No Abstract Available.
Allografts* ; Posterior Cruciate Ligament*

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation

Despite current practice there is no evidence to demonstrate the efficacy of intraurethral 2% lidocaine gel as an anesthetic for rigid cystoscopy. To evaluate the usefulness of lidocaine on decreasing pain associated with cystoscopy, we performed a randomized controlled study comparing 2% lidocaine gel with a plain water based lubricant. Pain was recorded on a visual analogue scale by the patient and by the physician. Physician perception of pain experienced by the patient was compared with the actual pain experienced. We found decrease in pain perception in men following lidocaine gel instillation with a 5 or 10 minute dwell time compared to instillation of the plain lubricant.
Anesthetics ; Cystoscopy* ; Humans ; Lidocaine* ; Male ; Pain Perception ; Water

No abstract available.
Paragonimiasis*

Large numbers of reports have shown that thermal injury (TI) causes a wide spectrum of defects in immune response that lead to a high susceptibility to various opportunistic infections. However, it is still a matter of debate whether TI induces Th2 polarization or global impairment in Th1/Th2 response. In this study, TI in a mouse model was induced by exposing shaved dorsal skin to boiling water and cytokine production was analyzed. At day 2 of injury, whole spleen cells and T cells were collected and then stimulated with an anti-CD3 antibody. The levels of cytokine secretion were determined by cytokine ELISA. Production of IFNgamma and IL 4 by whole spleen cells from injured mice were concurrently decreased when compared to those from sham-injured controls. Proportional changes in T, B, and T-subset cells were not accompanied. Using purified T cells devoid of accessory cells (AC), it was shown that those defects resulted primarily from lowered T cell potentials. By using mixed cultures of sham T and TI-AC and vice versa, it was revealed that AC also acted as inhibitor cells in IFNgamma and IL 4 production in less extent. Blockade of glucocorticoid signals rendered the T cells partially resistant to TI-induced inhibition in IFNgamma and but not IL 4 production. These results clearly demonstrate that TI induces overall suppression in Th1 and Th2 response through T cell dysfunction together with the inhibition of AC activity, and that reduction in only IFNgamma but not IL 4, production may be caused, in part, by corticosteroid hormone that is secreted prominently during trauma.
Animals ; Enzyme-Linked Immunosorbent Assay ; Mice ; Opportunistic Infections ; Skin ; Spleen ; T-Lymphocytes ; Water

PURPOSE: The study aimed to develop a play toolkit to facilitate infants' and toddlers' symbolic thought and fine motor development. METHODS: This study used a methodological study design including two phases of development and evaluation. After reviewing the play culture and developmental health issues in Kyrgyzstan through a literature review and interviews with local experts and parents, the toolkit was developed and evaluated using content validity and utilization tests. RESULTS: The toolkit was based on Westby's symbolic play and the fine motor milestones in the Bright Futures Guidelines. The Toolkits were composed of an overall suggested play schedule according to the child's age, four kinds of play props, and a utilization guidebook for parents. The play props were a felt book, sorting and assembling blocks, cup blocks, and a tangram. The guidebook contained age-appropriate operating methods and alternative ways to use the materials. CONCLUSION: A play toolkit was developed to enhance nurturing practices among parents of infants and toddlers. The findings may help facilitate effective interactions between parents and their children. Considering that nurturing care is critical for achieving better child health outcomes, enhancing parenting resources and parent-child relations could function as an effective strategy for promoting child health.
Appointments and Schedules ; Child ; Child Development ; Child Health ; Humans ; Infant ; Kyrgyzstan ; Methods ; Parent-Child Relations ; Parenting ; Parents ; Play and Playthings

BACKGROUND: The incidence of reported nontyphoidal Salmonellosis has increased during last decade in Korea. Salmonella typhimurium and Salmonella enteritidis are two major serotypes in nontyhoidal Salmonella. To determine the nature of potential outbreak S. typhimurium infection in a community, we retrospectively evaluated clinical and epidemiologic features of S. typhimurium infections and performed pulsed-field gel electrophoresis(PFGE) to investigate a genetic relatedness of S. typhimurium isolated in Guro Hospital. METHODS: From May 1998 to April 1999, a total of 20 S. typhimurium strains were isolated from 18 patients. PFGE patterns were analyzed for 20 S. typhimurium strains Clinical and epidemiological features were evaluated from their medical records. RESULTS: Seventy two percent(13/18) were acute gastroenteritis, and 11 %(2/18) were enteric fever and 16 %(3/18) were intussusception. Seventy eight percent(14 of 18) of patients were six years old or less than. There were two major type(A, B) on PFGE analysis. Eight of 20 strains showed identical PFGE type(A1). Eleven strains were subtypes of A1. One strain showed different type(B). Similarity coefficients between A1 and its subtypes were all over 0.765 and they showed close genetic distance on dendrogrm. Antibiogram of Al eight strains were various. CONCLUSIONS: High genetic relationship among 20 S. typhimurium strains for a year in Guro area indicates that they were possibly originated from one clone and that there might be a common source of infection. More efforts should be directed toward the epidemiological investigation of the cases to detect outbreaks and prevent further spread of the infection.
Clone Cells ; Disease Outbreaks ; Gastroenteritis ; Humans ; Incidence ; Intussusception ; Korea ; Medical Records ; Microbial Sensitivity Tests ; Molecular Epidemiology* ; Retrospective Studies ; Salmonella enteritidis ; Salmonella Infections ; Salmonella typhimurium* ; Salmonella* ; Tertiary Care Centers* ; Typhoid Fever

OBJECTIVES: Cord blood stem cells have been widely used as donor cells for bone marrow transplantation recently. These cells can give rise to a variety of hematopoietic lineages to repopulate the blood. Recent observations reveal that some bone marrow cells and bone marrow stromal cells(MSCs) can grow to become either neurons or glial cells. It is, however, unclear whether or not there exists stems cells which can differentiate into neurons in the blood during the early stages of postnatal life. METHODS: Human cord blood stem cells were prepared from human placenta after full term delivery. To induce neuronal differentiation of stem cells, beta-mercaptoethanol was treated. To confirm the neuro-glial characteristics of differentiated stem cells, immunocytochemical stain for NeuN, neurofilament, glial fibrillary acidic protein(GFAP), microtubule associated protein2(MAP2) was performed. RT-PCR was performed for detecting nestin mRNA and MAP2 mRNA. RESULTS: We showed in this experiment that neuro-glial markers(NeuN, neurofilament, MAP2, GFAP) were expressed and axon-like cytoplasmic processes are elaborated in the cultured human cord blood stem cells prepared from new born placenta after full term delivery. Nestin mRNA was also detected in fresh cord blood monocytes. Conclusions: These results suggest that human cord blood derived stem cells may be potential sources of neurons in early postnatal life.
Bone Marrow ; Bone Marrow Cells ; Bone Marrow Transplantation ; Cytoplasm ; Fetal Blood* ; Humans* ; Microtubules ; Monocytes ; Nestin ; Neural Stem Cells ; Neuroglia ; Neurons ; Placenta ; RNA, Messenger ; Stem Cells ; Tissue Donors ; Umbilical Cord*

inhibitor, 2-aminobicyclo-(2,2,1)-heptane-2-carboxylic acid (BCH). The affinity of [14C]L-leucine uptake and the inhibition profiles of [14C]L-leucine uptake by various amino acids in the Saos2 cells were comparable with those for the LAT1 expressed in Xenopus oocytes. The majority of [14C]Lleucine uptake is, therefore, mediated by LAT1 in the Saos2 cells. These results suggest that the transports of neutral amino acids including several essential amino acids into Saos2 human osteogenic sarcoma cells are for the most part mediated by LAT1. Therefore, the Saos2 human osteogenic sarcoma cells are excellent tools for examine the properties of LAT1. Moreover, the specific inhibition of LAT1 in tumor cells might be a new rationale for anti-tumor therapy.
Amino Acid Transport System L* ; Amino Acids ; Amino Acids, Essential ; Amino Acids, Neutral ; Humans* ; Oocytes ; Osteosarcoma* ; Xenopus

OBJECTIVES: We aimed to compare and distinguish the characteristics of anaphylaxis and angioedema, especially with oral mucosal involvement and treatment of patients who visited the Pediatric Emergency Department. METHODS: We retrospectively analyzed patients under age 18-year-old who were diagnosed with anaphylaxis and angioedema with oral mucosal involvement and treated with epinephrine from May 2008 to May 2013 in a single Pediatric Emergency Department in Seoul, Korea. We evaluated their past history, possible triggering causes, symptoms, vital signs and treatment and discharge with education. RESULTS: During the study period the total cases of anaphylaxis were 79 and angioedema with oral mucosal involvement were 218. The age of patients with anaphylaxis was significantly higher (6.6+/-4.9 years vs. 4.1+/-3.3 years). The heart rate relative to age was significantly higher in the anaphylaxis group (49.4% vs. 36.2%). After discharge from the Emergency Center, 3.8% of anaphylaxis patients were prescribed an epinephrine injection. Education to avoid the triggering factor was provided in 32.9% of anaphylaxis group and 17.4% in the angioedema group. CONCLUSION: Besides blood pressure, we should pay attention to the heart rate in pediatric patients with severe allergic reactions. More active follow-up of anaphylaxis and angioedema with oral mucosal involvement is needed to educate parents and prescribe emergency medication.
Adolescent ; Anaphylaxis* ; Angioedema* ; Blood Pressure ; Child ; Education ; Emergencies ; Emergency Service, Hospital* ; Epinephrine ; Heart Rate ; Humans ; Hypersensitivity ; Korea ; Parents ; Retrospective Studies ; Seoul ; Vital Signs