ABSTRACT
Purpose@#This is the first report to compare 3-dimensional computed tomography (3D-CT) images between pediatric patients with enuresis and children without lower urinary tract symptoms who underwent pelvic CT for other reasons. @*Methods@#Forty-seven children (33 boys and 14 girls) with primary enuresis underwent 3D-CT of sacrococcygeal bones. The control group consisted of 138 children (78 boys and 60 girls) who underwent pelvic CT for other reasons. First, we determined the presence or absence of unfused sacral arches at the L4-S3 levels in both cohorts. Subsequently, we compared the fusion of sacral arches in age- and sex-matched children from these 2 groups. @*Results@#Dysplastic sacral arches, characterized by lack of fusion at 1 or more levels of the S1–3 arches, were observed in nearly all patients in the enuresis group. In the control group (n=138), 54 of 79 children over 10 years old (68%) exhibited fused sacral arches at 3 S1–3 levels. All 11 control children under 4 years old displayed at least 2 unfused sacral arches at the S1–3 levels. In a comparative study of age- and sex-matched patients with enuresis and control children aged 5 to 13 years (n=32 for each group, with 21 boys and 11 girls; mean age, 8.0±2.2 years [range, 5–13 years]), only 1 patient (3%) in the enuresis group exhibited fusion of all S1–3 arches. In contrast, 20 of 32 control group participants (63%) had 3 fused sacral arches (P<0.0001). @*Conclusions@#Sacral vertebral arches typically fuse by the age of 10 years. However, in this study, children with enuresis exhibited a significantly elevated prevalence of unfused sacral arches, suggesting that dysplastic development of sacral vertebral arches may play a pathological role in enuresis.
ABSTRACT
RNA methyltransferase is responsible for transferring methyl and resulting in methylation on the bases or ribose ring of RNA, which existed widely but mostly remains an open question. A recombinant protein PH1948 predicting RNA methyltransferase from Pyrococcus horikoshii OT3 has been crystallized. The crystals of selenomethionyl PH1948 belong to space group C2, with unit-cell parameters a=207.0 A, b=43.1 A, c=118.2 A, b=92.1 degrees , and diffract X-rays to 2.2 A resolution. The V(M) value was determined to be 2.8 A3/Da, indicating the presence of four protein molecules in the asymmetric unit.
Subject(s)
Crystallization , Methods , Molecular Conformation , Pyrococcus horikoshii , X-Ray Diffraction , tRNA Methyltransferases , ChemistryABSTRACT
We report a case of reactive hypoglycemic coma in a 77-year-old man. Seven months after partial gastrectomy for early gastric cancer, he presented with syncopal attacks and seizure. His plasma glucose and insulin levels at coma were 18 mg/dl and 27μU/ml. Insulinoma was neglected with computerized tomography, magnetic resonance imaging and angiography. Because dietary control was insufficient, oral diazoxide therapy was done. But diazoxide did not protectthe overresponse of the insulin and reactive hypoglycemia in 75 g GTT. Octreotide (100 micrograms IM) inhibited insulin release and prevented hypoglycemia. Acarbose delayed the response of insulin butdid not inhibited insulin release. However, acarbose also prevented reactive hypoglycemia. We concluded that acarbose is an effective therapy for reactive hypoglycemic coma.
ABSTRACT
This report concerns a 62-year-old woman with Wegener's granulomatosis. She complained cough, macroscopic hematuria and oligulia. She had a consolidation without a cavity in the left upper lung field, massive proteinuria (2.5 g/day) and massive hematuria. The serum creatinine level was 2.5 mg/dl. The C-ANCA was positive. Renal biopsy revealed crescentic glomerulonephritis. She wa treated with prednisone and trimethoprim-sulfamethoxazole. The lung shadow, proteinuria and hematuria disappeared in one month. The C-ANCA titer also decreased. The use of trimethoprimsulfamethoxazole which may eliminate an infection as a cause to promote Wegener's granulomatosis should be actively included in the conventional treatment.
ABSTRACT
The patient was a 56-year-old male. He had a history of alcoholism since 1975 and diabetes mellitus since 1978. He was treated with insulin therapy. But the control of diabetes mellitus was very poor and he had six hypoglycemic comas attacks. He had diabetic triopathy but no symptoms of gait disturbance, dementia and incontinence. Brain computerized tomography and magneting resonance imaging revealed severe communicating hydrocephalus with mild brain atrophy.<SUP>111</SUP>In-DPTA cisternography revealed retension of isotope in the ventricle after 48 hours. The pressure of cerebrospinal fluid was normal.<BR>This case report is interesting as it suggests the relationship between normal pressure hydrocephalus and hypoglycemia.
ABSTRACT
An 78-year-old woman visited our hospital with the chief complaints of abdominal pain, nausea, vomiting and diarrhea. She was operated on for gastric ulcer when she was 56 years old and complained of abdominal discomfort after operation. One day she wished to take Confrey (<I>Symphytum officinale</I>), but she took digitalis leaves (<I>Digitalis purpurea</I>) by mistake. On admission she was drowsy and the systolic blood pressure was 60 mmHg on palpation. Electrocardiograms showed bradycardia, irregular AV-nodal rhythm and ST depressions and T wave inversions with the shortening of the QT interval. Serum levels were potassium, 6.4 mEq/1 ; BUN, 34.4 mg/di ; creatinine, 1.5 mg/di ; digoxin, 2.0 ng/ml (therapeutic level, up to 2.0 ng/ml); and digitoxin, 111ng/ml (therapeutic level, up to 25 ng/ml). Hemodynamic data showed HR, 49 beats/min ; CO, 2.81/min; CI, 2.31/min/m<SUP>2</SUP>; SV, 57 ml/beat and SI, 47 ml/beat/m<SUP>2</SUP> on administration of dopamine 7μg/kg/min. So VVI pacing was started at 70 bpm and CO increased to 3.6 1/min after pacing. But unfortunately she died of ventricular fibrillation. The digitalis leaves resemble the Confrey leaves and it is easy to mix up these two plants. Although this is a rare case, digitalis intoxication can be life-threatening. So we should prepared ourselves for the treatment of patients poisoned with digitalis and other poisonous herbs.