PURPOSE: Febrile seizure, the most common seizure disorder in children between 6 months and 5 years of age, is mostly caused by viral infections, except severe CNS infection. It can also be caused by disorders in organic acid metabolism, especially accompanied by fever. Therefore we decided to investigate the relationship between children with febrile seizures and disorders in organic acid metabolism. METHODS: We examined 54 children with febrile seizure who visited Chunchon Sacred Heart Hospital Emergency Department from February 2002 to January 2004. We conducted urine organic acid analysis, CBC, urine analysis, serum ammonia and gas analysis. RESULTS: Thirteen(24.1%) patients showed ketonuria, eight(14.8%) patients showed lactic aciduria and ketonuria, two(3.7%) patients showed pyruvic aciduria, and one(1.8%) showed mandelic aciduria. CONCLUSION: Twenty four of 54(44.4%) showed abnormal findings in urine organic acid analysis. Most results are ketonuria or lactic aciduria with ketonuria. They may show in fasting, severe infection or ketolytic defect(ex, 3-ketothiolase deficiency). Patients with 3-ketothiolase deficiency, can develop seizures during fever, and fasting state. Therefore further evaluation is necessary.
Acetyl-CoA C-Acyltransferase ; Ammonia ; Child ; Emergency Service, Hospital ; Epilepsy ; Fasting ; Fever ; Gangwon-do ; Heart ; Humans ; Ketosis ; Lactic Acid ; Metabolism ; Seizures ; Seizures, Febrile*

PURPOSE: This study was performed to investigate the change of weight and body composition, and lipid profiles in the idiopathic epileptic children treated with valproate. METHODS: We measured the weight, height, left arm circumference, left triceps skinfold thickness of 30 idiopathic epileptic children treated with valproate before, at 1 month and 4 months of treatment. We also analyzed the serum lipid profiles of the patients before and at 4 months of treatment. We analyzed the change of Body Mass Index (BMI), Arm Muscle Area(AMA), Arm Fat Area(AFA), and the serum lipid profiles. Two-way analysis of variance, chi-square test and paired-t test were used for statistical analysis. RESULTS: There was no statistically significant change in BMI, AFA, AMA of the patients. But the weight of 13(44.3%) children increased greater than 10% with valproate treatment. AMA were not changed, but AFA were significantly increased, 791.2+/-209.6 mm2 before treatment, 858.1+/-246.6 mm2 at 1 month, 1051.7+/-393.2 mm2 at 4 months, in 13 patients, whose weight gain were greater than 10%(P<0.05). There was no change in cholesterols, low density lipoproteins, high density lipoproteins of the 30 children. CONCLUSION: The increase of the weight in the children treated with valproate resulted from the increase body fat. So the weight gain may be a risk factor of obesity
Adipose Tissue ; Arm ; Body Composition ; Body Mass Index ; Child* ; Cholesterol ; Humans ; Lipoproteins, HDL ; Lipoproteins, LDL ; Obesity ; Risk Factors ; Skinfold Thickness ; Valproic Acid* ; Weight Gain*

BACKGROUND: The purpose of this study was to evaluate mivacurium in the pharmacokinetics of onset and offset. METHODS: In 127 adult patients of ASA physical status I or II without any factors involving the neuromuscular function under general anesthesia, onset time (lag and manifest time) and clinical duration were measured after bolus or divided doses of ED95 x 2 of succinylcholine (SCC), rocuronium (ROC), atracurium (ATR), mivacurium (MIV), pancuronium (PAN) or vecuronium (VEC). Recovery time was defined as the recovery index and total duration measured after subsequent ED95 of MIV at 25% recovery of control twitch height from neuromuscular block induced by ED95 x 2 of ATR, MIV, PAN or VEC. Plasma cholinesterase (PChE) levels were measured following PAN or ATR. RESULTS: Onset time was faster with SCC and ROC, the low potency drugs, than with ATR, MIV, PAN or VEC, the high potent drugs. Manifest time was shorter in low potency drugs but longer in high potency drugs than lag time after bolus or divided doses of muscle relaxants given. Divided doses of various drugs induced a shortened onset time, but the patterns of relationship between lag and manifest time associated with drug potency did not alter. The recovery times with administered MIV were slowest after PAN pretreatment, and fastest after MIV pretreatment. PChE levels decreased significantly from 3 min to over 180 min after PAN administeration but not ATR. CONCLUSIONS: The onset time of MIV was not improved due to high drug potency as other nondepolarizing neuromuscular blockers. However, in spite of high potency, the recovery time of MIV was faster than other drugs. This results may be depend upon PChE activity rather than drug potency. Additionally, the prolonged recovery of MIV was not only under the influence of low PChE activity but also other some factors such as: the first relaxants administered before MIV dominated the neuromuscular block so that the duration of MIV given subsequently changed to resemble that of the first. The longer elimination half-life of the underlying relaxant prolonged the effects of subsequentshorter acting MIV. Structural similarities or dis-similarities between the interacting MIV and other drugs may have effects more potent in dis-similarity than in similarity.
Adult ; Anesthesia, General ; Atracurium ; Cholinesterases ; Half-Life ; Humans ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pancuronium ; Pharmacokinetics* ; Plasma ; Succinylcholine ; Vecuronium Bromide

Objective: To investigate the cytotoxic activity of the hexane and ethyl acetate extracts of Curcuma mangga rhizomes against human colorectal adenocarcinoma cell lines (HT29). Methods: The cytotoxic activity of the hexane and ethyl acetate extracts of Curcuma mangga rhizomes against human colorectal adenocarcinoma cell lines (HT29) was determined by using the SRB assay. Results: The ethyl acetate extract showed a higher cytotoxic effect compared to the hexane extract. Morphological changes of the HT29 cells such as cell shrinkage, membrane blebbling and formation of apoptotic bodies while changes in nuclear morphology like chromatin condensation and nuclear fragmentation were observed. Further evidence of apoptosis in HT29 cells was further supported by the externalization of phosphatidylserine which indicate early sign of apoptosis. Conclusions: The early sign of apoptosis is consistent with the cell cycle arrest at the G

BACKGROUND: The interactions between furosemide and muscle relaxants is controversial. In this study, the effects of furosemide on the recovery from neuromuscular blockade induced by vecuronium were investigated in thirty ASA class 1 or 2 adult patients undergoning elective orthopedic surgery under the general aneshtesia with O2-N2O-enflurane. METHODS: Furosemide was administered intravenously at 20% spontaneous recovery of first twitch height of TOF(T1) under the neuromuscular monitoring using Relaxograph?(Datex Co. Finland) as follows: placebo in control group, 5mg in group 1 and 20mg in group 2. Recovery index(RI) defined as the time from 25% to 75% recovery of T1, urinary output during this period and serum K+ levels at 10% and 75% recovery of T1 were measured. RESULTS: RI was shortened significantly in group 1 (11.2+/-3.4 min.) and group 2 (14.9+/-2.7 min.) compared with control group (19.3+/-4.0 min.)(P<0.05). The urinary output was significantly greater in the groups received furosemide than that in the control group(P<0.05), but serum K+ levels were not significantly changed after administration of furosemide. CONCLUSIONS: Furosemide facilitates recovery of neuromuscular blockade induced by vecuronium.
Adult ; Furosemide* ; Humans ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Orthopedics ; Vecuronium Bromide*

Background/Aims: Although gastric neuroendocrine tumors (NETs) are uncommon neoplasms, their prevalence is increasing. The clinical importance of the World Health Organization (WHO) classification of gastric NETs, compared with NETs in other organs, has been underestimated.This study aimed to systematically evaluate the clinical and pathologic characteristics of gastric NETs based on the 2019 WHO classification and to assess the survival outcomes of patients from a single-center with a long-term follow-up. Methods: The medical records of 427 patients with gastric NETs who underwent endoscopic or surgical resection between January 2000 and March 2020 were retrospectively reviewed. All specimens were reclassified according to the 2019 WHO classification. The clinicopathologic characteristics, treatment, and oncologic outcomes of 139 gastric NETs were analyzed. Results: The patients’ median age was 53.0 years (interquartile range [IQR], 46.0 to 63.0 years). The median follow-up period was 36.0 months (IQR, 15.0 to 63.0 months). Of the patients, 92, 44, and 3 had grades 1, 2, and 3 NETs, respectively. The mean tumor size significantly increased as the tumor grade increased (p=0.025). Patients with grades 2 and 3 gastric NETs more frequently had lymphovascular invasion (29.8% vs 10.9%, p=0.005) and deeper tissue invasion (8.5% vs 0%, p=0.012) than those with grade 1 tumors. The overall disease-specific survival rate was 100%. Two patients with grades 2-3 gastric NETs experienced extragastric recurrence. Conclusions Although gastric NETs have an excellent prognosis, grade 2 or grade 3 gastric NETs are associated with a larger size, deeper invasion, and extragastric recurrence, which require active treatment.

The apprenticeship-based training method (ABTM) is highly effective for gastrointestinal (GI) endoscopic training. However, the conventional ABTM has significant issues. Although many supplementary training methods (TMs) have been developed and utilized, they cannot entirely replace the ABTM, which remains the major TM strategy. Currently, new TM construction is crucial and necessary due to financial constraints, difficulty of obtaining sufficient training time due to patient safety-related regulations, and catastrophic damage caused by disasters such as the coronavirus disease 2019 pandemic. The simulator-based TM (SBTM) is widely accepted as an alternative to the ABTM, owing to the SBTM’s advantages. Since the 1960s, many GI endoscopy training simulators have been developed and numerous studies have been published on their effectiveness. While previous studies have focused on the simulator’s validity, this review focused on the accessibility of simulators that were introduced by the end of 2021. Although the current SBTM is effective in GI endoscopic education, extensive improvements are needed to replace the ABTM. Incorporating simulator-incorporated TMs into an improved ABTM is an attempt to overcome the incompleteness of the current SBTM. Until a new simulator is developed to replace the ABTM, it is desirable to operate a simulator-integrated and well-coordinated TM that is suitable for each country and institution.

Advanced gastric cancer with skeletal muscle metastasis is a rare occurrence. Here, we report a rare case of gastric carcinoma with psoas muscle metastasis. This patient had advanced gastric carcinoma and complained of inability to extend the left hip joint due to pain. Because magnetic resonance imaging (MRI) revealed an iliopsoas mass showing heterogeneous signal intensity with fluid collection and enhancement around the mass, we speculated that the mass was an intramuscular metastatic tumor from primary gastric carcinoma as well as an intramuscular abscess. Histopathologically, the patient had a metastasis from primary gastric adenocarcinoma. Therefore, the patient was treated with radiotherapy and subsequent chemotherapy.
Abscess ; Adenocarcinoma ; Hip Joint ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Muscles ; Neoplasm Metastasis ; Psoas Muscles ; Stomach Neoplasms

Mature T-cell and natural killer-cell neoplasms account for 10 to 15% of all non-Hodgkin's lymphomas. Of the various subtypes of mature T-cell and NK-cell lymphomas, extranodal NK/T-cell lymphoma, nasal type (nasal type NK/T-L) is relatively more common among Asians including Koreans. Nasal type NK/T-L is an aggressive, Epstein-Barr virus-associated lymphoma with characteristic expression of NK-cell antigen CD56. In this report, we present an unusual case of EBV(+), CD56(-) NK/T-L of oropharynx which recurred in duodenum after the period of complete remission lasting for 10 years. A 58-year-old woman presented with 3 months history of abdominal pain. Gastroduodenoscopy showed the diffuse wall thickening with multiple ulcerations in bulb and proximal second portion of the duodenum. Pathological examination revealed the infiltration of atypical lymphocytes, which was positive for CD3, CD4, CD5, TIA-1, and EBV and was negative for CD15, CD20, and CD56, consistent with NK/T-L of mature T-cell origin. The past medical history included the presence of oropharyngeal mass 10 years earlier, which was diagnosed as polymorphic reticulosis. The mass resolved completely after the radiation therapy, and she remained free of the disease for 10 years. Upon review, the oropharyngeal biopsy showed an identical morphology and immunophenotype with duodenal lesion. In conclusion, we experienced an unusal case of NK/T-cell lymphoma, nasal type recured in the duodenum.
Abdominal Pain ; Asian Continental Ancestry Group ; Biopsy ; Duodenum ; Female ; Granuloma, Lethal Midline ; Herpesvirus 4, Human ; Humans ; Lymphocytes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Oropharynx ; Recurrence* ; T-Lymphocytes ; Ulcer

Advanced gastric cancer with skeletal muscle metastasis is a rare occurrence. Here, we report a rare case of gastric carcinoma with psoas muscle metastasis. This patient had advanced gastric carcinoma and complained of inability to extend the left hip joint due to pain. Because magnetic resonance imaging (MRI) revealed an iliopsoas mass showing heterogeneous signal intensity with fluid collection and enhancement around the mass, we speculated that the mass was an intramuscular metastatic tumor from primary gastric carcinoma as well as an intramuscular abscess. Histopathologically, the patient had a metastasis from primary gastric adenocarcinoma. Therefore, the patient was treated with radiotherapy and subsequent chemotherapy.
Abscess ; Adenocarcinoma ; Hip Joint ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Muscles ; Neoplasm Metastasis ; Psoas Muscles ; Stomach Neoplasms