OBJECTIVES: Over the last 30 years, despite the increasing sophistication in medical care, the mortality of acute renal failure(ARF) has remained virtually unchanged at 40-50%, but the reasons remain unknown. This study intend to identify prognostic risk factors influencing survival and predict the mortality in ARF patients. METHODS: We retrospectively analyzed 152 patients with ARF who required renal replacement therapy, or whose serum creatinine level above 5 mg/dl, from Jan. 1988 to May. 1995. Multiple factors which may influence mortality were evaluated by univariate and multivariate analysis. RESULTS: 1) Of the 152 patients, 97 were male and 55 were female. The mean age was 47 years and the overall mortality was 36.8%. 2) Based on the univariate analysis, age>60 years, cause of ARF, APACHE II score, number of failing organs, peak serum creatinine level, PaO2, coma, hypotension, ARDS, GI bleeding, ventilatory support, need for antiarrhythmics, DIC, cardiovascular failure, pulmonary failure, neurological failure, and gastrointestinal failure were all significant factors discriminating between survivors and nonsurvivors(p<0.05) 3) By multivariate analysis, hypotension, coma, ventilatory support, and age over 60 years were significant independent predictors influencing survival in ARF patients and logistic equation and logit score were as follows : z=-2.04+1.32(age over 60)+2.18(hypotension)+2.88 (ventilatory support) + 3.28(coma) P=ez/(1+ ez) 4) In ROC(receiver-operating characteristic)curve, when the cutoff point was 0.2, maximum sensitivity was 75% and maximum specificity was 82%. CONCLUSION: In ARF, prognostic risk factors for mortality were age over 60 years, hypotension, assisted ventilation and coma. The logit score by multiple analysis is a reliable predictor of mortality in ARF patients, however the further studies are required to confirm these results.
Acute Kidney Injury* ; APACHE ; Coma ; Creatinine ; Dacarbazine ; Female ; Hemorrhage ; Humans ; Hypotension ; Male ; Mortality* ; Multivariate Analysis ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors* ; Sensitivity and Specificity ; Survivors ; Ventilation

No abstract available.
Polyarteritis Nodosa*

No abstract available.

Classic Kaposi's sarcoma is a human herpesvirus-8 associated with a multicentric lymphoangioproliferative tumor primarily arising in the lower extremities, but rarely in the head and neck. We herein report a 63-year-old man with primary classic Kaposi's sarcoma on the face. He presented with asymptomatic, erythematous papules on the nasal ala which had been noticed 2 months earlier. Histopathologic examination and nested polymerase chain reaction analysis in the tissue disclosed typical features of Kaposi's sarcoma.
Head ; Humans ; Lower Extremity ; Middle Aged ; Neck ; Polymerase Chain Reaction ; Sarcoma, Kaposi*

No abstract available.
Humans ; Hypophosphatemia*

PURPOSE: To evaluate various sepsis screening tests, individually and in combination, to formulate a guideline for the diagnosis of neonatal sepsis. METHODS: The study was a retrospective cohort study. It took place at the neonatal intensive care unit of the Paediatric Department, Il Sin Christian Hospital, Busan, Korea, over a period of 68 months from 1st, April, 2001 to 31st, December, 2005. This study evaluated 100 neonates having clinical features of sepsis and 100 normal asymptomatic neonates and used screening tests including C-reactive protein (CRP), total leukocyte count (TLC), absolute neutrophil count (ANC), immature neutrophils to total neutrophil count ratio (I/T ratio), thrombocytopenia, degenerative changes in the neutrophils and gastric aspirate cytology (GAC) for the diagnosis of neontal sepsis. RESULTS: The sensitivity of CRP and ANC was high. CRP had 86 percent sensitivity for group-A (proven sepsis) and 74 percent sensitivity for group-B (probable sepsis) and 94 percent specificity for group-A, B. ANC had sensitivity of 72 percent for group-A and 62 percent for group-B and 86 percent specificity for group-A, B. For group-A, sensitivity, specificity of GAC for polymorphs was 74 percent and 94 percent respectively. As for sensitivity, specificity of platelet count for group-A was 64 percent and 89 percent respecively. The sensitivity, specificity and predictive values (PV) of the individual tests and different test combinations were also calculated for group-A and B. CONCLUSION: For the detection of culture negative cases in neonatal sepsis, screening tests including CRP, TLC, ANC, thrombocytopenia, cytoplasmic vacuolization in the neutrophils and GAC for polymorphs have high sensitivity. A combination of three tests has higher sensitivity.
Busan ; C-Reactive Protein ; Cohort Studies ; Cytoplasm ; Diagnosis ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Leukocyte Count ; Mass Screening* ; Neutrophils ; Platelet Count ; Retrospective Studies ; Sensitivity and Specificity ; Sepsis* ; Thrombocytopenia

We evaluated the antihypertensive effect of amlodipine, a calcium channel bloker, in 35 cases of essential hypertention. After 12 weeks' administration(5~10mg q.d.), the following results were obtained : 1) The systoloic and diastolic blood pressure were decreased significantly(170.3+/-12.2mmHg vs 143.7+/-13.0mmHg p<0.01 and 104.7+/-5.9mmHg vs 87.8+/-6.5mmHg, p<0.01, respectively) but the heart rate was independant of amlodipine administration. 2) The systolic blood pressure was lowered by 20mmHg or more in 26(76.5%) of 34 patients and the diastolic pressure was lowered by 10mmHg or more in 26(76.5%) of 34 patients at 12 weeks after amlodipine administration. 3) The adverse effects of amlodipine were dizziness in 5, edema in 5, indigestion in 3, constipation in 2, headache, flushing, insomnia in 1 patient respectively and only one of them discontinued amlodipine administration due to severs facial flushing and skin eruption.
Amlodipine* ; Blood Pressure ; Calcium Channels ; Constipation ; Dizziness ; Dyspepsia ; Edema ; Flushing ; Headache ; Heart Rate ; Humans ; Skin ; Sleep Initiation and Maintenance Disorders

No abstract available.
Appointments and Schedules* ; Hepatitis B Vaccines* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Infant, Newborn* ; Vaccination*

Pneumothorax was recognized as a potential hazard of mechanical ventilation shortly after the introduction of the technique of tracheal intubation in the 19th century. Because the gases used in anesthesia are delivered from cylinders and wall outlets at higher than atmoshperic pressure, the possibility of damage to the lung is ever present. Immediate, prompt and adequate management of bilateral tension Pneumothorax are essentil, otherwise the patient dies rapidly. We had a case of bilateral tension Pneumothorax in a 3 year-old boy who underwent a B-E amputation of a severely crushed hand. We report this case along with a review of the literature on Pneumothorax.
Amputation ; Anesthesia ; Anesthesia, General* ; Child, Preschool ; Gases ; Hand ; Humans ; Intubation ; Lung ; Male ; Pneumothorax* ; Respiration, Artificial

Coronary artery fistula is an unusual anomaly that consists of a communication between one of the coronary arteries and a cardiac chamber or vein. It has hemodynamic significance, complicated by congestive heart failure, bacterial endocarditis, rupture or thrombosis of the fistula or an associated arterial aneurysm, myocardial ischemia, and arrhythmias. It occurs in congenital, traumatic, neoplastic, or artherosclerotic cardiac disorders. It is being diagnosed with increasing frequency with widespread use of selective coronary angiography. However, acquired coronary artery fistula after acute myocardial infarction is a rare clinical entity, and it has not been reported in Korea yet. We observed a 62-year-old male patient with intermittent chest pain at rest, in whom serial coronary angiography showed newly developed communications from the left anterior descending coronary artery to the left ventricular chamber several months after acute myocardial infarction of the anteroseptal wall. The area of communication corresponded to the site of infarction as established by contrast echocardiography.
Aneurysm ; Arrhythmias, Cardiac ; Chest Pain ; Coronary Angiography ; Coronary Vessels* ; Echocardiography ; Endocarditis, Bacterial ; Fistula* ; Heart Failure ; Heart Ventricles* ; Hemodynamics ; Humans ; Infarction ; Korea ; Male ; Middle Aged ; Myocardial Infarction* ; Myocardial Ischemia ; Rupture ; Thrombosis ; Veins