BACKGROUND: Testicular rupture is a surgical emergency which command immediate repair. If surgery is delayed, a hematoma causes severe pain and loss of spermatogenesis as well as hormonal functions. Scrotal ultrasonography has been helpful in early diagnosis of testicular rupture. But disadvantage of ultrasonography include a relatively low signal-to-noise level, tissue nonspecificity, lack of contrast media, a small field of view, and dependence on the operators skill and the patients physique. Also the diagnostic accuracy, sensitivity or specificity of scrotal ultrasonography was variable in regard to authors. And so, a diagnostic accuracy of scrotal ultrasonography was evaluated in scrotal trauma. METHODS: We reviewed 38 patients of scrotal trauma from May, 1994 to March, 1998. 6 patients were treated conservatively following scrotal sonography and 10 patients treated only surgical exploration without ultrasonography. Surgical exploration was performed in 22 case, which were evaluated by ultrasound before surgical treatment. In a such 22 cases, diagnostic accuracy of scrotal ultrasonography was evaluated. RESULTS: We compared ultrasound before treatment with surgical exploration finding in a such 22 cases. The ultrasonographic features in 7(31.8%) out of 22 cases, which showed testicular ruptured, but surgical exploration revealed testicular rupture in 5 and epididymal rupture in 1, simple hematocele in 1. In 15(68.2%) out of 22 cases the simple hematocele was diagnosed by ultrasonography, but surgical finding feature in of the 7 cases revealed testicular rupture, epididymal rupture in 1, simple hematocele in 7. The sensitivity and specificity for the ultrasonography are 42.9% and 87.5%, and the positive and negative predictive values are 86.5% and 46.7%, respectively. Ultrasonography is low sensitive in identifying testicular rupture. CONCLUSION: Ultrasonography include a relatively low signal-to-noise level, tissue nonspecificity, lack of contrast media, a small field of view, and dependence on the operators skill and the patients physique. Therefore, early surgical exploration for saving the testis should be performed that sonographically by seeing hypoehoic peripheral lesions and disappearance of normal ovoid form of testis, hematocele in scrotal sac.
Contrast Media ; Early Diagnosis ; Emergencies ; Hematocele ; Hematoma ; Humans ; Male ; Rupture ; Sensitivity and Specificity ; Spermatogenesis ; Testis ; Ultrasonography*

No abstract available.
Anesthesia, General* ; Humans ; Infant, Low Birth Weight* ; Infant, Newborn ; Pulmonary Atelectasis*

No abstract available.
Child* ; Humans ; Scrub Typhus*

Neonatal sepsis is a major contributing factor for increased mortality and morbidity in the newbron and its successful outcome depends on early detection and prompt institution of an effective antimic robial therapy. Accurate diagnosis of the neonatal septicemia, however, is quite difficult because its early signs and symptoms are rather subtle. This study was conducted in an attempt to search for useful early markers for the clinical entity A total of 224 newborns, over a 17 month pcriod (1/90 5/91), who were evaluated for probable neonatal sepsis were analysed. The laboratory parameters that showed highest correlation with bacteriologically proves sopsis were as follows: Total WBC counts (<5,000/mm), Band/Total ncutrophils(>0.2), elevated ESR(>15mm/hr), CRP(>6ng/ml). Of the 224 study subjects, 41 had two or more parameters of which 12 subjects had positive blood cultures(positive predictive value:29%), only 4 of the 183 newborns who had less than 2 parameters had positive blood cultures(false negative:2%). It is concluded that the presence of two or more of the above parameters can be used as a strong indicator for neonatal sepsis and its sensitivity is 75% while specificity is 86%.
Diagnosis ; Early Diagnosis* ; Humans ; Infant, Newborn ; Mortality ; Sensitivity and Specificity ; Sepsis*

Generalized pustular psoriasis is the most servere form of psoriasis. This disorder is characterized by pustular skin lesions general symptoms such as high fever, weakness and peripheral blood leukocytosis. We have experienced a case of generalized pustular psoriasis after suffering from chickenpox which was diagnosed by clinical symptoms and pathologic features from a skin biopsy. This 4-year-old male patient was managed by local and oral corticosteroid therapy with excellent outcome. A brief review of the related literature is also included.
Biopsy ; Chickenpox* ; Child, Preschool ; Fever ; Humans ; Leukocytosis ; Male ; Psoriasis* ; Skin

PURPOSE: Acute scrotum is a clinical syndrome that is defined as an acute painful swelling of the scrotum. It is well known that early surgical exploration is needed to prevent the testicular loss when testicu lar torsion breakouts. But most of reports were only focused on testicular torsion of prepubertal age group. This fact let us examine the acute scrotum with all age group and the significance of surgical exploration. MATERIALS AND METHODS: We retrospectively reviewed the results collected from 112 patients (131 cases) with acute scrotum who had been admitted to our hospital between June 1994 and November 1999 with the exception of scrotal trauma. RESULTS: The incidence of acute scrotum over 20 years old was 72.4% of total acute scrotum patients. The most common disease was acute epididymitis giving the rate of 71.8% (94 cases). In adult the incidence of testicular torsion was low (3 cases). Surgical torsion was 12 cases and acute epididymitis was 12 cases as the cause of acute scrotum. CONCLUSIONS: Most cases of testicular torsion have been below 20 years old and only 3 cases have been over 20 years old. Although the incidence of testicular torsion over 20 years old has been low. There were severe infectious diseases needing surgical approach in the cases of aged patient. this research shows that the treatment of acute scrotum goes with the need of surgical therapy.
Acute Pain ; Adult ; Communicable Diseases ; Epididymitis ; Humans ; Incidence ; Linear Energy Transfer ; Male ; Retrospective Studies ; Scrotum* ; Spermatic Cord Torsion ; Young Adult

No abstract available.
Histiocytic Necrotizing Lymphadenitis* ; Lymphohistiocytosis, Hemophagocytic*

No abstract available.
Acrodermatitis*

Purpose: This study examined the effects of nutritional education related to sugar in elementary school children on nutritional knowledge, attitude, and dietary behavior. Methods: A questionnaire survey on the knowledge, attitudes, and intake related to sugar was conducted on 572 students in grades 4–5, who were attending five elementary schools in Seoul and Gyeonggi-do. Results: Among the survey subjects, 270 (49.8%) were cognitive in education, and 302 (50.2%) were non-cognitive. The sugar-related knowledge score was 3.67 points in the cognitive education group, which was significantly higher than the 3.55 points in the non-cognitive group. The rate of checking the sugar content in the nutrition label was 31.2% in the cognitive education group, which was significantly higher than in the non-cognitive group, 15.4%. The cognitive education group had a higher intake frequency of unsweetened candy, jelly, and raw fruits, and higher sugar intake of unsweetened bread, white milk, and raw fruits than the non-cognitive group. In the case of the cognitive education group, the total knowledge score showed a positive correlation with the food behavior scores, and a negative correlation with the frequency of purchasing snacks after school, and the average sugar intake per day. In the cognitive education group only, the education of nutrition teachers was analyzed as a factor to reduce the total sugar intake. The cognitive group of sugar education tried to eat foods with a lower sugar content than the non-cognitive group, and nutrition education was an important factor affecting the sugar intake. Conclusion To reduce the sugar intake of elementary school students, it will be necessary to practice oriented-nutrition education by nutrition teachers continuously. In addition, it is important to develop and disseminate various types of nutrition education materials related to sugar that can be utilized easily by nutrition teachers.

BACKGROUND: Oropharyngeal manipulation is problematic when patients have a gag reflex. Sedation can suppress gag reflex, but can cause serious airway problems. We compared remifentanil (Group R) and propofol (Group P) in terms of cooperation and loss of gag reflex, while drugs were administered incrementally using target controlled infusion (TCI). METHODS: Fifty seven patients who required awake fiberoptic intubation were randomized to Group R or Group P. After measurement of baseline gag trigger point index (GTPI), TCI was set to effect-site concentration (Ce) of 1 ng/ml (Group R) or 1 microg/ml (Group P), then titrated by 0.5 increment until GTPI score reached 0. The incidence of drop-out and decreased cooperation, Ramsay sedation scale (RSS) and Ce at loss of GR, and complications were assessed. RESULTS: Seven patients were dropped out in Group P due to deep sedation and disobedient behavior, but none in Group R (P = 0.015). Gag reflex suppressed as RSS increased in both groups (P < 0.001), however, the incidence of elimination of gag reflex clustered at RSS 2 in Group R (P < 0.001), whereas it was evenly distributed in Group P (P = 0.20). The incidence of patients who were spontaneously roused (gag reflex elimination at RSS 1 and 2) were higher in Group R than in Group P (P = 0.002). CONCLUSIONS: Deep sedation and impaired cooperation were observed only in Group P and spontaneously roused patients were higher in Group R, suggesting that remifentanil is more suitable for cooperative elimination of GR.
Conscious Sedation ; Deep Sedation ; Humans ; Incidence ; Intubation ; Piperidines ; Propofol ; Reflex ; Trigger Points