No abstract available.
Pressure Ulcer*

A 32 year-old man was scheduled for tracheal reconstruction after having special radiological studies and pulmonary function tests. Atropine was given preoperatively. A radial artery cannula was inserted for blood gas sampling and direct arterial pressure monitoring. The E,K.G. was monitored continuously. With the patient breathing a high concentration of oxygen from a mask, halothane was added to the inspired gas. After intramuscular injection of ketamine, halothane was discontinued. Spontaneous respiration was preserved with assistance when necessary. The larynx, pharynx and trachea were topically anesthetized and then a large-bore rubben orotracheal tube was placed in the trachea above the lesion. Anesthesia was maintained with additional ketamine injection. The trachea was explored through an anterior transverse cervical incision with a median sternotomy. The segment distal to the obstruction as dissected and found to be maligant tissue extending down to near the carina and behind the aortic arch. So, it was imperative to postpone further the surgery. Immediately after skin closure, the trachea was almost completely obstructed and PaCO2 value was above 150 mmHg. Therefore the airway was preserved by a pediatric bronchoscope, which was replaced by a pediatric endotracheal tube. Anesthetic management and tracheal resection and reconstruetion have been reviewed problems of induction in a patient with tracheal obstruction are discussed, and the technics for retaining control of the airway and reducing the hazards of hypoxia and hypercarbia are also stressed.
Adult ; Anesthesia* ; Anoxia ; Aorta, Thoracic ; Arterial Pressure ; Atropine ; Bronchoscopes ; Catheters ; Halothane ; Humans ; Injections, Intramuscular ; Ketamine ; Larynx ; Masks ; Oxygen ; Pharynx ; Radial Artery ; Respiration ; Respiratory Function Tests ; Skin ; Sternotomy ; Trachea

No abstract available.
Wilms Tumor*

Pigmented Paravenous Retinochoroidal Atrophy(PPRCA) is a type of pigmentary retinopathy that affects mostly both eyes symmetrically without inheritance. The PPRCA occurs in both progressive and non-progressive forms, but most cases are non-progressive forms. The fundus appearance of PPRCA is characteristic, with peripapillary pigmentary change as well as areas of retinochoroidal atrophy adjacent to the perivenular pigmentary change. The authors have studied a case of PPRCA which was diagnosed through the characteristic fundus appearance and other ophthalmological examinations.
Atrophy ; Retinitis Pigmentosa ; Wills

Background: Cellulitis is an inflammatory disease of the skin and subcutaneous tissue caused by bacterial infection and is one of the most common reasons for admission to the Department of Dermatology. There are many biomarkers to help diagnose inflammatory diseases, and the neutrophil-to-lymphocyte ratio (NLR) has recently been raised as an option. Objective: This study aimed to evaluate the efficacy of pretreatment NLR for predicting the severity and prognosis of cellulitis. Methods: We reviewed the medical records of 102 patients diagnosed with cellulitis over the past 5 years. White blood cell count, erythrocyte sedimentation rate, C-reactive protein (CRP) level, procalcitonin level, and NLR were measured on the first day of admission. The associations of CRP, procalcitonin, and NLR ratio with body temperature and number of hospitalization days were assessed. Results: The CRP level and NLR were positively correlated with body temperature. In addition, positive correlations were found between the number of hospitalization days and biomarkers (p＜0.05), with the NLR showing the highest coefficients. Conclusion In patients with cellulitis, the NLR is a helpful parameter for evaluating the severity and prognosis of the disease. However, further studies are required to confirm this.

BACKGROUND: Replication of defective adenoviral vectors can be used for gene transfer into a wide spectrum of replicating and nonreplicating cells. Accordingly, selective introduction of genes encoding for susceptibility to nontoxic drugs into proliferating tumor may be used to treat cancer. We investigated the efficacy of in vitro transduction of neuroblastoma cell with the herpes simplex virus thymidine kinase gene followed by administration of the antiviral drug ganciclovir. METHODS: The recombinant adenoviral vector ADV/TK carrying the HSV-TK gene, under the control of the promoter from Rous sarcoma virus long term terminal repeat was constructed. And 1 x 10(4) Neuro 2a cells were plated in 96 well cultured plates and infected with ADV/TK at multiplicity of infection of 0, 1, 10, and 100. Twenty-four hours later, the infected cells were treated with PBS or ganciclovir at a concentration of 10 g/ml. After 48hr, the surviving cells in 96 well plates were determined by MTT assay. RESULTS: After infection in vitro with ADV/TK at moi of 0, 1, 10, 100 and subsequent ganciclovir treatment, the percent survival rate of 1 x 10(4) Neuro 2a cells were 105%, 32%, 25%, and 15%. But the survival rate of 1 x 10(4) Neuro 2a cells with PBS treatment were 100%, 92%, 105%, 103%. CONCLUSION: We concluded that in vitro transduction of neuroblastoma cell with the herpes simplex-thymidine kinase gene followed by administration of the antiviral drug ganciclovir is very effective.
Cell Line* ; Ganciclovir* ; Neuroblastoma* ; Phosphotransferases ; Rous sarcoma virus ; Simplexvirus ; Survival Rate ; Terminal Repeat Sequences ; Thymidine Kinase

PURPOSE: This study aims to investigate postnatal growth and examine the longitudinal change of leptin, insulin, insulin-like growth factor-I (IGF-I), adiponectin, and ghrelin in very low birth weight (VLBW) infants. METHODS: Weight, height, and head circumference (HC) were prospectively measured at birth, full term, and at 2, 4, 6, 12 and 24 months of corrected age (CA) in 91 VLBW infants (41 females and 50 males). They were evaluated as either being small for gestational age (SGA) or appropriate for gestational age (AGA). Blood samples were serially taken for IGF-I, insulin, leptin, adiponectin, and ghrelin. RESULTS: 1) Weight, height, and HC Z scores decreased from birth to 2 months of CA at a deeper rate for AGA and birth weight < 1,000 g than for SGA and < 1,000 g birth weight < 1,500 g infants. 2) Weight, height, and HC Z scores increased from 2 months to 24 months of CA for the whole population. 3) 25.0% in the SGA and 5.4% in the AGA group did not show weight catch up growth (< -2 SDS) at 1 year of age (P < 0.05). 4) At 12 months of CA, 16.7% in the SGA and 13% in the AGA group did not show height catch up growth. 5) Leptin, ghrelin, IGF-I concentrations increased during the first 2 years of life in VLBW. 6) 1 year weight Z score is related to term weight Z score (beta = 0.775, P = 0.001). One year height Z score is related to term weight Z score. (beta = 0.632, P = 0.000) CONCLUSION: Rapid catch up growth occurred mainly during the first year of life, irrespective of SGA or AGA. Leptin, ghrelin, and IGF-I concentration increased during the first 2 years of life in VLBW. Rapid catch up growth is thus required to give rapid and enough nutrition after birth in VLBW.
Adiponectin ; Birth Weight ; Female ; Gestational Age ; Ghrelin ; Head ; Humans ; Infant ; Infant, Very Low Birth Weight ; Insulin ; Insulin-Like Growth Factor I ; Leptin ; Parturition ; Prospective Studies

Central precocious puberty (CPP), with early maturation of the hypothalamic-pituitary-gonadal axis, may develop in patients with pseudo-precocious puberty, which is secondary central precocious puberty. We have experienced two such boys who had diagnosed as congenital adrenal hyperplasia. These children had been treated with physiologic dose of hydrocortisone and 9alpha-fludrocortisone. One patient have diagnosed as CPP after treatment and the other, before treatment. They have been treated with gonadotropin releasing hormone agonist (GnRHa) when they developed CPP.
Adrenal Hyperplasia, Congenital ; Axis, Cervical Vertebra ; Child ; Gonadotropin-Releasing Hormone ; Humans ; Hydrocortisone ; Piperazines ; Puberty ; Puberty, Precocious

Central precocious puberty (CPP), with early maturation of the hypothalamic-pituitary-gonadal axis, may develop in patients with pseudo-precocious puberty, which is secondary central precocious puberty. We have experienced two such boys who had diagnosed as congenital adrenal hyperplasia. These children had been treated with physiologic dose of hydrocortisone and 9alpha-fludrocortisone. One patient have diagnosed as CPP after treatment and the other, before treatment. They have been treated with gonadotropin releasing hormone agonist (GnRHa) when they developed CPP.
Adrenal Hyperplasia, Congenital ; Axis, Cervical Vertebra ; Child ; Gonadotropin-Releasing Hormone ; Humans ; Hydrocortisone ; Piperazines ; Puberty ; Puberty, Precocious