PURPOSE: The aim of this study was evaluating the efficacy of endoscopic Deflux(R) submucosal injection in children with primary vesicoureteral reflux (VUR). METHODS: Retrospective analysis of medical record was conducted on 38 children (59 ureters) who underwent endoscopic Deflux(R) injection due to primary VUR. Data were collected from March 2000 to February 2006. Mean infused amount of Deflux(R) was 0.77 cc. After Deflux(R) injection, patients were reassessed by voiding cystourethrogram (VCUG) 6 months later. RESULTS: The success rate of endoscopic Deflux(R) submucosal injection 6 months later by VCUG was 100% for grade 1 VUR, 87.5% for grade 2, 60% for grade 3, 26.6% for grade 4, 16.6% for grade 5, respectively and there was negatively significant correlation between success rate and grade of VUR (P<0.01). Degree of improvement of VUR by endoscopic Deflux(R) submucosal injection was not related to age at diagnosis, time to operation, existence of voiding dysfunction or constipation and infused amount of Deflux(R). However, group with anticholinergics medication had significantly lower success rate than non-medication group (P<0.047). CONCLUSION: Endoscopic Deflux(R) submucosal injection is effective therapy in patient with primary VUR, especially low grade VUR. It can be not only a useful substitute for prophylaxis with antibiotics, but also an effective management prior to ureteroneocystostomy in children with primary VUR.
Anti-Bacterial Agents ; Child ; Cholinergic Antagonists ; Constipation ; Humans ; Medical Records ; Retrospective Studies ; Vesico-Ureteral Reflux

Slipped capital femoral epiphysis is a rare hip disorder that mainly occurs in pubertal children. Although the exact cause of this disorder is unknown, it is known to be associated with obesity, trauma, delayed sexual development, delayed bone maturation, chronic renal failure, genetic diseases, endocrine disorders (growth hormone deficiency, hypothyroidism, hypogonadism), growth hormone therapy, and gonadotropin releasing hormone agonist (GnRH agonist) therapy. We report 2 cases of slipped capital femoral epiphysis in adolescent females who were receiving growth hormone therapy. The first case is of a 16 year-old-girl with chronic renal failure and renal osteodystrophy. The second case is of an 11 year-old-girl with idiopathic precocious puberty who had received GnRH agonist and growth hormone therapy. Unilateral or bilateral slipped capital femoral epiphysis developed at 1 year 3 months after treatment in both the cases. The chief complaints were pain in the hip joint and lower extremities. Growth hormone and/or GnRH agonist therapy was stopped, and in situ screw fixations of the involved hip epiphyses were performed.
Adolescent ; Child ; Endocrine System Diseases ; Epiphyses ; Female ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Hip ; Hip Joint ; Humans ; Hypothyroidism ; Kidney Failure, Chronic ; Lower Extremity ; Obesity ; Puberty, Precocious ; Renal Osteodystrophy ; Sexual Development ; Slipped Capital Femoral Epiphyses

PURPOSE: The incidence of type 2 diabetes mellitus is increasing worldwide because of the increase in the incidence of obesity. We performed this study to determine the type of diabetes and the clinical characteristics and laboratory data of the children who were newly diagnosed with diabetes mellitus (DM). METHOD: We reviewed the medical data of 75 children (35 boys and 40 girls) who were diagnosed with DM at Kyungpook National University Hospital between January 2001 and June 2008. RESULTS: Sixty patients (80%) were diagnosed with type 1 DM and 15 (20%) with type 2 DM. Approximately 70% of the study subjects developed DM in spring and winter. Further, 38% and 60% of the patients had a family history of type 1 and type 2 DM, respectively. The average age of the patients with type 1 DM was 10.6+/-2.6 years. Diabetic ketoacidosis was the first symptom in 15% of these patients. The average body mass index of these patients was 18.2+/-4.5 kg/m2. At least one of autoantibodies against pancreas was positive in 69%. The average age of the patients with type 2 DM was 13.4+/-1.2 years. Fifty-three percent of these patients was diagnosed without any symptom. Fatty liver and hypertension were diagnosed in 20% of the patients. Fifty-three percent of these patients were obese or overweight. CONCLUSION: Twenty percent of the children who were newly diagnosed with diabetes at our institute had type 2 DM. Since the incidence of type 2 DM in children appears to be increasing with an increase in the occurrence of childhood obesity, special attention should be provided to obese children.
Autoantibodies ; Body Mass Index ; Child ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diabetic Ketoacidosis ; Fatty Liver ; Humans ; Hypertension ; Incidence ; Obesity ; Pancreas

No abstract available.
Nails*

No abstract available.
Fibroma* ; Fingers*

PURPOSE: We wanted to evaluate the clinical and radiological results of total hip arthroplasty using a ceramic-on-ceramic articulation. MATERIALS AND METHODS: From March 2004 to February 2006, total hip arthroplasty was performed in 21 patients and 31 hips. The mean follow up period was 56 months (range: 48~72 months). The causes for the AVN were alcohol in 12 cases, idiopathic in 10 cases, steroid in 6 cases and post-traumatic in 3 cases. The clinical results were evaluated using the Harris hip score and according to the pain on the inguinal area or thigh. The radiographic evaluation was performed to determine the level of osteolysis and instability around the acetabular cup and femoral stem, the position of the femoral stem and the wear of the articular surface. RESULTS: At the most recent follow-up, the mean Harris hip score was 93 points with no inguinal or thigh pain. The complications included one case of peroneal nerve palsy, one case of ceramic head fracture, two cases of noise in the joint, two cases of posterior dislocation and two patients died because of complication related to liver cirrhosis. Radiologically, bone ingrowth was noted in all the cases with no migration of the acetabular component and femoral stem, changing of the position or osteolysis. CONCLUSION: Total hip arthroplasty with ceramic on ceramic articulation shows satisfactory results at an average of 56 months follow up. There was bone ingrowth in all cases except for one ceramic head fracture. Further follow-up study should be performed to evaluate the long-term results.
Aluminum Oxide ; Arthroplasty ; Ceramics ; Dislocations ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Liver Cirrhosis ; Noise ; Osteolysis ; Paralysis ; Peroneal Nerve ; Thigh

BACKGROUND/AIMS: We evaluated the effects of a multifaceted intervention for controlling a carbapenem-resistant Acinetobacter baumannii (CRAB) epidemic in an intensive care unit (ICU) with no restrictions on carbapenem use. METHODS: This study was conducted in a medical ICU between April 2012 and June 2016. The baseline infection control programs included surveillance cultures, contact precautions, and environmental cleaning. However, increases in the detection of CRAB isolates beginning in May 2013 led to the implementation of a new protocol, consisting of universal glove and gown use with daily chlorhexidine bathing for all patients in combination with baseline programs. The efficacy of the intervention was subjected to interrupted time series (ITS) analysis. RESULTS: The multifaceted intervention led to a decrease in the incidence of CRAB from 17.65 to 0.89 cases per 1,000 patient-days, during the study period (p < 0.001). ITS analysis revealed a significant change in the trend of CRAB incidence (–0.413, p < 0.001). Over this same period, mean monthly use of carbapenems increased from 143.54 ± 95.73 to 204.95 ± 78.43 doses per 1,000 patient-days (p = 0.018). CONCLUSIONS: Our multifaceted intervention reduced the incidence of CRAB acquisition in an ICU where carbapenem use was not restricted.
Acinetobacter baumannii* ; Acinetobacter* ; Baths ; Carbapenems ; Chlorhexidine ; Critical Care* ; Drug Resistance, Bacterial ; Humans ; Incidence ; Infection Control ; Intensive Care Units* ; Interrupted Time Series Analysis

BACKGROUND AND OBJECTIVES: Peripartum cardiomyopathy (PPCM) is a rare form of heart failure affecting women between the last month of pregnancy and the first five months after delivery. The etiology and prognostic factors of PPCM remains poorly understood, although some risk factors have been described. SUBJECTS AND METHODS: In order to characterize the features of PPCM, clinical and echocardiographic data, obtained from 19 patients who fulfilled diagnostic criteria of PPCM, from January 1996 to march 2001, were retrospectively analyzed. We divided the sample into 2 groups, which were classified according to clinical and echocardiographic improvements. (Group I; patients who improved, Group II; patients who did not improved, or deteriorated). RESULTS: Patients with PPCM (n=19, age: 32+/-5 yrs, NYHA Class: II-IV, LVEF: 34.1+/-8.8%, follow-up period: 14.2+/-16.3 months) had a high frequencies of the following clinical factors: Anaemia (16/19, 84.2%); Pre-eclampsia (11/19, 57.9%); Multiparity (11/19, 57.9%); aged over 30 yrs old at delivery (11/19, 57.9%). During follow up, 10 patients improved to NYHA Class I, 8 patients failed to improve, or deteriorated, and 1 patient died due to ventricular fibrillation. Group II (n=9, age: 31+/-3 yrs, follow up LVEF: 38.8+/-12.9%), as compared to Group I (n=10, age: 33+/-6 yrs, follow up LVEF: 56.4+/-6.4%), had greater left ventricular end-systolic dimension (LVESD, 53.0+/-7.7 mm vs 45.9+/-4.8 mm; p<0.05). CONCLUSION: PPCM has a high rate of progression to dilated cardiomyopathy. Therefore, in pregnant women with common clinical findings of PPCM, including anemia, pre-eclampsia, multiparity and old age at delivery, the initial echocardiographic assessment for cardiac function is essential, and serial follow-up is required.
Anemia ; Cardiomyopathies* ; Cardiomyopathy, Dilated ; Echocardiography ; Female ; Follow-Up Studies ; Heart Failure ; Humans ; Parity ; Peripartum Period* ; Pre-Eclampsia ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Risk Factors ; Ventricular Fibrillation

Intrathoracic involvement of immunoglobulin G4 (IgG4)-related disease has recently been reported. However, a subset of the disease presenting as interstitial lung disease is rare. Here, we report a case of a 35-year-old man with IgG4-related lung disease with manifestations similar to those of interstitial lung disease. Chest computed tomography showed diffuse ground glass opacities and rapidly progressive pleural and subpleural fibrosis in both upper lobes. Histological findings showed diffuse interstitial lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. Serum levels of IgG and IgG4 were also increased. The patient was diagnosed with IgG4-related lung disease, treated with anti-inflammatory agents, and showed improvement. Lung involvement of IgG4-related disease can present as interstitial lung disease and, therefore, should be differentiated when evaluating interstitial lung disease.
Adult ; Anti-Inflammatory Agents ; Fibrosis ; Glass ; Humans ; Immunoglobulin G ; Immunoglobulins ; Lung ; Lung Diseases* ; Lung Diseases, Interstitial* ; Plasma Cells ; Thorax

OBJECTIVE: To evaluate for the clinical analysis on abruptio placenta, we examined its incidence, diagnostic methods, symptom and sign, perinatal mortality, and recurrence rate. METHODS: We reviewed the medical records of the 396 cases of abruptio placenta among 72.580 deliveries, from Jan. 1, 1990 to Dec. 31, 1997, at St. Mary, Kang Nam St. Mary, and Holy Family Hospital of Catholic University. RESULTS: The total incidence of abruptio placenta was 0.51%, the incidence plotted by age from 1993 to 1997 has shown that the age incidence was higher in 20-24years old(0.7%), and over 35years old (0.8%). 42.5% of the case occurred between 32 to 37weeks of gestational age, 39.6% was over 37weeks. 38% of the patient was diagnosed before delivery with ultrasonography and the most common complaint was vaginal bleeding. The complication of abruptio placenta is as follows, Couvelaire uterus occurred in 26cases(7.0 %), DIC in 10cases(2.7 %), ARF in 4cases (1.1 %), and uterine rupture in 1case(0.3 %). Perinatal mortality including 41cases of stillbirth was 19.9 %(73cases) but no maternal death was noted. A history of abruptio placenta increased risk of a similar incident in a subsequent pregnancy by 19 cases(4.6 %: 9.0 fold)complicated with 13 cases of pregnancy induced hypertension(76.5 %). CONCLUSION: The incidence of abruptio placenta plotted by age have shown higher in 20-25years old and over 35 years old, hypertensive women experienced abruptio placenta are more likely to have higher graded recurrent rate in subsequent pregnancy, and abruptio placenta is major obstetric bleeding disease causing serious maternal and fetal complication.
Adult ; Dacarbazine ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Maternal Death ; Medical Records ; Perinatal Mortality ; Placenta* ; Pregnancy ; Recurrence ; Stillbirth ; Ultrasonography ; Uterine Hemorrhage ; Uterine Rupture ; Uterus