Acute digitalization with ouabain were performed 28 times in 20 intact Mongrel dogs, who were devided into four groups : i.e. 1) Control group; Acute digitalizations were performed to observe the changes of the plasma potassium and sodium concentrations and the concomittent electrocardiographic findings. 2) Group 1;-Electrolyte solution, either KCl or NaCl, was infused during acute digitalization to observe the influences of these ions on the actions of cardiac glycoside, especially arrhythmia producing action. 3) Group 2 ; -The K depleted group and the Na depleted group was each made by the measure of diet control and the usage of oral diuretics to observe the influences of the state of depleted electrolyte (K or Na) on the action of cardiac glycoside during acute digitalization. 4) Group 3 ; -The intravenous infusion of either KCl or NaCl solution was introduced as the cardiac arrhythmia by the ouabain was produced to observe the effects of these ions on the digitalis induced arrhythmia. The results obtained were summarized as follows. (1) The arterial plasma concentration of potassium was increased during acute digitalization. The rise occurred at early stage, and the maximal increase of potassium was observed at the ventricular tachycardia. The average increase was 0.65 mEq/L as compared to control value (p<0.05). The arterial plasma concentration of sodium was reduced during acute digitalization. The fall occurred following the rise of plasma K level. The maximal reduction of sodium was observed after ventricular tachycardia, and the average decrease was 5.2 mEq/L as compared to control value (p<0.05). (2) Rapid increase up to toxic level of the plasma potassium concentration occurred occasionally during acute digitalization in the group with KCl infusion. This result was best explained due to the inhibitory action of cardiac glycoside on the K transport. (3) The interesting change was on T wave, which showed the peaking at late portion. This change occured in 60.6% during digitalization with ouabain, and paralleled mostly, but not consistently and even sometimes inversely, with the shift of plasma potassium concentration. It is tempting to assume that the change of T wave was resulted from an altered potassium gradient across the myocardial cells rather than a ssuming the changes of the plasma K level. (4) Just prior to intoxication, the marked prolongation of PR interval and ST depression were observed in about 70~80% of the cases studied. These changes might be applicable to a clue of the cardiac glycoside overdosage. (5) The intravenous infusion of KCl suppressed markedly the arrhythmia producing action of the cardiac glycoside, and resulted in prompt and dramatic abolishing, of digitalis induced arrhythmia. The intravenous infusion of KCl solution, however, produced A-V block or dissociation occasionally. This finding would be likely resulted from the additive or synergistic action of K and cardiac glycoside in suppressing A-V conducting system. (6) The NaCl infusion affected nothing to the arrhythmia producing action of cardiac glycoside. (7) The K depletion reduced markedly the threshold of the heart to the toxic effects of cardiac glycoside. (8) Potent diuretics in the state of deficient diet would produce clinically significant hypopotassemia and hyponatremia or both. The inducced hypopotassemia may provoke serious cardiac arrhythmia in the digitalized patients or animals.
Animals ; Arrhythmias, Cardiac ; Depression ; Diet ; Digitalis ; Diuretics ; Dogs ; Electrocardiography ; Electrolytes* ; Heart ; Humans ; Hypokalemia ; Hyponatremia ; Infusions, Intravenous ; Ions ; Ouabain ; Plasma ; Potassium ; Sodium ; Tachycardia, Ventricular

PURPOSE: Although influenza is regarded as one of the major causes of morbidity and mortality in children with cancer, the actual vaccine coverage remains poor. We conducted evaluation of immunogenicity and safety of influenza vaccine in children with cancer. METHODS: In this study, 25 children with cancer who received influenza vaccine (SK influenza IX vaccine(R)) at the Korea Cancer Center Hospital between October and December 2009 were analyzed. Blood samples of patients were collected twice (at the beginning of this study and at 30th day after vaccination) and their antibody titers were measured using the hemagglutination-inhibition (HI) assay. Immunogenicity of the influenza vaccine was assessed by seroprotection rate on days 0 and 30, seroconversion rate on day 30, and mean fold increase (MFI) of geometric mean titer (GMT) of HI between days 0 and 30. RESULTS: Any of the subjects in our study did not experienced serious adverse events after influenza vaccination. Seroprotection rates were 68% for H1N1, 40% for H3N2, and 36% for B. Seroconversion rates were 12% for H1N1, 16% for H3N2, and 20% for B. MFIs were 0.9 for H1N1, 1.2 for H3N2, and 1.8 for B. CONCLUSION: In the study, we found a limited protective immune response to influenza vaccine, among subjects with cancer. However, some subjects showed seroconversion, and there were no severe adverse events among all subjects, supporting the recommendation of annual influenza vaccination in children with cancer.
Child ; Humans ; Influenza Vaccines ; Influenza, Human ; Korea ; Vaccination

BACKGROUND: As the pleural inflammation progresses, exudative pleural fluid becomes loculated rapidly with pleural thickening. Complete drainage is important 13 prevent pleural fibrosis, entrapment and depression of lung function Intrapleural urokinase instillation therapy has been advocated as a method to facilitate drainage of gelatinous pleural fluid and to allow enzymatic debriment of pleural surface. This study was designed to investigate the Predictors of effeotiveness of intrapleural urokinase in treatment of loculated pleural effusion METHOD: Thirty-five patients received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French Twenty-two patients had tuberculous pleural effusions, and 13 had non-tuberculous postpneumonic empyemas. A total of 240,000 units of urokinase was dissolved in 240 ml of normal saline and the aliquots of 80mL was instilled into the pleura1 cavity via pig-tail catheter per every 8hr. Effectiveness of intrapleural urokinase instillation therapy was assessed by biochemical markers, ultrasonography, and technical details. A greater than 50% improvement on follow-up chest radiographs was defined as success group. RESULT: Twenty-seven of 35 (77.1%) patients had successful outcome to urokinase instillation therapy. Duration of symptoms before admission was shorter in sucess group (11.8α6.9day) than in failure group (26.62α16.5day) (P<0.05). Amount of drained fluid during urokinsse therapy was larger in success group (917.1α392.7ml) than in failure group (613.8α259.7ml) (P<0.05). Pleural fluid glucose was higher in success group (89.7 α35.9mg/dl) than in failure group (41.2α47.1mg/dl) (P<0.05). Pleural fluid LDH was lower in success group (878.4α654.31U/L) than in failure group (2711.1α973.1IU/L) (P<0.05). Honeycomb septated pattern on chest ultrasonography was observed in six of eight failure group, but none of success group(P<0.05). CONCLUSION: Longer duration of symptoms before admission smaller amount of drained fluid during urokinase therapy, lower glucose value, higher LDH value in pleural fluid examination and honeycomb septation pattern on chest ultrasonography were predictors for failure group of intrapleural urokinase instillation therapy.
Biomarkers ; Catheters ; Depression ; Drainage ; Empyema ; Fibrosis ; Follow-Up Studies ; Gelatin ; Glucose ; Humans ; Inflammation ; Lung ; Pleural Effusion* ; Radiography, Thoracic ; Thorax ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

BACKGROUND: Dermatologists frequently see morbilliform rash in the clinic, drug eruptions and viral eruptions. Due to close clinical similarities, it is difficult to differentiate them. OBJECTIVE: The purpose of this study was to review the histopathologic differences between drug eruption and viral eruption. METHOD: In this study, 13 patients diagnosed as rubella and 13 patients diagnosed as drug eruption in Department of Dermatology, Presbyterian Medical Center from 1995 to 1997 were included. We reviewed the epidermal changes such as vacuolopathy, dyskeratotic cells, spongiosis and exocytosis and dermal changes by light microscopy. RESULTS: 1. Vacuolopathy of basal layer was observed in 92.3% of patients in both diseases. 2. Dyskeratotic cells, spongiosis and exocytosis were observed significantly highly in drug eruption. 3. Perivascular lymphohistiocytic infiltration was mild in both diseases, but eosinophilic infiltration was significantly higher in drug eruption(84.6%) than viral eruption(15.4%). 4. Atypical lymphocytes were observed in both diseases. 5. Red blood cell extravasation was observed only in viral eruption. 6. Perivascular edema was significantly higher in drug eruption(76.9%) than viral eruption(38.4%) CONCLUSION: There were statistically significant differences in dyskeratotic cells, spongiosis, dermal eosinophilic infiltration and Red blood cell extravasation. Considering these observation, histopathologic findings may be helpful in differentiating between drug eruption and viral eruption.
Dermatology ; Drug Eruptions* ; Edema ; Eosinophils ; Erythrocytes ; Exanthema ; Exocytosis ; Humans ; Lymphocytes ; Microscopy ; Protestantism ; Rubella*

As the society became more aging, prevalence of senile spinal diseases such as osteoporotic spinal fracture, spinal sprain, myofascial pain, degenerative intervertebral disc disease, spondylitis, metastatic spinal disease, and infectious disease has increased. If spinal pain occurs in old age, complication of osteoporotic fracture must be considered. Before treating osteoporotic spinal fracture, degree of pain, fracture characteristics, presence of neurologic symptom, degree of kyphotic deformity, and general condition of the patient should be considered in order to choose the appropriate treatment method. Conservative treatment for osteoporotic fracture includes pain control, medication for osteoporosis, spinal brace and exercise treatment, and diverse surgical treatment methods such as vertebroplasty, kyphoplasty, or anterior and posterior instrumentation are preformed nowadays. We will investigate the definition of osteoporotic spinal fracture and several treatments and the indications and methods of which by reviewing references.
Aging ; Braces ; Communicable Diseases ; Congenital Abnormalities ; Humans ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Kyphoplasty ; Neurologic Manifestations ; Osteoporosis ; Osteoporotic Fractures ; Prevalence ; Spinal Diseases ; Spinal Fractures ; Spondylitis ; Sprains and Strains ; Vertebroplasty

PURPOSE: To compare the pullout strength and insertion torque of proximally tapered screw (PT) with fully tapered screw (FT) and to investigate the correlation between the pullout strength and bone mineral density, morphology of pedicle, and insertion torque of the screw in osteoporotic lumbar spine. MATERIALS AND METHODS: Fifteen osteoporotic lumbar vertebrae from four white human cadavers were used. Bone mineral density, pullout strength and insertion torque were measured by dual energy x-ray absorptiometry, MTS and torque screw driver individually. RESULTS: The FT screw provided greater pullout force and insertion torque than the PT screw in 12 of 15 vertebrae tested (p<0.01). Pullout strength was correlated with insertion torque in PT (r=0.666, P=0.0006) and FT (r=0.464, P=0.19) screws. CONCLUSIONS: Results of this study indicate that the FT screws provide higher pullout strength and insertion torque than PT screws in osteoporotic lumbar spine and suggest that the development of tapered minor diameter may lead to an improved pedicle screw with high pullout strength and insertion torque. Nevertheless, further study is needed to investigate the effect of tapering the minor diameter on the mechanical bending strength of the screw.
Absorptiometry, Photon ; Bone Density ; Cadaver ; Humans ; Lumbar Vertebrae ; Spine* ; Torque

Hydrops fetalis is diagnosed when abnormal fluid collections are manifest in two or more fetal compartments, including abdominal ascites, pleural effusions, pericardial effusions, skin edema, polyhydroamniosis and placental edema. Although fetal hydrops was hystorically most commonly associated with Rh blood group isoimmunization, the availability of Rh immunoglobulin has increased the proportion of fetuses affected due to nonimmune etiologies. We have experienced a case of nonimmune hydrops fetalis at 32 weeks of gestation in a 27-year-old woman and reported that with brief review of related literatures.
Adult ; Ascites ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Immunoglobulins ; Pericardial Effusion ; Pleural Effusion ; Pregnancy ; Skin

OBJECTIVES: We investigated the parenting stress and depressive mood of mothers with developmentally-delayed children and the effects of participation in a mother-child development promotion program on same. METHODS: Subjects were the mothers of 20 developmentally-delayed children. The severity of the mothers' parenting stress was evaluated via the Korean version of the Parenting Stress Index, Short Form (K-PSI-SF) and the severity of their depressive symptoms were evalueted by the Korean version of the Beck Depression Inventory (K-BDI). RESULTS: The mean K-PSI-SF score and mean K-BDI score for these mothers were 93.35 (SD=10.47) and 23.25 (SD=10.42), respectively. These scores correspond to high parenting stress and moderate depression. The mothers who participated in a mother-child attachment- promotion program showed significant decreases in their K-PSI-SF and KBDI scores. CONCLUSION: Our data suggest that a mother-child attachment promotion program with emphasis on child development is effective in reducing parenting stress and depressive mood in mothers of developmentally-delayed children.
Child ; Child Development ; Depression ; Humans ; Mothers ; Parenting ; Parents

The subepidermal calcified nodule, also known as a form of calcinosis cutis, is characterized by solitary circumscribed deposits of insoluble calcium within the subepidermis. The disease is not associated with any systemic or cutaneous diseases, or any biochemical abnormalities. The pathogenesis is still unknown. A 55-year-old female presented with a 4-month history of solitary skin-colored, hyperkeratotic papule on the left upper eyelid. The lesion was asymptomatic and had increased slowly in size. It is interesting that excisional biopsy showed typical histopathologic features of the subepidermal calcified nodule and the clear cell syringoma.
Biopsy ; Calcinosis ; Calcium ; Eyelids ; Female ; Humans ; Middle Aged ; Syringoma*

Acquired tumors of the nonpigmented ciliary epithelium are rare diseases. They are difficult to diagnose and present as pseudoadenomatous hyperplasia, adenoma or adenocarcinoma. They exhibit slowly progressive enlargement leading to a subluxated lens, cataract, and secondary glaucoma. And some of the more malignant tumors may extend extrasclerally. We report a case of adenoma of nonpigmented ciliary epithelium which produced a cataract.
Adenocarcinoma ; Adenoma* ; Cataract ; Epithelium* ; Glaucoma ; Hyperplasia ; Rare Diseases