Bacterial endocarditis is a disease with protean manifestations whose presentation has recently changed greatly. Right-sided endocarditis associated with congenital heart lesions is now relatively less common. Patients with ventricular septal defect are at risk for right-sided endocarditis, but its incidence is low in children and adolescents. The organism is frequently a staphylococcus and the clinical course is dominated by septic pulmonary infarction and septicemia. We reported two cases of pulmonic vegetation and pulmonary infarction associated VSD with brief review of literature.
Adolescent ; Child ; Endocarditis ; Endocarditis, Bacterial ; Heart ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Pulmonary Infarction* ; Sepsis ; Staphylococcus

BACKGROUND: It is well known that ischemic preconditioning protects the heart against infarction or arrhythmias from a subsequent ischemic injury. Recent laboratory data indicate that the adenosine during the ischemic period may trigger protection via A1 or A3 adenosine receptor and also protein kinase C(PKC) plays a central role. This study was designed to determine the role of adenosine receptor subtypes and PKC in the preconditioning protection. METHODS: All cat heart groups were subjected to 40min ischemia and 30min reperfusion. The preconditioning protocol consists of 4min ischemia and then 10min of reperfusion 4 times. The effects of ischemic preconditioning, nonselective adenosine receptor blocker(SPT), an A1 specific antagonist(DPCPX) and protein kinase C inhibitor(Polymyxin B), on ischemic preconditioning were determined by infarction size. There were 5 groups : (1) control group (Group 1, n=10)(2) Ischemic preconditioned group(Group 2, n=9)(3) DPCPX pretreatment group(Group 3, n=6)(4) SPT preteatment group(Group 3, n=6)(5) Polymyxin B pretreatment group(Group 5, n=6). SPT and DPCPX were given intravenously 5 min before ischemic preconditioning. Polymyxin B was administered to cats for 30min during ischemic preconditioning period. RESULTS: Ischemic preconditioning only or pretreatment with DPCPX prior to preconditioning demonstrated a significant reduction in infarct size(22.6+/-1.5, 25.4+/-0.9% infarction of the risk zone, respectively, p<0.05) with respect to control, SPT-pretreatment, and polymyxin B-pretreatment groups(44.0+/-1.7, 43.0+/-2.0 and 40.3+/-0.4% infarction of the risk zone, respectively). CONCLUSIONS: Ischemic preconditioning protects heart from subsequent ischemia. Protection was blocked by SPT and protein kinase C inhibitor(polymyxin B), but not by A1 antagonist DPCPX. The cardioprotective effects by ischemic preconditioning in the in vivo cat heart appear to be dependent on A3 adenosine receptors and activation of protein kinase C.
Adenosine* ; Animals ; Arrhythmias, Cardiac ; Cats* ; Heart* ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Polymyxin B ; Polymyxins ; Protein Kinase C* ; Protein Kinases* ; Receptors, Purinergic P1* ; Reperfusion

OBJECTIVE: To investigate the roles of ET in the regulation of peripheral vascular tone, we studied the effect of hyperlipidemia on vascular responsiveness in femoral arteries from rabbits with control groups of rabbits and test groups receiving a hyperlipidemic diet. MATERIALS AND METHODS: New Zealand Whites were anesthetized with pentobabital and killed by exsanguination from the femoral arteries. Arteries which were suspended on muscle chambers at their optimal length for contractile properties, were examined. RESULTS: 1. After 14-16 weeks of cholesterol-rich diet, plasma cholestrol and HDL levels were significantly higher in the hyperlipidemic rabbits than in the control rabbits. There was no significant difference in the triglyceride levels between the two groups. 2. The contractions caused by 60 mM KCI in the femoral arterial strips were significantly augmented (P<0.01). The contractile responses to phenylephrine or angiotensin II were also augmented, whereas 5-hydroxytryptamine or U46619- induced contraction was not affected by the hyperlipidemic diet. 3. In control rabbits, ET-1 and ET- 2 contracted femoral arteries in a concentraction-dependent manner, whereas sarafotoxin S6c and IRL 1620 had no effect. 4. Contractions caused by ET-1 and ET-2 were significantly diminished by hyperlipidemia. 5. ET-1-induced concentration-response curves were inhibited by BQ-610, but not affected by BQ-788 in the femoral arterial strips from control and hyperlipidemic rabbits. CONCLUSIONS: These results suggest that ET is involved in the regulation of vascular tone in peripheral arteries and ETA receptor subtypes are mainly present in rabbit femoral arteries. Further more, ET-induced contraction is attenuated in hyperlipidemic rabbit, and the attenuated responses might be caused at least in part by the alteration of ET receptors (e.g. desensitization).
Angiotensin II ; Arteries ; Diet ; Endothelin-2 ; Endothelins* ; Exsanguination ; Femoral Artery* ; Hyperlipidemias ; New Zealand ; Phenylephrine ; Plasma ; Rabbits* ; Receptors, Endothelin ; Serotonin ; Triglycerides

It has been generally agreed that most fractures of the humeral shaft are best treated non-operatively although occasionally there are indications for primary operative treatment. Recent advances in internal fixation techniques and instrumentation have led to an expansion of surgical indications, and operative treatment produces higher rates of nonunion, infection and other associated complication when compared with closed treatmet techniques. Because of the significant morbidity of the operative treatment, closed intramedullary fixation techniques that provide stability of the fracture site without opening and reduce the postoperative complications, were developed. In this paper we document forty two fractures of the humeral shafts that were treated by functional bracing(Group I: 24 cases) and intramedullary fixation with functional bracing(Group II: 18 cases) between October, 1982 and August, 1986. And the obtained results were as follows: 1. The everage healing time was 9 weeks in the Group I, and 11 weeks in the Group II . 2. The non-union has not been encountered in the Group I, but non-union and delayed union were 4 cases (22.2%) in the Group II. 3. The complication rate was 9 cases(37.5%) in the Group I, and was 12 cases(66.7%) in the Group II, but deep infection did not occured in all cases. 4. The residual angulation more than 5 degrees was 20 cases(83.3%) in the Group I, and was 2 cases(11.1%) in the Group Il. However the results of the group Il were inferior ot the group I, of more proper selection of the patients, more accurate technique and adequate type of nails have been used, the better results will be taken.
Braces ; Humans ; Postoperative Complications

PURPOSE: To construct new Korean reference curves for birth weight by sex and gestational age using contemporary Korean birth weight data and to compare them with the Lubchenco and the 2010 United States (US) intrauterine growth curves. METHODS: Data of 2,336,727 newborns by the Korean Statistical Information Service (2008-2012) were used. Smoothed percentile curves were created by the Lambda Mu Sigma method using subsample of singleton. The new Korean reference curves were compared with the Lubchenco and the 2010 US intrauterine growth curves. RESULTS: Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles birth weight by gestational age were made using 2,249,804 (male, 1,159,070) singleton newborns with gestational age 23-43 weeks. Separate birth weight curves were constructed for male and female. The Korean reference curves are similar to the 2010 US intrauterine growth curves. However, the cutoff values for small for gestational age (<10th percentile) of the new Korean curves differed from those of the Lubchenco curves for each gestational age. The Lubchenco curves underestimated the percentage of infants who were born small for gestational age. CONCLUSION: The new Korean reference curves for birth weight show a different pattern from the Lubchenco curves, which were made from white neonates more than 60 years ago. Further research on short-term and long-term health outcomes of small for gestational age babies based on the new Korean reference data is needed.
Asian Continental Ancestry Group ; Birth Weight* ; Female ; Gestational Age* ; Growth Charts ; Humans ; Infant ; Infant, Newborn ; Information Services* ; Male ; United States

Statistical analysis according to W.H.O. classification for the patients admitted the Ped. Dept. of Han-Il Hospital was carried out during 4 years from Jan. 1974 to Dec. 1977. The following results were observed. 1. Total No. of patient during 4 years period were 1955, of which 1199 were male(61.33%, 756 were female(38.67%) and male to femal ratio was 1.57:1. 2. There was no significant variation. 3. According to age, preschool aged group as the most frequent group consistin of 488 cases(24.49%), school aged group and adolescent in the order of frequency. 4. On monthly distribution, there was no significant variation 5. Most frequent diseases in pediatric age group were respiratory tract one, 851 cases(39.29%) : infectious and parasitic ones, 553(25.53%) and neonatal disease, 204 cases(9.42%) in the order of frequency. 6. Among respiratory tract disease, pneumonia was the most frequent one, 587 cases(27.10%). 7. Among infectious and parasitic disease group, gastrointestinal infectious one was the most frequent, 224 cases(10.34%) : other viral disease and tuberculosis in the order of frequency. 8. Among neonatal diseases, prematurity was the most frequent one, 82 cases(3.79%).
Adolescent ; Classification ; Humans ; Male ; Parasitic Diseases ; Pneumonia ; Respiratory System ; Respiratory Tract Diseases ; Tuberculosis ; Virus Diseases

Primary or isolated chylopericardium of unknown etiology is considered a rare cause of pericardial effusion. Its etiology is obscure but certain communication between the lymphatic system and pericardial sac was suggested. Up to 1991, there was only one case report that successfully showed the direct communication by a lymphangiogram. We report a case of chylopericardium occurring in a nearly asymptomatic 22-year-old man with no apparent history of trauma, infection or mediastinal neoplasm, in which we succeeded in visualizing the communication between the thoracic duct and pericardial sac by lymphangiography and computed tomography of the chest. A review of the previous cases is described also.
Adult ; Case Report ; Chyle/*metabolism ; Human ; Lymphography ; Male ; Pericardial Effusion/*metabolism/radiography ; Radiography, Thoracic ; Tomography, X-Ray Computed

The purpose of this longitudinal study was to examine the growth changes of mandibular symphysis and lower incisors with age. The material was 294 lateral cephalometric radiographs taken longitudinally from 6 to 13 year old children, who were not teated orthodontically. The following conclusions seem to be warranted. 1. The sex difference of the measurements of mandibular symphysis and lower incisors were not statistically significant. 2. There were growth increments (2.69mm in boys and 2.08mm in girls) in the total thickness of mandibular symphysis. 3. There were a great change and individual variations on the curvature of anterior border of mandibular symphysis. 4. The chin angle had a tendency to decrease progressively in both sexes. 5. There were growth increments (8.23mm in boys and 7.40mm in girls) in the anterior dental height. 6. The lower anterior teeth tended to incline labially with age.
Adolescent ; Child ; Chin ; Humans ; Incisor* ; Longitudinal Studies ; Sex Characteristics ; Tooth

Berardinelli lipodystrophy syndrome is a rare autosomal recessive disorder, characterized by loss of body fat, muscular hypertrophy, acanthosis nigricans, hepatomegaly, hyperlipidemia, insulin resistant diabetes, and elevated metabolic rate. The mechanism(s) responsible for these abnormalities is not known. We report a forteen-month old girl with Berardinelli Lipodystriphy Syndrome, who had signs above mentioned, with a brief review and its related literatures.
Acanthosis Nigricans ; Adipose Tissue ; Female ; Hepatomegaly ; Humans ; Hyperlipidemias ; Hypertrophy ; Insulin ; Lipodystrophy*

BACKGROUND: Following several decades of decline, the incidence of tuberculosis has recently begun to increase in many countries and the control of this disease has been impeded by the emergence of multi-drug resistant tuberculosis (MDR-TB). The development of rapid diagnostic methods and effective new drugs are needed to control MDR-TB. One of the new drugs for MDR-TB is rifabutin (RBU) which has been known to be effective in some patients with MDR-TB. A few reports showed that some types of mutaitions of the rpoB gene, which were known to be present in 96-98% of rifampicin-resistant M. tuberculosis, were associated with the rifampicin-resistant but RBU-susceptible phenotype. This study was performed to investigate the correlation between RBU susceptibility and the patterns of rpoB gene mutations in Korean MDR-TB. METHODS: Sixty-five clinical isolates of multi-drug resistant Mycobacterium tuberculosis, gathered from patients two visited the Asan Medical Center from July 1997 to June 1999, were investigated. Clinical responses to rifabutin-containing regimen were evaluated. An RBU susceptibility test and sequencing analysis of rpoB gene were performed, and the result were analyzed to confirm which mutations correlated with RBU-susceptible MDR-TB. RESULTS: Fifty-three of 56 (95%) clinical isolates of MDR-TB had 60 mutations of the rpoB gene. The most frequent mutations were found at codon 531 (43%), and two mutations were combined in seven clinical isolates. Five of 53 (10%) clinical isolates showed the RBU-susceptible phenotype, and in them the characteristic patterns of point mutations were found at codon 509, 516, and 526. CONCLUSION: The frequency and pattern of mutations of the rpoB gene of Korean MDR-Tb isolates were similar to those in western countries, where the prevalence of tuberculosis is low, but some show RBU-susceptible phenotypes. RBU-susceptible MDR-TB isolates showed the characteristic pattern of mutations of the rpoB gene which could be used to rapidly diagnose RBU susceptibility.
Chungcheongnam-do ; Codon ; Humans ; Incidence ; Mycobacterium tuberculosis* ; Mycobacterium* ; Phenotype ; Point Mutation ; Prevalence ; Rifabutin* ; Tuberculosis ; Tuberculosis, Multidrug-Resistant