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.

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*

Laser photocoagulation is commonly used for the treatment of retinal neo-vascularization in ischemic retinal diseases. Transforming growth factor-beta2 is known to be produced by RPE cells after laser photocoagulation and to be related to both regression of neovascularization and acceleration of preretinal fibrosis. In this study, we investgated the safe extent of laser photocoagulation not promoting the fibrosis by measuring intravitreal TGF-beta2 released following treatment. In gray rabbit eyes, trans pars plana vitrectomies and laser photocoagulations[1/8, 1/4, 1/2 of the fundus]were performed. The each eyeball was enucleated and TGF-beta2 concentration was measured at 12, 24, 72 hours after laser photocoagulation. And fibrotic activity was observed by the subconjunctival injection of fibrocyte and TGF-beta2 [0.1, 1, 10ng/milliliter]. The results were as follows:1. When TGF-beta2 was injected subconjunctivally along with fibrocytes, fibrocytic activity was observed found at the concentration of 1 or 10ng/milliliter of TGF-beta2. 2.The intravitreal concentration of TGF-beta2 after laser photocoagulation to the 1/8, 1/4, 1/2 of fundus area were 0.05, 0.1, 0.2ng/milliliter respectively. From the above results, we suggest to treat limit the area of laser photo-coagulation to 1/8 of fundus area in order to prevent the retinal fibrosis.
Acceleration ; Fibrosis ; Light Coagulation ; Retinal Diseases ; Retinaldehyde* ; Transforming Growth Factor beta2 ; Vitrectomy

PURPOSE: To evaluate the radiologic findings of granulosa cell tumor of the ovary. MATERIALS AND METHODS: Fourteen cases (fifteen tumors) of pathologically confirmed ovarian granulosa cell tumor were retrospectively analyzed on the basis of CT (n=10), MR imaging (n=4), and ultrasound (n=7) findings. The patients' mean age was 44.3 (range, 5-71) years. RESULTS: The mean diameter of the tumors was 12.1 (range, 5-26.5)cm. Thirteen cases were unilateral, and one was bilateral. Eleven tumors (ten cases) were mainly solid and eight of these had focal cystic components. Multilocular cysts accounted for three cases, and in two of these, mural nodules were present. One case was a unilocular cyst with no mural nodule. Ten cases were well demarcated. All the solid tumors were enhanced on postcontrast CT and MR imaging. Endometrial thickening was seen in five cases, ascites in six, and peritoneal implants or omental fat infiltration in five. One was associated with lymph node metastasis. All the postmenopausal patients had solid tumors, whereas 66.7% (4 of 6 cases) of young adults and children had cystic tumors. CONCLUSION: Granulosa cell tumors of the ovary were solid or cystic; the former were more common. There were no characteristic findings which permitted definitive differentiation from other ovarian tumors.
Ascites ; Child ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Ovary* ; Retrospective Studies ; Ultrasonography ; Young Adult

Mesenchymal chondrosarcoma arising in the central nervous system is extremely rare and most of case described are intracranial. During the last ten years, the authors have encountered three cases of spinal mesenchymal chondrosarcoma; These involved a four-year-old boy, a 29-year-old man, and a 36-year women. Their location was lumbosacral, at the cervicothoracic junction, and in the midcervical area, respectively. The three patients underwent surgery, and microscopic examination revealed mesenchymal chondrosarcoma. The postoperative result was good. The related literature is also reviewed.
Adult ; Central Nervous System ; Chondrosarcoma, Mesenchymal* ; Female ; Humans ; Male ; Meninges ; Spine

We experienced a 61-year old man with Pneumocystis carinii pneumonia who had been diagnosed as having relapsed acute myelogenous leukemia(AML). He developed severe dyspnea in the nadir state after reinduction chemotherapy. His chest X-ray showed bilateral interstitial pneumonia in both lung fields. We started ventilator therapy and obtained sputum through the endotracheal tube. Typical P. carinii cysts were found in the sputum by Giemsa stain. No other organisms were found in thelavage sediments. From clinical observation and the presence of typical P. carinii cysts, the patient was diagnosed as having P. carinii pneumonia and was treated with sulfamethoxazole/trimethoprim and glucocorticoid. This was the first reported case of P. carinii pneumonia in an AML patient undergoing chemotherapy in Korea.
Azure Stains ; Drug Therapy ; Dyspnea ; Humans ; Korea ; Leukemia ; Leukemia, Myeloid, Acute* ; Lung ; Lung Diseases, Interstitial ; Middle Aged ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Sputum ; Thorax ; Ventilators, Mechanical