BACKGROUND: Leukocytes, both polymorphonuclear leukocytes(PMNL) and monocytes/macrophages have been implicated in the pathogenesis of the cerebral ischemia and stroke. Neutrophils accumulate in post-hypoxic-ischemic neonatal rat brain prior to the evolution of necrosis and neutrophil depletion attenuates hypoxic-ischemic brain injury. However, the mechanisms leading to post-hypoxic-ischemic neutrophil accumulation are unknown yet. We hypothesized that Intercellular Adhesion Molecule-1 might mediate post-hypoxic-ischemic injury in the immature brain; thus, we evaluated ICAM-1 gene expression in post-hypoxic-ischemic neonatal(postnatal day 7) rat brain. METHODS: Neonatal rats(n=36) underwent right carotid ligation followed by exposure in 8% O2 for 2.5 hours; this procedure typically produces ipsilateral striatal, hippocampal and cortical infarction. Control groups are included by carotid ligation alone, hypoxia alone, and neither hypoxia nor ligation. For RNA extraction, rats were killed 0, 1, 2, 4, 8, 12, 24 and 48 h post- hypoxia-ischemia and RT-PCR was carried out. RESULTS: ICAM-1 mRNA was barely detected in the controls including normal and sham operated animals. In the cortex, striatum and hippocampus, ICAM-1 mRNA was significantly induced in the ipsilateral(right) side compared to the contralateral(left) side just after hypoxia-ischemia. The elevated ICAM-1 mRNA gradually reached a peak at 4 or 8 h and then decreased to an almost basal level by 24 to 48 h. In contrast, the less pronounced contralateral(left-sided) ICAM-1 mRNA expression appeared to peak earlier, within 2 h post-hypoxia-ischemia. CONCLUSION: The temporal profiles of post-hypoxic-ischemic ICAM-1 mRNA expression are consistent with a role in post-hypoxic-ischemic neutrophil recruitment and in the evolution of subsequent brain injury.
Animals ; Anoxia ; Brain Injuries* ; Brain Ischemia ; Brain* ; Gene Expression ; Hippocampus ; Infarction ; Intercellular Adhesion Molecule-1* ; Leukocytes ; Ligation ; Necrosis ; Neutrophil Infiltration ; Neutrophils ; Rats* ; RNA ; RNA, Messenger* ; Stroke

The incidence of tinea capitis was the least in the middle of 1970s, and thereafter it has been msrkedly increased along with other superficial mycoses due to Microsporum cania This study was to investigate the recent clinical and mycological trends of tinea capitis among the individuals of both out-patients of dermatologic clinic and orphanage children. These study data were compiled from 47 out-patients, which consisted of 31 patients from St. Pauls Hospital from September, 1980 to August, 1981 and 16 from St. Marys Hospital and Kangnam St. Marys Hospital from February to May in 1981, and from 79 patients of the orphage located in Seoul area in May, 1981. The results were as follows: 1. M. canis was isolated from all 47 out-patients with tinea capitis(male: 21, female 26). In orphanage, from 50 patients(63.3%) among the 79 patients with tinea capitis, 46 strains(92%) of T. ferrugineum from 30 male and 16 female patients, 3(6%) of M. canis from 3 males, and 1(2%) of T. violaceurn from a female were isolated. 2. The incidence of tinea capitis by M. canis in a total 5, 340 out-patients was 0. 58% (0. 62% in male, 0.56% in female) and its monthly distribution was almoat even through the studied period. The male to female ratio was 1:1,24, being more prevalent in female. 3. The age of onset was younger in female with tinea capitis due to M. canis than in male: The median age of onaet was 5 years in female and 7 years in male. In the group below 7 years of age, the maIe to female ratio was 1:1.84 and in the group above 8 years of age, l.74: 1.4. Most lesions of tinea capitis due to M. canis from out-patients showed multiple round grey scaled patches with shrotened hairs or round erythematous scaled alopetic patches. Kerion celsi were found in 4(9%) out of 47 out-patiente. Tinea corporia was combined in 4(9%) out-patients. There were domestic animals shch as kit or dog in 7(29%) among 24 houses of the patients.
Age of Onset ; Animals ; Animals, Domestic ; Child ; Dogs ; Female ; Hair ; Humans ; Incidence ; Male ; Microsporum ; Mycoses ; Orphanages ; Outpatients ; Seoul* ; Tinea ; Tinea Capitis

Two cases with umbilical polyp are reported. One was 7-year-old boy who had l. 5cm x l. 6cm protruded urnbilieal growth, the other was 2-year-old baby who had 0. 7crn x 0. 6cm umbilical growth. This uncommon malforrnation arises from remnants of the omphalomesenteric duct and should be clinically discerned from a granuloma pyogenicum or other benign umbilical neoplasms. Histllogically umbilical polyp shows blanching glandular structures lined by intestinaI mucosa in connection with the surface of the skin. When the umbilical polyp is not associated with any other types of underlying abnormalities, it may be treated by a simple surgical excision.
Child ; Child, Preschool ; Granuloma, Pyogenic ; Humans ; Male ; Mucous Membrane ; Polyps* ; Skin ; Vitelline Duct

The 1918 "Spanish Flu", cause of the largest causality rate ever recorded in human history with 50 million deaths, is genetically related to the current H5N1 virus, suggesting the potential emergence of H5N1 influenza as the next pandemic wave. In the process of co-infection and genetic reassortment of human and H5N1 avian influenza, the H5N1 strain could acquire human viral gene(s) to ignite the human to human spread, as occurred in 1957 and 1976 pandemics. All countries are vulnerable to infection as no effective vaccine has yet been developed for avian influenza. Once developed into a pandemic, the socio-economic impact of avian influenza would be enormous. In response to this danger, Korea recently proposed to establish an international consortium, the Pandemic Influenza Consortium, Korea (PICK), to emphasize close collaboration, especially among Pacific Rim countries. PICK proposes to support the following three areas: 1) international efforts in the implementation of national and regional preparedness plans through the development of epidemiological, microbiological and clinical tools and mechanisms for early detection of pandemic influenza epidemics, 2) the development and clinical evaluation of pandemic influenza candidate vaccine, and 3) the establishment of appropriate mechanisms to ensure the capacity to produce, the availability of supply, and the rational distribution of pandemic influenza vaccines to countries suffering from or at high risk of experiencing outbreaks. Finally, the effort is expected to serve as a basis for initiating, establishing and strengthening the international infrastructure for investigation of the infection mechanism and devising prophylactic and therapeutic responses to various infectious diseases.
Animals ; Coinfection ; Communicable Diseases ; Cooperative Behavior* ; Disease Outbreaks ; Humans ; Influenza A Virus, H5N1 Subtype ; Influenza in Birds* ; Influenza Vaccines ; Influenza, Human ; Korea ; Pandemics

Purpura fuIminans is a rare form of nonthrombocytapenic purpura characterized by sudden onset, fever, prostration, anemia and symmetrical massive ecchymoses, usually of the lower extremities, and hypotension associated with disseminated intravascular coagulation (DIC). A 18 years old female patieat with characteristic clinical manifestations of purpura fulminans was seen at the department of Dermatology, St. Pauls Hospital. With intensive systemic corticasteroid and heparin treatmemts, the ecchymoses and necrosis began to heal, leaving multiple, thick esehar formation from 8th day, Although purpura fulminana has been known to attack mainly children, this case was of adolescent age.
Adolescent ; Anemia ; Child ; Dermatology ; Disseminated Intravascular Coagulation ; Ecchymosis ; Female ; Fever ; Heparin ; Humans ; Hypotension ; Lower Extremity ; Necrosis ; Purpura Fulminans* ; Purpura*

PURPOSE: We compared clinical findings of headaches to find out important characteristics for the differential diagnosis of headaches. We tried to find out specific electroencephalogram (EEG) findings according to the types of primary headache and the relationship between clinical characteristics and EEG findings by analyzing EEGs of migraine. METHOD: We conducted a retrospective analysis by reviewing medical records of 275 patients who visited the Department of Pediatrics of Korea University Guro Hospital from November 2010 to October 2013. The headaches were classified according to the International Classification of Headache Disorders-II (ICHD-II). EEG was analyzed in relation to the type of headache. RESULTS: 245 (89.1%) were primary headache patients, and 30 (10.9%) were secondary headache patients.There were no differences in the frequencies of abnormal EEG findings according to the type of primary headache (P=0.855), and epileptiform discharge was most common abnormal EEG finding in the primary headache. Comparing the patients with epileptiform discharges to the patients with normal EEG finding in migraine, the patients showing epileptiform discharge were younger (P=0.035) and presented with occipital and atypical (i.e., not pulsating or pressing) headache (P=0.005). CONCLUSION: History and physical examination are the most important in the diagnosis of headache in children. There were no significant differences in EEG findings among the different types of primary headaches.However,we could find a relationship between clinical features of the migraine and its epileptiform discharge, so more studies correlating EEG findings to clinical features are needed in the future.
Child* ; Classification ; Diagnosis ; Diagnosis, Differential ; Electroencephalography* ; Headache* ; Humans ; Korea ; Medical Records ; Migraine Disorders ; Pediatrics ; Physical Examination ; Retrospective Studies ; Tension-Type Headache

BACKGROUND AND OBJECTIVES: The objective of this research was to study the change of lung volume after uvulopalatopharyngoplasty (UPPP) in obstructive sleep apnea (OSA) patients. MATERIALS AND METHOD: Eight OSA patients were participated in this study. These patients were treated with UPPP at Seoul adventist hospital. Vital capacity (VC), inspiratory capacity (IC), expiratory residual volume (ERV) and FEV1, FEV1/FVC, FEV25-75% were determined by standard spirometry at the preoperative, at 3 postoperative days and 1 postoperative month. RESULTS: Vital capacity (VC) was significantly larger at 3 post-operative days (3.58+/-0.87 L, mean+/-SD) than those at pre-operative (3.12+/-0.69 L, mean+/-SD) in the patient with OSA (p=0.047). FEV 1 (L) was larger at 3 post-operative days (2.91+/-0.76 L, mean+/-vSD) than those at pre-operative (2.68+/-0.85 L, mean+/-vSD), but was not significantly correlated statically (p=0.249). CONCLUSION: We found significant correlation between preopeative and postoperative VC, IC.
Humans ; Inspiratory Capacity ; Lung* ; Residual Volume ; Respiratory Function Tests ; Seoul ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Spirometry ; Vital Capacity

No abstract available.
Brain* ; Choriocarcinoma* ; Female ; Neoplasm Metastasis* ; Pregnancy

BACKGROUND: The new, long-acting local anesthetic ropivacaine is structurally very similar to bupivacaine, but the motor block is less profound and of shorter duration. The aim of this study was to compare analgesic effectiveness and side effects during postoperative pain control after a Caesarean section with either a bupivacaine/fentanyl or ropivacaine/fentanyl mixture. METHODS: Thirty-nine patients undergoing a Caesarean section were randomized in a double-blinded manner to receive bupivacaine or ropivacaine. Postoperative epidural analgesia was provided using a PCA pump with either bupivacaine/fentanyl 0.075%/3.4 microgram/ml after 10 ml of 0.125% bupivacaine with morphine (n = 18) or ropivacaine/fentanyl 0.125%/3.4 microgram/ml after 10 ml of 0.2% ropivacaine with morphine (n = 21). Verbal rating pain scores (rest and cough), side effects (nausea, vomiting, pruritus, sedation, motor block and hypotention) and time to ambulation were measured for 48 hr after surgery. RESULTS: There were no significant differences between the groups in verbal pain scores, sensory level, motor blockade and other side effects, but time to ambulation was earlier in the ropivacaine group. CONCLUSIONS: 0.125% ropivacaine with 3.4 microgram/ml fentanyl provided similar successful pain relief as 0.075% bupivacaine/fentanyl. However, earlier recovery of ambulation in patients receiving ropivacaine/ fentanyl will improve outcome after surgery.
Analgesia, Epidural* ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Humans ; Morphine ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Pregnancy ; Pruritus ; Vomiting ; Walking

BACKGROUND AND PURPOSE: Lacosamide (LCM) is an antiepileptic drug that enhances the slow inactivation of sodium channels and modulates collapsin response mediator protein-2. LCM was recently demonstrated to exert a neuroprotective effect in a murine model of traumatic brain injury and status epilepticus. Assuming the same underlying excitotoxicity-related brain injury mechanism, we hypothesized that LCM would have a neuroprotective effect in hypoxic-ischemic brain injury. METHODS: We divided rats into three groups at each testing session: pre- or postfed with LCM, fed with normal saline, and sham. A hypoxic-ischemic brain injury was induced by subjecting 7-day-old rats to right carotid artery coagulation followed by 2.5 h of exposure to 8% oxygen. The animals were killed on postnatal day 12 to evaluate the severity of brain damage. Open field testing was also performed between week 2 and week 6, and the Morris water maze test was performed in week 7 after hypoxia-ischemia. RESULTS: The incidence of liquefactive cerebral infarction was lower in rats prefed with LCM at 100 mg/kg/dose, with the mortality rate being higher at higher doses (200 and 300 mg/kg/dose). The infarct areas were smaller in LCM-prefed rats in several brain regions including the hemisphere, hippocampus, cortex, and striatum. Spatial learning and memory function were better in LCM-prefed rats (p<0.05). No effect was observed in postfed rats. CONCLUSIONS: This study suggests that LCM pretreatment exerts a neuroprotective effect on hypoxia-ischemia in neonatal rats. The obtained results suggest that LCM pretreatment could be used as an effective neuroprotective method for neonates under hypoxic-ischemic conditions including heart surgery.
Animals ; Brain Injuries* ; Brain* ; Carotid Arteries ; Cerebral Infarction ; Hippocampus ; Humans ; Incidence ; Infant, Newborn ; Memory ; Methods ; Mortality ; Neuroprotection ; Neuroprotective Agents* ; Oxygen ; Rats* ; Semaphorin-3A ; Sodium Channels ; Spatial Learning ; Status Epilepticus ; Thoracic Surgery ; Water