No abstract available.

No abstract available.

PURPOSE: Vesicoureteral reflux (VUR) is the major cause of urinary tract infection (UTI) in children. Prolonged untreated UTI associated with VUR may result in serious complications, such as renal scarring, renal atropy, and decreased renal function. Therefore, follow up must be continued until UTI is cured completely, to prevent of serious complication. The authors conducted this study to evaluate results of the follow-up of UTI associated with VUR. METHODS: During the period from March 1991 to July 1996, we had 47 children with urinary tract infection associated with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Presbyterian Medical Center. The patients were managed medically or surgically. RESULTS: 1) There were no differences in sex distribution in the 47 cases with VUR. The intensity of 67 refluxing ureters, classified by the International Reflux Study Committee, grade I, 10 cases; grade II, 11 cases; grade III, 20 cases; grade IV, 17 cases; grade V, 9 cases. 2) The most common causative agent in UTI was E. coli. Fourty-six cases underwent ultrasonography and 24 showed abnormal findings. Fourty-four cases underwent a 99mTc-DMSA renal scan, and 25 showed abnormal findings. The incidence of renal scarring showed a direct correlation with the severity of VUR. 3) The incidence of urinary tract infection during follow-up did not differ between the groups medical management versus surgical management. 4) Fourty-four refluxing ureters were treated primary medically and 38 of them were followed up. Twenty-five of the 38 ureters were disappeared or improved, and 9 persisted. The rest showed aggravation of reflux. Twenty-five of the 32 refluxing ureters showed disappearance or improvement of reflux before 5 years of age, The spontaneous cure rate of vesicoureral reflux seemed to be higher in the cases with a milder grade of reflux. 5) Although refluxing ureter disappeared completely on VCUG, we found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG. 6) Thirty-three refluxing ureters were treated surgically and one of them was stationary on follow-up VCUG, while the others were cleared. CONCLUSIONS: As a result of follow-up the 47 patients with VUR, the incidence of urinary tract infection did not differ between the groups medical versus surgical management. Rates of disappearance of VUR in medical and surgical management were 66%, 97%, respectively. The spontaneous cure rate of VUR seemed to be higher in the cases with a milder grade of reflux and before 5 years of age. We found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG.
Child ; Cicatrix ; Follow-Up Studies* ; Humans ; Incidence ; Pediatrics ; Protestantism ; Sex Distribution ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Ureter ; Urinary Tract Infections* ; Urinary Tract* ; Urology ; Vesico-Ureteral Reflux*

PURPOSE: Vesicoureteral reflux (VUR) is the major cause of urinary tract infection (UTI) in children. Prolonged untreated UTI associated with VUR may result in serious complications, such as renal scarring, renal atropy, and decreased renal function. Therefore, follow up must be continued until UTI is cured completely, to prevent of serious complication. The authors conducted this study to evaluate results of the follow-up of UTI associated with VUR. METHODS: During the period from March 1991 to July 1996, we had 47 children with urinary tract infection associated with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Presbyterian Medical Center. The patients were managed medically or surgically. RESULTS: 1) There were no differences in sex distribution in the 47 cases with VUR. The intensity of 67 refluxing ureters, classified by the International Reflux Study Committee, grade I, 10 cases; grade II, 11 cases; grade III, 20 cases; grade IV, 17 cases; grade V, 9 cases. 2) The most common causative agent in UTI was E. coli. Fourty-six cases underwent ultrasonography and 24 showed abnormal findings. Fourty-four cases underwent a 99mTc-DMSA renal scan, and 25 showed abnormal findings. The incidence of renal scarring showed a direct correlation with the severity of VUR. 3) The incidence of urinary tract infection during follow-up did not differ between the groups medical management versus surgical management. 4) Fourty-four refluxing ureters were treated primary medically and 38 of them were followed up. Twenty-five of the 38 ureters were disappeared or improved, and 9 persisted. The rest showed aggravation of reflux. Twenty-five of the 32 refluxing ureters showed disappearance or improvement of reflux before 5 years of age, The spontaneous cure rate of vesicoureral reflux seemed to be higher in the cases with a milder grade of reflux. 5) Although refluxing ureter disappeared completely on VCUG, we found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG. 6) Thirty-three refluxing ureters were treated surgically and one of them was stationary on follow-up VCUG, while the others were cleared. CONCLUSIONS: As a result of follow-up the 47 patients with VUR, the incidence of urinary tract infection did not differ between the groups medical versus surgical management. Rates of disappearance of VUR in medical and surgical management were 66%, 97%, respectively. The spontaneous cure rate of VUR seemed to be higher in the cases with a milder grade of reflux and before 5 years of age. We found that follow-up is continued until the disappearance of reflux is confirmed on two serial VCUG.
Child ; Cicatrix ; Follow-Up Studies* ; Humans ; Incidence ; Pediatrics ; Protestantism ; Sex Distribution ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Ureter ; Urinary Tract Infections* ; Urinary Tract* ; Urology ; Vesico-Ureteral Reflux*

The authors analyzed 28 cases with hypertensive cerebellar hemorrhage, diagnosed by computerized tomography(CT), between 1987 and 1990, in Chonbuk National University Hospital. The authors assessed the relationship of outcome to the CT appearance of the quadrigeminal cistern, which in some cases was obliterated by rostral displacement of the vermis resulting from the cerebellar mass. Obliteration of the quadrigeminal cisterns was classified on the CT scans into three grades:Normal(Grade I), Compressed(Grade II), or Absent(Grade III). There were 7 cases with Grade I, 9 with Grade II, and 12 with Grade II cisterns. Of the 28 cases, 6(85%) of those with Grade I, 7(78%) of those with Grade II, and none of those with Grade III cisterns respectively returned to their previous activities at 6 months or more after onset. A Grade I cisterns predicted a good outcome whether the hematoma was evacuated or not, as long as obstructive hydrocephalus, if present, was relieved early. However, a Grade II cistern was not predictive of a good outcome unless the hematoma was evacuated within 48 hours after onset of the hemorrhage. A Grade III cisterns predicted an unfavorable outcome. Taken together, these results strongly suggest that the CT grade of quadrigeminal cistern obliteration may be an indicator of outcome and may be useful in selecting treatment for patients with cerebellar hemorrhage.
Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Jeollabuk-do ; Tomography, X-Ray Computed

The authors analyzed 28 cases with hypertensive cerebellar hemorrhage, diagnosed by computerized tomography(CT), between 1987 and 1990, in Chonbuk National University Hospital. The authors assessed the relationship of outcome to the CT appearance of the quadrigeminal cistern, which in some cases was obliterated by rostral displacement of the vermis resulting from the cerebellar mass. Obliteration of the quadrigeminal cisterns was classified on the CT scans into three grades:Normal(Grade I), Compressed(Grade II), or Absent(Grade III). There were 7 cases with Grade I, 9 with Grade II, and 12 with Grade II cisterns. Of the 28 cases, 6(85%) of those with Grade I, 7(78%) of those with Grade II, and none of those with Grade III cisterns respectively returned to their previous activities at 6 months or more after onset. A Grade I cisterns predicted a good outcome whether the hematoma was evacuated or not, as long as obstructive hydrocephalus, if present, was relieved early. However, a Grade II cistern was not predictive of a good outcome unless the hematoma was evacuated within 48 hours after onset of the hemorrhage. A Grade III cisterns predicted an unfavorable outcome. Taken together, these results strongly suggest that the CT grade of quadrigeminal cistern obliteration may be an indicator of outcome and may be useful in selecting treatment for patients with cerebellar hemorrhage.
Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Jeollabuk-do ; Tomography, X-Ray Computed

Isolated and severe left main coronary ostial stenosis is a rare case. In the majority of these patients ostial stenosis was associated with any of the conditions known to involve the coronary ostia. These conditions include syphilitic aortitis, Takayasu's aortitis, familial hypercholesterolemia, and aortic valve disease. A 34-year young female patient was presented with exertional and stabbing anterior chest pain. There was no history of syphilis, diabetes mellitus, hypertension, hyperlipidemia and smoking. Coronary angiogram showed isolated left main coronary ostial stenosis. Transesophageal echocardiography(TEE) showed acute angle takeoff of the left main coronary artery. She underwent surgical angioplasty of coronary ostia with a patch of autologous pericardium. After angioplasty, TEE showed dilatation of left main coronary ostium and her clinical symptom improved.
Angioplasty ; Aortic Valve ; Aortitis ; Chest Pain ; Constriction, Pathologic* ; Coronary Vessels ; Diabetes Mellitus ; Dilatation ; Female ; Humans ; Hyperlipidemias ; Hyperlipoproteinemia Type II ; Hypertension ; Pericardium ; Smoke ; Smoking ; Syphilis ; Syphilis, Cardiovascular

PURPOSE: To compare histopathological and apoptotic changes of ophthalmoscopically similar subthreshold laser burns made by a low power-long duration (LD) and a high power-short duration (SD) subthreshold laser treatment. METHODS: Ophthalmoscopically invisible subthreshold laser burns with a 3.0 mm spot size were made using an 810 nm diode laser on the rabbit retina. Lasers were applied for 60 seconds in the LD group, and 1 second in the SD group. Laser power was adjusted to achieve ophthalmoscopically invisible burns just below the threshold. The rabbits were sacrificed at 6, 12, 24, and 72 hours, 1, 2, and 4 weeks after laser treatment. The eyes were processed for light microscopic examination using hematoxylin and eosin (H&E), toluidine blue, and TdT-dUTP terminal nick-end labeling (TUNEL) staining. Eyes were also processed for electron microscopic examination. RESULTS: The changes in the retina were different between the two groups. The LD group showed abundant TUNEL positive cells in all the retinal layers at 6 hours after laser treatment, and distinct histological changes in the outer nuclear layer. Conversely, in the SD group, apoptosis did not occur and histological alteration in the outer nuclear layer was minimal. CONCLUSIONS: Subthreshold laser treatment for 1 second reduced damage of the inner retinal layer and did not result in apoptosis in the neurosensory retina while maintaining a similar effect on the RPE and its adjacent region.
Apoptosis ; Burns ; Electrons ; Eosine Yellowish-(YS) ; Eye ; Hematoxylin ; In Situ Nick-End Labeling ; Lasers, Semiconductor ; Light ; Macular Degeneration ; Rabbits ; Retina ; Retinaldehyde ; Tolonium Chloride

PURPOSE: To analyze localized RNFL defect cases that were identified in retinal nerve fiber layer (RNFL) fundus photographs but not in optical coherence tomography (OCT). METHODS: Analysis of OCT scans and images was performed for 14 eyes (17 locations) that showed localized RNFL defects in RNFL fundus photographs but not in RNFL thickness average analysis. RESULTS: With respect to the range of RNFL defects, 41.2% were less than 10degrees, 47.0% were 11 to 20degrees, and 11.8% were 21 to 30degrees. In 71.4% of the RNFL cases the defects were less than 10degrees and the decrease of RNFL thickness was not readily observable on the OCT scan images. In all cases of RNFL defects in the 11 to 30degrees range the decrease in RNFL thickness could be assessed on the OCT scan images. Nonetheless, the decrease of RNFL thickness could not be seen on the OCT analysis images in which the results of the RNFL thickness made through an automated computer algorithm were displayed. CONCLUSIONS: The range of localized RNFL defects that were difficult to detect with OCT consisted of those cases that were almost less than 20degrees. The limitations of the OCT scan itself in patients with RNFL with an angular width defect less than 10degrees and the problems of RNFL thickness analysis processing in patients with an angular width of 11 to 30degrees may decrease the sensitivity of OCT in diagnosing RNFL defects.
Eye ; Humans ; Nerve Fibers ; Retinaldehyde ; Tomography, Optical Coherence

The purpose of this study was to analyze the relationship of nutritional status measured by the body composition and dietary nutrients intakes with calcaneal broadband ultrasound attenuation in college students. Total of 886 (462 male and 424 female) students who received health examination in May 2007 participated in this research.Participants bone status was measured by a quantitative ultrasound method and t-score was calculated via WHO guideline. For body composition measurements, body fat, height and weight were measured and BMI was calculated. Dietary data were collected by a 24-hour recall method. Based on Asia-Pacific standard of WHO, BMI was divided into 3 groups; UW (BMI<18.5), NW + OW (18.5< or =BMI<25) and Obese group (25< or =BMI). Among male students, 2.4% belong to the UW group, 45.0% to the NW+OW group and 52.6% belong to the obese group, while 10.4% of female students belong to the UW group, 71.9% to the NW + OW group and 17.7% of female students belong to the Obese group. Differences among male and female students were statistically significant (p<0.001). Students with higher BMI showed significantly higher bone health status. Male students did not show any significant differences in nutrients intakes by BMI groups while female students showed the higher intakes of energy, protein, pyridoxin, phosphorus, iron and zinc among NW + OW group than other groups (p < 0.05). The qualitative and quantitative evaluation of diet by BMI groups did not show any significant differences in both male and female students. The result of the multiple regression analyses showed that the body fat and bone status was negatively related while energy intake was positively related with the bone status. These results revealed that bone health status was positively affected by BMI but not by body fat. In conclusion, among those who are at their twenties, the period when the bone density becomes maximized, body fat may negatively affect bone health unlike during other life cycle stages.
Adipose Tissue ; Body Composition ; Bone Density ; Diet ; Energy Intake ; Evaluation Studies as Topic ; Female ; Humans ; Iron ; Life Cycle Stages ; Male ; Nutritional Status ; Phosphorus ; Pyridoxine ; Zinc