PURPOSE: Norepinephrine has modulatory effects on neuronal excitability and, in some cases, has a proconvulsant effect. Intraperitoneal imipramine treatment increases norepinephrine level, and to a lesser extent, dopamine and serotonin in brain dialysate from rats. We sought to determine the effects of imipramine on pilocarpine-induced seizures in the immature rats. METHODS: Right and left cortical and hippocampal electrodes were placed in 10~15 day old Sprague-Dawley rats. The following day 3-hour video EEG recordings were obtained to monitor electrographic seizures and status epilepticus induced by intraperitoneal injection of high dose(200mg/kg : HD) and low dose (75mg/kg : LD) pilocarpine. A first group of rats received HD pilocarpine alone(n=25), or pretreatment with 0.5(n=6). 1(n=6), 2(n=6), 5(n=6), or 10(n=11)mg/kg of imipramine. A second group of rats received LD pilocarpine alone(n=6) or pretreatment with 2mg/kg of imipramine (n=6). Data were analyzed using the Fisher exact test. RESULTS: Treatment with HD pilocarpine alone resulted in electrographic seizures in 76%(n=19) and status epilepticus in 44%(n=11). In the HD pilocarpine group, status epilepticus was seen in 100% of rats pretreated 1, 2, and 5mg/kg imipramine. 90.9% of the rats pretreated with 10mg/kg of imipramine developed seizures and 36.4% developed status epilepticus. Imipramine at 0.5, 1,2, and 5mg/kg increased the incidence of seizures and status epilepticus in the HD pilocarpine group, but the incidence was statistically significant only for status epilepticus(p<0.05). The latency for the occurrence of first status epilepticus was 12.3+/-1.3 min in the HD pilocarpine alone group, and it was 21+/-3.8 min and 25.3+/-5.7 min in the group pretreated with 5 and 10mg/kg imipramine, respectively(p<0.02). Treatment with LD pilocarpine alone resulted in seizures in 50% and status epilepticus in 16.7%. In the LD pilocarpine group with imipramine 2mg/kg pretreatment, 83.3% had seizures and status epilepticus. Imipramine at 2mg/kg increased the incidence of seizures and status epilepticus in the LD pilocarpine group, but the increase was statistically significant only for status epilepticus(p<0.05). CONCLUSION: Imipramine exhibits a proconvulsant effect at low doses and an anticonvulsant effect at high doses in the pilocarpine seizure model in immature rats. There may be a dose-dependent effect on monoaminergic receptors which results in increased neuronal excitability.
Animals ; Brain ; Dopamine ; Electrodes ; Electroencephalography ; Imipramine* ; Incidence ; Injections, Intraperitoneal ; Neurons ; Norepinephrine ; Pilocarpine ; Rats* ; Rats, Sprague-Dawley ; Seizures* ; Serotonin ; Status Epilepticus

No abstract available.
Asthma* ; Immunotherapy*

Generalized perforating granuloma annulare is a rare variant of granuloma. annulare, which was first described by Duncan et al 1) in 1973. A 21-year-old female had hundreds of 3 to 5mm papules over the whole body, which were mainly distributed in the extremities and trunk since three months ago. Individual papules developed a central umbilication with a peripheral collarette of scale. Histopathologic examination showed an epidermal perforation and transepidermal elimination of necrobiotic material. The epidermal perforation communicated with areas of necrobiotic collagen surrounded by palisading granulorna in the dermis. We treated her with oral prednisolone and dapsone, but there was no clinical improvement.
Collagen ; Dapsone ; Dermis ; Extremities ; Female ; Granuloma Annulare* ; Granuloma* ; Humans ; Prednisolone ; Young Adult

A hemangioma occurred in the bony epiphysis is extremly rare. A 5-year-old boy visited to our hospital with pain and flexion contracture on the right knee. MRI showed some lesions scattered in the epiphysis of the distal femur and the proximal tibia. Biopsy specimen from the distal femoral epiphysis revealed pathologic findings compatible with hemangioma. On 8 years follow-up, the lesion in the distal femoral epiphysis had been cured, and those in the proximal tibial epiphysis were spontaneously disappeared without surgery. The scanogram shows no leg length discrepancy and angular deformity. We reports a rare case of hemangioma occurred in the bony epiphysis with the results of 8 year follow-up with the review of literatures.
Biopsy ; Congenital Abnormalities ; Contracture ; Epiphyses ; Femur ; Follow-Up Studies ; Hemangioma ; Knee ; Leg ; Preschool Child ; Tibia

No abstract available.
Epilepsy*

Clinical studies were made on 50 cases of chronic cough infants who were admitted to the department of Pediatrics of Kangnam St. Mary' s hospital from January, 1990 to July, 1991. The results were as follows; 1) The age distribution was from 3 months to 24 months old, and the most prevalent age group was 13~18months old. The male to female was 2.1:1. 2) The etiologic classification of the 50 cases were infantile asthma in 23 cases(46%), viral lower respiratory infection in 13 cases(26%), and infantile asthma associated with sinusitis in 5 cases(10%). 3) Cough was the most common clinical manifestation in all cases and followed by rhinorrhea, dyspnea, fever, and nasal stuffiness. Among physical findings, wheezing rales, and chest retraction were noted. 4) The duration of cough was 5 to 8 weeks in 26 cases(52%), 2 to weeks in 19 cases(38%), and above 9 weeks in 5 cases(10%). 5) 13 of 50 cases had a past allergic history and 8 of 50 cases had a family history of allergy. 6) In 50 cases, formula feeding was done in 28 cases(56%), breast feeing in 13 cases(26%), and mixed feeding in 9 cases(18%). 7) Eosinophilia was noted in 39.3% of infantile asthma and total IgE level above 100IUm/ml was noted in 60.7% of infantile asthma and in 18.2% of other diseases. 8) RAST results of infantile asthma showed that the positivity was 21.4% in house dust, 32.1% in Dermatophagoides pteronyssinus, 28.6% in Dermatophagoides farinae, 28.6% in egg white, 35.7% in milk. The ratio of positive RAST results were higher in infantile asthma than in other diseases. 9) Abnormal findings, including overinflation, infiltration, increased bronchovascular marking, and atelectasis, were noted in 42 cases(84%) on chest X-ray. In 7 cases, total opacification was noted on Waters' and Caldwell's view. In conclusion, chronic cough in infancy is best managed by determining the precise cause of the cough, then specificially treating the underlying disorder.
Age Distribution ; Asthma ; Breast ; Child, Preschool ; Classification ; Cough* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Dyspnea ; Egg White ; Eosinophilia ; Fees and Charges ; Female ; Fever ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Male ; Milk ; Pediatrics ; Pulmonary Atelectasis ; Respiratory Sounds ; Sinusitis ; Thorax

BACKGROUND: A medulloblastoma is a primitive neuroepithelial tumor of the cerebellum that occurs in children and metastasizes through the cerebrospinal fluid. It is highly malignant and invasive, and the 5-year survival rate is only 60%. Surgical resection techniques, radiation, and chemotherapy have improved the overall survival but the patients suffer life-long cognitive dysfunctions or endocrine abnormalities as the side effects of treatment. Therefore it is essential to identify prognostic markers to determine the appropriate treatment strategy in order to minimize the side effects. METHODS: This study evaluated the immunohistochemical differentiation and survival rate with synaptophysin, glial fibrillary acidic protein, epithelial membrane antigen, vimentin and primitive neuroepithelial marker nestin of 55 paraffin-embedded medulloblastomas, using a tissue microarray. The expression of survivin, the apoptotic inhibitor, and the survival rate with regard to the proliferation index of Ki-67 were also investigated. RESULTS: The group testing positive to vimentin, a mesenchymal differentiation marker, had a worse prognosis and there was a strong correlation between vimentin expression and nestin expression. Patients with a survivin expression rate >35% had a significantly poorer clinical course and there was a correlation between the survivin expression rate and Ki-67 expression rate. CONCLUSION: In conclusion, vimentin and survivin are negative prognostic markers in medulloblastomas.
Cerebellum ; Cerebrospinal Fluid ; Child ; Drug Therapy ; Glial Fibrillary Acidic Protein ; Humans ; Medulloblastoma* ; Mucin-1 ; Nestin ; Neuroectodermal Tumors, Primitive ; Prognosis ; Survival Rate ; Synaptophysin ; Vimentin*

With the development of antenatal diagnostic tools such as ultrasonography, some congenital anomalies or diseases can be detected in early fetal life. Routine serial antenatal check-ups have made it possible to predict the prognosis of these problems, and a few life-threatening single anatomic malformations have been treated by open fetal surgery. The experience of fetal surgery revealed that the human fetus appears to heal without any scarring. In contrast to adult animals, the response to tissue injury in the fetus is conspiciously devoid of acute inflammation. Indeed, the absence of neutrophils is perhaps the most consistent observation in fetal wounds and seems to be followed by absent or scanty fibroblast infiltration, which results in healing with sparse and well organized collagen deposition. Actually, the amount and quality of the collagen deposition were decided by the fibroblasts which infiltrated the wound. It is well known that fetal wounds have sparse collagen deposition, however, the mechanisms are still unclear. This study was designed to evaluate the role of fibroblast activity in the differences of the scar formation between the fetus and neonate. Fibroblast activity such as the cell growth rate, the amount of collagen synthesis and the synthesized collagen types of fetus(IUP 18-22 weeks) was compared with that of neonate. The amount of collagen synthesis was measured by H-proline uptake and the amount of collagen type III was measured by Western blot using antihuman procollagen type III. The cell growth rate as determined by cell proliferation from the initial cell count of 5x10(5) to cell confluence was 3.6 x 10(6) in the fetal fibroblasts compared to 2.5x10(6) in neonatal fibroblasts. Fetal fibroblast synthesize 16.9 x 10(4) cpm of collagen and neonatal fibroblasts synthesize 2.7 x 10(4) cpm of collagen. The synthesized amount of type III collagen was 2.1x10(4) ug/ml, and 1.5x10(4) ug/ml by fetal and neonatal fibroblasts, respectively. In conclusion, fetal fibroblasts grow faster and synthesize a smaller amount of collagen, but produce more type III collagen than neonatal fibroblasts.
Adult* ; Animals ; Blotting, Western ; Cell Count ; Cell Proliferation ; Cicatrix ; Collagen Type III ; Collagen* ; Fetus* ; Fibroblasts* ; Humans ; Infant, Newborn ; Inflammation ; Neutrophils ; Prognosis ; Ultrasonography ; Wounds and Injuries

No abstract available.
Androgen-Insensitivity Syndrome* ; Male

No abstract available.
Androgen-Insensitivity Syndrome* ; Male