No abstract available.
Female ; Lactation*

No abstract available.
Carcinoma, Small Cell* ; Female ; Ovary*

BACKGROUND AND PURPOSE: The systemic inflammatory response syndrome(SIRS), as defied recently by critical-care specialists, may result from various etiologies including infection, bum, or trauma. The purpose of this study was to determine whether TNF- alpha is associated with the development of systemic inflammatory response syndrome caused by multiple trauma. METHODS: The study population consisted of 21 patients with multiple trauma presented emergency department within 2 hours after insult were enrolled in this study Multiple blood samples were serially drawn to measure seam TNF-alpha level on admission, 12 hours, 24 hours, and every day until 5 days after injury. Serum TNF-alpha was measured by ELISA ("Sandwich type"). Blood samples of fifteen volunteers were used as a reference value far serum TNF-alpha. RESULTS: Serum TNF-alpha. levels of SIRS group were persistency elevated above reference value until 3 days after on admission. Peak seam TNF-alpha level at 12 hours after admission was higher in SIRS group than non-SIRS group(p< 0.05). There was no significant correlation between injury severity score and TNF-alpha levels on regression analysis, all patients with ISS higher than 16 had SIRS. No one had SIRS among patients with ISS less than 16. CONCLUSION: the result of this study suggests that persistent elevation of TNF-alpha and degree of injury severity are associated with the development of systemic inflammatory response syndrome in multiple trauma.
Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Humans ; Injury Severity Score ; Multiple Trauma* ; Reference Values ; Specialization ; Systemic Inflammatory Response Syndrome* ; Tumor Necrosis Factor-alpha* ; Volunteers

No abstract available.
Humans ; Perfusion* ; Prenatal Diagnosis*

OBJECTIVES: This study was undertaken to evaluate correlation between the levels of hippuric acid in blood plasma (HAP) and those of toluene concentration in the workplace air. METHODS: Study subjects were composed of two groups; 21 workers who were occupationally exposed to toluene and 25 rural-area residents who were not exposed to any known occupational toluene source, as an exposed group and a reference group, respectively. Mean age and work duration of the exposed was 42 years and five years, respectively. Mean age of the reference was 42 years. To determine toluene concentrations in the workplace air, air sampling has been conducted for more than six hours using a personal sampler, and analyzed by a gas chromatography-flame ionization detector. Concentrations of hippuric acid in biological samples were determined by a high performance liquid chromatography-ultraviolet detector. RESULTS: Geometric mean(geometric standard deviation) of HAP and hippuric acid in urine(HAU) for the exposed was 1.39(2.21) mg/L and 2.77(1.46) g/L, respectively, which were significantly different from those of the reference [HAP, 0.45(2.94); HAU, 0.37(0.45)]. Toluene concentration in the workplace air was 86.92(range: 45.18~151.23) ppm. The level of HAP or HAU was significantly correlated (r=0.70 and r=0.63, respectively) with that of toluene in the workplace air. The estimated regression equation was logHAP(mg/L)=-3.60+1.93 log(toluene, ppm) or logHAU(g/L)=-0.85+0.67 log(toluene, ppm). The magnitude of correlation was further enhanced when analyzing relationship between toluene concentrations lower than 100 ppm and its corresponding HAP levels. CONCLUSION: Overall, plasma hippuric acid levels were well correlated with toluene concentrations in the workplace air, and a statistically significant correlation was observed for the samples with toluene concentration lower than 100 ppm.
Chromatography, High Pressure Liquid ; Humans ; Occupations ; Plasma* ; Toluene*

BACKGROUND: Severe neutropenia is defined as an absolute neutrophil count (ANC) less than 0.5×109/L, which is known to increase the risk of serious bacterial infections. The aim of this study was to investigate characteristics, etiology and differences between transient and chronic severe neutropenia in children.METHODS: 204 children, who were diagnosed with severe neutropenia at the Ajou University Hospital during a 5-year period, were included in the study. Clinical and laboratory features were analyzed. The patients were classified as having transient severe neutropenia (TSN) if recovery occurred within 6 months of diagnosis, and chronic severe neutropenia (CSN) if the neutropenia persisted for 6 months or more.RESULTS: 184 (90.2%) patients with TSN and 20 (9.8%) patients with CSN were identified. Most of the TSN occurred in patients less than 2 year of age (75.5%) and rarely occurred in patients 5 years or older (5.4%). The most common cause of TSN was infection-related neutropenia (82.6%), and most of the associated infections were respiratory infections (44.6%). Compared to TSN, CSN patients were younger at diagnosis (1.00 vs. 0.71, P < 0.001), had a lower ANC at diagnosis (364.8 vs. 214.9, P < 0.001), lower ANC at nadir (356.0 vs. 50.0, P < 0.001), and higher platelet count (188×10⁹ vs. 308×10⁹, P < 0.001), monocyte count (491.5×10⁶ vs. 832.9×10⁶, P=0.010) and CRP (0.22 vs. 0.85, P=0.036).CONCLUSION: Most of the severe neutropenia occurred in children younger than 2 years of age, and virus infection was the most common cause of TSN.
Bacterial Infections ; Child ; Diagnosis ; Humans ; Monocytes ; Neutropenia ; Neutrophils ; Platelet Count ; Respiratory Tract Infections

PURPOSE: We evaluated the results of Holmium:YAG laser lithotripsy according to the size and location of the ureteral stones. MATERIALS AND METHODS: Between March 1998 and April 2007, the medical records of 203 patients who were treated with ureteroscopic Holmium: YAG laser lithotripsy due to ureteral calculi were reviewed. They were subgrouped by the size and the location of the ureteral stones. The results of treatment were evaluated by the stone free rate and the mean operation time of each group. RESULTS: The stone free rates of the upper, mid and lower ureter stone groups were 73.3%, 96.1% and 100%, respectively. There was a significant difference in the upper ureter stone group compared to the other two groups, and especially for the group with stone less than 10mm. Stone migration into the renal pelvis or calyx was a major cause of failure in the patients with upper ureter stones. 8 cases showed stone migration and 2 cases showed fragment migration. CONCLUSIONS: As Holmium:YAG laser lithotripsy has a low complication rate and a high stone free rate, it is an effective treatment modality for ureteral calculi. However, such procedures should be performed carefully because the thermal effect of the Holmium:YAG laser causes ureteral perforation, and especially in the cases of impacted or large stones. Other effective alternatives such as trapping devices need to be studied for patients with upper ureteral stones to prevent stone migration.
Holmium ; Humans ; Kidney Pelvis ; Lasers, Solid-State ; Lithotripsy ; Lithotripsy, Laser ; Medical Records ; Ureter ; Ureteral Calculi

Clonorchis sinensis infection is one of the most common parasitic infections that is widely distributed in Southern Korea as well as China, Japan, Taiwan, Hong kong, and Vietnam and countries in Eastern Asia. The disease is caused by the ingestion of infected raw or under- processed freshwater fish. The clinical manifestations depend on the number of flukes in a patient, the period of infestation, and the complications. We experienced a 10-year-old boy who had a history of ingestion of raw fresh-water Chinese mitten crab preserved in soy sauce and presented with chronic urticaria. The causal organism, Clonorchis sinensis, was found by the identification of parasite ova in stool. We report a rare case of chronic urticaria related to Clonorchis sinensis that was successfully treated with praziquantel and review the pertinent literature.
Asian Continental Ancestry Group ; Child ; China ; Clonorchis sinensis* ; Eating ; Far East ; Fresh Water ; Hong Kong ; Humans ; Japan ; Korea ; Male ; Ovum ; Parasites ; Praziquantel ; Soy Foods ; Taiwan ; Trematoda ; Urticaria* ; Vietnam

Selection of a treatment modality for traumatized renal rupture depends on the renal injury grade, hemodynamic stability, combined organ injury, and the physician's experience. Treatment for renal injury tends to be conservative to maintain renal function and lessen the morbidity of surgery. If renal injuries were well-staged and selected by radiologic evaluation, hemodynamically stable patients with significant injuries (grades II through V) can usually be managed without surgical exploration. We report 3 cases of grade 4 renal injuries successfully treated with selective renal arterial embolization.
Emergencies ; Hemodynamics ; Hemorrhage ; Humans ; Rupture

PURPOSE: Video-assisted minilaparotomy surgery (VAMS) is a hybrid of conventional open and laparoscopic surgeries, which combines the benefits of both techniques. Our initial experiences with 33 cases were analyzed to assess the feasibility of VAMS. MATERIALS AND METHODS: Between May 2004 and April 2006, a total of 33 patients underwent VAMS-radical (n=20) and VAMS-live donor nephrectomies (n=13). The results of each operation were analyzed in terms of patient age, operation time, blood loss during surgery, time of oral intake and full ambulation, post operative stay period and amount of analgesic use. RESULTS: The mean age of the patients that had undergone the VAMS- radical and VAMS donor nephrectomies were 55.9 12.4 and 36.0 8.6 years, respectively. The mean results of the VAMS radical nephrectomy and VAMS donor nephrectomy with regard to the operative time, blood losses, time to oral intake, time to ambulation, postoperative length of stay and postoperative length of analgesics use were 225+/-72 / 253+/-67 minutes, 378+/-254 / 447+/-208cc, 2.1+/-0.7 / 1.4+/-0.5 days, 2.1+/-1.1 / 1.6+/-0.7 days, 6.2+/-1.1 / 6.2+/-1.0 days and 1.7+/-0.8 / 1.6+/-0.5 days, respectively. The mean warm ischemic time of VAMS donor nephrectomy was 2.4+/-0.8 minutes. The mean operation time of the 10 earliest cases of VAMS radical nephrectomy was 283 minutes; whereas, that of the last 10 cases decreased to 166 minutes. The mean operation time of the 7 earliest cases of VAMS donor nephrectomy was 299 minutes, which decreased to 206 minutes in the last 6 cases. Complications included 3 wound extensions in 5 patients experiencing massive intraoperative bleeding, 1 pneumonia, 1 wound dehiscence and 1 postoperative bleeding, all of which occurred in the 8 earliest cases. CONCLISIONS: VAMS could be a safe and feasible minimally invasive surgical procedure as experience is accumulated; when the initial learning curve has been overcome.
Analgesics ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy* ; Learning Curve ; Length of Stay ; Nephrectomy ; Operative Time ; Pneumonia ; Tissue Donors ; Walking ; Warm Ischemia ; Wounds and Injuries