Anti-M antibodies are usually assumed to be naturally occurring and to consist of immunoglobulin M reacting at 4degrees C. They are not usually considered to be clinically significant, however, many of them have an immunoglobulin G component reacting at 37degrees C and can be correlated with hemolytic disease of the newborn (HDN). We report a moderate case of HDN by anti-M. A 2-days old baby born from a mother with preeclampsia as a second pregnancy was admitted due to anemia, hyperbilirubinemia and hypoxic encephalopathy. The blood type of mother was AB, ccDEE, NN, and the blood type of baby was A, D+, and MN. Antibody screening and identification identified anti-M antibody which was strong reactive at 37degrees C albumin and antiglobulin phase in both baby's and her mother's serum. The direct antiglobulin test of baby's red blood cells was negative. The infant was transfused with group O red cells which have negative to trace reaction with her mother's serum in antiglobulin phase. Two days later, the hemoglobin level elevated from 6.7 g/dL to 15.9 g/dL falled to below 11 g/dL quite soon. After all, newborn died of cardiac arrest due to her basic disease at age of 49 days; metabolic acidosis and hypernatremia.
Acidosis ; Anemia ; Antibodies ; Coombs Test ; Erythrocytes ; Heart Arrest ; Humans ; Hyperbilirubinemia ; Hypernatremia ; Hypoxia, Brain ; Immunoglobulin G ; Immunoglobulin M ; Infant ; Infant, Newborn* ; Mass Screening ; Mothers ; Pre-Eclampsia ; Pregnancy

No abstract available.
Bone Cysts* ; Fractures, Spontaneous*

PURPOSE: To determine the intraocular pressure (IOP) lowering effects on the change of anterior chamber depth (ACD), corneal thickness, corneal cell area and density in normal eyes. METHODS: We investigated 58 eyes of 29 volunteers for this study whose refractive error was +/-3 D, IOP was below 21 mmHg, anterior segment and fundus was within normal limit. All of them had normal visual fields. They were randomly classified into two groups. Anterior chamber depth, IOP, central corneal thickness, cell density, cell area, and coefficient of variation of corneal endothelium were measured by single observer in each group. After oral medication of 50% glycerin 1 cc/kg (body weight) in group 1 and Diamox 500 mg and K-contin 600 mg in group 2, IOP, anterior chamber depth, central corneal thickness, cell density, cell area, and coefficient of variation were measured at 1, 2, and 3 hours. RESULTS: In glycerin group after 1 hour, decreased IOP was stastically significant (P<0.05). In Diamox group after 2 hours, decreased IOP was stastically significant (P<0.05). But the change of anterior chamber depth, central corneal thickness, cell density, cell area, and coeff icient of variation was not stastically significant (p>0.05). There was no significant correlation between decreased IOP and the change of anterior chamber depth, central corneal thickness, cell density, cell area, and coefficient of variation. The IOP change was not statistically different between the two groups. CONCLUSIONS: There was no stastically significant correlation between decreased IOP in normal range and the change of ACD, central corneal thickness, cell density, cell area, and coefficient of variation.
Acetazolamide ; Anterior Chamber* ; Cell Count ; Endothelium, Corneal ; Glycerol ; Intraocular Pressure* ; Reference Values ; Refractive Errors ; Visual Fields ; Volunteers

Purpose: This study investigated the efficacy and safety of selective laser trabeculoplasty (SLT) in Korean patients with medically uncontrolled pseudoexfoliation glaucoma (PEXG). Methods: This retrospective observational study enrolled 43 medically uncontrolled PEXG patients who underwent a 360° SLT and were followed up for at least 12 months after SLT. The intraocular pressure (IOP) before and after SLT at 1 week, 1, 3, 6, and 12 months was evaluated. Treatment success was defined as an IOP reduction of ≥20% from the baseline and an IOP equal to lower than 22 mmHg without additional anti-glaucomatous intervention. Additionally, every follow-up medical record was reviewed to assess any possible side effects of SLT. Results: Based on the Kaplan-Meier survival analysis, the treatment success rate at 12 months after SLT was 41.9% (18 eyes). For the success group at the 12 months follow-up, SLT showed a mean IOP reduction of 10.3 ± 5.0 mmHg (from 25.6 ± 4.4 to 15.2 ± 2.9 mmHg; 39.3%, p < 0.05). Among the 25 eyes that were considered as the treatment failure group, 14 eyes underwent glaucoma filtering surgeries, four eyes received additional SLT, and further intervention and follow-up was refused for seven eyes. During the overall follow-up period, there were no significant adverse events. Conclusions SLT is a partially effective and safe procedure for lowering IOP in Korean patients with medically refractory PEXG. Therefore, it can be considered as one of the alternative treatment modalities in patients who are at high risk for conventional filtering surgery.

BACKGROUND: Whether intraoperative fluid therapy should contain glucose for the pediatric outpatient surgery remains controversial. This study was designed to compare the effects of glucose and glucose-free solutions on perioperative blood glucose change. METHODS: Healthy pediatric outpatients (n = 130) for minor procedure were randomly assigned to one of two fluid therapy groups. Patients in the group H (n = 65) received lactated Ringer's solution, and patients in the group D (n = 65) received 5% dextrose perioperatively. Blood glucose was checked before infusion (a), 10 minutes after induction (b), 30 minutes after induction (c), and at the time of discharge (d). RESULTS: The preoperative fasting glucose concentrations were 97.6 +/- 12.1 mg/dl and 97.7 +/- 11.3 mg/dl for the group H and D, respectively. The patients in the group D showed significantly increased blood glucose level after induction (135.9 +/- 42.7, 150.3 +/- 36.0, 123.6 +/- 26.8 mg/dl). The patients in the group H also showed significantly increased blood glucose levels (112.2 +/- 14.0, 121.4 +/- 11.4 and 105.8 +/- 18.3 mg/dl). The glucose level of group D was significantly higher than the glucose level of group H at b, c and d. Seven patients in the group D showed hyperglycemia (> 200 mg/dl). CONCLUSIONS: Dextrose containing fluid therapy resulted dangerous hyperglycemia in the pediatric outpatient surgery. We recommend lactated Ringer's solution or other glucose-free crystalloid for the healthy outpatient pediatric population undergoing minor procedures.
Ambulatory Surgical Procedures ; Blood Glucose* ; Fasting ; Fluid Therapy* ; Glucose ; Humans ; Hyperglycemia ; Outpatients*

OBJECTIVES: Some reports have suggested that 5-HT5A polymorphism allelic association was associated with depression, however, there has been no report about relationship between the 5-HT5A gene and antidepressant response. We conducted the association study of the 5-HT5A receptor gene polymorphisms (-19G/C,12A/T) and response to citalopram in Korean patients with major depressive disorder(MDD). METHODS: A total of 106 patients with major depressive disorder were included in this study. The patient's symptoms were measured by 21-item Hamilton Depression Rating Scale(HAMD) at baseline, week 1, week 2, week 4 and week 8 during citalopram treatment. A Responder to citalopram was defined by 50% reduction of total HAMD scores. To analyze genetic polymorphisms, a polymerase chain reaction based method was used. RESULTS: At week 8, responders were 62, non-responders were 44. No significant differences of genotypes or allelic association in 19G/C and 12A/T polymorphisms were observed between responsive and non-responsive patients. CONCLUSION: These results do not support the hypothesis that this polymorphism of the HT5A receptor gene is involved in the therapeutic response to citalopram.
Citalopram ; Depression ; Depressive Disorder, Major ; Genotype ; Humans ; Pharmacogenetics ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Receptors, Serotonin

Tracheoesophageal fistula (TEF) is a rare disease which develops as a result of congenital or acquired causes. We report on two TEF female stroke patients with associated endotracheal intubation. Endotracheal intubation was kept for 13-14 days because of decreased mentality by intracranial hemorrhage. Recurrent pneumonia was a predominant symptom. Computed tomography and bronchoscopy were used to diagnose TEF. Both patients expired by sepsis and recurrent pneumonia before definite TEF treatment. The excessive dilatation of the cuff balloon of the endotracheal tube was considered one of the main causes of TEF. Prevention is most important and early treatment is required in this fatal disease.
Bronchoscopy ; Dilatation ; Female ; Humans ; Intracranial Hemorrhages ; Intubation, Intratracheal* ; Pneumonia ; Rare Diseases ; Sepsis ; Stroke ; Tracheoesophageal Fistula*

Tracheoesophageal fistula (TEF) is a rare disease which develops as a result of congenital or acquired causes. We report on two TEF female stroke patients with associated endotracheal intubation. Endotracheal intubation was kept for 13-14 days because of decreased mentality by intracranial hemorrhage. Recurrent pneumonia was a predominant symptom. Computed tomography and bronchoscopy were used to diagnose TEF. Both patients expired by sepsis and recurrent pneumonia before definite TEF treatment. The excessive dilatation of the cuff balloon of the endotracheal tube was considered one of the main causes of TEF. Prevention is most important and early treatment is required in this fatal disease.
Bronchoscopy ; Dilatation ; Female ; Humans ; Intracranial Hemorrhages ; Intubation, Intratracheal* ; Pneumonia ; Rare Diseases ; Sepsis ; Stroke ; Tracheoesophageal Fistula*

BACKGROUND: Through differentiation processes, keratinocytes provide a physical barrier to our bodies and control skin features such as moisturization, wrinkles and pigmentation. Keratinocyte differentiation is disturbed in several skin diseases such as psoriasis and atopic dermatitis. OBJECTIVE: The aim of this study is to evaluate the keratinocyte differentiation-enhancing effect of rose absolute oil (RAO). METHODS: Primary cultured human normal keratinocytes were treated with RAO, and differentiation then checked by the expression of marker genes. RESULTS: RAO did not induce cytotoxicity on cultured keratinocytes at a dose of 10microM. The level of involucrin, an early marker for keratinocyte differentiation, was significantly increased by RAO. Concomitantly, RAO increased involucrin promoter activity, indicating that RAO increased involucrin gene expression at the mRNA level. Furthermore, RAO increased the level of filaggrin in cultured keratinocytes, and in the granular layer of mouse skin. In line with these results, RAO decreased the proliferation of keratinocytes cultured in vitro. When RAO was applied topically on the tape-stripped mouse skins, it accelerated the recovery of disturbed barrier function. CONCLUSION: These results suggest that RAO may be applicable for the control of skin texture and keratinocyte differentiation-related skin diseases.
Animals ; Dermatitis, Atopic ; Gene Expression ; Humans ; Intermediate Filament Proteins ; Keratinocytes ; Mice ; Pigmentation ; Protein Precursors ; Psoriasis ; RNA, Messenger ; Skin ; Skin Diseases

PURPOSE: The purpose of this study is to assess the utility of PTBD spiral CT cholangiography, after infusion of contrast media through a PTBD tube, for evaluation of a biliary lesion after emergency PTBD due to severe jaundice. MATERIALS AND METHODS: Forty patients with emergency PTBD due to extrahepatic biliary obstruction were transferred to our clinic and prospectively studied. The causes of obstruction were 17 extrahepatic cholangiocarcinomas (including three Klatskin's tumors), seven pancreatic head carcinomas, six calculous diseases of the common bile duct, six periampullary lesions, two ampulla of Vater carcinomas, one gall bladder carcinoma with invasion of the common hepatic duct, and one cholangitis. Diagnosis was on the basis of pathologic, radiologic, and clinical findings. Pre-contrast CT scanning was performed. After the infusion of contrast media (iothalamate : normal saline=1:10) through a PTBD tube, spiral CT scans were obtained. After IV infusion of contrast media (Ultravist, 100cc), early- and delayed-phase spiral CT scans were obtained at 45 and 210 seconds, respectively, with an interscan interval of 5mm. 3-D CT cholangiograms were then reconstituted. Spiral CT without infusion of contrast media through a PTBD tube and PTBD spiral CT cholangiography were performed in 14 cases. The level of extrahepatic biliary obstruction was categorized as either upper, middle, or lower third. In 21 surgically confirmed cases, we evaluated the accuracy with which the level and cause of obstruction was determined; levels and causes during surgery and by as seen on PTBD cholaniography were compared. RESULTS: The levels of obstruction diagnosed on PTBD spiral CT cholangiography and on 3-D CT cholangiography corresponded in all cases to the levels during surgery and on PTBD cholangiography [upper third (n=7), middle third (n=12), lower third (n=21)], and the level diagnosed on spiral CT without infusion of contrast media through a PTBD tube corresponded to the level during surgery in ten of 14 cases. The cause of obstruction diagnosed on PTBD spiral CT cholangiography corresponded to pathologic findings in 19 of 21 cases. In 15 cases, 3-D CT cholangiography was diagnostically helpful. CONCLUSION: PTBD spiral CT cholangiography is a useful diagnostic method for determining the level and cause of biliary obstruction.
Ampulla of Vater ; Cholangiocarcinoma ; Cholangiography* ; Cholangitis ; Common Bile Duct ; Contrast Media ; Diagnosis ; Emergencies ; Head ; Hepatic Duct, Common ; Humans ; Jaundice ; Prospective Studies ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Urinary Bladder