Twenty-five neonates were observed for the relationship between phenobrbital loading dose, plasma concentrations and control of seizures. Nineteen neonates (76%) had seizures controlled by phenobarbital alone. Effective plasma concentration were 10.0~31.1microgram/ml. Although 14 neonates had seizures controlled by phenobarbital concentration below 20microgram/ml, neonate required level above 30microgram/ml. We found that continued benefit was obtained until phenobarbital plasma concentrations reached 40microgram/ml and there was no adverse effects on cardiorespiratory function. We recommend that plasma phenobarbital concentrations should equal or surpass 40microgram/ml before additional anticonvulsants are used for neonates with seizure.
Anticonvulsants ; Humans ; Infant, Newborn ; Phenobarbital* ; Plasma ; Seizures*

This study is aimed to observe the expressions of different genes, including the extracellular matrix proteins, growth factors, and transcription factors during different developmental stages of mouse submandibular gland. Reverse transcription-polymerase chain reaction (RT-PCR) and the antisense inhibition in organ culture system were performed using mouse embryos and newborns. Total 140 mouse embryos (E14(80), E15(20), E16(20), E18(20)) and 30 newborn mice (D2(10), D3(10), D6(10)) obtained from 60 pregnant mice and 3 adult mice (3 weeks old) were used for the cDNA production and the salivary gland organ culture. Syndecan, perlecan, laminin alpha1 chain, TGF beta1, beta 3, and sonic hedgehog mRNAs were expressed in the early stage (E14~E16) of the submandibular gland development, whereas transglutaminase C (TGase C), E-cadherin, epimorphin, laminin beta2 and gamma1 chains, and HGF mRNAs were expressed in the middle and late stages (E16~E18, D2~D6). Antisense inhibition of different genes in the organ culture of E14 mouse embryos of submandibular gland showed specific growth retardation in the development of ductal and acinar cells. Especially, the antisense inhibition of perlecan, E-cadherin, laminin alpha1 chain, laminin beta2 chain, and syndecan mRNA arrested the growth of ductal and acinar cells. While the antisense inhibition of integrin beta5 greatly affected the acinar cell differentiation and also produced cystic dilatation of salivary ducts, the antisense inhibition of fibronectin showed aberrant growth of ectomesenchymal tissues of the mouse submandibular gland.
Acinar Cells ; Adult ; Animals ; Cadherins ; Dilatation ; DNA, Complementary ; Embryonic Structures ; Extracellular Matrix Proteins ; Fibronectins ; Gene Expression* ; Hedgehogs ; Humans ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Laminin ; Mice* ; Organ Culture Techniques* ; RNA, Messenger ; Salivary Ducts ; Salivary Glands ; Submandibular Gland* ; Syndecans ; Transcription Factors

Bronchiectasis means a permanent abnormal dilatation of one or more large bronchi owing to destruction of theelastic and muscular components of the bronchial wall. Radiological study is the most importat and mandatory procedure. Especially bronchography is essential for the definitive diagnosis of bronchiectasis and for theprecise delineation of the type and extent of the disease. The radiological and clinical findings of 48 cases ofbronchiectasis diagnosed by bronchography and treated at Chosun University Hospital during the 5 years fromJanuary 1980 to Dec. 1984 were analyzed retrospectively. The results were as follows; 1. Among the 48 cases, 34cases(70.8%) were male and 14 cases(29.2%) were female. Peak incidence was in second decade. 2. Chronic cough,productive sputum and hemoptysis are main symptoms and others are chest pain, dyspnea and recurrent bouts ofpneumonia. The most common physical sign is persistent moist rales over the involved area in 23 cases(47.9%).Others are no sign in 17 cases(35.4%), wheezing in 11 cases(22.9%) and digit clubbing in 3 cases(6.3%). 3. Thepresumed causes were composed of not known in 30 cases(62.5%) and complications of measles in 7 cases(14.6%),pertusis in 5 cases(10.4%) and pneumonia in 4 cases(8.3%). Two cases were Kartagener's syndrom and unilateralhyperlucent lung. 4. Plain chest roentgenographic findings were abnormal in 42 cases(87.5%) but normal in 6cases(12.5%). The most common radiological findings was accentuation of lung markings in 36 cases(85.7%) theothers are include in order of frequency; pneumonic infiltration, linear radiolucencies, cystic radiolucencies,decreased affected lung volume air-fluid level and pleural thickening. 5. Bilateral bronchiectasis was demonstrated in 11 cases(22.9%) and the disease was much more often involved left lung than right. The mostcommonly involved lobe is left lower lobe, and the most common site of involvement was the posterior basal segmentof the lower lobe. The type of bronchiectasis is cylindrical in 22 cases(45.8%), varicose in 11 cases(22.9%),saccular in 9 cases(18.8%) and mixed type in 6 cases(12.5%)
Bronchi ; Bronchiectasis ; Bronchography ; Chest Pain ; Diagnosis ; Dilatation ; Dyspnea ; Female ; Hemoptysis ; Humans ; Incidence ; Lung ; Male ; Measles ; Pneumonia ; Respiratory Sounds ; Retrospective Studies ; Sputum ; Thorax

Dieulafoy's vascular malformation is a rare cause of massive gastrointestinal bleeding. Most often it occurs in stomach within 6 cm from the gastroesophageal junction. Only a few cases have been reported to occur in the small intestine and colon. Occasionally, Dieulafoy's lesion of small intestine is difficult to recognize because of rarity, a paucity of symptoms and negative findings on barium studies. Therefore, this lesion needs to be considered in a patient with massive lower gastrointestinal bleeding. We report a case of Dieulafoy's vascular malformation in ileum 2 m proximal to ileocecal value in a 41-year-old woman who visited emergency clinic because of hematemesis, dizziness and vomiting. Small intestine revealed a wide-caliber artery within the submucosa showing intimal thickening, medial muscular hypertrophy and thrombosis.
Adult ; Arteries ; Barium ; Colon ; Dizziness ; Emergencies ; Esophagogastric Junction ; Female ; Hematemesis ; Hemorrhage* ; Humans ; Hypertrophy ; Ileum* ; Intestine, Small ; Stomach ; Thrombosis ; Vascular Malformations* ; Vomiting

PURPOSE: To report a case of bilateral trochlear nerve palsy following cisternography. CASE SUMMARY: A 43-year-old male with intermittent watery rhinorrhea persisting for 3 months visited the neurosurgery department of our institute. His past medical history included removal of a pituitary adenoma 22 years prior to presentation. Cerebrospinal fluid leakage was suspected and cisternography was performed. The patient was referred to our ophthalmology department for diplopia 3 days after the cisternography. An alternate prism cover test showed 5 prism diopter (PD) right hypertrophia in the primary position, and underaction of bilateral superior oblique muscles and overaction of the left inferior oblique muscle. A positive Bielschowsky test with the head tilted to either side was observed and excyclotorsion was 9degrees on the double Maddox rod test. The patient was diagnosed with bilateral trochlear nerve palsy. After 2 years of follow-up, diplopia persisted and recession of the bilateral inferior oblique muscles was performed. After the surgery, diplopia disappeared, the fundus photography showed no excyclotorsion, and the double Maddox rod test indicated 3degrees of excyclotorsion. CONCLUSIONS: Cisternography should be carefully performed due to the possibility of bilateral trochlear nerve palsy, an extremely rare but possible occurrence following the procedure.
Adult ; Cerebrospinal Fluid ; Diplopia ; Follow-Up Studies ; Head ; Humans ; Male ; Muscles ; Neurosurgery ; Ophthalmology ; Photography ; Pituitary Neoplasms ; Spinal Puncture ; Trochlear Nerve Diseases* ; Trochlear Nerve*

No abstract available.
Apgar Score* ; Humans

No abstract available.
alpha-Fetoproteins* ; Infant, Newborn ; Jaundice, Neonatal* ; Plasma*

No abstract available.
Carcinoma, Merkel Cell* ; Recurrence*

Peripheral ameloblastoma (PA) in gingiva is rare and often confused with oral basal cell carcinoma (OBCC). The tissues of one case of PA and one case of OBCC with the same mandibular molar area affected were compared via an immunohistochemical examination using 50 antisera. The PA and OBCC showed similar proliferation of basaloid epithelial strands, but toluidine blue staining revealed that the PA had pinkish juxta-epithelial myxoid tissue, whereas the OBCC was infiltrated by many mast cells. Immunohistochemical comparisons showed that the PA was strongly positive for ameloblastin, KL1, p63, carcinoembryonic antigen, focal adhesion kinase, and cathepsin K, and slightly positive for amelogenin, Krox-25, E-cadherin, and PTCH1, whereas the OBCC was not. On the other hand, the OBCC was strongly positive for EpCam, matrix metalloprotease (MMP)-1, alpha1-antitrypsin, cytokeratin-7, p53, survivin, pAKT1, transforming growth factor-beta1, NRAS, TGase-1, and tumor nescrosis factor-alpha, and consistently positive for beta-catenin, MMP-2, cathepsin G, TGase-2, SOS-1, sonic hedgehog, and the beta-defensins-1, -2, -3, while the PA was not. These data suggest that the tumorigeneses of PA and OBCC differ, and that PAs undergo odontogenic differentiation and generate oncogenic signals for infiltrative growth and bone resorption, whereas OBCCs undergo basaloid epidermal differentiation as a result of growth factor/cytokine-related oncogenic signals.
Ameloblastoma* ; Amelogenin ; beta Catenin ; Bone Resorption ; Cadherins ; Carcinoembryonic Antigen ; Carcinogenesis ; Carcinoma, Basal Cell* ; Cathepsin G ; Cathepsin K ; Focal Adhesion Protein-Tyrosine Kinases ; Gingiva ; Hand ; Hedgehogs ; Immune Sera ; Immunohistochemistry ; Keratin-7 ; Mast Cells ; Molar* ; Tolonium Chloride

BACKGROUND: Pathergy, or skin hypersensitivity to needle puncture has been reported as a diagnostic test for Behcets ciisease. But the positivity of pathergy test in recurrent aphthous stomatitis which can be a comporent of Behcets disease is obscure. In recent years it has been noted that the positivity of the test has decreased. It is possible to say that the disposable needles used nowadays are less trauniatic to initiate the reaction than are the nondisposable ones used in the preAIDS ara by some uthors. OBJECTIVE: It is the porpose of this study to clarify the value of pathergy test in differentiating Behcets disease from recurrent aphthous stomatitis and to evaluate the difference of positivity using various kinds of needles, and finally to suggest the most profitable one. METHODS: 34 patients with Behcets disease according to the diagnostic criteria of Shimizu(revisecl) 25 ones in case of applying that of International study group for Behcets disease(ISG) and 21 ones with recurrent aphthous stomatitis, and 25 normal controls were selected. A pathergy test, i.e., intradermal injection of 0.1 ml physiological saline by using 26 gauge & 20 gauge disposable needles and 26 gauge & 20 gauge nondisposable ones were given and the evaluation was made after 24 hours and 48 hours. RESULTS: 1. The positive rates of pathergy test using all kinds of needles in Behcets disease were significantly higher than thoen recurrent aphthous stomatitis and normal controls(p=0.00000-0.03600). The sensitivity were 29.4% 64.7% (Shimizu) and 32.0% 76.0% (ISG), respectively, and the specificity were 91.3%-100.0% for all of them. 2. In Behcets disease, the positive rates of the pathergy test using 26 gauge disposable needles were not significantly different from that of using ZO gauge disposable needles in total and active patients after 24 and 4.3 hours and so were 26 gauge R 20 gauge nondisposable ones(p=0.40134 -0.80603(Shimizu), 0.37551-0.77078(ISG) ). 3. In Behcets disease, the positive rates of pathergy test using 26 gauge nondisposable needles were 59%-68%(Shimiu) and 64% 79% (ISG), which were significantly different, from the test using 20 gauge disposable needles, i.e. 29%-36%(Shimizu), 40%-46%(ISG) in total and active patients(p==0.00753-0.01512) after 24 and 48 hours except for those by the criteria of ISG after 24 hours(p=0.14573-0.15597). CONCLUSION: This study shows that the pathergy test is obviously useful in differentiating Behcets disease from ecurrent aphthous stomatitis and we recommend the intradermal injection of 0.1 ml physiological saline by using 26 gauge nondisposable needle and the evaluation after 48 hours as a standard mithod of pathergy test.
Diagnostic Tests, Routine ; Humans ; Hypersensitivity ; Injections, Intradermal ; Needles ; Punctures ; Sensitivity and Specificity ; Skin ; Stomatitis, Aphthous*