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.

No abstract available.
Humans ; Hypophosphatemia*

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*

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

A 55-year-old female presented to the emergency room with a complaint of aphasia. Her initial brain computed tomography scan showed an intracranial hemorrhage in the left frontal area. After surgery, histopathological examination confirmed the diagnosis of a chondroma. Intradural chondroma is a rare, slow growing, benign intracranial neoplasm, but is even rarer in combination with an intratumoral hemorrhage. Chondromas are generally avascular cartilaginous lesions. Our case was thought to be caused by the rupture of abnormally weak vessels derived from the friable tumor. Intradural chondromas may be included in the differential diagnosis of intracranial tumors with acute hemorrhages.
Aphasia ; Brain ; Brain Neoplasms ; Chondroma* ; Diagnosis ; Diagnosis, Differential ; Emergencies ; Female ; Hemorrhage* ; Humans ; Intracranial Hemorrhages ; Middle Aged ; Rupture

A postoperative epidural hematoma (EDH) is a serious and embarrassing complication, which usually occurs at the site of operation after intracranial surgery. However, remote EDH is relatively rare. We report three cases of remote EDH after brain tumor surgery. All three cases seemed to have different causes of remote postoperative EDH; however, all patients were managed promptly and showed excellent outcomes. Although the exact mechanism of remote postoperative EDH is unknown, surgeons should be cautious of the speed of lowering intracranial pressure and implement basic procedures to prevent this hazardous complication of brain tumor surgery.
Brain Neoplasms* ; Brain* ; Craniotomy ; Hematoma* ; Humans ; Intracranial Pressure ; Neurosurgery

BACKGROUND: Recent studies suggest aggressive management combining a grossly total resection (GTR) with adjuvant radiotherapy (RT) as a treatment of choice for intracranial hemangiopericytoma (HPC). However, in these papers, the definitions of complete or GTR are equivocal. In the present study, we reviewed the relevant cases from our experience focused on the clinical efficacy of surgical grading of resection, and analyzed the optimal treatment strategies as well. METHODS: From January 1995 through December 2014, 17 patients treated for intracranial HPC were included in this study. We analyzed clinical presentation, radiologic appearance, pathologic diagnosis, extent of resection, and follow-up outcomes. RESULTS: A total of 26 operations were performed including 9 recurrent intracranial HPCs. Every tumor was single and had no evidence of metastasis. Most common area of tumor was parasagittal (8 patients, 47.1%), which is adjoined to superior sagittal sinus. For the initial operation, GTR was performed in 16 cases (61.5%), partial resection (PR) in 8 cases (30.8%), and an endoscopic biopsy in 2 patients (7.7%). In Simpson grading system, grade 1 was done in 2 patients (7.7%), grade 2 in 11 patients (42.3%) and grade 3 in 3 patients (11.5%). Postoperative RT was delivered in 16 patients (94.1%) regardless of the extent of resection. The median 57.57 Gy (range, 50-60 Gy) was delivered in median 33 fractions (range, 30-40). The extent of resection (conventional classification and Simpson grading system) and adjuvant RT were significantly associated with recurrence-free survival. CONCLUSION: Surgical resection of intracranial HPC, in an attempt to reach Simpson grade 1 removal, is necessary for better outcome. Adjuvant RT should be done as recommended before, to prevent recurrence, regardless of surgical resection and pathological diagnosis.
Biopsy ; Brain Neoplasms ; Classification ; Diagnosis ; Follow-Up Studies ; Hemangiopericytoma* ; Humans ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence ; Superior Sagittal Sinus