No abstract available.
Endoderm* ; Endodermal Sinus Tumor*

BACKGROUND: Organophosphate and carbamate insecticides have been used extensively in agriculture resulting in serious increases in poisoning. Levels of poisoning by carbamates and organic phosphorus compounds and the severity of associated symptoms are dependent not only on the degree of reduction of acetylcholinesterase activity in the nervous system but also on the rate of inhibition and the type of inhibitive action. The most striking differences between the clinical effects of the two groups of compounds are the much more rapid and spontaneous recovery from poisoning by carbamates and the relatively large difference between the smallest dosage of any carbamate that will cause mild illness and the lethal dosage of the same compound. The purpose of this study is to compare the clinical characteristics of acute intoxication by organophosphate and carbamate insecticides. METHOD: We retrospectively analyzed the clinical characteristics of 41 patients poisoned with organophsphates and 12 patients poisoned with carbamates, who were admitted to the department of internal medicine, Soonchunhyang Chunan hospital from January 1995 to December 1996. RESULTS: 1) The most common organophosphate was EPN (9 cases) followed by Dichlorvos (7 cases). In the carbamates group, Carbofuran (5 cases) was the most common followed by Methomyl (3 cases).2) The main cause of poisoning was ingestion for the purpose of suicide in both groups.3) The severity of poisoning was more acute in the organophosphate group than in the carbamate group.4) Altered consciousness and respiratory depression occurred more frequently in the organophosphate group than in the carbamate group. Six cases out of the organophosphate group suffered from respiratory depression 24 hours to 96 hours after poisoning.5) The activity of serum cholinesterase showed no significant difference between poisoning with organophosphates and with carbamates.6) The mortality rate was 22% in organophosphate intoxication and 16.7% in carbamate intoxication. The most common complication of organophosphate and carbamate intoxication was aspiration pneumonia. CONCLUSION: Carbamate insecticides exhibited less toxicity than organophosphates.
Acetylcholinesterase ; Agriculture ; Carbamates ; Carbofuran ; Cholinesterases ; Chungcheongnam-do ; Consciousness ; Dichlorvos ; Eating ; Humans ; Insecticides* ; Internal Medicine ; Methomyl ; Mortality ; Nervous System ; Organophosphates ; Phosphorus Compounds ; Pneumonia, Aspiration ; Poisoning* ; Respiratory Insufficiency ; Retrospective Studies ; Strikes, Employee ; Suicide

No abstract available.
Bowen's Disease*

No abstract available.
Membranes* ; Pregnancy* ; Rupture*

Transhiatal gastric transpositions were performed in two case of long gap esophageal atresia without tracheoesophageal fistula. The patients were a 12 months old female and an 18 months old male. Stamm type gastrostomies were performed at other hospitals in both cases. The stomach was mobilized preserving the right gastric artery, the right gastroepiploic artery and spleen. The proximal and distal esophageal pouches were excised by transcervical and transhiatal route, respectively. The mobilized stomach was pulled up to the neck through esophageal hiatus and posterior mediastinal route. The esophagogastrostomy, the only one anastomosis of this procedure, was performed in the neck. There was no clinical evidence of anastomotic leakage, stricture, regurgitation, difficulty of gastric emptying, hoarseness or respiratory problem. Transhiatal gastric transposition seems to be a safe and easy alternative surgical procedure for esophageal replacement in long gap esophageal atresia.
Anastomotic Leak ; Arteries ; Constriction, Pathologic ; Esophageal Atresia* ; Female ; Gastric Emptying ; Gastroepiploic Artery ; Gastrostomy ; Hoarseness ; Humans ; Infant ; Male ; Neck ; Spleen ; Stomach ; Tracheoesophageal Fistula

Plexiform neurofibroma is considered a pathognomic of Von Recklinghousen's disease, which involves the deep and large nerve trunk. These are large irregular nerve fascicles which result from an increase in endoneural matrix within individual nerve facicles, without an increased number of nerve fibers. We experenced a case of Von Recklinghausen's disease in a 24 year-old male who had variable cutaneous skeletal, and CNS lesions. He presented multiple neurofibromas, cafe-au-lait spots, and axillary freckles as common cutaneous lesions of NF-I and giant pigmentation, sacral hypertrichosis, and plexiform neurofibroma as unusual cutaneous lesions. Also he had a scoliosis, bowing deformity of the humerous and wedging deformity of the body of the 5th cervical spine as a skeletal manifestation and cortical calcification in the occipital area as a CNS manifestation.
Cafe-au-Lait Spots ; Congenital Abnormalities ; Humans ; Hypertrichosis ; Male ; Melanosis ; Nerve Fibers ; Neurofibroma, Plexiform* ; Neurofibromatoses ; Neurofibromatosis 1 ; Pigmentation* ; Scoliosis ; Spine ; Young Adult

It has been widely accepted that complete surgical resection of hepatoblastoma is essential for long-term survival. But unfortunately less that 50% of hepatic tumors in children can be totally removed at the time of diagnosis. This report is to present the experience of successful resection of hepatoblastoma after concurrent radiotherapy with transarterial chemoinfusion in a child. We believe this modality of treatment enables complete resection of unresectable hepatoblastoma, which is resistant to the systemic chemotherapy.
Child ; Diagnosis ; Drug Therapy ; Hepatoblastoma* ; Humans ; Radiotherapy*

Background: Esmolol is rapid hydrolyzed by plasma esterase but may inhibit plasma cholinesterase activity based on its structure. This study was designed to evaluate the interactions between esmolol and succinylcholine or mivacurium which are metabolized by plasma cholinesterase and to determine the inhibitory effect of esmolol on human plasma cholinesterase. Methods: Neuromuscular effects of succinylcholine (1.0 mg/kg) and mivacurium (0.15 mg/kg) with or without esmolol (0.5 mg/kg or 1.0 mg/kg) were compared in 57 adult patients (ASA class I) during O2-N2O-isoflurane anesthesia. Neuromuscular block was monitored by recording the compound electromyogram of the hypothenar muscle resulting from supramaximal train of four stimuli applied to the ulnar nerve. Also plasma cholinesterase activity was measured before and 5, 10 minutes after injection of esmolol. Results: Time from injection to onset of over 95% block, clinical duration from injection to 25% recovery of control twitch, and recovery index defined as from 25% to 75% twitch recovery of succinylcholine or mivacurium were not altered by pretreatment of esmolol. Plasma cholinesterase activity was not decreased after injection of esmolol 0.5 mg/kg, but decreased by 5% after injection of 1.0 mg/kg (p<0.05). Conclusions: It is unlikely that neuromuscular blocking effects of succinylcholine and mivacurium are prolonged by administration of clinical doses of esmolol (0.5~1.0 mg/kg) due to inhibition of plasma cholinesterase activity in human.
Adult ; Anesthesia ; Cholinesterases ; Humans ; Neuromuscular Agents ; Neuromuscular Blockade ; Plasma ; Succinylcholine* ; Ulnar Nerve

No abstract available.
Rhabdomyosarcoma*

Thymic diseases such as thymic hyperplasia, thymic cysts, thymoma, and thymic carcinoma are common causes of mediastinal masses that present with diverse clinical and radiological features. Magnetic resonance imaging (MRI) is a pivotal tool for evaluating thymic pathologies as it offers superior soft-tissue contrast and has the ability to distinguish between benign and malignant lesions. Thymic MRI protocols include T1- and T2-weighted imaging, diffusion-weighted MRI (DW-MRI) with apparent diffusion coefficient mapping, and contrast-enhanced MRI (CE-MRI), each offering unique diagnostic insights into the composition and behavior of thymic lesions. However, interpreting MRI findings in thymic diseases may present challenges. Thymic cysts containing hemorrhage or proteinaceous material may mimic solid lesions owing to altered signal intensities, necessitating DW-MRI and CE-MRI for accurate differentiation. Small thymic lesions, particularly those <1 cm in diameter, are susceptible to signal distortion and partial volume effects, complicating their detection and characterization. Furthermore, respiratory and cardiac motion artifacts can degrade the image quality and obscure important diagnostic details, especially in lesions near the heart and lungs. Despite these challenges, MRI remains a critical imaging modality for assessing and managing thymic diseases, offering detailed tissue characterization. Interpretive pitfalls and technical limitations underscore the importance of employing optimized imaging protocols and expert analyses to ensure diagnostic accuracy and guide appropriate clinical decision-making.