PURPOSE: Since the effect of intravenous immunoglobulin (IVIG) therapy in Kawasaki disease was reported in 1984, the combined therapy of IVIG & oral aspirin has been popular. In early period, the protocol of 400mg/kg/day for 3-5 days of IVIG had been used, but rescently, the protocol of 2g/kg/day single dose has been preferred. So authers performed a clinical study to compare th efficacies & side effects between 400mg/ kg/day for 5 days & 2g/kg/day single dose of IVIG plus oral aspirin (100mg/kg/ day). METHODS: Seventy five patients who admitted to Eulji medical college hospital from January 1990 to July 1996 were evaluated retrospectively. Twenty nine patients (Group A) were treated with 400mg/kg/day for 5 days of IVIG plus aspirin (100mg/kg/day) and 46 patients (Group B) were treated with 2g/kg/day single dose of IVIG plus oral aspirin (100mg/kg/day). RESULTS: 1) The duration of fever after treatment was not significant difference between two groups (Group A, 25.5+/-30.3 days : Group B, 29.7+/-44.5 days P=0.7440) 2) The total admission days were significant difference between two groups (Group A, 9.9+/-0.4; Group B, 8.2+/-3.0, P=0.0308). 3) The incidence of side effects was not significant difference between two groups (Group A, 62%; Group B, 80%, P=0799). 4) The attack rate of coronary artery involvement was not significant difference between two groups (Group A, 34.5%; Group B, 26%, P=0.1198) 5) The case of re-treatment of IVIG due to relapse was not in Group A, but 5 in Group B (P=0.0661). 6) The mean platelet counts at admission were not difference between two groups (Group A, 434.4+/-17.2x103/mm3; Group B, 374.0+/-13.3x103/mm3, P=0.1449), but on the 7th hospital day, platelet counts were significant differnece between two groups (Group A, 531.9+/-16.5x103/mm3; Group B, 419.8+/-19.0x103/mm3, P=0.0066). 7) There was no significant difference in laboratory findings on admission and in the rate of coronary artery involvement between recurrent and non-recurrent cases of Group B. Conculusions : We conculuded that the protocol of 2mg/kg/day single dose of IVIG in Kawasaki disease may be have some benefits of shorter admission days and less coronary artery involvement, but the incidence of side effects and relapse rate might be less in the protocol of 400mg/kg/day of IVIG for 5 days.
Aspirin ; Coronary Vessels ; Fever ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Platelet Count ; Recurrence ; Retrospective Studies

Since Feingold and his collegues first described the trisomy 9 syndrome in 1973, approximately 30 patients with trisomy of the chromsome 9 have been described. Trisomy 9 has been reported as either partial or complete. Complete trisomy is rare and incompatible with a long life. Before this report, this syndrome has not been reported in Korea. A neonate was diagnosed trisomy 9 syndrome by clinical feature and chromosomal study. He had multiple anomalies such as broad-based nose, partially cleft lip, ambiguous genitalia, hyperconvex nails, overriding of fingers, and ventricular septal defect. The patient died at home on the 113th day of life.
Cleft Lip ; Disorders of Sex Development ; Fingers ; Heart Septal Defects, Ventricular ; Humans ; Infant, Newborn ; Korea ; Nose ; Trisomy*

The midpalatal suture area and maxillary interdental area are suitable site for the placement of orthodontic mini-implant. The purpose of this study was to provide a guideline to indicate the best location for mini-implant placement as it relates to the thickness of soft tissue and cortical bone. Fifteen maxilla from 15 cadavers were cut in midsagittal plane and buccopalatal plane to measure the thickness of soft tissue and cortical bone of midpalatal and maxillary posterior interdental areas. Sectioned samples were scanned and the thickness was measured. The thickness of soft tissue and cortical bone were measured at 6 points from the interdental papilla with 5-mm intervals in the mid-sagittal section. And, the thickness of soft tissue and cortical bone were also measured at 5 points from the alveolar crest with 1-mm intervals in the buccopalatal section. The mean and standard deviation of the measurement were calculated. Soft tissue thickness at the midpalatal suture area was 1.46 mm at 15 mm from the interdental papilla and remained uniformly thick posterior to this point, and steeply increased at 35 mm area posteriorly. Cortical bone thickness were greatest (2.13 mm) at 20 mm from the interdental papilla and remained uniformly thick posterior to this point, and decreased at 30 mm area posteriorly. Palatal soft tissues thickness in all groups was thinnest at the 1 mm from the alveolar crest and gradually increased from alveolar crest to apical portion. Cortical bone thickness in all groups was thickest at the 1 mm from the alveolar crest and slightly decreased from alveolar crest to apical portion. Buccal soft tissue thickness in all groups was thickest at the 1 mm from the alveolar crest and gradually decreased from alveolar crest to apical portion. Cortical bone thickness in all groups was thinnest at the 1 mm from the alveolar crest and slightly increased from alveolar crest to apical portion. Soft tissue thicknesses were greater on the palatal side than on the buccal side. Cortical bone thicknesses of the buccal side were thicker than the palatal side. These results provide anatomical data of soft tissue and cortical bone thickness to assist in the determination of safe location for the mini-implant placement in the midpalatal and maxillary interdental areas.
Cadaver ; Gingiva ; Maxilla ; Sutures

Intraocular tension may be acutely changed by many drugs and by various physiologic events. AN acute rise in intracoular tension may be catastrophic if it occurs when the globenis open and leads to expulsion of contents. Most general anesthetics cause a decrease in intraocular pressure, although a few causes increased intraocular pressure. Midazolam is a 1,4-benzodiazepin derivative synthesized by Walser and Freyer in 1975. Earlier studies with midazolam have demonstrated it efficacy for induction of anesthesia and premedication. It is also desirable to know if all anesthetic agents which produce general anesthesia and which are pharmacologically different affect intraocular pressure in a similar manner. Therefore investigation of the influence of midazolam on intraocular pressure in 25 patients was undertaken at the Department of Anesthesiology, Hanyan University. All patients had no known eye abnormalities. The patients were not premedicated. In all patients the intraocular pressure was measured before induction of anesthesia, after instilling a 0.5% tetracaine into the conjunctival sac. A second reading was taken after induction of midazolam (0.2mg/kg of body weight) and a third after injection of succinylcholine(1mg/kg of body weight) and a fourth after endotracheal intubation. A Schiotz tonometer with a 5.5gm and a 7.5gm weight was used. In addition to the tonometric determination, the blood pressure, pulse rate and respiratory rate were recorded before and after induction of midazolam. An attempt was tried to keep the intraocular pressure changed as many and to minimize the other factors affecting intraocular pressure. To achieve this, supine position and constant gas flow was maintained. Special care was taken to avoid pressure on the patients eye and to maintain a fully patent airway to prevent respiratory disturbances leading to straining and increased venou pressure. Endotracheal intubation was performed with the aid of succinylcholine to avoid cough or laryngospasm. The results of the observation with the above mentioned method were tested by student t-test statistically. Each patient acted as his own control. There was a fall in intraocular pressure in 17 patients among 25 patients(average 1.8mmHg), but no significant change followed by the use of midazoam. The blood pressure variations were between 10 and 40 mmHg, during the course of anesthesia and could not be related to intraocular pressure changes. Intraocular pressure changes had no relation to pulse and respiratory rate variations. This finding indicated that benzodiazepine as a class of drugs have well described muscle relaxant properties that are primarily central(supraspinal)rather than peripheral(myoneural) in action. There was a rise in intraocular pressure in 19 patients among 25 patients, followed by the use of succinylcholine and 23 patients among 25 patients, after endotracheal intubation. According to Feldman and Crawley, diazepam potentiated the myoneural blocking effects of gallamine and antagonizes the effects of succinylcholine. Nevertheless Dretchen demonstrated that the clinical doses of diazepam did not potentiated the muscle relants. Our finding showing no apparent succinylcholine interaction with midazolam are consistent with the finding of Dretche.
Anesthesia ; Anesthesia, General ; Anesthesiology ; Anesthetics ; Anesthetics, General ; Benzodiazepines ; Blood Pressure ; Cough ; Diazepam ; Eye Abnormalities ; Gallamine Triethiodide ; Heart Rate ; Humans ; Intraocular Pressure ; Intubation, Intratracheal ; Laryngismus ; Midazolam* ; Premedication ; Respiratory Rate ; Succinylcholine ; Supine Position ; Tetracaine

Recently, mini-implant is popular in the orthodontic treatment due to its simplicity and convenient surgical procedure. The objective of this study is to provide the anatomical guideline for mini-implant placement by analysing the cortical bone thickness in Korean. Hemi-sections of sixteen maxillae and twenty-two mandibles with normal teeth were used. Interdental areas between the 1st premolar and the 2nd premolar (Group 1), the 2nd premolar and the 1st molar (Gruop 2), and the 1st molar and the 2nd molar (Group 3) were sectioned and then scanned. After setting the axis of teeth, the cortical bone thickness was measured at the distance of 2 mm, 4mm, 6 mm, and 8 mm from alveolar crest. The mean thickness of cortical bone in the maxilla according to distance from alveolar crest was 1.30 +/- 0.63 mm (2 mm), 1.49 +/- 0.62 mm (4mm), 1.72 +/- 0.64 mm (6mm), and 1.90 +/- 0.90 mm (8 mm) at the buccal side and 1.33 +/- 0.47 mm, 1.31 +/- 0.45 mm, 1.37 +/- 0.55 mm, and 1.39 +/- 0.58 mm at the palatal side. In the mandible, that was 3.14 +/- 1.71 mm, 4.31 +/- 2.22 mm, 4.23 +/- 1.94 mm, and 4.30 +/- 1.57 mm at the buccal side and 1.98 +/- 0.88 mm, 2.79 +/- 1.01 mm, 3.35 +/- 1.27 mm, and 3.93 +/- 1.38 mm at the lingual side. The buccal cortical bone thickness in the maxilla was decreased from Group 1 to Group 3, while the thickness of palatal side was no change. In the mandible, it did not show a tendency at the buccal side and it was decreased from Group 1 to Group 3 without significant difference at the lingual side. Therefore, the buccal side of the Group 1 and Group 2 in both the maxilla and mandible seems to be the most appropriate site for a mini-implant placement with taking the stability and retention.
Axis, Cervical Vertebra ; Bicuspid ; Mandible ; Maxilla ; Molar ; Retention (Psychology) ; Tooth

NFI-C null mice demonstrate aberrant odontoblast differentiation and abnormal dentin formation, and thus develop molars lacking roots. However, other tissues and organs in the body including ameloblasts appear to be unaffected. Abnormal dentin in NFI-C null mice shares morphological similarities to the osteodentin that is formed in dental caries. However, little is known about the relationship between NFI-C and osteodentin formation. In this study, to elucidate the molecular characteristics of abnormal odontoblast in NFI-C null mice, we examined the levels of Ask-1, Cdc-2, Smad2/3, and TGF-betaR1 in cell culture and tissue sections from NFI-C null mice using immunofluorescence and immunohistochemistry. NFI-C protein was localized in the nucleus and cytoplasm of normal odontoblasts in vitro. Ask-1 and Cdc-2 proteins were shown in the perinuclear cytoplasm of both normal and NFI-C null mice. There were no differences in the pattern of production of Ask-1 and Cdc-2 proteins between normal and NFI-C null mice. Smad2/3 was not found in the odontoblast and subodontoblastic cells of the normal mice, whereas NFI-C null mice showed Smad2/3 immunoreactivity in the odontoblasts and subodontoblastic cells of the tooth pulp. TGF-betaR1 was weakly immunopositive in the odontoblast and subodontoblastic cells of normal mice, whereas it was detected strongly in the subodontoblastic cells of the NFI-C null mice. These results suggest that disruption of NFI-C increased the expression of Smad2/3 and TGF-betaR1 in developing odontoblasts and consequently caused abnormal dentin formation, similar to osteodentin.
Ameloblasts ; Animals ; Cell Culture Techniques ; Cytoplasm ; Dental Caries ; Dentin ; Fluorescent Antibody Technique ; Immunohistochemistry ; Mice ; Molar ; Odontoblasts ; Tooth

PURPOSE: This study was designed to investigate the relationship between the histological composition of the prostate, preoperative clinical parameters, and the results of transurethral resection of prostate (TURP). MATERIALS AND METHODS: A total of 61 patients with benign prostatic hyperplasia (BPH) who had undergone TURP were enrolled retrospectively. Slides were surveyed for relative areas (%) of glandular epithelium (GE), stroma (ST), and smooth muscle (SM) in stroma by performing immunohistochemistry, and the mean outcomes were calculated with a computer-assisted image analyzer (x200). RESULTS: Total prostate volume was less than 40 ml in 19 patients (group 1), 40 to 80 ml in 23 patients (group 2), and more than 80 ml in 19 patients (group 3). The percentage of SM was significantly greater in group 1 (29.5+/-4.2%) than in group 3 (23.7+/-3.2%), but GE and ST did not differ significantly. AG number was significantly higher in group 3 than in the other groups but did not correlate with SM. Improvements in International Prostate Symptom Score, which were similar in each group, were positively correlated with SM. CONCLUSIONS: SM in prostate adenoma is increased in men with a small prostate and may play an important role in lower urinary tract symptoms in small BPH
Adenoma ; Epithelium ; Humans ; Immunohistochemistry ; Lower Urinary Tract Symptoms ; Male ; Muscle, Smooth ; Prostate ; Prostatic Hyperplasia ; Retrospective Studies ; Transurethral Resection of Prostate ; Urinary Tract ; Urodynamics

We evaluated the therapeutic effects of tamsulosin for women with non-neurogenic voiding dysfunction. Women who had voiding dysfunctions for at least 3 months were included. Inclusion criteria were age > or =18 yr, International Prostate Symptom Score (IPSS) of > or =15, and maximum flow rate (Q(max)) of > or =12 mL/sec and/or postvoid residuals (PVR) of > or =150 mL. Patients with neurogenic voiding dysfunction or anatomical bladder outlet obstruction were excluded. All patients were classified according to the Blaivas-Groutz nomogram as having no or mild obstruction (group A) or moderate or severe obstruction (group B). After 8 weeks of treatment, treatment outcomes and adverse effects were evaluated. One hundred and six patients were evaluable (70 in group A, 36 in group B). After treatments, mean IPSS, bother scores, Q(max), PVR, diurnal and nocturnal micturition frequencies and scored form of the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTS-SF) were changed significantly. Eighty-nine patients (84%) reported that the treatment was beneficial. The proportion of patients reported that their bladder symptoms caused "moderate to many severe problems" were significantly decreased. No significant difference were observed between the groups in terms of IPSS, bother score, Q(max), PVR, micturition frequency, and BFLUTS-SF changes. Adverse effects related to medication were dizziness (n=3), de novo stress urinary incontinence (SUI) (n=3), aggravation of underlying SUI (n=1), fatigue (n=1). Tamsulosin was found to be effective in female patients with voiding dysfunction regardless of obstruction grade.
Adrenergic alpha-Antagonists/adverse effects/pharmacokinetics/*therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Middle Aged ; Questionnaires ; Severity of Illness Index ; Sulfonamides/adverse effects/pharmacokinetics/*therapeutic use ; Treatment Outcome ; Urination Disorders/*drug therapy