PURPOSE: Hemolytic uremic syndrome is one of the most frequent cause of acute renal failure in children and can lead to progressive deterioration of renal function. Present nationwide study was undertaken to determine the clinical characteristcs and prognostic factors of hemolytic uremic syndrome in korean children during past 10 years(1990-1999). METHODS: Questionnaires(including clinical data, prodromal illness, lab data, treatment modality and prognosis) were mailed to all teaching hospitals in korea and 27 hospitals responded. During past 10 years, total 149 cases of HUS were diagnosed. Statistical analysis was done by chi-square test, using p<0.05 being "statistically significant". RESULTS: Sex distribution showed slight female preponderance(female 84 vs male 65 cases) and "under 5 years of age" comprised 71.8%(107 cases). Yearly distribution showed increasing number of HUS cases during past 3-4 years and the majority of cases occurred during summer months. Diarrhea was the most common prodromal illness comprising 75.2 % followed by URI 18.2% and in 3.5% of cases no prodromal illness was noted. Lab data (mean+/-SD) showed Hb 7.3+/-2.1g/dL, platelet 49+/-32 X 103cells/mm3, BUN 74+/-36mg/dL, and creatinine 3.7+/-2.8mg/dL. Hypertension was seen in 32.9%, convulsion in 16.7%, mental change in 15.4% and renal replacement therapy(PD or HD) was done in 49.7% of cases. Clinical outcome showed complete recovery in 75.5%, persisting abnormal urinalysis without renal failure in 11.1%, chronic renal failure(including ESRD) in 6.7% and death in 6.7%(9 cases). Poor prognosis was associated with older patients age, higher serum creatinine level, existence of mental change and longer duration of oligoanuria. Out of these, duration of oligoanuria was the most closely associated factor leading to poor outcome. Out of 119 cases with "oligoanuria under 2 weeks", CRF and death were seen in 2 and 7 cases respectively. Compared to this, out of 12 cases with "oligoanuria over 2 weeks", CRF and death were seen in 4 and 2 cases respectively(p<0.0005). CONCLUSION: The incidence of HUS is increasing recently in Korean children. And out of various prognostic factors(older age, higher serum creatinine, existence of mental change and duration of oligoanuria), duration of oligoanuria was the most significantly associated factor leading to poor outcome.
Acute Kidney Injury ; Blood Platelets ; Child* ; Creatinine ; Diarrhea ; Female ; Hemolytic-Uremic Syndrome* ; Hospitals, Teaching ; Humans ; Hypertension ; Incidence ; Korea ; Male ; Postal Service ; Prognosis ; Renal Insufficiency ; Seizures ; Sex Distribution ; Urinalysis

PURPOSE: Hemolytic uremic syndrome is one of the most frequent cause of acute renal failure in children and can lead to progressive deterioration of renal function. Present nationwide study was undertaken to determine the clinical characteristcs and prognostic factors of hemolytic uremic syndrome in korean children during past 10 years(1990-1999). METHODS: Questionnaires(including clinical data, prodromal illness, lab data, treatment modality and prognosis) were mailed to all teaching hospitals in korea and 27 hospitals responded. During past 10 years, total 149 cases of HUS were diagnosed. Statistical analysis was done by chi-square test, using p<0.05 being "statistically significant". RESULTS: Sex distribution showed slight female preponderance(female 84 vs male 65 cases) and "under 5 years of age" comprised 71.8%(107 cases). Yearly distribution showed increasing number of HUS cases during past 3-4 years and the majority of cases occurred during summer months. Diarrhea was the most common prodromal illness comprising 75.2 % followed by URI 18.2% and in 3.5% of cases no prodromal illness was noted. Lab data (mean+/-SD) showed Hb 7.3+/-2.1g/dL, platelet 49+/-32 X 103cells/mm3, BUN 74+/-36mg/dL, and creatinine 3.7+/-2.8mg/dL. Hypertension was seen in 32.9%, convulsion in 16.7%, mental change in 15.4% and renal replacement therapy(PD or HD) was done in 49.7% of cases. Clinical outcome showed complete recovery in 75.5%, persisting abnormal urinalysis without renal failure in 11.1%, chronic renal failure(including ESRD) in 6.7% and death in 6.7%(9 cases). Poor prognosis was associated with older patients age, higher serum creatinine level, existence of mental change and longer duration of oligoanuria. Out of these, duration of oligoanuria was the most closely associated factor leading to poor outcome. Out of 119 cases with "oligoanuria under 2 weeks", CRF and death were seen in 2 and 7 cases respectively. Compared to this, out of 12 cases with "oligoanuria over 2 weeks", CRF and death were seen in 4 and 2 cases respectively(p<0.0005). CONCLUSION: The incidence of HUS is increasing recently in Korean children. And out of various prognostic factors(older age, higher serum creatinine, existence of mental change and duration of oligoanuria), duration of oligoanuria was the most significantly associated factor leading to poor outcome.
Acute Kidney Injury ; Blood Platelets ; Child* ; Creatinine ; Diarrhea ; Female ; Hemolytic-Uremic Syndrome* ; Hospitals, Teaching ; Humans ; Hypertension ; Incidence ; Korea ; Male ; Postal Service ; Prognosis ; Renal Insufficiency ; Seizures ; Sex Distribution ; Urinalysis

A 35 year old woman, gravid 5, multiparous, was admitted to our department at 6 weeks and 5 days of gestation after being diagnosed with cervical pregnancy. Before the evacuation, the uterine arteries were embolized using angiographic techniques. As a result, dilatation and curettage were performed with minimal hemorrhage. We report one case of cervical pregnancy managed, successfully with preoperative uterine artery embolization and evacuation.
Adult ; Dilatation and Curettage ; Female ; Hemorrhage ; Humans ; Pregnancy* ; Uterine Artery Embolization* ; Uterine Artery*

PURPOSE: Despite the large number of analytical reports regarding the learning curve in the transition from open to robot-assisted radical prostatectomy (RARP), few comparative results with laparoscopic radical prostatectomy (LRP) have been reported. Thus, we evaluated operative and postoperative outcomes in RARP versus 100 simultaneously performed LRPs. MATERIALS AND METHODS: A single surgeon had performed more than 1,000 laparoscopic operations, including 415 cases of radical nephrectomy, 85 radical cystectomies, 369 radical prostatectomies, and treatment of 212 other urological tumors, since 2009. We evaluated operative (operation time, intraoperative transfusion, complications, hospital stay, margin status, pathological stage, Gleason score) and postoperative (continence and erectile function) parameters in initial cases of RARP without tutoring compared with 100 recently performed LRPs. RESULTS: Mean operation time and length of hospital stay for RARP and LRP were 145.5+/-43.6 minutes and 118.1+/-39.1 minutes, and 6.4+/-0.9 days and 6.6+/-1.1 days, respectively (p=0.003 and p=0.721). After 17 cases, the mean operation time for RARP was similar to LRP (less than 2 hours). Positive surgical margins in localized cancer were seen in 11.1% and 8.9% of cases in RARP and LRP, respectively (p=0.733). At postoperative 3 months, sexual intercourse was reported in 14.0% and 12.0%, and pad-free continence in 96.0% and 81.0% in patients with RARP and LRP, respectively (p=0.796 and p=0.012). CONCLUSIONS: Previous large-volume experience of LRPs may shorten the learning curve for RARP in terms of oncological outcome. Additionally, previous experience with laparoscopy may improve the functional outcomes of RARP.
Coitus ; Cystectomy ; Humans ; Laparoscopy ; Learning Curve* ; Length of Stay ; Nephrectomy ; Prostatectomy* ; Prostatic Neoplasms ; Robotics ; Treatment Outcome

No abstract available.
Child* ; Humans ; Reye Syndrome*

This experimental study was conducted to evaluate the effect of indomethacin and methylprednisolone on PAN-induced nephrosis in rats. Sprague-Dawley rats weighing 150~200gm were used and divided into controls, group I (PAN intraperitoneally), group II(PAN intraperitoneally, followed by indomethacin peritoneally for 12 days), group III (PAN intraperitoneally, followed by methylprednisolone peritoneally for 12 days) and group IV (PAN intraperitoneally, followed by cyclosporin subcutaneously for 12 days). Twenty four-hour urinary protein excretion was measured on day 0, 5, 10 and 17. On the 17th day, rats were sacrificed for the determination of total serum protein, albumin and cholesterol levels. Foot process widths of glomerular epithelial cells were measured, and anionic sites of lamina rara externa were determined by using PEI as cationic probes. The following results were obtained. Twenty four-hour urinary protein excretion (mg/day) of group I was significantly increased to 455.7+/-188.8 on the 5th day compared to 15.2+/-3.7 on day 0 (p<0.01), and increased gradulally to 525.6+/-203.5 on the 10th day, then decreased to 280.6+/-25.2 on the 17th day. In group III, 24 hr urinary protein excretion on 17 th day (180.7+/-64.5) was significantly lower than that of group I (280.6+/-25.2). Total serum protein of group III was significantly lower than that of group I, and serum albumin and cholesterol did not show any significant difference among Group I, II, III and IV. Foot process widths (nm) of glomerular epithelial cells in group I, II, III and IV were 409.5+/-15.2, 387.8+/-49.2, 279.9+/-36.9 and 398.3+/-38.3, respectively. And the value of group of group III was significantly lower than that of group I (p<0.01). The number of anionic sites per 1micrometer length of glomerular basement membrane in Group I, II, III and IV were 10.3+/-1.3, 10.1+/-1.6, 12.5+/-1.5and 10.2+/-1.5, respectively. And the value of group III was significantly lower than that of group I (P<0.01). In conclusion, cyclosporin and indomethacin did not show any significant effect on PAN nephrosis in rat. However, methylprednisolone reduced the urinary protein excretion and showed significant recovery of foot process widths and number of anionic sites of glomerular basement membrane.
Animals ; Cholesterol ; Cyclosporine* ; Epithelial Cells ; Foot ; Glomerular Basement Membrane ; Indomethacin* ; Methylprednisolone* ; Nephrosis* ; Nephrotic Syndrome ; Rats* ; Rats, Sprague-Dawley ; Serum Albumin

A statistical analysis of the diagnostic value for 244 aspiration biopsy cytology(ABC) among a total 1,043 cases from various sites was performed. ABC, using diagnostic terminology similar to that of a surgical pathology reports, was compared to the final tissue diagnosis. For the entire series, a sensitivity of 91.8%, a specificity of 99.3%, a positive predictive value of 98.9%, a negative predictive value of 94.8%, and an efficacy of the test of 96.3% were shown. There were 8 false negative and 1 false positive diagnosis. The diagnostic accuracy was 89.8%. Those results indicate that the ABC is a considerably highly accurate procedure that should be routinely employed.
Biopsy, Needle ; Child* ; Diagnosis ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Intranuclear Inclusion Bodies ; Meningioma ; Pathology, Surgical ; Sensitivity and Specificity

No abstract available.
Hemolytic-Uremic Syndrome*

No abstract available.
Child* ; Hemorrhagic Fever with Renal Syndrome* ; Humans

No abstract available.
Liver* ; Paratyphoid Fever* ; Typhoid Fever*