PURPOSE: The symptoms and signs of urinary tract infection (UTI) in early infancy are non-specific. Prompt diagnosis of UTI is important, as untreated UTI results in renal damage. Especially, febrile UTI in young infants coexist with other serious bacterial infections. The purpose this study was to propose modified Rochester criteria to differentiate viral infection from urinary tract infection. METHODS: We carried out a retrospective investigation of 168 infants less than three months old with a tympanic temperature >38degrees C who were admitted to Chung-Ang University Hospital between 2011 and 2014. We compared the symptoms, physical examination results, and laboratory data between viral infection and UTI groups. A modified Rochester criterion was composed of statistically significant factors. RESULTS: A total of 76 and 92 infants with UTI and a viral infection, respectively, were included. Statistically significant differences in gender, previous admission history, neutrophil ratio, and urine WBC count were found between the two study groups. Using a cut off value of 3 points, the sensitivity and specificity of the modified Rochester criteria were 71.28% and 78.57%, respectively. CONCLUSION: The modified Rochester criteria may give an outline for identifying young infants with UTI.
Bacterial Infections ; Diagnosis ; Humans ; Infant* ; Neutrophils ; Physical Examination ; Retrospective Studies ; Sensitivity and Specificity ; Urinary Tract Infections* ; Urinary Tract*

OBJECTIVE: This study evaluates the effect of the specific human papillomavirus (HPV) genotype as a prognostic factor in stage I-IIA cervical cancer patients following primary surgical treatment. METHODS: The medical records of 116 cervical cancer patients treated with primary surgical treatment were reviewed. The HPV genotypes were categorized into following groups: negative and unclassified, HPV 16, HPV 18, and other high risk (HPV 31, 33, 35, 45, 51, 52, 56, and 58). RESULTS: Among the HPV genotypes, HPV 16 predominated (40.52%), followed by intermediate risk and unclassified (25%), HPV 18, 45, and 56 (17.24%) and negative (17.24%). In univariate analysis, HPV genotypes (P=0.03), parametrial spread (P=0.02), depth of invasion (DOI) (P<0.01) and lymph-vascular space invasion (P=0.02) were significantly associated with progression free survival (PFS). In multivariate analysis, HPV 18 (hazard ratio [HR], 5.2; 95% confidence interval [CI], 1.29 to 20.90; P=0.02) and > or =one half of DOI (HR, 5.4; 95% CI, 1.08 to 27.31; P=0.04) were significantly associated with PFS. HPV genotypes are not significantly associated with overall survival. CONCLUSION: HPV 18 was a poor prognostic factor for the PFS in stage I-IIA cervical cancer patients following primary surgical treatment. Careful long-term observation and regular exams are recommended for cervical cancer patients with HPV 18 compared to those with other HPV genotypes.
Disease-Free Survival ; Genotype ; Human papillomavirus 16 ; Human papillomavirus 18* ; Humans ; Medical Records ; Multivariate Analysis ; Prognosis ; Uterine Cervical Neoplasms*

PURPOSE: The aim of this study was to design an intraoral environment simulator and to assess the accuracy of two intraoral scanners using the simulator. MATERIALS AND METHODS: A box-shaped intraoral environment simulator was designed to simulate two specific intraoral environments. The cast was scanned 10 times by Identica Blue (MEDIT, Seoul, South Korea), TRIOS (3Shape, Copenhagen, Denmark), and CS3500 (Carestream Dental, Georgia, USA) scanners in the two simulated groups. The distances between the left and right canines (D3), first molars (D6), second molars (D7), and the left canine and left second molar (D37) were measured. The distance data were analyzed by the Kruskal-Wallis test. RESULTS: The differences in intraoral environments were not statistically significant (P>.05). Between intraoral scanners, statistically significant differences (P < .05) were revealed by the Kruskal-Wallis test with regard to D3 and D6. CONCLUSION: No difference due to the intraoral environment was revealed. The simulator will contribute to the higher accuracy of intraoral scanners in the future.
Georgia ; Molar ; Seoul

OBJECTIVE: Emergency department (ED) visits by nonurgent patients are controversial because they are considered one of the causes of ED overcrowding and an example of the improper use of medical resources. On the other hand, some non-urgent patients do require hospitalization. The purpose of this study was to compare hospitalized and discharged patients who were classified as nonurgent upon their initial ED visit and identify the predictive factors associated with hospitalization in nonurgent patients visiting an ED. METHODS: Among a nonurgent patient group visiting an urban university hospital ED in 2016, the hospitalized and discharged patients were compared. RESULTS: A total of 13,988 nonurgent patients were analyzed, of which 773 (5.5%) were hospitalized. The predictive factors related to hospitalization for nonurgent patients were as follows: male, age 65 years or older, ED visits during outpatient clinic availability, and in the evening, heart rate greater than 100 per minute, respiration rate greater than 20 per minute and body temperature over 38℃ CONCLUSION: Among nonurgent patients, there are patients who require hospitalization. If these predictive factors are considered in the initial ED triage, it should improve the safe treatment of nonurgent patients and improve the efficiency of the use of limited resources.
Ambulatory Care Facilities ; Body Temperature ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Hand ; Heart Rate ; Hospitalization* ; Hospitals ; Humans ; Male ; Respiratory Rate ; Triage

Listeria monocytogenes is a rare cause of bacterial meningitis, particularly beyond the neonatal period. This article describes a 16-month-old girl who presented with a new-onset febrile status epilepticus, and subsequently developed altered mentality and lethargy. L. monocytogenes was detected on a point-of-care, multiplex polymerase chain reaction using the cerebrospinal fluid. On day 3, she developed a rapidly progressive hydrocephalus. Her consciousness improved after placement of an external ventricular drain. After 3-week antibiotic therapy, she was successfully discharged without residual complications.

Porphyrias are inherited metabolic disorders resulting from a specific enzyme defect in the heme biosynthetic pathway. Porphyrias are induced by various precipitants. Clinical features include abdominal pain, neurologic manifestations, autonomic neuropathy, and mental disturbance. Diagnosis may be delayed because of variable symptoms that mimic other diseases and because of the rarity of of porphyrias. Although most patients with known porphyria can complete anesthesia and surgery safely, undiagnosed porphyric patients are in danger of porphyric crisis due to inadvertent exposure to precipitating drugs and environment. We report a case of a patient who experienced delayed emergence with neurological disturbance after general anesthesia, ultimately diagnosed as acute intermittent porphyria.
Abdominal Pain ; Anesthesia ; Anesthesia, General* ; Biosynthetic Pathways ; Delayed Emergence from Anesthesia ; Diagnosis ; Guillain-Barre Syndrome ; Heme ; Humans ; Neurologic Manifestations* ; Porphyria, Acute Intermittent* ; Porphyrias ; Spine* ; Wernicke Encephalopathy

BACKGROUND AND OBJECTIVES: Bondy operation is a type of modified radical mastoidectomy whose operation window is through an external auditory canal via removal of superior and posterior walls without management of the middle ears. However, the usefulness of this operation is unclear. This study aimed to review our clinical experience of modified Bondy operations and to clarify its usefulness. MATERIALS AND METHODS: Fifteen patients underwent a modified Bondy operation at the Department of Ajou University Hospital between 1996 and 2010. Their clinical data were retrospectively reviewed including age, gender, chief complaint, diagnosis, pure tone average (PTA, a mean threshold of 0.5, 1, 2, and 3 kHz before and 3 months after the operation), otoscopic finding, temporal bone computed tomography, and recurrence rate. RESULTS: The mean age of the 15 patients was 35.3+/-14 (range 18-65) years. Post-operative diagnosis of all cases was cholesteatoma (nine attic, three external auditory canal, one sinus, and two recurrent). Pre- and postoperative PTAs were 27.4+/-18.3 dBHL and 26.0+/-10.7 dBHL, respectively (p=0.72). No postoperative recurrence or complications were noted over at least a 3-month follow-up. CONCLUSIONS: Modified Bondy operation is a good option to preserve hearing and prevent recurrence after operations in cases of cholesteatoma with relatively preserved middle ears.
Cholesteatoma ; Ear Canal ; Ear, Middle ; Hearing ; Humans ; Recurrence ; Retrospective Studies ; Temporal Bone

BACKGROUND AND OBJECTIVES: Bondy operation is a type of modified radical mastoidectomy whose operation window is through an external auditory canal via removal of superior and posterior walls without management of the middle ears. However, the usefulness of this operation is unclear. This study aimed to review our clinical experience of modified Bondy operations and to clarify its usefulness. MATERIALS AND METHODS: Fifteen patients underwent a modified Bondy operation at the Department of Ajou University Hospital between 1996 and 2010. Their clinical data were retrospectively reviewed including age, gender, chief complaint, diagnosis, pure tone average (PTA, a mean threshold of 0.5, 1, 2, and 3 kHz before and 3 months after the operation), otoscopic finding, temporal bone computed tomography, and recurrence rate. RESULTS: The mean age of the 15 patients was 35.3+/-14 (range 18-65) years. Post-operative diagnosis of all cases was cholesteatoma (nine attic, three external auditory canal, one sinus, and two recurrent). Pre- and postoperative PTAs were 27.4+/-18.3 dBHL and 26.0+/-10.7 dBHL, respectively (p=0.72). No postoperative recurrence or complications were noted over at least a 3-month follow-up. CONCLUSIONS: Modified Bondy operation is a good option to preserve hearing and prevent recurrence after operations in cases of cholesteatoma with relatively preserved middle ears.
Cholesteatoma ; Ear Canal ; Ear, Middle ; Hearing ; Humans ; Recurrence ; Retrospective Studies ; Temporal Bone

Xanthogranulomatous inflammation is a rare benign condition involving various organs. However, its pancreas involvement is very rare. To the best of our knowledge, only 17 cases have been described in the literature. Interestingly, all reported 17 cases due to various causes underwent surgical resection. Here, we present a case of xanthogranulomatous pancreatitis in a 63-year-old man. He presented with epigastric pain and solid mass mimicking ductal adenocarcinoma in the body and tail of pancreas on magnetic resonance imaging. The patient was diagnosed as xanthogranulomatous pancreatitis via endoscopic ultrasound-guided fine needle aspiration. After that, he was followed up and monitored without any surgical treatment. Here, we show imaging findings and serial image changes of xanthogranulomatous pancreatitis for this case.
Adenocarcinoma ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Humans ; Inflammation ; Magnetic Resonance Imaging* ; Middle Aged ; Pancreas ; Pancreatic Neoplasms* ; Pancreatitis* ; Tail

In vivo 31P NMR spectra were obtained in eight infant brain at 4.7T. Each phosphorus metabolite and its ratio were analyzed to evaluate the brain damage and maturity, and compared with the reported data obtained at the lower field strength. Measurement of T1 relaxation time at 4.7T was done in an infant and a cat brain in vivo. PCr/Pi and PCr/β-ATP ratio were used as a marker of brain damage. PME/PDE revealed higher values than those of the reported data obtained at the lower field strength and the difference was partly attributed to the long T1 relaxation time of PME rather than the brain immaturity. Although the resolution of the spectrum was improved at 4.7T, a long repetition time is recommended to minimize T1difference of phosphorus metabolites of brain at 4.7T.
Animals ; Brain* ; Cats ; Humans ; Infant ; Magnetic Resonance Spectroscopy* ; Phosphorus ; Relaxation