PURPOSE: This study was done to define clinical characteristics of fever without localizing signs (FWLS) in infants younger than 100 days of age with a goal of providing baseline data to establish a new diagnostic paradigm in the future. METHODS: We reviewed medical records of 183 patients who admitted to Daegu Catholic University Medical Center for FWLS younger than 100 days of age from January 2013 to September 2015 retrospectively. Demographic, clinical features and laboratory findings were analyzed. Patients were divided into serious bacterial infection (SBI) and non-SBI groups, and then were compared between two groups to find risk factors for SBI. RESULTS: Among 183 patients, lumbar puncture was performed in 98.9% and CSF pleocytosis was present in 35.9%. Sterile CSF pleocytosis was found in 43% of urinary tract infection (UTI) patients. None had concomitant bacterial meningitis in patients with UTI. As final diagnosis, febrile syndrome without source (25.7%) was most common. Among SBI, UTI was most common (99%). Birth weight, ESR, and CRP were significantly higher in SBI group compared to non-SBI group. Male sex (OR 4.93, 95% CI 1.60-15.24) and pyuria (OR 18.88, 95% CI 6.76-52.76) were identified as risk factors for SBI. Presence of sibling (OR 0.30, 95% CI 0.11-0.83) was significantly lower in SBI group. CONCLUSIONS: Our results showed UTI was the most common SBI in young infants with FWLS. Though aseptic meningitis can be coexisting with UTI, lumbar puncture may not be necessary in all patients having UTI.
Academic Medical Centers ; Bacterial Infections ; Birth Weight ; Daegu ; Diagnosis ; Fever* ; Humans ; Infant* ; Leukocytosis ; Male ; Medical Records ; Meningitis, Aseptic ; Meningitis, Bacterial ; Pyuria ; Retrospective Studies ; Risk Factors ; Siblings ; Spinal Puncture ; Urinary Tract Infections

No abstract available.
Asthma* ; Theophylline*

This is a report of a successful, rapid two-stage arterial switch operation in an infant with dextrotransposition of great arteries with an intact ventricular septum beyond the appropriate time for arterial switch operation. A 4-month-old female infant was admitted due to severe cyanosis, respiratory insufficiency, and frequent diarrhea secondary to ischemic colitis. Echocardiographic examination presented marked leftward deviation of the interventricular septum, and left and right ventricular pressures as measured by cardiac catheterization were 40/4 mm Hg and 85/2 mm Hg, respectively. Fifteen days after a preparatory operation (pulmonary artery band with modified right Blalock-Taussig shunt), left ventricular-right ventricular systolic pressure ratio increased to 105/90. Arterial switch operation associated with the division of the right Blalock-Taussig shunt and the removal of pulmonary artery band was performed. After the operation, the infant showed normal cardiac function with no postoperative complication.
Arteries* ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Colitis, Ischemic ; Cyanosis ; Diarrhea ; Echocardiography ; Female ; Humans ; Infant ; Postoperative Complications ; Pulmonary Artery ; Respiratory Insufficiency ; Ventricular Pressure ; Ventricular Septum*

No abstract available.
Epinephrine*

No abstract available.
Epinephrine*

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Physical Examination

To evaluate the risk and factors associated with seizure recurrence in children with epilepsy while receiving the adequate anticonvulsant treament, we studied 58 patients with newly diagnosed epilepsy who were followed prospectively for a median of 26 months (range 7 to 54). The results were as follows: 1) Forty-four of the 58 patients (75.9%) had recurrence of seizure. 2) The rate of recurrence according to type of seizure was observed to be 22 patients (68.8%) in generalized tonic-clonic seizure, 6 patients (85.7%) in simple partial seizure, 5 patients (83.3%) in complex partial seizure, 3 patients (100%) in mixed seizure, 2 patients (100%) in absence, 3 patients (100%) in infantile spasm, 1 patient (100%) in atonic seizure, 2 patients (50%) in secondary generalized seizure. There was no significant difference in the risk of recurrence observed among these seizure types. 3) The risk of recurrence varied according to the history of seizure, seizure recurrence was observed in 100% of the cases with history of neonatal seizure, 72.7% of the cases with febrile convulsion, and 73.3% of the cases with non-specific history. No significant difference was observed among these past history of seizure. 4) The rate of seizure recurrence according to electroencephalographic abnormalities did not differ significantly. Seizure recurrence was noted in 13 of the 18 patients with mildly disordered tracings (72.2%), 15 of the 20 patients with moderate abnormality (75.0%), and 12 of the 16 patients with severe abnormality (75.0%). 5) Recurrence rate according to cause of seizure was more significantly frequent in those with symptomatic epilepsy than in those with idiopathic type (100% vs 70.2%, p<0.05). 6) The frequency percentage of seizure recurrence by age groups of below 1 year, 1 to 3 years, 4 to 6 years, and above 6 years at onset of seizure were 100, 66.7, 57.1, and 72.7, respectively. The rate of seizure recurrence was significantly highest in patients aged below 1 year at onset of seizure. 7) There was significant difference in seizure recurrence between those with and without abnormalities as shown by neurologic examination (100% vs 70.8%, p<0.05). 8) There was no consistent difference in valproic acid serum levels between those who had a recurrence and those who did not. The patients receiving phenobarbital had significantly high serum levels of the phenobarbital in recurrent groups than those who had no recurrence. In conclusion, factors associated with an increased risk of seizure recurrence were early age at onset of epilepsy, symptomatic epilepsy, and neurologic abnormalities. We found no associations between risks of recurrence and types of epilepsy, or electroencephalographic abnormalities.
Anticonvulsants* ; Child ; Epilepsy ; Humans ; Infant ; Infant, Newborn ; Neurologic Examination ; Phenobarbital ; Prospective Studies ; Recurrence* ; Risk Factors ; Seizures* ; Seizures, Febrile ; Spasms, Infantile ; Valproic Acid

To evaluate the relationship between spontancous diuresis and improvement of pulmonary function in respiratory distress syndrome, 15 premature neonates requiring mechanical ventilation for RDS, who admitted in NICU of Wonkwang University Hospital from January 1990 to June 1992, were studied. The results were as follows (results are mean+/-SEM) 1) Mean birth weight of study infants was 1.82+/-0.08Kg, and mean gestational age was 32.80+/-0.54 weeks. 2) The onset of diuresis occured at a mean age of 29.1+/-2.48 hours with maximum diuresis at a mean age of 41.9+/-1.8 hours 3) Mean urine output increased from 2.25+/-0.43ml/Kg/hr at the stage of pre 12 hours-onset of diuresis (p<0.001), then decreased 3.5+/-0.2ml/Kg/hr at the stage of after maximum diuresis (p<0.05). 4) After maximum diuresis, inspired oxygen gradient, peak inflating pressure, peak end expiratory pressure, mean airway pressure, and respiratory rate were decreased significantly (p<0.05), and alveolar-arterial oxygen gradient was decreased more significantly (p<0,01). So, We conclude that the pulmonary function was rapidly improving after maximum diuresis and these changes reflect the general principle used in ventilatory management of infants with RDS.
Birth Weight ; Diuresis* ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Oxygen ; Respiration, Artificial ; Respiratory Rate

PURPOSE: This study was to investigate factors that influence health examination for unmarried women. METHODS: A correlation study was carried out with 144 unmarried women with an age range of 35~49 years through self-administered questionnaires. This questionnaire included Health Belief Model modifying factors (demographic . sociological, structural, and cues to action variables). Data were analyzed using descriptive statistics, chi2-test, multiple logistic regression. RESULTS: The mean age of participants was 37.2+/-2.67 years. Rates for breast cancer, cervical cancer and comprehensive health examination were each 34.7%, 38.2% and 94%. In multiple logistic regression analysis, influencing factors on physical examination were age(OR=0.06, 95% CI: 0.02~0.26), personal medical insurance (OR=6.30, 95% CI: 1.60~24.82), housemate (OR=7.63, 95% CI: 2.58~22.52), exercise (OR=3.72, 95% CI: 1.37~10.12) in breast cancer examination, and age (OR=0.08, 95% CI: 0.02~0.34; OR=0.07, 95% CI: 0.01~0.85), personal medical insurance (OR=14.17, 95% CI: 2.94~68.23), sexual experiences (OR=3.38, 95% CI: 1.28~8.91), drinking (OR=2.92, 95% CI: 1.14~7.49) in cervical cancer examination. CONCLUSION: The results emphasize the necessity of preparing nursing education and intervention in consideration of associated factors which influence on the health examination in unmarried women.
Breast Neoplasms ; Cues ; Drinking ; Early Detection of Cancer ; Education, Nursing ; Female ; Humans ; Insurance ; Logistic Models ; Physical Examination ; Surveys and Questionnaires ; Single Person* ; Statistics as Topic ; Uterine Cervical Neoplasms

Merkel cell carcinoma, also known as neuroendocrine carcinoma of skin is now well recognized entity of malignant skin tumor to clinicians and pathologists. A few cases have been reported up to now in the literature, but the information regarding the appropriate treatment modalities have not been obtained in detail. The clinical, histologic and ultrastructural features and the treatment of a case of primary Merkel cell carcinoma of eyelid in a 75 year-old male is presented.
Aged ; Carcinoma, Merkel Cell* ; Carcinoma, Neuroendocrine ; Eyelids* ; Humans ; Male ; Skin