No abstract available.
Mesenteric Lymphadenitis*

The efficacy of acetaminophen, sponging plus acetaminophen, and sponging alone as method of lowering body temperature was compared in 108 children aged 8 weeks to 5 years who presented with an axillary temperature of 38.5degrees C or greater during the period from January 1993 to April 1993. The following results were obtained. 1) The male to female ratio was 2.5:1 and clinical diagnosis in the order of frequency were upper respiratory infection, gastroenteritis, pneumonia, urinary tract infection, cellulitis, chickenpox and hand-foot-mouth disease. 2) At thirty minutes after treatment, there was no significant difference on the decrement of temperature among the three groups. 3) At sixty minutes, the temperature decrement was the greatest in the group of sponging plus acetaminophen and that was statistically significant (P<0.01). But there was no significant difference between the group of acetaminophen and that of sponging.
Acetaminophen ; Body Temperature ; Cellulitis ; Chickenpox ; Child* ; Diagnosis ; Female ; Fever* ; Gastroenteritis ; Humans ; Male ; Pneumonia ; Urinary Tract Infections

PURPOSE: After Langendorff made aortic perfusion system with the extracted animal heart for the experimental study regarding cardiac mechanical action and rhythm, this system has been modified by various methods for the hemodynamic studies. The authors developed cardiac perfusion system using personal computer for mechanical cardiac contraction and electrophysiologic studies without the effects of autonomic nervous system and hemodynamic influences from various causes. METHODS: This system consisted of perfusion system, electrical pulse generator, and data acquisition system. the perfusion system has reservoir containing physiologic solution, heat exchange system, and organ chamber. The pulse generator composed of personal computer and digital/analog converter can produce electrical pulses with adjustable amplitude and cycle length. The mode of stimulations were as follows; maintenance, programmed, and burst mode. The data acquisition system was composed of amplifier, analog/digital converter, and AcqKnowledge program that are provided by Biopac system. The data were sampled at 1kHz as a digitized form, and the noises wee reduced by filtering at band width 30-500Hz. Krebs' solution was used as perfusate through the aorta of isolated heart with mean pressure of 40mmHg. RESULTS: With this system, AH and HV interval, refractory period of AV node and His-Purkinje system, and Wenckebach cycle length were measured. CONCLUSION: Studies for cardiac mechanical contraction as well as electrophysiologic properties in vitro with or without specific cardiac drugs would be possible with this system in isolated experimental heart without autonomic nervous effects.
Animals ; Aorta ; Atrioventricular Node ; Autonomic Nervous System ; Electrophysiology ; Heart ; Hemodynamics ; Hot Temperature ; Humans ; Microcomputers* ; Noise ; Perfusion*

The authors determined the value of performing urine microscopy on biochemically negative urine sepcimens in a pediatric population. The 746 urine specimens of patients who were either visited or admitted to the Department of Pediatrics, National Police Hospital, from March 1991 to July 1992 were reviewed on the basis of comparative evaluation of biochemical and microscopic urine analysis. Eight reactions of Clinitek(r) 200 were used as biochemical indicators, namely, pH, nitrite, albumin, glucose, ketone, urobilinogen, bilirubin, and blood. Out of 746 urine specimens studied, 186 were true positive. Thirty-six specimens reacted biochemically in the absence of positive microscopic findings (false postive), 492 specimens were true negatives. Thirty-two specimens had negative biochemical indicators, in spite of positive microscopy. The sensitivity of the biochemical parameters for predicting significant microscopy of urinary sediment is 85% and the specificity is 99%. The positive predictive value is 69.7% and the negative predictive value is 99.3%. The sensitivity of blood for RBC is 94%. and the specificity is 99%. The predictive value of a positive result is 84.6% and that of a negative result is 99.7%. We therefore conclude that urine microscopy is less necessary in biochemically negative urine specimens from asymptomatic pediatric patients, with hopefully resultant time and cost effectiveness.
Bilirubin ; Cost-Benefit Analysis ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Microscopy ; Pediatrics ; Police ; Sensitivity and Specificity ; Urinalysis* ; Urobilinogen

PURPOSE: There are many prognostic factors in the recurrence and the progression of T1 superficial bladder cancer. Among these factors, microstaging evaluation in T1 bladder cancer may be of important value in patients with T1 superficial bladder cancer. To evaluate the usefulness of microstaging evaluation, we analyzed the microstage in T1 superficial bladder cancer and analyzed the recurrence rate and the progression rate of each microstage. MATERIALS AND METHODS: A retrospective analysis was done on 87 patients with T1 primary superficial bladder cancer managed in our hospital between January 1992 and April 1998. Microstages were assigned according to the following system: pT1a, invasion of lamina propria: pT1b, invasion to the level of the muscularis mucosa; pT1c, invasion through the muscularis mucosa but superficial to the muscularis propria. We analyzed the relationship between the microstage and the grade, the relationship between the recurrence or the progression of diseases and the grade of the tumor, the relationship between the grade or the microstage and the recurrence of diseases. All specimens were obtained from transurethral resection. RESULTS: The recurrence rates of pT1a, pT1b and pT1c were 9.1%(3/33), 40%(8/33) and 64.7%(22/33) respectively(p<0.001). The progression rates of pT1a, pT1b and pT1c were 0%(0/33), 10%(2/20) and 20.6%(7/34) respectively(p=0.005). The recurrence rates of grade I, grade II and grade III were 23.1%(3/13), 26.7%(12/45) and 62.1%(18/29) respectively(p=0.002). The progression rates of grade I, grade II and grade III were 7.7%(1/13), 4.4%(2/45) and 20.7%(6/29) respectively(p=0.062). pT1a, pT1b and pT1c were 21.2%(7/33), 20%(4/40) and 5.9%(2/34) in the patients of the grade I. pT1a, pT1b and pT1c were 69.7%(23/33), 50%(10/20) and 35.3%(12/34) in the grade II. pT1a, pT1b and pT1c were 9.1%(3/33), 30%(6/20) and 58.8%(20/34) in the grade III. Thus the relationship between the grade and the microstage was statistically significant(p=0.001). The recurrece rates of pT1a in the grade I, pT1b in the grade I and pT1c in the grade I were 14.3%(1/7), 0%(0/4) and 100%(2/2). The recurrence rates of pT1a in the grade II , pT1b in the grade II and pT1c in the grade II were 8.7%(2/23), 40%(4/10) and 50%(6/12). The recurrence rates of pT1a in the grade III, pT1b in the grade III and pT1c in the grade III were 0%(0/3), 66.7%(4/6) and 77.8%(14/20)(p=0.176). The progression rates of pT1a in the grade I, pT1b in the grade I and pT1c in the grade I were 0%(0/7), 0%(0/4) and 50%(1/2). The progression rates of pT1a in the grade II, pT1b in the grade II and pT1c in the grade II were 0%(0/23), 10%(1/10) and 8.3%(1/12). The progression rates of pT1a in the grade III, pT1b in the grade III and pT1c in the grade III were 0%(0/3), 16.7%(1/6) and 25%(5/20)(p=0.526). CONCLUSIONS: Microstaging in T1 superficial bladder cancer appears to be a significant prognostic factor in the recurrence and the progression of the diseases.
Humans ; Mucous Membrane ; Recurrence* ; Retrospective Studies ; Urinary Bladder Neoplasms* ; Urinary Bladder*

BACKGROUND: This study investigated the protective mechanism of Prostagladin E1 (PGE1) against intimal hyperplasia after vein interposition grafts in rabbits. It has been demonstrated that active oxygen species contribute to vascular smooth muscle cell growth via early cell cycle gene activation. We attempted to study whether PGE1 had an effect on the inhibition of the oxidative stress injury index (8-OHdG, MDA). METHODS: Forty-eight jugular vein grafts were inserted into the carotid arteries of male hyperlipidemic New Zealand white rabbits, which were divided into 2 groups (saline group and PGE1 group). Saline and Prostaglandin E1 (0.1 microgram/kg/min) were administered as a continuous infusion for 2 hours every day from just before graft interposition to harvest. The vein grafts were harvested at 6 hour, 1 day, 1 week, and 2 week after grafting and rapidly stored in liquid nitrogen ( 70oC). 8-OHdG was measured by using high performance liquid chromatography coupled with electrochemical detection (HPLC-EC), and malondialdehyde (MDA) was measured by using thiobarbituric acid (TBA) assay. PC 10 index and intimal thickness of the grafts were measured with a computer digitalized image analyzer. RESULTS: There was no difference in 8-OHdG levels between the saline and the PGE1 groups. PGE1 had more inhibitory effect on the MDA level as an oxidative stress injury index, but its action was restricted to 1 day. A morphometric analysis and an immunohistochemical study showed that the PGE1 group had more suppressive effects both in intimal thickeness and proliferating cell nuclear antigen (PCNA) expression than the saline group (p<0.05). CONCLUSION: These results suggest that PGE1 is effective in preventing intimal hyperplasia after vein interposition grafts in rabbits and may play a role in inhibiting oxidative stress injury.
Alprostadil ; Carotid Arteries* ; Chromatography, Liquid ; Genes, cdc ; Humans ; Hyperplasia ; Jugular Veins ; Male ; Malondialdehyde ; Muscle, Smooth, Vascular ; Nitrogen ; Oxidative Stress* ; Proliferating Cell Nuclear Antigen* ; Rabbits ; Reactive Oxygen Species ; Transplants* ; Veins*

PURPOSE: This study aimed to identify the true extent of non-responsiveness in full-term infants born from HBsAg-negative or HBsAg-positive mothers and vaccinated against hepatitis B virus (HBV) at 0, 1, and 6 months of age and to evaluate the effect of revaccination among non-responders. METHODS: The study included 716 full-term infants born in 2004-2007. Of 716, 662 infants (A group) were born to HBsAg- negative mothers and 54 infants (B group: 50, except HBsAg-positive infants) were born to HBsAg-positive mothers. All infants were administered DNA recombinant vaccines at 0, 1, and 6 months of age. B group infants received hepatitis B immunoglobulin at birth. Anti-HBs titers were tested at 7-12 and 9-15 months in A and B groups, respectively. Three revaccination doses were administered to non-responders whose anti-HBs titers were under 10 mIU/ml; revaccinated infants were retested at 1-3 months after last vaccination. The association between HBeAg seropositivity of mother and the failure of HBV immunoprophylaxis was evaluated. RESULTS: The seroconversion rates after primary hepatitis B vaccination were higher in A group (94.1%) than in B group (78%, P<0.001). The seroconversion rates were high in revaccinated infants (A group non-responders: 96.9%, B group non- responders: 87.5%). The failure of HBV immunoprophylaxis was significantly associated with maternal HBeAg seropositivity (P<0.001). CONCLUSION: The seroconversion rates after primary hepatitis B vaccination were low in B group infants. Revaccination of non-responders in B group was very effective. Therefore, anti-HBs testing and revaccination of B group is very important. Revaccination of non-responders in A group was also very effective. Thus, testing the immune status of infants born to HBsAg-negative mothers even after primary hepatitis B vaccination should be considered. However, to realize this, further studies on the cost-effectiveness of anti-HBs testing in healthy full-term infants are necessary.
DNA ; Hepatitis ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Immunization, Secondary ; Immunoglobulins ; Infant ; Mothers ; Parturition ; Vaccination ; Vaccines, Synthetic

PURPOSE: Although progenitor cells may contribute to intimal hyperplasia (IH) after arterial injury, positive contribution of IH is variable with type of injury or cells. This study was designed to examine whether differentiated muscle derived stem cells (MDSC) attenuate IH in rat. METHODS: MDSCs were retrieved using preplate techniques from rat calf muscle and MDSCs (preplate 6th culture fraction, pp6) were exposed to VEGF (50 ng/ml) for endothelial differentiation prior to injection. Male rats were divided into two groups (cell treated vs. control) and underwent carotid balloon injury with 2-Fr catheter. The virus containing Green fluorescent protein (GFP) gene was transfected into cells for monitoring. Cells (5x10(6)) were indwelled into carotid artery for 30 minutes after injury and then blood flow was restored. Arteries were harvested at various intervals (1, 2 and 4 weeks) after injury. The intima to media thickness ratio (IMTR) was calculated with morphometric analysis. RESULTS: Endothelial surface markers such as VE-CADHERIN were strongly expressed on differentiated MDSCs. At 4 weeks after injury, IH was predominantly observed in control group compared to cell treated group. The intensity of GFP was strongly observed at 1 week and declined at 4 weeks in carotid artery wall at MDSC group. CD31(+) endothelial cells were observed at MDSC group compared to control. The mean IMTR in cell treated groups were significantly lower than control at 2 weeks (P=0.005) and 4 weeks (P< or =0.001). CONCLUSION: Our study demonstrates that MDSCs therapy promotes re-endothelialization and leads to attenuation of IH after balloon injury in rat.
Animals ; Antigens, CD ; Arteries ; Cadherins ; Carotid Arteries ; Catheters ; Endothelial Cells ; Humans ; Hyperplasia ; Male ; Muscles ; Rats ; Stem Cells ; Vascular Endothelial Growth Factor A ; Viruses

STUDY DESIGN: This is a retrospective study. OBJECTIVE: We wanted to evaluate the efficacy of epidural steroid injection (ESI) for treating lumbar spinal stenosis (LSS) SUMMARY OF LITERATURE REVIEW: Treatment for lumbar spinal stenosis has generally consisted of some form of conservative treatment or surgery. Surgery may be contraindicated in many stenotic patients because of their significant comorbidities. Therefore, conservative management is necessary for those who cannot or do not want to undergo surgery. MATERIALS AND METHODS: From January 2002 to June 2003, we retrospectively analyzed 128 patients, 55 years or older, who received ESI (s). The average age of the men and women was 47 and 81, respectively. Their mean age was 76 (age range: 55~84). The injection materials were 2 ml methylprodnisolone acetate (40 mg/cc) in combination with 3 cc normal saline and 3 cc lidocaine. The follow up period was 12 months to 30 months. We measured the outcomes by the duration and amount of pain relief, the change in functional status and the rate of performing surgery; patient satisfaction was assessed by a 5-item questionnaire. RESULT: Of the 128 participants, 31% reported more than 2 months of pain relief, 41% reported less than 2 months of pain relief and 27% reported no relief from the injection (s). Sixteen percent subsequently had surgery. Sixty-nine percent reported improvement in their functional abilities. Seventy-two percent were at least somewhat satisfied with ESI as a form of treatment. CONCLUSION: ESI is a reasonable treatment for LSS as it provided one third of our patient population with sustained relief and more than half with sustained improvement in function.
Comorbidity ; Female ; Follow-Up Studies ; Humans ; Lidocaine ; Male ; Patient Satisfaction ; Surveys and Questionnaires ; Retrospective Studies ; Spinal Stenosis* ; Spine

Proliferation of vascular smooth muscle cells (VSMCs) is the utmost important pathophysiologic mechanism of intimal hyperplasia and atherosclerosis. With a hyperlipidemic rabbit model of jugular vein graft to carotid artery, we invesigated the oxidative stress injury in intimal hyperplasia and correlation of PCNA expression with VSMCs proliferation and intimal hyperplasia. Twenty jugular vein grafts were inserted into the carotid arteries of male New Zealand White rabbit and the vein grafts were harvested at 6 hr, 1 day, 7 days, 14 days, respectively after grafting and rapidly stored in buffered formalin for morphometric analysis, PCNA expression or frozen in liquid nitrogen for MDA (Malondialdehyde) analysis. Total wall and intimal thickness of grafts were measured with an computer digitalized image analyzer. Intimal thickening was rapidly increased at 7 days and peaked at 14 days (125.05 19.80 and 180.25 6.38 mum, respectively) and significantly thicker than control group or 6 hr, 1day after graft implantation (p<0.05). MDA level was significantly higher in vein grafting groups than control group (9.13 1.80 vs. 6.08 1.00 muM/mg protein, p=0.011) by Ohkawa method. In immunohistochemical staining, expression for PCNA (PC10 index: %) in media was peaked at 7 days (12.91 1.22) and significantly higher than control group or 6 hr, 1 day (0, 0.66 0.90, and 3.00 1.22, respectively) after graft implantation (p<0.05) and decreased thereafter. Expression for PCNA (PC10 index) in intima was markedly noted at 7 days (8.60 0.95), peaked at 14 days (16.90 2.14) and significantly higher than control group or 6 hr, 1 day (0, 0.31 0.63, and 1.44 1.00, respectively) after graft implantation (p<0.05). In conclusion, oxidative stress injury by active oxygen species increased in this model of vein graft suggests a role of this oxidant in intimal hyperplasia. PCNA expression was well correlated with the proliferation and migration of VSMCs from media to intima as the pathophysiology of intimal hyperplasia. Therefore, use of PCNA expression in this model of vein graft provides a reproducible method of assessing cellular proliferation after vascular injury. This experimental models of vessel wall injury are helpful in understanding the pathophysiologic mechanism of intimal hyperplasia and are useful in initial assessment of agents intended for reducing intimal hyperplasia.
Atherosclerosis ; Carotid Arteries ; Cell Proliferation ; Formaldehyde ; Humans ; Hyperplasia* ; Jugular Veins ; Male ; Malondialdehyde ; Models, Theoretical ; Muscle, Smooth, Vascular ; New Zealand ; Nitrogen ; Oxidative Stress* ; Proliferating Cell Nuclear Antigen* ; Reactive Oxygen Species ; Transplants* ; Vascular System Injuries ; Veins*