No abstract available.

No abstract available.
Humans

No abstract available.

Spinal anesthesia is a safe anesthetic technique and relative easy to perform, but occasionally neurologic injuries after spinal anesthesia have been reported. A 53-year old female patient visited the emergency room due to abdominal pain and she was diagnosed with acute appendicitis. Thus, an emergent appendectomy was planned. During the preoperative evaluation, we noticed that she had a history of intermittent low back pain for the previous 5 years. However, because her stomach was not fully empty, we decided to administer spinal anesthesia. When the spinal needle passed the subarachnoid membrane, she suddenly complained of severe paresthesia on her right posterior thigh. However the parethesia subsided soon, and 2.2 cc of 0.5% bupivacaine was injected via a spinal needle, and aftewards, an appendectomy was done without any complications. As she recovered from the spinal anesthesia, she started complaining of shooting, stabbing and burning pain on her right buttock and posterior thigh Because a neurologic injury after spinal anesthesia was suspected, we inserted an epidural catheter to the same lumbar vertebral level for administering the mepivacaine and ketamine mixture and we also performed a right second sacral nerve root block and a lumbar sympathetic ganglion block. Magnetic Resonance Imaging showed spondylosis of lumbar spine and associated disc degeneration and a bulging disc at the L3-4, L4-5 and L5-S1 level. After treatments, her symptoms improved gradually. When she was discharged on the 16th hospital day, she complained of only minor discomfort on her right posterior thigh.
Abdominal Pain ; Anesthesia ; Anesthesia, Spinal* ; Appendectomy ; Appendicitis ; Bupivacaine ; Burns ; Buttocks ; Catheters ; Emergency Service, Hospital ; Female ; Ganglia, Sympathetic ; Humans ; Intervertebral Disc Degeneration ; Ketamine ; Low Back Pain ; Magnetic Resonance Imaging ; Membranes ; Mepivacaine ; Middle Aged ; Needles ; Paresthesia ; Spine ; Spondylosis ; Stomach ; Thigh

No abstract available.
Dapsone*

Wilson s disease is an autosomal recessive disorder characterized by degenerative changes in the brain, liver, and cornea. Treatment includes D-penicillamine, trientine, and zinc sulfate. D-penicillamine has been used frequently as first line therapy for Wilson s disease. However, nephrotoxicity can occur after D-penicillamine treatment. Among them membranous glomerulopathy is the most common histological abnormality but minimal change lesions have also been reported. Nephrotic syndrome is a late complication of D-penicillamine treatment but very rarely can occur within 2 months after treatment of D-penicillamine. We report the early development of minimal change nephrotic syndrome in a 3-year-old girl with Wilson s disease 3 weeks after initiation of D-penicillamine.
Brain ; Child, Preschool ; Cornea ; Female ; Glomerulonephritis, Membranous ; Humans ; Liver ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Penicillamine* ; Trientine ; Zinc Sulfate

OBJECTIVE: To investigate whether there was any correlation between sonographic parameters and perinatal course of fetal ovarian cysts. METHODS: This was a retrospective analysis of cases from July, 1994 through February, 2003. The pre- and postnatal data of 10 fetuses who prenatally diagnosed to have an ovarian cyst, delivered and followed up in our obstetric center were analyzed. Maternal age, gestational age of diagnosis, ovarian cyst location, size, combined anomaly, mode of delivery, changes of ultrasonographic parameters, management of ovarian cysts and pathologic findings were reviewed. RESULTS: A total of 10 fetal ovarian cysts were all purely cystic, with well defined margins. Three of 10 cases (30%) showed antenatal sonographic patterns of complicated cysts (2 septa, 1 intraluminal echo) which spontaneously resolved during serial sonographic monitoring. In 2 cases the sonographic findings became complicated postnatally and were operated on revealing dermoid cyst with torsion. Five uncomplicated cysts of 10 cases were spontaneously resolved during perinatal follow-up. In eight cases of ovarian cysts larger than 4 cm, there was only one case which required postnatal surgery. CONCLUSION: There was no single ultrasonographic parameter (internal echoes, septum, character, size) to predict perinatal course of ovarian cysts including spontaneous resolution, torsion and need of operation.
Dermoid Cyst ; Diagnosis ; Female ; Fetus ; Follow-Up Studies ; Gestational Age ; Maternal Age ; Ovarian Cysts* ; Prenatal Diagnosis ; Retrospective Studies ; Ultrasonography

The goal for the treatment of patients with diabetes has today shifted from merely reducing glucose concentrations to preventing the natural decline in beta-cell function and delay the progression of disease. Pancreatic beta-cell dysfunction and decreased beta-cell mass are crucial in the development of diabetes. The beta-cell defects are the main pathogenesis in patients with type 1 diabetes and are associated with type 2 diabetes as the disease progresses. Recent studies suggest that human pancreatic beta-cells have a capacity for increased proliferation according to increased demands for insulin. In humans, beta-cell mass has been shown to increase in patients showing insulin-resistance states such as obesity or in pregnancy. This capacity might be useful for identifying new therapeutic strategies to reestablish a functional beta-cell mass. In this context, therapeutic approaches designed to increase beta-cell mass might prove a significant way to manage diabetes and prevent its progression. This review describes the various beta-cell defects that appear in patients with diabetes and outline the mechanisms of beta-cell failure. We also review common methods for assessing beta-cell function and mass and methodological limitations in vivo. Finally, we discuss the current therapeutic approaches to improve beta-cell function and increase beta-cell mass.
Glucose ; Humans ; Insulin ; Obesity ; Pregnancy

PURPOSE: The aim of this study was to identify usefulness of simple oral and gastric pH measurement using pH paper on detection of symptomatic gastroesophageal reflux in neonates. METHODS: This prospective study included a total of 66 neonates born at Konyang University Hospital from June 2004 to June 2005. Each neonate's oral and gastric pH levels measured with pH paper at 6 hourly intervals. Suspected gastroesophageal refluex neonates were studied 24-hr lower esophageal pH monitoring or upper GI series and confirmed. We compared oral and gastric pH between symptomatic gastroesophageal reflux (GER) group and asymptomatic (control) group. RESULTS: GER group consist of 12 neonates and control group consist of 54 neonates. Oral and gastric pH were 5.4+/-0.6, 2.9+/-0.5 in GER group, 6.0+/-0.3, 3.9+/-0.9 in control group, the differences between two groups were significant (P<0.05). All neonates of GER group were corfirmed gastroesophageal reflux by 24-hr lower esophageal pH monitoring or upper GI series studies. Our data indicate as a predictor for significantly symptomatic gastroesophageal reflux, at oral pH 5.75, has a sensitivity 92%, specificity 89%, positive predictive value of 65%, and negative predictive value of 98%. The difference between oral and gastric pH (oral pH-gastric pH) was not significant in each group. CONCLUSION: In neonates with symptomatic gastroesophageal reflux oral and gastric pH were significantly lower than asymptomatic neonates. Oral and gastric pH were related with clinically significant symptoms of gastroesophageal reflux. We suggest that pH measurement could be a possible simple screening test of symptomatic gastroesophageal reflux.
Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn* ; Mass Screening ; Prospective Studies ; Sensitivity and Specificity

PURPOSE: Antibody persistence after primary series of Haemophilus influenzae type b (Hib) vaccine and responses to boosters are seldom studied in Korean children. We performed this study to evaluate the antibody titer in relation to booster immunization of Hib vaccine in Korean children. METHOD: One hundred forty four children aged 12-23 months were enrolled in three university hospitals. The immunogenicity of boosters with Hib vaccine was assessed in children previously primed with Hib vaccine. Antibody persistence was also assessed in children who had received 3 doses of Hib vaccine without a booster. Anti-polyribosylribitol phosphate (PRP) IgG antibody levels and bactericidal titers were determined by enzyme immunoassay and bactericidal assay at the Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University. RESULTS: Prior to a booster in the second year of life, geometric mean antibody concentrations were 2.39 microgram/mL and the percent of subjects who had a anti-PRP antibody level > or =1 microgram/mL was 68.6%. After boosting, antibody concentration was 19.09 microgram/mL and the percent of subjects who had a anti- PRP antibody level > or =1 microgram/mL was 96.5%, which reflects previous immune priming. In subjects who had finished primary immunization only, the bactericidal titer was 3,946 and in subjects who had a booster, it was 11,205. Anti-PRP antibody level was correlated with serum bactericidal titer. CONCLUSION: Many children aged 12-23 month old still had protective antibodies after recommended primary immunization only. A booster dose seemed to induce good anamnestic antibody responses in Korean children.
Academies and Institutes ; Antibodies ; Antibody Formation ; Child* ; Female ; Haemophilus influenzae type b* ; Haemophilus influenzae* ; Haemophilus* ; Hospitals, University ; Humans ; Immunization ; Immunization, Secondary ; Immunoenzyme Techniques ; Immunoglobulin G ; Vaccination*