Central diabetes insipidus is a rare disorder that can result as a consequence of diverse etiologies, including malformations, autoimmune, infiltrative(e.g. neoplastic or histiocytosis) or traumatic processes, as well as mutations in the gene encoding arginine vasopressin. Idiopathic central diabetes insipidus is a diagnosis of exclusion, one that has been made less frequently through the decades. Idiopathic central diabetes insipidus in children and adolescent requires a frequent follow-up regimen using serial brain MRI and CSF examinations especially if an isolated pituitary stalk thickening or loss of a hyperintense signal in the posterior lobe is observed. Also, so-called "idiopathic" central diabetes insipidus warrants close follow-up to determine the etiology, especially if anterior pituitary hormone deficiencies are detected. We report a case of idiopathic central diabetes insipidus with growh hormone deficiency and loss of a hyperintense signal in the posterior lobe. He is a 13 years old. We are scheduled to follow-up with serial contrast enhanced brain MRI and CSF evaluation for the early detection of an evolving occult hypothalamic-stalk lesion.
Adolescent ; Arginine Vasopressin ; Brain ; Child ; Diabetes Insipidus, Neurogenic* ; Diagnosis ; Follow-Up Studies ; Growth Hormone* ; Humans ; Magnetic Resonance Imaging ; Pituitary Gland

Trichophyton verrucosum is a worldwide zoophilic dermatophye. The human infection was first reported in t.he South western part of Korea in 1986 and Fas been increasing in Taegu area. Thirty-one strains of T. verrucosum isolated from the patients in Taegu area were investigated for their mycological features. Gross observation on Sabot rauds dextrose agar, microscopic examination by scotch tape method and slide culture or Sabourauds dextrose agar and potato dextrose agar, and hair perforation test were perforn ed at 37C. The averages of the largest dimensions of the colonies were .9mm at 2 weeks and 59mm at 4 weeks. The morphologic features of the colonies were clasified into three types. Eighteen of 31 strains showed flatwhitish, disc-like colonies with suvmerging hyphae, 11 strains had large radiating follows on the center of the colonies, and 2 strains showed colonies having diffuse fine folds on their surfaces with well-defined borders. On microscopic exaniination, many chlamydospores, antlerlive hyphae, oval and clavate microconidia, and rat tail or string bean shaped macroconidia were observed. It seemed that observation on potato dextrose agar during 10 to 14 days af er inoculation was suitable method for microscopic examination of T. verrucosum. All 31 strains showed positive reaction on hair perforation test.
Agar ; Animals ; Daegu* ; Glucose ; Hair ; Humans ; Hyphae ; Korea ; Rats ; Solanum tuberosum ; Tail ; Trichophyton*

PURPOSE: One of the most difficult problems in the care of children with nephrotic syndrome remains the occurrence of relapses, despite initial response to steroids. Constantinescu reported that rapidity of initial response to steroid therapy could predict fewer relapses in the first year. So we evaluated the changes in serum lipid abnormalities in children with corticosensitive nephrotic syndrome before steroid treatment and the correlation between serum lipid levels and renal function, days to remission. METHODS: We analyzed the medical records of children who were managed by us between October 1994 and August 2000. In 33 patients with corticosensitive nephrotic syndrome, we evaluated the correlation between serum lipid levels and renal function [Creatinine clearance(Ccr)] and proteinuria before steroid treatment, and days to remission defined as the third day when the patient`s urine becomes protein free. RESULTS: There were 21 males and 12 females. Median age at presentation was 6.4 years (range: 1.8-17.3 years). Median days to remission were 15.4 days (range 4-42 days) on Prednisolone 60mg/m2 daily. The increased levels of triglyceride, total cholesterol, LDL cholesterol, apolipoprotein B, total cholesterol/HDL cholesterol, Lipoprotein(a) were observed. But the level of HDL cholesterol was not increased. Serum albumin was decreased and proteinuria was increased before steroid treatment. But Ccr was not decreased. There were negative correlation between serum albumin and total cholesterol (r = -0.5157, P<0.005), LDL cholesterol (r = -0.5543, P<0.005), total cholesterol/HDL cholesterol (r = -0.4506, P<0.01), lipoprotein(a) (r = -0.4570, P<0.025), apolipoprotein B (r = -0.5297, P<0.025), apolipoprotein B/apolipoprotein A1 (r = -0.5851, P<0.01), apolipoprotein B/HDL cholesterol (r = -0.4961, P<0.05) before steroid treatment. There was no correlation between proteinuria and serum lipid profiles. Also Ccr and serum lipid profiles were not correlated. There was positive correlation between days to remission and HDL cholesterol (r = +0.4511, P<0.05), apolipoprotein B (r = +0.5190, P<0.05), apolipoprotein B/HDL cholesterol (r = +0.7169, P<0.005). CONCLUSIONS: This results reveal that HDL cholesterol, apolipoprotein B and apolipoprotein B/HDL cholesterol can be used as a predictive factor in corticosensitive nephrotic syndrome. We could not determine the significant level of these lipids for insufficient patients number, but these level may predict future relapses of corticosensitive nephrotic syndrome patients and thus may allow to better management and treatment protocols. More data and long term follow up studies should be needed.
Apolipoproteins ; Child ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Female ; Follow-Up Studies ; Humans ; Hyperlipidemias* ; Lipoprotein(a) ; Male ; Medical Records ; Nephrotic Syndrome* ; Prednisolone ; Proteinuria ; Recurrence* ; Serum Albumin ; Steroids ; Triglycerides

Choroid plexus papilloma is a very rare disease in children. The manifestations of the disease differ according to the tumor size and the location. Increased CSF production by the tumor, hydrocephalus and symptoms of increased ICP are the main symptoms. The first line of treatment is surgical excision, but sometimes excision itself is very difficult due to the site and the size of the mass. Adjunctive radiation therapy or chemotherapy is not recommended. Since gross total resection without adjunctive therapy offers highest likelihood of success. Significant prognostic factors are sex, age, time of diagnosis, the duration between the appearance of symptoms and diagnosis, tumor volume, tumor site and the extent of surgery. We report a case of choroid plexus papilloma, in a child with anorexia and failure to thrive.
Anorexia* ; Child* ; Choroid Plexus* ; Choroid* ; Diagnosis ; Drug Therapy ; Failure to Thrive* ; Humans ; Hydrocephalus ; Papilloma, Choroid Plexus* ; Rare Diseases ; Tumor Burden

PURPOSE: Organotypic slice cultures are suitable for morphological and electrophysiological studies, and a valuable method to evaluate physiological and pathological responses to external stimuli. This study was designed to establish a method and to assess its values of organotypic slice cultures of rats' hippocampus for neuroscience research. METHODS: 8-day-old neonatal Sprague-Dawley rat's brain was dissected quickly and the brain was removed. Both of the hippocampi were dissected out in Petri dishes and placed on a chopper or tissue cutter with Gey's balanced salt solution(GBSS). Slices of 450 micrometer were cut and separated by adding of a drop of GBBS. Extra GBBS was aspirated. Transfer tissue slices of Millicell membrane were inserted in six-well plates containing 1 mL of warmed Gahwiler's media. Six-well plates were placed in an incubator at 36 degrees C with 5% CO2, and the media were changed regularly every 2 to 3 days. Some tissues were placed in 4% paraformaldehyde for staining and others were placed in Phosphate buffered saline(PBS) for 30 min for Western blotting. Then, we stained the free-floating, cryocutting or paraffin embedded slices with H&E or the days of 6, 9, 14 and 24 in vitro(DIV), and evaluated any changes of tissues and neurons by an image analysis system RESULTS: Hippocampal cultures had well-defined cell body layers of dentate gyrus, CA1, 2, 3 and 4 as early as the day of 6 in vitro(DIV). After 14 DIV, the cultures became gradually thinner from 450 micrometer to 150 micrometer. After 21 DIV, there were migrations of cells away from the margins of the slices and degenerative changes of some neuronal cells occurred. But pyramidal cells always were organized in well-defined cellular layer even after several weeks in the culture. Therefore, the best results were obtained by culturing slices of 6 to 14 DIV. Slice cutures was maintained after 4 weeks in vitro, but the oppotunity of contamination and infection increased as the periods of cultures trolonged. In staining, after any tissue was cultured in 2 weeks in vitro, no differentiation of the morphology and distribution in dentate gyrus, CA1, 2 and 3 were seen. In organo-typic slice culture of rats' hippocampus, we witnessed growth of glial and neuronal cell, and found pyramidal and granular cells. NeuN proteins were identified by Western blotting, and the density of NeuN protein bands was at the maximum value on the day of 9 in vitro. CONCLUSION: Since the organotypic slice cultures of rats' hippocampus were similar to the hippocampus in vivo in terms of anatomical and cellular morphology, it will become a valuable method for neuroscience research.
Animals ; Blotting, Western ; Brain ; Dentate Gyrus ; Hippocampus* ; Incubators ; Membranes ; Neurons ; Neurosciences* ; Paraffin ; Pyramidal Cells ; Rats* ; Rats, Sprague-Dawley

PURPOSE: Organotypic slice cultures are suitable for morphological and electrophysiological studies, and a valuable method to evaluate physiological and pathological responses to external stimuli. This study was designed to establish a method and to assess its values of organotypic slice cultures of rats' hippocampus for neuroscience research. METHODS: 8-day-old neonatal Sprague-Dawley rat's brain was dissected quickly and the brain was removed. Both of the hippocampi were dissected out in Petri dishes and placed on a chopper or tissue cutter with Gey's balanced salt solution(GBSS). Slices of 450 micrometer were cut and separated by adding of a drop of GBBS. Extra GBBS was aspirated. Transfer tissue slices of Millicell membrane were inserted in six-well plates containing 1 mL of warmed Gahwiler's media. Six-well plates were placed in an incubator at 36 degrees C with 5% CO2, and the media were changed regularly every 2 to 3 days. Some tissues were placed in 4% paraformaldehyde for staining and others were placed in Phosphate buffered saline(PBS) for 30 min for Western blotting. Then, we stained the free-floating, cryocutting or paraffin embedded slices with H&E or the days of 6, 9, 14 and 24 in vitro(DIV), and evaluated any changes of tissues and neurons by an image analysis system RESULTS: Hippocampal cultures had well-defined cell body layers of dentate gyrus, CA1, 2, 3 and 4 as early as the day of 6 in vitro(DIV). After 14 DIV, the cultures became gradually thinner from 450 micrometer to 150 micrometer. After 21 DIV, there were migrations of cells away from the margins of the slices and degenerative changes of some neuronal cells occurred. But pyramidal cells always were organized in well-defined cellular layer even after several weeks in the culture. Therefore, the best results were obtained by culturing slices of 6 to 14 DIV. Slice cutures was maintained after 4 weeks in vitro, but the oppotunity of contamination and infection increased as the periods of cultures trolonged. In staining, after any tissue was cultured in 2 weeks in vitro, no differentiation of the morphology and distribution in dentate gyrus, CA1, 2 and 3 were seen. In organo-typic slice culture of rats' hippocampus, we witnessed growth of glial and neuronal cell, and found pyramidal and granular cells. NeuN proteins were identified by Western blotting, and the density of NeuN protein bands was at the maximum value on the day of 9 in vitro. CONCLUSION: Since the organotypic slice cultures of rats' hippocampus were similar to the hippocampus in vivo in terms of anatomical and cellular morphology, it will become a valuable method for neuroscience research.
Animals ; Blotting, Western ; Brain ; Dentate Gyrus ; Hippocampus* ; Incubators ; Membranes ; Neurons ; Neurosciences* ; Paraffin ; Pyramidal Cells ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: Sometimes general anesthesia is required for dental surgery in pregnant women. Facial bone fractures or neck abscess should be treated immediately. Dental surgery, however, creates a stressful situation that can cause inflammation. Inflammatory responses are a well-known major cause of preterm labor and preterm birth. Here we demonstrate the effects of remifentanil on the factors related to preterm labor and its mechanism of action on amniotic-derived epithelial cells (WISH cells). METHODS: WISH cells were exposed to lipopolysaccharide (LPS) for 24 h and co-treated with various concentrations of remifentanil. MTT assays were performed to measure cell viability. To explain the effects of remifentanil on the factors related to inflammation in WISH cells, activation of nuclear factor kappa B (NF-κB) and p38 and the expression of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, cyclooxygenase (COX)2, and prostaglandin E (PGE)2 were quantified using western blotting and RT-PCR, respectively. RESULTS: Remifentanil did not affect WISH cell viability. In western blot analysis, co-treatment with remifentanil resulted in decreased phosphorylation of NF-κB, and expression of COX2 and PGE2 in LPS-induced inflammation, but the results were statistically significant only at low concentrations. Reduction of IL-1β and TNF-α expression was also observed with RT-PCR. CONCLUSION: Co-treatment with remifentanil does not affect the viability of WISH cells, but reduces the expression of the factors related to inflammation, which can induce uterine contraction and preterm labor. These findings provide evidence that remifentanil may inhibit uterine contraction and preterm labor in clinical settings.
Abscess ; Amnion ; Anesthesia, General ; Blotting, Western ; Cell Survival ; Dinoprostone ; Epithelial Cells ; Facial Bones ; Female ; Humans ; Inflammation ; Interleukins ; Neck ; NF-kappa B ; Obstetric Labor, Premature ; Phosphorylation ; Pregnancy ; Pregnant Women ; Premature Birth ; Prostaglandin-Endoperoxide Synthases ; Tumor Necrosis Factor-alpha ; Uterine Contraction

Desmoid tumor is histologically benign, but this tumor is clinically considered to be malignant. Surgical resection is one of the most effective therapeutic options for patients with this tumor and resection is the best choice for cases of recurrence. We experienced two cases of recurrence of thoracic desmoid tumor, and the patients were repeatedly treated by surgical resection. The patients were discharged without any complications, and careful follow up has been performed periodically. Therefore, we report on these cases of recurrent desmoid tumor along with a review of the related literature.
Fibromatosis, Aggressive ; Follow-Up Studies ; Humans ; Recurrence ; Thoracic Neoplasms

In order to investigate the trend of prevalence of heart disease in Korea, statistical observation was made on 19,239 cases of medical in-patients who were treated in 3 general hospitals, Korea University Hospital, Seoul Red Cross Hospital and Seoul Adeventist Hospital, on 73,484 cases of medical out-patients who were seen at Korea University Hospital and Seoul Adventist Hospital during the period of 5 years, from 1972 through 1976, on 7,746 cases of medical in-patients during the period of 10 years (1967 through 1976), and on 50,083 cases of medical out-patients during the period of 15 years (1962 through 1976) who were treated in Korea University Hospital. The results obtained were as follows. 1. Heart disease was 5.5% (male 5.4%, female 5.7%) of medical out-patients and 16.1% (male 16.7%, female 15.5%) of medical in-patients. 2. The incidence of heart disease was increased with the increase of age in both out-patients and in-patients. The incidences of heart disease in out-patients by age group to the total out-patients of each age group were 1.8% in 15~40 year group, 10.2% in 41~60 year group and 18.4% in over 61 year group, and those in in-patients were 5.0% in 15~40 year group, 24.4% in 41~60 year group and 30.8% in over 61 year group. 3. The incidences of individual heart disease to 4,074 cases with heart disease (male 1,986, female 2,088) of out-patients were as follows. Rheumatic myocarditis was 0.5% (male 0.6%, female 0.5%), mitral valvular disease 8.3% (male 5.8%, female 10.6%), aortic valvular disease 3.1% (male 3.9%, female 2.2%), mitral and aortic valvular disease 0.7% (male 1.3%, female 0.7%), hyper tension 72.0% (male 72.8%, female 71.0%), myocardial infarction 0.7% (male 1.2%, female 0.2%), angina pectoris 2.2% (male 3.1%, female 1.4%), atherosclerotic heart failure 4.5% (male 4.8%, female 4.1%), pericarditis 0.4% (male 0.6%, female 0.3%), idiopathic myocardiopathy 0.5% (male 0.5%, female 0.6%), postpartum myocardiopathy 0.3% in female, cor pulmonale 0.3%(male 0.2%, female 0.4%) and congenital heart disease 1.4% (male 1.8%, female 1.1%). 4. Incidences of individual heart disease to total 3,091 cases with heart disease (male 1,573, female, 1,518) of in-patients were as follows. Rheumatic myocarditis was 0.4% (male 0.5%, female 0.3%), mitral valvular disease 8.1% (male 5.1%, female 11.2%), aortic valvular disease 1.1% (male 1.3%, female 0.8%), mitral and arotic valvular disease 0.3% (male 0.3% female 0.4%), hypertension 69.6% (male 71.3%, female 68.5%), myocardial infarction 2.8% (male 4.3%, female 1.4%), angina pectoris 1.7% (male 2.0%, female 1.3%), atherosclerotic heart failure 7.5%(male 7.7%, female 6.8%), pericarditis 0.8% (male 0.9%, female 0.8%), idiopathic myocardiopathy 1.3% (male 1.3%, female 1.3%), postpartum myocardiopathy 0.7% in female, cor pulmonale 1.5% (male 1.5%, female 1.6%) and congenital heart disease 0.5% (male 0.4%, female 0.5%). 5. There was no significant seasonal variation of the incidences of individual heart diseases. 6. The incidences of rheumatic valvular heart disease, coronary heart disease and congenital heart disease of medical out-putients of Korea University hospital by 5-year-period for 3 consecutive periods (1962 through 1976) were increased and those of hypertension and cor pulmonale were decreased. 7. The incidneces of coronary heart disease and idiopathic myocardiopathy of medical in-patients of Korea University Hospital by 5-year-period for 2 consecutive periods (1967 through 1976) were increased and those of rheumatic myocarditis, hypertension and postpartum myocardiopathy were decreased. There was no change in incidence of rheumatic heart disease including rheumatic myocarditis, and congenital heart disease. 8. The trend of increasing prevalence of coronary heart disease, especially angina pectoris, was noted. Although hypertension was decreased in relative incidence, the total number of patients with hypertension was increased. This seems to suggest that hypertension tends to increase.
Angina Pectoris ; Cardiomyopathies ; Coronary Disease ; Epidemiologic Studies* ; Female ; Heart Defects, Congenital ; Heart Diseases* ; Heart Failure ; Heart Valve Diseases ; Heart* ; Hospitals, General ; Humans ; Hypertension ; Incidence ; Korea* ; Myocardial Infarction ; Myocarditis ; Outpatients ; Pericarditis ; Postpartum Period ; Prevalence ; Pulmonary Heart Disease ; Red Cross ; Rheumatic Heart Disease ; Seasons ; Seoul

PURPOSE: Metastatic biliary tract cancer (mBTC) has a dismal prognosis. In this study, an independent dataset of patients with mBTC was used to implement and validate a routine clinico-laboratory parameter-based scoring model for risk group identification. MATERIALS AND METHODS: From September 2006 to February 2015, 482 patients with mBTC were assigned randomly (ratio, 7:3) into investigational (n=340) and validation datasets (n=142). The continuous variables were dichotomized using a normal range or the best cutoff values determined using the Contal and O'Quigley statistical methods. Following a Cox’s proportional hazard model, the scoring model was derived by summing the rounded chi-square scores for the factors identified by multivariate analysis. RESULTS: The performance status (Eastern Cooperative Oncology Group 3-4), hypoalbuminemia (< 3.4 mg/dL), carcinoembryonic antigen (≥ 9 ng/mL), neutrophil-to-lymphocyte ratio (≥ 3.0), and carbohydrate antigen 19-9 (≥ 120 U/mL) were identified as independent prognosticators (Harrell’s C index, 0.682; integrated area under the curve, 0.653). Survival was clearly correlated with the risk groups (low, intermediate, and high, 14.0, 7.3, and 2.3 months, respectively; p < 0.001). The prognosis was also discriminative in the validation data set (median survival, 16.7, 7.5, and 1.9 months, respectively; p < 0.001). Chemotherapy did not offer any survival benefits for high-risk patients. CONCLUSION: These proposed prognostic criteria for mBTC can facilitate accurate patient risk stratification and treatment-related decision-making.
Biliary Tract Neoplasms* ; Biliary Tract* ; Carcinoembryonic Antigen ; Dataset ; Drug Therapy ; Humans ; Hypoalbuminemia ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Reference Values ; Social Identification