Myasthenia Gravis is a chronic disease characterized by excessive fatiguability of striated muscle. The illness has a tendency to exacerbation and to the periods of spontaneous remission. The auther observed a case of ocular myasthenia gravis who has gained spontaneous remission 5 years after from the onset, and reviewed the references related to this disease.
Chronic Disease ; Muscle, Striated ; Myasthenia Gravis* ; Remission, Spontaneous

No abstract available.

No abstract available.
Animals ; Blood Platelets* ; Butylated Hydroxytoluene* ; Rats* ; Streptococcus* ; Thrombin*

BACKGROUND: Approxinately 30%-70% of patients hospitalized receive intravenous(IV) therapy[l-4], It is generally believed that many hospitalized patients experienced IV therapy related complications-including infiltration(swelling), phlebitis, pain, suppurative phlebitis and bacterernia. These complications may be critical to ill children in the hopsital. This study was done to assess the IV therapy related complications and characteristics od the phlebitis of the hospitalized children. METHODS: We collected date prospectively from December 8, 1994 to December 14 at the tertiary care hospital in Seoul. The subhects of this study were children who got new IV catheters during that period. RESULTS: There were 306 new cases(176 children) that got IV therapy and which meant 63.8 per 100 discharge patients. Male(62.8%), pediatric surgery patients(70.6%) were more than female(37.2%) and pediatrucs(28.4%) respectively. The usually used IV sites were the upper extermities(71.3%). Among various purposes of IV therapy, the most common was to administer drugs(74.2%) including antibiotics, and next was to keep vein open (41.2%). By the way, 172 cases(56.3%) had IV related complications and 14 resulted in phlebitis. The most common IV related complication of hospitalized children was swelling(35.1%). The incidence of IV related complication of hospitalized children was swelling(35.1%). The incidence of IV phlebits was higher in pediaterics than in pediatrid surgery (P<0.05), over 12 years old than under that aged patients (P<0.01). CONCLUSION: This study revealed that many hospitalized children experienced the IV related complications. In order to decrease the IV related complications, reduce the incidence and thorough care is recommanded.
Anti-Bacterial Agents ; Catheters ; Child* ; Child, Hospitalized ; Humans ; Incidence ; Phlebitis ; Prospective Studies ; Seoul ; Tertiary Healthcare ; Veins

No abstract available.
Intestinal Obstruction*

BACKGROUND: Naringin, one of the flavonoids in citrus fruit peels, is known to have antioxidant and hepatotonic effects in animal studies. We evaluated the effect of naringin on 1) blood lipid profiles, 2) regression of fatty streak of aorta, and 3) liver toxicity in diet-induced hypercholesterolemic rabbits. METHODS: New Zealand White Rabbits (2.0 - 2.5 Kg) were divided to three groups; group without treatment, group treated with 100 mg/kg/d or 500 mg/kg/d naringin, and group treated with 1 mg/kg/d or 20 mg/kg/d lovastatin. They were fed on 0.25% or 1.0% cholesterol-containing diet for 8 weeks and then sacrificed. Blood samples were collected for measurement of total cholesterol, HDL-cholesterol, triglyceride, serum GOT and GPT. Aortas and livers were harvested for evaluation of fatty streak and pathologic examination. RESULTS: 1)Feeding of 1% cholesterol diet for eight weeks significantly increased the cholesterol level upto 20 folds. Neither lovastatin nor naringin did lower these marked hypercholesterolemia. But both naringin (500 mg/kg/d) and lovastatin (1 mg/kg/d) significantly reduced the area of fatty streak by 75% and 58%, respectively. Naringin was more effective in inhibition of fat infiltration into liver than lovastatin which showed hepatotoxicity as increase of serum GPT level (p=0.01). 2)Feeding of 0.25% cholesterol diet for eight weeks significantly increased the cholesterol level upto 17 folds. Total cholesterol and triglyceride levels tended to decrease by treatment with naringin (500 mg/kg/d) and lovastatin (20 mg/kg/d), but this decreases were not statistically significant. However, areas of fatty streak significantly decreased by treatment with naringin and lovastatin by 64 and 82%, respectively (p<0.05). Microscopic analysis revealed that foam cell infiltration into intima was significantly reduced by naringin and lovastatin. In contrast to lovastatin, naringin significantly reduced the level of serum GPT (p<0.05). CONCLUSION: Like lovastatin, naringin has strong antiatherogenic action which may not be associated with its very mild lipid lowering action. In contrast to lovastatin, naringin does have hepatoprotective effect.
Animals ; Aorta ; Cholesterol ; Citrus ; Diet ; Flavonoids ; Foam Cells ; Hypercholesterolemia ; Liver ; Lovastatin ; Rabbits* ; Triglycerides

OBJECTIVE: To evaluate common symptoms and severities of swallowing disorders in pediatric patients with a central nervous system disorder. METHOD: Twenty six pediatric patients with age ranging from 1 month to 3 years who had complained feeding and swallowing difficulties were studied. The subjects were divided into two groups according to the presence or absence of a central nervous system disorder. After taking the history and physical examination, a bedside swallowing test and a videofluoroscopic swallowing study were done. The parameters of oral preparatory phase, oral phase and pharyngeal phase were evaluated. RESULTS: In the bedside swallowing test, the patients with a central nervous system disorder showed a significantly higher incidence of decreased swallowing reflex, postural abnormality, tendency of poor secretion control and absent gag reflex. In the videofluoroscopic swallowing study, patients with a central nervous system disorder showed delayed oral transport time, poor oral control, pharyngeal triggering, aspiration, nasal regurgitation and esophageal reflux. Compared to the patients without a central nervous system disorder, the patients with a central nervous system disorder showed a significantly higher incidence of decreased pharyngeal peristalsis and delayed pharyngeal triggering. The patients with a central nervous system disorder also showed a more profound swallowing disorder than that of the patients without a central nervous system disorder, having more chances of a non-oral feeding than those without a central nervous system disorder. CONCLUSION: The children with a swallowing disorder and central nervous system disordershowed the different features from those without a central nervous system disorder in the bedside swallowing test and videofluoroscopic swallowing study. So that a complete swallowing evaluation including the videofluoroscopic a swallowing study will be helpful to children with swallowing disorder and central nervous system disorder for the evaluation and treatment of pharyngeal stage swallowing dysfunction.
Central Nervous System Diseases* ; Central Nervous System* ; Child ; Deglutition Disorders* ; Deglutition* ; Gastroesophageal Reflux ; Humans ; Incidence ; Peristalsis ; Physical Examination ; Reflex

Gastrointestinal hemorrhage in neonates is commonly associated with necrotizing enterocolitis, cow's milk protein allergy, and gastrointestinal malformation. Gastrointestinal bleeding on the first day of life, presenting as the first manifestation of a disorder, has rarely been reported associations with gastric ulceration, Salmonella infection, and allergic colitis. Hemophilia B is also a rare cause of gastrointestinal bleeding during the neonatal period. In the present case, a male infant developed repetitive hematemesis on the first day of life. His initial level of coagulation factor IX was 1.9%, and he was diagnosed with moderate hemophilia B. No further hematemesis or melena was observed during recombinant factor IX therapy. The infant did not have a family history of hemophilia. In conclusion, although gastrointestinal hemorrhage on the first day of life as the first manifestation of a disease is rare, infants who present with spontaneous gastrointestinal hemorrhage after birth and with unexplained prolonged activated partial thromboplastin time should be evaluated for coagulation factor deficiency regardless of whether they have any family history of hemophilia.
Blood Coagulation Factors ; Colitis ; Enterocolitis, Necrotizing ; Factor IX ; Gastrointestinal Hemorrhage* ; Hematemesis ; Hemophilia A* ; Hemophilia B* ; Hemorrhage ; Humans ; Hypersensitivity ; Infant ; Infant, Newborn ; Male ; Melena ; Milk Proteins ; Partial Thromboplastin Time ; Parturition ; Salmonella Infections ; Stomach Ulcer

PURPOSE: H. pylori infection is thought to contribute to iron-deficiency anemia, especially during puberty. The ferritin protein Pfr of H. pylori is homologous to eukaryotic and prokaryotic ferritins. The purpose of this study was to analyze the H. pylori pfr status in gastric biopsy specimens according to clinical data, including antral gastritis with or without iron-deficiency anemia. METHODS: A total of 26 H. pylori-positive patients aged from ten to 18 years were categorized into subgroups based on the presence or absence of iron-deficiency anemia. All of them had antral gastritis. Sixteen patients were proved to have iron-deficiency anemia by hematological study, two of which had a duodenal ulcer. The other ten patients showed normal hematological findings. DNA isolation was performed from each of the gastric biopsy specimens. PCR amplification of the pfr gene coding was done using two sets of primers. The pfr region, 501 bp, was generated by linking the sequences of the two PCR products. The nucleotide and protein sequences were compared between the pfr regions from Korean H. pylori strains and the NCTC 11638, 26695, and J99 strain, which were obtained from the Genbank. Sequence comparisons were also performed for the pfr regions between the iron-deficiency anemia (+) and (-) groups. RESULTS: Analysis of the complete coding region of pfr gene revealed three sites of mutation. The Ser39Ala mutation was found in 100% (26/26), Gly111Asn in 26.9% (7/26), and Gly82Ser in 11.5% (3/26). There were no significant differences in the mutations of the pfr regions between the iron deficiency anemia (+) and (-) groups. CONCLUSION: The mutation in the pfr gene did not relate with the clinical phenotype, iron deficiency anemia. Further studies are needed on the aspects of host side or other complex factors to elucidate anemia. Further studies are needed on the aspects of host side or other complex factors to elucidate the mechanisms by which the H. pylori infection might lead to iron deficiency anemia.
Adolescent ; Anemia ; Anemia, Iron-Deficiency* ; Biopsy ; Clinical Coding ; Databases, Nucleic Acid ; DNA ; Duodenal Ulcer ; Ferritins ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Iron* ; Phenotype ; Polymerase Chain Reaction ; Puberty

PURPOSE: This study was carried out to identify and re-establish the professional identity in clinical nurses. METHOD: From Dec. 1999, for 4 months, the study had been conducted by narrative analysis method based on hermeneutic principles. Subjects were ten nurses with 3-4 years of nursing experience at a university hospital. The data were collected and transcribed through narrative interviews. RESULT: As a result, the maternal role was identified as the most dominant discourse in which nurses formed their identity. Subjects felt that a maternity is socio-culturally needed in case of nursing. Reconstruction of professional identity consists of 3 stages, Telling, Retelling and Rebuilding. At first, nurses felt confused by skeptism of the profession, interpersonal difficulties, and heavy work loads. However, during the interviews, nurses recognized that nursing is not regarded as significant, effort to make nursing meaningful were small, and there was a lack of understanding others. From this new insight, they re-established a new image of nursing "through better understanding of others, seeking knowledge, and making positive efforts towards qualified nursing". CONCLUSION: The above narrative interviews may help nurses reflect and contextually interpret themselves, so that a new identity could be established. Furthermore researchers can obtain new insight from the subjects, while the subjects form a new nursing image from self-reflection.
Nursing