OBJECTIVE: Immune hemolytic jaundice is caused by the destruction of antibody-sensitized erythrocytes and is associated with antibody-dependent cellular cytotoxic effects mediated by Fc receptor-bearing cells of the reticuloendothelial system. Intravenous immune globulin(IVIG) may have exerted its effect through Fc receptor blockade. We studied the effect of high-dose intravenous immune globulin(HDIVIG) in neonatal hemolytic jaundice unresponsive to phototherapy. METHODS: We selected only those with Coombs test(+) immune hemolytic jaundice who had admittcd at the NICU of the Dcpartment of Pediatzics of Dongsan Medical Center, Keimyung University between January 1995 and December 1998. They were unresponsive to phototherapy. Ten newborn infants(9 ABO incomplatibilities, l minor group incompatabillity due to anti-E) received HDIVIG therapy combined with phototherapy. IVIG was given as a dose of lg/kg for 6 hours, and serial hemoglobin, reticulocyte count, and bilirubin levels were evaluated. If the serum bilirubin level went up and reached the level above 22mg/dl, we conducted exchange transfusion for the patient. RESULTS: HDIVIG induced a significant decrease of serum billirubin levels in 8(80%, group I, HDIVIG responsive poup) of 10 cases and only 2 cases(group II, HDIVIG unreponsive group) required exchange tnnsfusions. No side effect was observed after HDIVIG therapy. CONCLUSION: We suggest HDIVIG may be effective in the treatment of phototherapy-resistant hyperbilirubinemia due to blood group incompatibility. More studies are needed to confirm the optimal dosage and therapeutic indication of HDIVIG in the therapy of neonatal immune hemolytic jaundice.
Bilirubin ; Blood Group Incompatibility ; Erythrocytes ; Humans ; Hyperbilirubinemia ; Immunoglobulins, Intravenous ; Infant, Newborn ; Jaundice* ; Mononuclear Phagocyte System ; Phototherapy* ; Receptors, Fc ; Reticulocyte Count

No abstract available.
Neck*

Acne vulgaris is a chronic dermatologic problem with multiple factors involved in its pathogenesis. Alternative solutions to acne treatment were instigated by antibiotic resistance despite of its extensive use. Purified bee venom (PBV) has been proposed as a promising candidate for that purpose. The present study was designed to confirm the antibacterial effect of PBV and access the efficacy of cosmetics containing PBV in subjects with acne vulgaris.

A Clinical observation was made of 20 cases of testicular tumor admitted to the Department of Urology, Kei-myung University Medical College and Hospital during the period from May 1971 through July 1982. Among the 20 cases, 4 cases were transferred to this department for further treatment and tumor recurrence following orchiectomy. The results of clinical observation are summarized as below: 1. Age distribution was between 9 months and 57 years old, showing the highest incidence below 10 years old (65%). 2. There were 7 cases of teratoma, 5 cases of seminoma, 5 cases of embryonal carcinoma, 1 case of teratocarcinoma and 2 cases of metastatic neoplasm. 3. Stages of primary germ cell tumors; stage A 6 cases, stage B 2 cases and stage C 3 cases. 4. These patients were managed by surgery, radiation therapy and chemotherapy according to the histologic findings and clinical stages.
Age Distribution ; Carcinoma, Embryonal ; Child ; Drug Therapy ; Humans ; Incidence ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; Orchiectomy ; Recurrence ; Seminoma ; Teratocarcinoma ; Teratoma ; Urology

BACKGROUND: Epidural adhesion can cause pain from compression and irritation of nerves. But a simple injection into the lumbar epidural space usually goes into the area of least resistance and cannot deliver the medication to the target area. Thus, the adhesiolysis of the affected area is sometimes mandatory. We performed an adhesiolysis, irrigating with normal saline, and targeted an injection of a local anesthetic and steroid mixture to the epidural space, using a flexible catheter-secured epiduroscopic unit in 15 patients with low back pain, and assessed the pain score changes. METHODS: With the patient in the prone position, the epidural space was entered with a 17-gauge Tuohy needle. A guide-wire was inserted through the needle and advanced under fluoroscopic guidance to the level of the suspected pathology. A catheter was then advanced over the guide-wire. After the removal of the guide-wire, an adapter was then attached to the proximal end of the catheter, and its side arm was connected to a syringe containing normal saline flush. The 0.9 mm diameter fiberoptic scope was introduced into the catheter via the adaptor, and a video camera was then attached. Gentle irrigation of normal saline less than 50 ml distended the epidural space. The catheter and fiberoptic scope were advanced to the adhesion area and adhesiolysis was done by moving the tip of the steering catheter. Assuming that original NRS (Numeric Rating Scale) before the procedure was 10, we asked the NRS at 1, 4, 8, 12, 16 weeks after the epiduroscope. RESULTS: NRS at 1, 4, 8, 12, 16 weeks after the epiduroscope showed significant decrease of both low back pain and radiating pain, compared with the original pain (P<0.05). CONCLUSIONS: The flexible catheter-secured epiduroscopic unit proved to be painless, safe, and more simple, than an operation, it is, thus, a practical method for pain relief using adhesiolysis and irrigation of epidural space under the direct visualization of the epidural space in patients with low back and lower extremity pain.
Arm ; Catheters ; Epidural Space ; Humans ; Low Back Pain ; Lower Extremity* ; Needles ; Pathology ; Prone Position ; Syringes

We prepared two monoclonal antibodies-A-I30 and A-I4 to HDL apo A-I-with the ultimate goals of expressing and overproducing the valuable immunodiagnostic single chain Fv by phage display libraries in E, coli. Monoclonal antibodies were produced by immunizing mice with apolipoprotein A-I, and purified from ascitic fluid by affinity chromatography on a Protein A Sepharose CL-4B column. The specificity of A-I30 and A-I4 was confirmed by ELISA and Western blotting. The dissociation constants(Kd) of antigen-antibody complex obtained by enzyme linked immunosorbent assay(ELISA) method were 2.25 x 10(-8) M for A-I30 and 2.15 x 10(-8) M for A-I4. The experimental values of Kd are shown to be close to those obtained by immunoprecipitation of the radiolabeled antigen. From the above results, it was shown that A-I30 and A-I4 could be provided as excellent reagents for the determination of plasma HDL concentrations in clinical specimens using ELISA.
Animal ; Antibodies, Monoclonal/*immunology/isolation & purification ; Antibody Affinity ; Apolipoprotein A-I/*immunology ; Blotting, Western ; Hybridomas ; Lipoproteins, HDL/immunology ; Mice ; Mice, Inbred BALB C ; Tumor Cells, Cultured

BACKGROUND: Catheterization of central vein may cause fetal complications such as cardiac arrhythmia, cardiac temponade, atrial perforation etc. For prevention of these complications, tip of central venous catheter should located in superior vena cava. The purpose of this study was to investigate the optimal positioning of central venous catheters. METHOD: From March 1996 to Jun 1996, a total of 50 patients who requiring central venous catheters were involved. First, we evaluate the accuracy of predetermined formula of 'Peres'. Second, we hypothesized that height of patients was correlated with optimal length of central venous catheters and we analysed relationship between height and optimal length of central venous catheters using simple regression analysis by SAS. RESULTS: 1) Predetermined formula of 'Peres' inaccurately predicted required length of central venous catheter. The accuracy was 78%. 2) There were a linear relationships between height and optimal length of central venous catheter. Their relationships was followed, Y=0.09X(Y: optimal length of central venous catheters, X: height, p=0.0001, R2=0.39). CONCLUSION: Using height of patients, we can accurately predict the optimal length of central venous catheters.
Arrhythmias, Cardiac ; Catheterization ; Catheters ; Central Venous Catheters* ; Humans ; Veins ; Vena Cava, Superior

PURPOSE:Autonomic neuropathy in adult diabetics is known to be common and poor in prognosis. Cardiac autonomic neuropathy increases sudden cardiac death and is present before apparant cardiac symptoms. Subclinical diabetic peripheral neuropathy is common with type 1 diabetes. In children, few studies for subclinical peripheral neuropathy and cardiac autonomic neuropathy were reported but the results were inconsistent. The authors investigated subclinical cardiac and peripheral neuropaties and evaluated correlation between nerve conduction velocity(NCV) and cardiac autonomic function(CAF) test in type 1 diabetic children and adolescents METHODS:Over 5 years from 1997 to 2002, 27 IDDM without clinical neuropathy were registered. Total 57 CAF and NCV were tested every 2 or 3 years. Duration of diabetes, average HbA1c during 1 year prior to the test, and urinary microalbumin excretion for 24 hours were assessed. Diabetic autonomic nervous function was evaluated by cardiovascular reflex test:falling systolic blood pressure in response to standing, heart rate changes in response to standing, beat-to-beat rate variation during deep breathing, RR interval change during and after Valsalva maneuver. Subclinical peripheral neuropathy was evaluated by NCV in both upper and lower extremities. Correlation of parameters according to NCV abnormality and microalbuminuria were analyzed. RESULTS:The age, duration of diabetes and microalbuminuria were not statistically different between children with normal and abnormal NCV. The level of HbA1c was associated with NCV abnormality. In a multivariate logistic model for NCV abnormality, level of HbA1c showed statistical significance after controlling the effects of age, duration of diabetes, and urinary microalbumin level, and the odd ratio was 1.532. The degree of CAF abnormality was marginally significant in the logistic model. Children with microalbuminuria showed older age and longer duration of diabetes than those without microalbuminuria. However, mean HbA1c level was not significantly different between the two groups. Degree of CAF abnormality was not significantly associated with microalbuminuria, either. In a general linear model including urinary albumin level as the dependent variable, none of independent variables was statistically significant. CONCLUSION: Therapy against neuropathy should be considered in patients with high HbA1c and abnormal CAF test even without clinically apparent neuropathy.
Adolescent ; Adult ; Blood Pressure ; Child* ; Death, Sudden, Cardiac ; Diabetes Mellitus, Type 1 ; Diabetic Neuropathies ; Heart Rate ; Humans ; Linear Models ; Logistic Models ; Lower Extremity ; Neural Conduction ; Peripheral Nervous System Diseases ; Prognosis ; Reflex ; Respiration ; Valsalva Maneuver

PURPOSE: To evaluate the usefulness and safety of unified technique of vascular control before renal exposure in reconstructive surgery of renal trauma. MATERIALS AND METHODS: From July 1995 to June 1997, 10 patients with major renal trauma who operated by unified approach technique were included in this study. Blunt trauma was the mechanism of injury in 8 patients and 2 were resulted from penetrating(stab) injury. Of the injuries 2 were grade 3, 7 grade 4, 1 grade 5. RESULTS: Of the 10 patients, 8(80%) were performed kidney preserving surgery and 2(20%) resulted in nephrectomy. Partial nephrectomy was underwent in 6 patients(with vascular repair in 2 cases) and renorrhaphy in 2 patients. Pedicle flap of omentum was used mainly and polyglycolic acid mesh also used in 2 cases as coverage material of parenchymal defect. Complications occurred in 2 cases(20%) but none resulted in renal loss with the mean followup of 10 months(1 to 15 months). CONCLUSIONS: Unified approach technique of vascular control before renal exposure seems to be a safe and effective method for reconstructive surgery in renal trauma. To confirm this result, studies with more cases and longer followup are needed.
Follow-Up Studies ; Humans ; Kidney* ; Nephrectomy ; Omentum ; Polyglycolic Acid

No abstract available.
Carcinoma, Small Cell* ; Female ; Ovary*