PURPOSE: Since children under two years with suspected urinary tract infections (UTIs) cannot control urination, urine cultures in such children are usually performed via urine bags. This method is noninvasive but has a high contamination rate. We studied the contamination rate of bag urine culture in diagnosing UTIs in infants under two years and the factors responsible for contamination. METHODS: We examined patients under 2 years in whom urine culture through the urine bag method yielded over 105 colonies of a single pathogen. We defined UTIs by referring to the guidelines of The Korean Society of Pediatric Nephrology, 2005. We examined the factors responsible for contamination according to sex, duration of urine collection, and whether diarrhea took place with contamination rate. RESULTS: We examined 717 patients (412 males and 305 females). The contamination rate of one bag urine culture was 37.9%. Gender was not related to the contamination rate (P>0.05). Duration of urine collection showed an association with the contamination rate. The longer the duration of collecting urine, the higher was the contamination rate. Duration of urine collection was divided into three groups: first group, <2 hours; second group, 2-4 hours; and third group, > or =4 hours. The contamination rates were 30.0%, 42.2%, and 43.7% for the first, second, and third groups, respectively, with statistical significance (P=0 .001). Diarrhea at admission had no impact on the contamination rate (P>0.05). CONCLUSION: The contamination rate of urine culture in the examined patients was 37.9%. Gender and diarrhea symptoms were not responsible for contamination. In infants with a suspected UTIs, urine should be collected within 2 hours through the urine bag method. If urine collection takes over 2 hours, the urine bag should be resterilized and reattached to the patient.
Child ; Diarrhea ; Humans ; Hypogonadism ; Infant ; Male ; Mitochondrial Diseases ; Nephrology ; Ophthalmoplegia ; Urinary Tract Infections ; Urination ; Urine Specimen Collection

PURPOSE: We attempted to compare the independent factors such as age, sex, C-reactive protein(CRP), and white blood cell count(WBC) in children with radiologic studies and assess the necessity of performing voiding cystourethrography(VCUG). METHOD: 98 children who have been diagnosed their first time febrile urinary tract infection from Janurary 2002 to Januray 2005 were enrolled. In all patient, the duration of fever which occurred before and after treatment was recorded, and CRP, WBC, (99m)Tc-2,3-dimercaptosuccinic acid((99m)Tc-DMSA) renal scans, renal ultrasound and VCUG were analyzed. RESULTS: Of the 98 children diagnosed with urinary tract infection(UTI), 52 were male and 46 were female. 18 had abnormalities in VCUG, 17 had abnormalities in kidney ultrasound, and 20 had partial defects or diffuse uptake decrease in (99m)Tc-DMSA renal scans. There were no significant relationship between incidence of radiologic abnormalities and age. The risk of renal scar was significantly higher in children who had a longer febrile period before treatment than in those with shorter period. Both CRP and WBC were significantly elevated in children with the radiological abnormalities. A positive of (99m)Tc-DMSA renal scans and renal ultrasound were highly associated with vesicoureteral reflux(VUR). CONCLUSION: If there are abnormalities in the kidney ultrasound and (99m)Tc-DMSA renal scan of a child with initial UTI, a VCUG is recommended. Even in cases without abnormal findings in (99m)Tc-DMSA renal scan and renal ultrasound, clinical data such as CRP and WBC should be assessed, and VCUG should be performed for the undetected VUR.
Child* ; Cicatrix ; Female ; Fever ; Humans ; Incidence ; Kidney ; Leukocytes ; Male ; Ultrasonography ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

Hyponatremia which is a very common electrolyte abnormality in hospitalized patients is defined as a plasma sodium concentration less than 135 mEq/L. Hyponatremia is generally caused by intravascular volume depletion, excessive salt loss and hypotonic fluid overload. It also can be caused by intravascular osmotic agent. Although most cases are mild and asymptomatic, acute severe hyponatremia can cause severe neurologic symptoms, such as seizures and coma. We report a rare case of severe hyponatremia induced by radiographic contrast agent.
Coma ; Humans ; Hyponatremia ; Neurologic Manifestations ; Plasma ; Seizures ; Sodium

PURPOSE: Thyroid cancer is the most common malignancy affecting the endocrine glands. The incidence of his malady has conspicuously increased during the recent years. Thyroid diseases affect women approximately 3 times more often than men, and this incidence decreases after menopause. This gender difference has suggested that the female sex steroids stimulate the growth of the thyroid, the same as for the breast. In the present study, we investigated the expressions of estrogen receptor (ER) and progesterone receptor (PR) in thyroid lesions. METHODS: The tissues from 193 human thyroid glands (136 thyroid cancers and 57 adenomatous hyperplasias) were used for the present immunohistochemical assessment of the ER and PR expressions. RESULTS: The incidences of the estrogen and progesterone receptor positive cases were 19.7 and 41.5%, respectively. The incidence of the progesterone receptor positive cases was higher for females (46.5%) than for males (19.4%) however, the expression of estrogen receptor was not different significantly between the females and males. Higher expressions of estrogen and progesterone receptors were detected in the thyroid cancers than in the adenomatous hyperplasias. The PR expression seemed to correlate with the tumor size: a higher PR expression was found in the T3 cancers than in the T2 cancers. CONCLUSION: Our findings provide new insight that the ER and PR expressions may be related to the pathogenesis and progression of thyroid cancer.
Breast ; Endocrine Glands ; Estrogens* ; Female ; Humans ; Hyperplasia ; Incidence ; Male ; Menopause ; Progesterone* ; Receptors, Progesterone* ; Steroids ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule*

BACKGROUND/AIMS: Hepatic cysts are incidentally found at laparotomy or through abdominal imaging studies. When they become symptomatic, treatment is indicated. The aim of this study is to evaluate many options of their management, especially about surgical methods. METHODS: Data were retrospectively analyzed from the clinical charts of 21 patients undergoing surgery for symptomatic hepatic cysts from January, 1995, through December, 2002 in department of Surgery, Pusan University Hosipital. Charts were obtained from the original hosipital referral. We considered the following variables for analysis: age, sex, symptoms, hepatic cyst location, size, operative methods, histological confirm, postoperative morbidity and mortality, length of postoperative hosipital stay, and follow-up outcome. RESULTS: Mean age of the 21 patients was 53 years. The ratio of male and female was 1:4.3. Their main symptoms were right upper quadrant pain or discomfort, epigastric pain, and abdominal distension. Rarely, palpable mass, dyspepsia, mild jaundice, and acute abdominal pain from ruptured hepatic cyst were observed. Preoperative abdominal ultrasound and computed tomographic scannig were done in all patients. The mean size of hepatic cysts was 9.04 cm in computed tomographic scanning. The 61.9% of patients had the location in right lobe. Simple cyst was characterized by homogeneous, low attenuated and unilocular mass in computed tomographic scanning: in difference, biliary cystadenoma, internal intervening septation and papillary infoldings with cyst itself. Fifteen patients underwent partial cystectomy and 4, complete cystectomy and 1, non-anatomical hepatic resection and 1, left lateral segmentectomy. Hepatic cysts were consisting of 15 cases of simple cyst, 4 cases of biliary cystadenoma, 1 case of Caroli's disease and 1 case of polycystic liver disease. Postoperative complication was bile leakage in one case. No symptomatic recurrence occured during a mean follow-up period of 42.5 months. CONCLUSION: According to the characteristics of symptomatic hepatic cyst, proper operative methods of management were considered. More long-term follow-up is necessary but in simple cyst in histological type, partial cystectomy can be the acceptable technique, complete cystectomy or hepatic resection should be perfomed in biliary cystadenoma for recurrence and malignant potential.
Abdominal Pain ; Bile ; Busan ; Caroli Disease ; Cystadenoma ; Cystectomy ; Dyspepsia ; Female ; Follow-Up Studies ; Humans ; Jaundice ; Laparotomy ; Liver Diseases ; Male ; Mastectomy, Segmental ; Mortality ; Postoperative Complications ; Recurrence ; Referral and Consultation ; Retrospective Studies ; Ultrasonography

Bronchogenic cysts are rare congenital anomalies that arise early in gestation from abnormal budding of the developing respiratory system. Mediastinal bronchogenic cysts account for 10-15 percent of all primary mediastinal masses; 63.7 percent of patients are symptomatic. Common symptoms are fever, chest pain, cough, dyspnea, and dysphagia. Gastrointestinal symptoms except dysphagia are rare. It can be life threatening with compression, infection, hemorrhage, or rupture. Symptoms and signs of compression are more frequent in infants and children than in adults. It may be asymptomatic, or cough, infection, and hemoptysis may be observed. Complete excision is recommended. We report a case of bronchogenic cyst misdiagnosed as chronic gastritis with nausea and epigastric pain for a year.
Adult ; Bronchogenic Cyst* ; Chest Pain ; Child ; Cough ; Deglutition Disorders ; Dyspnea ; Fever ; Gastritis ; Hemoptysis ; Hemorrhage ; Humans ; Infant ; Nausea* ; Pregnancy ; Respiratory System ; Rupture

Pfeiffer syndrome is one of a rare form of craniosynostosis syndrome, showing variable degree of craniosynostosis, midface hypoplasia, broad thumbs and toes and syndactyly. This is transmitted in autosomal dominant pattern and known to be related to mutations in FGFR (Fibroblast Growth Factor Receptor) 1 or FGFR 2. We experience a case of newborn Pfeiffer syndrome type 3 who had multiple facial anomalies, thumbs and great toes anomalies, ankylosis of radius and ulnar and hydrocephalus.
Acrocephalosyndactylia* ; Ankylosis ; Craniosynostoses ; Humans ; Hydrocephalus* ; Infant, Newborn ; Radius ; Syndactyly ; Thumb ; Toes

To determine chronic alcoholism (or alcohol abuse) in postmortem cases, investigating the evidence in incident (or medical) reports is important, but it may not be certain. The indicator of alcohol abuse over long time periods was analyzed from hair as ethyl glucuronide (EtG). Beta-hydroxybutyrate (BHB) was analyzed from blood as a representative indicator of ketosis. Moreover, the blood was analyzed for ethanol (ethyl alcohol, EtOH) and EtG before death to determine drinking. Case 1 had chronic alcoholism and a history of diabetic disease. EtG concentration was 1,244 pg/mg in hair, and BHB in the blood was 276 mg/L. EtOH was less than 0.010% in the blood, however EtG was 0.38 mg/ L as drinking positive. Case 2 had a habit of drinking well, with EtG in hair of 54 pg/mg, BHB in the blood of 371 mg/L, EtOH of < 0.010%, and EtG of 0.81 mg/L.Although the EtOH was not detected in the blood, it was evaluated that alcohol was consumed before death, due to the EtG detected. In conclusion, forensic information from simultaneous analysis of EtG and BHB in biological samples (hair or blood) could be more cause of death effective assistant in chronic alcoholism (or alcohol abuse).

Infants who are born between 24 hours and 1 year of age require extreme caution in their care due to their fragility. However, if there are multiple risk factors associated with the infant, caretaker, household, and surrounding circumstances, providing proper and appropriate care becomes problematic. This difficulty in caring for infants can contribute to abuse, neglect, or even death. This study investigates unexplained infant deaths that occur in the presence of multiple psychosocial risk factors. This study aimed to explore the relationship between various psychosocial risk factors and sudden, unexplained infant deaths. We examined nine cases from the autopsy archive of the National Forensic Service using a statistical approach. Among these cases, three were subject to legal action, while six were closed without further legal process. Although it was difficult to establish a clear relationship between death and abuse or neglect in the six cases, all were found to have experienced a harsh environment that was similar to abuse or neglect. We discuss the implications of our findings for understanding infant deaths and legal outcomes and propose a new framework to understand the deaths of infants.

PURPOSE: Rotavirus is an enteric pathogen that affects millions of children globally each year. But no specific therapy is available for the management of rotavirus diarrhea. Due to the clear need to define improved modality for treatment of rotavirus diarrhea, we evaluated the efficacy of anti- rotavirus IgY in the treatment of infants and children with gastroenteritis. METHODS: First, the amount of viral particle in the stools of thirteen patients (seven were given IgY, 6 placebo) infected by rotavirus were evaluated for 3 days with the quantitative RT-PCR method. Second, 36 children with known rotavirus infection identified by ELISA or semi-quantitative RT- PCR were evaluated. We gave 5 g anti-rotavirus egg yolk daily in two equally divided doses for 3 days to two groups (an 18 IgY group and an 18 placebo group), respectively after parenteral consent. Daily vomiting frequency, stool frequency, oral intake and urine output were monitored for 3 days, and electrolyte and blood chemistry were checked at the first and third days. RESULTS: First, in the placebo group, the amount of virus particles increased daily, but in the IgY group it decreased daily. Second, when IgY and placebos were given to children infected with rotavirus, diarrhea on the third day decreased significantly in the IgY group, compared with the placebo group. CONCLUSION: Treatment with antirotavirus immunoglobulin from immunized chicken's egg resulted in a decrease in the amount of viral particles in stools and diarrhea frequency in children. These results suggest that anti-rotavirus IgY is effective in the treatment of rotavirus gastroenteritis.
Infant ; Child ; Male ; Female ; Humans