PURPOSE: Neonatal jaundice is one of the most common problems in our country leading to hospitalization. Agar is low cost, low risk, and easily fed orally; it can bind bilirubin in the intestine, decreasing its enterohepatic circulation, thereby decreasing serum bilirubin levels. At present, however, the effectiveness of agar in the prevention and treament of neonatal jaundice is quite conflicting and controversy. Recently we have read Caglayan's 'Superiority of Oral Agar and Phototherapy Combination in the Treatment of Neonatal Hyperbilirubinemia'. The result was very hopeful and attractive enough, and which gave us a motivation to study if it was really of value. METHODS: From May 1995 to April 1996, a total 50 term neonates admitted in nursery of Dong-Eui Medical Center with the capillary serum bilirubin levels greater than 10mg/ dl were enrolled in the study. Those with pathologic causes and breast fed infants were all excluded. The neonates were randomly devided into two groups; 25 of conventional phototherapy alone (P group) and 25 of oral agar plus conventional phototherapy combination (A+P group). The study was terminated when the capillary serum bilirubins were decreased to 8mg/dl. Pastagar B (Pasteur Institute 64946) 500mg in 10ml distilled water were fed four times a day using 10ml syringes prior to bottle feeding. Capillary serum bilirubin levels were measured daily at 10:00 a.m. with heel pad samples. Daily stool frequency and adverse effects of treatment were observed closely. RESULTS: 1) The decrement of the serum bilirubin levels at first 24 hours of therapy was significantly different between P and A+P groups showing as 1.7+/-1.2 and 2.4+/-1.0mg/dl respectively (p<0.05). 2) Mean time for bilirubin to decrease to 8mg/dl was shorter in A+P group than in P group showing as 45.7+/-20.8 and 57.5+/-32.3 hours each other, but those differences were statistically insignificant (p>0.05). 3) No adverse effects such as rashes or abdominal pains were observed during treatment. Differences of mean stool frequency were significant between P and A+P groups showing as 3.7+/-1.2 and 4.7+/-2.0 times per day respectively (p<0.05). CONCLUSION: The agar plus conventional phototherapy combination was superior to conventional phototherapy alone at first 24 hours of therapy in neonatal hyperbilirubinemia, but further more careful researches would be necessary for using it routinely in the treatment of neonatal hyperbilirubinemia in future.
Abdominal Pain ; Agar* ; Bilirubin ; Bottle Feeding ; Breast ; Capillaries ; Enterohepatic Circulation ; Exanthema ; Heel ; Hope ; Hospitalization ; Humans ; Hyperbilirubinemia, Neonatal* ; Infant ; Infant, Newborn ; Intestines ; Jaundice, Neonatal ; Motivation ; Nurseries ; Phototherapy* ; Syringes ; Water

Immunohistochemical staining on paraffin sections for S-100 protein improved diagnostic accuracy for melanocytic tumor. But specificity of S-100 protein in the diagnosis of melanocytic tumor is very low, because S-100 protein was also expressed in neurogenic tumor and salivary gland tumor. To investigate a specific tumor marker for the malignant melanoma, immunohistochemical staining for HMB-45 and S-100 protein was performed on the paraffin sections of 25 cases of malignant melanoma and 46 cases of nevi. Positive reaction for HMB-45 and S-100 protein was diffusely identified in the cytoplasm of tumor cells. Positive ratio for HMB-45 was 100% in malignant melanoma, 92% in junctional component of compound nevus and 0% in intradermal nevus. Positive ratio for S-100 protein was 92% in malignant melanoma, 100% in compound nevus and 100% in intradermal nevus. The sensitivity and specificity for HMB-45 in malignant melanoma were 100%, but those for S-100 protein were 92% in sensitivity and 86.7% in specificity. These results indicate that HMB-45 has a high sensitivity and specificity for malignant melanoma cells and it can be quite useful for the histopathological diagnosis of malignant melanoma.
Sensitivity and Specificity ; Tumor Markers, Biological

Negative pressure pulmonary edema (also known as postobstructive pulmonary edema) is a medical emergency that usually arises from attempted ventilations against an acutely obstructed upper airway, such as occurs during laryngospasm. Often this occurs in the perioperative period when general anesthesia is used. It is most important to the clinician because it must be promptly recognized and appropriately managed. Since hypoxia is the chief problem associated with this complication, adequate oxygen saturation remains the primary goal of treatment. We report a case of a 42-year-old female patient who was submitted to laparoscopic tubal reversal under general anesthesia and developed negative pressure pulmonary edema after an acute airway obstruction.
Adult ; Airway Obstruction ; Anesthesia, General ; Anoxia ; Emergencies ; Female ; Humans ; Laparoscopy* ; Laryngismus ; Oxygen ; Perioperative Period ; Pulmonary Edema* ; Ventilation

Gastrointestinal cytomegalovirus(CMV) infection in adults is observed as a part of a generalized or localized infection in patients who are immunocompromized. We report a case of CMV infection of the small intestine. The patient is a 34 year-old woman who has complained of palpable purpura in the lower extremities and buttocks, and arthralgia of large joints. The skin biopsy showed fibrinoid necrosis and neutrophils with leukocytoclasis, which findings are compatible with hypersensitivity angiitis. The patient received steroid and cyclophosphamide. During the follow-up period, generalized edema and bloody stool were detected. Resected specimen of small bowel has multiple aphthous ulcer. Microscopically, cytomegalic cells are observed along the endothelial cells and mesenchymal cells. In situ hybridization using DNA probes against CMV revealed positive staining in the cytomegalic inclusions in vascular endothelial and mesenchymal cells.
Adult ; Male ; Female ; Humans ; Biopsy

No abstract available.
Meningitis, Aseptic*

PURPOSE: The Purposes of this study are to identify the circulating etiologic viruses of acute lower respiratory tract infection in children and to understand the relation with clinical diagnosis. METHODS: We obtained a total of 418 nasopharyngeal aspirates from children admitted for their acute lower respiratory tract infections at three tertiary hospitals in Seoul from September 2008 to March 2009. We performed multiplex RT-PCR to identify 14 etiologic viruses and analyzed their emerging patterns and clinical features. RESULTS: Average age of patients was 16.4 months old and the ratio of male to female was 1.36. Viruses were detected in 56.2% of a total of 418 samples. Respiratory syncytial virus (35%) was the most frequently detected and followed by human rhinovirus (22%), human bocavirus, adenovirus, human metapneumovirus, parainfluenza virus, influenza virus and human coronavirus. Co-infection reached 21.9% of positive patients. CONCLUSION: When we manage the patients with acute lower respiratory infectious diseases, we should remind the role of various viral pathogens, which might be circulating by seasons and by local areas.
Adenoviruses, Human ; Child ; Coinfection ; Communicable Diseases ; Coronavirus ; Female ; Human bocavirus ; Humans ; Male ; Metapneumovirus ; Orthomyxoviridae ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Respiratory System ; Respiratory Tract Infections ; Rhinovirus ; Seasons ; Tertiary Care Centers ; Viruses

PURPOSE: Bilirubin values may vary depending on the site of sampling. The purpose of this study is to compare simultaneously obtained capillary and venous serum bilirubin to assess neonatal jaundice. METHODS: The subjects for the study included 135 healthy inborn as well as outborn full-term infants admitted to Dong-Eui Medical Center for evaluation of jaundice from May 1997 to February 1999. A paired capillary and venous sample was simultaneously drawn from each neonate, and their serum bilirubins were measured by direct spectrophotometric method. RESULTS: A high correlation between capillary and venous serum bilirubin(correlation coefficient(r) =0.949, P<0.05) was observed. No significant difference between mean capillary and venous bilirubin was detected when capillary bilirubin was less than 10 mg/dL(P>0.05), however, the mean venous bilirubin was significantly higher than the mean capillary bilirubin(mean difference;0.65+/-1.04 mg/dL, P<0.0001) when the capillary bilirubin was greater or equal to 10 g/dL(P>0.05). CONCLUSION: There was a trend toward venous bilirubin being higher than capillary bilirubin at higher serum bilirubin levels. However, further studies are needed to ascer-tain the relationship between the site of the sampling and methodology in measurement of bilirubin.
Bilirubin* ; Capillaries* ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Jaundice, Neonatal*

We evaluated the effects of guanosine 5′-monophosphate (GMP)-chelated calcium and iron (CaFe-GMP) on health and egg quality in layers experimentally infected with Salmonella Gallinarum. In this study, a CaFe-GMP feed additive was added to a commercial layer feed and fed to layers over a four-week period. All were inoculated with Salmonella Gallinarum. Body weight, mortality, clinical symptoms, and poultry production including feed intake, egg production, egg loss, and feed conversion rate were observed, and Salmonella Gallinarum was re-isolated from the liver, spleen, and cecum of the layers. All tested internal organs for the CaFe-GMP additive group exhibited significantly lower re-isolation numbers of Salmonella Gallinarum and less severe pathological changes than those in the control group, indicating that the CaFe-GMP feed supplement induced bacterial clearance and increased resistance to Salmonella Gallinarum. Additionally, due to the inhibitory action of CaFe-GMP on the growth of Salmonella Gallinarum, the CaFe-GMP additive group exhibited better egg production, including a higher laying rate and fewer broken eggs. The results suggest that a 0.16% CaFe-GMP additive may help prevent salmonellosis in the poultry industry.
Body Weight ; Calcium* ; Cecum ; Eggs ; Guanosine* ; Iron* ; Liver ; Mortality ; Ovum* ; Poultry ; Poultry Products ; Salmonella Infections ; Salmonella* ; Spleen

The subacute necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease, is a benign, self-limited disorder of unknown cause. This rare disease is characterized by fever, lymphadenopathy, leukopenia, and elevated sedimentation rate. This disease preferentially affects young women. The diagnosis of this disease is confirmed by involved lymphnodes biopsy. Evidence for autoimmune dysfunction has been reported, but is usually lacking. According to the review of the literatures, a total of 192 cases of subacute necrotizing lymphadenitis were reported in Korea since 1983 mostly in literatures of pathology or internal medicine and only 7 cases in pediatrics. There was female predominance in a 141:51 ratio. However, among 25 cases of under 20 years of age, there was male predominance in a 16:9 ratio. The patients of under and over 20 years of age were 29 and 82, respectively among the age-known 111 cases of 192 reported. We experienced a 13-year-old boy, who had right cervical lymphadenitis with persisting high temperature and pain on lymph nodes for more than 10 days. An excisional cervical lymph node biopsy was performed and pathologic diagnosis was compatible with subacute necrotizing lymphadenitis. Most antibiotics were not effective, but fever subsided with one day of oral prednisolone therapy. Various laboratory studies for prolonged fever were negative except leukopenia and increased sedimentation rates. The CD4/CD8 ratios in acute and recovery stages were 1.1 and 1.5 respectively, showing mild decrease of CD4/CD8 ratio in the acute stage. Decreased T cell proportions in the acute stage were also noted.
Adolescent ; Anti-Bacterial Agents ; Biopsy ; Diagnosis ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Internal Medicine ; Korea ; Leukopenia ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Lymphocyte Subsets* ; Lymphocytes* ; Male ; Pathology ; Pediatrics ; Prednisolone ; Rare Diseases

The subacute necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease, is a benign, self-limited disorder of unknown cause. This rare disease is characterized by fever, lymphadenopathy, leukopenia, and elevated sedimentation rate. This disease preferentially affects young women. The diagnosis of this disease is confirmed by involved lymphnodes biopsy. Evidence for autoimmune dysfunction has been reported, but is usually lacking. According to the review of the literatures, a total of 192 cases of subacute necrotizing lymphadenitis were reported in Korea since 1983 mostly in literatures of pathology or internal medicine and only 7 cases in pediatrics. There was female predominance in a 141:51 ratio. However, among 25 cases of under 20 years of age, there was male predominance in a 16:9 ratio. The patients of under and over 20 years of age were 29 and 82, respectively among the age-known 111 cases of 192 reported. We experienced a 13-year-old boy, who had right cervical lymphadenitis with persisting high temperature and pain on lymph nodes for more than 10 days. An excisional cervical lymph node biopsy was performed and pathologic diagnosis was compatible with subacute necrotizing lymphadenitis. Most antibiotics were not effective, but fever subsided with one day of oral prednisolone therapy. Various laboratory studies for prolonged fever were negative except leukopenia and increased sedimentation rates. The CD4/CD8 ratios in acute and recovery stages were 1.1 and 1.5 respectively, showing mild decrease of CD4/CD8 ratio in the acute stage. Decreased T cell proportions in the acute stage were also noted.
Adolescent ; Anti-Bacterial Agents ; Biopsy ; Diagnosis ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Internal Medicine ; Korea ; Leukopenia ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Lymphocyte Subsets* ; Lymphocytes* ; Male ; Pathology ; Pediatrics ; Prednisolone ; Rare Diseases