Polycstic kidney was rare problem of pediatric disease category. We have experienced one case of polycstic kidney(Potter type I) with pulmonary hypoplasia who born after 35 weeks of gestation to a 34 year-old mother. The clinical course of this infant was characterized by respiratory difficulty with apnea, cyanosis and marked abdominal distension. Chest X-Ray film showed no airation in the both lung fields. He died from respiratory failure due to pulmonary hypoplasia, 3 hrs after birth. We tried discussion about polycstic kidney with literature review.
Adult ; Apnea ; Cyanosis ; Humans ; Infant ; Infant, Newborn* ; Kidney ; Lung ; Mothers ; Parturition ; Polycystic Kidney Diseases* ; Pregnancy ; Respiratory Insufficiency ; Thorax ; X-Ray Film

To know the amplification pattern according to relative concentration ratio in mixed samples, two STRloci, vwF locus and MBP locus and two VNTR loci, D1S80 locus and d17S5 locus were amplified in DNA with various concentration of two individuals were easily identified. But when the concentration of one person were lowered to 1/20-1/40 of the other's the intensity of product bands diminshed and hardly discernible. Also different amplification efficiency according to the template length was noted, especially in VNTR loci. Using automatic sequencer and RFLP scan program, the intensity OD of each PCR product band could be calculated, and this correlates the felative amplification efficiency of each allele. By using this we could construct quantitative PCR for the mixed samples. This could be used in practical case work for forensic purpose, and also be a valuable candidate for 'chimerism detection' in case of bone marrow transplatation.
Alleles ; Bone Marrow ; DNA ; Humans ; Minisatellite Repeats ; Polymerase Chain Reaction* ; Polymorphism, Restriction Fragment Length

Background: The highly lipid soluble opioid, fentanyl, has a rapid onset and short duration of action. The present study was designed to examine the analgesic efficacy and side effects of the combination of fentanyl with morphine in patients using intravenous PCA. Methods: Patients were randomly assigned to receive one of three PCA regimens: M4 group (40 mg morphine+90 mg ketorolac+1.5 mg dorperidol), M2F2 group (20 mg morphine+200 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol), or M2F4 group (20 mg morphine+400 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol). All patients were given initial loading dose of 0.1 mg/kg morphine plus 1 mg droperidol at the end of surgery. Pain score, side effects, and overall satisfaction were assessed at 30 min, 1 hr, 8 hr, 24 hr, and 48 hr postoperatively. Results: The pain score was significantly higher in the M2F2 group than in the M4 group and M2F4 group during 1 hr and 8 hr postoperatively. The total opioid consumption was significantly greater in the M2F4 group than in the M4 group. Patient satisfaction was better in the M2F4 than other two groups. There were no differences in the overall incidence of side effects among three groups. Conclusions: The present results suggest that the combination of fentanyl with morphine for intravenous patient-controlled analgesia is a useful method, and the double dose of fentanyl in comparison with the equipotent morphine dose is recommended in the early postoperative period.
Analgesia, Patient-Controlled* ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine* ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Postoperative Period

Background: Desflurane, a fluorinated methyl-ethyl ether, has some advantageous properties including low blood solubility, stability in soda lime, and resistance to biodegradation. Desflurane in vivo has demonstrated myocardial depressant property. The purpose of this study was to test the direct effects of desflurane on myocardial contractile function and coronary flow in the isolated heart. Methods: Twelve isolated rat hearts were continuously perfused with modified Krebs solution containing 6, 9 and 12 vol% of desflurane for 10 min at each concentration. Systolic left ventricular pressure and rate of change of ventricular pressure (dp/dt) were measured. Heart rate and coronary flow were also measured. To differentiate direct vasodilatory effect of desflurane from an indirect metabolic effect due to autoregulation of coronary flow, oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated. Results: Heart rate (control 266+/-22 beats/min) decreased to 250+/-23 beats/min at 6 vol%, 236+/-26 beats/min at 9 vol% and 223+/-22 beats/min at 12 vol% of desflurane. Systolic left ventricular pressure and dp/dt decreased in a concentration-dependent manner. In spite of decrement of myocardial oxygen consumption, coronary flow (control 12.0+/-1.2 ml/min) increased to 12.8+/-1.6 ml/min at 6 vol%, 12.9+/-1.6 ml/min at 9 vol% and 13.7+/-1.4 ml/min at 12 vol% of desflurane. Oxygen delivery increased proportionally with coronary flow. Percent oxygen extraction decreased in a concentration-dependent manner. Conclusion: These results suggest that desflurane has a direct myocardial depressing and coronary vasodilating effect in a concentration-dependent manner.
Animals ; Ether ; Heart Rate ; Heart* ; Homeostasis ; Oxygen ; Oxygen Consumption ; Rats* ; Solubility ; Ventricular Pressure

PURPOSE: To correlate SOhographic and pathologic findings of gallbladder adenoma, and to evaluate the clinical significance of sonographic findings. MATERIALS AND METHODS: Ultrasound findings of twenty gallbladder adenomas were retrospectively reviewed to evaluate the size, shape and echogenicity of the adenoma, and was correlated with the pathological finding. RESULTS: Among 14 patients, 11 patients had single lesion and 3 patients had multiple lesions. Three patients showed 2, 3 and 4 adenomas, respectively. Nine of 20 lesions showed focal dysplasia pathologically. Among the nine adenomas with dysplasia, two adenomas showed focal cancerous change. The nine adenomas showing focal dysplasia measured 25.6mm (14-35mm) in mean diameter, while the mean diameter of adenomas without dysplasia was 8.7 mm (3-13mm). The echogenicity of adenoma with focal dysplasia were hyperechoic in 8, isoechoic in 1. The echogenicity of adenomas without dysplasia were hyperechoic in 7, isoechoic in 4. Sessile(7/9) and papillary shape(6/9) were predominant in adenoma with dysplasia, but smooth shape(8/11) and stalked type(9/11) were predominant in adenoma without dysplasia. Two adenomas with focal cancerous change showed histological transition from cancer to dysplasia and to adenomatous tissue. In adenoma with dysplasia, the diameter more than 14 mm on sonography was statistically significant (p<0. 005). Also age of patient was significantly different between the two groups (p<0.01), while echogenicity and associated stone were not statistically significant. CONCLUSION: As gallbladder adenoma more than 14ram in diameter on US is suggestive of dysplasia on pathology, so, close follow up US or surgery is recommended.
Adenoma* ; Follow-Up Studies ; Gallbladder* ; Humans ; Pathology ; Retrospective Studies ; Ultrasonography

The mesectodermal leiomyosarcoma of the orbit is extremely rare disease. An 81-year-old woman presented with progressive painless proptosis in her right eye of 1 month duration. Computed tomographic scan of the orbit demonstrated 5-cm size lobulating mass of the right orbit which displaces eyeball anteriorly and bulges out to temporalis portion with severe destruction of lateral orbital wall and intracranial extension. For diagnostic pur-pose, incisional biopsy was performed. Light microscopic examination showed the characteristics of neurogenic tumor. Electron microscopic examination disclosed the features of smooth muscle cells as well as neural differentiation of the tumor, leading to the diagnosis of mesectodermal leiomyosarcoma. To the best of our knowledge, this is the first case of mesectodermal leiomyosar-coma of the orbit in Korea
Aged, 80 and over ; Biopsy ; Diagnosis ; Exophthalmos ; Female ; Humans ; Korea ; Leiomyosarcoma* ; Myocytes, Smooth Muscle ; Orbit ; Rare Diseases

This study was designed to find an effective delay method for preventing the ischemic compromise of TRAM flap in rat. Forty Sprague-Dawley rats were divided into 4 groups evenly and a left inferior epigastric vessel pedicled TRAM flap, sized 5.0 x 3.5 cm was created on the upper abdomen. Experimental groups included group 1(control): no delay procedure before elevation of flap, group 2(surgical delay): the left superior epigastric vessels and the contralateral rectus perforators were ligated 2 weeks before elevation of flap, group 3(pharmacological delay): prostaglandin E>(0.5 microgram) was given intraperitoneally for 2 weeks before elevation of flap daily, group 4(surgical and pharmacological delay): the same surgical and pharmacological delay have been done simultaneously. On the seventh day after operation, we evaluated and compared the results by the measurement of the flap survival area, the observation of the vessel distribution through Microfil casts and the measurement of vessel surface area through histologic slides. The results were as follows; 1) The mean percentages of the flap survival area of group 2(73.32+/-21.07%), 3(71.77+/-l 17.49%) and 4(89.54 +/-11.38%) were higher than that of group 1(41.23 +/- 14.26%) significantly(p < 0.05). 2) The vessel distributions of group 2, 3 and 4 were much abundant than that of group 1 in Microfil casts. 3) The vessel surface areas of group 2, 3 and 4 were higher than that of group 1 significantly(p < 0.01) and that of group 4 was higher than that of group 2(p < 0.05). In conclusion, prostaglandin E could be used to increase the flap survival area in rat TRAM flap model as a pharmacological delay and the effect of prostaglandin E was comparable to that of the surgical delay.
Abdomen ; Alprostadil* ; Animals ; Myocutaneous Flap* ; Rats* ; Rats, Sprague-Dawley ; Rectus Abdominis* ; Silicone Elastomers

Background: We hypothesized that intravenous lidocaine mixed with propofol may have an influence on anesthesia induction and hemodynamic responses to propofol induction and endotracheal intubation as well as propofol-induced pain on injection. Methods: Seventy-five patients were allocated to group L1 (2% lidocaine 1.5 mg/kg, n=25), group L2 (2% lidocaine 2 mg/kg, n=25) or group C (normal saline 0.05 mL/kg, n=25) according to the lidocaine dosage mixed with propofol 2 mg/kg. The pain on injection was scored as none, mild, moderate, and severe. The site of pain and recall of pain were also recorded. Loss of verbal response was observed during induction. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded before anesthetic induction (baseline value), immediately before and after endotracheal intubation, and every min until 5 min thereafter. Results: Ninety-two percent of patients reported pain upon injection in group C, whereas 8% of the patients in group L1 and no patient in group L2. Loss of verbal response before injection of total dose of propofol was observed in 44% in group L2, 36% in group L1 and 28% in group C. Lowered MAP caused by propofol increased significantly after endotracheal intubation in all three groups (p<0.05). HR increased immediately and 1 min after endotracheal intubation in all three groups (p<0.05). Conclusions: Our results indicate that intravenous lidocaine 1.5 mg/kg or 2 mg/kg mixed with propofol 2 mg/kg significantly reduces the incidence and the degree of pain, but does not affect anesthesia induction and hemodynamic responses to propofol and tracheal intubation.
Anesthesia ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Lidocaine* ; Propofol*

Unilateral localized hyperhidrosis over scalp and face is an extremely rare disease that usually has undetermined origin. We report a case of idiopathic unilateral localized hyperhidrosis over left scalp and face. A 55-year-old female patient with unilateral hyperhidrosis that is localized in the left side of scalp and face visited our dermatology clinic. She had increased sweating in left face and scalp, recurring in summer for 3 years. She complained of the exacerbation by thermal and gustatory stimuli and exercise. The starch iodine test and digital infrared thermal imaging test revealed a marked increase in sweat gland activity on the affected areas as compared to the contralateral normal sites.
Dermatology ; Female ; Humans ; Hyperhidrosis* ; Iodine ; Middle Aged ; Rare Diseases ; Scalp* ; Starch ; Sweat ; Sweat Glands ; Sweating

PURPOSE: To evaluate the therapeutic effect of the combined treatment of excision of the papillae and a supratarsal injection of triamcinolone on refractory vernal keratoconjunctivitis (VKC). METHODS: Twenty-three eyes of 14 patients with refractory vernal keratoconjunctivitis were included. Patients were treated with the combined excision of papillae and supratarsal injection of triamcinolone. Best corrected visual acuity (BCVA), intraocular pressure, symptoms of itching, tearing, discomfort, secretion and epiphora, and signs including limbal hypertrophy, hyperemia, papilla size, keratitis, corneal neovascularization and blepharitis were evaluated before and two weeks, four weeks, and eight weeks after treatment. The CCL11 level in the tears of each eye were analyzed before and two weeks after treatment. RESULTS: The mean scores of subjective symptoms and objective signs as well as BCVA were significantly improved two weeks after treatment. CCL11 levels in the tears were 389.5+/-474.9 pg/ml before treatment and were undetectable two weeks after treatment. Improvement of symptom and sign parameters was maintained up to eight weeks after treatment. However, seven eyes (30.4%) recurred within two weeks after treatment. CONCLUSIONS: Combined excision of the papillae and a supratarsal injection of triamcinolone may be effective in the treatment of refractory VKC.
Blepharitis ; Conjunctivitis, Allergic ; Corneal Neovascularization ; Eye ; Humans ; Hyperemia ; Hypertrophy ; Intraocular Pressure ; Keratitis ; Lacrimal Apparatus Diseases ; Pruritus ; Tears ; Triamcinolone ; Visual Acuity