Congenital hypoprothrombinemia is a rare congenital coagulation defect. The clinical signs are manifestation of generalized tendency such as; mucosal bleeding, hypermenorrhea and post tooth extraction hemorrage. It is associated with prolongation of PT and PTT with normal thrombin time and decreased serum prothrombin level. A case with congenital hypoprothrombinemia was experienced by the authors. A 36 days old male baby was admitted with palor skin and vomiting started one day before admission. Right side brain parenchymal hemorrhage and left shift of lateral ventricle were on brain CT scan. Prologation of prothrombin time and partial prothrombin time with decreased serum prothrombin level were resulted. Serum factor I, V, VII, VIII, IX and X were within normal level. We report a case congenital hypoprothrombinemia with a brief review of relaed literatures.
Brain ; Female ; Fibrinogen ; Hemorrhage ; Humans ; Hypoprothrombinemias* ; Lateral Ventricles ; Male ; Menorrhagia ; Prothrombin ; Prothrombin Time ; Skin ; Thrombin Time ; Tomography, X-Ray Computed ; Tooth Extraction ; Vomiting

Schonlein-Henoch purpura is a generalized small vessel vasculitis characterized by nonthrombocytopenic purpura, arthritis, abdominal pain and nephritis. In 1914 Osler described an allergic purpura associated with hemiplegia. After then Lewis et al. reported the cases of Schonlein-Henoch purpura associated with convulsion, coma, confusion, intracranial hemorrhage, and chorea, CNS complication has been reported in 1-8% of children and subsided spontaneously in most cases. Headache is a remarkable sympton and appears nonspecific nature. In 1991 Ostergaard and Storm reported that headache occured during the first week following skin rash and frequently showed abnormal EEG findings. We investigated prospectively the presence of a possible cerebral and renal involvement in the case of Schonlein-Henoch purpura. EEG abnormality demonstrated in 52.6% of all cases, and headache or irritability in 47.4% of all cases. A significant association was found between abnormal EEG finding and presence of headache, but was not found between EEG findings and presence of renal involvement and hypertension. Patients with abnormal EEG had no Past or famity history of febrile convulsion or ididopathic epilepsy.
Abdominal Pain ; Arthritis ; Child ; Chorea ; Coma ; Electroencephalography* ; Epilepsy ; Exanthema ; Headache ; Hemiplegia ; Humans ; Hypertension ; Intracranial Hemorrhages ; Nephritis ; Prospective Studies ; Purpura, Schoenlein-Henoch* ; Seizures ; Seizures, Febrile ; Vasculitis

Synthetic genes encoding the gag p24 and the part of the envelope protein gp41 of the human immunodeficiency virus (HIV-1) were cloned and overexpressed as fusion proteins in Escherichia coli, using an expression vector carrying 77 promoter and the poly-histidine leader sequence. The overexpressed p24 fusion protein was purified by centrifugation, Ni-affinity chromatography and CM-sepharose chromatography The overexpressed gp41 fusion protein was purified by centrifugation, C4 chromatography and DEAE-sepharose chromatography. The purified fusion proteins showed a high level of purity and immunoreactivity in SDS-polyacrylamide gel electrophoresis and western blot analysis. These results suggest that this prokaryotic expression-purification method is suitable for obtaining a large amount of the viral antigen which may be useful for screening of antibodies to HIV-1 in human blood samples.
Antibodies ; Blotting, Western ; Centrifugation ; Chromatography ; Clone Cells ; Electrophoresis ; Escherichia coli ; Genes, Synthetic ; HIV* ; HIV-1* ; Humans* ; Mass Screening

Hyperplasia of the gingivae may occur as a secondary reaction in the treatment of epilepsy with diphenylhydantoin sodium. This study is intended to investigate the incidence and dharacteristics of gingival hyperplasia in 124 epileptic patients taking diphenylhydantoin longstandingly. The results are as follows: 1. The incidence of diphenylhydantoin induced gingival hyperplasia is approximately 69.4%. 2. The individual tolerance or sensitivity may determine the incidence and severity of gingival hyperplasia and are not directly related with the duration of drug use and its dosage. 3. Gingival hyperplasia is more frequent in female patients and younger patients than male and older. 4. There is no direct relationship betwwen occurance of gingival hyperplasia and meticulous oral hygiene. 5. The mechanism involved in a causation of diphenylhydantoin induced gingival hyperplasia has not been elucidated. 6. We recommand that diphenylhydantoin may be prescribed as the drug of the first choice for the control of epileptic seizure in the adolescent female patients and children especially receiving certain dental treatments.
Adolescent ; Child ; Epilepsy ; Female ; Gingiva ; Gingival Hyperplasia* ; Humans ; Hyperplasia ; Incidence ; Male ; Oral Hygiene ; Phenytoin ; Sodium

BACKGROUND: Tetanic spasm is often noted in hyperventilating patients coming in to emergency departments. Classical explanation far this phenomenon was decreased ionized calcium levels due to respiratory alkalosis precipitated by the hyperventilation. Clinically these symptoms were observed in hypocalcemia and were thought as such without doubt. But clinical investigation on the levels of ionized calcium levels have not been clarified. Recent investigations on hyperventilating volunteers have suggested other pathophysiology for tetanic spasm in hyperventilating patients which is the decrement of ionized magnesium level rather than ionized calcium. We wanted to see if these results applied to our hypeventilating patients and see if ionized magnesium level was a factor producing tetanic symptoms. METHOD AND MATERIAL : 35 patients with diagnosis of hyperventilation syndrome by emergency physician were studied retrospectively. Hyperventilating patients arriving at Severance hospital Emergency Center from Jan.1996 to Feb. 1998 were included. Patients with cardiovascular, pulmonary diseases, history of renal or liver disease were excluded. Ion-selective method was used to detect ionized calcium, magnesium levels and arterial blood gas features. Average levels were compared to reference ranges and Wilkoxon-rank. sum test was used to compare hyperventilating patients with tetanic spasm and those with other symptoms such as dyspnea, chest pain and palpitations. RESULTS: 1) Sodium, potassium and chloride levels were 138mmol/L, 3.6mmo1/L, 106mmol/L each which were within a normal range. 2) Degrees of hyperventilation were similar with average of PH 7.54(7.4-7.71), pCO2 23.6mmHg, showing respiratory alkalosis. 3) Ionized calcium and ionized magnesium each showed 0.61mg/dL, 0.16mg/dL lower values than the lowest reference ranges which were 4.5-5.6mg/dL for ionized calcium and 1.19-1.63 for ionized magnesium. 4) No statistical difference points were observed between the tetanic spasm group and group without spasm. Female preponderance were noted in tetanic spasm group. CONCLUSION: We conclude that ogler than decrement of ionized calcium, decrement of ionized magnesium could be a factor far inducing tetanic spasm in respiratory alkalosis caused by hyperventilation.
Alkalosis, Respiratory ; Calcium* ; Chest Pain ; Diagnosis ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Female ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation* ; Hypocalcemia ; Liver Diseases ; Lung Diseases ; Magnesium* ; Potassium ; Reference Values ; Retrospective Studies ; Sodium ; Spasm ; Volunteers

No abstract available.
Histiocytosis*

No abstract available.
Nocardia Infections* ; Nocardia*

Neonatal sepsis is a major contributing factor for increased mortality and morbidity in the newbron and its successful outcome depends on early detection and prompt institution of an effective antimic robial therapy. Accurate diagnosis of the neonatal septicemia, however, is quite difficult because its early signs and symptoms are rather subtle. This study was conducted in an attempt to search for useful early markers for the clinical entity A total of 224 newborns, over a 17 month pcriod (1/90 5/91), who were evaluated for probable neonatal sepsis were analysed. The laboratory parameters that showed highest correlation with bacteriologically proves sopsis were as follows: Total WBC counts (<5,000/mm), Band/Total ncutrophils(>0.2), elevated ESR(>15mm/hr), CRP(>6ng/ml). Of the 224 study subjects, 41 had two or more parameters of which 12 subjects had positive blood cultures(positive predictive value:29%), only 4 of the 183 newborns who had less than 2 parameters had positive blood cultures(false negative:2%). It is concluded that the presence of two or more of the above parameters can be used as a strong indicator for neonatal sepsis and its sensitivity is 75% while specificity is 86%.
Diagnosis ; Early Diagnosis* ; Humans ; Infant, Newborn ; Mortality ; Sensitivity and Specificity ; Sepsis*

PURPOSE: The analgesic efficacy and side-effects of continuous intravenous infusion of Butorphanol for postoperative pain relief after evisceration were evaluated. METHODS: We evaluated the postoperative pain using Numerical Rating Scale in 19patients undergoing evisceration under general anesthesia. One group (group2, 9patients) received continuous intravenous injection of Butorphanol 14 mg mixed with 5% D/W 100ml using silicone balloon infuser for 2days. The other group (group1, 10patients) was not received it. RESULTS: The second group patients reported less pain compared to the first group patients in the first and second post operative day. The total NRS value of pain was 28.1+/-4.73 (group1) vs 11.22+/-0.99 (group2). CONCLUSIONS: For 48hr post operative pain relief in patients undergoing evisceration, the analgesic efficacy of the continuous intravenous injection of Butorphanol is useful.
Anesthesia, General ; Butorphanol* ; Humans ; Infusions, Intravenous* ; Injections, Intravenous ; Pain, Postoperative* ; Silicones*

The renin-angiotensin system plays an important role in renal growth and development. Exposure of the fetus or neonate to angiotensin converting enzyme (ACE) inhibitors increases mortality, growth retardation, and results in renal anomalies. This study was designed to investigate the effects of ACE inhibition in the neonatal rat on the expression of genes known to modulate renal cellular proliferation, cell interactions, and extracellular matrix. Newborn rat pups were treated with enalapril (30mg/ kg/day) or vehicle for 14 days, and kidneys were removed for determination of mRNA for transforming growth factor-beta 1 (TGF- B1) and prepro epidermal growth factor (EGF). Enalapril treatment resulted in 40Yo mortality by day 14 as well as reduced body and kidney weight (P<0.05 vs vehicle group). Also enalapril decreased renal TGF-Bl and EGF mRNA expression (P<0.05). These results indicate that ACE inhibition in the developing kidney reduces the renal expression of critical growth factors, which may account for renal growth impairment.
Angiotensins* ; Animals ; Cell Communication ; Cell Proliferation ; Enalapril ; Epidermal Growth Factor ; Extracellular Matrix ; Fetus ; Growth and Development ; Humans ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Kidney* ; Mortality ; Peptidyl-Dipeptidase A* ; Rats* ; Renin-Angiotensin System ; RNA, Messenger ; Transforming Growth Factor beta1