Follow-up sonographic studies of three infants, whose initial sonograms showed findings suggestive of choledochal cyst, demonstrated disappearance of cystic dilatation of the common bile ducts. The phenomena could be accounted for by acute common bile duct obstruction secondary to bile sludge. Bile plug syndrome should also be included in the differencial diagnosis. When a cystic or fusiform dilatation of the common bile duct is seen on sonogram. Conservative management must be the choice of approach unless the finding is proven to unchanged over a period of time and irreversible.
Bile ; Choledochal Cyst ; Common Bile Duct* ; Diagnosis ; Dilatation* ; Follow-Up Studies ; Humans ; Infant* ; Sewage ; Ultrasonography

No abstract available.

A 7-year-old boy presented with productive cough and mild dyspnea. He had a history of intlermittant attacksof broanchopneumonia, but otherwise he was healthy. He had a small right lung on chest roentgenogram. Thediagnosis of developmental hypoplasia of the right lung due to congenital absence of the right pulmonary arterywas made by radionuclide angiocardiography and subsequently confirmed by cardiac catheterization and angiography.
Angiocardiography ; Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Child ; Cough ; Diagnosis ; Dyspnea ; Humans ; Lung ; Male ; Thorax

We report a 14-months-old infant who had obstructive jaundice caused by idiopathic fibrosing pancreatitis. Ultrasonography and abdominal computed tomography showed dilatation of the intrahepatic ducts, common bile duct, and the pancreatic duct. Diffuse swelling of the pancreas was also noted on CT. At laparotomy, the head portion of the pancreas revealed a stony hard consistency, and proliferation of fibrotic tissue was confirmed pathologically. Idiopathic fibrosing pancreatitis is a very rare disease entity in childhood, but should be considered in the differential diagnosis of obstructive jaundice in children who demonstrate bile duct and pancreatic duct dilatation and/or diffuse pancreas swelling.
Bile Ducts ; Child ; Common Bile Duct ; Diagnosis, Differential ; Dilatation ; Head ; Humans ; Infant ; Jaundice, Obstructive* ; Laparotomy ; Pancreas ; Pancreatic Ducts ; Pancreatitis* ; Rare Diseases ; Ultrasonography

The cardiomyopathy associated with Adriamycin is frequently fatal and full clinical recovery is uncommon. To evaluate the radiological manifestation and the outcome of Adriamycin induced cardiac toxicity, we retrospectively reviewed the serial chest X-ray films of children treated with Adriamycin. Among 154 children with leukemia, fourteen patients developed clinical and radiologic evidence of congestive heart failure(CHF), Six out of 14(43%) died of CHF within 2 weeks after attack and eight children survived after their acute episodes of CHF, were controlled following digoxin and diuretic therapy. Despite the improving clinical evidence of heart failure, the follow-up chest roentgenograms of these 8 children showed definite cardiomegaly as compared with the pre-treatment chest X-ray. Three children among 8 had minimal cardiomegaly and the remaining five children showed persistent, marked cardiomegaly during the period of 9-25 months of follow up. In summary, when CHF develops during chemotherapy in leukemic children, the possibility of Adriamycin induced cardiac toxicity should be suspected. Our findings showed that persistence of cardiomegaly represented significant cardiomyopathy despite clinical improvement of CHF.
Cardiomegaly ; Cardiomyopathies* ; Cardiotoxicity ; Child ; Digoxin ; Doxorubicin* ; Drug Therapy ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Heart ; Heart Failure ; Humans ; Leukemia* ; Retrospective Studies ; Thorax ; X-Ray Film

The incidence of uterine prolapse during pregnancy is rare. A 34-year-old G3P1 was initially presented at 16 weeks 5days of gestation with a prolapse of the uterine cervix. The cervix was edematous and protruding beyond introitus. Management included bed rest, and the patient was discharged after several days with a vaginal pessary to help maintain cervical placement. At 35 weeks of gestation, the patient did not experience any further prolapse after the removal of the pessary. Pregnancy progressed to term with no further prolapse. She was readmitted at 38weeks 5days of gestation with spontaneous labor. She delivered a 3.36kg male with an Apgar score at 1 minute and at 5 minutes of 7 and 8 respectively. The patient's cervix remained prolapsed in the early postpartum period; however it was easily reduced prior to discharge. After puerperium, the patient's cervix remained prolapsed. She was fitted with a vaginal pessary for uterine support. We reported this case with related literature.
Adult ; Apgar Score ; Bed Rest ; Cervix Uteri ; Female ; Humans ; Incidence ; Male ; Pessaries ; Postpartum Period ; Pregnancy* ; Prolapse ; Uterine Prolapse*

The overall prognosis of acute pyelonephritis is good, but the infections by extended spectrum beta-lactamase (ESBL) producing Escherichia coli (E.coli) cause poor responses to empirical antibiotic treatment, and consequently increase mortality. ESBL can hydrolyze the antibiotics with a beta-lactam ring and confer resistance to oxyimino-cephalosporins and monobactams. If the patient shows poor responses to empirical antibiotics or severe septic conditions, physicians must switch the antibiotics to other antibiotics covering resistant strains without delay. We report a case of acute pyelonephritis by extended-spectrum beta-lactamase producing E.coli in a 29-year-old woman who was empirically treated with oral ciprofloxacin as an initial treatment, but progressed to sepsis.
Adult ; Anti-Bacterial Agents ; beta-Lactamases ; Ciprofloxacin ; Escherichia ; Escherichia coli ; Female ; Humans ; Monobactams ; Prognosis ; Pyelonephritis ; Sepsis

The overall prognosis of acute pyelonephritis is good, but the infections by extended spectrum beta-lactamase (ESBL) producing Escherichia coli (E.coli) cause poor responses to empirical antibiotic treatment, and consequently increase mortality. ESBL can hydrolyze the antibiotics with a beta-lactam ring and confer resistance to oxyimino-cephalosporins and monobactams. If the patient shows poor responses to empirical antibiotics or severe septic conditions, physicians must switch the antibiotics to other antibiotics covering resistant strains without delay. We report a case of acute pyelonephritis by extended-spectrum beta-lactamase producing E.coli in a 29-year-old woman who was empirically treated with oral ciprofloxacin as an initial treatment, but progressed to sepsis.
Adult ; Anti-Bacterial Agents ; beta-Lactamases ; Ciprofloxacin ; Escherichia ; Escherichia coli ; Female ; Humans ; Monobactams ; Prognosis ; Pyelonephritis ; Sepsis

Purpose: We aimed to investigate the association between daily sunlight exposure duration and fractures in older Korean adults with osteoporosis. Materials and Methods: We utilized data from the 2008–2011 Korea National Health and Nutrition Examination Survey. Osteoporosis was diagnosed based on a T-score of ≤-2.5 using dual energy X-ray absorptiometry. The duration of daily sunlight exposure and fracture were assessed via intensive health interviews by trained staff using standardized health questionnaires. Fracture was defined as one or more fractures of the femur, wrist, and spine. Results: A total of 638 patients with osteoporosis aged ≥65 years were included. The odds ratio (OR) of total fractures was 0.55 times lower in the group with ≥5 h of daily sunlight exposure than in the group with <5 h of exposure after adjusting for age, sex, family history of osteoporosis or fracture, body mass index, bone mineral density of the femoral neck, serum 25-hydroxyvitamin D, current smoking, alcohol intake, daily calcium intake, and physical activity [95% confidence interval (CI) 0.31–0.97, p=0.040].In patients with vitamin D insufficiency, the OR of total fracture was 0.52 times lower in the group with ≥5 h of daily sunlight exposure than in the group with less exposure after adjusting the above variables (95% CI 0.28–0.97, p=0.041). Conclusion Sunlight exposure for ≥5 h a day was significantly associated with a decreased OR of fracture in older Korean adults with osteoporosis. This association was also significant in patients with vitamin D insufficiency.

Purpose: We aimed to investigate the association between daily sunlight exposure duration and fractures in older Korean adults with osteoporosis. Materials and Methods: We utilized data from the 2008–2011 Korea National Health and Nutrition Examination Survey. Osteoporosis was diagnosed based on a T-score of ≤-2.5 using dual energy X-ray absorptiometry. The duration of daily sunlight exposure and fracture were assessed via intensive health interviews by trained staff using standardized health questionnaires. Fracture was defined as one or more fractures of the femur, wrist, and spine. Results: A total of 638 patients with osteoporosis aged ≥65 years were included. The odds ratio (OR) of total fractures was 0.55 times lower in the group with ≥5 h of daily sunlight exposure than in the group with <5 h of exposure after adjusting for age, sex, family history of osteoporosis or fracture, body mass index, bone mineral density of the femoral neck, serum 25-hydroxyvitamin D, current smoking, alcohol intake, daily calcium intake, and physical activity [95% confidence interval (CI) 0.31–0.97, p=0.040].In patients with vitamin D insufficiency, the OR of total fracture was 0.52 times lower in the group with ≥5 h of daily sunlight exposure than in the group with less exposure after adjusting the above variables (95% CI 0.28–0.97, p=0.041). Conclusion Sunlight exposure for ≥5 h a day was significantly associated with a decreased OR of fracture in older Korean adults with osteoporosis. This association was also significant in patients with vitamin D insufficiency.