Neurological manifestations of systemic lupus erythematosus (SLE) can mimic multiple sclerosis (MS) or Devic's syndrome (DS). We report a 16-year-old woman with recurrent myelitis and optic neuritis. She also had an antinuclear antibody, an anti double-stranded DNA antibody and a positive lupus erythematosus cell. Because MS is a diagnosis of exclusion, brainstem involvement is not compatible with DS. We therefore diagnosed her case as a SLE with recurrent myelitis and optic neuritis.
Adolescent ; Antibodies, Antinuclear ; Brain Stem ; Diagnosis ; DNA ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Multiple Sclerosis ; Myelitis* ; Neurologic Manifestations ; Neuromyelitis Optica ; Optic Neuritis*

Multiple gastric caner, now considered to be a sort of multiple primary cancer by Moertel's classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Although its incidence is rare and it has never been reported in Korea yet, the report of multiple gastric cancer is increasing with lengthened life survival and improved diagnostic method. We recently experienced two cases of triple gastric cancer, the one in 53-years-old male who had well differentiated adenocarcinoma(EGC IIb+c) on antrum, poorly differentiated adenocarcinoma on cardia and moderately differentiated adenocarcinoma on mid-body, and the other in 65-years-old female who had two poorly differentiated adenocarcinoma on cardia and anterior wall of low body and moderately differentiated adenocarcinoma (EGCIIc) on posterior wall of low body. Triple gastric cancer is rare, so we reported 2 cases of triple gastric cancer.
Adenocarcinoma ; Cardia ; Classification ; Female ; Humans ; Incidence ; Korea ; Male ; Stomach ; Stomach Neoplasms*

Aspiration pneumonia is usually caused by aspiration of gastric contents during anesthesia. It causes severe pulmonary complications. Povidone iodine was used widely as an oral antiseptic. Although povidone iodine is thought to be a safe and effective antiseptic, severe complications from its aspiration may occur. We present a case of pneumonia secondary to aspiration of povidone iodine in a 16 year old female patient who underwent orofacial surgery. Aspiration pneumonia must be treated immediately. Mechanical ventilation with PEEP and periodical bronchial toilet with fiberoptic bronchoscopy were carried in the operating room and ICU. Bronchodilators, antibiotics, steroids and diuretics were also used to treat pneumonia. The patient was treated successfully without any complication.
Anesthesia ; Anesthesia, General ; Anti-Bacterial Agents ; Bronchodilator Agents ; Bronchoscopy ; Diuretics ; Female ; Humans ; Iodine ; Operating Rooms ; Pneumonia ; Pneumonia, Aspiration ; Povidone-Iodine ; Respiration, Artificial ; Steroids

The authors evaluated whether cataract surgery developed ocular surface changes or not. Fifty three cataract patients were divided into 2 groups according to the method of subconjunctival injection at the end of the operation. In the first group, betamethason was injected in the lower nasal quadrant and gentamicin was injected in the lower temporal quadrant. In the second group, both betamethason and gentamicin were injected together in the lower nasal quadrant. The tear film break-up time and Schirmer test results were reduced significantly after cataract surgery in both groups. Goblet cell numbers were reduced significantly on the 12 o'clock, lower temporal quadrant and lower nasal quadrant conjunctiva, and especially that of the lower quadrant, in which gentamicin was injected, was reduced more. Instilled drug before and after the operation, electric cauterization, conjunctival incision, and subconjunctival injection of drugs, such as gentamicin and betamethason, may induce the precorneal tear film instability.
Cataract* ; Cautery ; Conjunctiva ; Gentamicins ; Goblet Cells ; Humans ; Tears

No abstract available.
Heart* ; Thoracic Surgery* ; Thyroid Gland*

OBJECTIVE: Previous studies have demonstrated that axon regeneration or remyelination after spinal cord injury occurs when provided with a suitable substratum such as fetal spinal cord (FSC). We carry out this study to determine whether FSC transplants can reduce the glial scar at the interface between host and graft. METHODS: Hemisectioned spinal cord injury was made by aspiration at T3 or T4 spinal cord level in rat. Cell suspension of E-14 FSC was introduced into the injured cavity contaning glial scar tissue. To indentify the transplanted cells from host tissue, FSC cells were labeled with DiI. Rats were sacrificed at 1, 2, 3, and 8 weeks after transplanation and spinal cord was undergone serial sections for immunocytochemistry and histological observation. The observation by electron microscope was carried out too. RESULTS: We could observe that the FSC transplants survived in host spinal cord and generally occupied most of the neuron-depleted area. Examination of serial sections through the graft-host interface which had been immunoreacted for glial fibrillary acidic protein demonstrated that the glial scar was no longer a continuous wall separating the graft and host tissues at eight weeks after injury. We could observe oligodendrocyte and the reformed myelin at the interface by electron microscope. CONCLUSION: The fetal spinal cord transplant can reduce an established glial scar or restrict the reformation of a scar following surgical manipulation, and that the FSC transplant can promote remyelination.
Animals ; Axons ; Cicatrix ; Glial Fibrillary Acidic Protein ; Immunohistochemistry ; Myelin Sheath ; Oligodendroglia ; Rats* ; Regeneration ; Spinal Cord Injuries ; Spinal Cord* ; Transplants

PURPOSE: This study was aimed to determine the predictive risk factors for the treatment response and relapse rate in children diagnosed with idiopathic nephrotic syndrome. METHODS: We analyzed the medical records of children who were diagnosed and treated for childhood idiopathic nephrotic syndrome from November 1991 to May 2005. Variables selected in this study were age at onset, sex, laboratory data, concomitant bacterial infections, days to remission, and interval to first relapse. RESULTS: There were 46 males and 11 females, giving a male:female ratio of 4.2:1. The age(mean+/-SD) of patients was 5.8+/-4.1 years old. Of all patients who were initially given corticosteroids, complete remission(CR) was observed in 54(94.7%). Of the 54 patients who showed CR with initial treatment, 40(70.2%) showed CR within 2 weeks and 14(24.6%) showed CR after 2 weeks. The levels of serum IgG were lower in the latter group who showed CR after 2 weeks(P=0.036). Of the 54 patients who showed CR with initial treatment, 47(82.5%) relapsed. Of these patients, 35.1% were frequent relapsers and 43.9% were infrequent relapsers. There was no significant correlation between the frequency of relapse and the following variables:sex, days to remission, and laboratory data. However, age at onset and interval to first relapse had a negative correlation with the frequency of relapse (Pearson's coefficient=-0.337, -0.433, P<0.012, P<0.01). CONCLUSION: The age at onset and the interval to first relapse were found to be predictive clinical parameters for the relapse rate, while the levels of serum IgG at initial presentation were a predictive laboratory factor for treatment response in childhood idiopathic nephrotic syndrome.
Adrenal Cortex Hormones ; Bacterial Infections ; Child ; Female ; Humans ; Immunoglobulin G ; Male ; Medical Records ; Nephrotic Syndrome* ; Recurrence* ; Risk Factors

For the evaluation of exercise induced R wave amplitude changes in lead V5 (big up tri, openR) and multiple leads(summation operatorR), we studied 20 normal subjects and 21 ischemic heart disease patients with positive exercise test. All underwent submaximal, multiple leads multistage treadmill exercise testing. 14 to 20 normal subjects(70%) there were decreased R wave amplitude in multiple leads on treadmill exercise testing. 16 of 21 patients(76%) there were increased R wave amplitude on treadmill exercise testing. In normal group, R wave amplitude between rest and exercise was significantly decreased in lead V5 and multiple leads. In patients grous, R wave amplitude between rest and exercise was significantly increased in lead V5 and multiple leads. It is suggested exercise induced R wave amplitude changes probably enhance the diagnostic reliability by ST segment changes on treadmill exercise testing.
Exercise Test* ; Humans ; Myocardial Ischemia

No abstract available.
Humans ; Lung Neoplasms* ; Lung*

BACKGROUND: Bupivacaine is a amide type local anesthetic agent, widely used for its excellent quality of analgesia and long duration of action. But unintended intravenous injection causes severe complication such as convulsion and cardiovascular collapse, which is known for its difficulty in resuscitation. With all the study, the exact mechanism is still unclear and there are much debate on the method of resuscitation. METHOD: We studied the effect of clonidine pretreatment on bupivacaine-induced cardiac toxicity and resuscitation in anesthetized dog. Twelve dogs were divided into two groups. : saline pretreatment group (control, N=6) and clonidine pretreatment group (clonidine group, N=6). The dogs were anesthetized with N2O-O2-enflurane and vecuronium. Thoracotomy was done in 4th or 5th intercostal space for open cardiac massage. After confirming stability of vital signs, we administered clonidine (10 mcg/kg) or saline, and then administered bupivacaine with the rate of 2 mg/kg/min. When the electeocardiogram showed asystole, 20 mcg/kg of epinephrine was administered via central venous line and open cardiac massage with the rate of 120 beat/min. was performed. We observed electrocardiogram (lead II), arterial blood pressure, heart rate, dose of infused bupivacaine to be required for QRS widening and arrest, required time and administered dose of epinephrine for resuscitation. RESULTS: Clonidine group showed significant decrease of heart rate after pretreatment (p<0.05). There was no significant difference in required dose for QRS widening between two groups. The dose administered for inducing arrest was less in clonidine group than control group (p<0.05). The time required for resuscitation was shorter in clonidine group than control group (p<0.05). The total dose of epinephrine required for resuscitation was less in clonidine group than control group (p<0.05). The blood concentration of catecholamine did not showed significant difference during the whole course of experiment. CONCLUSIONS: Above results demonstrated that clonidine, a central nervous system-mediated sympatholytic agent, facilitated cardiac arrest when bupivacaine was infused intravenously and cardiac rescucitation.
Analgesia ; Animals ; Arterial Pressure ; Bupivacaine ; Clonidine* ; Dogs* ; Electrocardiography ; Epinephrine ; Heart Arrest ; Heart Massage ; Heart Rate ; Injections, Intravenous ; Resuscitation* ; Seizures ; Thoracotomy ; Vecuronium Bromide ; Vital Signs