No abstract available.
Dandy-Walker Syndrome* ; Prenatal Diagnosis* ; Trisomy*

Lanolin is a complex material consisting of a mixture of numerous esters and polyesters of high-moleculer-weight alcohols and fatty acids, Lanolin allergy is important because lanolin is widely used as an emulsifier in topical medicaments and in numerous cosmetic preparations. We report a case of allergic contact dermatitis in a 27-year-old female. An erythematous pruritic rash develgood around the eyelid developed after applying a new eye cream and was aggravated after applying Cambison ophthalmic ointment. Patch testing showed positive reactions to Cambison ophthalmic ointment, 30% wool alcohol, Amerchol L101 and Nivea cream. A use test with 100% Cambison ophthalmic ointment base was positive
Adult ; Alcohols ; Dermatitis, Allergic Contact* ; Esters ; Exanthema ; Eyelids ; Fatty Acids ; Female ; Humans ; Hypersensitivity ; Lanolin* ; Patch Tests ; Polyesters ; Wool

Objective: This study aims to identify the usefulness of voice function in early screening for dysphagia. We sought to evaluate if screening tests through the functions of production and quality of voice were correlated with aspiration in dysphagic patients. Methods: This study involved 55 participants who were referred to videofluoroscopic swallowing study (VFSS) for suspected dysphagia. Blinded examiners rated the voice production function (MVI, MPT) using a portable instrument and evaluated the quality of voice (jitter, shimmer, NHR) using Visi-pitch. Swallowing functions were also evaluated by utilizing the penetration-aspiration scale (PAS), American Speech-Language-Hearing Association (ASHA), National Outcome Measurement System (NOMS) swallowing scale and VDS. The patients were divided into two groups, the penetration group, and the aspiration group according to the PAS score. The difference in variables was analyzed using the Mann-Whitney U test between the two groups. The relationship between voice parameters and swallow-related parameters was determined using the Spearman correlation coefficient. In addition, the cut-off, sensitivity, and specificity of meaningful variables in silent aspiration were analyzed using the ROC curve analysis. Results: The functions of production and quality of voice were found to be significantly different between the penetration and aspiration groups (P＜.000). The PAS score was correlated with all parameters of the functions of production and quality of voice (P＜.001). VDS was correlated with MVI, ASHA was correlated with MVI, and Shimmer (P＜.001). The meaningful variables for silent aspiration were jitter and shimmer. Conclusion Through a clinical screening test, it may be possible to predict the difference between penetration and aspiration through the functions of production and quality of voice.

Elephantiasis nostras verrucosa is an uncommon disorder that is characterized by dermal fibrosis, hyperkeratotic verrucous and papillomatous lesions and this is all caused by chronic non-filarial lymphedema secondary to infections, surgeries, tumor obstructions, radiations, congestive heart failure and obesity. We report here on a case of elephantiasis nostras verrucosa that occurred on the left lower leg of a 54-year-old woman who had a past history of extensive skin grafts and recurrent infection.
Elephantiasis ; Female ; Fibrosis ; Heart Failure ; Humans ; Leg ; Middle Aged ; Non-Filarial Lymphedema ; Obesity ; Skin ; Skin Transplantation ; Transplants

Diuretics are natriuretic agents which inhibit sodium reabsorption at their major site of action on the renal tubules and increase the excretion of sodium and combined anions. Increment of urine volume is the secondary to the natriuretic effects. Diuretic resistance occurs that threshold dose of diuretics is higher than that of other patients. It is frequently manifested among the edematous patients such as those with the nephrotic syndrome. Prolonged use of diuretics decreases the natriuretic effect of diuretics, which is called diuretic tolerance. This is important adaptations of distal nephron segment. To elucidate the mechanism of diuretic resistance, 1 mg of bumetanide was given to the nephrotic syndrome(NS) patients group and control group, respectively. The peak plasma concentration was delayed in NS patients. The proportion of urine free bumetanide for 24 hours was 73% in NS patients but 100% in control group. The ratio of urine volume and amount of Na+ and Cl - for 24 hours to the total and free urine bumetanide was decreased in NS patients. The study suggests that pharmacokinetic and pharmacodynamic changes of the diuretics induce the diuretic resistance. To determine the additive diuretic effect of albumin to the action of the furosemide, 160 mg of furosemide was administered intravenously with albumin in NS patients. Simultaneous infusion of albumin and furosemide did not enhance the diuretic effect of furosemide pharmacodynamically and pharmacokinetically. Albumin preinfusion 30 minutes before furosemide administration potentiates the diuresis, but natiuresis and pharmacokinetics were not changed. Semiquantitative immunoblotting of rat kidneys was carried out to investigate whether chronic diuretics adminstration induces changes in the abundance of Na+ transporters in distal nephron. Furosemide infusion increased cortical and outer medullary abundances of Na+-Cl- cotransporter(TSC) and all 3 subunits of the epithelial sodium channel(ENaC). Hydrochlorothiazide infusion increased abundances of some kinds of subunits of ENaC. These increases in the abundances of Na+ transporters may account for the generation of diuretic tolerance.These data suggest that to overcome the diuretic resistance or tolerance, diuretic dose increment over the threshold level and more frequent administration of the diuretics are recommended. Diuretic combinations are also proposed. Addition of albumin to augment the diuretics effect ought to be considered cautiously.
Rats ; Animals

OBJECTIVES: The purpose of this study was to make empirical evidence for a community based case management program for the first episode of psychosis. METHODS: We provided a case management program for first episode psychosis patients and assessed their symptoms, function, insight, and satisfaction using Positive and Negative Syndrome Scale (PANSS), the Health of Nation Outcomes Scales (HoNOS), Scale to assess Unawareness of Mental Disorder (SUMD), Global Assessment of Functioning Scales (GAF), and Quality of Life scales (QOL) at baseline and after the program. We also evaluated the treatment maintenance rate and the changes of their developmental task achievement. RESULTS: Significant improvement was observed in all sub-domains of PANSS and significant changes were also observed in the areas of symptoms and function of HoNOS. Significant improvement was observed in awareness of mental illness itself and its outcomes. The treatment maintenance rate was 87.5%, including three patients who stopped their medication with the doctor's order. The rate of participation in meaningful social activities, such as school or job showed an increase, from 25% at baseline to 81% after the program. CONCLUSION: Results of this study demonstrate the possibility of community programs for prevention of relapse, improvement of symptoms and function, and facilitation of return to meaningful social activities of first episode psychosis patients.
Case Management ; Humans ; Mental Disorders ; Psychotic Disorders ; Quality of Life ; Recurrence ; Weights and Measures

PURPOSE: Dexmedetomidine, a potent selective alpha2-adrenergic agonist, produces sedation and analgesia. This study was conducted to assess the effect of dexmedetomidine infusion on sevoflurane requirements, recovery profiles, and emergence agitation in children undergoing ambulatory surgery. MATERIALS AND METHODS: Forty children undergoing ambulatory hernioplasty or orchiopexy were randomized into two groups. The dexmedetomidine group (Group D, n=20) received dexmedetomidine 1 microg/kg, followed by 0.1 microg/kg/h until the end of surgery, whereas the saline group (Group S, n=20) received volume-matched normal saline. Sevoflurane was used for induction and maintenance of anesthesia and caudal block was performed in all children. End-tidal sevoflurane concentration (ET-sevo), the incidence of emergence agitation, pain scores, and sedation scores were recorded. Hemodynamic changes and other adverse effects were assessed in the perioperative period. RESULTS: ET-sevo of Group D was significantly reduced in 23.8-67% compared to Group S during surgery. The incidence of emergence agitation was lower in Group D than in Group S (5% vs. 55%, p=0.001). Postoperative pain was comparable, and discharge time was not different between the groups. Mean arterial pressure and heart rate were significantly lower in Group D during surgery. CONCLUSION: Intraoperative infusion of dexmedetomidine reduced sevoflurane requirements and decreased emergence agitation without delaying discharge in children undergoing ambulatory surgery. However, caution should be taken in regard to bradycardia and hypotension.
Adolescent ; Adult ; Ambulatory Surgical Procedures/*methods ; Child ; Dexmedetomidine/*therapeutic use ; Female ; Hemodynamics/drug effects ; Humans ; Male ; Methyl Ethers/*therapeutic use ; Psychomotor Agitation/drug therapy ; Young Adult

Corals are the marine organism that belongs to the phylum Cnidaria, and are one of the common causes of superficial injury in the marine environment. In addition to acute reactions such as burning or stinging pain and erythema, coral injuries may present with complications such as foreign body reactions, bacterial infections, and/or localized eczematous reactions. A 23-year-old male presented with an erythematous edematous tender patch with centrally grouped vesicles on the left ankle; the injury had occurred during skin-scuba diving 2 days before. A biopsy of the lesion treated with hematoxylin-eosin stain showed epidermal necrosis with subepidermal blisters and neutrophilic panniculitis. Herein we report a case of cellulitis caused by the nematocyst stings of corals.
Anthozoa ; Aquatic Organisms ; Bacterial Infections ; Biopsy ; Bites and Stings ; Blister ; Burns ; Cellulitis ; Cnidaria ; Diving ; Erythema ; Foreign Bodies ; Humans ; Male ; Necrosis ; Nematocyst ; Neutrophils ; Panniculitis ; Young Adult

Neuroendocrine tumors derive from the diffuse neuroendocrine system producing hormonal peptides and/or biogenic amines. Histologically neuroendocrine differentiation includes ultrastructural demonstration of neurosecretory granules and staining with immunhistochemical markers such as neuron-specific enolase, chromogranin, synaptophysin, and cytokeratin. Neuroendocrine carcinoma of the skin is rare but can be shown as an initial manifestation of metastatic neuroendocrine carcinoma as well as primary cutaneous neuroendocrine carcinoma. Histological differentiation between primary cutaneous Merkel cell carcinoma and metastatic neuroendocrine carcinoma of the skin is difficult and clinical correlation is important. We report a case of metastatic neuroendocrine carcinoma of the lung occurring on the scalp as a single nodule in a 65-year-old female who previously diagnosed with adenocarcinoma of the stomach.
Adenocarcinoma ; Aged ; Biogenic Amines ; Carcinoma, Merkel Cell ; Carcinoma, Neuroendocrine ; Female ; Humans ; Keratins ; Lung ; Neuroendocrine Tumors ; Neurosecretory Systems ; Peptides ; Phosphopyruvate Hydratase ; Scalp ; Skin ; Stomach ; Synaptophysin

PURPOSE: Ghrelin stimulates the secretion of growth hormone and other pituitary hormones, and has orexigenic effects. It may have a physiologic role in fetal and neonatal growth. Leptin secreted by the adipocytes reflects fat mass in infants as well as adults. The aim of this study was to evaluate the relation of cord blood ghrelin and leptin levels to body weight(BW), body mass index(BMI), insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding protein-3(IGFBP-3) levels in appropriate for gestational age(AGA) newborns. METHODS: Sixty healthy AGA newborns(31 males and 29 females, gestational age[GA] 34-42 weeks) were included in this study, whose BW and BMI were measured at delivery. Umbilical cord venous blood samples were withdrawn, and ghrelin and leptin were measured by radioimmunoassay. Cord blood IGF-I and IGFBP-3 were determined by immunoradiometric assay. RESULTS: The mean levels of ghrelin were inversely correlated with BW(r=-0.29, P<0.05) and GA (r=-0.28, P<0.05), but were not affected by gender. The mean levels of leptin levels showed positive correlation with BW(r=0.44, P<0.01), GA(r=0.36, P<0.01), and BMI(r=0.28, P<0.05). The leptin levels of females were higher than those of males. There was no gender difference in leptin levels in neonates under GA 37 weeks. However, the leptin levels of females were higher than those of males (P<0.01) in newborns with GA 37 weeks or over. There was no correlation between ghrelin and leptin levels. Ghrelin and leptin levels showed no relations to cord blood IGF-I and IGFBP-3 levels. CONCLUSION: These data suggest that cord blood ghrelin may have an inverse correlation with BW in AGA newborns, and leptin levels are positively correlated with BW and fat mass. Further study of ghrelin concentrations in cord blood is necessary to elucidate the physiological and pathological roles of ghrelin during the fetal and neonatal periods.
Adipocytes ; Adult ; Anthropometry* ; Female ; Fetal Blood* ; Gestational Age* ; Ghrelin* ; Growth Hormone ; Humans ; Immunoradiometric Assay ; Infant ; Infant, Newborn* ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Leptin* ; Male ; Pituitary Hormones ; Radioimmunoassay ; Umbilical Cord