CHAP syndorme consists of choreoathetosis, orofacial dyskinesia, affective change, hypotonia, and pseudobulbar signs. CHAP syndrome was firstly des- cribed with onset 1 to 7 days after induced profound hypothermia and complete circulatory arrest for con- genital heart lesion repair. Since then, only a few cases have been reported until now. Case We report a patient who demonstrated all of the elements of the CHAP syndrome in severe cachexic state. Brain SPECT(99mTC-ECD) shows decreased perfusion in left fronto-parieto-temporal lobe. Comments The pathogenesis of CHAP syndrome is obscure. However our case led us to suggest that more essential component pre- disposing to the CHAP syndrome is hypoxia rather than hypothermia. Furthermore, it seems to be related with circulatory insufficiency in extrapyramidal nervous systems.
Anoxia ; Brain ; Heart ; Humans ; Hypothermia ; Movement Disorders ; Muscle Hypotonia ; Nervous System ; Perfusion

Objective To investigate the development of ultrastructure in grafts from a xenograft model of human hemangioma on nude mice.Methods Human infantile hemangioma tissue was obtained in surgery and planted into subcutaneous layer of nude mice in small pieces.The grafts were harvested on the 2~(nd),5~(th),15~(th),30~(th),45~(th) day and then at 2~(nd),3~(rd),4~(th),6~(th) month for transmission electron microscopic view.Results In early stage after transplantation,signs of degeneration and necrosis were more evident.On the 30~(th) day,the number of endothelial cells increased and some of the endothelial cells were larger in size with high nuclear to plasm ratio.At the 2~(nd) month,the number of endothelial cells increased,while some of these cells turned flat.Later,high endothelial cells decreased in number and collapse and pyknosis of plasm,formation of secondary lysosome,margination of chromatin,fragmentation of nucleus were evident with surrounding deposition of adipose and collagen.Conclusions With xenotransplantation of human infantile hemangioma tissue onto nude mice,the grafts may survive ischemia and proliferate,and then gradually involute.The development resembles a natural course of human infantile hemangioma.

To investigate the therapeutic effect and molecular mechanism of the main flavonoid components of Silybum marianum (S. marianum) on nonalcoholic fatty liver disease (NAFLD), we identified nine flavonoids in S. marianum through TCMSP, PubChem database and corresponding literatures. The potential therapeutic targets of NAFLD were predicted by SwissTargetPrediction, GeneCards and Venny 2.1.0 platform, while the protein-protein interaction (PPI) network of potential targets was analyzed using String platform and Cytoscape software. Then GO and KEGG pathway enrichment analysis were performed using David 6.8 database, followed by molecular docking verification using AutoDock software. In vitro, components with higher degree value in the "components-targets-pathway" network were chosen for further analysis. L02 cells were used to establish lipid accumulation model and treated with different components. Furthermore, the effects of four pure active compounds from S. marianum on lipid accumulation in hepatocytes were analyzed by oil red O staining. The results showed that the main nine flavonoids extracted from S. marianum contained 24 potential NAFLD targets. Several critical pathways closely related to NAFLD process were identified by GO and KEGG enrichment analysis, including phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt) pathway, type 2 diabetes pathway, tumor necrosis factor (TNF) pathway and insulin resistance pathway. The results of molecular docking further indicated that the core components displayed strong binding abilities with key targets respectively, and silandrin showed better binding activity as compared to other components. The results obtained from L02 cells showed that the lipid accumulation was reduced by treatment with isosilybin A, isosilybin B, silydianin and silychristin, while the activity of isosilybin B was better than that of isosilybin A. Taken together, we concluded that the main flavone components of S. marianum could improve lipid accumulation through multiple signaling pathway in hepatocytes, and this could be a potential new strategy for the treatment of NAFLD.

Objective To optimize a W/O microemulsion formulation of troxerutin and evaluate its physical properties such as morphology, droplet size, stability and content of troxerutin. Methods The W/O microemulsion was optimized using a pseudoternary phase diagram and the area of the microemulsion region was used to screen and determine microemulsion components.HPLC assay was used for determination of the loading content. Results The optimal formulation contained lecithin, ethanol, isopropyl myristate and water (23.30:11.67:52.45:12.59).The microemulsion was physicochemically stable with round shape and uniform size, and the mean droplet size was about 50. 20 nm. Conclusion Microemulsion was developed successfully.It will expect to be the new preparation for troxerutin.

Tomography, X-Ray Computed ; trends

We reviewed the magnetic resonance imaging (MRI) of intracranial teratoma to detect the characteristic findings. Five patients with intracranial teratoma were evaluated with MRI from January 1988 to December 1990. Four male and one female patients with age ranging from 6 to 14 years were surgicelly confirmed MRI was done with 2.0T superconducting system(Spectro 20000, Goldstar, Seoul) and gadolinium enhancement was done in 4 patients. We retrospectively reviewed the clinical, operative, pathologic, and radiologic findings. Intracranial teratomas showed fatty component, calcification and cystic component filled with sebum or serous fluid. Peripheral rim enhancement was seen in three and irregular enhancement in two cases. There were hydrocephalus in all teratoma, but neither surrounding edema nor surrounding tissue invasion was seen. Low signal intensity rim was noted around the solid component of all tumors and they were not enhanced. MRI showed multicomponent of intracranial teratoma including the solid and cystic component, and low singal rim which might be the characteristic findings of the intracranial teratoma.
Edema ; Female ; Gadolinium ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Male ; Retrospective Studies ; Sebum ; Teratoma*

Pulmonary arteriovenous malformations (PAVMs) are direct communications between pulmonary arteries and pulmonary veins, resulting in right-to-left shunts that may cause cyanosis, dyspnea, and digital clubbing. Neurological complications such as intrace rebral hemorrhage or brain abscess may result from cerebral thrombosis or emboli. In most cases, they remain unrecognized until the late te enage years. Here, we report a case of a 6-year-old boy who presented with perioral cyanosis, digital clubbing, and dyspnea on exertion. A plain chest X-ray showed a focal nodular opacity in the right lower lobe (RLL), and a diagnosis of a large PAVM in the RLL was confirmed by chest computed tomography. A right lower lobe ctomy was successfully performed without any complications. Although their incidence in children is low, PAVMs should be suspected as a possible cause of cyanosis and dyspnea of non-cardiac origin, and should be treated promptly to prevent further neurological complications.
Arteriovenous Malformations ; Brain Abscess ; Child ; Cyanosis ; Dyspnea ; Hemorrhage ; Humans ; Incidence ; Intracranial Thrombosis ; Pulmonary Artery ; Pulmonary Veins ; Thorax

Hyperthyroidism is a well known cause of atrial fibrillation. It is also known that control of hyperthyroidism can usually curb thyrotoxic atrial fibrillation and restore sinus rhythm. In this study, 282 patients with hyperthyroidism were investigated to quantify the incidence of atrial fibrillation, and to identify the vulnerable groups. In addition, we compared two groups of subjects with atrial fibrillation-one group with hyperthyroidism and the other group without
Aged ; Atrial Fibrillation ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Hyperthyroidism ; Incidence ; Male ; Sex Ratio ; Thyroid Gland

Spinal stenosis has several types of etiology such as degenerative, spondylolisthetic and postoperative, etc. Operative management for spinal stenosis is adequate decompression and stabilization of the unstable lumbar spine created by the decompressive procedure. We analysed 52 operative cases of spinal stenosis delete from January 1994 to October 1996. The following results were obtained 1) The male and female ratio was 1:1.9 and mean age was 52.1 years old 2) Mean follow-up period was 20.3 months 3) The involved site was one level in(28)(53.9%), two level in(19)(36.5%), and three levels in(5)(9.6%) 4) For decompression method, total laminectomy combined with foraminotomy and facetectomy was employed procedure. 5) For stabilization, bilateral posterolateral fusion was performed in major damaged facet joint and transverse process. Instrumentation was combined in 61.5% delete of all cases 6) According to the criteria of Kirkaldy-willis, excellent and good results were shown in 90.6% of fused group with instrumentation and 85% of fused group without instrumentation.
Decompression ; Female ; Follow-Up Studies ; Foraminotomy ; Humans ; Laminectomy ; Male ; Spinal Stenosis* ; Spine ; Zygapophyseal Joint

PURPOSE:To identify the clinical features of human metapneumovirus (hMPV) and the respiratory syncytial virus (RSV) infection in children. METHODS:The participants of our study were 1,104 children who were admitted to Bungdang CHA hospital for lower respiratory infection from August 2006 through July 2007. Nasopharyngeal swabs were taken from the patients, and viruses were identified by RT-PCR. The clinical features of 51 patients with hMPV infection and 138 patients with RSV infection were compared by retrospective review of their medical records. RESULTS:The peak incidence of hMPV infection was noted in April, and that of RSV was noted in November. Both viruses had the highest incidence in patients age <1 year and hMPV infections occurred in 40% and 25% of patients age <6 months, respectively. In the hMPV group, 33.4% of the patients were age > or =2 years, while in the RSV group, 19% were age > or =2 years. In both groups, pneumonia was the most common clinical diagnosis, followed by acute bronchiolitis, acute bronchitis, and asthma. The white blood cell counts were higher in the RSV group, and fever was more frequent on admission in the hMPV group. CONCLUSION:hMPV was the fourth most common virus causing lower respiratory tract infections in children. The clinical features of hMPV infection were similar to those of RSV infection. This study may be helpful for the effective treatment of lower respiratory tract infection in children.
Asthma ; Bronchiolitis ; Bronchitis ; Child ; Fever ; Humans ; Incidence ; Leukocyte Count ; Metapneumovirus ; Pneumonia ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Retrospective Studies ; Viruses