Liver abscess in children is rare in developed countries; the incidence is 25 per 100,000 admissions in USA. Common complications are pleural effusion, empyema, pneumonitis, hepatopleural or hepatobronchial fistula, intraperitoneal or intrapericardiac rupture, septic shock, cerebral amebiasis, etc. These complications may lead to death if the management is delayed. However, recent management results in a mortality of less than 15%. We report a case of liver abscess in a child. He manifested with fever and abdominal pain in the right upper quadrant. On computerized tomography scans, multiple cystic lesions were seen in both lobes of the liver and were 5 to 55 mm in size. In laboratory findings, neutrophilic leukocytosis, peripheral eosinophila, elevated values of ESR, C-reactive protein, and elevated serum AST, ALT, ALP and GGT were detected. Furthermore, we determined the organisms in the blood culture and serum. Blood culture was positive for Streptococcus spp., and amebic indirect hemagglutination antibody titer was increased to 1:512.
Abdominal Pain ; Abscess ; Amebiasis ; C-Reactive Protein ; Child ; Empyema ; Fever ; Fistula ; Hemagglutination ; Humans ; Incidence ; Leukocytosis ; Liver ; Liver Abscess ; Neutrophils ; Pleural Effusion ; Pneumonia ; Rupture ; Shock, Septic ; Streptococcus

No abstract available.
Embryonic Stem Cells*

No abstract available.
Muscle, Smooth*

BACKGROUND: According to the 1992 version of ACLS guideline, adenosine is recommended as the first line drug far the treatment of paroxysmal supraventricular tachycardia(PSYT). But adenosine is not used frequently in our country, despite currency proven effect and safety. Therefore we tried to compare the efficacy and safety of adenosine with verapamil for the treatment far PSVT. MATERIALS AND METHODS: We prospectively reviewed charles of PSVT patients admitted to YongDong Severance Hospital from Jan. 1995 to Dec. 1996. These patients were randomly divided into two groups. The flat group was given 6mg of adenosine initially, and another 12mg was given within 5 minutes if fast dose failed. The other group was given 5mg of verapamil initially, and if failed, 10mg was given within 10 minutes. The results were analyzed by Chi-square test and student-t method. RESULTS: In converting PSVT to normal rhythm, adenosine and verapamil showed similar results and there was no difference between the two Groups in frequency of side elects, but serious arrhythmia such as ventricular fibrillation and ventricular tachycardia was not seen in the adenosine group. CONCLUSION: Adenosine not only showed comparable effect and safety, but also had shorter action time than verapamil. Therefore we recommand adenosine, as a safe and effective fort line drug for PSVT.
Adenosine* ; Arrhythmias, Cardiac ; Humans ; Prospective Studies ; Tachycardia, Supraventricular* ; Tachycardia, Ventricular ; Ventricular Fibrillation ; Verapamil*

Excitatory amino acids have been implicated as one of the important putative cellular toxins in ischemic brain. Ketamine antagonizes the excitotoxic action of excitatory amino acids in the central nervous system. The present study was undertaken to determine whether ketamine anesthesia protect the formation of brain edema in the model of focal cerebral ischemia in rats. Forty adult male Sprague-Dawley rats weighing between 300gm and 400gm were used in this study. The animals were anesthetized with either halothane or ketamine, and then right middle cerebral artery occlusion were performed. After 4 hours of ischemia, the brain water and ion contents(Na+ and K+) were determined in the central, intermediate, and outer zones of each cortical mantle. In both halothane and ketamine anesthetized groups, there were significant brain edema in the ischemic central and intermediate zones. Ionic shifts were also observed in the ischemic central and intermediate zones to approximately same extent as the brain water content in both groups. However, there were no significant differences of brain edema between the two groups in the corresponding ischemic zones. These results suggest that ketamine anesthesia does not have significant protective effect on the formation of brain edema during the early stages of permanent incomplete cerebral ischemia.
Adult ; Anesthesia* ; Animals ; Brain Edema* ; Brain Ischemia ; Brain* ; Central Nervous System ; Excitatory Amino Acids ; Halothane ; Humans ; Infarction, Middle Cerebral Artery ; Ischemia* ; Ketamine* ; Male ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: The improved technique for cardiopulmonary resuscitation(CPR) has resulted in the survival of many patient who experienced cardiac arrest. However, mortality in resuscitated patients is high, and the survival rate without brain damage is very low. Various neurological examination models, neuro-imaging techniques, electrophysiological procedures, and biochemical tests have been studied with respect to the detection of cerebral damage and outcome, but an early, reliable prediction of individual outcomes is still uncertain. METHODS: We studied twenty patient who had been in a coma for more than 24 hours after CPR, Somatosensory evoked potentials(SEP) were measured within the first three days after CPR. RESULTS: Of the twenty patients, seven patients(35%) had a good outcome, and thirteen patients(65%) had a bad outcome. Of the eleven patients with loss of the cortical evoked potential's N20 peak, all had a bad outcome. CONCLUSION: SEPs are of great benefit in prognostic evaluation after CPR.
Brain ; Cardiopulmonary Resuscitation* ; Coma* ; Evoked Potentials, Somatosensory* ; Heart Arrest ; Humans ; Mortality ; Neurologic Examination ; Survival Rate

PURPOSE: To evaluate neurotoxic effects induced by oxygen-radicals, which were generated by adding xanthine oxidase(XO) and hypoxanthine(HX), and protective effects of glutamate receptor antagonist such as MK-801 and 6-cyano-7-nitroquinoxaline(CNQX). METHODS: Dissociated cell cultures were prepared from cerebrum of neonatal mouse. Tissues were dissected and diced into small pieces in phosphate buffered saline and were incubated at 37degrees C. Isolated cells were resuspended in Eagle's minimum essential medium and plated poly-L-lysine coated plastic coverslips in 96 well multichambers at a cell density of 3x105 cells/well. Cells were grown in a 5% CO2/95% air atmosphere at 37degrees C. Cytotoxic effects were examined in cerebral cortical neurons cultured for 3 hours in media containing various concentration of XO and HX. The protective effects of glutamate receptor antagonist were also examined by MTT assay and neurofilament enzymeimmunoassay(EIA). Microscopic examinations were also done. RESULTS: Oxygen radicals markedly induced decrement of the cell viability of cultured mouse cerebral cortical neurons in a dose-dependent manner. Midpoint cytotoxicity value was 30mU/ml XO/0.1mM HX, when mouse cerebral cortical neurons were incubated for 3 hours with various concentrations of XO and HX. The number of cells and neurites was decreased when cerebral cortical neurons were cultured for 3 hours in a medium containing 30mU/ml XO/0.1mM HX. MK- 801 was very effective in blocking oxidant-induced neurotoxicity, while CNQX falied to show any protective effect in these cultures. CONCLUSION: It is suggested that oxygen radicals are neurotoxic, and selective N-methyl-D-aspartate antagonists such as MK-801 are very effective in protecting neurotoxicity induced by oxygen radicals in cultured cerebral cortical neurons of neonatal mouse.
6-Cyano-7-nitroquinoxaline-2,3-dione ; Animals ; Anoxia ; Atmosphere ; Cell Count ; Cell Culture Techniques ; Cell Survival ; Cerebrum ; Dizocilpine Maleate ; Excitatory Amino Acid Antagonists* ; Glutamic Acid* ; Ischemia ; Mice* ; N-Methylaspartate ; Neurites ; Neurons* ; Oxidative Stress* ; Plastics ; Reactive Oxygen Species ; Receptors, Glutamate* ; Xanthine

PURPOSE: Local anesthetic effect is thought to be a part of mechanisms of musculotropic agents, and the clinical trials of local anesthetics in the treatment of hyperreflexic neurogenic bladder or in the cystoscopic biopsies have been made, but not much has been uncovered about their exact mechanism of the action on bladder. We attempted to uncover the effects of several local anesthetics on the intrinsic nerve and the smooth muscle of the bladder, and compare the potencies of them. MATERIALS AND METHODS: Male 12 week-old Sprague-Dawley rats(384+/-31gm, n=36) were killed by cervical dislocation and the urinary bladder was immediately obtained. The urinary bladder was dissected free from surrounding tissues and the bladder muscle strips(0.7x1.1x5.6mm) were prepared. The contractile responses were monitored via an FT03 force transducer(Grass) and recorded on a Grass Polyview in 95%O2/5%CO2-bicarbonate solutions. Utilizing electrical field stimulation and carbachol(5.0microM), the inhibitory effect of local anesthetics(lidocaine, bupivacaine, tetracaine) in intrinsic nerves and smooth muscle of the bladder were studied. RESULTS: The contractile response elicited by electrical field stimulation(70V/cm2, 0.8msec duration, 50Hz, trains of 2.5sec every 3 min) in local anesthetics treated Tyrode`s solution were diminished in a dose dependent manner. And their potency was in following order(bupivacaine, tetracaine, lidocaine, IC50=1-10microM) In order to study the effects on the smooth muscle itself, tetrodotoxin(0.3microM) were given to block the intrinsic nerve. After doing this, the contractile response elicited by electrical field stimulation(800msec duration pulse) in local anesthetics treated Tyrode`s solution were diminished in a dose dependent manner. And local anesthetics reduced the maximum contractile response of isolated rat detrusor muscle to carbachol(5microM) in a dose dependent, noncompetitive manner with potency in following order(tetracaine, bupivacaine, lidocaine, IC50=50-500microM). CONCLUSIONS: From these studies, local anesthetics is shown to exert direct inhibitory effect on bladder muscle as well as the intrinsic nerve, and further studies on the exact mechanism of the action on bladder smooth muscle will be needed.
Anesthetics ; Anesthetics, Local* ; Animals ; Biopsy ; Bupivacaine ; Dislocations ; Humans ; Lidocaine ; Male ; Muscle, Smooth* ; Poaceae ; Rats* ; Rats, Sprague-Dawley ; Tetracaine ; Urinary Bladder* ; Urinary Bladder, Neurogenic

This study was conducted to obtain accurate data on the intake, digestibility and nitrogen balance of protein in Korean college women. Subjects were 8 female college students, aged from 21 to 23, and maintained their menu and life patterns regular during a 4-week study. The same amount of diet that the subjects had consumed, and feces and urine were collected and measured to extract their nitrogen content by Kjeldahl method. From this data, apparent digestibility and the body nitrogen balance were estimated by determing daily protein intake and excretion. The daily protein intake was 56.9+/-1.4g and daily fecal protein loss was 6.3+/-0.2g. The apparent digestibility of protein was 89.6+/-0.7%. The daily nitrogen intake measured by Kjeldahl method was 9.43+/-0.2g. The urinary nitrogen excretion was 7.64+/-0.23g and fecal nitrogen excretion was 1.02+/-0.03g. The nitrogen balance indicated a positive balance of 0.45+/-0.18g.
Diet ; Dietary Proteins* ; Feces ; Female ; Humans ; Nitrogen

No abstract available.
Animals ; Histamine* ; Hydroxyzine* ; Rats* ; Urinary Bladder*