Sick neonates often require periodic small volume transfusion (10mg/kg) to replace blood draw for laboratory monitoring during their hospital stay. The effect of packed red cel transfudion on the hematocrit, potassium, ionized calcium, acid base status, glucose and indirect bilirubin was investigated in 25 transfusions. Analysis of transfused blood by the age of the red cells, older red cells (more than 5 days old, 13+/-7 days) showed increased potassium (27.2+/-14.1mEq/L vs 11.3+/-4.9mEq/L), decreased bicarbonate (14.4+/-2.6mEq/L) and glucose (130+/-28mg/dl vs 203+/-93mg/dl) compared with newer red cells (less than 5 days)(p<0.05). No significant changes occured in hematocrit and pH. Inspite of these results, the transfusion of the older red cells did not affect the older red cells did not affect the serum potassium, ionized calcium, pH, bicarbonate, glucose and indirect bilirubin level in neonates. The hematocrit of infants increated significantly after transfusion from 29.6%+/-4.3% to 38.3%+/-6.1%(mean+/-SD)(P<0.05). Transfusion of older red cells seemed to be as equally effective as newer ones. The valus of hematocrit obtained immediately after transfusion does not show any differences compared to those obtained 30 min, 1, 2, 4, 6 and 24 hours after transfusion. The result in the study indicate that there was no adverse effect after transfusion with packed red cell more than 5 days old and no significant difference in hematocrit observed between 0 to 24 hours following transfusion. Therfore old red cell more than 5 days can be used safely for sick neonatal transfusion and the stored donor blood can be optimzed for repeated blood transfusion.
Bilirubin ; Blood Transfusion ; Calcium ; Glucose ; Hematocrit* ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Length of Stay ; Potassium ; Tissue Donors

No abstract available.
Cefazolin* ; Erythromycin* ; Latency Period (Psychology)* ; Membranes* ; Rupture*

Herpes simplex esophagitis has been recognized with increased frequency as an opportunistic infection in immunosuppressed or debilitated patients. However, it is also documented as self-limited esophagitis in apparently healthy patients. We report two cases of herpetic esophagitis diagnosed by biopsies. One case was noted in an immunocompetent patient having gastric peptic ulcer who had clinical improvement with symptomatic treatment. And the other was noted in an immunosuppressed patient having chemotherapy for gastric carcinoma who had resolution of symptoms with acyclovir therapy. Histologically, esophageal mucosa exhibited erosion and inflammatory cellular exudate with intranuclear eosinophilic inclusions in the epithelial cells. These were confirmed by the PCR and immunohistochemical stain for herpes simplex virus using a biopsy material.
Acyclovir ; Biopsy ; Drug Therapy ; Eosinophils ; Epithelial Cells ; Esophagitis* ; Exudates and Transudates ; Herpes Simplex* ; Humans ; Mucous Membrane ; Opportunistic Infections ; Peptic Ulcer ; Polymerase Chain Reaction ; Simplexvirus

Dysarthric patients often present velopharyngeal incompetence (VPI), characterized nasalization articulation for hypernasality,which seriously impaired their communication. Research of evaluation of VPI is mainly about cleft palate and postoperative, few about the dysarthria. Some approaches, such as physiologic approach to rehabilitation, have been used to correct hypernasality, and prosthesis,such as palatal lift prosthesis (PLP) and nasal speaking valve (NSV), are also proved effectively. PLP has been widely used for hypernasality oversea, but fewer in China.

Objective To investigate the vowel's nasalance and contact quotient (CQ) in children with hearing loss. Methods 57 subjects were divided to 3 groups: profound hearing loss children with hearing aids (HA, n=19), profound hearing loss children with cochlear implant (CI, n=19) and children without hearing loss (n=19). With the help of NV and electroglottography (EGG), the subjects' nasalance and CQ were recorded when they said /a/, /æ/, /i/, /o/, /u/. Results There was no significant differences among the 3 groups on nasalance (P>0.05). There was significant difference among 5 vowels on nasalance, ranked as /u/, /o/, /æ/, /i/, and /a/ (P<0.001). There was significant difference among 3 groups on CQ, ranked as HA, normal, and CI group (P<0.001). There was significant difference on CQ among 5 vowels,ranked as /i/, /u/, /æ/, /o/, and /a/ (P<0.001). Conclusion The voice and resonance should be assessed before speech therapy, which the speech therapy starts from the most correct vowel for children with profound hearing loss.

The VATER syndrome is a group of congenital anomalies with a nonrandom tendency for concurrence. Defects include vertebral, anorectal malformation, tracheoesophageal fisutla with esophageal atresia, radial-limb, vascular, and renal abnormalities. The critical period of organogenesis is at or before the sixth or seventh week of gestation. We experienced one case of VATER syndrome in a 1 day old male neonate having vertebral anomalies, esophageal atresia with tracheoesophageal fistula to the distal esophageal segment, imperforated anus, left renal dysplasia with hydronephrosis of the right kidney and both hydroureter, patent ductus arteriosus. We report a case of VATER syndrome with brief review of related literature.
Anal Canal ; Critical Period (Psychology) ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Humans ; Hydronephrosis ; Infant, Newborn ; Kidney ; Male ; Organogenesis ; Pregnancy ; Tracheoesophageal Fistula

Nucleolar organizer regions are DNA loops encoding rihbosomal RNA production and detectable by the argyrophilia of their associated proteins(AgNORs). AgNOR numbers correlate with cellular proliferating activity. Many studies have shown a significnt difference in AgNOR counts between benign and malignant tumors. AgNOR counts were also helpful in differential diagnosis. For the evaluation of its diagnostic utility in gastric lesions, a silver staining technique was carried out in paraffin sections of 5 control cases, 5 benign peptic ulcers, 7 hyperplastic polyps, 10 tubular adenomas, 16 early gastric adenocarcinomas and 15 advanced gastric adenocarcinomas. The results were as follows. The mean numbers of AgNORs in early and advanced gastric adenocarcinomas(1.94 and 2.16) were significantly higher than those of normal foveolar epithelium(1.43) and epithelia of benign gastric ulcers(1.54), hyperplastic polyps(1.64) and tubular adenomas(1.79). In malignancy, there was increased variability in size and shape of AgNORs. There was little differences in mean AgNOR numbers between early and advanced gastric adenocarcinomas. Differentiation of the tumor made no difference in AgNOR numbers. From the above results, the AgNORs count, if its morphologic change are taken into consideration, is helpful in differentiation between malignant and non-malignant lesions.
Diagnosis, Differential ; Adenocarcinoma

No abstract available.
Carcinoma, Papillary* ; Thyroid Gland*

Plexiform neurofibroma is considered to be pathognomic of neurofibromatosis type 1 (NF1). Herein we report a solitary plexiform neurofibroma which is not associated with NF1. A 61-year-old man presented with asymptomatic skin colored nodules on the medial side of his left great toe. No other abnormalities were found in his personal or family history. Clinically, the tumor was simulating the appearance of mucous cysts. Microscopically,it was a plexiform neurofibroma located in the dermis which seemed to originate from small superficial nerves. This case would seem to confirm that the superficial form of plexiform neurofibroma involving small nerves in the dermis or subcutis is not necessarily pathognomic for NF1.
Dermis ; Humans ; Middle Aged ; Neurofibroma, Plexiform* ; Neurofibromatosis 1 ; Skin ; Toes

Epithelial cadherin (E-cadherin) is a Ca2+ -dependent cell-cell adhesion molecule that connects cells via homotypic interactions. Its function is critical in the induction and maintenance of cell polarity and differentiation, and its loss is associated with an invasive and poorly differentiated phenotype in a wide range of tumors. Formalin-fixed, paraffin-embedded tissue sections from 36 cases of cervical intraepithelial neoplasia (CIN) and 14 cervical squamous cell carcinomas were investigated for the expression of E-cadherin immunohistochemically. While E-cadherin expression was usually restricted on the cell membrane of basal and parabasal cells in normal cervix, the presence of cytoplasmic E-cadherin was found to be associated with its grade in CIN lesions. Also, marked cytoplasmic staining was commonly revealed in poorly differentiated ones than well-differentiated squamous cell carcinomas. More intense reactivity of cytoplasmic E-cadherin was frequently seen in the foci of invasion than adjacent carcinoma in situ, and in its periphery than the center of tumor islands. In addition, DNA ploidy and S-phase fraction of squamous cell carcinomas were analyzed and compared with those of CIN lesion. We found that invasive squamous cell carcinomas more frequently disclosed DNA aneuploidy than CIN lesions, and there was correlation between cytoplasmic E-cadherin expression and DNA aneuploidy. Also, cytoplasmic E-cadherin-reactive cervical neoplasms had a higher rate of cell proliferation than that of membranous E-cadherin-reactive cases. These data suggest that the increased cytoplasmic E-cadherin expression may represent one of the abnormalities underlying the loss of polarity and invasiveness of cancer cells, and the abnormal E-cadherin expression combined with/without DNA ploidy or S-phase fraction may serve as a prognostic indicator.
Aneuploidy ; Cadherins* ; Carcinoma in Situ ; Carcinoma, Squamous Cell* ; Cell Membrane ; Cell Polarity ; Cell Proliferation ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Cytoplasm ; DNA* ; Female ; Islands ; Phenotype ; Ploidies* ; Uterine Cervical Neoplasms