No abstract available.
Cheek* ; Microcirculation* ; Skin* ; Smoke* ; Smoking*

BACKGROUND: EMLA cream is a eutectic mixture of lidocaine and prilocaine and has excellent anesthetic effect on tympanic membrane but histologic influence on tympanic membrane is uncertain. OBJECTIVE: To investigate its histologic effects on tympanic membrane. MATERIALS AND METHODS: 18 Sprague-Dawly rats were divided into 6 groups. Each group was treated with application of EMLA cream into external ear canal and then were sacrificed at 4 hours, 24 hours, 3 days, 7 days, and 14 days after application of the agents. RESULTS: 1) Transmission electron microscopy revealed partial loss of epithelial cell at 4 hours after application of the agents. 2) The specimen showed damaged cells in the epidermal layer and partial loss of basement membrane at 24 hours after application of the agents. 3) At 1 week after application of the agents epidermal layer and inner epithelium with connective tissue predominated. Thus the fibrous layer represent only 1/3 of total drum thickness. In the basal layers widened intercellular spaces were noted. 4) At 2 weeks after application of the agents newly formed connective tissue was found at fibrous layer and numerous fibroblasts were noted at inner epithelial layer. but overall histologic changes of the drum were not significant and healing processes was noted. CONCLUSION: EMLA cream has less histopathologic effects on tympanic membrane, and early recovery process occurred.
Anesthetics ; Animals ; Basement Membrane ; Connective Tissue ; Ear Canal ; Epithelial Cells ; Epithelium ; Extracellular Space ; Fibroblasts ; Lidocaine ; Microscopy, Electron, Transmission ; Prilocaine ; Rats* ; Tympanic Membrane*

PURPOSE: The purpose of this trial was to determine whether salbtamol and budesonide combined inhalation therapy is more efficacious than conservative treatment for admitted infants with bronchiolitis in early phase. METHODS: The study subjects were 72 infants admitted to Sun Hospital in Taejeon from July 1994 to June 1995, whose age from 1 month to 12 months with clinical diagnosis of bronchiolitis. Infants were randomly assigned to different three treatment groups as follw: Group C: 21 infants who received conservative treatment with oxygen (4liter/min); Group A: 23 infants who received salbutamol (0.1mg/kg) inhalation therapy using ultrasonic nebulizer at 6 hours interval add to conservative therapy; Group B: 28 infants who received budesonide (0.1mg/kg) inhalation therapy with above mentioned treatment at 12 hours interval. Then, infants were analyzed by comparison of clinical score, repiratory rate at time order of entry, 12 hours, 24 hours, 48 hours, 72 hours, and 5 days after treatment. We also compared ABGA of admission time to 24 hours after treatment of all groups and appreciate total hospital days of three groups. On follow up, same analyzing methods of comparison were used on 42 non-recurrent wheezing infants. RESULTS: The mean values of clinical score and respiratory rate were significantly improved in salbutamol and budesonide inhalation treatment group at 24 hours from medium of 6.1 60.7/min to 2.4, 42.3/min respectly. This effect was sustained thereafter. On the while, salbutamol inhalation group was significantly improved the clinical score and respiratory reate at 12 hours after therapy, but thereafter there was no obvious difference to conservative treatment. After then we exclude the recurrent infants and analyzed above mentioned items retrospectively. The improvement of clinical score and respiratory rate of salbutamol and budesonide inhalation therapy group was significant. Oxygenation was improved after 24hours of salbutamol and budesonide inhalation therapy. Total hospital stay was significantly reduced in salbutamol and budesonide inhalation group, and slightly reduced inthe salbutamol inhalation group. CONCLUSION: Infants with bronchiolitis treated with salbutamol and budesonide inhalation achieved better results in clinical score, repiratory rate PO2, and hospital days than no inhalation therapy. No reapiratory failure was occurred. So, this trial as treatment of bronchiolitis may be useful and effective therapy in those infants.
Albuterol* ; Bronchiolitis* ; Budesonide* ; Daejeon ; Diagnosis ; Follow-Up Studies ; Humans ; Infant* ; Inhalation* ; Length of Stay ; Nebulizers and Vaporizers ; Oxygen ; Respiratory Rate ; Respiratory Sounds ; Respiratory Therapy* ; Retrospective Studies ; Solar System ; Ultrasonics

PURPOSE: The purpose of this trial was to determine whether salbtamol and budesonide combined inhalation therapy is more efficacious than conservative treatment for admitted infants with bronchiolitis in early phase. METHODS: The study subjects were 72 infants admitted to Sun Hospital in Taejeon from July 1994 to June 1995, whose age from 1 month to 12 months with clinical diagnosis of bronchiolitis. Infants were randomly assigned to different three treatment groups as follw: Group C: 21 infants who received conservative treatment with oxygen (4liter/min); Group A: 23 infants who received salbutamol (0.1mg/kg) inhalation therapy using ultrasonic nebulizer at 6 hours interval add to conservative therapy; Group B: 28 infants who received budesonide (0.1mg/kg) inhalation therapy with above mentioned treatment at 12 hours interval. Then, infants were analyzed by comparison of clinical score, repiratory rate at time order of entry, 12 hours, 24 hours, 48 hours, 72 hours, and 5 days after treatment. We also compared ABGA of admission time to 24 hours after treatment of all groups and appreciate total hospital days of three groups. On follow up, same analyzing methods of comparison were used on 42 non-recurrent wheezing infants. RESULTS: The mean values of clinical score and respiratory rate were significantly improved in salbutamol and budesonide inhalation treatment group at 24 hours from medium of 6.1 60.7/min to 2.4, 42.3/min respectly. This effect was sustained thereafter. On the while, salbutamol inhalation group was significantly improved the clinical score and respiratory reate at 12 hours after therapy, but thereafter there was no obvious difference to conservative treatment. After then we exclude the recurrent infants and analyzed above mentioned items retrospectively. The improvement of clinical score and respiratory rate of salbutamol and budesonide inhalation therapy group was significant. Oxygenation was improved after 24hours of salbutamol and budesonide inhalation therapy. Total hospital stay was significantly reduced in salbutamol and budesonide inhalation group, and slightly reduced inthe salbutamol inhalation group. CONCLUSION: Infants with bronchiolitis treated with salbutamol and budesonide inhalation achieved better results in clinical score, repiratory rate PO2, and hospital days than no inhalation therapy. No reapiratory failure was occurred. So, this trial as treatment of bronchiolitis may be useful and effective therapy in those infants.
Albuterol* ; Bronchiolitis* ; Budesonide* ; Daejeon ; Diagnosis ; Follow-Up Studies ; Humans ; Infant* ; Inhalation* ; Length of Stay ; Nebulizers and Vaporizers ; Oxygen ; Respiratory Rate ; Respiratory Sounds ; Respiratory Therapy* ; Retrospective Studies ; Solar System ; Ultrasonics

No abstract available.
Pregnancy*

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

The claw-foot deformity is only a symptom of some primary lesion, not an entity in itself. The treatment of claw-foot usually depends on the type and severity of the deformity. In the past two years, authors have treated 7 cases of claw-foot, 3 of which were treated by Cole's anterior tarsal wedge osteotomy and 4 cases by Japas “V”-osteotomy of tarsus. In all 7 cases, Steindler's plantar fasciotomy for cavus deformity were combined and 1 case was combined with Achilles tendon lengthening. The followings were noted. 1. AlI patients were military personals and the ages were between 21 to 27 years old male. 2. Two patients were bilateral claw-foot deformity and both sides were operated. 3. The causes were secondary to poliomyelitis in one case and the others were idiopathic. 4. Postoperative complications were skin necrosis in one case and sensory disturbance on the dorsum of the first web space of the foot in 3 cases. 5. All patients can walk and run without pain after average 1 year follow-up period.
Achilles Tendon ; Ankle ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Foot Deformities ; Humans ; Male ; Military Personnel ; Necrosis ; Osteotomy ; Poliomyelitis ; Postoperative Complications ; Skin

PURPOSE: It was noted some changes of clinical manifestations of mycoplasma pneumonia. we reviewed and compared these changes and saught any clues causes for proper dignosis and treatment. METHODS: We divided patients with mycoplasma pneumonia into two groups, Group 1 (from Jan. to Dec. 1996) and Group 2 (from Jan. to Dec. 1994), and analyzed clinical, radiologic, and serologic differences. RESULTS: Mean age of onset lowered markedly from was 8.34 +/- 2.56 years to 6.91 +/- 3.28 years (P<0.05). In clinical symptoms, high fever lasted longer and gastrointestinal symptoms were more frequent noted group 1. Serologically, high titers of mycoplasma-specific antibody (>1 : 1280) were more frequently observed in group 1 and correlated with severity of clinical manifestations. In radiologic findings, alveolar consolidation were significantly prominent findings in Group (P<0.05). The mean period of response to Roxithromycin was not difference between two groups but longer lasting fever (> or = 3 days) in spite of medication were more prevalent in Group 1 (P<0.05), suggesting increased cases of diminished responsiveness to treatment. CONCLUSIONS: Recently, there was some clinical changes of mycoplasma pneumonia, lowering of onset age, severe clinical symptoms, and more decreased responsiveness to antibiotic treatment. We suggest that it is to neccessary to make some efforts to prevent antibiotics abuse and to decrease the occurrence of resistant strains by introducing of new method for early diagnosis, selective identification of micro-organism and minute sensitivity test for antibiotics.
Age of Onset ; Anti-Bacterial Agents ; Early Diagnosis ; Fever ; Humans ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Roxithromycin

Pneumocystis carinii causes serious pulmonary infection in immunosuppressed patients. This study was undertaken to observe the cytoskeletal proteins of P. carinii by immuno-electron microscopy. P. carinii infection was experimentally induced by immunosuppression of Sprague-Dawley rats for seven weeks, and their lungs were used for the observations of this study. The gold particles localized actin, tropomyosin, and tubulin. The actin was irregularly scattered in the cytoplasm of the trophic forms but was much more concentrated in the inner space of the cell wall of the cystic forms called the inner electron-lucent layer. No significant amount of tropomyosin was observed in either trophic forms or cystic forms. The tubulin was distributed along the peripheral cytoplasm and filopodia of both the trophic and cystic forms rather than in the inner side of the cytoplasm. Particularly, in the cystic forms, the amount of tubulin was increased and located mainly in the inner electron-lucent layer of the cell wall where the actin was concentrated as well. The results of this study showed that the cell wall of P. carinii cystic forms is a structure whose inner side is rich in actin and tubulin. The location of the actin and tubulin in P. carinii suggests that the main role of these proteins is an involvement in the protection of cystic forms from the outside environment by maintaining rigidity of the cystic forms.
Actins/analysis ; Animals ; Cytoskeletal Proteins/*analysis ; Fungal Proteins/*analysis ; Histocytochemistry ; Microscopy, Immunoelectron ; Pneumocystis/*chemistry/cytology ; Rats ; Rats, Wistar ; Support, Non-U.S. Gov't ; Tropomyosin/analysis ; Tubulin/analysis

Acute appendicitis is one of the most common diseases of young people that requires emergency operation. This is especially true for those age 10 years old and older. However, the numbers of cases of appendicitis are increasing in both the young and the elderly. The main purpose of this study is to understand the clinical features of acute appendicitis in children and elderly patients. We retrospectively compared clinical characteristics in 4 groups of patients who underwent appendectomy in our hospital. There were 16 patients in the pre-school age group, 9 were males and 7 females. The total number of patients in the juvenile group were 287, 156 were males and 131 females. The total numbers of patients in the adult group were 794, 436 were males and 358 females. The numbers of elderly patients were 189, 91 were males and 98 females. Complicated appendicitis was found in 15 patients (93.7 %) in the pre-school age group, 79 patients (27.5 %) in the juvenile group, 332 patients (41.8 %) in the adult group, and 96 patients (50.7 %) in the elderly group. Four patients (40 %) had generalized panperitonitis in the pre-school group. The occurrence of perforated appendicitis was the highest in the pre-school age group and the lowest in the juvenile group. Since generalized panperitonitis has a higher incidence in the pre-school age group, prudent and careful diagnosis and treatment are required for the pre-school age group.
Adult ; Aged ; Appendectomy ; Appendicitis ; Child ; Emergencies ; Female ; Humans ; Incidence ; Male ; Retrospective Studies