Irradiation which acts directly and produces the reactive oxygen radicals by ionizing water molecules, causes significant morbidity and mortality. The muscle is damaged by direct action, oxygen radicals and the alterations of microcirculation and metabolism after irradiation. The changes of SOD immunoreactivities in muscles of the rats after irradiation were observed. The ultrastructural changes of the irradiated muscles with the pretreatment of SOD (superoxide dismutase) or without were also investigated. A total of 60 healthy Sprague-Dawley male rats weighing from 200g to 250g were used as experimental animals. Under urethane (1.15g/kg. IP.2 times) anesthesia,30 Gy irradiation to lower extremities by PICKER-C9 Cobalt-60 teletherapy unit was done. 15,000 unit/kg of SOD was administered intraperitoneally 1 hour before irradiation. The experimental animals were sacrificed 1 day, 3 days, 7 days, 2 weeks and 4 weeks after irradiation. The superficial portions of the mid-belly of the rectus femoris muscles were obtained and sliced into portions, 2 mm in length, 1 mm in width and in thickness. The specimens were prepared by routine methods for the electron microscopic observation. All preparations were stained with uranyl acetate and lead citrate and observed with a Hitachi-600 electron microscope. The other parts of mid-belly of the rictus femoris muscles were sectioned in 14 micrometer thickness with cryostat at -20 degrees C. The immunoreactivities of SOD by use of antihuman Cu, Zn-and Mn-SOD antibodies were observed. The results were obtained as follows . 1. After irradiation, the immunoreactivities of SOD in the rictus femoris muscle were decreased. 2 weeks after irradiation, the immunoreactivities of Cu, Zn-SOD were trace, which was lowest.4 weeks after irradiation, the immunoreactivities were trace or weak. 1 day after irradiation, the immunoreactivities of Mn-SOD were trace, which was lowest. The immunoreactivities of Mn-SOD were increased gradually 4 weeks after irradiation, the immunoreactivities of Mn- SOD were moderate or weak. 2. The ultrastructural changes in the rectus femoris muscles of the rats were getting severer and severer after irradiation. 2 weeks after irradiation, unclear A band and I band, myofibrillolysis, increased and dilated cistemae of sarcoplasmic reticulum and mitochondria with dilated cristae and electron lucent matrix were seen. 4 weeks after irradiation, lysis of sarcomere and increased cisternae of sarcoplasmic reticulum were seen. 3. The ultrastructural changes in the rectus femoris muscles of the rats were getting worse and worse after 3 days of irradiation with the pretreatment of SOD. 2 weeks after irradiation with the pretreatment of SOD, myofibrillolysis, increased and dilated cisternae of sarcoplasmic reticulum and damaged mitochondria were seen. 4 weeks after irradiation with the pretreatment of SOD, the ultrastructures of rectus femoris muscles were recovered to normal. Consequently, after irradiation of 30 Gy, the immunoreactivities of SOD are decreased and SOD attenuates the reversible changes of ultrastructures in muscles.
Animals ; Antibodies ; Citric Acid ; Humans ; Lower Extremity ; Male ; Metabolism ; Microcirculation ; Mitochondria ; Mortality ; Muscles ; Quadriceps Muscle* ; Rats* ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Sarcomeres ; Sarcoplasmic Reticulum ; Superoxide Dismutase ; Urethane

PURPOSE: To determine the result of early surgery for intermittent exotropia for children under 4 year old and the factors which affect it. METHODS: The study subjects consisted of 25 children younger than 4 years who had received surgery for intermittent Exotropia. They were followed up for more than 1 year after surgery by the Department of Ophthalmology of the Gachon Medical School, between July 1998 and December 2003. The interval from onset to initial surgery, preoperative deviation angle, dissociated vertical deviation, stereopsis, preoperative patching, type of surgery, and initial postoperative deviation angle were compared and analyzed in a retrospective manner. RESULTS: The average age of the subjects and the preoperative deviation angle were 3.2 years and 28.67+/-8.08PD respectively. The average deviation angle at postoperative year 1 was 5.60+/-8.69PD. Out of the 25 patients, 19 (76%) showed a deviation angle less than 10PD were and 4 (16%) had recurrence of exotropia. Consecutive esotropia occurred in 2 (8%). The clinical factor statistically related to results was the initial postoperative deviation angle. The group who had esophoria of more than 10 PD (18.27+/-6.18 PD) showed 93% orthophoria at postoperative year 1, which was statistically significant. CONCLUSIONS: Though a patient be under 4 years old, if their deviation angle is in progress or if non-surgical treatment is ineffective in the case when surgery is delayed, it is presumed that performing surgery at postoperative day 1 with an overcorrection of about 10 PD is preferred.
Child* ; Child, Preschool ; Depth Perception ; Esotropia ; Exotropia* ; Humans ; Ophthalmology ; Recurrence ; Retrospective Studies ; Schools, Medical

XO/XY mosaicism is frequently observed in the most patients with mixed gonadal dysgenesis. Mixed gonadal dysgenesis is a condition of Intersexuality characterized by asymmetric gonads or ambiguous genitalia or both. The external genitalia are always masculinized to some extent, on occasion represent a hypospadias as a common genetic form of a mixed gonadal dysgenesis. The disorder probably results from a cytogenic error that occurs early in embryogenesis. Phenotypic males with mixed gonadal dysgenesis have a high risk of developing gonadal tumors. We describe a case of hypospadias with a unilateral testis and XO/XY chromosome complement that is considered as a mixed gonadal dysgenesis.
Chromosome Aberrations* ; Complement System Proteins ; Disorders of Sex Development ; Embryonic Development ; Female ; Genitalia ; Gonadal Dysgenesis, Mixed ; Gonads ; Humans ; Hypospadias* ; Male ; Mosaicism ; Pregnancy ; Testis

A clinical observation was made on 52 cases of hypospadias which were treated at the department of Urology, Kyung Hee University Hospital during the period of January, 1972 through December, 1985 and the following results were obtained. 1. The patients` age were between 2 to 28 years. Only 22 patients(41.6%) were found in the age group under 6 years. 2. Of 52 cases of hypospadias, 27 cases(50.9%) were penoscrotal, 11 cases(22.7%) were penile, 6 cases(11.3%) were perineal, 4 case(7.5%) were scrotal, 3 cases were glandular and 1 case(1.9%) was chordee without hypospadias in type. 3. Cryptorchidism was the most common among the associated anomalies and it occupied 25% of all patients. 4. Of the 52 cases of hypospadias, one stage operation was done in 12 cases, two stage operation in 32 cases and their success rate was 58.5%, 40.6% in respectively. 5. The most common complication was fistula formation and it occurred in 20 cases(54.5%)of hypospadias repair.
Cryptorchidism ; Female ; Fistula ; Humans ; Hypospadias* ; Male ; Urology

PURPOSE: To examine the difference of clinical features according to age of onset of refractive accommodative esotropia. METHODS: We retrospectively analyzed the medical record of 52 cases of refractive accommodative esotropia for more than 12 months of follow-up from March, 2000 to December, 2003. The factors we compared were gender, age of first ocular examination, interval from age of onset to first glasses, preoperative refractive error, amount of deviation corrected with hyperopic glasses, stereopsis and associated ocular conditions. RESULTS: Cases were grouped according to age of onset. Fourteen (27%) patients were less than 2 years old., 32 (62%) were between 2 to 4 years old, and 6 (11%) were between 4 to 6 years old 6. the group less than 2 years old showed lower levels of preoperative refractive error than the group more than 2 years old. The younger the age of onset, the lager the deviation angle without hyperopic glasses. There were no differences according to age of onset in gender, interval from age of onset to first glasses, stereopsis, anisometropia or amblyopia. CONCLUSIONS: In refractive accommodative esotropia, the younger the age of onset is, the lager the deviation angle without hyperopic glasses and the greater the deviation can be corrected with hyperopic glasses.
Age of Onset* ; Amblyopia ; Anisometropia ; Child ; Child, Preschool ; Depth Perception ; Esotropia* ; Eyeglasses ; Follow-Up Studies ; Glass ; Humans ; Medical Records ; Refractive Errors ; Retrospective Studies

The purpose of this study was to compare and evaluate the differences in masticatory performance, muscle activity, and patterns of occlusal contact between persons with natural dentition and removable partial denture wearers. Twenty healthy adult subjects with more than 28 teeth and thirteen removable partial denture wearers that classified Kennedy classification I was selected. The degree of pulverized rice and peanut was measured and analyzed by means of sieving method to compare the masticatory performance. For the muscle activity, EMG was recorded in selected muscles(Temporalis and masseter muscle)during mastication and resting state. The occlusal record in maximal intercuspation was taken with a silicone occlusal bite registration material for analysis of the patterns of occlusal contact. The obtained results were as follows: When chewed peanuts, masticatory performance ratio at 10-sieve size was 81.31% in natural dentition group. In removable partial denture wearer, 27.01% without RPD and 69.09% with RPD. When chewed rice, 42.04%, 11.87%, and 21.58%, respectively. The differences of masticatory performance ratio between groups were statistically significant at the 0.05 level. The mean EMG value in resting state was 1.06mV on temporal muscle, 0.98mV on masseter muscle in natural dentition group. In removable partial denture wearers, 1.13mV on temporal muscle, 1.05mV on masseter muscle without RPD and 1.11mV on temporal muscle, 1.04mV on masseter muscle with RPD. The mean EMG value during mastication was 45.64mV in natural dentition group, and in removable partial denture wearers, 22.06mV without RPD and 31.01mV with RPD when chewed peanuts. When chewed rice, 45.24mV, 25.53mV and 32.14mV, respectively. The differences of mean masticatory EMG value between groups were statistically significant at the 0.05 level. The number of posterior occlusal contact point was 20.15 in natural dentition group and 11.92 in removable partial denture wearers. The area of perforated surface was 16.50mm2in natural dentition group and 6.06mm2in removable partial denture wearers. The area of contact surface was 78.93mm2, 51.52mm2, respectively. The area of contact surface was effective to masticatory performance ratio in natural dentition group and removable partial denture wearers (P<0.05) From these results, it is concluded that in partially edentulous patient, masticatory efficiency can be improved by removable partial denture wearing, and for effcient mastication, tigth occtact surface shoud be maintained by maximum support that is provided from mucosa.
Adult ; Arachis ; Classification ; Dentition ; Denture, Partial, Removable* ; Humans ; Jaw Relation Record ; Masseter Muscle ; Mastication ; Mucous Membrane ; Silicones ; Temporal Muscle ; Tooth

PURPOSE: Glyphosate is widely used and its toxic exposures are not rare. Occasionally, glyphosate intoxication can lead to death. The aim of this study is to analyze clinical findings and fatality in glyphosate intoxication. METHODS: Clinical data on acute glyphosate intoxication were prospectively collected at 28 hospitals nationwide between August 2005 and July 2006. The patients' clinical symptoms and characteristics of fatalities were investigated and statistical analysis was performed. RESULTS: Among 105 patients who were finally included, gastrointestinal symptoms(59%) were the most common. A significant difference in the amount ingested was observed between patients with higher systolic blood pressure and those with systolic blood pressure less than or equal to 80 mmHg (p<0.001). The more the patients ingested, the more aggravated their mental status became (p=0.004). Seven patients(6.7%) died, and all of them had ingested greater than or equal to 200 ml. Patients who died had ingested greater amounts than the survivors (p<0.001), and their mental status was worse (p<0.001), and systolic blood pressure was lower (p<0.001). According to the result of logistic regression analysis, relative risk was 24.1-fold higher in the 'poor' mental status group compared with 'good'. CONCLUSION: Patients who ingested large amounts of glyphosate showed poor mental status and lower blood pressure. Statistical difference in amount ingested, mental status, and systolic blood pressure was observed between survivors and patients who died. Ingested amounts and mental status were the most important factor of the prognosis of glyphosate intoxication.
Blood Pressure ; Herbicides ; Humans ; Logistic Models ; Poisoning ; Prognosis ; Prospective Studies ; Survivors

PURPOSE: We compared the prophylatic effects and complications of intravesical instillation of the epirubicin and Bacillus Calmette-Guerin (BCG) in patients with stage T1 bladder cancer. MATERIALS AND METHODS: A total 87 patients with stage T1 bladder cancer were treated with transurethral resection (TUR) between January 1992 and April 1998. Of them, 51 patients received BCG (Connaught strain, 81mg), 16 patients received 50mg epirubicin and 20 patients underwent TUR alone. The patients were followed for 18-78 months (mean 40 months). Recurrence rates, progression rates, mean months to tumor recurrence, recurrence free survival rate using Kaplan-Meier curve and complications were compared among three groups. RESULTS: The overall recurrence rate was 27.5% in BCG group, 37.5% in epirubicin group and 65% in control group. Mean months to tumor recurrence and recurrence free survival rate showed that both drugs were superior to TUR alone. The incidence of complications was 94% in BCG group and 12.5% in epirubicin group. CONCLUSIONS: BCG and epirubicin were superior to TUR alone in the prophylaxis of recurrence in stage T1 bladder cancer. Although the prophylactic efficacy of BCG was a little higher than that of the epirubicin, the toxicity rate of epirubicin was much lower than that of BCG. Therefore, epirubicin may be regarded as an alternative treatment of the BCG, especially for the patients who cannot tolerate the side effects of BCG.
Administration, Intravesical ; Bacillus* ; Epirubicin* ; Humans ; Incidence ; Mycobacterium bovis ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

The incidence of autoimmune hemolytic anemia in children is rarer than that in adults. It is estimated that the rate of autoimmune hemolytic anemia is around 2 persons per 10,000,000. We describe here a boy with warm autoimmune hemolytic anemia that was due to immunoglobulin G with an anti-e specificity. A 13-month-old boy with severe hemolytic anemia (hemoglobin: 6.0 g/dL) showed strong anti-IgG reactivity (4+) on the direct antiglobulin test. Antibody targeted against the e antigen was identified from both of his serum and the RBC eluate. In addition, he had e antigen on his RBCs. He was treated with prednisolone for 4 days and RBCs transfusions. After the second transfusion of RhD positive/e negative RBCs, his hemoglobin-level was increased to 10.3 g/dL. On his fifth hospital day, he was discharged with showing clinical improvement and improved values on his laboratory tests.
Adult ; Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune ; Antibodies, Anti-Idiotypic ; Child ; Coombs Test ; Humans ; Immunoglobulin G ; Incidence ; Infant ; Prednisolone ; Sensitivity and Specificity

Trichobezoar usually occurs in patients who have trichotillomania combined with trichophagia. Bezoars can result in serious complications including gastric ulceration, bleeding, perforation and small bowel obstruction when undiagnosed. The three main venues of bezoar removal (chemical dissolution, endoscopic removal and surgical removal) are chosen mainly by the size and composition of the bezoar. Trichobezoars generally require endoscopic or surgical removal. An 8-year-old girl visited our emergency room with recurrent epigastric pain and vomiting. Gastroduodenoscopy showed a 2x10 cm trichobezoar causing pyloric obstruction. During endoscopic removal of trichobezoar, esophageal impaction occurred. The trichobezoar was pushed into the stomach and was removed through surgical gastrostomy under general anesthesia. We report this case as an instructive reference for the proper treatment of trichobezoar in children.
Anesthesia, General ; Bezoars ; Child ; Emergencies ; Gastrostomy ; Hemorrhage ; Humans ; Stomach ; Stomach Ulcer ; Trichotillomania ; Vomiting