Benign convulsion with mild gastroenteritis (CwG) is a type of afebrile seizure that occurs in children. CwG is defined as a convulsion in a previously healthy child with no known central nervous system infection or encephalopathy, accompanying mild diarrhea without fever, electrolyte imbalance, or moderate to severe dehydration. Convulsions in CwG are characterized by multiple brief episodes of generalized or focal seizures. Although the etiology and pathophysiology have yet to be fully explained, many pathogenic mechanisms have been proposed including the possibility of direct invasion of the central nervous system by a gastrointestinal virus such as rotavirus or the possibility of indirect influence by the production and effects of certain mediators. The electroencephalogram findings are benign and long-term antiepileptic treatment is typically not required. Long-term prognosis has been favorable with normal psychomotor development. This review provides a general overview of CwG with the goal of allowing physicians practicing in the field of pediatrics to better recognize this unique entity and, ultimately, to minimize unnecessary evaluation and treatment.
Central Nervous System ; Central Nervous System Infections ; Child ; Dehydration ; Diarrhea ; Electroencephalography ; Fever ; Gastroenteritis* ; Humans ; Norovirus ; Pediatrics ; Prognosis ; Rotavirus ; Seizures*

To investigate the possible involvement of outward potassium (K+) currents in nitric oxide-induced relaxation in intestinal smooth muscle, we used whole-cell patch clamp technique in freshly dispersed guinea-pig ileum longitudinal smooth muscle cells. When cells were held at -60 mV and depolarized from - 40 mV to + 50 mV in 10 mV increments, sustained outward K+ currents were evoked. The outward K+ currents were markedly increased by the addition of 10 muM sodium nitroprusside (SNP). 10 muM S-nitroso-N-acetylpenicillamine (SNAP) and 1 mM 8-Bromo-cyclic GMP (8-Br-cGMP) also showed a similar effect to that of SNP. 1 mM tetraethylammonium (TEA) significantly reduced depolarization-activated outward K+ currents. SNP-enhanced outward K+ currents were blocked by the application of TEA. High EGTA containing pipette solution (10 mM) reduced the control currents and also inhibited the SNP-enhanced outward K+ currents. 5 mM 4-aminopyridine (4-AP) significantly reduced the control currents but showed no effect on SNP-enhanced outward K+ currents. 0.3 muM apamin and 10 muM glibenclamide showed no effect on SNP-enhanced outward K+ currents. 1 muM 1H-(1,2,4)oxadiazolo (4,3-a)quinoxaline-1-one (ODQ), a specific inhibitor of soluble guanylate cyclase, significantly blocked SNP-enhanced K+ currents. We conclude that NO donors activate the Ca2+-activated K+ channels in guinea-pig ileal smooth muscle via activation of guanylate cyclase.
4-Aminopyridine ; Apamin ; Egtazic Acid ; Glyburide ; Guanylate Cyclase ; Humans ; Ileum* ; Muscle, Smooth* ; Myocytes, Smooth Muscle* ; Nitric Oxide* ; Nitroprusside ; Potassium Channels, Calcium-Activated ; Potassium* ; Relaxation ; S-Nitroso-N-Acetylpenicillamine ; Tea ; Tetraethylammonium ; Tissue Donors

Experiments were designed to characterize the cellular mechanisms of action of endothelium-derived vasodilator substances in the rabbit femoral artery. Acetylcholine (ACh, 10(-8)-10(-5) M) induced a concentration-dependent relaxation of isolated endothelium-intact arterial rings precontracted with norepinephrine (NE, 10(-6) M). The ACh-induced response was abolished by the removal of endothelium. NG-nitro-L-arginine (L-NAME, 10(-4) M), an inhibitor of NO synthase, partially inhibited ACh-induced endothelium-dependent relaxation, whereas indomethacin (10(-5) M) showed no effect on ACh-induced relaxation. 25 mM KCl partially inhibited ACh-induced relaxation by shifting the concentration-response curve and abolished the response when combined with L-NAME and NE. In the presence of L-NAME, ACh-induced relaxation was unaffected by glibenclamide (10(-5) M) but significantly reduced by apamin (10(-6) M), and almost completely blocked by tetraethylammonium (TEA, 10(-3) M), iberiotoxin (10(-7) M) and 4-aminopyridine (4-AP, 5 x 10(-3) M). The cytochrome P450 inhibitors, 7-ethoxyresorufin (7-ER, 10(-5) M) and miconazole (10(-5) M) also significantly inhibited ACh-induced relaxation. Ouabain (10(-6) M), an inhibitor of Na+, K(+)-ATPase, or K(+)-free solution, also significantly inhibited ACh-induced relaxation. ACh-induced relaxation was not significantly inhibited by 18-alpha-glycyrrhetinic acid (18 alpha-GA, 10(-4) M). These results of this study indicate that ACh-induced endothelium-dependent relaxation of the rabbit femoral artery occurs via a mechanism that involves activation of Na+, K(+)-ATPase and/or activation of both the voltage-gated K+ channel (Kv) and the large-conductance, Ca(2+)-activated K+ channel (BKCa). The results further suggest that EDHF released by ACh may be a cytochrome P450 product.
Acetylcholine/pharmacology ; Animal ; Biological Factors/physiology* ; Female ; Femoral Artery/physiology* ; Femoral Artery/drug effects ; In Vitro ; Male ; Potassium Channels/physiology* ; Rabbits ; Vasodilation/physiology ; Vasodilator Agents/pharmacology

To determine the incidence, clinical characteristics and coronary angiographic findings of postinfarction angina, clinical course and coronary angiogram were studied in 45 patients with acute myocardial infarction. During a mean follow-up period of 12 weeks, 17 patients(37.8%) developed angina. Of 5 patients with postinfarction angina within 1 week of infarction, 2 patients died during hospitalization, whereas all 12 patients with postinfarction angina which occured more than 1 week after acute myocardial infarction were discharge alive. The frequency of stenosis over 90% and multivessel disease by coronary angiography were 51.7% and 64.7% respectively in patients with postinfarction angina, and 25%, 28.5% respectively in patients without postinfarction angina.
Constriction, Pathologic ; Coronary Angiography ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Infarction ; Myocardial Infarction

The vascular actions of local anesthetics are important in determining the uptake and distribution of these agents from their site of injection as well as influencing their hemodynamic effects once absorbed. Because of the importance of the endothelium in determining of modulating the vascular response of a wide variety of agents, cumulative dose-dependent vasular effects of lidocaine, mepivacaine and bupivacaine on isolated rings of thoracic aorta in normotensive rats(NTR) and spontaneously hypertensive rats(SHR) were studied in the presence and absence of intact endothelium. The results were as follows ; The body weight of NTR and SHR averaged 274.71+/-55.80(N = 38) and 241.43+/-17.73gm(N = 18) and mean arterial pressure was 74.4l+/-3.60 and 129.34+/-2.89mmHg respectively. The mean absolute value of the contraction induced by 5Xl0(-6) M phenylephrine was 3.27+/-0.98(N = 18) and 2.3l+/-50.64gm(N = 18) with intact endothelium and 3.12+/-0.92 and 2.46+/-0.87 gm without intact endothelium in aortic rings of NTR and SHR respectively. In the response to local anesthetics in preparation with resting tension(1.0 gm), lidocaine and mepivacaine in concentration of 10(-3) to 1.25X10(-2) M not produced dose dependent contraction in aortic ring with intact endothelium from NTR. but bupivacaine produced dose-dependent contraction in aortic rings with intact endothelium from NTR. In the aortic rings from NTR and SHR previously contracted with phenylephrine, lidocaine in contraction of 10(-3) to 1.25X10(-2) M caused dose related relaxation in aortic rings with or without endothelium but in concentration of 10(-3) to 510(-3) M, aortic rings with endothelium were more relaxed than those af without endothelium in NTR. In SHR, aortic rings without endothelium in concentration of 5X10(-3) to 1.25X10 M were more significantly relaxed than those of with endothelium. In aortic rings from NTR previously contracted with phenylephrine, mepivacaine caused dose-related relaxation, which was more profound in SHR. In aortic rings with endothelium from NTR previously contracted with phenylephrine, bupivacaine in concentration of 10(-3) to 1.5X10(-3) M caused a relaxation and in concentration of 2.5X10(-3) to 7.5X10(-3) M and 1.25X10(-3) M caused a relaxation again. But in the aortic rings without intact endothelium, bupivacaine caused dose-related relaxation. In the aortic rings without intact endothelium, bupivacaine caused dose-related relaxation in NTR. In the aortic rings from SHR previously contracted with phenylephrine, bupivacaine caused dose-related relaxation, which was more profound than those of NTR. The local anesthetics appear to exert their relaxant effect on endothelium independently and more profoundly in SHR.
Anesthetics, Local* ; Aorta, Thoracic* ; Arterial Pressure ; Body Weight ; Bupivacaine ; Endothelium ; Hemodynamics ; Lidocaine ; Mepivacaine ; Muscle, Smooth, Vascular ; Phenylephrine ; Rats, Inbred SHR* ; Relaxation

OBJECTIVE: This study was performed to prove the significance of the oligohydramnios in the intrauterine growth restriction. METHODS: Eighty two patients were identified to have intrauterine growth restriction with oligohydramnios (Group of IUGR+Oligihydramnios) and fifty six patients were identified to have intrauterine growth restriction without oligohydramnios (Group of IUGR) on ultrasound examination from January 1st, 2005 to December 31st, 2007 at St. Vincent Hospital of Catholic University of Korea. Perinatal outcomes were compared between two groups. RESULTS: Statistically significant differences were not shown between two groups in the maternal characteristics and fetal clinical features except amniotic fluid index and the duration between diagnosis and delivery. The incidence of hyperbilirubinemia and complications in the urogenital system were significantly increased in the group of IUGR+ Oligihydramnios. The other complications were not shown significant difference between two groups. CONCLUSION: Oligohydramnios may not seem to be significant predictor of adverse neonatal outcome of IUGR except the development of hyperbilirubinemia and urogenital complications.
Amniotic Fluid ; Female ; Fetal Growth Retardation ; Humans ; Hyperbilirubinemia ; Incidence ; Korea ; Oligohydramnios ; Pregnancy ; Urogenital System

BACKGROUND: Clonidine depress the surge of sympathetic system outflow via central alpha 2 adrenergic effect. Still on a debate is the receptor relevant to analgesic effect of clonidine. METHODS: Intrathecal catheter(PE-10, 10 cm in length) was inserted via the atlanto-occipital membrane and the tip of intrathecal catheter was allowed to reach at the lumbar area. At the fifth day after catheter insertion, all experimental animals were ramdomly divided to two groups. Clonidine (5 microgram) in clonidine group and morphine (45 microgram) in morphine group was administered into subarachnoid space 20 minutes before tail-clamping test. Heart rate and blood pressure changes were recorded during the experimental period. Then naloxone was given intravenously 5 minutes after the first tail-clamping test. In 2 minutes after that, the second tail clamping was done. RESULTS: Results were as follows. First, comparing the highest blood pressure changes before and after administration of naloxone, the elevation of blood pressure was significant after administration of naloxone in morphine group(p<0.05), but not in clonidine group. Second, comparing the change of heart rate, in morphine group there was significant elevation of heart rate before and after administration of naloxone. And comparing the highest elevation of heart rate, morphine group showed significant difference before and after naloxone administration(p<0.05), but not in clonidine group. CONCLUSIONS: From above results, we assumed that the analgesic effect of clonidine was not related to the opiate receptor.
Adrenergic Agents ; Animals ; Blood Pressure ; Catheters ; Clonidine* ; Constriction ; Heart Rate ; Membranes ; Morphine ; Naloxone* ; Rats* ; Receptors, Opioid ; Subarachnoid Space

PURPOSE: This study was aimed to evaluate the clinical features of seizures in breastfed children with vitamin D deficient rickets. METHODS: Seventeen children, breastfed and diagnosed as vitamin D deficient rickets at Inha University Hospital from January 2000 to July 2010, were retrospectively investigated. Subjects were divided into two groups according to the presence/absence of seizures. Demographic and biochemical results were compared and statistically analyzed between the two groups, and the relative risk for seizure occurrence was estimated. Clinical features of seizures were also analyzed. RESULTS: Out of the 17 subjects, nine patients (53.0%) had seizures, while eight patients (47.0%) did not. The mean age for the two groups were 4.1+/-2.0 months and 9.3+/-2.7 months, respectively, which was statistically different between the two groups (P<0.0001). Serum calcium (Ca) and 25-hydroxyvitamin D3 (25-OHD3) levels were significantly lower in the 'seizure' group (5.7+/-1.0 vs. 9.5+/-0.9 mg/dL, P<0.0001; 5.7+/-0.8 vs. 15.3+/-4.2 IU/L, P<0.0001). The relative risk for seizure occurrence was 8 times higher in hypocalcemia and 17 times higher in 25-OHD3<8 ng/mL. Seizures occurred several times as generalized or focal types, but none of them developed epilepsy nor showed developmental abnormalities later on. CONCLUSION: Seizures in breastfed children with vitamin D deficiency rickets are mainly due to hypocalcemia, which is affected by 25-OHD3 levels. Seizures may also occur more frequently in children in the stages of rapid growth. Although seizures occurred multiple times, future outcomes were favorable. Further large-scaled prospective studies are required in the future.
Breast Feeding ; Calcifediol ; Calcium ; Child ; Epilepsy ; Humans ; Hypocalcemia ; Retrospective Studies ; Rickets ; Seizures ; Vitamin D ; Vitamin D Deficiency

Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder that affects synovium, tendon sheath and bursa. Although the condition can present in any joint, knee joint is the most commonly affected site and only 2.5% of cases occur in foot and ankle joint. PVNS occurs in two types: localized and diffuse. Localized type is characterized by focal involvement of the synovium with either nodular or pedunculated masses, Diffuse type affects virtually the entire synovium. Diffuse type has reported more recurrence rate. We have experienced a patient who has diffuse type PVNS of ankle joint and report an optimal method of surgical treatment.
Animals ; Ankle ; Ankle Joint ; Foot ; Humans ; Joints ; Knee Joint ; Recurrence ; Synovial Membrane ; Synovitis, Pigmented Villonodular ; Tendons

Mucormycosis is an uncommon, frequently fatal, opportunistic fungal infection. Rhinocerebral and pulmonary involvement are the most common forms and usually occur in immunecompromised patients. Gastrointestinal involvement is extremely rare, the stomach being the most frequently involved site among them. When gastric mucormycosis presents as an invasive fungal infection the prognosis is extremely poor. Alternatively when the fungus may colonize the gastric mucosa without invasion of the blood vessels, the prognosis is good. Early diagnosis and tirnely institution of aggressive treatment is essential for the patients with mucormycosis. We report a 72-year-old man of gastric mucormycosis confirmed by histologic examination of endoscopic biopsy specimen. The patient was admitted. to intensive care unit under the diagnosis of adult respiratory distress syndrome and sepsis. He has been suffered from 5 years of end stage renal disease and 4 months of pulmonary tuberculosis and managed by continuous ambulatory peritoneai dialysis and anti-tubereulosis medications. On the 5th hospital day, esophagogastroduodenoscopy was underwent to remove the pieces of thermometer accidentaly broken, which revealed the 1.0 cm ulcerative lesion on the posterior wall of the upper body of stomach. The base of ulcer was coated with whitish-yellow dirty exudates and slightly irregular and the margin was nodular. The mucosae were friable and easily bled with light touch. The histologic examination of biopsy specimen revealed the multiple non-septated fungal hyphae branching right-angle.
Aged ; Biopsy ; Blood Vessels ; Colon ; Diagnosis ; Dialysis ; Early Diagnosis ; Endoscopy, Digestive System ; Exudates and Transudates ; Fungi ; Gastric Mucosa ; Humans ; Hyphae ; Intensive Care Units ; Kidney Failure, Chronic ; Mucormycosis* ; Mucous Membrane ; Prognosis ; Respiratory Distress Syndrome, Adult ; Sepsis ; Stomach ; Stomach Ulcer* ; Thermometers ; Tuberculosis, Pulmonary ; Ulcer