Zonisamide was administered to 20 patients with refractory epileptic seizures. The mean duration of the administration was 6 months, and the mean dosage was 7.2 mg/kg/day. The efficacy of zonisamide was rated remarkable in 15% of the cases, improvement in 40%, and no change in 45%. The response rates of zonisamide were 62.5% for myoclonic seizures, 50% for tonic-clonic seizures, 80% for atonic seizures and 33.3% for atypical absence seizures. There was no correlation between the clinical response and dose or serum concentration of the drug. The adverse effects were observed in 35% of the cases which were drowsiness, dizziness, ataxia, nausea, and vomiting. In all cases, however, the administration of zonisamide could be continued.
Ataxia ; Child* ; Dizziness ; Epilepsy* ; Epilepsy, Absence ; Humans ; Nausea ; Seizures ; Sleep Stages ; Vomiting

No abstract available.
Humans ; Hyperbilirubinemia, Hereditary* ; Siblings*

No abstract available.
Carcinoma, Squamous Cell* ; Maxillary Sinus* ; Nose* ; Papilloma, Inverted*

Fracture healing in the hand is not an isolated goal. The functional end result is of paramount importance. When the correct techniques are used, miniplate fixation for metacarpal and phalangeal fractures of the hand provides rigid internal fixation, stabilizes the skeleton, preserves the gliding tissue, and therefore allowing immediate active range of motion exercise as well as minimizing joint and tendon complications. The authors have reviewed 39 patients, 52 cases of metacarpal and phalangeal fractures of the hand which were treated with miniplate in the department of orthopaedic surgery, Chang Ang Gil hospital from Sep. 1989 to Feb. 1993. The following results were obtained. 1. Miniplate fixation, in terms of fracture reduction and maintenance, allows on accurate anatomic reduction with rigid fixation which in turn affords on early mobilization without loss of reduction alignment. 2. The roentgenographic union was obtained within 15.1 weeks in average. The mean total acitve motion at the fractured finger was 230°. The complication rate was 11.5%. 3. In the treatment of metacarpal and phalangeal fractures of the hand, especially fractures of metacarpal bones, fixation with miniplate is considered to be an useful method in terms of getting fracture union and good range of motion with relative low complication rates.
Early Ambulation ; Fingers ; Fracture Healing ; Hand ; Humans ; Joints ; Metacarpal Bones ; Methods ; Range of Motion, Articular ; Skeleton ; Tendons

PURPOSE: Tumor necrosis factor-alpha(TNF-alpha) is a pro-inflammatory cytokine that has been implicated in the pathogenesis of cardiovascular disease. Serum levels of TNF-alpha are elevated in many human cardiac related pathogenic conditions, including heart failure. It is well known that TNF-alpha inhibits myocardial contractility and induces apoptosis of adult rat cardiomyocytes via stimulation of TNF receptor 1. But pathophysiologically relevant low levels of TNF-alpha can not induce apoptosis of neonatal cardiomyocytes. So, we evaluated the effects of different concentrations of TNF-alpha in cultured rat neonatal cardiomyocytes : apoptosis or necrosis. METHODS: Neonatal ventricular myocytes were isolated from 3-day-old rats by stepwise collagenase dissociation, and the cells were cultured for 3 days. After that, cardiomyocytes were treated with low(25 ng/mL) and high(250 ng/mL) concentration of TNF-alpha for 48 hours. Apoptosis was determined by terminal deoxynucleotidyl transfer-mediated end labelling(TUNEL) staining, and cell viability was evaluated by lactate dehydrogenase(LDH) measurements using cell culture supernatants. RESULTS: Low dose TNF-alpha did not induce apoptosis compared with controls(10.5 +/- 3.5% : 10.4 +/- 4.3%). And high dose TNF-alpha also did not induce significant apoptosis(10.2 +/- 3.6% : 10.4 +/- 4.3%). There was no detectable morphological changes of cardiomyocytes after low and high concentration of TNF-alpha treatment. LDH levels after TNF-alpha treatment was not significant compared with control(control : low : high, 3.2 +/- 0.1% : 3.1 +/- 0.2% : 3.3 +/- 0.3%). CONCLUSIONS: Our results suggest that high concentration of TNF-alpha alone can not induce apoptosis and significant cytotoxicity in neonatal rat cardiomyocytes.
Adult ; Animals ; Apoptosis ; Cardiovascular Diseases ; Cell Culture Techniques ; Cell Survival ; Collagenases ; Heart Failure ; Humans ; Lactic Acid ; Muscle Cells ; Myocytes, Cardiac* ; Necrosis ; Rats* ; Receptors, Tumor Necrosis Factor ; Tumor Necrosis Factor-alpha*

BACKGROUND: Calcium disturbance may clinically produce diaphragmatic weakness. Extracellular calcium is necessary for diaphragmatic contraction, suggesting that the diaphragm behaves more like cardiac muscle. The effect of extracellular Ca2 concentrations on the relaxation action of vecuronium was studied in rat hemidiaphragm-phrenic nerve preparations. METHODS: Hemidiaphragm-phrenic nerve preparations were obtained from male Sprague-Dawley rats (200 300 g). Preparations were bathed in Kreb's solution of (mM): NaCl 118, KCl 5, CaCl2 2.5, NaHCO3 30, KH2PO4 1, MgCl2 1 and glucose 11, then maitained at 37oC when aspirated with a mixture of 95% O2 and 5% CO2. Isometric forces generated in response to 0.1 Hz, 2 Hz for 2 seconds and, 50 Hz for 2 seconds with supramaximal electrical stimulation (0.2 msec, rectangular) to the phrenic nerve, were measured with a force transducer. Single twitch tension and peak tetanic tension were calculated as a percentage of control. TOF fade was calculated as (1-(T4/T1))x100. Each preparation was exposed to the alterations in calcium concentrations of the Kreb's solution (3.75, 3.125, 1.5, 1.25, 0.625, 0.3125 (mM)), and the adequate volume of vecuronium stock solution was added to the tissue bath for desired bath concentration. The effects of calcium and vecuronium were allowed to reach a steady state before measurement of tension parameters was done. Single twitch tensions or peak tetanic tensions, which were measured at each calcium concentration, were compared respectively. EC5, EC25, EC50, EC75, and EC95 of vecuronium for a single twitch tension, TOF fade, and peak tetanic tension at each calcium concentration, were calculated using a sigmoid Emax model. We compared the EC50 of vecuronium according to calcium concentrations. Data was compared by the Kruskal-Wallis test with a post hoc Wilcoxon rank sum test. A p-value of below 0.05 was considered significant. RESULTS: The range of calcium concentration studied didn't produce differences among single or tetanictensions respectively. The EC50's of vecuronium decreased as calcium concentration decreased. CONCLUSIONS: The reduction of calcium concentration can augment the action of vecuronium on the diaphragm.
Animals ; Baths ; Calcium* ; Colon, Sigmoid ; Diaphragm ; Electric Stimulation ; Glucose ; Humans ; Magnesium Chloride ; Male ; Myocardium ; Neuromuscular Agents* ; Paralysis ; Phrenic Nerve ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Transducers ; Vecuronium Bromide*

BACKGROUND: The purpose of this study was to evaluate the safety and efficacy of low-flow anesthesia with a semi-closed circle anesthesia system in infants. METHODS: Twenty, ASA physical status 1 or 2, infants were randomly assigned into two groups: high-flow anesthesia (HFA) or low-flow anesthesia (LFA). An identical semi-closed Dr ger circle anesthesia system (Cato) was used to all patients. Initial fresh gas flow (FGF) was N2O 1.5 L/min and O2 1.5 L/min in both groups. This FGF of 3 L/min was maintained in the HFA group. After 10 min of HFA, the FGF was reduced to 500 ml/min (N2O 250 ml/min and O2 250 ml/min) in the LFA group. RESULTS: Hypoxic or hypercarbic gas concentrations were not observed in all patients. Enflurane consumption during LFA was about 1/3 of that during HFA (6.8 +/- 1.3 ml vs. 19.5 +/- 5.8 ml). The mean highest esophageal temperature was similar in both groups. The mean highest inspiratory gas and soda lime temperatures were significantly higher in the LFA group than in the HFA group. CONCLUSIONS: Low-flow anesthesia in a circle system with a fresh gas flow of N2O 250 ml/min and O2 250 ml/min could be performed safely and economically for infants.
Anesthesia* ; Enflurane* ; Humans ; Infant*

No abstract available.
Animals ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Gene Expression* ; Mice*

No abstract available.
Desmin* ; Intermediate Filament Proteins* ; Intermediate Filaments* ; Muscle, Skeletal* ; Muscular Diseases* ; Sciatic Nerve* ; Vimentin*

The vesicoureteral reflux (VUR) is frequently found among the patients with urinary tract infection (UIT) and some patients with VUR progress to reflux nephropathy. The presence of scarring at UIT is an important determinant in the selection of those at risk of progressive damage. 99m Technetium dimercaptosuccinic acid (99m Tc-DMSA) is a renal scanning agent provides a good quality of renal image as a result of preferential cortical accumulation. 99m Tc-DMSA scan and VCUG were performed in 133 patients diagnosed UTI at pediatric department of Kyung Hee University, College of Medicine from May, 1990 to May, 1992 The results were as follows: 1) VUR was seen in 27 children among 133 patients with UTI. The incidence was 20.3%. Under 1 year of age, male to female ratio was higher incidence of VUR. 2) Incidence of renal scarring was higher in patients with VUR than those of without VUR. 3) Grading of VUR in relation to age, the older the age, the lower the grade. 4) There is no correlation between renal scarring and grades of VUR. 5) In distribution of renal scarring, it was found to have tendency to develop at upper polar area, there was diffuse and multiple in patients with VUR. In conclusion the incidence of renal scarring was related to the age of onset, duration of UTI and the severity of the VUR and 99mTc-DMSA scan is mandatory in patient with UTI even without VUR in order to detect early phase of renal scarring.
Age of Onset ; Child ; Cicatrix* ; Female ; Humans ; Incidence ; Male ; Succimer ; Technetium ; Technetium Tc 99m Dimercaptosuccinic Acid ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux