PURPOSE: Ibuprofen is used for prevention and treatment of patent ductus arteriosus as an alternative drug of indomethacin in very premature infants. We aimed to determine the effect of prophylactic ibuprofen on patent ductus arteriosus and clinical outcomes in preterm infants less than 1,250 g. METHODS: A retrospective review of 39 preterm infants who were admitted to our neonatal intensive care unit from November 2009 to July 2010 was performed. Patients were divided into a prophylactic group (n=13) and a matched historical control group (n=26), where prophylactic ibuprofen were administrated within 24 hours after birth. The rate of ductal closure, side-effects of drug treatment and clinical outcomes were compared between two groups. RESULTS: Comparison of the prophylactic and control groups revealed no significant differences in the rate of ductal closure (69.2% vs 77.7%, P=0.825) and surgical ligation (23.1% vs 30.8%, P=0.719). Occurrence of bowel perforation was more frequent in the prophylactic group than the control group, but was not significant (30.8% vs 11.5%, P=0.194). The frequency of intraventricular hemorrhage (grade> or =3) and other outcomes did not differ between the groups. CONCLUSION: Ibuprofen prophylaxis in preterm infants did not decrease the rate of ductal closure, the need for surgical ligation and the incidence of intraventricular hemorrhage. Further studies are needed to investigate the beneficial effect and associated adverse events attributed to ibuprofen prophylaxis.
Birth Weight ; Ductus Arteriosus, Patent ; Hemorrhage ; Humans ; Ibuprofen ; Incidence ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Ligation ; Parturition ; Retrospective Studies

PURPOSE: Previous studies have outlined mechanisms by which Mycoplasma pneumonia (M. pneumonia) infection may promote allergic lung inflammation and airway remodeling, and increasing evidence from human studies suggests that atypical bacterial infections contribute to asthma exacerbation, chronic asthma, and disease severity with changes in cytokine expression. The present study evaluated changes in serum levels of vascular endothelial growth factor (VEGF) and interleukin (IL)-5 in atopic children with Mycoplasma pneumoniae pneumonia. METHODS: We recruited a total of 72 children with pneumonia. The patients were divided into 4 groups: atopic children with M. pneumonia pneumonia (group I, n=24), non-atopic children with M. pneumonia pneumonia (group II, n=23), atopic children with viral pneumonia (group III, n=13), and non-atopic children with viral pneumonia (group IV, n=12). Serum levels of IL-5, IL-13, VEGF, and tumor necrosis factor-alpha were measured at admission and at recovery using enzyme-linked immunosorbent assays. RESULTS: Serum levels of VEGF and IL-5 were elevated in group I compared with the other groups at both admission phase and clinical recovery phase. In group I, serum levels of VEGF and IL-5 were higher at recovery phase than at admission phase (VEGF: 1,102.2+/-569.4 vs. 874.9+/-589.9 pg/mL, respectively; IL-5: 150.5+/-63.9 vs. 120.2+/-46.7 pg/mL, respectively). CONCLUSIONS: The serum levels of VEGF and IL-5 were more increased in atopic children with M. pneumonia pneumonia than in the other groups. In this group, the serum levels of VEGF and IL-5 were more increased at recovery phase than at admission phase. The results of this study suggest that increases in VEGF and IL-5 may contribute to the development of hypersensitivity during M. pneumonia infection. These cytokines may act through their respective pro-inflammatory pathways to aggravate the allergic status and induce airway hypersensitivity during M. pneumonia pneumonia in atopic children.
Airway Remodeling ; Asthma ; Bacterial Infections ; Child ; Cytokines ; Humans ; Hypersensitivity ; Interleukin-13 ; Interleukin-5 ; Interleukins ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Pneumonia, Viral ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

Astrocytes play important roles in normal brain development and the physiological processes. In particular, 30% of the brain volume consists of astrocytes, and they are the primary target cell in the brain for cellular injuries from chemical exposures. The present study attempts to establish an immortalized murine astrocyte cell line to study the mechanisms of chemical-induced carcinogenesis of astrocytes. Primary astrocytes isolated from mice were transfected with plasmid carrying the SV40 T antigen. Clonal cells obtained after G418 selection were continuously subcultured to establish an immortalized astrocyte cell line. The cell line was positive on GFAP expression and was sensitive to exposure to such chemicals as MNNG. Cells were treated with MNNG for 5 days, with doses ranging from 0.001ug/ml to 1ug/ml. Dose-dependent cellular transformations of astrocytes were observed. Treatments at 0.01ug/ml showed the most distinct characteristics of neoplastic transformation. Subsequent treatment with TPA produced higher levels of neoplastic cell transformation than MNNG treatment alone, as evidenced by increases of saturation density, soft-agar colony formation and cell aggregation. Promotional effects of TPA on cell transformation was further demonstrated by the shortening duration of foci appearance. Addition of hydrocortisone to the culture media resulted in further promotion of cell transformation in astrocytes treated with MNNG and TPA, suggesting that glucocortocoid also plays a role in the promotion of chemical-induced astrocyte transformation. The present study demonstrates that astrocytes are susceptible to chemical-induced carcinogenicity and subject to mechanisms of multistage carcinogenesis. Analysis of MNNG-transformed astrocytes showed that, while the expression of TGF-beta was decreased, expression of GFAP, IL-1betaand fibronectin were increased. The results suggest that these factors are associated with mechanisms of MNNG-induced astrocyte transformation and may be used as potential candidates for biomarkers representing astrocyte-related tumors and cell toxicities. The study showed scientific evidence that growth factors, cytokine and the extracellular matrix are involved in processes of chemical-induced transformation of astrocytes. In addition, the present work provided an excellent opportunity to develop an immortalized astrocyte cell line that can be used for studying mechanisms of astrocyte-related diseases.
Animals ; Antigens, Viral, Tumor ; Astrocytes* ; Biomarkers ; Brain ; Carcinogenesis* ; Cell Aggregation ; Cell Line ; Cell Transformation, Neoplastic ; Culture Media ; Extracellular Matrix ; Fibronectins ; Hydrocortisone ; Intercellular Signaling Peptides and Proteins ; Methylnitronitrosoguanidine ; Mice ; Physiological Processes ; Plasmids ; Transforming Growth Factor beta

BACKGROUND AND OBJECTIVES: The ocular vestibular evoked myogenic potential (OVEMP) is a recently discovered test of labyrinthine function, analogous to the cervical VEMP. Recent works have demonstrated the existence of OVEMPs, which likely reflect otolith-ocular reflex. The purpose of this study was to identify the optimal plateau and rise/fall times of short tone bursts to detect OVEMPs in healthy subjects. MATERIALS AND METHODS: Thirteen healthy subjects (26 ears) were included in this study. Surface electromyographic activity was recorded from active electrodes placed inferior to each eye. Stimulation with 500 Hz short tone bursts was used. We used a variety of plateau and rise/fall times. Three different plateau times (1, 2, and 3 ms) and rise/fall times (0.5, 1, and 2 ms) were used. The incidence, amplitudes and latencies were compared. RESULTS: VEMP responses were clearly observed in all 26 ears at the plateau time of 2 ms and two rise/fall times (0.5 and 1 ms). The amplitudes in the individual ears tested were lower at the rise/fall time of 2 ms than at the other conditions. The amplitudes were lower at the plateau time of 3 ms compared to the other conditions. When the rise/fall time was prolonged from 0.5 to 2 ms, the n1 and p1 latencies were prolonged in parallel. However, there was no such change in latencies according to the plateau times. CONCLUSIONS: Our findings show that the ideal stimulation pattern for evoking OVEMP is at the rise/fall times of 0.5 or 1 ms and the plateau time of 2 ms. The waveform morphology of the VEMP responses observed with this stimulation pattern was simultaneously the most constant and marked.
Ear ; Electrodes ; Evoked Potentials ; Eye ; Incidence ; Otolithic Membrane ; Reflex ; Reflex, Vestibulo-Ocular ; Vestibular Evoked Myogenic Potentials

Presently talc is one of the agents most commonly used for producing a pleurodesis in patients with either a recurrent pleural effusion or a spontaneous pneumothorax. Talc can be instilled into the pleural space either as an aerosol (insufflation) or as a suspension (slurry) in saline. They are quite effective in producing a pleurodesis. However, they rarely have acute serious adverse effects including acute respiratory distress syndrome, and recently a discussion for using pleurodesis has been reported. We experienced a case of acute respiratory distressed syndrome after talc pleurodesis. A 64 year old man, who was diagnosed lung cancer with a malignant pleural effusion at the same side, was treated by pleurodesis using talc to control the effusion. After 3 days, he suffered fever, chill and breathlessness. The chest PA and CT revealed a bilateral infiltration in both lungs and the blood gas analysis confirmed hypoxemia, which required mechanical ventilation.
Anoxia ; Blood Gas Analysis ; Fever ; Humans ; Lung ; Lung Neoplasms ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurodesis* ; Pneumothorax ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; Talc* ; Thorax

BACKGROUND AND OBJECTIVES: A significant recovery of resting activity in the vestibular nuclei ipsilateral to the unilateral labyrinthectomy has been reported by the time symptoms such as spontaneous nystagmus and roll head tilt have largely disappeared. However, the dynamic vestibular response after unilateral vestibular loss to passively imposed vestibular stimuli does not recover. MATERIALS AND METHODS: We investigated changes of the caloric responses in 32 patients with vestibular neuritis during in- and out-patient visits separated by 2 months in an attempt to identify changes brought about by peripheral and/or central compensation processes. RESULTS: The slow-phase eye velocities stimulated by warm caloric stimulation at acute and follow-up stage were 6.6+/-6.6 degrees/s, 9.5+/-9.9 degrees/s in the lesioned side; 28.4+/-19.1 degrees/s, 24.5+/-11.6 degrees/s in the intact side. The slow-phase eye velocities stimulated by cold caloric stimulation at acute and follow-up stage were 5.9+/-7.7 degrees/s, 10.3+/-8.2 degrees/s in the lesioned side; 19.8+/-10.3 degrees/s, 18.8+/-9.9 degrees/s in the intact side. CONCLUSION: Our findings show that the recovery of caloric responses comes mostly from the recovery of the eye responses to the caloric stimulation in the lesioned side and the eye responses to the caloric stimulation in the intact side does not change over time after vestibular neuritis.
Caloric Tests ; Cold Temperature ; Compensation and Redress ; Eye ; Eye Movements ; Follow-Up Studies ; Head ; Humans ; Outpatients ; Reflex, Vestibulo-Ocular ; Vestibular Neuronitis ; Vestibular Nuclei

PURPOSE: The trinucleotide repeat expansion in the 3' untanslated resion of the gene is known to be the cause of myotonic dystrophy which is one of most common neurodegenerative disorder manifested by myotonia, cataract, mental retardation and even respiratory distress in neonates. The hereditary pattern of myotonic dystrophy shows more severe symptoms and shows earlier onset with successive generations and congenital cases, the most severe form of myotonic dystrophy,. Occurs by maternal transmission. This genetic transmission mode does not follow Mendelian genetic trait. To find the molecular genetic abnormalities of Korean myotonic dystrophy patients, we investigated the general distribution of myotonic dystrophy alleles and compared the results with referred patients. METHODS: During an 8 month study, from June 1995 to February 1996, 5 patients were referred with presumed diagnosis of myotonicdystrophy. Among these patients, four cases were confirmed to have the disease by clinical and electrophysiological findings. We included family members of the studied probands and 50 normal blood donor DNAs were included as controls. The DNAs of the enrolled cases were evaluated by Southern blot. Subsequently, copy numbers of the repeats were determined using PCR amplification. RESULTS: (1) Two peaks were found in the distribution of trinucleotide repeats in the normal Korean population. One peak had 5 copies and the other had 11 to 13 copies. The highest number of copies was 27. (2) Of the referred cases, 4 pedigrees showed typical expanded repeats. (3) The minimum expanded copy number was 55 and we were able to detect the expanded band only by PCR in 2 cases. In other cases, expaded bands were visible by Southern blotting. (4) There were trend of earlier onset of the disease, progressive worsening symptoms and larger expanded bands with successive generations. CONCLUSION: We established the methodology for myotonic dystrophy DNA diagnosis using Southern blot and PCR amplification based on the normal Korean allele distribution. These methods might be useful in genetic counselling and detection of minimally affected myotonic dystrophy patients.
Alleles ; Blood Donors ; Blotting, Southern ; Cataract ; Diagnosis ; DNA ; Family Characteristics ; Humans ; Infant, Newborn ; Intellectual Disability ; Molecular Biology ; Myotonia ; Myotonic Dystrophy* ; Neurodegenerative Diseases ; Polymerase Chain Reaction ; Trinucleotide Repeat Expansion* ; Trinucleotide Repeats*

PURPOSE: To evaluate on abdominal CT the type and incidence of various complications of abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: Twenty six suspected cases of AAA were confirmed by operation(n=21) and by CT(n=5). The etiology, size, shape and incidence of various complications of AAA were then retrospectively evaluated. In addition, post-operative complications were also evaluated in five cases. RESULTS: The etiology ofthe aneurysm was atherosclerotic in 18 cases and mycotic in three ; it showed the presence of Behcet disease in three cases, of tuberculosis in one, and of Marfan syndrome in one. Among the 18 fusiform AAA, the mean maximum diameter of ruptured AAA(7.5+/-3.3cm, n=3) was significantly larger than that of unruptured AAA(4.9+/-1.6cm, n=15)(p<0.05). The saccular type was much more likely to rupture than the fusiform type(p<0.00001). Out of the eight saccular AAA, seven ruptured ; their mean maximum diameter was 3.9+/-1.3cm This was significantly smaller than that of ruptured fusiform aneurysm(p<0.05). The most common complication was rupture, and occurred ten of 26 cases(38%). Others included hydronephrosis in three cases, bowel infarction in one, and perianeurysmal retroperitoneal fibrosis in one case. Various post-operative complications developed in five patients ; these comprised periprosthetic pseudoaneurysm with hematoma (two cases), bowel ischemia (one), focal renal infarction(one), and secondary aorticoduodenal fistula (one). CONCLUSION: The most common complication of AAA was rupture, the rate of which was much higher in the saccular type with smaller size than the fusiform type. Other various and uncommon complications were observed. CT was helpful in detecting complications arising from AAA and in planning its treatment.
Aneurysm ; Aneurysm, False ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Behcet Syndrome ; Fistula ; Hematoma ; Humans ; Hydronephrosis ; Incidence ; Infarction ; Ischemia ; Marfan Syndrome ; Retroperitoneal Fibrosis ; Retrospective Studies ; Rupture ; Tomography, X-Ray Computed ; Tuberculosis

PURPOSE: To evaluate on abdominal CT the type and incidence of various complications of abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: Twenty six suspected cases of AAA were confirmed by operation(n=21) and by CT(n=5). The etiology, size, shape and incidence of various complications of AAA were then retrospectively evaluated. In addition, post-operative complications were also evaluated in five cases. RESULTS: The etiology ofthe aneurysm was atherosclerotic in 18 cases and mycotic in three ; it showed the presence of Behcet disease in three cases, of tuberculosis in one, and of Marfan syndrome in one. Among the 18 fusiform AAA, the mean maximum diameter of ruptured AAA(7.5+/-3.3cm, n=3) was significantly larger than that of unruptured AAA(4.9+/-1.6cm, n=15)(p<0.05). The saccular type was much more likely to rupture than the fusiform type(p<0.00001). Out of the eight saccular AAA, seven ruptured ; their mean maximum diameter was 3.9+/-1.3cm This was significantly smaller than that of ruptured fusiform aneurysm(p<0.05). The most common complication was rupture, and occurred ten of 26 cases(38%). Others included hydronephrosis in three cases, bowel infarction in one, and perianeurysmal retroperitoneal fibrosis in one case. Various post-operative complications developed in five patients ; these comprised periprosthetic pseudoaneurysm with hematoma (two cases), bowel ischemia (one), focal renal infarction(one), and secondary aorticoduodenal fistula (one). CONCLUSION: The most common complication of AAA was rupture, the rate of which was much higher in the saccular type with smaller size than the fusiform type. Other various and uncommon complications were observed. CT was helpful in detecting complications arising from AAA and in planning its treatment.
Aneurysm ; Aneurysm, False ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Behcet Syndrome ; Fistula ; Hematoma ; Humans ; Hydronephrosis ; Incidence ; Infarction ; Ischemia ; Marfan Syndrome ; Retroperitoneal Fibrosis ; Retrospective Studies ; Rupture ; Tomography, X-Ray Computed ; Tuberculosis

We present a patient who developed a psoas muscle hematoma after spinal anesthesia. He had received hemodialysis with heparin every two days because of end stage renal disease. Under the jack-knife position, he underwent spinal anesthesia and a paramedian approach was used for incision and drainage of an anal abscess. The coagulation tests were normal throughout the surgery. Eleven days after the operation, he complained of sudden onset of right buttock pain and a psoas muscle hematoma was diagnosed by CT. Although heparin is recommended after regional anesthesia, it is a major cause of delayed hematoma. Because of this potential complication, anesthesiologists and clinicians should carefully monitor the usage of anticoagulants after spinal anesthesia, and it is necessary to use active diagnostic tools such as CT for early diagnosis when hematoma formation is suspected in patients receiving anticoagulants.
Abscess ; Anesthesia, Conduction ; Anesthesia, Spinal ; Anticoagulants ; Buttocks ; Drainage ; Early Diagnosis ; Hematoma ; Heparin ; Humans ; Kidney Failure, Chronic ; Organothiophosphorus Compounds ; Psoas Muscles ; Renal Dialysis