BACKGROUND: Caudal anesthesia is considered a safe and reliable anesthetic technique for many pediatric surgical procedures. It is well known that extradural clonidine produces analgesia in adult. The purpose of this study is to assess its efficacy in children. METHODS: We randomized 45 pediatric patients aged under 10 years, weighted under 25 kg presented for lower abdominal surgery with duration of operation would be shorter than 2 hours, into three groups of 15 each. After sedation with the use of intravenous thiopental sodium, caudal anesthesia was performed with the use of 1 mL/kg of 0.25% bupivacaine. We allocated randomly the patients who received no additional medication in 0.25% bupivacaine (group I), with epinephrine 1/200,000 (group II), and with 1 mcg/kg of clonidine (group III). The degree of postoperative analgesia was evaluated using the Broadman ""Objective Pain/discomfort Scale"" (OPS) at hourly intervals for 24 hours. RESULTS: Duration of sleep in the recovery room was significantly longer in group III than in group I and group II, and statistical significant difference was found between the group I and group II. Duration of analgesia was significantly longer in group III than in group I and group II. Overall hourly OPS scores were lower in group III than in group I and group II. CONCLUSION: Duration of postoperative analgesia with caudal bupivacaine was increased by addition of 1 mcg/kg of clonidine.
Adult ; Analgesia ; Anesthesia, Caudal* ; Bupivacaine ; Child ; Clonidine* ; Epinephrine ; Humans ; Recovery Room ; Thiopental

No abstract available.
Femur* ; Gestational Age* ; Ultrasonography*

Objective: To examine the effects of Tribulus terrestris L. (T. terrestris) extract on the modulation of calcium channels to evaluate its use in topical agents for treatment of atopic dermatitis. Methods: The 70% methanol extract of T. terrestris was prepared. Human HEK293T cells with over-expressed calcium release-activated calcium channel protein 1 (Orai1), transient receptor potential vanilloid 1, or transient receptor potential vanilloid 3 (TRPV3) were treated with T. terrestris extract. Modulation of ion channels was measured using a conventional whole-cell patch-clamp technique. Results: T. terrestris extract (100 mg/mL) significantly inhibited Orai1 activity in Orai1-stromal interaction molecule 1 co-overexpressed HEK293T cells. In addition, T. terrestris extract significantly increased the TRPV3 activity compared with 2-Aminoethyl diphe-nylborinate (100 mmol/L), which induces the full activation of TRPV3. Conclusions: Our results suggest that T. terrestris extract may have a therapeutic po-tential for recovery of abnormal skin barrier pathologies in atopic dermatitis through modulating the activities of calcium ion channels, Orai1 and TRPV3. This is the first study to report the modulatory effect of a medicinal plant on the function of ion channels in skin barrier.

Purpose: We evaluated a new color vision test, thus the ColorDx Cone contrast test HD ([CCT-HD]; Konan Medical, Inc., Irvine, CA, USA) in normal and color vision-deficient (CVD) eyes of Koreans. Methods: The CCT-HD was performed on 66 healthy Koreans (125 normal eyes) and 25 patients (50 eyes) with congenital CVD. The results from normal eyes were compared and analyzed in terms of binocular agreement, patient ages, and spherical equivalents. The CCT-HD results on CVD eyes were compared and analyzed. Results: We found no significant difference in any of the long (L), medium (M), or short wavelength (S) cone cell sensitivity (L-CCT, M-CCT, S-CCT) scores for normal eyes; also, there was no significant effect of age and no significant correlation between the spherical equivalent and the CCT score. In normal eyes, all scores were >75 (normal ≥75). The average protan L-CCT score was significantly reduced (13.0 ± 13.2; p < 0.001) as was the average deutan M-CCT score (31.7 ± 16.6; p < 0.001). The CCT-HD L-CCT and M-CCT exhibited 100% sensitivity and specificity in terms of diagnosing protans and deutans respectively. Conclusions CCT-HD allows classification and quantitative evaluation of protans and deutans, and is thus useful when examining color vision status.

Purpose: To analyze prognostic factors for morphological and functional recovery after vitrectomy in patients with idiopathic epiretinal membrane (ERM). Methods: We conducted a retrospective analysis of patients with ERM who underwent vitrectomy. Postoperative outcomes were evaluated in terms of functional and morphological changes, assessing best-corrected visual acuity (BCVA) and central macular thickness (CMT) after 6 months. Logistic regression was used to identify factors influencing postoperative outcomes. Results: This study included 77 patients (35.1% men). Thirty-eight patients underwent combined vitrectomy and cataract surgery. Logistic regression revealed that better preoperative BCVA was associated with improved postoperative BCVA (p = 0.002). Among the 38 eyes that underwent combined surgery, longer preoperative axial length was linked to better visual outcomes in univariate analysis (p = 0.043), although the association was not statistically significant in multivariate analysis (p = 0.064). Younger age and thinner preoperative CMT were associated with better morphological outcomes (p = 0.034 and p = 0.001, respectively). Conclusions Preoperative BCVA, age, preoperative CMT, and axial length are predictive factors for functional and morphological outcomes after vitrectomy in patients with ERM. These findings may facilitate treatment planning and prognosis prediction before surgery.

Purpose: To analyze prognostic factors for morphological and functional recovery after vitrectomy in patients with idiopathic epiretinal membrane (ERM). Methods: We conducted a retrospective analysis of patients with ERM who underwent vitrectomy. Postoperative outcomes were evaluated in terms of functional and morphological changes, assessing best-corrected visual acuity (BCVA) and central macular thickness (CMT) after 6 months. Logistic regression was used to identify factors influencing postoperative outcomes. Results: This study included 77 patients (35.1% men). Thirty-eight patients underwent combined vitrectomy and cataract surgery. Logistic regression revealed that better preoperative BCVA was associated with improved postoperative BCVA (p = 0.002). Among the 38 eyes that underwent combined surgery, longer preoperative axial length was linked to better visual outcomes in univariate analysis (p = 0.043), although the association was not statistically significant in multivariate analysis (p = 0.064). Younger age and thinner preoperative CMT were associated with better morphological outcomes (p = 0.034 and p = 0.001, respectively). Conclusions Preoperative BCVA, age, preoperative CMT, and axial length are predictive factors for functional and morphological outcomes after vitrectomy in patients with ERM. These findings may facilitate treatment planning and prognosis prediction before surgery.

Purpose: To analyze prognostic factors for morphological and functional recovery after vitrectomy in patients with idiopathic epiretinal membrane (ERM). Methods: We conducted a retrospective analysis of patients with ERM who underwent vitrectomy. Postoperative outcomes were evaluated in terms of functional and morphological changes, assessing best-corrected visual acuity (BCVA) and central macular thickness (CMT) after 6 months. Logistic regression was used to identify factors influencing postoperative outcomes. Results: This study included 77 patients (35.1% men). Thirty-eight patients underwent combined vitrectomy and cataract surgery. Logistic regression revealed that better preoperative BCVA was associated with improved postoperative BCVA (p = 0.002). Among the 38 eyes that underwent combined surgery, longer preoperative axial length was linked to better visual outcomes in univariate analysis (p = 0.043), although the association was not statistically significant in multivariate analysis (p = 0.064). Younger age and thinner preoperative CMT were associated with better morphological outcomes (p = 0.034 and p = 0.001, respectively). Conclusions Preoperative BCVA, age, preoperative CMT, and axial length are predictive factors for functional and morphological outcomes after vitrectomy in patients with ERM. These findings may facilitate treatment planning and prognosis prediction before surgery.

Pancreaticoduodenectomy is the treatment of choice for adult periampullary lesions. However there has been no studies on the clinical outcomes of pancreaticoduodenectomy in children. To evaluate the clinical outcomes, records of 13 patients who underwent pancreaticoduodenectomy, from 1989 to 2009, at Seoul National University Children's Hospital were reviewed. Mean follow up period was 83 (2-204) months, the male to female ratio was 1:3.3, and the mean age was 11 (2-14) years. Ten patients underwent PPPD and 3 patients had Whipple's operation. The postoperative diagnosis included solid pseudopapillary tumor (9), cavernous hemangioma (1), pseudocyst (1), benign cyst (1), pancreatic disruption (1). Two patients developed postoperative adhesive ileus and among them one patient required operative intervention. Four patients required pancreatin supplementation due to steatorrhea and other gastrointestinal symptoms. There were no postoperative mortality during the follow up period and no evidence of recurrence in SPT patients. This study demonstrates that the pancreaticoduodenectomy procedure in children is not only feasible but also safe, with no mortality and an acceptable complication rate.
Adhesives ; Adult ; Child ; Female ; Follow-Up Studies ; Hemangioma, Cavernous ; Humans ; Ileus ; Male ; Pancreaticoduodenectomy ; Pancreatin ; Recurrence ; Steatorrhea

PURPOSE: Mutation of the p53 tumor suppressor gene is the most common genetic defect in all human tumors. Because of the widespread mutations and polymorphism in the p53 gene, the conventional screening methods cannot distinguish between polymorphisms or functionally silent mutations and inactivating mutations. It is well known that plasmids can be generated by homologous recombination in vivo in the yeast by cotransforming the PCR product with a linearized yeast expression vector encoding part of a gene and a selectable marker gene. The aim of this study is to develop more easy and reliable method for functional assay of p53 mutation. MATERIALS AND METHODS: We constructed a gap vector which can reliably and conveniently be used to screen p53 mutations in a simple yeast growth assay. The gap vector was constructed as follows: About 100 bp DNA fragments containing parts of N- and C- terminal portion of p53 were cloned into XbaI/SmaI and HindIII/XhoI sites of yeast expressing vector, respectively. The gap vector was obtained by double cutting with SmaI and HindIII followed by gel elution. Yeast was transformed with the reporter vector containing three tandem copies of the consensus p53 binding site by lithium acetate-mediated method. RT-PCR amplification of p53 transcripts from cell lines or tumor tissues was carried out. To investigate whether p53 gene is mutated or not, yeast containing reporter gene was cotransformed with PCR product and linearized gap vector, plated on SD medium minus histidine, and incubated for 3 days. The colonies on selective media were isolated and characterized. RESULTS: The tumor tissues examined were one hepatocellular carcinoma, three breast cancers, two stomach cancers and two colon cancers. One hepatocellular carcinoma tissue had mutation in both alleles of the p53 gene, and 7 cancer tissues had heterozygous mutations in the p53 gene. The result of functional assay was well correlated with mutational analysis by sequencing. CONCLUSION: p53 functional assay system might be easy and reliable method for functional screening of p53 on tumor tissues and this might be used for screening of other mutated gene. This technique, FASAY, requires only a few steps, can be automated readily and should permit screening for germline or somatic heterozygous mutations in any gene whose function can be monitored in yeast.
Alleles ; Binding Sites ; Breast ; Carcinoma, Hepatocellular ; Cell Line ; Clone Cells ; Colonic Neoplasms ; Consensus ; DNA ; Genes, p53 ; Genes, Reporter ; Genes, Tumor Suppressor ; Genes, vif ; Histidine ; Homologous Recombination ; Humans ; Lithium ; Mass Screening ; Plasmids ; Polymerase Chain Reaction ; Stomach Neoplasms ; Yeasts*

We investigated 248 patients who were diagnosed as malignant tumor in the department of Oral and maxillofacial Surgery of Kyungpook National University from 1999 to 2006, and following results were obtained. 1. Among 248 patients who have malignant tumor, 164 were men and 84 were women, which made the ratio of male to female 1.95 : 1. 2. The average age of oral cancer patients was 58.3. 3. As of the primary origin site, lower alveolus and gingiva were the greatest with 70 cases(28.2percent), followed by tongue(16.9percent), upper alveolus and gingiva(14.9percent), palate(13.7percent), mouth floor(9.7percent), buccal mucosa(4.8percent), retromolar trigone(4.4percent), Mx. and Mn. bone(3.2percent) and lip(2.8percent). 4. As of histologic distribution, squamous cell carcinoma was the greatest with 170 cases(68.6percent), followed by sarcoma with 17 cases(6.9percent), adenoid cystic carcinoma with 17 cases(6.9percent), malignant lymphoma with 15 cases(6.0percent), mucoepidermoid carcinoma with 13 cases(5.2percent), metastatic carcinoma with 6 cases(2.4percent) and malignant melanoma with 4 cases(1.6percent). 5. Period between recognition of the symptom and the first visit to hospital was less than 3 months for 58.9percent of the patients, and more than 3 months for 41percent of the patients. 6. Investigation of whether the patients drink or smoke revealed that the number of non-smoking and non-drinking patients was 63 among 170 patients (37.0percent) that were able to investigate. The number of patients who smoke only was 29(17.1percent) and both drinking and smoking patients were 78(45.9percent). 7. In clinical stage order, Stage IV(61.7percent) was found th be the largest, followed by stage I(17.2percent), stage II(13percent) and stage III(7.8percent). 8. The 5-year survival rate of the entire oral cancer patients appeared to be 57.7percent. The survival rate was higher in younger group and women had higher survival rate but there was no statistical significance to this. In the aspect of stage, the survival rate was Stage I, Stage II, Stage IV and Stage III in decreasing order. The order according to T classification was the same. In N classification, patients with N0 had the highest survival rate and the survival rate decreased in the order of N1 and N2. Survival rate was especially low in patients with N2.
Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Classification ; Drinking ; Female ; Gingiva ; Gyeongsangbuk-do ; Humans ; Lymphoma ; Male ; Melanoma ; Mouth ; Mouth Neoplasms* ; Sarcoma ; Smoke ; Smoking ; Surgery, Oral ; Survival Rate