Changes of blood pressure, heart rate, ECG, respiration rate and pupil size by intracerebroventricular(ICV) infusion of hypertonic NaCl with 0.04 ml/min for 5 min(total 0.2ml) were observed in urethane-anesthetized rabbits. ICV infusion of 0.75M NaCl produced slight pressor effect (11mmHg) and did not affect other parameters. ICV infusion of 1.5M NaCl began to increase blood pressure from 2~3 min after the infusion and produced maximal increase(24mmHg) at 5~10 min. Then the pressor effect was recovered to the original level at 30~60 min. Change of heart rate by the infusion was not clear, but ST-segment of ECG was markedly depressed. Respiration rate increased about 1.5 times than the control in accordance with the pressor effect and the state was continued even after the recover of the pressor effect. Both pupils dilated markedly and light-reflex was lost. Changes of parameters by ICV infusion of 3.0M NaCl were similar to those by 1.5M NaCl and some rabbits caused severe arrhythmias and died. The purpose of present study is to investigate the mechansim(s) of the pressor effect induced by the ICV infusion of 1.5M NaCl. The pressor effect of 1.5M NaCl was attenuated by the continuous infusion of vasopressin antagonist(20microm/kg/min) but not affected by intravenous treatment with 2mg/kg phentolamine, 2mg/kg propranolol and 1mg/kg chlorisondamine. The pressor effect was not altered with ICV 0.12mg/kg phenoxybenzamine, 0.4mg diltiazem, 0.1mg/kg mecamylamine and 0.2mg/kg atropine. After ICV infusion of 25microg/kg/min of diazepam, however, the pressor effect was completely abolished and restored 3~4 hours after stopping diazepam infusion. The pressor effect was rather potentiated than inhibited in bilateral adrenalectomized or nephrectomized rabbits. Infusion of 2microg/kg/min of saralasin for 10 min in the bliateral adrenalectomized rabbit did not affect the pressor effect at all. These results suggest that hypertensive effect induced by ICV infusion of hypertonic NaCl is mediated by the increase of vasopressin secretion.
Arrhythmias, Cardiac ; Atropine ; Blood Pressure ; Chlorisondamine ; Diazepam ; Diltiazem ; Electrocardiography ; Heart Rate ; Infusions, Intraventricular* ; Mecamylamine ; Phenoxybenzamine ; Phentolamine ; Propranolol ; Pupil ; Rabbits* ; Respiratory Rate ; Saralasin ; Vasopressins

PURPOSE: Cholestatic liver disease is a frequent complication of prolonged parenteral nutrition, especially in premature infants. The purpose of present study is to evaluate the clinical and biochemical efficacy of ursodeoxycholic acid (UDCA) in premature infants with total parenteral nutrition (TPN) cholestasis. METHODS: Retrospective chart review of 31 prematures with TPN cholestasis in Neonatal Intensive Care Unit of Chonnam University Hospital from January 1995 and December 2002 was done. Prematures were divided into two groups based on UDCA treatment: the study group (n=22, with UDCA treatment) and the control group (n=9, without UDCA treatment). Treatment efficacy of UDCA was evaluated by monitoring the changes of serum direct bilirubin level for more than one to two months. RESULTS: In study group, cholestasis appeared at a mean age of 23+/-18.8 days after a mean of 21+/-19.7 days of TPN. UDCA was initiated (ranged 15-30 mg/kg/day) at a mean age of 54+/-22.3 days for a mean of 32+/-19.0 days. There was no significant difference in decrease of direct bilirubin level between the study and control group. However, the day of initial enteral feeding and full enteral feeding were earlier in control group compared with study group. CONCLUSIONS: This study shows that UDCA treatment is not effective in the treatment of TPN cholestasis among premature infants unlike that of results reported in children and adults. To reduce the incidence of TPN cholestasis in premature infants, early introduction of enteral feeding as soon as possible is most important.
Adult ; Bilirubin ; Child ; Cholestasis* ; Enteral Nutrition ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Jeollanam-do ; Liver Diseases ; Parenteral Nutrition ; Parenteral Nutrition, Total* ; Retrospective Studies ; Treatment Outcome ; Ursodeoxycholic Acid*

No abstract available.

We herein report a case of occupational contact urticaria syndrome induced by cefotiam di-hydrochloride in a nurse. She had generalized pruritic wheals accompanied by palpitations and tachypnea during the preparation of cefotiam solution. A scratch patch test with cefotiam di-hydrochloride, a major component of cefotiam ingredient showed multiple erythema and wheals within 5 minutes, accompanied by palpitations and tachypnea. No delayed type reaction was observed. Based on her clinical history and scratch test result, we diagnosed her condition as contact urticaria syndrome caused by cefotiam.
Cefotiam* ; Erythema ; Patch Tests ; Tachypnea ; Urticaria*

BACKGROUND: Dermatologists frequently see morbilliform rash in the clinic, drug eruptions and viral eruptions. Due to close clinical similarities, it is difficult to differentiate them. OBJECTIVE: The purpose of this study was to review the histopathologic differences between drug eruption and viral eruption. METHOD: In this study, 13 patients diagnosed as rubella and 13 patients diagnosed as drug eruption in Department of Dermatology, Presbyterian Medical Center from 1995 to 1997 were included. We reviewed the epidermal changes such as vacuolopathy, dyskeratotic cells, spongiosis and exocytosis and dermal changes by light microscopy. RESULTS: 1. Vacuolopathy of basal layer was observed in 92.3% of patients in both diseases. 2. Dyskeratotic cells, spongiosis and exocytosis were observed significantly highly in drug eruption. 3. Perivascular lymphohistiocytic infiltration was mild in both diseases, but eosinophilic infiltration was significantly higher in drug eruption(84.6%) than viral eruption(15.4%). 4. Atypical lymphocytes were observed in both diseases. 5. Red blood cell extravasation was observed only in viral eruption. 6. Perivascular edema was significantly higher in drug eruption(76.9%) than viral eruption(38.4%) CONCLUSION: There were statistically significant differences in dyskeratotic cells, spongiosis, dermal eosinophilic infiltration and Red blood cell extravasation. Considering these observation, histopathologic findings may be helpful in differentiating between drug eruption and viral eruption.
Dermatology ; Drug Eruptions* ; Edema ; Eosinophils ; Erythrocytes ; Exanthema ; Exocytosis ; Humans ; Lymphocytes ; Microscopy ; Protestantism ; Rubella*

Various anatomical defects have been described in the surviving co-twin who had stillborn, macerated monozygotic co-twin with disseminated intravascular coagulation. The suggested mechanism was the transfer of emboli or thromboplastic materials of dead fetus to co-twin through placental vascular anastomoses. Multicystic encephalomalacia is the condition defined anatomically by the presence of multiple cavities in the great part of both cerebral hemispheres. The most common pathogenesis is circulatory disturbance caused by neonatal asphyxia during the perinatal period. We experienced two cases of monozygotic twin with deceased co-twin at 26 weeks, 33 weeks of gestation and confirmed the diffuse multicystic encephalomalacia by cranial ultrasonography and MRI in a surviving co-twin. Only one patient has been followed who showed spastic cerebral palsy and severe mental retardation. We report two cases of multicystic encephalomalacia in a surviring co-twin with a intrauterine fetal death and its related literatures.
Asphyxia ; Cerebral Palsy ; Cerebrum ; Disseminated Intravascular Coagulation ; Encephalomalacia* ; Fetal Death* ; Fetus ; Humans ; Intellectual Disability ; Magnetic Resonance Imaging ; Pregnancy ; Pregnancy, Twin ; Twins, Monozygotic ; Ultrasonography

No abstract available.
Ascites ; Hydrops Fetalis* ; Pleural Effusion ; Ultrasonography

PURPOSE: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. METHODS: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. RESULTS: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was 3.6+/-2.8 year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period (4.18+/-2.10 vs 4.79+/-1.49 days, P=.17) and total fever duration (5.32+/-2.07 vs 6.41+/-3.25 days, P=.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. CONCLUSION: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.
Bacterial Infections ; Bronchiolitis ; Bronchitis ; Child* ; Croup ; Fever ; Hospitalization ; Hospitals, University* ; Humans ; Influenza B virus* ; Influenza, Human ; Inpatients ; Medical Records ; Oseltamivir* ; Outpatients ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Thorax

OBJECTIVE: To evaluate the perinatal prognosis of fetuses with a single umbilical artery. METHODS: From 1992 to 1998, nineteen cases with single umbilical artery(SUA) was observed in 8,704 deliveries at Chonnam University Hospital. RESULTS: Out of nineteen fetuses, thirteen fetuses with single umbilical artery were detected by antenatal ultrasonographic examination and six fetuses were detected after birth. The male to female ratio was 0.9: 1. Congenital malformations were observed in 8 babies(42.1%) and included leg deformity, esophageal atresia, imperforated anus, ventriculomegaly, meningocele, hydronephrosis, ventricular septal defect, joint contracture, cleft lip and palate, toe anomaly, imperforated anus, kyphosis, no urethra and testis, clubfoot, patent ductus arteriosus and rnild mitral regurgitation. Among 10 cases of karyotyping analysis three cases were diagnosed as trisomy 18. Fourteen fetuses(77.8%) showed growth restriction at delivery. Antenatal obstetric complications were hydramnios(n = 3), oligohydramnios(n =2), and severe preeclampsia(n = 3). CONCLUSION: Careful ultrasonographic evaluation for the identification of a SUA is necessary because of its frequent association with congenital anomaly, growth restriction and cytogenetic abnormality.
Anal Canal ; Chromosome Aberrations ; Cleft Lip ; Clubfoot ; Congenital Abnormalities ; Contracture ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Female ; Fetus ; Heart Septal Defects, Ventricular ; Humans ; Hydronephrosis ; Jeollanam-do ; Joints ; Karyotyping ; Kyphosis ; Leg ; Male ; Meningocele ; Mitral Valve Insufficiency ; Palate ; Parturition ; Prognosis* ; Single Umbilical Artery* ; Testis ; Toes ; Trisomy ; Urethra

OBJECTIVES: Xylitol is an effective anticarious natural sugar substitute, by inhibiting the virulence of Streptococcus mutans (S. mutans). However, long-term xylitol consumption leads to an emergence of the xylitol-resistant (XR) strains. This study aimed to confirm the general characteristics, mRNA expression of gtf genes, and adhesive ability of the xylitol-sensitive (XS) and XR S. mutans , by xylitol-treated concentrations. METHODS: S. mutans KCTC3065 was maintained in TYE medium, containing 0.4% glucose with 1% xylitol for 30 days at 37degrees C, 10% CO2 to form XR strain and the same procedures, without xylitol, were repeated for the formation of XS S. mutans. Both XS and XR were cultured by xylitol-treated concentrations (0%, 0.1% and 1%), then, general characteristics, such as growth and acid production, mRNA expression of gtf genes and adhesive ability were analyzed. RESULTS: Xylitol reduced the cell growth of XS S. mutans in a dose-dependent manner, but did not reduce the XR. Xylitol inhibited acid production of XS in a dose-dependent manner. However, it did not inhibit that of XR. Xylitol reduced the gtfB and gtfD mRNA expression of the XS S. mutans, which the genes synthesized soluble and insoluble extracellular polysaccharides, but not reduced that of the XR. By a microtiter plate assay, biofilm formation was more reduced in the XR strains, which means biofilm's adhesive ability of XR S. mutans was lower than that of the XS. CONCLUSIONS: These results indicate that a lower level of adhesive ability for XR S. mutans is related with mRNA expression level of gtf genes, which suggested that the XR strains may be less cariogenic than that of the XS.
Adhesives ; Biofilms ; Glucose ; Glucosyltransferases ; Polysaccharides ; RNA, Messenger ; Sprains and Strains ; Streptococcus ; Streptococcus mutans ; Sweetening Agents ; Xylitol