Antenatal corticosteroids and outcomes of preterm small-for-gestational-age neonates in a single medical center

OBJECTIVE: This study investigated the effect of an antenatal corticosteroid (ACS) in preterm small-for-gestational-age (SGA) neonate. METHODS: This study was a retrospective cohort study. We compared women who received ACS with unexposed controls and evaluated neonatal complications among those having a singleton SGA neonate born between 29 and 34 complete gestational weeks. The neonates born after 32 weeks of gestation were divided into subgroups. Multivariable logistic regression analysis was performed. RESULTS: A total 82 of the preterm infants met inclusion criteria; 57 (69.5%) were born after 32 weeks of gestation. There were no significant differences in terms of mechanical ventilation, seizure, intracranial hemorrhage, retinopathy of prematurity, necrotizing enterocolitis, feeding difficulty, and neonatal mortality between infants whose mothers received ACS ant those whose mothers did not (all P>0.05). However, newborns whose mothers received ACS exhibited a significantly increased risk of developing respiratory distress syndrome (RDS) (adjusted odds ratio [aOR], 3.271; 95% confidence interval [CI], 1.038–10.305; P=0.043). In case of neonates born beyond 32 weeks of gestation, the risk of neonatal hypoglycemia was significantly higher in women receiving ACS after controlling for confounding factors (aOR, 5.832; 95% CI, 1.096–31.031; P=0.039). CONCLUSION: ACS did not improve neonatal morbidities, in SGA neonates delivered between 29 and 34 gestational weeks. Rather, ACS could increase the risk of RDS. In cases of SGA neonate delivered between 32 and 34 complete gestational weeks, the risk of hypoglycemia was significantly increased. The use of ACS in women with preterm SGA infants needs to be evaluated further, especially after 32 weeks' gestation.

A Case of Dermatomyositis Presenting with Rhabdomyolysis

Rhabdomyolysis is caused by injury to skeletal muscle and it involves leakage of intracellular contents into the plasma. Rhabdomyolysis is an extremely rare manifestation of dermatomyositis. Dermatomyositis is a rare idiopathic inflammatory myopathy that is characterized by chronic inflammation of skeletal muscles and skin, resulting in muscle weakness. A 20 year old Korean male soldier presented with acute muscle pain, weakness and skin rashes over the face, neck and anterior chest. He received military training with carrying a radio set one week previouslyago. The patient was treated for rhabdomyolysis. However, the patient's symptoms did not improve. Muscle biopsy results suggested the diagnosis of rhabdomyolysis. Nevertheless, the features of skin and muscle inflammation raised the possibility of dermatomyositis. High dose steroid treatment was started, and then the symptoms and signs of muscle inflammation were improved. Rhabdomyolysis as the presenting sign of dermatomyositis has not been reported in Korea. Thus, we report on this case with a literature review.

Effects of Cooking Methods on Peanut Allergenicity / 소아알레르기및호흡기학회지

PURPOSE: Peanut allergy is a major cause of fatal food-induced anaphylaxis. Cooking methods can affect the allergic properties of peanut proteins. The aim of this study was to determine the allergenicity of peanut according to cooking methods. METHODS: Eight kinds of peanut were included in the study: raw peanut, boiled peanut, roasted peanut (10 min, 20 min and 30 min), peanut butter, fried peanut and vinegarish peanut. The proteins were extracted with PBS and analyzed using the SDS-PAGE IgE immunoblot assay with pooled sera from 8 patients with atopic dermatitis. These patients had peanut- specific IgE levels greater than 15 kU/L, which were measured by the CAP-FEIA. RESULTS: The SDS-PAGE IgE immunoblot assay revealed more intense protein bands of Ara h 2 in roasted peanut and peanut butter than in raw, boiled, fried and vinegarish peanut. The protein band of Ara h 1 was not undetected in fried and vinegarish peanut. Ara h 3 had a stable band pattern in all samples, but there was the most prominent band at 37-40 kDa in vinegarish peanut. The IgE immunoblot assay revealed that 10 min roasted peanut had more IgE binding to Ara h 2, and there was no IgE binding to Ara h 1 in fried and vinegarish peanut. In vinegarish peanut, there was almost no IgE binding to it. CONCLUSION: The results of this study suggest that the roasted peanut may increase the allergenicity of Ara h 2 as compared to Ara h 1. Fried and vinegarish peanut may reduce the allergenicity of peanut.

The Evaluation of Gallbladder Function by Tc-99m-DISIDA Scintigraphy in Diabetic Patients / 대한내과학회지

OBJECTIVES: Diabetic autonomic neuropathy is a common complication of long standing diabetes mellitus and is well known to induce the motor dysfunction of cardiovascular system, genitourinary system and diges tive system. Although many studies have done to eval uate the diabetic autonomic neuropathy, gallbladder motor function and biliary dynamic study to evaluate the change of gallbladder function in diabetic patients is relatively rare. This study was performed to measure the gall bladder ejection fraction using Tc- 99m-DISIDA with fatty meal in order to evaluate the gallbladder motor func tion in diabetic patients and to examine the usefulness of it in analyzing diabetic autonomic neuropathy. METHODS: 51 diabetic patients(males 31, females 18, mean age 57yr(39-77yr)) and 18 control subjects(males 14, females 4, mean aged 47yr(31-70yr)) without gall stone and impaired liver function were enrolled in our study. Also the diabetic patients were categorized by age, disease duration, body weight and diabetic complications such as retinopathy, peripheral neuropathy and cardiovas cular autonomic neuropathy accompanying with or not. RESULTS: 1) Median value and interquartile range of gallbladder ejection fraction(%) were 66%(48-79%) in diabetic pa tients group and 75%(64-80%) in control subjects. There was no statistically significant difference between the two groups, but the mean value of diabetic patients was slightly lower than that of control subjects. 2) There was no significant difference between the two groups in mean value of gallbladder ejection fraction in every age group(P>0.05). 3) Median value of gallbladder ejection fraction in diabetic groups with less than 10 years of duration (both under 5 years and 5 to 10 years groups) was similar to that of control subjects. However in patients whose diabetic conditions last more than 10 years, the median range of gallbladder ejection fraction was significantly lower than that of control subjects(p0.05). Also seven diabetic patients whose gallbladder ejection fraction was reduced under 35% have had at least two diabetic complications. CONCLUSION: We observed that gallbladder ejection fraction of diabetic patients was reduced compared with that of control subjects. This is due to the reduced gallbladder muscle contractility resulting from diabetic autonomic dysfunction. These results suggest that the assessment of gallbladder ejection fraction using 99m- Tc-DISIDA would be useful to diagnose diabetic auto nomic neropathy.

A Case of Retroperitoneal Castleman`s Disease / 대한비뇨기과학회지

We report a case of Castleman`s disease of the hyaline-vascular type which was located in retroperitoneum. A 20-year-old girl was admitted because of a history of postprandial epigastric discomfort. Computed tomography of the abdomen demonstrated a solid 7 x 7 cm mass between the abdominal aorta and the left kidney in the retroperitoneum. At surgery, a solid 9 x 8 x 6 cm tumor was resected. Pathologic diagnosis was Castleman`s disease of the hyaline-vascular type.

Comparison of Thiopental Sodium and Propofol as to the Effects of Anesthesia Induction and Hemodynamic Changes to Endotracheal Intubation / 대한마취과학회지

The purpose of this study is to compare thiopental sodium and propofol as to the effects of anesthesia induction and hemodynamic changes associated with endotracheal intubation. Forty healthy adult patients, scheduled for elective surgery under general anesthesia, were randomly assigned to receive either thiopental sodium 5 mg/kg (Group 1, n =20) or propofol 2 mg/kg (Group 2, n=20) as an induction agent. Endotracheal intubation was performed following injection of succinylcholine 1 mg/kg. Anesthesia was maintained with 1.5~2% ethrane and 50% N2O in O2. The results were as follows, 1) Both thiopental sodium and propofol revealed high incidence of pain in the site of injection (13/20, 10/20, respectively). 2) The time from the start of injection to spontaneous closing of eyes and to loss of eyelid reflex were 42 and 43 sec in group 1 and 46 and 51 sec in group 2, respectively. 3) The loss of respiratory efforts. Occured in all cases and took 65 and 59 sec, in group 1 and 2 respectively. 4) The blood pressure was more decreased in group 2 than group 1 during induction period, but there was no significant difference between two groups. Also, there was no significant difference of the heart rate between two groups. 5) The increments of systolic blood pressure and rate-pressure-product to endotrachal intubation in group 2 were less than group 1 at time of immediate and 1 minute after intubation. Also, the increments of mean arterial pressure, disastolic blood presure and heart rate were lessen in group 2 than group 1. The retum of blood pressure, heart rate and RPP to the control was fasten in group 2 than group l. In conclusion, propofol may be an alternative to thiopental sodium in patients who require endotracheal intubation without hemodynamic instability.