Urinalysis is the most convenient and important diagnostic tool for the kidney diseases. Abnormal urinary findings provide powerful information for the diagnosis of a kidney disease. There are several common urinary abnormalities without subjective symptoms : hematuria, proteinuria, and asymptomatic bacteriuria. There are many causes of hematuria : glomerulonephritis, interstitial nephritis, vascular diseases, cystic kidney disease, renal calculi, coagulation disorders, urinary tract infection, trauma, and tumors. It is essential to clarify the origin of hematuria by the use of diagnostic flow sheets. Despite all the diagnostic approaches, however, unexplained hematuria is found in 10~15% of subjects with hematuria. Periodic follow-up is recommended per 3 to 6 months for at least three years for them. The proteinuria of the glomerular origin is important for the progression of the renal diseases. We have to differentiate the proteinuria according to its origin and underlying systemic diseases including diabetes mellitus and hypertension. We also recommend a kidney biopsy for nephrotic range proteinuria for the diagnosis, treatment, and prognosis of the disease. Asymptomatic bacteriuria is define as a bacterial colony count above 105/ml in two consecutive urine cultures. Management is generally not recommended for the asymptomatic bacteriuria in elderly patients but recommended in pregnant women and diabetes mellitus patients. From our point of view, subjects showing urinary abnormalities, such as hematuria, proteinuria, and bacteriuria, must be kept under close surveillance.
Aged ; Bacteriuria ; Biopsy ; Diabetes Mellitus ; Diagnosis ; Female ; Follow-Up Studies ; Glomerulonephritis ; Hematuria ; Humans ; Hypertension ; Kidney ; Kidney Calculi ; Kidney Diseases ; Kidney Diseases, Cystic ; Nephritis, Interstitial ; Pregnant Women ; Prognosis ; Proteinuria ; Urinalysis ; Urinary Tract Infections ; Vascular Diseases

No abstract available.
Aged* ; Humans ; Nutritional Support* ; Postoperative Care* ; Stomach Neoplasms*

No abstract available.

No abstract available.
DNA Repair* ; DNA* ; Ichthyosis* ; Skin Neoplasms* ; Skin* ; Ultraviolet Rays* ; Xeroderma Pigmentosum*

Gradual distraction on living tissues creates stress that stimulates growth and regeneration. Timing and rate of distraction are one of the major factors affecting callus distraction. Slow rate of distraction often led to premature consolidation of the lengthening bone, while rapid rate of distraction often resulted in undesirable change within lengthening bone. Since Dr. McCarthy reported the successful lengthening of mandible in hemifacial microsomia, most of craniofacial bone lengthening has been done at a rate of 1.0 mm per day. The purpose of this study is to present my experience of rapid and multidirectional distraction of mandible in hemifacial microsomia. I have performed distraction osteogenesis of mandible in 33 patients of hemifacial microsomia with an age of 2-9 years from November, 1995 to October 1997. A complete osteotomy was made at the angle of mandible posterior border of the ramus proximal to the osteotomy and two threaded wires were inserted aling the lower border of the body distal to the osteotomy. Long PennigMinifixator(Orthofix, Bussolengo, Italy) maintained the mandible in fixation for 4 days. Following this period, the device was lingthened serially 1 mm every 12 hours by turning the nut. After the period of active lingthening was complicated, the mandible was maintained in external fixation until the radiological consolidation of the bone was confirmed. According to a study protocol, photographs, cephalograms(lateral and frontal), and panoramic view of mandible were obtained preoperatively, just before the active lengthening, at the time of removal of the device, and at 6 months intervals thereafter. The amount of vertical distraction along the posterior border of the ramus was from 19 to 32 mm and horizontal distraction along the lower border of the body was from 3 to 18 mm. The total amount of distraction was from 25 to 47 mm. The period of rapid distraction was from 13 to 27 days. Following the period of rapid distraction the mandible was maintained in external fixation for an average of 8.5 weeks(ranging from 7 to 11 weeks). There was no preoperative complications, and the length of clinical follow-up tangles from 3 to 26 months. Early reconstruction with minimal morbidity of rapid and multidirectional mandibular distraction in the hemidacial microsomia was successful without relapse. Orthodontic treatment can begin as soon as possible after gradual distraction in order to establish normal dental occlusion.
Bone Lengthening ; Bony Callus ; Dental Occlusion ; Follow-Up Studies ; Goldenhar Syndrome* ; Humans ; Mandible* ; Nuts ; Osteogenesis, Distraction* ; Osteotomy ; Recurrence ; Regeneration

No abstract available.
Telemedicine*

BACKGROUND: Medical emergency teams (METs) have shown their merit in preventing unexpected cardiac arrest. However, it might be impractical for small- or medium-sized hospitals to operate an MET due to limited manpower and resources. In this study, we sought to evaluate the feasibility of a medical alert system (MAS) that alerts all doctors involved in patient care of patient deterioration via text message using smart-phones. METHODS: The MAS was test-operated from July 2015 to September 2015, in five general wards with a high incidence of cardiac arrest. The number of cardiac arrests was compared to that of 2014. The indication for activation of MAS was decided by the intensive care unit committee of the institution, which examined previous reports on MET. RESULTS: During the three-month study period, 2,322 patients were admitted to the participating wards. In all, MAS activation occurred in 9 patients (0.39%). After activation, 7 patients were admitted to the intensive care unit. Two patients (0.09%) experienced cardiac arrest. Of 13,129 patients admitted to the ward in 2014, there were 50 cases (0.38%) of cardiac arrest (p = 0.009). CONCLUSIONS: It is feasible to use MAS to prevent unexpected cardiac arrest in a general ward.
Emergencies ; Heart Arrest ; Hospital Rapid Response Team ; Humans ; Incidence ; Intensive Care Units ; Mortality ; Patient Care ; Patients' Rooms ; Pilot Projects* ; Text Messaging

No abstract available.
Delivery of Health Care ; Informatics

No abstract available.

Although alpha2-adrenoceptor agonists are widely used as postoperative sedatives in adults, the postoperative effects in pediatric patients with secondary pulmonary arterial hypertension (PAH) due to congenital heart disease are not well known. We experienced a case of successful ventilator weaning with continuous intravenous administration of dexmedetomidine (DEX) after surgical correction in a 46-month-old child with congenital ventricular septal defect (VSD) with severe PAH. She underwent VSD closure on cardiopulmonary bypass (CPB). After successful weaning from the CPB, hemodynamics and oxygenation were stabilized on DEX and nitroglycerin in the intensive care unit. The patient was successfully weaned from the ventilator 46 hours after surgery. The transthoracic echocardiogram two weeks after surgery showed a closed VSD with no residual shunt and trivial tricuspid regurgitation (Vmax = 2.5 m/sec) without PAH.
Administration, Intravenous ; Adult ; Cardiopulmonary Bypass ; Child* ; Child, Preschool ; Dexmedetomidine* ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular* ; Hemodynamics ; Humans ; Hypertension* ; Hypnotics and Sedatives ; Intensive Care Units ; Nitroglycerin ; Oxygen ; Tricuspid Valve Insufficiency ; Ventilator Weaning ; Ventilators, Mechanical ; Weaning