When chemical agents penetrate the placenta, it is potentially hazardous to the embryo because the embryonic stage is known to be extremely sensitive to various toxic agents. It has been reported that exposure to some chemical agents during pregnancy resulted in the induction of malformation or cancer in the offspring of experimental animals (Larsen, 1947; Klein, 1952; DiPaolo, 1964; Druckrey et al. 1966; Mohr et al, 1966; DiPaolo and Elis, 1967; Spatz and Laqueus, 1967; Alexandrov, 1968; Fujii and Nishimura, 1969; Rice, 1969; Bulay and Wattenberg, 1970; Currie, 1970; Vesselinovitch et al, 1971; Swenberg et al, 1972; Nomura et al, 1973). Fraser and Fainstat (1954) and Kalter (1954) found that administration of cortisone to pregnant female mice induced the appearance of cleft palates in the offspring. The frequency with which this deformity appears was observed to depend on: I) the genotype of the treated animal (strain differences), 2) the dose of the chemical administered, 3) the time during the gestation period when the animal was treated. A single intraperitoneal injection of 5-fluorouracil at 10, 11, 12 or 13 days after copulation in mice also produced abnormalities to the feet, deft palate and deformities of the tail in a large proportion of fetuses (Dagg, 1960). Urethan has been considered to be a highly teratogenic and carcinogenic agent in experimental animals (Nishimura and Kuginuki, 1958: Nomura and Okamoto, 1972). However, they stated that accurate timing of urethan toxicity and accurate calculation of urethan dosage actually reaching the embryo make it possible to analyze the sensitivity of the developing mouse embryo to mortality, growth inhibition, malformation and neoplasm. Nomura and Okamoto (1972) reported that when pregnant mice were exposed to urethan on various days of gestation (day 5 to 19) by a single injection malformations and neoplasms were induced in their offspring. It is frequently implied that an abnormal phenotype is due to the aberration in the genotype, but it is not possible to prove the specitic causal relation. Though, the frequent association between a variety of chromosomal abnormalities solves the problem of how the genotypic and phenotypic are interreiated (Schultz, 1965). 5-bromodeoxyuridine (BUdR) and dimethylnitrosamine (DMN) induce chromosome aberrations in Chinese hamster cells cultured human lymphocytes and mouse cells in vivo (Somers and Hus, 1962; Kato, 1968; Matsuoka et al, 1979; Hahn and Kim, 1979). BUdR is a thymidine analog incorporated into only the DNA of proliferating cells and its mutagenic action is well understood (Freese, 1963). DMN is a potent carcinogen which induces tumors of the liver, lung, and kidney in rats (Magee and Bames, 1959). This agent has no teratogenic effect in rats when given in doses of different concentrations for different periods of time and by several routes of administeration during all stages of embryogeny (Alexandrov, 1967). The experiments reported in this study were undertaken to investigate the possibility that treatment of ICR inbred pregnant mice with BUdR and DMN might shows deformities or abnormalities in their offspring and also to determine whether chemical exposure during fetus will effect at 32 weeks after birth with second exposure to DMN by cytogenetical means. In this study, estrus ICR females were mated and 32 mice which had been diagnosed as pregnant were used. BUdR at the rate of 70, 100 and 150mg/kg of body weight was injected intraperitoneally at 6, 7, 8 days and 9, 11, 13 days of gestation, and DMN at the rate of 10, 20 and 30 mg/kg of body weight was injected at 8, 10, 12 days and 14, 15, 16 days of gestation, The offspring were examined macroscopicaily at time of birth for malformations. All animals were killed at 32 weeks of age and examined for liver abnormalities. The liver were cultured and treated with 1, 5 and 10 ug/ml of DMN for 18 hours. The frequencies of chromosome aberrations and sister chromatid exchanges (SCE) were analyzed. The results are summarized as follows: 1. The litter size was reduced on treated animals. 2. Among the 279 progeny from 36 BUdR treated mothers, malformations were seen in a total of 10 progeny and the group treated at the 9 to 13 gestation days stage had the most. 3. Of the 155 progeny from 24 mothers injected with DMN, none had any visible deformity. However. 37.5% of the group were found to have liver nodules after 32 weeks treated at the 8 to 12 gestation day stage. 4. Repetitive treatment with DMN of the liver culture of the previously BUdR and DMN treated progeny, showed increased chromosome aberrations and SCE frequencies. In conclusion since the exposure of the mother of BUdR and DMN during pregnancy leads to increased chromosomal abnormalities of the cultured liver cells of progeny when treated with DMN a second time, it is necessary to keep in mind that genetic damage may be occure to the progeny by exposing the mother during pregnancy.
Animals ; Body Weight ; Bromodeoxyuridine ; Chromosome Aberrations ; Cleft Palate ; Congenital Abnormalities ; Copulation ; Cortisone ; Cricetinae ; Cricetulus ; Cytogenetics ; Dimethylnitrosamine ; DNA ; Embryonic Structures ; Estrus ; Female ; Fetus ; Fluorouracil ; Foot ; Genotype ; Humans ; Injections, Intraperitoneal ; Kidney ; Litter Size ; Liver ; Lung ; Lymphocytes ; Mice ; Mortality ; Mothers ; Mutagens ; Palate ; Parturition ; Phenotype ; Placenta ; Pregnancy ; Rats ; Sister Chromatid Exchange ; Tail ; Thymidine ; Urethane

No abstract available.
Ileus* ; Lymph Nodes*

A 3 year and 3 months old boy with recurrent infections since his age of 5 months was presented with clinical data and autopsy findings. He was the 4th product of healthy parents. His elder brother died of recurrent perianal abscess and sepsis at his age of 3 years. His 2nd elder sister died on the 14th day of life probably from the complication of BCG vaccination. Beginnig with perianal abscesses at his age of 5 months, he has been continuously suffering from recurrent infections such as arthritis, ostomyelitis, pneumonia, epididymitis, subcutaneous abscesses and perianal abscesses. In spite of meticulous supportive and aggressive antibiotic therapy persistent positive cultures for staph. Aureus, klebsiella, E. Coli, Enterococcus and coliform bacilli from different sited were noted. Erythrocyte sedimentation rate of 25 to 40 were constant. White cell count varied frem 15500 to 33400 with polymorphonucleocytes predominance. NBT test showed persistent low scoring of 2% throught the course. He finally died of pneumonia and empyema. At postmortem examination, multiple abscesses and grnulomas of right lung and multipe granulomas in the liver, spleen, lymph node, bone, marrow, adrenal gland, kidney and intestinal wass were noted. At microscopic examination histiocytic granulomas with lipid containing histiocyte infiltrations were noted in every organs described including brain.
Abscess ; Adrenal Glands ; Arthritis ; Autopsy ; Blood Sedimentation ; Bone Marrow ; Brain ; Cell Count ; Empyema ; Enterobacteriaceae ; Enterococcus ; Epididymitis ; Granuloma ; Granulomatous Disease, Chronic* ; Histiocytes ; Humans ; Infant ; Kidney ; Klebsiella ; Liver ; Lung ; Lymph Nodes ; Male ; Mycobacterium bovis ; Parents ; Pneumonia ; Sepsis ; Siblings ; Spleen ; Vaccination

Neonatal bacterial meningitis remains as one of the significant causes of death and neurological sequellae. Twenty four cases of neonatal meningitis who were admitted to pediatric department, National Medical Center from Jan. 1970 to Dec. 1978 were reviewed clinically and the following results were obtained. 1. Age of onset was chiefly in the lst week of life(57.4%) followed by the 2nd week of life(25%). 2. Sex ratio showed predominance of male(83.3%). Seasonal distribution was non remarkable. 3. Among 24 cases, there noted 11 cases of positive cultrues for the etiologic agents, 5 of Gram positive and 6 of Gram negative. 4. Mean duration of days between the onset and the diagnosis was 2.5 days. The most common presenting symptoms and signs were poor sucking, irritability and lethargy. 5. On cerebrospinal fluid examination there noted increased cell count and protein and decreased sugar content in all cases 6. Case fatality rate was 25%. Subdural effusion was complicated in 20% of the cases but no hydrocephalus was noted.
Age of Onset ; Cause of Death ; Cell Count ; Cerebrospinal Fluid ; Diagnosis ; Hydrocephalus ; Lethargy ; Meningitis ; Meningitis, Bacterial* ; Mortality ; Seasons ; Sex Ratio ; Subdural Effusion

No abstract available.
Factor X*

No abstract available.
Colorectal Neoplasms* ; Mucins*

Peptic ulcer disease in children presents an interesting and sometimes difficult problem to the clinicians. Since the incidence is quite small in children, only small collected series have been reported in the literature. With the improvement of diagnostic aids (particularly radiologic equipments and greater attention paid by clinicians, peptic ulcers have been detected with increasing frequency. However, there is a paucity of information available concerning this disease in infancy and childhood in Korea. The symptoms and signs of peptic ulcer disease in childhood are obscure and have many differences from those of tihe adult, which too often go unrecogntzed until complications set in. The authors made on clinical observation on 14 patients with peptic ulcer under the age of 15 years, who had been admitted to the department of pediatrics of National Medical Center from Aug, 1972 to July 1978. The age, sex and seasonal incidences, type and location of ulcer, symptom curation, clinical and laboratory findings, complications and prognosis were analyzed and the data are summerized as follows. 1) The incidence of peptic ulcer in childhood was 0.33% of a total 4221 admissions, and the average number of patients of peptic ulcer per year was 2.3. 2) Among 14 patients, 9 cases (68%) were between 12 and 15 years of age, 4 patients (28%) between 7 and 11, and the majority (93%) were between the ages of 7 and 15. The youngest patients wea 4 year old male. 3) Sex incidence showed that males predominated in a proportion of 13:1. 4) Seasonal incidence was relatively high (inspring) (28.6%) and autumn (42.9%). 5) Three cases (21.5%) had gastric ulcer and 11 cases (78.5%) had duodenal (ulcer, 12 cases were diagnosed as primary type and 2 cases were) thought to be secondary type due to steroid therapy. 6) Duration of symptoms were variable, with the range between 1 week and 3 years. 7) The majority have abdominal pain (100%), vomiting (85.6%) and epigstric tenderness (71.4%), Other symptoms and signs were anemia (42.9%), indigestion (38.5%), melena (38.5%), epigastric pain (28.6%), general weakness (21.5%), weight loss (14.3%) and abdominal rigidity (14.3%). 8) Gastric analysis was performed in 5 patients, 2 of these patients had slight hyperchlorhydria, but 3 cases showed normal results. 9) Complications were found in 4 patients (28.6%). These were perforation (2 cases, 14.3%) and obstruction (2 cases 14.3%). Postoperative condition during hospitalization was excellent. 10) Among the chronic primary ulcer patients (12 cases), ulcer symptoms disappeared in 10 cases with medical treatment such as antacids, tranquilizers and other conservative treatments and within one month after treatments were discharged with improvement.
Abdominal Pain ; Adult ; Anemia ; Antacids ; Child ; Child, Preschool ; Dyspepsia ; Hospitalization ; Humans ; Incidence ; Korea ; Male ; Melena ; Only Child ; Pediatrics ; Peptic Ulcer* ; Prognosis ; Seasons ; Stomach Ulcer ; Ulcer ; Vomiting ; Weight Loss

The advent of minimally invasive surgery has provided many benefits to patients including less trauma, less pain, quicker recovery, and shorter hospital stays. A typical example of a minimally invasive surgery technique is laparoscopic surgery. Intraperitoneal insufflation of carbon dioxide is a routine procedure for creating pneumoperitoneum for accurate visualization and operative manipulation during laparoscopic surgery. However, pneumoperitoneum resulted in ventilatory, respiratory, and hemodynamic changes. Along with these changes, the patient position for the operation complicated anesthetic management. An understanding of these pathophysiologic consequences associated with laparoscopic surgery is important in anesthetic management. Robotic surgery was developed to alleviate the disadvantages of laparoscopic surgery. The advantages of computer-assisted robotic surgery include improved operative field visibility with a three dimensional imaging system and improved control of fine movement. However, the huge size of the robot itself unavoidably invades the anesthetic work space and may impair access to the patient. In addition, repositioning of a patient is almost impossible once the robot has been stationed for surgery. With the innovation of scientific technology, new surgical and anesthetic techniques are being developed for patient care. Anesthesiologists need to be aware of this fast changing surgical field and scientific technology and how it affects anesthetic management.
Anesthesia ; Carbon Dioxide ; Hemodynamics ; Humans ; Insufflation ; Laparoscopy ; Length of Stay ; Patient Care ; Pneumoperitoneum ; Robotics

No abstract available.
Humans ; Inpatients*

Cancer pain is among the most undesirable side effects and complications for cancer patients. Severe cancer pain acts as physical and psychological stress and makes it difficult for patients to perform daily activities. Uncontrolled cancer pain can be emotionally devastating to patients. However, cancer pain can be controlled with pharmacologic treatment. Traditionally, cancer pain was treated according to the WHO three-step analgesic ladder based on the severity of pain. Recently, it has become to administer weak opioids as well as non-opioid analgesics to patients with mild pain. For moderate pain, weak opioids or strong opioids can be used. Non-opioid analgesics and adjuvant analgesics can be used as an adjuvant to opioids for all severities of cancer pain. Effective cancer pain management depends on the proper selection of a drug, dose, and route and depends on treatment of common side effects associated with the medication. The usage of medication should be individualized to each patient. If necessary, we may use other modalities such as radiotherapy, nerve block, and non-pharmacologic interventions for cancer pain control. The goal of treatment of cancer pain is to obtain complete or partial pain relief with tolerable side effects of the medication, and ultimately, to improve the quality of life of cancer patients.
Analgesics ; Analgesics, Opioid ; Humans ; Nerve Block ; Pain Management ; Quality of Life ; Stress, Psychological