No abstract available.
Child* ; Humans ; Scrub Typhus*

No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Dyskeratosis Congenita*

PURPOSE: High dose intravenous immunoglobulin (IVIG) therapy is effective in reducing the incidence of coronary artery aneurysm in Kawasaki disease (KD) patients, however, the precise mechanisms by which IVIG reverses the immune activation is unknown. METHODS: The sera and peripheral mononuclear cells (PBMCs) were obtained from 10 KD patients in the acute stage (24 hrs before) and 24 hrs after one dose of IVIG (2g/kg) treatment. We measured serum interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) and compared them to the messenger RNA expression of the PBMCs by reverse transcription polymerase chain reaction. We also investigated the cytokines' or immunoglobulins' production of PBMCs which were stimulated with phytohemagglutinin-P (PHA-P) or pokeweed mitogen (PWM, without in vitro IVIG treatment) by enzyme-linked immunosorbent assay. RESULTS: The serum levels of IL-6 and TNF-alpha decreased significantly after IVIG treatment. However, the gene expression of IL-6 and TNF-alpha showed no significant difference after IVIG treatment. IL-6 and TNF-alpha productions of PBMCs stimulated with PHA-P decreased significantly after IVIG treatment, however, IL-4 and IFN-gamma production showed no significant differences. IL-6 production of PBMCs stimulated with PWM also decreased significantly after IVIG treatment, but TNF-alpha did not change significantly. The synthesis of IgG, IgM, IgA and IgG1 after IVIG treatment showed a significant decrease, and that of IgG2 showed a slight decrease, but was not statistically significant. CONCLUSION: The results demonstrate that the administration of IVIG in the acute stage of KD resulted in the alterations of activated immunologic abnormalities, especially in monocytes and B cells.
Aneurysm ; B-Lymphocytes ; Coronary Vessels ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Interleukin-4 ; Interleukin-6 ; Monocytes ; Mucocutaneous Lymph Node Syndrome* ; Phytolacca americana ; Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger ; Tumor Necrosis Factor-alpha

We report a case of acute transient encephalopathy with mental alteration, myoclonic jerks, and periodic triphasic wave electroencephalographic patterns caused by a therapeutic dose of baclofen. The clinical and electroencephalo-graphic abnormalities improved to a normal range shortly after baclofen was discontinued. We discuss the pathogenesis and review the literature about baclofen-induced encephalopathies.
Baclofen ; Myoclonus ; Reference Values

Four newborn infants with hyperbilirubinemia, caused by ABO blood group incompatibility, were treated with high-dose intravenous immune globulin(IVIG). As soon as the diagnosis was clinically suspected, these infants received conventional treatment including phototherapy and were monitored closely for bilirubin levels. When bilirubin concentrations reached the risk point in spite of phototherapy, IVIG was given at a dose of 1g/kg for 6 hours. In all cases, bilirubin levels declined within 12 hours after LVIG therapy, and to rebound effect was seen, No side effects of IVIG treatment were observed. We suggest that high-dose IVIG therapy may be useful in the treatment of hyperbilirubinemia due to ABO incompatibility, and reduce the need for exchange transfusion.
Bilirubin ; Blood Group Incompatibility ; Diagnosis ; Humans ; Hyperbilirubinemia* ; Hyperbilirubinemia, Neonatal ; Immunoglobulins, Intravenous* ; Infant ; Infant, Newborn ; Phototherapy

Lymphoma is the second most common neoplasm in the head and neck, and is the most common cause of unilateral neck mass in patients between 21 and 40 years of age. This report is a retrospective review of histologically proven lymphomas in 42 patients regarding histologic type, clinical stage, and CT imaging patterns. CT imaging plays an important role in making diagnosis, planning treatment, and evaluating recurrence after treatment. CT imaging patterns are classified into 4 types: Type 1 is nodal lymphoma, Type 2 extranodal lymphoma, Type 3 combined nodal and extranodal lymphoma, and Type 4 multifocal extranodal lymphoma. In conclusion, Lymphoma should be considered when multiple, nonnecrotic, homogenous lymph nodes are located in deep lymphatic chains (especially when they are large and bilateral or when both are the superficial and deep lymph node chains are involved simultaneously) and no mucosal abnormality of the aerodigestive tract is observed. Additionary, when a large nasopharyngeal mass lesion shows limited or equivocal bone destruction or a mass is identified on two sides of a nasal bone without frank destruction and when multiple sites of disease are identified in extranodal tissues.
Diagnosis ; Head* ; Humans ; Lymph Nodes ; Lymphoma* ; Nasal Bone ; Neck* ; Recurrence ; Retrospective Studies

Furlow's palatoplasty has been used as the primary treatment for cleft palate. From 1991 to 1999, 24 submucous cleft palate patients underwent Furlow's palatoplasty. The follow-up period was 3 months to 8 years (mean 24 months). Patients were selected after a thorough study for velopharyngeal insufficiency including intraoral examinatioin, speech assessment, digital subtraction radiography (DSR). Postoperatively velopharyngeal function was reevaluated with speech assessment and digital subtraction radiography in the 7 cooperative patients. Speech parameters including hypernasality, nasal emission, and Allison scale were improved after surgery. Digital subtraction radiography provided the value of velopharyngeal gap and the degree of the motion of lateral pharyngeal wall, both of which were improved after surgery. Furlows palatoplasty has advantage such as no impairment of nasopharyngeal physiology, no hannful effect on the hard palate and the realignment of the levator muscle which plays important role on the movement of the soft palate. The results show that a Furlow's palatoplasty can satisfactorily correct velopharyngeal insufficiency in carefully selected submucous cleft palate patients.
Cleft Palate* ; Follow-Up Studies ; Humans ; Palate, Hard ; Palate, Soft ; Physiology ; Radiography ; Velopharyngeal Insufficiency

BACKGROUND: As people have been interested in healt,h and as the microcomputers with multimedia steeing have been supplied more and more, there is increasing need of multimedia information about health. The CD-ROM, which is a representative multimedia tool, is capable of interacting between information-provider and users, offering audiovisual interface, and saving great deal of knowledge. METHODS: We developed the health-information system to provide ordinary people with hea1th information using multimedia tools. It, has 7 parts ; self-diagnosis, exploring human body, drug information, hospital information, first-aid treatment, Q and A, and medical common sense. We got image data such as figures, photos, X-rays, electrocardiograms and pathologic specimens with scanner and film scanner, also moving image(video) with video-capturing program. RESULTS & CONCLUSIONS: We hope the multimedia health-information system to become a useful methodology of patient education and to be used as an information source in medical information network in the near future.
CD-ROM ; Electrocardiography ; Hope ; Human Body ; Information Services ; Microcomputers ; Multimedia* ; Patient Education as Topic

BACKGROUND AND OBJECTIVES: Stroke onset is known to vary by several factors. Although it has been known that stroke may develop most frequently in the morning, its association with the type of activity has quite rarely been described. METHODS: We prospectively investigated by interview the time of and the activity during or before the onset of stroke in patients with acute cerebral infarction from Aug. 1995 to Mar. 1996. The activities were subdivided into basal metabolic rate state, sedentary, light, moderate, and heavy movements based on the caloric expenditure. RESULTS: One hundred-twenty five patients were enrolled. The time of day when ischemic stroke most frequently occurred was from 8:00 AM to noon. The type of activity was significantly associated with stroke onset in that it developed most commonly during and just after sleep or resting. The relationship between the onset of stroke and such patterns of onset time and the activity was found only in the atherothrombotic infarction, but not in the other stroke types. CONCLUSION: We demonstrated that stroke has clear diurnal variation. Our observations also suggested that the activity may be significantly associated with stroke onset. These findings may be useful for better understanding of the pathogenesis and prevention of ischemic stroke.
Basal Metabolism ; Cerebral Infarction* ; Health Expenditures ; Humans ; Infarction ; Prospective Studies ; Stroke