PURPOSE: Besides interferencence of esophageal motor function by the nasogastric tube, a decline of the positive gastro-esophageal pressure gradient caused by intermittent positive pressure ventilation seems to have a major role in the pathogenesis of gastroesophageal reflux (GER) in mechanically ventilated preterm infants. The aim of this study was to determine the incidence of GER and associated risk factors in mechanically ventilated preterm infants. METHODS: Twenty four hour esophageal pH monitorings were performed using a antimony electrode on 11 mechanically ventilated preterm infants in Neonatal Intensive Care Unit in Pusan National University Hospital. We evaluated the following reflux parameters; reflux index, reflux episodes/ hour, reflux episodes > or =5 min/hour, duration of longest episode, and percent episodes > or =5 min. Patients were considered to have significant GER if more than 2 among 5 parameters were satisfied. RESULTS: The mean gestational age of the patients was 30.9 weeks, mean birth weight was 1,568 g, and mean age at the time of pH monitoring was 2.8 days. Significant GER was detected in 4 patients (36.4%). There was no relationship between the incidence of GER and gestational age, birth weight, postnatal age, or the ventilator settings. CONCLUSION: The incidence of GER in mechanically ventilated preterm infants was similar, compared with other previous studies. Associated risk factors of GER in these patients were not detected. Therefore, mechanical ventilation in preterm infants does not seem to be the high risk factor of GER.
Antimony ; Birth Weight ; Busan ; Electrodes ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Intermittent Positive-Pressure Ventilation ; Respiration, Artificial ; Risk Factors ; Ventilators, Mechanical

No abstract available.
Dislocations* ; Knee*

Aplastic anemia following acute hepatitis or acute hepatic failure is an uncommon disease and has a poor prognosis. We experienced a case of aplastic anemia following acute hepatic failure in a 10- year-old girl. She was admitted because of jaundice and lethargy for 8 days. Laboratory findings revealed marked elevated serum transaminases and bilirubin levels, prolonged prothrombin time and partial thromboplastin time, and massive hepatic necrosis on the pathological study. There was no evidence of metabolic, toxic or autoimmune hepatitis. During the treatment of acute hepatic failure, pancytopenia developed and marked hypocellularity of all hematopoietic elements in bone marrow was revealed. She recovered partially from aplastic anemia after treatment with anti-thymocyte globulin, corticosteroid and cyclosporine.
Anemia, Aplastic* ; Antilymphocyte Serum ; Bilirubin ; Bone Marrow ; Cyclosporine ; Female ; Hepatitis* ; Hepatitis, Autoimmune ; Humans ; Jaundice ; Lethargy ; Liver Failure* ; Liver Failure, Acute ; Massive Hepatic Necrosis ; Pancytopenia ; Partial Thromboplastin Time ; Prognosis ; Prothrombin Time ; Transaminases

BACKGROUND: Paraquat is a bipyridyl compound, and when ingested, concentrated paraquat can cause either rapid death from multisystem failure and cardiovascular shock or delayed death from progressive pulmonary fibrosis. Paraquat is poorly absorbed by inhalation, but when ingested orally, severe illness can occur. Death usually occurs within 2 days if more than 50mg/kg of paraquat is ingested. The most important prognostic indicator is the quantity of paraquat absorbed, as shown by the plasma paraquat concentration. However, in Korea, there are few, if any, institutes that can measure the plasma paraquat concentration, and the prognostic indication depends mostly on the description given by the patients and their families about the amount of paraquat ingested, which is often underestimated or overestimated. For these reasons, we tried to compare the plasma paraquat concentrations with amount of paraquat described by patients or their families. METHODS: We reviewed the medical records of 59 patients with acute paraquat poisoning from February 1998 through February 1999. The paraquat concentrations in plasma were measured at Presbyterian Medical Center by using high performance liquid chromatography. RESULTS: There was a striking discrepancy between the plasma paraquat concentration and the ingested amount described by the patients or their families. CONCLUSION: We recommend that the plasma paraquat concentration be measured in patients being treated for acute paraquat poisoning.
2,2'-Dipyridyl ; Academies and Institutes ; Chromatography, Liquid ; Humans ; Inhalation ; Korea ; Medical Records ; Paraquat* ; Plasma* ; Poisoning* ; Protestantism ; Pulmonary Fibrosis ; Shock ; Strikes, Employee

Torsion of the fallopian tube is an uncommon cause for acute low abdominal pain in female that is difficult to diagnose. Because it has no pathognomonic clinical symptoms or laboratory findings, a high index of suspicion is important when there is history of pelvic pathologic conditions or surgery. The early diagnosis and surgical treatment of the disease are mandatory to preserve oviduct.
Abdominal Pain ; Adolescent* ; Animals ; Early Diagnosis ; Fallopian Tubes* ; Female ; Humans ; Oviducts

Congenital pleural effusions are uncommon. The majority of cases are due to chylothorax, hydrops fetalis, and infection. Effusions of this nature are, for the most part, self-limited. We experienced a rare case of a congenital unilateral pleural effusion due to an extralobar sequestraion with pulmonary lymphangiectasia. Pleural effusion was found by antenatal ultrasonography and confirmed by CT scans and CT angiography of the chest in the neonatal period. The patient underwent an open thoracotomy where extralobar sequestraion located between the diaphragm and the left lower lobe was removed. His postoperative course was uncomplicated and there was complete resolution of the pleural effusion.
Angiography ; Bronchopulmonary Sequestration* ; Chylothorax ; Diaphragm ; Humans ; Hydrops Fetalis ; Pleural Effusion* ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography

Sagittal split ramus osteotomy (SSRO) is one of the surgical techniques used to correct mandibular deformities. In order to prevent many surgical anatomical problems, we observed the anatomical structures related to SSRO. In dry mandibles of Koreans, lingular tips were located somewhat posteriorly and superiorly on the mandibular ramus. On the coronal sections of mandible, the mean cortical width of facial cortex was increased toward the ramus region while the lingual cortex was thinnest in the ramus region. On the same sections, all the fusion points of the buccal and lingual cortical plate were located above the mandibular lingula and beneath the mandibular notch. So, performing the SSRO on Koreans, medial horizontal osteotomy should be done through the superior aspect of the mandibular lingula. The cut line is extended 5-8 mm posterior to the mandibular lingula to preserve sufficient cortical width to strengthen the involved osseous segments and reduce possible surgical complications.
Anatomy, Artistic ; Human ; Human ; Mandible/surgery* ; Mandible/anatomy & histology* ; Medical Illustration ; Osteotomy/methods*

OBJECTIVE: This study was performed to evaluate the possibility of prolonged culture of human embryonic stem cells (hESC; SNUhES2) on human amniotic fluid cells (hAFC), which had been storaged after karyotyping. METHOD: The hAFC was prepared for feeder layer in the presence of Chang's medium and STO medium (90% DMEM, 10% FBS) at 37degrees C in a 5% CO2 in air atmosphere. Prior to use as a feeder layer, hAFC was mitotically inactivated by mitomycin C. The hESCs on hAFC were passaged mechanically every seven days with ES culture medium (80% DMEM/F12, 20% SR, bFGF). RESULTS: The hAFC feeder layer support the growth of undifferentiated state of SNUhES2 for at least 59 passages thus far. SNUhES2 colonies on hAFC feeder appeared slightly angular and flatter shape as compared with circular and thicker colonies observed with STO feeder layer and showed higher level with complete undifferentiation in seven days. Like hESC cultured on STO feeders, SNUhES2 grown on hAFC expressed normal karyotype, positive for alkaline phosphatase activity, high telomerase activity, Oct-4, SSEA-3, SSEA-4, Tra-1-60 and Tra-1-81 and formed embryoid bodies (EBs). CONCLUSION: The hAFC supports undifferentiated growth of hESC. Therefore, these results may help to provide a clinically practicable method for expansion of hESC for cell therapies.
Alkaline Phosphatase ; Amniotic Fluid* ; Atmosphere ; Embryoid Bodies ; Embryonic Stem Cells* ; Feeder Cells ; Female ; Humans* ; Karyotype ; Karyotyping ; Mitomycin ; Telomerase

Lobulated intradermal nevus is an unusual form of regressing melanocytic nevus. Clinically, it shows a lobulated plaque and biopsy specimens display fatty infiltration within nests of nevus cells, dermal fibrosis and neuroid differentiation of nevus cells. We report a case of lobulated intradermal nevus resembling linear epidermal nevus in a 45-year-old female patient.
Biopsy ; Female ; Fibrosis ; Humans ; Middle Aged ; Nevus ; Nevus, Intradermal* ; Nevus, Pigmented

PURPOSE: Water is magnetically charged upon contact with a magnet. Although magnetic water products have been promoted since the 1930's, they have not received wide acceptance since their effectiveness is still in question; however, some have reported their therapeutic effects on the body, especially the digestive, nervous, and urinary systems. METHODS: In this study, the effect of magnetized water on glycemic control of 14 diabetic mice (CB57BK/KsJ-db/db) in comparison with 10 control mice (CB57BK/KsJ-db/+(db/+)) was investigated. Seven diabetic control (DMC) mice and seven diabetic mice + magnetized water (DM+MW) were kept for 16 weeks, followed by intraperitoneal glucose tolerance test (IPGTT). Weekly blood glucose was measured from tail veins. Blood obtained from heart puncture was used for HbA1c analysis. RESULTS: Blood glucose level showed a significant difference starting from the 10th week of study (496.1 ± 10.2 mg/dl in DMC vs. 437.9 ± 76.9 mg/dl in DM+MW). Blood glucose followed by IPGTT showed no significant difference between groups at 0, 30, 60, 90, and 120 min, although glucose level at 180 min was significantly reduced in DM+MW mice. Plasma insulin level in DM+MW groups was only 39.5% of that of DMC groups (5.97 ± 1.69 ng/ml in DMC vs. 2.36 ± 0.94 ng/ml in DM+MW). Levels of HbA1c were 12.4% and 9.7% in DMC and DM+MW groups, respectively. CONCLUSION: These results show the promising therapeutic effect of magnetized water in regulating blood glucose homeostasis; however, long-term supplementation or mechanistic study is necessary.
Animals ; Blood Glucose ; DNA Damage* ; DNA* ; Glucose ; Glucose Tolerance Test ; Heart ; Homeostasis ; Insulin ; Mice* ; Plasma ; Punctures ; Tail ; Therapeutic Uses ; Veins ; Water*