Acute infectious myocarditis in children can be caused by many pathogens, including bacteria, viruses, fungi and protozoa. Patients may be asymptomatic or may have 'flu-like symptoms' to life-theratening arrhythmias or sudden death. We herein report a case of acute myocarditis complicated by complets and permanent AV block, associated with Salmonella group B gastroenteritis in a previously healthy 5-year-old boy. Presenting symptoms were dyspnea, cyanosis, vomiting, and diarrhea. Electrocardiography on admission showed very slow ventricular escape rhythm at 37 beats/minute. He was treated with antibiotics, inotropic agents, ventilatory support, and transvenous temporary pacemaker. Ten days later, permanent dual chamber pacemaker was implanted. All three consecutive stool cultures done after admission grew Salmonella group B. His ventricular function recovered rapidly and completely and he became fully active 2 months after the onset. However, his conduction system was totally destroyed and at last follw up evaluation 2 years after the onset, he is still totally dependent on the pacemaker without any escape rhythm.
Anti-Bacterial Agents ; Arrhythmias, Cardiac ; Atrioventricular Block* ; Bacteria ; Child ; Child, Preschool ; Cyanosis ; Death, Sudden ; Diarrhea ; Dyspnea ; Electrocardiography ; Fungi ; Gastroenteritis* ; Humans ; Male ; Myocarditis* ; Salmonella* ; United Nations ; Ventricular Function ; Vomiting

No abstract available.
Masticatory Muscles* ; Spasm* ; Tetanus*

BACKGROUND: Thromboembolism is the major complication in patients with the insertion of cardiac prosthetic valves. The purpose of this study is evaluate the risk factors about the formation of left atrial thrombi after cardiac valve replacement. METHOD: Transesophageal(TEE) and transthoracic echocardiography(TTE) were done to evaluate postoperative cardiac condition in 98 patients with cardiac prosthetic valves from Jan. 1991 to Oct 1991. Several clinical and echocardiographic parameters were analyzied to evaluate the relationship with the formation of left atrial thrombi. RESULT: In univariate analysis, important factors related to the formation of left atrial thrombi are type of operation (p=0.027), postoperative left ventricular function(p=0.003), preoperative(p=0.037) and postoperative systolic ventricular size(p=0.024). However, in multivariate analysis postoperative left ventricular size(p=0.017), presence of previous thrombi(p=0.014), preoperative left atrial size(p=0.014) and postoperative left atrial size(p=0.014) are significant factors. CONCLUSION: Patients with high risk and low risk for the formation of left atrial thrombi after valve replacement can be identified by readily available clinical and echocardiographic variables.
Echocardiography ; Heart Valves ; Humans ; Multivariate Analysis ; Risk Factors* ; Thromboembolism

No abstract available.
HIV-1* ; Humans* ; Tumor Necrosis Factor-alpha*

OBJECTIVE: The purpose of this study was to assess new three-dimensional (3D) cephalometric variables, and to evaluate the relationships among skeletal and dentoalveolar variables through 3D cephalometric analysis. METHODS: Cone-beam computed tomography (CBCT) scans were acquired from 38 young adults (18 men and 20 women; 22.6 +/- 3.2 years) with normal occlusion. Thirty-five landmarks were digitized on the 3D-rendered views. Several measurements were obtained for selected landmarks. Correlations among different variables were calculated by means of Pearson's correlation coefficient values. RESULTS: The body of the mandible had a longer curve length in men (102.3 +/- 4.4 mm) than in women (94.5 +/- 4.7 mm) (p < 0.001), but there was no significant difference in the maxillary basal curve length. Men had significantly larger facial dimensions, whereas women had a larger gonial angle (117.0 +/- 4.0 vs. 113.8 +/- 3.3; p < 0.001). Strong-to-moderate correlation values were found among the vertical and transverse variables (r = 0.71 to 0.51). CONCLUSIONS: The normative values of new 3D cephalometric parameters, including the maxillary and mandibular curve length, were obtained. Strong-to-moderate correlation values were found among several vertical and transverse variables through 3D cephalometric analysis. This method of cephalometric analyses can be useful in diagnosis and treatment planning for patients with dentofacial deformities.
Adult ; Cone-Beam Computed Tomography ; Dentofacial Deformities ; Female ; Humans ; Male ; Mandible ; Young Adult

Calcitonin gene-related peptide (CGRP), a well-known neuropeptide in primary sensory neurons carrying noci-ceptive information, includes two different peptides of similar structure, the alpha- and beta-CGRP. The distribution of these two peptides in the central nervous system is known to be similar and no functional differences have been reported. The aim of this study is to investigated the changes of alpha- and beta-CGRP expression following efferent or afferent disconnection of anterior horn cells in the rat spinal cord. One week after ventral rhizotomy (left L4-6), dorsal rhizotomy (left L4-6) or spinal cord transection (at lower thoracic level), the animals were sacrified and the L5 segments of the spinal cord were excised to perform immunohistochemistry and in situ hybridization histochemistry. In the control group, 4.45+/-1.51 anterior horn cells showed CGRP immunoreactivity per tissue section in one side. After ventral rhizotomy, the number of CGRP immunoreactive neurons increased to 9.12+/-2.52 at the ipsilateral ventral horn. After dorsal rhizotomy, CGRP immunoreactive neurons increased to 7.29+/-3.69 at the ipsilateral ventral horn and 6.26+/-1.53 at the contralateral ventral horn. In cases of spinal cord transection, almost all the anterior horn cells lost CGRP immunoreactivity in both sides. Neurons expressing alpha- or beta-CGRP mRNA could be distinguished by in situ hybridization histochemistry. In the control group, anterior horn cells expressing alpha-CGRP mRNA numbered 4.16+/-1.32 per section and beta-CGRP cells numbered 5.50+/-1.38. After ventral rhizotomy, the number of cells expressing alpha-CGRP mRNA increased to 10.07+/-2.86 in the ipsilateral side without any changes in beta-CGRP mRNA expression. After dorsal rhizotomy, no significant changes in alpha-CGRP mRNA expression were detected, but the number of cells expressing beta-CGRP mRNA increased to 7.45+/-2.04 in the ipsilateral side and to 7.02+/-1.38 in the contralateral side. In cases of spinal cord transection, the anterior horn cells lost alpha- and beta-CGRP mRNA signals almost completely in both sides. These results showed that alpha-CGRP expression increased in axotomized anterior horn cells of the spinal cord, and that beta-CGRP expression increased in anterior horn cells which had lost their afferent input through the primary sensory neurons. These findings provide evidence showing the functional difference of the two peptides in anterior horn cells of the spinal cord.
Animals ; Anterior Horn Cells ; Calcitonin Gene-Related Peptide ; Central Nervous System ; Horns ; Immunohistochemistry ; In Situ Hybridization ; Neurons ; Neuropeptides ; Peptides ; Rats* ; Rhizotomy* ; RNA, Messenger ; Sensory Receptor Cells ; Spinal Cord Injuries* ; Spinal Cord*

Visceral afferent nerve fibers containing substance P or calcitonin gene-related peptide (CGRP) are distributed in the bladder wall, and are known to be stimulated by and then desensitized by capsaicin. Recently, there have been some reports on the effectiveness of intravesical capsaicin administration for the treatment of hypersensitive lower urinary tract disorder or neurogenic bladder. In this study, the effects of intravesical capsaicin on the substance P or CGRP immunoreactivities in the spinal dorsal horn were investigated and the mechanism of capsaicin treatment for bladder disorders was revealed. After intravesical administration of capsaicin, the substance P and CGRP immunoreactive areas were measured at the dorsal horn of L4 and S1 spinal cord. Before capsaicin treatment, the substance P immuno- reactive area was 2.61+/-0.78 x 105 mm2 in L4 and 1.66+/-0.49 x 105 mm2 in S1. The substance P immunoreactivity was markedly reduced 1~2 weeks after capsaicin treatment in both L4 and S1 spinal cord. The CGRP immunoreactive area was 1.74+/-0.52 x 105 mm2 in L4 and 1.14+/-0.69 x 105 mm2 in S1, but was not reduced after capsaicin treatment. Therefore, capsaicin administered intravesically desensitizes nerve fibers containing substance P and consequently suppresses pain and voiding reflex.
Administration, Intravesical ; Animals ; Calcitonin Gene-Related Peptide ; Capsaicin* ; Horns* ; Nerve Fibers ; Rats* ; Reflex ; Spinal Cord ; Substance P ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Tract ; Visceral Afferents

Background: The Advanced RBC Application of the CellaVision DM9600 system (CellaVision AB, Lund, Sweden) automatically characterizes and classifies red blood cells (RBCs) into 21 morphological categories based on their size, color, shape, and inclusions. We evaluated the diagnostic performance of the CellaVision Advanced RBC Application with respect to the classification and grading of RBC morphological abnormalities in accordance with the 2015 International Council for Standardization in Haematology (ICSH) guidelines. Methods: A total of 223 samples, including 123 with RBC morphological abnormalities and 100 from healthy controls, were included. Seven RBC morphological abnormalities and their grading obtained with CellaVision DM9600 pre- and post-classification were compared with the results obtained using manual microscopic examination. The grading cut-off percentages were determined in accordance with the 2015 ICSH guidelines. The sensitivity and specificity of the CellaVision DM9600 system were evaluated using the manual microscopic examination results as a true positive. Results: In pre-classification, > 90% sensitivity was observed for target cells, tear drop cells, and schistocytes, while > 90% specificity was observed for acanthocytes, spherocytes, target cells, and tear drop cells. In post-classification, the detection sensitivity and specificity of most RBC morphological abnormalities increased, except for schistocytes (sensitivity) and acanthocytes (specificity). The grade agreement rates ranged from 35.9% (echinocytes) to 89.7% (spherocytes) in pre-classification and from 46.2% (echinocytes) to 90.1% (spherocytes) in post-classification. The agreement rate of samples with withinone grade difference exceeded 90% in most categories, except for schistocytes and echinocytes. Conclusions The Advanced RBC Application of CellaVision DM9600 is a valuable screening tool for detecting RBC morphological abnormalities.

TO know the causative agent of asptic meningitis. we performed and cerebrospinal fluid study on 24 children who had been admitted to the department of Pediatrics.. Asam Medical Center form Jume. 1991 to July 1991. In the 10 cases of them. CSF virus culture was done Special Reference Laboratory, Japan The most of the patients were young infants, and 15 cases of them were under 3 months of age. The male to female ratio was 1:1.4 We observed the main symptoms as fever 100%. irritability 67%, vomiting 17%. poor feeding 13%, seizure 8%. In the 4 cases among the 10 cases with virus culture, Coxsackievirus B5 was cultured. We concluded that the causative agent of this epidemic aseptic meningitis in 1991 was Coxsakievirus B5.
Cerebrospinal Fluid ; Child ; Female ; Fever ; Humans ; Infant ; Japan ; Male ; Meningitis ; Meningitis, Aseptic* ; Pediatrics ; Seizures ; Vomiting

PURPOSE: The role of local excision in treating rectal cancer patients continues to be controversial. The aim of this study was to evaluate the long-term oncological results of local excision for early rectal adenocarcinomas and review the outcomes of salvage therapy on rectal cancer patients. MATERIALS AND METHODS: Between March 1992 and September 2005, 35 consecutive patients with early-stage primary rectal adenocarcinomas were treated by local excision with curative intent. The mean tumor distance from the anal verge was 5 cm (range, 1-10 cm). RESULTS: The median follow-up was 66 months (range, 17-161 months). Pathological examination revealed 23 cases of T1 and 12 cases of T2. Recurrence had developed in 10 patients (6 local recurrences, 4 systemic recurrences). Purely extrapelvic recurrence was observed in only two (5.7%) patients. Of the eight recurrent patients with surgical salvage, five survived with no evidence of disease at the time of this analysis. The 5-year local recurrence-free and disease-free survival rates were 79.6% and 67.9%, respectively. CONCLUSION: Local excision alone of early-staged rectal adenocarcinomas, even in the ideal candidate, is followed by a relatively higher local recurrence rate than previously reported and may not be a valid modality. Either the use of adjuvant therapy with local excision, even in patients with T1 lesions or the use of preoperative therapy followed by local excision has good promise.
Adenocarcinoma/*pathology/surgery ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology/*pathology/surgery ; Rectal Neoplasms/*pathology/surgery ; Retrospective Studies ; Risk Factors ; Salvage Therapy ; Time Factors ; Treatment Outcome