To evaluate the effect of a new topical anesthetic cream (EMLA : Eutectic mixture of local anesthetics) on reducing pain associated with DPT vaccination, we conducted a clinical observation on eighty infants who were brought to well baby clinic of Yeungnam University Hospital for DPT vaccination. 80 Infants, who were between 2 months and 8 months in age, were divided into two groups. EMLA treated group and control group. Male to femle sex ratio was 1.4 to 1. EMLA cream was applied 60 minutes before DPT vaccination, the effect of reducing pain was assessed by using McGrath's face scale, Oucher pain scale and modified behavioral pain scale (MBPS) and also evaluated by measuring the duration and time of crying (the time of the first crying after iniection, duration of the first crying, total duration of crying). The scores of those scales were lower in EMLA treated group than in control group significantly (P<0.01 in McGrath's face scale. MBPS and p<0.05 in Oucher pain scale). There was no difference in the time of the first crying after vaccination in both groups. The duration of the first crying was shorter in EMLA treated group than control group of crying was also shorter in EMLA treated group (EMLA treated group 9.0±12.5 sec, p<0.05). Transient skin erythema was noted in 5 infants after EMLA application, but no other adverse effects were observed. We conclude that the application of EMLA cream before vaccination seems to be an effective and safe way to reduce the pain from vaccination, but it takes usually 60 minutes to get the anesthetic effect of EMLA and it is expensive, so EMLA cream can not be recommended in routine vaccination in infants now.
Anesthetics ; Crying ; Erythema ; Humans ; Infant ; Male ; Sex Ratio ; Skin ; Vaccination* ; Weights and Measures

Rheumatoid arthritis is considered to be a collagen disease which mainly involves articular structures, sometimes has extraarticular manifestations. It is generally accepted now that periarticular osteoporosis develops in early phase of rheumatoid arthritis and generalized osteoporosis in late period. Of several methods of non-invasive measurement of bone mass, single photon absorptiometry was introduced by Cameron and Sorenson(1963) and it has been used for measuring bone mass by many authors with its precision, reproducibility and objective quantification. We tried to observe the quantitative changes of bone mass in rheumatoid arthritis patients with single photon absorptiometry technique. Through the study of bone densitometry in 30 rheumatoid arthritic women compared with age-matched 60 healthy controls, we obtained follow results. 1. Bone mineral density of the rheumatoid arthritis group was lower than that of the control group, but had no significant statistical difference. 2. Bone mineral density of the 40–49-year-old group and 50–59-year-old group was considerablely different in the rheumatoid arthritis group and control group. 3. Bone mineral density of the group whose rheumatoid arthritis history was over 2 year was lower than that of the group below 2 year.
Absorptiometry, Photon ; Arthritis, Rheumatoid ; Bone Density ; Collagen Diseases ; Densitometry ; Female ; Humans ; Osteoporosis

No abstract available.
Child* ; Diabetes Mellitus* ; Humans ; Insulin*

Primary tumors of the heart are rare. Half of all cardiac tumors are myxoma of which 20% are located in the right atrium. Especially multiple myxomas in the cardiac chamber were rarely reported. Clinically, myxomas present with various manifestations due to obstruction to blood flow, embolization,and constitutional changes. The association of pulmonary emboli and right atrial myxoma has been well documented but pulmonary emboli are more likely to be asymptomatic, misdiagnosed, or diagnosed late than peripherally-sited emboli. We report a case of multiple right atrial myxomas complicating pulmonary emboli in a 73-year-old man who had features of pulmonary embolism and was found to have multiple right atrial myxomas.
Aged ; Heart ; Heart Atria ; Heart Neoplasms ; Humans ; Myxoma* ; Pulmonary Embolism*

A rare case of giant invasive intraosseous schwannoma in lumbar vertebra with no neurologic deficit is reported. This tumor had vertebral body, left paravertebral tissue and lamina invasion and thus classified as type V giant invasive schwannoma according to Sridhar's classification of benign nerve sheath tumor. Because intraosseous portion was significantly larger than extraosseous portion, this tumor was mentioned as intraosseous schwannoma. Tumor was successfully resected using corpectomy, mesh cage insertion and posterior fixation. Pathological diagnosis was benign schwannoma.
Neurilemmoma ; Neurologic Manifestations ; Spine

OBJECTIVES: Manganese is cytotoxic to the central nervous system including basal ganglia. Its toxic mechanism is related to oxidative stress, mediated by toxic free radicals but is specultives. In the present study, we have investigated to manifest apoptosis in manganese-induced cytotoxicity in primary neuronal cell culture of rat basal ganglia. METHOD: To detect apoptotic neuronal cells were stained by the terminal deoxynu-cleotide(TdT)-mediated dUTP nick end-labelling(TUNEL) method and apoptotic changes in nuclei of neurons were observed by electron microscopy. RESULTS: We showed that TUNEL immunostain showed brownish signal in the nuclei of apoptotic cells and the proportions of apoptotic cells in Manganese treatment groups were more higher than controls. On transmission electron microscopy, there were chromatine condensation with margination toward nuclear membrane and condensation of cytoplasm in the treated with luM MnC1, for 48 hours in a basal ganglia neurons. Apoptotic bodies were found and consisted of semilunar-like condensed nuclei with relatively intact cytoplasmic organelles. CONCLUSIONS: Apoptosis appears to be one mechanism in the manganese-induced neuronal cell death. Manganese intoxication is a convenient model for apoptosis study.
Animals ; Apoptosis* ; Basal Ganglia* ; Cell Culture Techniques* ; Cell Death ; Central Nervous System ; Chromatin ; Cytoplasm ; Free Radicals ; In Situ Nick-End Labeling ; Manganese* ; Microscopy, Electron ; Microscopy, Electron, Transmission ; Neurons* ; Nuclear Envelope ; Organelles ; Oxidative Stress ; Rats

O1igodendrocytes are known to be responsible for the synthesis and maintenance of myelin sheath in the central nervous system, and their functional disturbance leads to defect in myelination. But, the fine mechanism of myelination by oligodendrocytes is not yet known, and iron metabolism in central nervous system is suspected to be related with myelination process by oligodendrocytes. Carbonic anhydrase-II[CA-II], transfe-rrin, and ferritin are known to be present at oligodendrocytes and suspected to play a role in iron metabolism of central nervous system. In this study, demyelination and remyelination of ICR mouse brains were induced using cuprizone, the copper-chelating agent, and immunohistochemical changes of CA-II-, transferrin-, and ferritin-immunoreactive oligodendrocytes at corpus callosum were observed. During demyelination by cuprizone feeding, the numbers of CA-II- and transferrin-immunoreactive oligodendrocytes were decreased. Especially, the decrease ratio of CA-II-positive cells was great. In contrast, the number of ferritin-positive oligodendrocytes was increased during demyelination by cuprizone feeding. Cessation of cuprizone feeding leaded remyelination and the numbers of CA-II-, transferrin-, and ferritin-immunoreactive oligodendrocytes were returned to normal level. In conclusion, the derangement of iron metabolism in oligodendrocytes may be related to demyelination mechanism of central nervous system, and the CA-II is suspected to have an important role in iron metabolism of oligodenrocytes in relation to demyelination and remyelination induced with cuprizone.
Animals ; Brain ; Carbon* ; Central Nervous System ; Corpus Callosum ; Cuprizone* ; Demyelinating Diseases ; Ferritins ; Iron ; Iron-Binding Proteins* ; Metabolism ; Mice* ; Mice, Inbred ICR ; Myelin Sheath ; Oligodendroglia ; Transferrin

The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.
Adenoidectomy ; Adenoids ; Child ; Continuous Positive Airway Pressure ; Enuresis ; Failure to Thrive ; Follow-Up Studies ; Humans ; Hypertension ; Hypertrophy ; Palatine Tonsil ; Pulmonary Heart Disease ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy

BACKGROUND: We assessed the effectiveness of arthroscopic capsular release for the treatment of adhesive capsulitis. Further, we tried to ascertain the clinical benefits, if any, of pancapsular release over selective capsular release, where the two differ by performing or not performing a posterior capsular release, respectively. METHODS: Thirty-five consecutive patients with either primary or secondary adhesive capsulitis who failed conservative treatment for more than 6 months were enrolled in the study. A total of 16 patients allocated in group 1 received a pancapsular release that comprises the release of the rotator interval, anteroinferior capsular, and the posterior capsular release, whereas 19 patients in group 2 received a selective capsular release that comprises only the release of the rotator interval release and anteroinferior capsular release. The clinical outcomes, visual analogue scale (VAS) score, Constant score, and range of motion, were assessed preoperative and postoperatively. RESULTS: In both groups, the preoperative VAS score, Constant score, and ROM showed a significant improvement by the 6-month follow-up. We found that the immediate postoperative internal rotation was significantly higher in group 1 than group 2. Despite significant differences seen between the two groups at the initial postoperative period, there were no significant differences in Constant score, VAS score, and the ROM at all the subsequent follow-ups between the two groups. CONCLUSIONS: Arthroscopic capsular release for the treatment of adhesive capsulitis is very effective. However, pancapsular release did not show any advantage over selective capsular release in terms of overall clinical outcome.
Bursitis* ; Follow-Up Studies ; Humans ; Joint Capsule Release* ; Postoperative Period ; Range of Motion, Articular

No abstract available.
Child* ; Humans ; Purpura, Thrombocytopenic, Idiopathic*