was particularly valuable for the diagnosis of tumor, complicated with meningitis, congenital hydrocephalus, vascular lesions, tuberous sclerosis, infarction, abscess, congenital toxoplasmosis & skull fracture. 4. Patients with focal slowing or focal spike with focal slowing on EEG findings manifested significant positive results on CT scan.(93.4%, 100%). 5. The number of patients who revealed abnormalities on contrast enhancement were 13 patients Among those 13 patients, 4 patients were with tuberculous meningitis and these all 4 patients showed characteristic findings of hydrocephalus with prominent basal and Sylvian fissure enhancement after injection of intravenous contrast media. 6. No. particular correlationship was noticed between simple skull roentgenorraphy and brain CT scan in the diagnosis of intracranial pathology except in the detection of skull fracture & large calcification.
Abscess ; Age of Onset ; Atrophy ; Brain Neoplasms ; Brain* ; Child ; Contrast Media ; Diagnosis ; Electroencephalography ; Humans ; Hydrocephalus ; Incidence ; Infarction ; Meningitis ; Pathology ; Pediatrics* ; Seizures ; Skull ; Skull Fractures ; Tomography, X-Ray Computed ; Toxoplasmosis, Congenital ; Tuberculosis, Meningeal ; Tuberous Sclerosis