PURPOSE: In most emergency department (ED), sedation is required before carrying out an invasive procedure on a pediatric patient. In the ED setting, it is essential to determine the optimal dose and administration route of CH for successful sedation. The aim of this study was to determine the optimal dose of CH for an invasive procedure and to examine the effectiveness of the drug's different administration routes. Furthermore, in this study, we performed simple survey using questionnaire which composed of Likert-scale to evaluate satisfaction of medical staffs in ED with administration routes. METHODS: This study was conducted prospectively. The study participants were pediatric patients under 8 years old who visited the ED in two tertiary hospitals in South Korea within a period of 12 months. RESULTS: Overall, 300 patients were included in this study. The age, sex, and weight of the patients were not shown to influence the sedation time. Chloral hydrate dosage is the independent factor to influence the both sedation and discharge time (p<0.01). In the comparison of the groups, groups 1, 2, and 5 showed no significant difference. On the other hand, groups 3 and 4 were shown to be statistically significantly different from group 1. CONCLUSION: Up to 100 mg/kg CH is safe to use in the emergency department for pediatric patients, but the initial dose of 50 mg/kg for oral administration should be considered in advance because it can provide safe and effective sedation with a lower possibility of causing an adverse effect.
Administration, Oral ; Chloral Hydrate* ; Deep Sedation ; Emergency Service, Hospital ; Hand ; Humans ; Korea ; Medical Staff ; Prospective Studies ; Tertiary Care Centers

PURPOSE: Both antithrombin III(ATIII) and Gabexate mesilate(Foy) are effective for the treatment of disseminated intravascular coagulation(DIC). However, their mechanisms of action are slightly different, and combined effect of ATIII and Foy in premature infant with DIC has not been studied. We evaluated therapeutic efficacy of treatments with either ATIII or Foy alone or both in combination. METHODS: We studied 23 premature infants of gestational ages between 30 and 36 weeks with DIC. Group A(n=10) was treated by ATIII only, Group B(n=7) by Foy only and Group C(n=6) by both ATIII and Foy. Three groups were compared for volume of blood sampling and transfusion and hematologic data. RESULTS: Improvement of hematologic data(platelet, PT, aPTT, fibrinogen, FDP) was not significantly different among 3 groups. The mean volume of blood sampling during 5 days of treatment was 30 mL, 22.5 mL, and 30 mL, respectively. The mean volume of packed RBC transfusion was 12.8 mL, 9 mL, and 2.5 mL, respectively: and mean volume of platelet transfusion was 25.9 mL, 10 mL, and 0 mL, respectively, showing no significant statistical difference. But the mean volume of FFP transfusion was 141 mL only in group B, significantly higher compared to other groups. CONCLUSION: The combination therapy of ATIII and Foy significantly decreased the volume of FFP transfusion and may be more effective than monotherapy with ATIII or Foy alone in DIC of premature infant.
Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrinogen ; Gabexate* ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature* ; Platelet Transfusion ; Thrombin*

OBJECTIVE: We previously described that Diva is highly expressed in matured metaphase II (MII) oocytes compared to immature germinal vesicle (GV) oocytes in mouse.1 We report here that the expression of Diva transcript as well as protein is oocyte-specific. To elucidate its physiological role in oocyte, the binding partner(s) of Diva has been identified by using immunoprecipitation (IP) followed by Mass Spectrometry. METHODS: NIH/3T3 cells were transiently transfected for 24 h with either empty vector for control or FLAG-tagged mouse Diva construct, and IP was performed with anti-FLAG antibody. The immuno-isolated complexes were resolved by SDS-PAGE on a 12% gel followed by Coomassie Blue staining. For in-gel digestion, 15 bands of interest were excised manually and digested with trypsin. All mass spectra were acquired at a positive reflector mode by a 4700 Proteomics Analyzer (Applied Biosystems, Framingham, MA). Proteins were identified by searching the NCBI nonredundant database using MASCOT Peptide Mass Fingerprint software (Matrixscience, London). RESULTS: Diva-associated complexes were formed in FLAG-tagged mouse Diva-overexpressed NIH/3T3 cells via IP using anti-FLAG-conjugated beads. Among the excised 15 bands, actin and actin-binding proteins such as tropomyosin, tropomodulin 3, and alpha-actinin were identified. Binding between Diva and actin or tropomyosin was confirmed by IP followed by Western blot analysis. Both bindings were also detected endogenously in mouse ovaries, indicating that Diva works with actin and tropomyosin. CONCLUSIONS: This is the first report that immuno-isolated Diva-associated complexes are related to actin filament of the cytoskeletal system. When we consider the association of Diva with actin and tropomyosin, oocyte-specific Diva may play a role in modulating the cytoskeletal system during oocyte maturation.
Actin Cytoskeleton ; Actinin ; Actins ; Animals ; Blotting, Western ; Dermatoglyphics ; Digestion ; Electrophoresis, Polyacrylamide Gel ; Female ; Immunoprecipitation ; Mass Spectrometry* ; Metaphase ; Mice ; Microfilament Proteins ; Oocytes ; Ovary ; Proteomics ; Tropomodulin ; Tropomyosin ; Trypsin

PURPOSE: Androgen plays an important role during penile development and is essential for libido in the male, but its role in the regulation and maintenance of the erectile response has been controversial. We investigated the effect of castration and androgen replacement on penile erection in the adult rat. MATERIALS AND METHODS: Adult male Spargue-Dawley rats were divided into three groups: control, castration, and androgen replacement after castration. Androgen (testosterone, DHT) was administrated for 7 days at week 1, 2, 3, and 4 after castration. The intracavernosal pressure was recorded after submitting the rats to cavernous nerve stimulation. The percentages of cells in the penis expressing Ki-67 (proliferative index) and of apoptotic cells, assessed by morphologic analysis (apoptotic index), were analyzed. Nitric oxide synthase (NOS) activity was measured by the arginine-citrulline conversion ratio, and expression of nNOS and eNOS was determined by Western blot analysis. RESULT: After castration, a significant increase was noted in the apoptotic index, with a decrease in the expression of nNOS and eNOS. Replacement of androgen increased the proliferative index and the expression of cavernous nerve stimulation; NOS activity and erectile function were restored with androgen replacement. CONCLUSIONS: These results suggested that the penile tissue and NOS activity of the adult rat are affected by the androgen milieu and androgen such as testosterone and DHT play a direct role in the erectile function at the level of the erectile tissue.
Adult* ; Animals ; Apoptosis ; Blotting, Western ; Castration ; Humans ; Libido ; Male ; Nitric Oxide ; Nitric Oxide Synthase ; Penile Erection ; Penis* ; Rats* ; Testosterone

PURPOSE: The purpose of this study was to evaluate the effect of amino acid mixtures on incidence and severity of total parenteral nutrition associated-cholestasis(PNAC) in very low birth weight infants. METHODS: Retrospective review of 63 very low birth weight infants(birth weight < or =1,500 g) who received total parenteral nutrition(TPN) in our neonatal intensive care unit from January 2000 to December 2004 was performed. Patients were divided into 2 groups : Group I(n=32, Jan 2000-Jun 2002) and Group II(n=31, Jul 2002-Dec 2004), where infants in Group II received taurine and glutamic acid-rich amino acid mixtures. PNAC was defined as serum direct bilirubin(DB) level greater than 2.0 mg/dL. The incidence and severity of PNAC were compared between these groups. RESULTS: The incidence of PNAC was significantly lower in Group II than in Group I(21.9% vs 6.5%, P<0.148). Maximum and mean DB levels were also significantly lower in Group II(P<0.05). CONCLUSION: The incidence and severity of PNAC in very low birth weight infants may be reduced with different composition of amino acid mixtures in TPN. Further prospective randomized controlled studies are needed to determine an ideal composition of acid mixtures to prevent the development of PNAC.
Cholestasis* ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Parenteral Nutrition, Total ; Retrospective Studies ; Taurine

PURPOSE: The excision of breast lesion with using ultrasound-guided Mammotome(R) is currently used for both the treatment and diagnosis of benign lesions. However sonographic evidence for tumor removal by Mammotome(R) excision does not confirm histological clearance of the resection margin. The purpose of this study was to evaluate the efficacy of ultrasound-guided Mammotome(R) for the removal of fibroadenomas by performing histological examination of an additional margin biopsy. METHOD: From March 2003 to May 2005, percutaneous removals of fibroadenoma with using ultrasono-guided Mammotome(R) biopsy were performed for 167 fibroadenomas in 154 women. Margin biopsies were additionally done after complete excision was achieved via ultrasonography. Histological evaluation was performed for these specimens. The patients were scheduled for follow-up ultrasound examination at 6 months. RESULTS: The mean tumor diameter was 1.32+/-0.54 cm. 45 (26.9%) lesions of the 167 lesions showed histological remained fibroadenoma on margin biopsies. The risk factors for remnant lesions were the age of a patient and the size of a lesion. No further ultrasonographic evidence of tumors was noted for 96.9% of the lesions at 6 months CONCLUSION: Although the breast fibroadenoma is a common benign breast tumor, the treatment and follow-up for these lesions is still debatable. We suggest that excision of breast lesion using ultrasound-guided Mammotome(R) can be used as minimally invasive surgery for fibroadenoma. If a lesion is larger than 2cm in a young woman, the physician should be careful to achieve enough excision for a complete removal of tumor.
Biopsy ; Breast Neoplasms ; Breast* ; Diagnosis ; Female ; Fibroadenoma* ; Follow-Up Studies ; Humans ; Risk Factors ; Surgical Procedures, Minimally Invasive ; Ultrasonography

PURPOSE: The excision of breast lesion with using ultrasound-guided Mammotome(R) is currently used for both the treatment and diagnosis of benign lesions. However sonographic evidence for tumor removal by Mammotome(R) excision does not confirm histological clearance of the resection margin. The purpose of this study was to evaluate the efficacy of ultrasound-guided Mammotome(R) for the removal of fibroadenomas by performing histological examination of an additional margin biopsy. METHOD: From March 2003 to May 2005, percutaneous removals of fibroadenoma with using ultrasono-guided Mammotome(R) biopsy were performed for 167 fibroadenomas in 154 women. Margin biopsies were additionally done after complete excision was achieved via ultrasonography. Histological evaluation was performed for these specimens. The patients were scheduled for follow-up ultrasound examination at 6 months. RESULTS: The mean tumor diameter was 1.32+/-0.54 cm. 45 (26.9%) lesions of the 167 lesions showed histological remained fibroadenoma on margin biopsies. The risk factors for remnant lesions were the age of a patient and the size of a lesion. No further ultrasonographic evidence of tumors was noted for 96.9% of the lesions at 6 months CONCLUSION: Although the breast fibroadenoma is a common benign breast tumor, the treatment and follow-up for these lesions is still debatable. We suggest that excision of breast lesion using ultrasound-guided Mammotome(R) can be used as minimally invasive surgery for fibroadenoma. If a lesion is larger than 2cm in a young woman, the physician should be careful to achieve enough excision for a complete removal of tumor.
Biopsy ; Breast Neoplasms ; Breast* ; Diagnosis ; Female ; Fibroadenoma* ; Follow-Up Studies ; Humans ; Risk Factors ; Surgical Procedures, Minimally Invasive ; Ultrasonography

BACKGROUND: Among 5 subfamilies of dopamine receptors (DAR), D3 and D5 DAR are expressed on peripheral blood mononuclear cells (PBMC). Recently, those DARs have been reported to change in Parkinson's disease (PD). METHODS: We measured the DAR mRNA expression in PBMC from 15 PD patients who had never taken antiparkinson medication, and 16 age-matched healthy people by reverse transcription and quantitative competitive polymerase chain reaction. The beta-actin mRNA expression was also measured to evaluate the relative expression of DAR mRNA. RESULTS: The D3 and D5 DAR mRNA expression was not different between patients and controls. In patients, no significant cor-relation was found between DAR mRNA expression in PBMC and clinical variables such as severity and duration of symptoms, and patients' age. CONCLUSIONS: We confirmed the presence of D3 and D5 DAR in PBMC. However, their mRNA expressions were not influenced by the disease process of PD.
Actins ; Dopamine* ; Humans ; Parkinson Disease* ; Polymerase Chain Reaction ; Receptors, Dopamine* ; Reverse Transcription ; RNA, Messenger*

Primary aldosteronism is in most cases due either to a unilateral adrenal adenama or to a bilateral hyperplasia of the adrenal cortex. But, a few of bilateral adrena1 tumors in primary aldosteronism also have been reported. In these cases, it is important to differentiate the bilateral aldosterone producing adenomas from the unilateral aldosteronoma in the presence of a contralateral nonhmctioning adenoma for marking a treatment plan. We report a case of primary aldosteronism due to a unilateral aldosteronoma in the presence of a contralateral nonfunctioning adenoma. Abdominal CT sean revealed bilateral adrenal tumors, of which the functioning one was successfully localized using adrenal scintigraphy and selective adrenal venous sampling.
Adenoma ; Adrenal Cortex ; Aldosterone* ; Hyperaldosteronism* ; Hyperplasia ; Radionuclide Imaging ; Tomography, X-Ray Computed

The clinical and pathological features of warty dyskeratoma are presented. Warty dyskeratoma is a rarely encountered, solitary, benign cutaneous tumor occurring most often on the head and neck and to our knowledge, no cases associated with cutaneous horn have been published in western literature. We experienced a case of warty dyskeratoma with a cutaneous horn occurring in a 70-year-old male, who had a 1.3 cm-sized and slowly growing nodule on his neck. A brief review of the literature, was made especially in relation to the pathological findings and histogenesis of warty dyskeratoma.
Aged ; Animals ; Head ; Horns* ; Humans ; Male ; Neck