BACKGROUND: It was recognized that the intake of the whole cow's milk(WCM) early (before 1 year old of age) and large amount in early childhood is related to the iron deficiency, sometimes the iron deficiency anemia in advanced state. To verify the relationship between the variables in the WCM intake and the iron status, we carried out this study. METHODS: Thirty subjects(1 year to 3 years old of age) were classified as a WCM large intake group and a WCM small intake group. The relationship between the WCM commencing age and the iron status(serum ferritin, transferrin saturation and hemoglobin) in the WCM large intake group was evaluated and analyzed by the linear regression. Futhermore, the relationship between the value of WCM intake amountxduration/10 and the iron status(serum ferritin, transferrin saturation and hemoglobin) in the WCM large and small intake groups was evaluated and analyzed by the linear regression. RESULTS: As the WCM commencing age was earlier, the values of serum ferritin, transferrin saturation and hemoglobin decreased significantly(P<0.05). The values of serum ferritin and transferrin saturation decreased significantly as the value of WCM intake amountxduration/10 increased(P<0.05). But the value of hemoglobin decreased insignificantly as the value of WCM intake amountxduration/10 increased(P>0.1). CONCLUSION: The variables in the intake of WCM influence upon the iron status in early childhood. The early commencing of the WCM(before 1 year old of age) is the worst variable that influences adversely upon the iron status in early childhood. The amount of WCM intake and the duration influence upon the storage iron(serum ferritin and transferrin saturation), but not hemoglobin. In this regard, it is necessary to inform the parents of the correct WCM intake ways to avoid the irreversible recognition impairment and behavioral change.
Anemia, Iron-Deficiency ; Child, Preschool ; Ferritins ; Humans ; Iron* ; Linear Models ; Milk* ; Parents ; Transferrin

No abstract available.
Radiosurgery* ; Trigeminal Neuralgia*

No abstract available.
Larynx* ; Pharmacology ; Succinylcholine* ; Vecuronium Bromide*

Hepatie hilar ductal carcinoma is relatively rare, but the prognosis is known to be poor because an early diagnosis is difficult. Because the majority of patients are already infiltrated into adjacent organ by itself at the diagnosis, the rate of resectability is low. The best method of treatment is curative resection, and the range of tumor invasion is very important. The preoperative diagnosis is difficult because the cholangiography may be normal in cases of superficial invasion. Multifocal lesions within the biliary tract may be identified in as many as 10 percent of patients, Especially, the papillary type has the best prognosis and is associated with multiple tumors within the bile duct. We report a case that percutaneous transhepatic cholangiogram showed normal distal common bile duct, but the hepatic hilar confluence and ampulla of Vater lesion was confirmed as adenocarcinoma.
Adenocarcinoma ; Ampulla of Vater* ; Bile Ducts ; Biliary Tract* ; Carcinoma, Ductal ; Cholangiocarcinoma* ; Cholangiography ; Common Bile Duct ; Diagnosis ; Early Diagnosis ; Humans ; Pancreas* ; Prognosis

BACKGROUND: Propofol(2,6 diisopropylphenol) is a potent hypnotic currently formulated as an oil-in-water emulsion. Although previous studies reported decreases in arterial pressures and heart rate, no detailed studies of hemodynamic effects of propofol administration alone are available in Korea. This study is to determine the hemodynamic changes induced by doses of propofol. METHODS: Sixty patients(ASA physical status 1 or 2) were divided randomly into three groups as follows: group I, pmpofol 1.5 mg/kg; group 2, propofol 2.0 mg/kg; group 3, propofol 2.5 mg/kg. Heart rate and mean arterial pressure were measured by Datascope 2200I, and cardiac index(CI) and systemic vascular resistance index(SVRI) were obtained by doppler cardiac output monitor(Datascope Accucom 2) at the suprasternal notch before and after induction of propofol. RESULTS: Statistically significant decreases in mean arterial pressure were observed since 2 min after induction. CI was decreased from 2.94+/-0.51 to 2.35+/-0.57 L/min/m(2) at 6 min after induction of propofol 2.5 mg/kg, and no differences among groups. CI was also decreased in group 1 and 2 but without any significance. SVRI was decreased in all groups but there were no significance, and no differences among groups. CONCLUSIONS: The data suggest that the usual doses of propofol do not significantly cause hemodynamic changes, and a decrease in mean arterial pressure is a result of decreased CI and reduced SVRI.
Anesthetics ; Arterial Pressure ; Cardiac Output ; Heart Rate ; Hemodynamics* ; Korea ; Propofol* ; Vascular Resistance

The success of accelerating the onset of neuromvacular blocking drugs by giving them in divided doses encouraged others to attempt the same "priming principle" using reversal agents. Naguib et al and Abdulatif et al demonstrated that the reversal time(time to reach a TOF of 0.75) was reduced when the reversal agent was administered in divided doses at T, 10% of control. But Donati et al and Szalados et al either could not detect any differences in the rate of reversal when anticholinestereses were administered in divided doses. This study hes been conducted to evaluate the reversal effects of neostigmine or pyridostigmine with priming principle in the rabbit after pancuronium injection when pro- found relaxation(PTC=0) was confirmed. Rabbits(n=60) were randomly allocated to 4 groups. After pancuranium 0.2mg/kg IV, the onset and recovery times were evalusted. When the profound relaxation(PTC=0) was confirmed at Smin. after pancuronium injection, neostigmine 50 ug/kg and atropine sulfate (atropine) 20 ug/kg were injected in group 1. At thst time, neostigmine 10/kg and atropine 4 ug/kg were injected and after 3min. neostigmine 40/kg and atropine 16 ug/kg were injected in group 2. At that time, pyridostigmine 250 ug/kg and atropine 20 ug/kg were injected in group 3. At that time, pyridostigmine 50 ug/kg and atropine 4 ug/kg were injected and after 3min. pyridostigmine 200 ug/kg and atropine 16 ug/kg were injected in group 4. The results were as follows :. 1) The time until 75% recovery of twitch amplitude was 53.1+/-12.4min. in group 1, 44.9+/-212.1min. in group 2, 54.9+/-9.7min. in group 3 and 48.2+/-7.1min. in group 4. The reversal times were tended to reduce when the reversal agents were administered with "priming principle" at the profound relaxation. 2) At the profound relaxation the reversal effects of neostigmine were greater than that of pyridostigmine.
Atropine ; Cholinesterase Inhibitors* ; Muscle Relaxation* ; Neostigmine ; Pancuronium ; Pyridostigmine Bromide ; Relaxation

BACKGROUND: According to the report that KCNK activity in transfected COS-7 and HEK-293 cells was modulated by volatile anesthetics and activation of KCNK channels by neuroprotectants, the importance of KCNK2 were emphasized. In this study, we studied the effect of halothane and isoflurane on KCNK2 in the KCNK2 transfected HEK-293 cells. METHODS: Multiple patch clamp experiments with halothane and isoflurane were conducted to characterize KCNK2 in the KCNK2 transfected HEK-293 cells. KCNK2 cDNA were transiently transfected with FuGENE6 transfection reagents and whole cell recordings were made using predesigned pulse protocol. RESULTS: KCNK2 transfected HEK cells exhibited rapid rising, a time-independent, non-inactivating, outward-rectifying currents and had no threshold for activation by voltage. Multiple patch clamp experiments showed the presence of outward-rectifying K+ selective channels with a conductance of 1.31 +/- 0.59 nS (n = 16) at positive potentials. Recordings of halothane 448microM (-2 MAC) increased outward currents from control by 218% in standard saline perfusate (n = 4, P<0.05, paired t-test) and that of isoflurane 822microM (-3 MAC) increased outward currents by 172% in standard saline perfusate (n = 12, P<0.05, paired t-test). Channel activity enhanced during the duration of the exposure to volatile anesthetics returned to the baseline quickly upon wash. CONCLUSIONS: Considering the activation of KCNK2 by neuroprotectants such as riluzole and PUFA, we might think of the possibility of halothane and isoflurane as neuroprotectants because these anesthetics activated background K+ channels in KCNK2 transfected HEK-293 cells.
Anesthetics ; DNA, Complementary ; Halothane* ; Indicators and Reagents ; Isoflurane* ; Neuroprotective Agents ; Riluzole ; Transfection

Gangliogliomas are rare benign tumors of the central nervous system consisting of neoplastic ganglion and low grade glial cells. The purpose of our investigation was to evaluate the clinical, radiological, surgical, and pathological features and outcome of ten patients with intracranial ganglioglioma who underwent surgery between June 1989 and December 1996. The mean follow-up period was about 24 months(range, 6-66 months) after their initial operation. The series consisted of six males and four females, and their mean age was 29.7 years. The mean length of symptoms was 9.1 years. Seizure was the most common presenting symptom and occurred in eight of ten patients. MRI findings were variable, and showed no characteristic patterns. The temporal lobe was the most common site of involvement(6/10). During surgery, a sharp demarcation between tumor and normal brain tissue was seen in seven of ten cases. Five of ten cases were solid, and the remaining cases were cystic in two, cystic with mural nodule in two, and soft, suckable in one. Total resection was possible in seven of ten patients. Diagnosis was established by identifying a mixture of abnormal astrocytic and neuronal components. Two patients showed astrocytic predominance; four, a neuronal predominance; and four, an equal admixture of cell types. All cases were benign. Other histopathological findings included microcystic change, desmoplasia, eosinophilic granular body, microcalcification, and lymphocytic infiltration. At the time of writing, all seven patients who underwent total resection were alive without recurrence; of the three who underwent subtotal resection, two were alive and in a stable condition, while in the other, the tumor had progressed within 12 months of surgery and adjuvant radiation therapy had thus been required. The patients was, though, still alive. In seven of eight patients, the frequency of seizure had markedly decreased. Our study confirms that this tumor is a distinct clinical and histological entity with a predilection for the temporal lobe. Although the number of patients and follow-up period are limited, this study also shows that epilepsy is extremely well controlled and that survival after surgical resection is good.
Brain ; Central Nervous System ; Diagnosis ; Eosinophils ; Epilepsy ; Female ; Follow-Up Studies ; Ganglioglioma* ; Ganglion Cysts ; Humans ; Magnetic Resonance Imaging ; Male ; Neuroglia ; Neurons ; Recurrence ; Seizures ; Temporal Lobe ; Writing

OBJECTIVE: Hypermethylation of p16, a tumor suppressor gene, has been frequently detected in a variety of cancer cells and is known to represent the level of p16 transcription. In human meningiomas, genetic alterations of p16 have shown to be infrequent. The purpose of this study is to investigate the role of p16 associated with the progression of meningiomas. METHODS: Sixty-eight meningiomas(randomly sampled 29 benign, 16 atypical and 23 malignant formalin-fixed, paraffin-embedded tissues) were analyzed. We examined the molecular mechanism of inactivation of p16 in these benign, atypical and malignant meningiomas by detecting the methylation status of p16 using methylation-specific polymerase chain reaction. RESULTS: One out of 29(3.4%) revealed hypermethylation of p16 in benign meningiomas. Atypical and malignant meningiomas showed hypermethylation of p16 in 2 out of 16 cases(12.5%) and in 5 out of 23 cases(21.7%), respectively. Immunohistochemical analysis of methylation-positive tumors demonstrated that tumor cells had reduced immunoreactivity compared to normal lymphocytes. CONCLUSIONS: Our results suggest that inactivation of p16 gene plays a role in the pathogenesis of meningioma and hypermethylation is one of the processes for gene inactivation.
CpG Islands* ; Gene Silencing ; Genes, p16 ; Genes, Tumor Suppressor ; Humans ; Lymphocytes ; Meningioma* ; Methylation* ; Polymerase Chain Reaction

OBJECTIVE: This study was undertaken to review the mortality, complications, risk factors and the surgical outcome in long-term follow-up cases of brain abscess. METHODS: The authors studied medical records and radiological findings in patients with brain abscess who underwent operations in our hospital from 1990 to 1997. RESULTS: There were 44 cases and the ratio of male to female was 32:12 which shows predominance in male. The ages of patients ranged from 2 to 73(average: 40). Lesions were located at frontal lobe in 16 cases, temporal in 8, parietal in 7, occipital in 5, cerebellum in 6, and multiple in 2. The ranges of follow-up periods were from 1 month to 96 months(average: 20.5 months). The primary origins of infection were found in only 15 cases(34%) and in 32 cases(73%), the organisms were identified from culture. The operative modalities were as follows; abscess aspiration (stereotactic or sono-guided) in 42 times and abscess excision in 13 times. There were 2 operations in 7 cases and 3 in 2 cases. In 2 cases, recurrences were occurred during antibiotics therapy after first operation. Three patients(6.8%) died due to sepsis in 2 cases, increased intracranial pressure in 1 case. We analysed 19 cases who were followed-up more than 12 months. In this group, there were intermittent seizures in 2 cases, antibiotics(metronidazole) induced polyneuropathy in 1 case, and avascular necrosis of hip in 2 cases which were suspected to have relation to long-term high dose steroid therapy. But there were no other sequalae or neurological deficits. CONCLUSION: The complication rate from long-term follow-up was high(26%) but the mortality rate was low(6.8%). Additionally, the findings such as multiple lesions, empyema, and fungal infection are suspected to be risk factors in mortality cases.
Abscess ; Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Cerebellum ; Empyema ; Female ; Follow-Up Studies ; Frontal Lobe ; Hip ; Humans ; Intracranial Pressure ; Male ; Medical Records ; Mortality ; Necrosis ; Polyneuropathies ; Rabeprazole ; Recurrence ; Risk Factors ; Seizures ; Sepsis