No abstract available.
Child* ; Gastroenteritis* ; Humans* ; Infant*

Hypothalamic suprachiasmatic nucleus (SCN) is a circadian pacemaker which controls diurnal behavioral and hormonal rhythms in mammals. The SCN receives environmental light signals through the retinohypothalamic tract, and glutamate is the major excitatory neurotransmitter in the retinohypothalamic tract. In the present study, we investigated the developmental expression of the mRNAs for N-methyl-D-aspartate type glutamate receptor (NR)1, NR2A, NR2B and NR2C subunits in the rat SCN using in situ hybridization with specific riboprobes. At postnatal day 2 (P2), P8, Pl5 and P45, the high level of NRI transcripts was observed in both ventrolateral and dorsomedial subdivisions of the SCN, and the distinct expression of NR2C mRNA was principally found in the dorsomedial SCN. The weak NR2B mRNA expression was clearly found in both subdivisions of the SCN at P2 and P8, whereas specific NR2B hybridization signals were not found at Pl5 and P45. There was no specific hybridization signal of NR2A in the SCN throughout the postnatal life. These findings implicate that NR may play an important role in the neonatal SCN. In addition, this study suggests that NR1, NR2B and NR2C might be the major NR subunits in the developing SCN, whereas NRI and NR2C could be the subunit components of NR in the adult SCN.
Adult ; Animals ; Glutamic Acid ; Humans ; In Situ Hybridization ; Mammals ; N-Methylaspartate* ; Neurotransmitter Agents ; Rats* ; Receptors, Glutamate ; RNA, Messenger* ; Suprachiasmatic Nucleus

We have experienced acute hepatitis after general anesthesia. We guess that acute hepatitis is caused by enflurane anesthesia. We will report this case with references. A 34 year old pregnant woman suffered from preeclamsia. She admitted for emergence repeat cesarean-section due to labor pain. In this operation general anesthesia was performanced with enflurane. The preoperative liver enzyme were normal and other tests were within normal range. She developed high fever, marked elevation of serum glutamic oxaloacetic transaminase(SGOT)/serum glutamic pyrubic transaminase(SGPT)/ alkaline phosphatase(ALP)/total bilirunbin(T-B) on the 2nd postoperative day. She recovered gradually and discharged after 13 day's hospitalization. A possible cause of the acute hepatitis in this case were considered to be the enflurane.
Adult ; Anesthesia ; Anesthesia, General* ; Enflurane* ; Female ; Fever ; Hepatitis* ; Hospitalization ; Humans ; Labor Pain ; Liver ; Pregnancy ; Pregnant Women ; Reference Values

For the evaluation of exercise induced R wave amplitude changes in lead V5 (big up tri, openR) and multiple leads(summation operatorR), we studied 20 normal subjects and 21 ischemic heart disease patients with positive exercise test. All underwent submaximal, multiple leads multistage treadmill exercise testing. 14 to 20 normal subjects(70%) there were decreased R wave amplitude in multiple leads on treadmill exercise testing. 16 of 21 patients(76%) there were increased R wave amplitude on treadmill exercise testing. In normal group, R wave amplitude between rest and exercise was significantly decreased in lead V5 and multiple leads. In patients grous, R wave amplitude between rest and exercise was significantly increased in lead V5 and multiple leads. It is suggested exercise induced R wave amplitude changes probably enhance the diagnostic reliability by ST segment changes on treadmill exercise testing.
Exercise Test* ; Humans ; Myocardial Ischemia

Damage of temporomandibular joints in infancy may result in ankylosis and alteration of the mandibular growth. In case of unilateral ankylosis occurring in early childhood, a mandibular hypoplasia of the affected side usually follows. The patients have limitation of mouth opening, poor oral hygiene, facial and mandibular growth disturbances, and rarely, upper airway obstruction in the form of either night snoring or obstruction sleep apnea. The objective of this study is to show the use of distraction osteogenesis in mandibular hypoplasia associated with ankylosis and to present our technique for the treatment of mandibular hypoplasia with unilateral ankylosis in infancy consisting of simultaneous arthroplasty which treats the ankylosis and mandibular distraction and enables to correct the facial asymmetry in the same procedure. Between November 1999 and May 2000, three girl patients (42, 44, and 48 months old) who had mandibular hypoplasia associated with ankylosis were treated with simulatneous arthroplasty and distraction osteogenesis. Two kinds of arthroplasties, consisting of gap arthroplasty for one patient and interpositional arthroplasty using a temporal fascia turn-over flap for the other two patients, were executed and mandibular distraction in all three patients. Mouth-opening exercises began on the first day following the operation. Mandibular distraction began on the fifth day after the operation at a rate of 1 mm per day (0.5 mm twice a day) and continued to achieve a slight overcorrection of deviated chin. From the first day after the operation, an increase in the mouth opening was achieved. The average duration of distraction was 20 days. Average duration of consolidation was 6 weeks. Oral opening increased from 2 to 20 mm in case of the first patient, from 4 to 28 mm in the second patient, and from 5 to 24 mm in the third patient. The follow-up period was from 5 to 12 months (mean 8 months). At the time of final evaluation, oral opening and a more normal facial contour persist. It is believed that mandibular distraction combined with arthroplasty offers a new therapeutic option for the treatment of mandibular hypoplasia associated ankylosis, with minimal morbidity and complications.
Airway Obstruction ; Ankylosis* ; Arthroplasty* ; Chin ; Exercise ; Facial Asymmetry ; Fascia ; Female ; Follow-Up Studies ; Humans ; Mouth ; Oral Hygiene ; Osteogenesis, Distraction ; Sleep Apnea Syndromes ; Snoring ; Temporomandibular Joint*

Purpose: To evaluate the proportion of bevacizumab and the reason for its usage in wet age-related macular degeneration (AMD). Methods: Retrospective analysis of medical records was performed for 1,541 patients who received ranibizumab, aflibercept, or bevacizumab injection to treat wet AMD. The proportion of bevacizumab among the entire set of injections was identified. The reason for selecting bevacizumab was additionally identified. Results: During the study period, a total of 2,929 anti-vascular endothelial growth factor (anti-VEGF) injections were performed; 2,236 (76.3%) were ranibizumab or aflibercept injections and 693 (23.7%) were bevacizumab injections. The most common reason for bevacizumab usage was ‘having a 0.1 or worse best-corrected visual acuity or being unable to assure reimbursement due to the development of extensive scarring or geographic atrophy’ (297 bevacizumab injections, 42.9%). The second most common reason was ‘the inability to assure reimbursement such as extrafoveal choroidal neovascularization (CNV) or early CNV without definite fluid in the foveal region’ (201 bevacizumab injections, 29.0%). Conclusions Bevacizumab was used in 23.7% of the anti-VEGF injections to treat wet AMD. When analyzing patients’ treatment burden and financial impact, the results of the present study may provide useful information. Further multi-center studies are required to evaluate more precisely the usage of anti-VEGF drugs.

Purpose: To evaluate the proportion and reasons for ineligibility to re-register for extended health insurance at 5 years in patients diagnosed with neovascular age-related macular degeneration (AMD) and registered for extended health insurance. Methods: This retrospective study was performed in patients diagnosed with neovascular AMD and registered for extended health insurance with follow-up for at least 5 years. The criteria for re-registration for extended health insurance were determined along with the ineligibility for re-registration. Results: In total, 263 patients were included in the analysis. Of these, 148 (56.3%) did not satisfy the criteria for re-registration. No active treatment was performed in 98 patients during the last 6 months of the study period (no recurrence, 51 patients; additional treatment was not considered beneficial due to retinal damage even without disciform scar formation, 44 patients). Macular disciform scar formation was noted in 50 patients (33.8%). Older age (p = 0.013), poor visual acuity (p = 0.004), and retinal angiomatous proliferation (p < 0.001) were associated with ineligibility for re-registration due to severe retinal damage. Conclusions Among the patients who were initially registered for extended health insurance, 56.3% failed to satisfy the re-registration criteria. The primary reason was advanced retinal damage. The results of this study provide useful information for patient education and to establish long-term treatment strategies.

Purpose: To evaluate the proportion of bevacizumab and the reason for its usage in wet age-related macular degeneration (AMD). Methods: Retrospective analysis of medical records was performed for 1,541 patients who received ranibizumab, aflibercept, or bevacizumab injection to treat wet AMD. The proportion of bevacizumab among the entire set of injections was identified. The reason for selecting bevacizumab was additionally identified. Results: During the study period, a total of 2,929 anti-vascular endothelial growth factor (anti-VEGF) injections were performed; 2,236 (76.3%) were ranibizumab or aflibercept injections and 693 (23.7%) were bevacizumab injections. The most common reason for bevacizumab usage was ‘having a 0.1 or worse best-corrected visual acuity or being unable to assure reimbursement due to the development of extensive scarring or geographic atrophy’ (297 bevacizumab injections, 42.9%). The second most common reason was ‘the inability to assure reimbursement such as extrafoveal choroidal neovascularization (CNV) or early CNV without definite fluid in the foveal region’ (201 bevacizumab injections, 29.0%). Conclusions Bevacizumab was used in 23.7% of the anti-VEGF injections to treat wet AMD. When analyzing patients’ treatment burden and financial impact, the results of the present study may provide useful information. Further multi-center studies are required to evaluate more precisely the usage of anti-VEGF drugs.

Purpose: To evaluate the proportion and reasons for ineligibility to re-register for extended health insurance at 5 years in patients diagnosed with neovascular age-related macular degeneration (AMD) and registered for extended health insurance. Methods: This retrospective study was performed in patients diagnosed with neovascular AMD and registered for extended health insurance with follow-up for at least 5 years. The criteria for re-registration for extended health insurance were determined along with the ineligibility for re-registration. Results: In total, 263 patients were included in the analysis. Of these, 148 (56.3%) did not satisfy the criteria for re-registration. No active treatment was performed in 98 patients during the last 6 months of the study period (no recurrence, 51 patients; additional treatment was not considered beneficial due to retinal damage even without disciform scar formation, 44 patients). Macular disciform scar formation was noted in 50 patients (33.8%). Older age (p = 0.013), poor visual acuity (p = 0.004), and retinal angiomatous proliferation (p < 0.001) were associated with ineligibility for re-registration due to severe retinal damage. Conclusions Among the patients who were initially registered for extended health insurance, 56.3% failed to satisfy the re-registration criteria. The primary reason was advanced retinal damage. The results of this study provide useful information for patient education and to establish long-term treatment strategies.

Thyroid cancer is increasing all over the world. The exact cause of this increase is still debated and there are conflicting reports. Sophisticated molecular studies suggest that environmental chemicals may have effects of thyroid carcinogenesis. The development of powerful molecular biology techniques has enabled targeted next-generation sequencing for detection of mutations in thyroid cancer, and this technique can make a specific diagnosis of thyroid cancer in cytologically indeterminate cases. The initial treatment of well-differentiated thyroid cancer (DTC) is surgery followed by radioiodine remnant ablation. However, further studies are needed to determine the optimal dosage of radioactive iodine for DTC patients with lateral neck metastasis. DTC is an indolent tumor and may cause death even decades later. Thus, long-term follow-up is mandatory. Recently, dynamic risk stratification (DRS) has begun to use stimulated thyroglobulin level at 1 year after the initial treatment and restratified the risk in accordance with the response to the initial treatment. This DRS strategy accurately predicts disease free survival and can be widely used in daily clinical settings. For the iodine refractory metastatic disease, redifferentiation therapy and targeted therapy are two promising alternative treatments. Sorafenib is the first approved agent for the treatment of progressive iodine refractory advanced thyroid cancer in Korea and may be very helpful for radioactive-refractory locally advanced or metastatic DTC. Selumetinib may be an effective redifferentiating agent and could be used within several years.
Carcinogenesis ; Diagnosis ; Disease-Free Survival ; Humans ; Iodine ; Korea ; Molecular Biology ; Neck ; Neoplasm Metastasis ; Prognosis ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms*