Patients with achondroplasia manifest various neurologic symptoms including megaencephaly, hydrocephalus, and progressive myelopathy or radiculopathy secondary to spinal stenosis. However, only anecdotal postmortem reports proved ruptured aneurysm or vascular malformation as a source of intracranial hemorrhage. We herein report a case of a 26-year-old woman with achondroplasia who underwent uneventful surgical treatment for the aneurysmal subarachnoid hemorrhage. In this literature, we review the pathophysiologic mechanism and emphasize the necessity of considering the possibility of sudden mental deterioration in achondroplastic patient.
Achondroplasia* ; Adult ; Aneurysm* ; Aneurysm, Ruptured ; Female ; Humans ; Hydrocephalus ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Neurologic Manifestations ; Radiculopathy ; Spinal Cord Diseases ; Spinal Stenosis ; Subarachnoid Hemorrhage* ; Vascular Malformations

To evaluate the effect of cetylpyridinium chloride in a powder form when used concomitantly with a conmercial fleuride containing tooth paste on inhibition of plaque formation, on gingivitis, and on irritation of oral mucosa. a double-blind, randomized parallel study was set up. Cetylpyridinium chloride was incorporated into a light brown colored powder with menthol added for scent. There were no differences between the active agent and the placebo which did not contain cetylpyridinium chloride in appearance, color, smell, taste, or dispenser. 98 healthy volunteers were assigned to one of two groups: brushing 3 times a day with flouride toothpaste and cetylpyridinium chloride powder, or brushing 3 times a day with flouride toothpaste and placebo. Before the test period, the subjects received through tooth cleaning and polishing. At basteline, GI, PI, BOP, and GCF of the Ramfjord teeth were measured in the experimental and placebo groups including 58 and 42 subjects repectively. After 4 weeks, GI, PI, BOP, GCF, compliance, irritation of the oral mucosa(redness, pus drainage, edema) and adverse reactions were measured. The PI, GI, and BOP of the experimental group recorded at baseline are 0.19+/-0.19, 0.42+/-0.31, and 0.08+/-0. 15. These scores showed significant decrease after 4 weeks of test period(0.11+/-0.15, 0.22+/-0.24, 0.02+/-0.09 repectively at the end of the study) and inhibition of plaque accumulation and resolution of gingival inflammation could be observed. GCF shoed slight increase but this was not Statistically different. Comparison of changes in measured scores of control and experimental groupshow GI, PI of the test indices have decreased. Test group showed significantly greater decrease in gingivitis and plaque accumulation after 4 weeks. GCF and BOP also showed greater decrease thant the control group but this difference was not statistically significant. At no time of the study period did any of the subjects show signs of irritation of the oral mucosa or adverse reactions. Following conclusions could be obtained from this study. The combined use of cetl powder and flouride toothpaste showed greater inhibition of plaque accumulation and greater decrease of gingivitis than use of flouride toothpaste with placebo agent.
Cetylpyridinium* ; Compliance ; Dental Plaque ; Drainage ; Gingivitis ; Healthy Volunteers ; Inflammation* ; Menthol ; Mouth Mucosa ; Periodontitis ; Smell ; Suppuration ; Tooth ; Toothpastes

OBJECTIVE: Cyclosporine(CsA) and tacrolimus, albeit different in structure, exert immunosuppressive effect by similar mechanism. Although most of clinical manifestations, including nephrotoxicity, are similar in the patients using these drugs, there are some differences including gum hyperplasia, neurotoxicity, and hepatic fibrosis between two drugs. There are several reports about association between reactive oxygen species(ROS) and CsA. In contrast, tacrolimus is known to decrease ROS in central nervous system. Thus, we investigated the possibility of different effects of tacrolimus and CsA on the generation of ROS, on the synthesis and degradation of collagen. METHODS: Experiments were done in primary cultured mesangial cells between 4th and 8th passages. CsA was added to the culture dishes in different concentration(making final CsA concentration of 0, 2, 4, 8 microgram/milliliter) and N-acetylcysteine(NAC) was also added in another mesangial cell culture at 4 microgram/milliliter of CsA concentration; tacrolimus was added in similar pattern(making final tacrolimus concentration of 0, 0.1, 0.2, 0.4 microgram/milliliter, NAC in 0.2 microgram/milliliter of tacrolimus concentration). RESULTS: No significant decrease in viability was noted in both cell groups, but growth retardation was weak in tacrolimus treated cells comparing with CsA treated cells. By flow cytometry, we could find the generation of ROS in CsA treated cells, but not in tacrolimus treated cells. In RT-PCR, there is no significant difference in m-RNA expression for a number of molecules including collagen III, MMP-2, TIMP-2, MT1-MMP in either CsA treated cells or tacrolimus cells. But in zymogram, MMP-2 activities were decreased at higher CsA concentration, then increased with addition of NAC. In tacrolimus cells, MMP2 activity was not changed at 0.1 and 0.2 microgram/milliliter; but, at the concentration of 0.4 microgram/milliliter, changed and not reversed by NAC. MMP-9 activity was similar in both cells. CONCLUSION: We could find ROS generation in CsA treated human mesangial cells, but not in tacrolimus treated cells. We think this difference resulted in the decrease of post-transcriptional MMP-2 activity in CsA treated cells and we also think tacrolimus cells in our experiments were not influenced by ROS. From these results, tacrolimus and CsA are different in the generation of ROS that have some effects in the matrix accumulation in mesangial cells. These result does not mean that tacrolimus is superior to CsA in nephrotoxicity, because nephrotoxicity is similar between two drugs. In conclusion, the mechanisms of nephrotoxicity are different between CsA and tacrolimus.
Central Nervous System ; Collagen ; Cyclosporine* ; Extracellular Matrix* ; Fibrosis ; Flow Cytometry ; Gingiva ; Humans* ; Hyperplasia ; Matrix Metalloproteinase 14 ; Mesangial Cells* ; Oxygen ; Tacrolimus* ; Tissue Inhibitor of Metalloproteinase-2

PURPOSE: To see if a similar relationship exists between the decreased number of circulating neutrophils and the development of bronchopulmonary dysplasia (BPD) in preterm infants, we tried to test the hypothesis that claims that preterm infants, who develop BPD, have decreased number of circulating neutrophils than those who do not develop BPD. METHODS: A retrospective cohort study was conducted in 167 preterm infants from August 1995 to July 1997, who were admitted in the neonatal intensive care unit (NICU) of Seoul National University Children's Hospital. RESULTS: BPD was diagnosed in 16% (27/167) of preterm infants. We compared the clinical characteristics of the study population according to the presence or absence of BPD. Compared to non-BPD group, the BPD group had a lower gestational age (29.4 +/- 2.7weeks versus 32.7 +/- 1.7 weeks), lower birth weight (1,240 +/- 486g versus 1,780 +/- 420g), lower incidence of prenatal steroid use (2/27 versus 41/140), decreased number of circulating neutrophils (3,622 +/- 4,866/microliter versus 7,586 +/- 4,545/microliter) at 1 day of life. After adjusting for the variables of the above risk factors, neutropenia (<2,500/microliter) in the peripheral blood increased the odds ratio of developing BPD (OR : 46.3, 95% CI : 17.3-117.2). CONCLUSION: Early postnatal neutropenia might be an important risk factor for the development of BPD and lung injury responsible for the development of BPD might begin at the early postnatal period.
Birth Weight ; Bronchopulmonary Dysplasia* ; Cohort Studies ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Lung Injury ; Neutropenia* ; Neutrophils ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Seoul

PURPOSE: To see if a similar relationship exists between the decreased number of circulating neutrophils and the development of bronchopulmonary dysplasia (BPD) in preterm infants, we tried to test the hypothesis that claims that preterm infants, who develop BPD, have decreased number of circulating neutrophils than those who do not develop BPD. METHODS: A retrospective cohort study was conducted in 167 preterm infants from August 1995 to July 1997, who were admitted in the neonatal intensive care unit (NICU) of Seoul National University Children's Hospital. RESULTS: BPD was diagnosed in 16% (27/167) of preterm infants. We compared the clinical characteristics of the study population according to the presence or absence of BPD. Compared to non-BPD group, the BPD group had a lower gestational age (29.4 +/- 2.7weeks versus 32.7 +/- 1.7 weeks), lower birth weight (1,240 +/- 486g versus 1,780 +/- 420g), lower incidence of prenatal steroid use (2/27 versus 41/140), decreased number of circulating neutrophils (3,622 +/- 4,866/microliter versus 7,586 +/- 4,545/microliter) at 1 day of life. After adjusting for the variables of the above risk factors, neutropenia (<2,500/microliter) in the peripheral blood increased the odds ratio of developing BPD (OR : 46.3, 95% CI : 17.3-117.2). CONCLUSION: Early postnatal neutropenia might be an important risk factor for the development of BPD and lung injury responsible for the development of BPD might begin at the early postnatal period.
Birth Weight ; Bronchopulmonary Dysplasia* ; Cohort Studies ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Lung Injury ; Neutropenia* ; Neutrophils ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Seoul

No abstract available.
Pulmonary Surfactants*

The hyaline membrane disease is not a common disease in Korea. Only a few reports of small scale are avaiable in the literature. We have experienced 5 cases of HMD during approximately 1 year period. The diagnosis was made either on characteristic clinical and roentgenological features or postmortem examination. The birth weights of these cases were in the range of 1,000-1,500gm in 2 cases and 2,000-2,500gm in 3 cases. And their gestational age was 28-34 weeks in most of the cases. Three cases were delivered by C-section. There was 1 case of placenta previa. Four of these 5 cases died after average 18 hours postnatum. Postmortem findings in two cases were characterized by typical hyaline membrane lining th respiratory bronchioles and alveolar ducts. Other prominent findings were atelectasis, interstitial edema and congestion and lymphatic dilatation. One case complicated with multifocal bronchopneumonia and perinatal telencephalic leukoencephalopathy. The other case showed acute subarachnoid hemorrhage probably from germinal matrix hemorrhage.
Autopsy* ; Birth Weight ; Bronchioles ; Bronchopneumonia ; Diagnosis ; Dilatation ; Edema ; Estrogens, Conjugated (USP) ; Gestational Age ; Hemorrhage ; Humans ; Hyalin* ; Hyaline Membrane Disease* ; Infant, Newborn ; Korea ; Leukoencephalopathies ; Membranes ; Placenta Previa ; Pulmonary Atelectasis ; Subarachnoid Hemorrhage

PURPOSE: The aim of this study was to compare the effectiveness of hydroxyapatite containing toothpaste with positive control toothpastes in reducing dentine hypersensitivity. MATERIALS AND METHODS: This clinical trial was a double-blind, randomized, parallel group comparison of two, namely hydroxyapatite containing toothpaste and strontium chloride containing toothpaste. A total of 55 subjects were included in this study. The subjects were given randomly assigned one of the two toothpastes after received tooth brushing instruction at baseline. Some clinical indices(PI, GI, PD), verbal rating score(VRS) for sensitivity to stimulus, the effect in relieving sensitivity and visual analogue scale(VAS) for sensitivity at baseline, week 2, week 4 and week 8 were assessed. All data were evaluated by intention-to-treat analysis. RESULTS: Overall, PI and GI scores were significantly reduced compare baseline in all groups(p<0.05). In addition, there was significant difference in PI at 4 weeks and in GI at 4, 8 weeks between groups. The proportions of subjects relieved sensitivity were 70.4% in experimental group and 57.1% in control group at 8 weeks respectively. The VRS for sensitivity to three kinds of stimuli and VAS for sensitivity decreased according to time, there was no overall difference between two groups(p>0.05). CONCLUSION: This study demonstrated that the new hydroxyapatite containing toothpaste was similarly effective in reducing dentine hypersensitivity with pre-existing benchmark toothpaste.
Dentin ; Dentin Sensitivity ; Durapatite ; Strontium ; Tooth ; Toothpastes

No abstract available.
Bleomycin* ; Lymphangioma, Cystic*

No abstract available.
Alkaline Phosphatase ; Cell Adhesion ; Fibronectins* ; Humans* ; Osteoblasts