No abstract available.
Brain* ; Child* ; Humans ; Magnetic Resonance Imaging*

BACKGROUND: This study was performed to evaluate the effects of intercostal nerve block added in intravenous patient-controlled analgesia (IV-PCA; PCA) on pain, pulmonary function and the movement of the ipsilateral arm after a thoracotomy. METHODS: Forty five patients undergoing elective thoracotomy were randomly allocated into one of three groups. The groups were divided as follows: PCA, ICB-PCA (PCA and intercostal nerve blocks by direct injection of 5 ml of 0.2% bupivacaine into the intercostal spaces of two upper and two lower segments around the surgical incision) and IM groups. For the PCA, the patients that received PCA, were administered IV bolus of 0.1 mg/kg of nalbuphine followed by PCA with 0.1% nalbuphine (basal rate 0.5 ml/hr, bolus dose 1 mg and lockout interval 8 minutes). In each group, VAS score, the inspiratory capacity and the movement of the ipsilateral arm were checked postoperatively at 6, 24, 48 and 72 hours. RESULTS: Inspiratory capacity was decreased less in ICB-PCA group (P<0.05) at 6 hour, but after 24 hour, there were no differences between the groups. The analgesic effect was significantly better in ICB-PCA group as compared to the PCA or IM groups (P<0.05). Furthermore, arm motion limitation after operation was the least in ICB-PCA group (P<0.01). CONCLUSION: Intraoperative intercostal nerve blocks added in PCA has a transient improvement of pulmonary function, and also provide better analgesia and improved ipsilateral arm motion after a thoracotomy than in PCA or IM analgesia. The authors recommend adding intercostal nerve block for patients undergoing thoracotomy who receive IV-PCA.
Analgesia ; Analgesia, Patient-Controlled ; Arm ; Bupivacaine ; Humans ; Inspiratory Capacity* ; Intercostal Nerves* ; Nalbuphine ; Passive Cutaneous Anaphylaxis ; Thoracotomy*

BACKGROUND: Chronic idiopathic thrombocytopenic purpura is an autoimmune disorder caused by sequestration of antibody-sensitized platelets in the reticuloendothelial system. However, uncertainty as to the specificity, frequency and clinical significance of such antibodies still remains. So, we tried to further clarify the above uncertainty in childhood chronic idiopathic thrombocytopenic purpura. METHODS: We analyzed sera from 29 patients. Twenty six patients were chronic ITP who were admitted or followed up to the Department of Pediatrics, Severance Hospital, Yonsei University Medical College from August 1996 to March 1997 by employing a modified antigen-capture ELISA(MACE), flow cytometry and electrophoresis(SDS-PAGE) and immuno-blotting(IB) assays. Three patients with ITP less than 6 months after onset of ITP were included to know the possibility to differrentiate between acute ITP and chronic ITP in this study. RESULTS: 1) Glycoprotein(GP)-specific antibodies were found in 28% (8/29) of patients, with 2 patients having antibodies directed solely to Gp II b/III a, no patients holding antibodies specific only for GPI b/I X and 6 possessing antibodies against both anti-GP I b/I X and Gp II b/III a antigen. 2) The detection rate of GP-specific antibodies of flow cytometry was about 10%. The positivity of anti-GPI b/I X antibodies by MACE and immunoblotting was 14% (4/29), respectively, the positivity of anti-Gp II b/III a antibodies by MACE and immunoblotting was, 21 % (6/29) respectively. The concordance rate between two assays(MACE and IB) was 79% (23/29). None of the three methods was good enough to stand alone. 3) Serum antibodies were not more frequently detected in active(p=1.0) or non-splenectomized(p=.54) chronic ITP patients. 4) No association was found between antibody specificity(anti-GPI b/I X, anti-Gp II b/ III a) and platelet counts(p : .87). CONCLUSION: We conclude that in korean childhood chronic ITP, antibodies against both anti-GPI b/I X and Gp II b/III a antigen were predominant antibody. But, the longterm follow-up in more cases is needed to further clarify the clinical significance of antral-platelet antibody in chronic ITP should be assessed.
Antibodies* ; Blood Platelets* ; Flow Cytometry ; Follow-Up Studies ; Humans ; Immunoblotting ; Mononuclear Phagocyte System ; Pediatrics ; Purpura, Thrombocytopenic, Idiopathic* ; Sensitivity and Specificity ; Uncertainty

The incidence of Australia antigen (HAA, HBsAg), a known market for hepatitis B virus (HBV), is expected to e high, esp. in the subclinial type. It is well known that the incidence of HAA positivity among the patients with specific diseases and group of blood donors is relatively high in adult age group. But since there is less research for the incidence of HAA in Pediatric age group, the necessecity of investigation of its incidence is required properly. Thirteen from 306 children (4.58%) who were selected randomly among hospitalized patients from Feb., 1975 to April, 1977, were positive for HAA in their serum sample tested by the apgar gel diffusion method. The incidence of HAA was higher (6.54%) in male than in female(0.99%) patients and a trend toward increments was noted with age.
Adult ; Australia* ; Blood Donors ; Child* ; Diffusion ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Humans ; Incidence ; Male ; Prevalence*

Premature rupture of membrane generally leads to a poor perinatal outcome. For better perinatal survival, transabdominal prophylatic amnioinfusion and active expectant management was performed. We experienced a case of fetal right arm multiple skin bullae and stomach perforation after amnioinfusion. Underskin bullae was to disappear within a few days and stomach perforation site was treated by primary closure.
Arm ; Membranes ; Rupture ; Skin* ; Stomach

Paroxysmal cold hemoglobinuria(PCH), a rare type of autoimmune hemolytic process caused by a complement-binding IgG anti-P biphasic hemolysin, is associated with a positive Donath-Landsteiner(D-L) test. Historically, PCH has been associated with syphilis, but is now most often seen following viral infections especially in children. Epstein-Barr virus(EBV), a member of Herpesviridae, can cause various hematologic complications such as neutropenia, thrombocytopenia, aplastic anemia, virus associated hemophagocytic syndrome and hemolytic anemia. We report a case of PCH following EBV infection confirmed by EBV panel test and D-L test. The patient, a 4-year-old male was seen at Yonsei Medical Center in April, 1997, complained high fever, jaundice and hematuria for 2 days. Direct antiglobulin test using anti-C3d monovalent antisera was strong positive, but was negative against anti-IgG monovalent antisera. D-L test showed a characteristic biphasic hemolysin pattern. EBV panel test showed primary infection with a result of EBV EA(early antigen) IgM(+), EBV EA IgG(-), EBV NA(nuclear antigen) IgG(-). He was improved with transfusion of packed red cells and discharged on 13 th hospital day. He was completely recovered and then no relapse occurred during follow up. PCH is thought to be a rare form of autoimmune hemolytic anemia, but recent studies suggest that PCH may account for a large percentage of cases of autoimmune hemolytic anemia as acute transient form, especially in children. Therefore, in unexplained hemolytic anemia, more careful serological examination and attention will result in high detection rate of PCH and cause of PCH.
Anemia, Aplastic ; Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune ; Child ; Child, Preschool ; Coombs Test ; Epstein-Barr Virus Infections ; Fever ; Follow-Up Studies ; Hematuria ; Hemoglobinuria, Paroxysmal* ; Herpesviridae ; Herpesvirus 4, Human* ; Humans ; Immune Sera ; Immunoglobulin G ; Jaundice ; Lymphohistiocytosis, Hemophagocytic ; Male ; Neutropenia ; Recurrence ; Syphilis ; Thrombocytopenia

Parkinson's disease (PD) is a progressive neurological disorder characterized by selective loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc). Despite extensive researches, the etiology of this disease is still unknown; however, the prevalence of PD is lower in the population of cigarette smokers. In this study, the effects of nicotine were investigated on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson's disease animal model and the spontaneous locomotor activity was analyzed. In comparison with MPTP-induced PD animals, nicotine-treated PD animals exhibited significant improvement in the number of dopaminergic neurons in the SNpc, the relative density of dopaminergic axon terminals in the striatum, and locomotor activity. Also, MPTP-induced astrogliosis was prevented by nicotine treatment. These results suggest that the dopamine depletion in the SNpc and striatum and the decreased spontaneous locomotor activity were prevented by nicotine treatment in the MPTP-induced PD animal model.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; Dopamine ; Dopaminergic Neurons ; Models, Animal ; Motor Activity ; Nervous System Diseases ; Nicotine ; Parkinson Disease ; Presynaptic Terminals ; Prevalence ; Specific Gravity ; Substantia Nigra ; Tobacco Products

Water transport in highly-permeable membranes is facilitated by some specialized pathways, which are called aquaporins (AQP). AQP1 (AQP-CHIP) is the first recognized aquaporin identified from red cells and renal proximal tubules. Up until now 4 other aquaporin homologs have been reported. Each aquaporin has its unique tissue distribution and regulatory mechanisms. To elucidate molecular mechanisms for their transcription regulation and tissue-specific expression isolation of aquaporin genes is required. To clone promoters of the AQP family mouse genomic library was screened by the 1st exon-specific probe of AQP4, and 5 different plaques were positively hybridized. Phage DNAs were purified and characterized by restriction mapping and sequencing. One of them is the mouse AQP-CD gene. The gene was consisted of 4 exons and the exon-intron boundaries of mouse AQP-CD gene were identified at identical positions in other related genes. The 5'-flanking region of AQP-CD gene contains one classic TATA box, a GATA consensus sequence, an E-box and a cyclic AMP-responsive element. The cloning of the mouse AQP-CD gene, of which product is expressed in the collecting duct and is responsible for antidiuresis by vasopressin, will contribute to understand the molecular mechanisms of tissue-specific expression and regulation of AQP-CD gene under various conditions.
Animals ; Aquaporin 2 ; Aquaporins ; Bacteriophages ; Clone Cells* ; Cloning, Organism* ; Consensus Sequence ; DNA ; Exons ; Genomic Library ; Humans ; Membranes ; Mice* ; Restriction Mapping ; TATA Box ; Tissue Distribution ; Vasopressins ; Water

The characteristics of Na+/-dependent cycloleucine uptake was investigated in OK cells with regard to substrate specificity and regulation by protein kinase C (PKC). Inhibition studies with different synthetic and natural amino acids showed a broad spectrum affinity to neutral amino acids regardless of their different side chains including branched or aromatic, indicating that the Na+/-dependent cycloleucine uptake in OK cells is mediated by System B-o or System B degree -like transporter rather than the classical System A or ASC. Phorbol 12-myristate 13-acetate (PMA) and phorbol 12,13-dibutyrate, but not 4 alpha-PMA elicited a time-dependent biphasic stimulation of Na+/-dependent cycloleucine uptake, which produced early transient peak at 30 min and late sustained peak at 180 min. Both the early and late stimulations by PMA were due to an increase in Vmax and not due to a change in Km. PKC inhibitors blocked both the early and late stimulation by PMA, while protein synthesis inhibitors blocked the late stimulation only. These results suggest the existence and regulation by PKC of System B degree or System B degree -like broad spectrum transport system for neutral amino acids in OK cells.
Amino Acid Transport Systems* ; Amino Acids ; Amino Acids, Neutral ; Cycloleucine ; Kidney* ; Opossums* ; Phorbol 12,13-Dibutyrate ; Protein Kinase C ; Protein Synthesis Inhibitors ; Substrate Specificity