Even though phototherapy is an effective means of treating hyperbilirubinemia, adequate binocular shields are essential to prevent light hazard of retina during phototherapy. The phototherapy to young albino rabbits was performed under various conditions; exposured for 12, 24, and 48 hours, continuity or intermittence of irradiation, and use of shields. Although there was no definite pathologic change in indirect ophthalmoscopic examination, severe damage was seen at electron microscopic level. In all experimental groups, swelling and edema of photoreceptor were seen. at right after phototherapy. Futhermore, more severe damage was seen in case of intermittent irradiated group and prolong exposed group. In mydriatic eyes, severity of damage was similiar to non mydi iatic eyes, but area of retinal damage was more extensive than non-mydriatic eves.. In control group which was protected by binocular shields during phototherapy, no significant abnormality was found.
Dermatitis, Phototoxic* ; Edema ; Hyperbilirubinemia ; Phototherapy ; Rabbits ; Retina ; Retinaldehyde* ; Telescopes

PURPOSE: Leptin and adiponectin levels show gender differences in adults, both of which are higher in women. We aimed to describe the gender differences in leptin and adiponectin levels according to pubertal development, and relationships of leptin, adiponectin, and leptin/adiponectin ratio (L/A) with sex steroids. METHODS: Seventy-seven healthy children (36 boys and 41 girls) were enrolled, and were divided into prepuberty, early puberty (Tanner stage 2 or 3), and late puberty (Tanner stage 4 or 5). Fasting plasma levels of leptin, adiponectin, testosterone, estradiol, and sex-hormone binding globulin (SHBG) were measured. RESULTS: 1) There was no gender difference in leptin and adiponectin in prepuberty. In early puberty, leptin was higher in girls, and in late puberty, both leptin and adiponectin were higher in girls than in boys. The L/A did not show any gender difference in our participants. 2) Leptin correlated with percent weight for height (%WFH) in both genders, and also with Tanner stage, estradiol, and FAI in girls. Adiponectin correlated inversely with %WFH, Tanner stage and FAI in boys. The L/A showed positive relationships with %WFH, Tanner stage and free androgen index (FAI) in both genders, and also with estradiol in girls. 3) In multiple regressions, age, %WFH, estradiol, and FAI were independently related to Ln (leptin) (R2=0.603). FAI was independently related with Ln (adiponectin) (R2=0.063), and the %WFH and estradiol with Ln (L/A) (R2=0.434). CONCLUSION: Gender differences of leptin and adiponectin become apparent with the progression of puberty. Estrogen is independently related to leptin levels, and androgen is related to both leptin and adiponectin.
Adiponectin* ; Adolescent ; Adult ; Child ; Estradiol ; Estrogens ; Fasting ; Female ; Humans ; Leptin* ; Plasma* ; Puberty* ; Steroids ; Testosterone

Manipulation of the sensory branches of the trigeminal nerve is known to cause autonomic changes, such as bradycardia or asystole, known as the trigemino-cardiac reflex. In this case, the patient underwent microvascular decompression due to trigeminal neuralgia and developed sudden bradycardia, followed by abrupt asystole with a concurrent fall in the systolic blood pressure. There was spontaneous return of cardiac rhythm and blood pressure, but two more episodes of sinus bradycardia occurred during the surgery.
Blood Pressure ; Bradycardia ; Heart Arrest* ; Humans ; Microvascular Decompression Surgery* ; Reflex, Trigeminocardiac ; Trigeminal Nerve ; Trigeminal Neuralgia*

PURPOSE: Occult papillary thyroid carcinomas (OPC) are defined as tumors measuring < or =15 mm in size. They are believed to be a less aggressive subset of papillary cancers, which behave more like benign lesions, and are often treated more conservatively. However, some groups have reported a high incidence of metastases from papillary microcarcinomas and favor an aggressive surgical resection followed by radioiodine therapy. We review our experience in an attempt to characterize the biology and optimal treatment for OPCs. METHODS: From October 2001 to March 2006, among impalpable thyroid nodules detected incidentally during screening exams, 214 patients underwent surgery for occult papillary thyroid cancer (OPC) at Kangnam Cha University hospital. The data from these patients were analyzed retrospectively. The mean follow up period was 19.9+/-11.7 (max : 53, min : 1) months. RESULTS: The mean age of these patients was 41.4 year, and 188 (87.7%) were female. 41% of the patients underwent a total or neartotal thyroidectomy, 42% had a central lymph node dissection and 41% had radioiodine ablation therapy after surgery. Of the 214 patients, 40 (18.7%) had lymph node metastases. The LN metastases were associated with the tumor size (P=0.0007), extracapsular invasion (P=0.0268) and multifocality (P=0.0024), but there was no association with age and gender. The incidence of the LN metastases (20%) and extracapsular invasion (59.1%) were higher in the tumors between 0.5~1.0 cm in size. With a follow-up up to 53 months, 3 patients had a local recurrence (0.014%) but no patients currently has active disease. No patients with OPC died died during this period. CONCLUSION: In OPC patients, a progressively increasing frequency of signs of tumor aggressiveness with increasing tumor size was observed but a small size itself could not guarantee a low risk or low recurrence rate. The prevalence of LN metastases and extracapsular invasion were higher in tumors > 0.5 cm in size. Therefore, we prefer near-total or total thyroidectomy with central lymph node dissection. Early detection and treatment of OPC might be warranted by the routine use of thyroid USG and USG-guided FNA.
Biology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis ; Prevalence ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy

Several investigators have described an interaction between muscle relaxants and hydrocortisones which have showed different results. The exact mechanism of this action is not clear and ther conflicting results have further confusion. The experimental methods were two ways. In the one of method, a group that vecuronium 0.1mg/kg was given intravenously is control and a group that hydrocortisones of various doses(0.3, 0.5 and 1 mg/kg) were administered into vein when T1 was appeared is compared. In the another of method, a control group was anticholinesterase(pyridostigmine 0.12 mg/kg, robinul 0.004mg/kg) were given at the time when T1 reached 25% and a group treated with hydrocortisone 0.5 mg/kg when T1 was appeared is compared. Neuromuscular blockade was measured by recording the twitch response following ulnar nerve stimulation by EMG(ABM, Datex Co. 2Hz 30mA supramaximal voltage). The recovery time from 25% to 75% recovery of twitch height was measured according to recovery index(RI). The results obtained were as follows: `) The RI of control group treated with vecuronium 0.1mg/kg alone was 40.32+/-20.24 minutes and the group which hydrocortisone 0.5mg/kg was combined, was shorten to 18.79+/-5.17 minutes, but in the group combined with hydrocortisone 1.0mg/kg and 0.3mg/kg, the RI was also tended to short, but not significant. 2) In the RI of vecuronium 0.1mg/kg, anticholinesterases were given, was 8.46+/-5.06 minutes and the group combined with hydrocortisone 0.5mg/kg was shorten to 4.77+/-1.82 minutes significantly. Conclusively, in the small doses of hydrocortisone, there is a effect of antagonism to the vecuronium induced blockade and a potentiated effect to the anticholinesterase activity to the vecuronium.
Cholinesterase Inhibitors ; Humans ; Hydrocortisone* ; Neuromuscular Blockade* ; Research Personnel ; Ulnar Nerve ; Vecuronium Bromide* ; Veins

Background: Estrogen status is important for maintaining the homeostasis of bone. Estrogen has direct effects on bone cells, through binding to the high-affinity estrogen receptor. Several recent studies suggest that there might be genetically determined variations in biosynthesis and function of estrogen receptor in postmenopausal osteoporosis. Also the main cause of postmenopausal osteoporosis is decreased level of serum estrogen, whereas there had been some suggestion that the remaining estrogen have some effect on bone metabolism after menopause. We investigated the relationship between estrogen receptor gene PvulI polymorphism and bone mineral density(BMD), and the relationship between 18 urinary metabolites of estrogen and BMD in Korean postmeno- pausal osteoporosis. Methods: We examined the PvuII polymorphism of the estrogen receptor gene in 5' upstream region and the first intron by restrietion frapnent length polymorphism analysis in 62 postmeno- pausal wornen, BMD was measured by DEXA. The urinary estrogen metabolites were determined by GC/MS(Gas Chromatography-Mass Spectrometry) at Korean Institute of Science and Techno- logy Doping Control Center. Results: BMD of the spine and the femoral neck correlated with body weight, height, body mass index as we expected. There was no polymorphism of PvuII restriction site on 5 upstream region of estrogen receptor gene. Whereas the prevalen~ee of the PP, Pp, pp genotype in the first intron of estrogen receptor was 12.9%, 45.2%, 41.9%, respectively. But, there was no correlation between PvuII genotype and the spinel and femoral neck BMD. 2(OH)E2 among 18 urinary metabolites of estrogen, showed a negative correlation with the spinal and femoral neck BMD(r =-0.2551, p<0.05, and r =-0.3341, p<0.01, respectively), and the ratio of 16a(OH)E2/2(OH)E1> revealed a positive correlation with the spinal BMD(r =0.3057, p<0.05). In stepwise multiple regression analysis, body weight, 2(OH)E2, 16a(OH)E1, 2(Meo)E1 were independent predictors of the spinal bone density, and body weight and 2(OH)E2 were independent predictors of the femoral neck bone density. Conclusion: These results suggested that restrietion fragment length polymorphism analysis of the estrogen receptor gene with PvuII restriction enzyme was not helpful for early detection of patients at risk of developing osteoporosis. However, the ratio of 16-hydroxylation to 2-hydroxylation of estrogen metabolism was reduced in postmenopausal women and high catecholestrogen formation might be a greater risk factor for osteoporosis.
Body Height ; Body Weight ; Bone Density ; Estrogens ; Female ; Femur Neck ; Genotype ; Homeostasis ; Humans ; Introns ; Menopause ; Metabolism ; Miners ; Osteoporosis ; Osteoporosis, Postmenopausal ; Risk Factors ; Spine

The hepatopulmonary syndrome is defined as the triad of liver disease, an increased alveolar-arterial gradient while breathing room air, and evidence of intrapulmonary dilatation. Other cardiopulmonary abnormalities(such as pleural effusion or decreased lung volumes) are common and may coexist in patients with the hepatopulmonary syndrome. An abnormal dilatation of intrapulmonary capillaries is evidenced by Tc 99m-MAA perfusion scan, contrast-enhanced echocardiography, and pulmonary angiography. We have experienced a case of hepatopulmonary syndrome in a fi7 year old woman with liver cirrhosis who complained of severe dyspnea and cyanosis. Her arterial blood gas analysis (ABGA) showed severe hypoxemia(PaO2 59mmHg), suggesting the hepatopulmonary syndrome, which was confirmed with the contrast-enhanced echocardiography. It showed delayc4 opacification of left side chambers during agitated saline injection', thus, intrapulmonary shunt was confirmed. So we report a case of hepatopulmonary syndrome with a rewiew of literature.
Angiography ; Blood Gas Analysis ; Capillaries ; Cyanosis ; Dihydroergotamine ; Dilatation ; Dyspnea ; Echocardiography ; Female ; Hepatopulmonary Syndrome* ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Lung ; Perfusion ; Pleural Effusion ; Respiration

Renal angiomyolipomas are benign mixed mesenchymal tumors, which are composed of atypical blood vessel, smooth muscle and fat cells. A 34-year-old woman presented with a palpable right abdominal mass, accompanied with discomfort. A CT scan showed a large right perinephric mass, with heterogeneous density, surrounding the kidney, with enlargement of the regional lymph nodes. The presumptive diagnosis was one of a malignant tumor of the retroperitoneum, with lymph node metastasis or an angiomyolipoma, involving both the kidney and lymph nodes. A right radical nephrectomy, including the tumor, was performed. The final diagnosis was an angiomyolipoma arising from the kidney, with the dissected lymph nodes having the same pathology. There was no evidence of a tumor recurrence during the six month follow-up period. This was an unusual case of a multicentric angiomyolipoma.
Adipocytes ; Adult ; Angiomyolipoma* ; Blood Vessels ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Kidney ; Lymph Nodes* ; Muscle, Smooth ; Neoplasm Metastasis ; Nephrectomy ; Pathology ; Recurrence ; Tomography, X-Ray Computed

No abstract available.
Oxygen*

Endoscopic hysterectomy is increasingly selected as a current trend to minimize invasion, tissue trauma and early recovery. However it has disadvantages of the difficulty to learn and needs expensive equipments. So we developed a new minimally invasive method of vaginal hysterectomy-minilaparotomically assisted vaginal hysterectomy (MAVH) in order to complement the current laparoscopic surgery. The principle of MAVH is based on suprapubic minilaparotomical incision and uterine elevator that allows access and maximal exposure of the pelvic anatomy and an easy approach to the surrounding anatomy enabling division of round ligaments, Fallopian tubes, tuboovarian ligaments, and dissection of bladder peritoneum. After then, the vaginal phase of MAVH is done by the traditional vaginal hysterectomy. We enrolled 75 consecutive cases and in 73 cases thereof MAVH was accomplished successfully. The technique of MAVH is simple and easy to learn and it involves a small incision causing less pain and complications. This practice does not require expensive equipments. MAVH is considered as a safe and effective alternative method for abdominal hysterectomy in most cases.
Adult ; Aged ; Blood Loss, Surgical ; Human ; Hysterectomy, Vaginal/*methods ; *Laparotomy ; Middle Aged ; Postoperative Complications ; Treatment Outcome