Subcutaneous fat necrosis of the newborn is an uncommon disorder which is characterized by multiple erythematous subcutaneous nodules and plaques appearing in the first week to a month of life. The chief precipitating factors presumably concerned in this disease are obstetric trauma, anoxia and cold exposure. We observed a case of subcutaneous fat necrosis of the newborn in which intrauterine asphyxia and preeclampsia had occured.
Anoxia ; Asphyxia ; Humans ; Infant, Newborn* ; Necrosis* ; Pre-Eclampsia ; Precipitating Factors ; Subcutaneous Fat*

BACKGROUND: Airwayscope (AWS), which has been used successfully for difficult airway in general anesthesia, has been anticipated that hemodynamic response to tracheal intubation in the difficult airway may be attenuated. Also, there is a series of reports demonstrating the successful use of lightwand to open the difficult airway. Thus, we decided to conduct a survey to compare AWS to lightwand and to direct laryngoscopy of cardiovascular response to tracheal intubation. METHODS: Of 64 healthy patients without cardiovascular disease, 22, 21, 21 patients were randomly assigned to AWS group, lightwand group and direct laryngoscope group. After induction of general anesthesia, intubation was performed with manual in-line neck stabilization. During laryngoscopy, a modified Cormack-Lehane grade was assessed and time to intubation was measured. Systolic arterial pressure (SAP) and heart rate (HR) were recorded at the following timepoints: baseline, just before intubation, 1 min, 2 min, 3 min, 4 min and 5 min after intubation. RESULTS: There were no significant differences between the 3 groups in SAP, HR (P > 0.05). However modified Cormack-Lehane grade of all patients in the AWS group was I, while that in direct laryngoscope group was IIB or III. In addition, the mean time to intubation of the direct laryngoscope group was significantly longer than that of the AWS and lightwand (P < 0.05). CONCLUSIONS: In the difficult airway, AWS was very effective in improving laryngeal view and decreasing time to intubation compared to direct laryngoscopey. In addition, lightwand reduced the time to intubation. However we could not find any significant difference in hemodynamic response to tracheal intubation among the 3 groups.
Anesthesia, General ; Arterial Pressure ; Cardiovascular Diseases ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Laryngoscopes ; Laryngoscopy ; Neck

Mycoplasma pneumoniae is a common cause of community-acquired respiratory infection in children. Through uncertain pathologic mechanisms, which most probably involve immunologically cell-mediated tissue damage, it causes life-threatening disease on rare occasion. We herein report a case of M. pneumoniae pneumonia, with encephalopathy followed by multiple organ failure in a previously healthy boy. Despite of intensive therapies with intravenous antibiotics, corticosteroid, hemodiafiltration, and transfusion, his neurologic and pulmonary sequales have remained. In most cases M. pneumoniae pneumonia are usually self- limiting with benign outcome. Even in healthy individual, however, it can manifest itself with a fulminant course and multi organ failure.
Anti-Bacterial Agents ; Child ; Hemodiafiltration ; Humans ; Multiple Organ Failure ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma

In the previous experiments, we reported that ethanol extract of Gastrodiae Rhizoma, the dried tuber of Gastrodia ElataBlume (Orchidaceae) increased pentobarbital-induced sleeping behaviors. These experiments were undertaken to know whether 4-hydroxybenzaldehyde (4-HBD), is one of the major compounds of Gastrodiae Rhizoma increases pentobarbital-induced sleeping behaviors and changes sleep architectures via activating GABA(A)-ergic systems in rodents. 4-HBD decreased locomotor activity in mice. 4-HBD increased total sleep time, and decreased of sleep onset by pentobarbital (28 mg/kg and 40 mg/kg). 4-HBD showed synergistic effects with muscimol (a GABA(A) receptor agonist), shortening sleep onset and enhancing sleep time on pentobarbital-induced sleeping behaviors. On the other hand, 4-HBD (200 mg/kg, p.o.) itself significantly inhibited the counts of sleep-wake cycles, and prolonged total sleep time and non-rapid eye movement (NREM) in rats. Moreover, 4-HBD increased intracellular Cl- levels in the primary cultured cerebellar cells. The protein levels of glutamic acid decarboxylase (GAD) and GABA(A) receptors subunits were over-expressed by 4-HBD. Consequently, these results demonstrate that 4-HBD increased NREM sleep as well as sleeping behaviors via the activation of GABA(A)-ergic systems in rodents.
Animals ; Ethanol ; Eye Movements* ; Gastrodia* ; Glutamate Decarboxylase ; Hand ; Mice ; Motor Activity ; Muscimol ; Pentobarbital ; Rats ; Receptors, GABA-A ; Rodentia*

OBJECTIVE: To investigate the survival outcomes in patients with bulky stage IIIC and IV ovarian cancer, treated by primary debulking surgery (PDS) and selective use of neoadjuvant chemotherapy (NAC) according to institutional criteria. METHODS: Medical records for advanced ovarian cancer patients who were treated at National Cancer Center (NCC) between December 2000 and March 2009 were retrospectively reviewed in the comprehensive cancer center. Bulky stage IIIC and IV ovarian cancer cases were included. Current NCC indication for NAC is determined based on patients' performance status and/or computerized tomography (CT) findings indicating difficult cytoreduction. After NAC, all traces of regressed metastatic ovarian cancer, potentially including chemotherapy-resistant cancer cells, were surgically removed. RESULTS: Of the 279 patients with bulky stage IIIC and IV, 143 (51%) underwent PDS and 136 (49%) received NAC. No gross residual and residual tumor measuring ≤1 cm was achieved in 66% and 96% of the PDS group and 79% and 96% of the NAC group, respectively. The median progression-free survival (PFS) and overall survival (OS) time were 20 months and not reached, but might be estimated more than 70 months in the PDS group and 15 and 70 months in the NAC group, respectively. CONCLUSION: Extensive cytoreductive surgery to minimize residual tumor and selective use of NAC based on the institutional criteria could result in improved survival outcomes. Until further studies can be done to define the selection criteria for NAC after surgery, institutional criteria for NAC should consider the ability of the surgeon and institutional capacity.
Cytoreduction Surgical Procedures ; Disease-Free Survival ; Drug Therapy* ; Humans ; Medical Records ; Neoadjuvant Therapy ; Neoplasm, Residual ; Ovarian Neoplasms* ; Patient Selection ; Retrospective Studies

Poria cocos is a well-known traditional Chinese traditional medicine (TCM) that grows around roots of pine trees in China, Korea, Japan, and North America. Poria cocos has been used in Asian countries to treat insomnia as either a single herb or part of an herbal formula. In a previous experiment, pachymic acid (PA), an active constituent of Poria cocos ethanol extract (PCE), increased pentobarbital-induced sleeping behaviors. The aim of this experiment was to evaluate whether or not PCE and PA modulate sleep architectures in rats as well as whether or not their effects are mediated through GABA(A)-ergic transmission. PCE and PA were orally administered to individual rats 7 days after surgical implantation of a transmitter, and sleep architectures were recorded by Telemetric Cortical encephalogram (EEG) upon oral administration of test drugs. PCE and PA increased total sleep time and non-rapid eye movement (NREM) sleep as well as reduced numbers of sleep/wake cycles recorded by EEG. Furthermore, PCE increased intracellular chloride levels, GAD65/67 protein levels, and alpha-, beta-, and gamma-subunits of GABA(A) receptors in primary cultured hypothalamic neuronal cells. These data suggest that PCE modulates sleep architectures via activation of GABA(A)-ergic systems. Further, as PA is an active component of PCE, they may have the same pharmacological effects.
Administration, Oral ; Animals ; Asian Continental Ancestry Group ; China ; Cocos* ; Electroencephalography ; Ethanol* ; Eye Movements ; Glutamate Decarboxylase ; Humans ; Japan ; Korea ; Medicine, Chinese Traditional ; Neurons ; North America ; Pinus ; Poria* ; Rats* ; Receptors, GABA-A ; Sleep Initiation and Maintenance Disorders

The present study was aimed at investigating whether FK506 alters the regulation of nitric oxide(NO) system. Male Sprague-Dawley rats were treated with FK506(1 mg/kg/day, i.m.) for 3 weeks. Control group was without treatment of FK506. Plasma levels and urinary excretion of NO metabolites(nitrite/nitrate, NOx) were measured. The protein expression of NO synthases(NOS) and tissue contents of NOx were determined in the kidney and thoracic aorta. The aorta was also examined of its changes in isometric tension in responses to acetylcholine and sodium nitroprusside. The arterial pressure did not significantly differ between FK506-treated and control groups. Plasma NOx levels remained unaltered, while urinary NOx excretion was significantly decreased in FK 506-treated group. Tissue contents of NOx were significantly decreased, although the expression of ecNOS and iNOS proteins was significantly altered neither in the kidney nor in the aorta. Acetylcholine-induced relaxation of the isolated aortic ring was significantly attenuated, whereas sodium nitroprusside-induced relaxation was not significantly affected. These results suggest that FK506 decreases the tissue contents of NO, without significantly affecting the expression of NOS.
Acetylcholine ; Animals ; Aorta ; Aorta, Thoracic ; Arterial Pressure ; Humans ; Kidney ; Male ; Nitric Oxide* ; Nitroprusside ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Sodium ; Tacrolimus*

OBJECTIVE: To evaluate survival and morbidity after pelvic exenteration (PE) for the curative management of recurrent cervical cancer. METHODS: We retrospectively evaluated patients with recurrent cervical cancer who underwent PE from January 2001 to April 2011. Patients were identified from the registry of our institution. The clinical status and demographic information was obtained by reviewing the medical records. RESULTS: Sixty-one recurrent cervical cancer patients underwent PE. Patients who received radiotherapy, operation, chemotherapy before PE were 98%, 41%, and 23%, respectively. The total morbidity rate was 44%; 10 (16%) patients had early complications (30 days or less after PE), whereas 22 (36%) patients had late complications. Wound problems were common early complications (7/18), and bowel fistulas were common late complications (9/30). The five-year overall survival and five-year disease-free survival were 56% and 49%, respectively. Median follow-up was 22 months (range, 1.8 to 60 months). Affecting factors for overall survival were resection margin status, pelvic wall and rectal involvement. CONCLUSION: Our overall 5-year survival is encouraging. Although the morbidity rate is still high, PE is a potentially curative opportunity in gynecological malignancies with no other treatment options. The most important factors for overall survival after PE are the resection margin status, pelvic wall involvement and rectal involvement.
Disease-Free Survival ; Fistula ; Follow-Up Studies ; Humans ; Korea ; Pelvic Exenteration ; Retrospective Studies ; Uterine Cervical Neoplasms

OBJECTIVE: To evaluate survival and morbidity after pelvic exenteration (PE) for the curative management of recurrent cervical cancer. METHODS: We retrospectively evaluated patients with recurrent cervical cancer who underwent PE from January 2001 to April 2011. Patients were identified from the registry of our institution. The clinical status and demographic information was obtained by reviewing the medical records. RESULTS: Sixty-one recurrent cervical cancer patients underwent PE. Patients who received radiotherapy, operation, chemotherapy before PE were 98%, 41%, and 23%, respectively. The total morbidity rate was 44%; 10 (16%) patients had early complications (30 days or less after PE), whereas 22 (36%) patients had late complications. Wound problems were common early complications (7/18), and bowel fistulas were common late complications (9/30). The five-year overall survival and five-year disease-free survival were 56% and 49%, respectively. Median follow-up was 22 months (range, 1.8 to 60 months). Affecting factors for overall survival were resection margin status, pelvic wall and rectal involvement. CONCLUSION: Our overall 5-year survival is encouraging. Although the morbidity rate is still high, PE is a potentially curative opportunity in gynecological malignancies with no other treatment options. The most important factors for overall survival after PE are the resection margin status, pelvic wall involvement and rectal involvement.
Disease-Free Survival ; Fistula ; Follow-Up Studies ; Humans ; Korea ; Pelvic Exenteration ; Retrospective Studies ; Uterine Cervical Neoplasms

The incidence rate of cervical cancer in Korea is still higher than in other developed countries, notwithstanding the national mass-screening program. Furthermore, a new method has been introduced in cervical cancer screening. Therefore, the committee for cervical cancer screening in Korea updated the recommendation statement established in 2002. The new version of the guideline was developed by the committee using evidence-based methods. The committee reviewed the evidence for the benefits and harms of the Papanicolaou test, liquid-based cytology, and human papillomavirus (HPV) testing, and reached conclusions after deliberation. The committee recommends screening for cervical cancer with cytology (Papanicolaou test or liquid-based cytology) every three years in women older than 20 years of age (recommendation A). The cervical cytology combined with HPV test is optionally recommended after taking into consideration individual risk or preference (recommendation C). The current evidence for primary HPV screening is insufficient to assess the benefits and harms of cervical cancer screening (recommendation I). Cervical cancer screening can be terminated at the age of 74 years if more than three consecutive negative cytology reports have been confirmed within 10 years (recommendation D).
Adult ; Age Factors ; Aged ; Early Detection of Cancer/adverse effects/*methods/standards ; Evidence-Based Medicine ; False Positive Reactions ; Female ; Humans ; Hysterectomy ; Middle Aged ; Papillomavirus Infections/diagnosis ; Papillomavirus Vaccines ; Patient Selection ; Pregnancy ; Pregnancy Complications, Neoplastic/diagnosis ; Republic of Korea ; Review Literature as Topic ; Uterine Cervical Neoplasms/*diagnosis ; Vaginal Smears/adverse effects/methods/standards ; Young Adult