No abstract available.
Lupus Erythematosus, Systemic*

PURPOSE:This study was performed to investigate the status of cardiac structure and function and to assess their alterations after growth hormone(GH) treatment in children with growth hormone deficiency(GHD). METHODS:Interventricular septal thickness and left ventriclular posterior wall thickness, ejection fraction(EF), fractional shortening(FS), systolic time interval(STI) of left ventricle were measured by two-dimensional and M-mode echocardiography in sixteen children with GHD and age, sex matched sixteen children with GH normal short stature as control. The measure were done before GH treatment and at 6 and 12 months of GH treatment, respectively. RESULTS: 1)Left ventricular posterior wall thickness in GHD group was significantly thinner than that of control group(P<0.05). 2)Interventricular septal thickness and left ventricular posterior wall thickness were increased with GH treatment from 10.4+/-1.7mm, 8.1+/-1.8mm before GH treatment to 11.0+/-0.9mm, 8.7+/-0.7mm and 11.2+/-1.7mm, 9.7+/-1.8mm at 6 and 12 months of GH treatment, respectively. The increment of left ventricular posterior wall thickness after 12 months GH treatment revealed statistic significance(P<0.05). 3)There was no significant alterations of EF, FS, STI of left ventricle after GH treatment at 6 months and 12 months, respectively. CONCLUSION: Left ventricular posterior wall thickness in GHD group was significantly thin compared to that of control group(P<0.05). GH treatment in GHD children for 12 months, resulted statistically significant increase(P<0.05) in posterior wall thickness. There is no evidence of hypertrophic cardiomyopathy after GH treatment. But we could not exclude the possibility of these alterations were induced by an increased overall body size and body surface area after GH treatment. To clarify the exact alterations of cardiac structures and function in children with GHD after GH treatment, long term follow-up studies should be necessary.
Body Size ; Body Surface Area ; Cardiomyopathy, Hypertrophic ; Child* ; Echocardiography ; Follow-Up Studies ; Growth Hormone* ; Heart ; Heart Ventricles ; Humans

The aim of the present study is to demonstrate the usefulness of intraoperative fine needle aspiration (FNA) of pancreatic lesions in 30 patients. A conclusive diagnosis was done in 27 patients and the diagnoses of three patients were deferred. No complications followed the procedure. Based on histologic findings of the resected specimens in 20 cases and of cell blocks in 10 cases, the final diagnoses were adenocarcinoma in 19 cases, chronic pancreatitis in nine cases and tuberculosis in two cases. The sensitivity, specificity and diagnostic accuracy were 95%, 100% and 96% resepectively and there were no false positives. The smear of aspirate was stained with toluidine blue and examined by light microscope. The presence of there-dimensional clusters of disoriented cells and the increased nuclear/cytoplasmic ratio with large prominent nucleoli were the most helpful criteria for a diagnosis of malignancy in the pancreas. The intraoperative FNA of pancreatic lesions was considered as a simple, safe, and highly specific and sensitive tool in differentiating benign from malignant lesions. The intraoperative FNA can be recommended as the first tool of choice of intraoperative diagnostic procedure in lesions of the pancreas.
Child ; Male ; Female ; Humans ; Adenocarcinoma

This clinical study is based on review of records of 87 patients with postoperative adhesive intestinal obstruction who were managed at the Department of Surgery of Dongbu City Hospital during 5 years from September, 1992 to August, 1997. The results of study were as follows: 1) The most prevalent age group was 5th decade(44.8%) and male to female ratio was 1.7:1. 2) The previous operations were operation for appendicitis(32.2%), operations for peritonitis due to peptic ulcer perforation(24.1%), gynecologic operations(13.8%), operation for gastric malignancy(8.1%). 3) The mean value of duration between previous operations and postoperative adhsive intestinal obstruction was 36 months and the mean value of duration of symptoms was two days. 4) 42(49.2%) of 87 patients were admitted under 24 hours after onset of symptoms. 5) The chief complaints on admission were abdominal pain(98.8%), vomiting(81.6%), abdominal distension(78.2%), failure to flatus(55.2%). 6) 23 cases(45.1%) of 51 cases having one or more abnormal physical and laboratory finding(fever, abdominal tenderness, abscence of defecation or gas out, or leukocytosis) were operated, and 5 cases(13.9%) of 36 cases having no physical finding were operated (p value < 0.05). 7) Emergency operation was performed in 9 cases, elective operation was performed in 19 cases which had deteriorating clinical course despite of conservative management for 48 hours, and conservative treatement was performed in 59 cases. 8) The postoperative complications were observed in 6 cases and the most common complication was wound infection(14.3%). In conclusions, The longer symptom duration and the longer interval between previous operation and onset of symptoms, the higer probability of surgical treatment is expected. The need for surgical treatment was increased acording the number of physical and laboratory findings(fever, abdominal tenderness, abscence of defecation or gas out, or leukocytosis). For the cases which have unimproving and deteriorating clinical course despite of conservative management for 72 hours, surgical operation shoud be considered.
Adhesives* ; Defecation ; Emergencies ; Female ; Hospitals, Urban ; Humans ; Intestinal Obstruction* ; Male ; Peptic Ulcer ; Peritonitis ; Postoperative Complications ; Wounds and Injuries

Evidence-Based Medicine ; Humans ; Mental Disorders ; drug therapy ; Psychiatry ; Psychopharmacology

No abstract available.
Diverticulum*

Rheumatoid arthritis is a chronic inflammatory disease that primarily affects joint synovium. Although its etiology has yet to be identified, the underlying mechanism of joint inflammation is understood as autoimmune process. The inflamed synovium is thickened due to synovial hyperplasia and infiltrating mononuclear cells such as T and B lymphocytes, macrophages, and plasma cells. Key inflammatory cytokines TNF-alpha and IL-1, as shown by the significant therapeutic effect of their blockade, are mainly secreted by macrophages whereas IL-17 is secreted by a newly recognized subset of T cells (Th17 cells) and induces TNF-alpha and IL-1 production by adjacent macrophages, synoviocytes, and chondrocytes. IL-17 has also been shown to induce RANKL from osteoblasts, thereby indicating that this cytokine plays as an upstream molecule that regulates inflammation and osteoclastogenesis. More importantly, IL-17 has been shown to convert acute inflammation into chronic inflammation and when combined with already important cytokines, more marked inflammation occurs. The role of B cells as antigen presenting cells are now being recognized based on the therapeutic effect of rituximab, a B cell inhibitor, in rheumatoid arthritis. Great attention has been turned to anti-citrullinated peptide antibodies because they form immune complex and contribute to inflammation by activating complement system. Recently, clinical trials showed therapeutic efficacy of tocilizumab, monoclonal antibody against IL-6 receptor, suggesting relevant involvement of IL-6 in disease process of rheumatoid arthritis. Thus, various cellular and molecular players seem to interact within rheumatoid synovium to perpetuate inflammation. Further studies are needed to explore the exact mechanisms of development and maintenance of inflammation in rheumatoid arthritis.
Antibodies ; Antibodies, Monoclonal, Humanized ; Antibodies, Monoclonal, Murine-Derived ; Antigen-Antibody Complex ; Antigen-Presenting Cells ; Arthritis, Rheumatoid ; B-Lymphocytes ; Chondrocytes ; Complement System Proteins ; Cytokines ; Hyperplasia ; Inflammation ; Interleukin-1 ; Interleukin-17 ; Interleukin-6 ; Joints ; Macrophages ; Osteoblasts ; Plasma Cells ; Receptors, Interleukin-6 ; Synovial Membrane ; T-Lymphocytes ; Tumor Necrosis Factor-alpha ; Rituximab

Laparoscopic surgery has become popular in the past few decades, owing to less postoperative pain, fast recovery, and better cosmetic outcomes. The laparoscopic approach has been employed in pediatric surgery for the same reasons. After the first attempts of single incision laparoscopic appendectomy in pediatrics in 1998, single incision laparoscopic surgery (SILS) has recently been proven to be safe and feasible for the pediatric population. However, limitations have been reported for SILS, such as the wide learning curve, compared to standard laparoscopic surgery, and the restricted number of hospitals with surgical training programs including SILS. In this study, we intend to present our initial experiences with SILS in children, and to describe the technique, instruments used, and outcomes. This is a retrospective study of 71 pediatric patients who underwent SILS, at a tertiary medical center, between September, 2012 and August, 2013. Electronic medical records were reviewed for demographics, type of procedure, operation time, use of additional ports, conversion to open surgery, complications and hospital stay. Additional ports were inserted in 4 cases, for the purpose of traction. Postoperative complications were noted in 13 cases, which were mostly related to wound inflammation or formation of granulation tissue. According to our analyses, patients with complications had significantly longer use and more frequent use of pain killers. Notwithstanding the small sample size, many of the procedures performed in pediatric patients seem to be possible with SILS.
Appendectomy ; Child ; Conversion to Open Surgery ; Demography ; Education ; Electronic Health Records ; Granulation Tissue ; Humans ; Inflammation ; Laparoscopy* ; Learning Curve ; Length of Stay ; Pain, Postoperative ; Pediatrics* ; Postoperative Complications ; Retrospective Studies ; Sample Size ; Traction ; Wounds and Injuries

Epidemiological study on Acaroid mite in dust different sites were carried out and the following results were obtained. Tyrophagus dimidiatus, Chibidania tokyoensis and Ornithonyssus nagayoi were found in living room(46.2 %), bath room(36.7 %), garden(27.0 %), shopping-store(28.8 %) and ware-house (29.2 %) in the Pusan area. Dermanyssus gallinae and Rhizoglyphus echinopus were found mainly in class rooms of girl's high school(34.0 %) and class room of girl's middle school(40.0 %) as well as in primary school(13.2 %), but they are not found in class rooms of boys high school. Generally, the various mites were found in the living room(57.0 %), under the carpet(50 %), under the furniture(52.0 %), on the furniture(27.5 %), lavatory(35.7 %) and garden(23.8 %).
parasitology-arthropod-acarid-migte ; Tyrophagus dimidiatus ; Chibidania tokyoensis ; Ornithonyssus nagayoi ; Dermanyssus gallinae ; Rhizoglyphus echinopus

Paraganglioma is a benign tumor arising in the paraganglion system scattered throughout the body, but its cytopathologic findings arenot well known. We experienced a case of paraganglioma of carotid body diagnosed by fine needle aspiration. The patient was a 30 year-old female who suffered from the left neck mass for 3 years. The mass was 3x3crn in size without pulsation or bruit. Cytologically, the smear revealed aggregated and singly scattered tumor cells having abundant pale cytoplasm and indistinct cell borders. Their nuclei were round to oval, but enlarged nuclei were occasionally observed. The nuclear membrane was smooth with fine clumping of chromatin. Differentiation from metastatic follicular carcinoma of the thyroid gland was difficult.
Adult ; Biopsy, Fine-Needle ; Carotid Body ; Chromatin ; Cytoplasm ; Female ; Glomerulosclerosis, Focal Segmental* ; Humans ; Neck ; Nephrotic Syndrome* ; Nuclear Envelope ; Paraganglioma ; Thyroid Gland