No abstract available.
Polycystic Kidney Diseases* ; Tuberous Sclerosis*

BACKGROUND: The purpose of this research was to compare one hospital family practise residents' diagnostic and therapeutic behavior with a Dupont et al described Guidelines on acute infectious diarrhea in adults and HARRISON'S PRINCIPLES OF INTERNAL MEDICINE 15th edition's algorithm for the management of acute diarrheal patients. METHODS: From March 1, 2003 to April 30, 2003, we reviewed 82 acute diarrheal patients (3.19% of the total patients) who had visited one hospital's emergency room which was located in Jeonju district. Doctor's diagnostic and therapeutic approaches were reviewed on the basis of history and physical exam. Then we compared with the standard algorithm referred above. RESULTS: Inpatients were 36.6% (30 patients) among the total of 82 and 63.4% (52 patients) returned home after symptomatic treatment. Among the 52 return home patients, doctors did not entirely conduct stool exam. Among the 30 hospitalized patients, doctors conducted stool exam in 25% among 4 of 16 high fever patients, in 25% among 2 of 8 moderately dehydrated who had diarrhea more than 10 times per day, and in 60% among 6 of 10 patients whose symptom duration was more than 48 hours. Doctors did not use antibiotics in 76.9% (40 patients) of 52 return home patients. Quinolone and Augmentin tablets were administered to each 6 patients of 12 return home patients. Among the 30 inpatients, Augmentin injection were given to 80% (24 patients) and second-generation cephalosporin with aminoglycoside combination injection to 13.3% (4 patients) and quinolone injection to 6.7% (2 patients). CONCLUSION: Compared with standard algorithm, doctors neglected testing stool examination that may be the most important way to diagnose the specific etiology of acute diarrhea. If we actively utilize the stool exam, it may help in providing the correct diagnosis and suitable treatment.
Adult ; Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Diagnosis ; Diarrhea ; Emergency Service, Hospital ; Fever ; Humans ; Inpatients ; Internal Medicine ; Jeollabuk-do ; Tablets

BACKGROUND/AIMS: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with heterogeneous clinical features. Data on the disease course and prognosis of UC patients who have been regularly treated are lacking. We aimed to investigate relapse rates of UC in remission and factors related to relapse. METHODS: We retrospectively analyzed clinical courses of 84 patients (43 males, median age 43 years, ranged 20-73 years) diagnosed as UC at Ajou University Hospital between January 1997 and December 2005 based on clinical, endoscopic and pathologic findings, and who were regularly followed for at least one year after the remission. RESULTS: Study subjects consisted of 32 proctitis (38%), 21 left-sided colitis (25%), and 31 subtotal or total colitis (37%). Of 84 patients, relapse was observed in 52 patients (62%) during the follow-up period (ranged 1-9 years). The relapse rate was 24%, 41%, 51%, 65%, 71%, and 79% at 1 year, 2 years, 3 years, 4 years, 5 years and 6 years, respectively. Among sex, age, hemoglobin, ESR, and the extent of disease on admission, decrease of hemoglobin level was the only independent factor related to relapse (odds ratio=2.67, 95% CI (1.32-5.42), p<0.01). CONCLUSIONS: In Korea, relapse of UC in remission is not rare. Decrease of hemoglobin level is an independent risk factor related to its relapse, while the extent of disease is not.
Adult ; Aged ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Antimetabolites/therapeutic use ; Azathioprine/therapeutic use ; Chronic Disease ; Colitis, Ulcerative/*diagnosis/*epidemiology/therapy ; Data Interpretation, Statistical ; Female ; Follow-Up Studies ; Hemoglobins/analysis ; Humans ; Male ; Mesalamine/therapeutic use ; Middle Aged ; Odds Ratio ; Recurrence ; Retrospective Studies ; Risk Factors ; Time Factors

STUDY DESIGN: Case report. OBJECTIVES: To report a case of paraplegia in a patient with thoracic kyphosis after osteosynthesis for a fracture of the femur. SUMMARY OF LITERATURE REVIEW: There are few reports about cases of paraplegia after low extremity fracture surgery in patients with thoracic kyphosis with ankylosing spondylitis. MATERIALS AND METHODS: An 86-year-old female patient presented with right hip pain. She had undergone surgery for an intertrochanteric fracture of the femur in the supine position under general anesthesia. Immediately after surgery, she showed paraplegia. Postoperative thoracolumbar spine images revealed a fracture through the disc at T12 and L1. However, she did not complain of back pain or any neurologic deficits before surgery. RESULTS: Although the patient underwent emergent posterior decompression and fusion surgery, her neurologic compromise did not improve during 1 year of follow-up. CONCLUSIONS: It is necessary to check preoperative spine radiographs before surgery in elderly patients who have a kyphotic deformity and lower extremity fractures. Surgeons should consider changing the position of the patient and the type of anesthesia used during surgery when spine stability is in doubt.
Aged ; Aged, 80 and over ; Anesthesia ; Anesthesia, General ; Back Pain ; Congenital Abnormalities ; Decompression ; Extremities ; Female ; Femur* ; Follow-Up Studies ; Hip ; Humans ; Kyphosis ; Lower Extremity ; Neurologic Manifestations ; Paraplegia* ; Spine* ; Spondylitis, Ankylosing* ; Supine Position ; Surgeons

The development of leukemia during pregnancy is rare and difficult to diagnosis and treatment. Acute leukemias are among the most common malignant neoplasms of young women, but paradoxically, their incidence complicating pregnancy is cited to be 0.9 to 1.2 cases per 100,000. l'he signs and symptoms of acut:e leukemia may mask the signs and symptoms of early pregnancy. 'I'he occurrence of acute leukemia during pregnancy raises many therapeut,ic and ethical dilemmas because of the potential tetatogenic effects of chemotherapy and the danger of fetal wastage, in addition to the well-known problem of marrow suppression in the mother. We experienced a case where diagnosis of a woman at the 15 gestational weeks revealed acute lymphocytic leukemia and immediate treatment. as well as termination of pregnancy was made to prevent abnormal neonatal birth. We present this case with review of related literatures.
Bone Marrow ; Diagnosis ; Drug Therapy ; Female ; Humans ; Incidence ; Leukemia ; Masks ; Mothers ; Parturition ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pregnancy*

PURPOSE: The aim of this study was to investigate the incidence and contributing factors of nonoliguric hyperkalemia in extremely low birth weight infants (ELBW) within 96 hours after birth in very low birth weight infants. METHODS: The incidence of non-oliguric hyperkalemia and difference of clinical feature between hyperkalemic (>or=7.0 mEq/L) and normokalemic (<7.0 mEq/L) groups were determined by reviewing medical records of 35 extremely low birth weight infants admitted in Samsung Medical Center between Jan. 2001 to Dec. 2001. We analyzed the serum levels of sodium, potassium, fluid intake, urine output, blood gas analysis values, and other factors that influenced serum electrolytes. RESULTS: Among 35 ELBW infants, 11 (31%) was hyperkalemia developed and 4 infants (36%) was associated with cardiac arrythmia. The incidence and onset time of hyperkalemia showed inverse correlation with birth weight and gestational age. Perinatal complications and serum levels of sodium, fluid intake, hourly urine output, and other blood gas analysis were no different in both groups. Dopamine administrations, UAC insertion rate, ICH incidence and base deficit were significantly increased in hyperkalemic group. CONCLUSION: Non-oliguric hyperkalemia is a frequent complication of ELBW infant. Serum potassium should be monitored closely to avoid life threatening cardiac arrhythmia in these infants.
Arrhythmias, Cardiac ; Birth Weight ; Blood Gas Analysis ; Dopamine ; Electrolytes ; Gestational Age ; Humans ; Hyperkalemia* ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Very Low Birth Weight ; Medical Records ; Parturition ; Potassium ; Sodium

Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.
Biliary Tract ; Colonic Neoplasms ; Communicable Diseases ; Diabetes Mellitus ; Endophthalmitis ; Escherichia coli ; Hepatic Artery ; Klebsiella pneumoniae ; Liver Abscess* ; Liver Abscess, Pyogenic ; Neoplasm Metastasis ; Pneumonia ; Portal Vein ; Pulmonary Embolism ; Risk Factors ; Stomach Neoplasms*

No abstract available.
Appointments and Schedules* ; Hepatitis B Vaccines* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Infant, Newborn* ; Vaccination*

OBJECTIVES: To analyze differences in health behaviors among the social strata in Korea by using the 1995 National Health and Health Behavior Survey Data. METHODS: Study participants numbered 2,352 men and 1,016 women aged between 15-64 years old, with housewives, students and non-waged family workers excluded. Health behaviors in this study were defined according to the recommendations of the Alameda 7 study. The measure of health behaviors was based on the Health Practices Index(HPI; 0-5 range, with the exclusion of snacking between meals and regularly eating breakfast) developed by the Alameda County research. The significance of the relationship between social strata and HPI was assessed by considering the adjusted means from the multi-variate model. RESULTS: For men, incidence rates of never having smoked, no/moderate use of alcohol, regular exercise, and regular 7-8 hours sleep per night were higher in the upper social strata. Meanwhile, for women, incidence rates of never having smoked, no/moderate use of alcohol, appropriate weight, regular exercise, and regular 7-8 hours sleep per night were higher in the upper strata. HPI varied significantly among social strata in both sexes (p<0.001), a result which held true when adjusted for age, education, income, social insurance type, marital status and region. CONCLUSIONS: Health behaviors assessed by Health Practices Index(HPI) varied significantly among social strata for both sexes. Therefore, the existing gap in health behaviors among social strata can be corrected more effectively by target oriented health promotional activities.
Eating ; Education ; Female ; Health Behavior* ; Health Promotion ; Humans ; Incidence ; Korea* ; Male ; Marital Status ; Meals ; Smoke ; Snacks ; Social Security

PURPOSE: Acinetobacter baumannii is increasingly recognized as an important cause of nosocomial infection, especially in neonatal intensive care units. But little is known about the clinical significance and hospital epidemiology of Acinetobacter species other than A. baumannii. The objective of this study is to describe the clinical characteristics and epidemiology of septicemia due to Acinetobacter species other than A. baumannii. METHODS: We retrospectively reviewed 11 cases of blood culture proven nosocomial infection which occured in our neonatal intensive care unit from 4th to 24th, February, 2004. To establish epidemiological analysis, we performed environmental cultures and an antibiogram was obtained from susceptability tests of isolated Acinetobacter species. RESULTS: Clinical manifestations including fever, poor feeding, abdominal distension, diarrhea, bloody stool passage, vomiting, tachypnea and apnea were similar to other infectious diseases. Benign clinical courses were compared with poor prognose, including a high mortality rate in septicemia due to A. baumannii. The major predisposing factor among our patients was the presence of a peripheral intravascular catheter. Antibiogram was similar, but surveillance cultures of environmental specimens failed to identify the source of infection. CONCLUSION: Acinetobacter species other than A. baumannii were often considered relatively avirulent bacteria, but could be pathologic organisms if cultured in patients with clinical symptoms.
Acinetobacter baumannii ; Acinetobacter* ; Apnea ; Bacteria ; Catheters ; Causality ; Communicable Diseases ; Cross Infection ; Diarrhea ; Disease Outbreaks ; Epidemiology ; Fever ; Humans ; Infant, Newborn ; Intensive Care Units ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal* ; Microbial Sensitivity Tests ; Mortality ; Retrospective Studies ; Sepsis* ; Tachypnea ; Vomiting