No abstract available.
Humans ; Lupus Erythematosus, Systemic* ; Renal Veins* ; Thrombosis*

PURPOSE: We investigated whether in utero exposure to magnesium sulfate is associated with lower incidence of neonatal mortality, morbidity, and neurodevelopmental abnormalities in very low birth weight infants. METHODS: We evaluated 172 infants with birth weight less than 1,500g. According to the maternal receipt of magnesium sulfate, we divided into two groups. We reviewed the medical records of mothers and their babies to evaluate clinical outcome. RESULTS: Of 172 infants, 58(GA 30.0+/-2.3weeks, BW 1,20+/-2221g) received magnesium sulfate prior to delivery for tocolysis or preeclampsia(study group). The remaining 114(GA 29.6+/-2.3weeks, BW 1,220 +/-198g) served as the control group. Neonatal mortality was not significantly different between the two groups(12.5% vs 26.0%). There was no significant difference between the two groups in neonatal complications' RDS(52.4% vs 67.6%), BPD(16.7% vs 29.6%), apnea(52.4% vs 67.6%), IVH(23.8% vs 31.0%), PVL(4.8% vs 11.3%), NEC(7.1% vs 7.0%), ROP(26.8% vs 41.2%), and neal infection(33.3% vs 54.9%). The duration of ventilator therapy(10.9+/-7.3 vs 14.2+/-10.6 days), oxygen administration(20.2+/-20.0 vs 24.3+/-19.9 days) and admission(51.5+/-16.9 vs 54.6+/-16.7 days) were not different. Among 64 patients in whom follow up evaluation was possible more than 1 year, the incidence of cerebral palsy or developmental delay was not different(12.0% vs 12.8%). CONCLUSION: Maternal receipt of magnesium sulfate does not seem to be associated with an appreciably reduced risk of neonatal mortality, morbidity, and neurodevelopmental abnormalities in very low birth weight infants. (Abbreviations. GA, gestational age, BW, birth weight; RDS, respiratory distress syndrome; BPD, bronchopulmonary dysplasia, IVH, intraventricular hemorrhage; PVL, periventricular leukomalacia; NEC, necrotizing enterocolitis; ROP, retinopathy of prematurity)
Birth Weight ; Bronchopulmonary Dysplasia ; Cerebral Palsy ; Enterocolitis, Necrotizing ; Follow-Up Studies ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant Mortality* ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Leukomalacia, Periventricular ; Magnesium Sulfate* ; Magnesium* ; Medical Records ; Mothers ; Oxygen ; Tocolysis ; Ventilators, Mechanical

No abstract available.
Adolescent* ; Humans

PURPOSE: To report a case of bilateral peripheral ulcerative keratitis after cataract extraction with a clear corneal incision in a patient with rheumatoid arthritis. CASE SUMMARY: A 67-year-old woman was referred to our clinic with bilateral ocular pain and visual disturbances, 10 days after a cataract extraction in her right eye. The patient had undergone a cataract extraction with clear corneal incision in the left eye and the same procedure was performed in the right eye after 1 week. During the surgery, hyphema occurred because of the iris damage by the phacoemulsification tip. Slit lamp examination showed bilateral peripheral ulcerative keratitis around the incision site and diffused corneal edema. Topical instillation and systemic administration of antibiotic agents were given as treatment but the patient showed no improvement. Corneal culture and smear were performed and showed a negative result. Because the patient was previously diagnosed with rheumatoid arthritis and showed the characteristic finger deformity, she was diagnosed with a sterile peripheral ulcerative keratitis and was treated with oral steroid, sulfasalazine, and steroid eye drop. After 1 month of treatment, epithelial thinning of the cornea and peripheral corneal ulcer stopped progressing and showed corneal re-epithelization. CONCLUSIONS: Because peripheral ulcerative keratitis after cataract extraction with clear corneal incision can occur in a patient with rheumatoid arthritis, caution is necessary to minimize damage by careful manipulation during the operation and requires special attention in preoperative and postoperative management.
Arthritis, Rheumatoid ; Cataract ; Cataract Extraction ; Congenital Abnormalities ; Cornea ; Corneal Edema ; Corneal Ulcer ; Eye ; Female ; Fingers ; Humans ; Hyphema ; Iris ; Phacoemulsification ; Sulfasalazine ; Ulcer

PURPOSE: To present a case of a unilateral diffuse retinal hemorrhage in a 15-year-old girl, who underwent bilateral trabeculectomy for steroid induced glaucoma. METHODS: Despite the maximally tolerable medical treatment, IOP in the right eye remained above 50 mmHg for four months, and was simultaneously elevated in the left eye. So we performed bilateral trabeculectomy. RESULTS: On the first postoperative day, diffuse retinal hemorrhages were observed in the right eye; however, no retinal hemorrhage was found in the left eye. The hemorrhages resolved completely without consequences two months later. CONCLUSIONS: In the case of high IOP for a long period, sudden lowering of IOP may acutely increase the blood flow and consequently rupture multiple retinal capillaries because of altered autoregulatory function. Special care is therefore needed to prevent an abrupt fall in IOP before, during, and after surgery, especially when IOP has been highly elevated for an extended period.
Administration, Topical ; Adolescent ; Female ; Fluorescein Angiography ; Fundus Oculi ; Glaucoma/chemically induced/*surgery ; Humans ; Retinal Hemorrhage/diagnosis/*etiology/pathology ; Steroids/administration & dosage/adverse effects/therapeutic use ; Trabeculectomy/*adverse effects ; Uveitis/drug therapy

PURPOSE: Nutcracker syndrome refers to compression of the left renal vein(LRV) between the aorta and superior mesenteric artery(SMA) that results in elevation of pressure in the LRV and development of collateral veins. It must be considered as a possible factor when hematuria or proteinuria occurs in a healthy child. The purpose of this study is to determine the time to spontaneous resolution in childhood nutcracker syndrome, and to observe whether this is affected by sex, age, proteinuria or initial ratio of peak velocity of LRV. METHODS: We investigated 26 patients who were found to have spontaneous resolution by follow-up Doppler ultrasonography among 117 patients diagnosed with nutcracker syndrome by renal Doppler ultrasonography from May 2001 to December 2005. We determined the time to spontaneous resolution in childhood nutcracker syndrome, and observed whether the duration was affected by sex, age, proteinuria or initial ratio of peak velocity. RESULTS: 26 patients(59%) achieved spontaneous resolution by 1.2 years(mean). The time to spontaneous resolution of childhood nutcracker syndrome in 26 patients was 16.71+/-9.99 months(range 6.0-49.2). The time to spontaneous resolution was not affected by sex, age, proteinuria nor initial ratio of peak velocity of LRV. CONCLUSION: More than half of the patients who were diagnosed by renal Doppler ultrasonography achieved spontaneous resolution. The time to spontaneous resolution was not affected by sex, age, proteinuria nor initial ratio of peak velocity of LRV.
Aorta ; Child ; Follow-Up Studies ; Hematuria ; Humans ; Proteinuria ; Ultrasonography, Doppler ; Veins

Type II collagen (CII), major component of hyaline cartilage, has been considered as an auto-antigen in rheumatoid arthritis (RA). However, the clinical and biological significances with regard to the CII autoimmunity need to be clarified in human RA. The presence of antibodies to CII has been identified in sera, synovial fluid, and cartilage of patients with RA. In our study, the increased titer of IgG anti-CII in sera was well correlated with C-reactive protein, suggesting that this antibody may reflect the inflammatory status of RA. The titer of anti-CII antibodies (anti-CII Abs) tended to be higher in early stages of diseases. In our extending study, among 997 patients with RA, 269 (27.0%) were positive for circulatory IgG antibody to CII, those levels were fluctuated over time. It is hard to assess the significant amount of T cell responses to CII and CII (255~274) in RA. By using a sensitive method of antigen specific mixed lymphocyte culture, we can detect the presence of CII-reactive T cells in peripheral blood mononuclear cells of RA patients. Sixty seven (46.9%) of 143 patients showed positive CII reactive T cell responses to CII or CII (255~274). The frequencies of CII reactive T cells were more prominent in inflamed synovial fluid (SF) than in peripheral blood. These T cells could be clonally expanded after consecutive stimulation of CII with feeding of autologous irradiated antigen presenting cells (APC). Moreover, the production of Th1-related cytokine, such as IFN-gamma, was strongly up-regulated by CII reactive T cells. These data suggest that T cells responding to CII, which are probably presenting the IFN-gamma producing cells, may play an important role in the perpetuation of inflammatory process in RA. To evaluate the effector function of CII reactive T cells, we investigated the effect of CII reactive T cells and fibroblasts-like synoviocytes (FLS) interaction on the production of pro-inflammatory cytokines. When the CII reactive T cells were co-cultured with FLS, the production of IL-15 and TNF-alpha from FLS were significantly increased (2 to 3 fold increase) and this increase was clearly presented in accord to the expansion of CII reactive T cells. In addition, the production of IFN-gamma and IL-17, T cell derived cytokines, were also increased by the co-incubation of CII reactive T cells with FLS. We also examined the impact of CII reactive T cells on chemokines production. When FLS were co-cultured with CII stimulated T cells, the production of IL-8, MCP-1, and MIP-1alpha were significantly enhanced. The increased production of these chemokines was strongly correlated with increase the frequency of CII reactive T cells. Conclusively, immune response to CII was frequently found in RA. Activated T cells in response to CII contributed to increase the production of proinflammatory cytokines and chemokines, which were critical for inflammatory responses in RA. The interaction of CII-reactive T cells with FLS further augmented this phenomenon. Taken together, our recent studies have suggested that autoimmunity to CII could play a crucial role not only in the initiation but amplification/perpetuation of inflammatory process in human RA.
Antibodies ; Antigen-Presenting Cells ; Arthritis, Rheumatoid* ; Autoimmunity ; C-Reactive Protein ; Cartilage ; Chemokine CCL3 ; Chemokines ; Collagen Type II* ; Cytokines ; Humans ; Hyaline Cartilage ; Immunoglobulin G ; Interleukin-15 ; Interleukin-17 ; Interleukin-8 ; Lymphocytes ; Synovial Fluid ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis

Ciliary neurotrophic factor (CNTF) is well known as a growth/survival factor of neuronal tissue. We investigated the expression of CNTF and its specific receptor alpha (CNTFRalpha) in a unilateral ureteral obstruction (UUO) model. Complete UUO was produced by left ureteral ligation in Sprague-Dawley rats. The animals were sacrificed on days 1, 3, 5, 7, 14, 21, and 28 after UUO. The kidneys were fixed, and processed for both immunohistochemistry and in situ hybridization. CNTF immunoreactivity in sham-operated kidneys was observed only in the descending thin limb (DTL) of the loop of Henle. In UUO kidneys, CNTF expression was induced in the S3 segment (S3s) of the proximal tubule from day 1, and progressively expanded into the entire S3s and a part of the convoluted proximal tubules, distal tubules (DT), and glomerular parietal epithelium up to day 7. Upregulated CNTF expression was maintained to day 28. From day 14, the inner medullary collecting duct showed weak CNTF immunoreactivity. The CNTFRalpha mRNA hybridization signal in sham-operated kidneys was weakly detected in the DTL, DT, medullary thick ascending limb, and in a few S3s cells. After UUO, CNTFRalpha mRNA expression increased progressively in both the renal cortex and the medulla up to day 7 and increased expression was maintained until day 28. The results suggest that the S3s may be the principal induction site for CNTF in response to renal injury, and that CNTF may play a role in chronic renal injury.
Animals ; Chimera ; Ciliary Neurotrophic Factor ; Ciliary Neurotrophic Factor Receptor alpha Subunit ; Epithelium ; Extremities ; Immunohistochemistry ; In Situ Hybridization ; Kidney ; Ligation ; Loop of Henle ; Neurons ; Rats, Sprague-Dawley ; RNA, Messenger ; Ureter ; Ureteral Obstruction

Cerebral arterial embolism which resulted in total occlusion of right proximal middle cerebral artery was occured in 33 years old female patients with severe mitral stenosis and atrial fibrillation during percutaneous mitral balloon valvuloplasty(PMV). The occluded artery could be detected by transfemoral carotid angiography and recanalized immediately by intra-arterial infusion of urokinase. There were no cerebral hemorrhage by CT scan after intra-arterial urokinase infusion and the patients discharged without any neurologic sequale 7 days after thrombolysis. We report a case of successful recanalization with intraarterial infusion of urokinase in patient with cerebral arterial embolism occurred during PMV.
Adult ; Angiography ; Arteries ; Atrial Fibrillation ; Cerebral Hemorrhage ; Embolism* ; Female ; Humans ; Infusions, Intra-Arterial* ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve Stenosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator*