Hypocalcemia is due to Hypoparathyroidism, Vitamin D deficiency, Hypomagnesemia, Inadequate calcium intake. The benefits of breast-feeding are well established. There are no need to supply calcium or Vitamin D in breast-fed infant. We report a case of infantile hypocalcemia caused by Vitamin D deficiency in exclusively breast-fed infant. He had no hypocalcemic symptom and hypocalcemia was found incidentally by routine laboratory tests during pneumonia treatment. He was presented with a low serum calcium level and 1,25(OH)2 Vit D3 level and high PTH. He was improved by Calcium and Vitamin D supplement. After then his mother continued breast feeding exclusively and resisted to feed her baby weaning food. During follow up period, hypocalcemia was recheked after discontinuation of vitamin D supplement. At 11 months of age, the calcium level was normal without vitamin D supplement after he had eaten weaning food. This report describes a case of hypocalcemia induced by vitamin D deficiency in exclusively breast-fed infant, with review of the literature.
Breast Feeding ; Calcium ; Follow-Up Studies ; Humans ; Hypocalcemia* ; Hypoparathyroidism ; Infant* ; Mothers ; Pneumonia ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins* ; Weaning

OBJECTIVE: The introduction of new psychiatric medications with better efficacy and tolerance seems to increase the frequencies of co-prescriptions of various psychotropic agents. We investigated the frequencies of the combined treatments of atypical antipsychotics and selective serotonin reuptake inhibitors (SSRIs) that are supposed to be common in clinical practice. METHODS: Data on 2783 outpatients from March 1, 2002 through June 31, 2002 in Seoul National University Hospital were collected. The number of cases with a co-prescription of atypical antipsychotics with SSRIs were counted and compared by diagnoses. The relations of diagnosis and age to the combined treatment were explored. RESULTS: 499 (17.4%) patients took co-prescriptions of antipsychotics with antidepressants, and 393 (13.7%) patients those of atypical antipschotics with SSRIs. Patients with obsessive compulsive disorder and schizophrenia took the combinations of atypical antipsychotics and SSRIs more frequently than patients with other diagnoses, as 41.6% and 20.8%, respectively. Controlling for diagnostic categories, age was significantly correlated with the presence of those co-prescriptions. CONCLUSION: The findings of the current study reflect evidence-based prescriptions in an educating hospital and provide basic data for further pharmaco-epidemiological studies. The co-prescription of atypical antipsychotic agents with SSRIs seems to occur only in proper indications, under the consideration of the risk of drug-drug interactions and adverse effects.
Antidepressive Agents ; Antipsychotic Agents* ; Diagnosis ; Humans ; Obsessive-Compulsive Disorder ; Outpatients* ; Prescriptions ; Schizophrenia ; Seoul ; Serotonin Uptake Inhibitors*

OBJECTIVE: The introduction of new psychiatric medications with better efficacy and tolerance seems to increase the frequencies of co-prescriptions of various psychotropic agents. We investigated the frequencies of the combined treatments of atypical antipsychotics and selective serotonin reuptake inhibitors (SSRIs) that are supposed to be common in clinical practice. METHODS: Data on 2783 outpatients from March 1, 2002 through June 31, 2002 in Seoul National University Hospital were collected. The number of cases with a co-prescription of atypical antipsychotics with SSRIs were counted and compared by diagnoses. The relations of diagnosis and age to the combined treatment were explored. RESULTS: 499 (17.4%) patients took co-prescriptions of antipsychotics with antidepressants, and 393 (13.7%) patients those of atypical antipschotics with SSRIs. Patients with obsessive compulsive disorder and schizophrenia took the combinations of atypical antipsychotics and SSRIs more frequently than patients with other diagnoses, as 41.6% and 20.8%, respectively. Controlling for diagnostic categories, age was significantly correlated with the presence of those co-prescriptions. CONCLUSION: The findings of the current study reflect evidence-based prescriptions in an educating hospital and provide basic data for further pharmaco-epidemiological studies. The co-prescription of atypical antipsychotic agents with SSRIs seems to occur only in proper indications, under the consideration of the risk of drug-drug interactions and adverse effects.
Antidepressive Agents ; Antipsychotic Agents* ; Diagnosis ; Humans ; Obsessive-Compulsive Disorder ; Outpatients* ; Prescriptions ; Schizophrenia ; Seoul ; Serotonin Uptake Inhibitors*

BACKGROUND AND OBJECTIVES: E-cadherin and catenins (alpha, beta, gamma, p120cat) are important epithelial adhesion molecules in normal epithelial cells. Loss of E-cadherin-catenin adhesion is an important step in the progression of epithelial cancers such as tongue cancer. E-cadherin and catenins expression in carcinoma of human tongue was evaluated in relation to their clinicopathological features and prognostic values. SUBJECTS AND METHOD: Thirty-nine specimens of tongue squamous cell carcinoma were examined in this study. These patients were all treated by primary surgery without prior radiotherapy or chemotherapy. The specimens of formalin-fixed and paraffin-embedded tumor tissues were investigated by immunohistochemical analysis using E-cadherin and catenin (alpha, beta, gamma, p120cat) monoclonal antibodies. RESULTS: The expressions of E-cadherin, alpha-catenin, beta-catenin, gamma-catenin and p120cat in cell membranes were reduced or absent in 71.8%, 74.4%, 76.9%, 59.0% and 82.1% of the tumors examined, respectively. The reduced expressions of alpha-catenin and gamma-catenin in the cell membranes was cor-related with tumore differentiation (p=0.018, p=0.004, respectively). There were significant correlations between E-cadherin and expressions of the four cantenins in the cell membranes of tongue cancer. There were no correlations between beta-catenin and p120cat expression in the cytoplasm, cell nucleus and clinicopathological features. There was significant correlation between E-cadherin expression and Kaplan-Meier survival curves. CONCLUSION: These results suggest that E-cadherin and catenins (alpha, beta, gamma, p120cat) can be used as prognostic markers of human tongue squamous cell carninoma. The result of beta-catenin and p120cat absence in the nucleus suggests that Wnt/Wingless signaling or Kaiso transcription did not occur in the human tongue squamous cell carcinoma.
alpha Catenin ; Antibodies, Monoclonal ; beta Catenin ; Cadherins* ; Carcinoma, Squamous Cell ; Catenins ; Cell Membrane ; Cell Nucleus ; Cytoplasm ; Drug Therapy ; Epithelial Cells ; gamma Catenin ; Humans ; Kaplan-Meier Estimate ; Prognosis ; Radiotherapy ; Tongue Neoplasms* ; Tongue*

BACKGROUND: Tetralogy of Fallot (TOF) with pulmonary atresia and major aortopulmonary collateral arteries (MAPCAs) is complex lesion with marked heterogeneity of pulmonary blood supply and arborization anomalies. Patients with TOF with PA and MAPCAs have traditionally required multiple staged unifocalization of pulmonary blood supply before undergoing complete repair. In this report, we describe recent change of strategy and the results in our institution. MATERIAL AND METHOD: We established surgical stratagies: early correction, central mediastinal approach, initial RV-PA conduit interposition, and aggressive intervention. Between July 1998 and August 2004, 23 patients were surgically treated at our institution. We divided them into 3 groups by initial operation method; group I: one stage total correction, group II: RV-PA conduit and unifocalization, group III: RV-PA conduit interposition only. RESULT: Mean ages at initial operation in each group were 13.9+/-16.0 months (group I), 10.4+/-15.6 months (group II), and 7.9+/-7.7 months (group III). True pulmonary arteries were not present in 1 patient and the pulmonary arteries were confluent in 22 patients. The balloon angioplasty was done in average 1.3 times (range: 1~6). There were 4 early deaths relating initial operation, and 1 late death due to incracranial hemorrhage after definitive repair. The operative mortalities of initial procedures in each group were 25.0% (1/4: group I), 20.0% (2/10: group II), and 12.2% (1/9: group III). The causes of operative mortality were hypoxia (2), low cardiac output (1) and sudden cardiac arrest (1). Definitive repair rates in each group were 75% (3/4) in group I, 20% (2/10, fenestration: 2) in group II, and 55.6% (5/9, fenestration: 1) in group III. CONCLUSION: In patients of TOF with PA and MAPCAs, RV-PA connection as a initial procedure could be performed with relatively low risk, and high rate of definitive repair can be obtained in the help of balloon pulmonary angioplasty. One stage RV-PA connection and unifocalization appeared to be successful in selected patients.
Angioplasty ; Angioplasty, Balloon ; Anoxia ; Arteries* ; Cardiac Output, Low ; Death, Sudden, Cardiac ; Hemorrhage ; Humans ; Mortality ; Population Characteristics ; Pulmonary Artery ; Pulmonary Atresia* ; Tetralogy of Fallot*

PURPOSE: The incidence of complete remission is lower and the relapse is more frequent in adult-onset minimal change nephrotic syndrome (MCNS) are observed especially when compared with those in children. This study was designed to examine the effect of methylprednisolone pulse therapy in adultonset MCNS comparing to oral steroid as an initial therapeutic modality. METHODS: We have retrospectively reviewed the clinical data of 25 adult-onset MCNS patients. Twelve patients were treated with three intravenous pulses of methylprednisolone (1 g daily) followed by oral prednisolone 1 mg/kg daily for 4-8 weeks and also by low doses of oral prednisolone for 4-6 months (MP group) Thirteen patients were initially treated with oral prednisolone 1 mg/kg daily for 4-8 weeks and then with low doses of oral prednisolone (PD group). RESULTS: The response to therapy was similar between MP and PD group, with a complete remission obtained in 83.3% and 84.6%, respectively. No statistically significant difference between the two groups was observed in the rate of response at 8 weeks (58.3% versus 69.2%). The mean time to response was not different between MP group (37.9+/-28.0 days) and PD group (45.5+/-40.2 days). No difference was recognized between the two groups with respect to relapse rate. CONCLUSION: These data suggest that a short course of methylprednisolone pulse therapy followed by oral prednisolone is not superior to oral prednisolone therapy as an initial therapeutic modality in adult-onset MCNS.
Child ; Humans ; Incidence ; Methylprednisolone* ; Nephrosis, Lipoid* ; Prednisolone ; Recurrence ; Retrospective Studies