PURPOSE: Glucose has been recommended as an analgesic for mild to moderately painful procedures in neonates. The goal of this study was to assess the optimal dextrose concentration for pain control in newborns. METHODS: This prospective, randomized, blinded clinical trial included 116 healthy full-term newborns. The neonates were randomly assigned to the following four groups by drawing straws: groups receiving sterile water or a 10%, 20%, or 40% dextrose solution orally. Each group was treated with the assigned solution prior to hepatitis B vaccination. The Neonatal Facial Coding System (NFCS) and the Neonatal Infant Pain Scale (NIPS) scores were evaluated before, immediately after, and 2 minutes after the injection in all neonates. Premature Infant Pain Profile (PIPP) scores were evaluated during the injection. All procedures were video-recorded, and pain scores were assessed by two independent observers who were not involved in the care of the newborns studied. The pain scores were compared among the four groups. RESULTS: The 40% dextrose solution significantly reduced the NFCS (P=0.002) and the PIPP scores (P=0.001) compared with sterile water. No hyperglycemic events were noted in the study subjects 2 hours after the injection. CONCLUSION: The 40% dextrose solution effectively relieved pain due to intramuscular injection in full-term newborns without causing hyperglycemic events. However, the 10% and 20% dextrose solutions did not affect neonatal pain scores.
Clinical Coding ; Glucose* ; Hepatitis B* ; Hepatitis* ; Humans ; Infant ; Infant, Newborn* ; Infant, Premature ; Injections, Intramuscular ; Pain Management ; Prospective Studies ; Vaccination* ; Water

PURPOSE: To report a case of globe perforation and linear retinal tear after periocular acupuncture therapy which resulted in persistent temporal field defect with normal retinal function evidenced by multifocal electroretinogram (MERG). CASE SUMMARY: A 42-year-old female presented with decreased visual acuity and pain in her right eye after a periocular acupuncture therapy for blepharospasm. At initial presentation, the best corrected visual acuity (BCVA) was 0.08 in the injured eye and the intraocular pressure was 15 mmHg. Ultrasonography showed minimal vitreous hemorrhage and fundus examination revealed a linear retinal tear in the posterior pole sparing the macula. Consequently, barrier laser photocoagulation was performed around the lesion. The patient suffered from metamorphopsia and persistent decreased visual acuity even after 3 months. On fundus examination, epiretinal membrane with macular pucker was observed on the macula. Spectral domain optical coherence tomography (SD-OCT) revealed retinal nerve fiber layer defect with a full-thickness posterior wall tear. Multifocal electroretinogram showed normal retinal function; however, Humphrey visual field test demonstrated field defect corresponding to the injury. A 25-gauge pars plana vitrectomy was performed with membranectomy and ILM peeling. One month postoperatively, improvement in BCVA and metamorphopsia was achieved; however, the scotomata remained unchanged. CONCLUSIONS: Ocular perforation or retinal tear caused by an acupuncture needle is a rare condition that has not been reported previously in Korea. Furthermore, no case of traumatic visual field defect with preserved retinal function has been reported elsewhere. Hence, the authors present a case of isolated visual field defect without retinal dysfunction following full-thickness retinal tear caused by an acupuncture needle.
Acupuncture ; Acupuncture Therapy ; Adult ; Blepharospasm ; Disaccharides ; Epiretinal Membrane ; Eye ; Female ; Humans ; Intraocular Pressure ; Korea ; Light Coagulation ; Needles ; Nerve Fibers ; Retinal Perforations ; Retinaldehyde ; Tomography, Optical Coherence ; Vision Disorders ; Visual Acuity ; Visual Field Tests ; Visual Fields ; Vitrectomy ; Vitreous Hemorrhage

BACKGROUND/AIMS: Mirizzi syndrome is a rare complication of longstanding gallstone disease which resulting in obstructive Jaundice. It is benign stricture of common hepatic duct because of stone impacted with in the cystic duct or Hartmann pouch of the gallbladder. The aim of this study is to evaluate our experience of Mirizzi syndrome and consider its surgical treatment. METHODS: During the years 1994 to 2001 at Asan medical center, 23 cases of Mirizzi syndrome were diagnosed on the basis of preoperative and postoperative findings and they were retrospectively reviewed. RESULTS: There were 12 patients with Csendes type I, 6 patients with type II, and 5 patients with Type III. Average age was 61 years (range: 31 to 83 years) For preoperative evaluation Endoscopic retrograde cholangiopancreatography (ERCP) and Ultrasonography were performed in all cases. Laparoscopic cholecystectomy was tried in 7 type I cases. 5 were successfully treated and 2 conversions were reported, all because of unclear anatomy. In 6 type II cases open cholecystrctomy, CHD repair and T tube insertion were performed. 5 patients with type III were required hepaticojejunostomy. CONCLUSIONS: High index of suspicion is required for diagnosis of Mirizzi syndrome and laparoscopic approach is permissible in specialized center especially in the case of suspected Mirizzi type I, under the recognition of biliary anatomy through preoperative imaging studies. If there is fistula or unclear anatomy, we recommend open operative techniques for the safety and the efficiency.
Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Chungcheongnam-do ; Constriction, Pathologic ; Cystic Duct ; Diagnosis ; Fistula ; Gallbladder ; Gallstones ; Hepatic Duct, Common ; Humans ; Jaundice, Obstructive ; Mirizzi Syndrome* ; Retrospective Studies ; Ultrasonography

No abstract available.
Cranial Irradiation ; Leukoencephalopathies* ; Parkinsonian Disorders*

Background: Polo-like kinase 4 (PLK4) is a serine/threonine protein kinase located in the centriole of the chromosome during the cell cycle. PLK4 overexpression has been described in a variety of many common human epithelial tumors. Conversely, PLK4 acts as a haploinsufficient tumor suppressor in some situations, highlighting the importance of strict regulation of PLK4 expression, activity, and function. Meanwhile, the importance of chemoradiation resistance in rectal cancer is being emphasized more than ever. We aimed to analyze PLK4 expression and the tumor regression grade (TRG) in patients with rectal cancer, treated with chemoradiotherapy (CRT). Methods: A retrospective study was conducted on 102 patients with rectal cancer who received preoperative CRT. Immunohistochemistry for PLK4 in paraffin-embedded tissue was performed from the biopsy and surgical specimens. Results: We found significant association between high expression of PLK4 and poor response to neoadjuvant CRT (according to both Mandard and The Korean Society of Pathologists TRG systems) in the pre-CRT specimens. Other clinicopathologic parameters did not reveal any correlation with PLK4 expression. Conclusions This study revealed an association between high expression of PLK4 in the pre-CRT specimens and TRG. Our results indicated that PLK4 could potentially be a new predictor for CRT effect in patients with rectal cancer.

BACKGROUND AND OBJECTIVES: Ischemic stroke caused by middle cerebral artery occlusion (MCAo) is the major type of stroke, but there are currently very limited options for cure. It has been shown that neural stem cells (NSCs) or neural precursor cells (NPCs) can survive and improve neurological deficits when they are engrafted in animal models of various neurological diseases. However, how the transplanted NSCs or NPCs are act in vivo in the injured or diseased brain is largely unknown. In this study, we utilized magnetic resonance imaging (MRI) techniques in order to understand the fates of human NSCs (HB1.F3) following transplantation into a rodent model of MCAo. METHODS AND RESULTS: HB1.F3 human NSCs were pre-labeled with ferumoxides (Feridex(R))-protamine sulfate complexes, which were visualized and examined by MRI up to 9 weeks after transplantation. Migration of the transplanted cells to the infarct area was further confirmed by histological methods. CONCLUSIONS: Based on these observations, we speculate that the transplanted NSCs have the extensive migratory ability to the injured site, which will in turn contribute to functional recovery in stroke.
Brain ; Dextrans ; Humans ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Magnetite Nanoparticles ; Models, Animal ; Neural Stem Cells ; Rodentia ; Stroke ; Track and Field ; Transplants