No abstract available.
Hemorrhage* ; Humans ; Infant* ; Infant, Very Low Birth Weight*

PURPOSE: Intestinal malrotation is a developmental anomaly and may be complicated by volvulus and intestinal necrosis. We performed anatomic classification and compared clinical profiles to understand their relationship. METHODS: Twenty-eight children were diagnosed as intestinal malrotation at Seoul National University Children's Hospital between Jan. 1980 to Dec. 1995. The patients were classified into 4 groups by age at initial presentation(=x). [group 1 : x<1 week, group 2 : 1 week< OR =x<1 month, group 3 : 1 month< OR =x<1 year, group 4 : 1 year< OR =x] Anatomic classification was performed by radiologic and operative findings. RESULTS: There were 20 males and 8 females. More than half(15/28) of the patients presented in the first month of life, and most of whom presented with bilous vomiting. Most patients older than 1 year of age presented with recurrent abdominal pain and vomiting. The anatomic classification contained 12 patients of type I, 3 patients of type II(IIA : 1, IIC : 2) and 13 patients of type III(IIIA : 5, IIIB : 8). Volvulus occurred in patients of type I and type IIIA and Ladd's band was a major cause of obstruction in patients of type IIIB. Twenty-six patients underwent operation and most had good outcomes except 3 patients. CONCLUSION: Intestinal malrotation should be considered in children with chronic abdominal pain and vomiting as well as infants with bilous vomiting. By performing anatomic classification, we can understand more precisely this disease and care for patients more effectively.
Abdominal Pain ; Child ; Classification* ; Female ; Humans ; Infant ; Intestinal Volvulus ; Male ; Necrosis ; Seoul ; Vomiting

Tsutsugamushi disease is an acute febrile illness caused by infection with Orientia tsutsugamushi transmitted by the bite of larval trombiculid mites and characterized by fever, myalgia, lymphadenopathy, rash and eschar. O. tsutsugamushi has been known to cause diffuse vasculitis of small blood vessels. Disseminated intravascular coagulation associated with endothelial cellular injury by O. tsutsugamushi has been occasionally reported. However, in our knowledge, splenic infarction-associated scrub typhus has not been previously reported. We experienced two cases of tsutsugamushi disease with splenic infarction, which were improved after doxycycline treatment finished.
Blood Vessels ; Disseminated Intravascular Coagulation ; Doxycycline ; Exanthema ; Fever ; Lymphatic Diseases ; Myalgia ; Orientia tsutsugamushi ; Scrub Typhus* ; Splenic Infarction* ; Trombiculidae ; Vasculitis

PURPOSE: This study was designed to aid the diagnosis and to predict the outcorne by understanding the clinical course of nutcracker syndrome in childhood. METHODS: The clinical, laboratory, radiological and cystoscopic data from the medical records of eleven children who were diagnosed as nutcracker syndrome by gross hematuria and pressure gradient criteria (>3mrnHg) were studied retrospectively and analyzed. RESULTS: Sex ratio of the cases was 7:4, and the median age of onset was 12.8 (3-14.3) years. Six cases showed persistent and 5 cases manifested interrnittent, exercise induced hematuria. Left flank pain (64%), abdominal pain (18%), left varicocele (9%) were associated in some of the children, but hematuria was the only symptom in 36Yo. Left renal vein entrapment was documented in 10 cases by ultrasonography. Out of the 5 cases studied by renal Doppler ultrasonography, 4 and 5 cases showed higher (>5) mean left renal vein diameter ratio (Distal/ Aortomesenteric portion) and mean peak velocity ratio respectively. Unilateral bleeding from left ureteral orifice was documented in 7 of the 9 cases at cystoscopy. The mean pressure gradient between proximal left renal vein and inferior vena cava was 4.4+/-1.6 (3-7) mmHg. Hematuria of 25% and 57% of the cases disappeared spontaneously in 3 and 5 years after onset respectively. Proteinuria disappear- ed in 3 of the 5 initial proteinuric cases. CONCLUSION: Nutcracker syndrome must be considered in the differential diagnosis of non-glomerular, especially gross hematuria in childhood, and Doppler ultrasonography can aid diagnosis non-invasively. The renal function remained stable, but 4396 of the cases continued to show hematuria still 5 years after onset.
Abdominal Pain ; Age of Onset ; Child ; Cystoscopy ; Diagnosis ; Diagnosis, Differential ; Flank Pain ; Hematuria* ; Hemorrhage ; Humans ; Medical Records ; Proteinuria ; Renal Veins ; Retrospective Studies ; Sex Ratio ; Ultrasonography ; Ultrasonography, Doppler ; Ureter ; Varicocele ; Vena Cava, Inferior

BACKGROUND AND OBJECTIVES: With the increasing use of high resolution sonography and fine needle aspiration biopsy, the proportion of newly diagnosed thyroid papillary carcinomas have increased. However, it is not entirely clear whether microcarcinomas detectable by the above technology the should be considered a threshold for risk evaluation. The purpose of this study is to evaluate the clinical behavior of papillary carcinomas smaller than 1.5 cm. SUBJECTS AND METHOD: A retrospective chart review was conducted for 181 patients who underwent surgery for thyroid cancer and was proven to have papillary carcinoma smaller than 1.5 cm in size from 1997 to 2006. The patients were divided into 3 groups according to cancer size. The patient's gender, age, surgical method, pathology, initial neck node and neck recurrence was analyzed by chi-square test, analysis of variance (ANOVA) test and multinomial logistic regression analysis. RESULTS: Progressively increasing frequency of signs of tumor aggressiveness (multifocal, bilateral, extracapsular spread) was observed with increasing size. The rate of lymph node metastasis increased also, but it did not reach a significant value. Despite the increasing rate of aggressiveness and lymph node metastasis, there was no significant difference in recurrence between these groups. CONCLUSION: Although the long term outcome does not seem to directly depend on tumor size in these small thyroid cancers, a progressing frequency of aggressiveness with increasing cancer size at presentation is evident.
Biopsy ; Biopsy, Fine-Needle ; Carcinoma ; Carcinoma, Papillary ; Humans ; Logistic Models ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms

BACKGROUND: A balanced nutrient intake is important for patients with diabetes. Even if individuals have the same number of residual natural teeth, there are large differences in the masticatory performance between edentulous sites restored with a fixed dental prosthesis, including dental implants, and those restored with a removable dental prosthesis. This study assessed whether the prevalence and control of diabetes differed based on the use of removable dental prostheses through an analysis of nationally representative data. METHODS: Overall, 8,155 individuals (3,525 men and 4,630 women) aged ≥ 50 years were included in this study and were classified into the following 3 groups: group 1, did not use any removable dental prostheses (NF); group 2, used removable partial dentures (RPD); and group 3, used removable complete dentures on at least 1 jaw (CD). The characterization of diabetic patients and glycemic control were analyzed and compared among groups. To determine the relationship between diabetes and the use of dental prostheses, multivariable logistic regression analysis was performed (P < 0.05). RESULTS: The adjusted odds ratios and 95% confidence intervals for diabetes in men participants in groups NF, RPD, and CD were 1 (reference), 1.165 (0.878–1.544), and 1.491 (1.034–2.151), respectively, after adjusting for confounding factors. Diabetes and glycemic control were significantly associated with the use of removable dental prostheses among men. CONCLUSION: The use of removable dental prostheses is a potential risk indicator for uncontrolled diabetes in Korean men adults, suggesting the need for a comprehensive approach to minimize the complications of diabetes mellitus.
Adult ; Dental Implants ; Dental Prosthesis ; Denture, Complete ; Denture, Partial, Removable ; Dentures ; Diabetes Complications ; Diabetes Mellitus ; Humans ; Jaw ; Logistic Models ; Male ; Odds Ratio ; Oral Health ; Prevalence ; Tooth

PURPOSE: A stability-measuring device that utilizes damping capacity analysis (DCA) has recently been introduced in the field of dental implantology. This study aimed to evaluate the sensitivity and reliability of this device by measuring the implant stability of ex vivo samples in comparison with a resonance frequency analysis (RFA) device. METHODS: Six implant beds were prepared in porcine ribs using 3 different drilling protocols to simulate various implant stability conditions. Thirty-six pork ribs and 216 bone-level implants measuring 10 mm in height were used. The implant beds were prepared using 1 of the following 3 drilling protocols: 10-mm drilling depth with a 3.5-mm-diameter twist drill, 5-mm drilling depth with a 4.0-mm-diameter twist drill, and 10-mm drilling depth with a 4.0-mm-diameter twist drill. The first 108 implants were external-connection implants 4.0 mm in diameter, while the other 108 implants were internal-connection implants 4.3 mm in diameter. The peak insertion torque (PIT) during implant placement, the stability values obtained with DCA and RFA devices after implant placement, and the peak removal torque (PRT) during implant removal were measured. RESULTS: The intraclass correlation coefficients (ICCs) of the implant stability quotient (ISQ) results obtained using the RFA device at the medial, distal, ventral, and dorsal points were 0.997, 0.994, 0.994, and 0.998, respectively. The ICCs of the implant stability test (IST) results obtained using the DCA device at the corresponding locations were 0.972, 0.975, 0.974, and 0.976, respectively. Logarithmic relationships between PIT and IST, PIT and ISQ, PRT and IST, and PRT and ISQ were observed. The mean absolute difference between the ISQ and IST values on a Bland-Altman plot was −6.76 (−25.05 to 11.53, P<0.05). CONCLUSIONS Within the limits of ex vivo studies, measurements made using the RFA and DCA devices were found to be correlated under a variety of stability conditions.

Infliximab is a chimeric antibody against tumor necrosis factor-alpha and it can be used in the treatment of ankylosing spondylitis. Tumor necorosis factor-alpha is a potent proinflammatory cytokine and plays a key role in the host response against tuberculosis. Infliximab is known to be effective on active ankylosing spondylitis but it can also cause reactivation of latent tuberculosis. Physicians should screen patients for latent tuberculous infection or disease before prescribing the drug. We experienced a case of tuberculous pleurisy after taking infliximab in a patient suffering from ankylosing spondylitis. We present the case with a review of literature.
Humans ; Latent Tuberculosis ; Spondylitis, Ankylosing ; Tuberculosis ; Tuberculosis, Pleural* ; Tumor Necrosis Factor-alpha ; Infliximab

A 68-year-old man who had suffered left nephrectomy 6 years previously for renal cell carcinoma presented with a 6-week history of melena episodes. Physical examination and laboratory data were irrelevant. Gastroduodenoscopy and colononoscopy could not reveal a bleeding focus. An angiography was undertaken, which confirmed the presence of an abnormal tumor staining at the jejunum. For the preoperative evaluation, a small bowel study showed an about 2 cm sized eccentric filling defect at mesenteric side wall of distal jejunum in the left lower quadrant. A CT scan also showed a heavily enhancing bowel wall thickening. Small bowel resection was performed, and a 3 X 3 cm ulceroinfiltrating jejunal lesion was found which microscopically consisted of a proliferation of trabeculated clear cells. He had an unremarkable postoperative recovery. A follow-up CT scan at 3 months later showed no evidence of recurrence.
Aged ; Angiography ; Carcinoma, Renal Cell* ; Follow-Up Studies ; Hemorrhage ; Humans ; Jejunum ; Melena ; Neoplasm Metastasis ; Nephrectomy ; Physical Examination ; Recurrence ; Tomography, X-Ray Computed

BACKGROUNDS: House-dust mites are the main cause of allergic rhinitis in Asia, for which immunotherapy (SLIT) is a currently accepted treatment. However, few studies have evaluated the efficiency of SLIT on Asian children with allergic rhinitis for a period longer than one year. The aim of this study was to investigate the efficacy and safety of SLIT for Asian children with allergic rhinitis due to house-dust mites over a 2-year period. MATERIALS AND METHODS: This study included 65 patients who had allergic rhinitis due to Dermatophagoides pteronyssinus and Dermatophagoides farinae. All patients were treated with SLIT (Staloral(R)). Symptom scores and quality of life were evaluated by using questionnaires over two years. The medication score was assessed monthly by a diary medication card and serologic tests were evaluated before and two years after the start of treatment. Adverse effects and dropout rates were also investigated. RESULTS: All nasal and non-nasal symptoms and quality of life were significantly improved after two years of treatment. Furthermore, the total medication score decreased significantly and the serologic tests showed a significant change two years after the start of SLIT. Although minor adverse effects were reported, no systemic reactions were observed. The dropout rate was 40%. CONCLUSION: SLIT is an efficient and safe therapeutic tool for a period of two years in Asian children with allergic rhinitis to house-dust mites.
Asia ; Asian Continental Ancestry Group* ; Child* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Follow-Up Studies* ; Humans ; Immunotherapy ; Mites ; Patient Dropouts ; Quality of Life ; Rhinitis ; Serologic Tests ; Sublingual Immunotherapy*