BACKGROUND: Intussuseception is one of the most common diseases requiring abdominal emergency care in early childhood. The delay in diagnosis increases morbidity and, in particular, reduces the success rate of the non-surgical method of reduction. In this report, the authors determined the clinical characteristics of pediatric patients with intussusception, and the factors involved in delayed diagnosis and the efficacy of doppler ultrasonography in diagnosis. METHODS: The authors performed a retrospective study of 44 cases in 42 patients with intussusception who had visited the emergency room of SamSung medical center from January 1st to December 31, 1996. RESULTS: The sex ratio was equal and 64.3% of the patients were under 1 year of age. The prevalent complaints were vomiting(36.4%) and abdominal pain(33.8%). Ultrasonography was used in 11 cases, 3 of them were performed because of obscure symptoms and the rest were due to diagnostic delay. The average time past from visit to diagnosis was 4 hours and 20 minutes, and there were 4 diagnostic delays. Air enema reductions were unsucessful in 11 cases(25%) and that was related to hospital-visit delays and long time past from symptom onset to diagnosis. There were no motalities. CONCLUSION: To reduce delays in diagnosis and unnecessary operations, the use of doppler ultrasonography is recommanded in suspicious cases. And to reduce the hospital-visit delays, related to the failure on non-surgical reduction, the education about this disease is necessary.
Delayed Diagnosis ; Diagnosis ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Enema ; Humans ; Intussusception* ; Retrospective Studies ; Sex Ratio ; Ultrasonography ; Ultrasonography, Doppler

No abstract available.
Lipoma* ; Mesocolon*

No abstract available.
Pancreas*

OBJECTIVES: This study was to investigate the fertilization rate after intracytoplasmic sperm injection (ICSI) or partial zona dissection (PZD) of human and hamster sperm into hamster oocyte in in vitro fertilization (IVF). In addition, the possibility of clinical application was evaluated by the comparison of usefulness and difference of these method. MATERIALS AND METHODS: Hamster immature oocytes were obtained from oviducts superovulated by PMSG and hCG, and hamster sperms were obtained from epididymis. The freezed human sperms were thawed before use. Fertilization were confirmed by two pronuclei, one pronucleus, swollen sperm head or/and two polar bodies at 7~8 hour after ICSI or PZD. RESULTS: The fertilization rates after ICSI and PZD of human sperm to hamster oocyte were 3.6%, 64.2%, 73.6%, and 55.6% for negative control, positive control, ICSI, and PZD respectively, suggesting that ICSI only showed improved fertilization rate (p<0.01). The fertilization rates after ICSI and PZD of hamster sperm to hamster oocyte were 11.1%, 51.2%, 39.6%, and 72.7% for negative control, positive control, ICSI, and PZD respectively, suggesting that PZD only showed improved fertilization rate (p<0.01). PZD showed significantly higher fertilization rate than ICSI (p<0.05). CONCLUSIONS: As for the fertilization rate by ICSI and PZD using hamster oocyte in IVF, ICSI technique was considered to be more useful for human sperm and PZD technique for hamster sperm. Therefore, ICSI technique was considered more appropriate for experimental application using human sperm and hamster oocyte.
Humans

OBJECTIVES: This study was carried out to evaluate the effects of embryonic stage, cryoprotectant, and freezing-thawing method on the rates of survival and development of the cryopreserved mouse early embryo and finally to establish the cryopreservation method of surplus embryos obtained during assisted reproductive technology (ART). MATERIALS AND METHODS: Two to eight cell embryos were obtained from oviducts of mated F1 hybrid female mice superovulated by pregnant mare's serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG). Two-step 1,2-propanediol (PROH), dimethylsulfoxide (DMSO) and 4-step PROH, DMSO were used as cryoprotectant and dehydration and rehydration method of embryos, and slow- cooling or rapid-cooling method was used as frozen program. The survival rates of embryos were measured after thawing and rehydration, and the developmental rates of embryos were compared and observed during culturing embryos for 24, 48, 72, 96 hrs. RESULTS: As for the survival and development rates of embryos according to embryonic stage, the survival rate of 2 cell stage in PROH and DMSO was significantly higher than 4-8 cell (64.5% versus 62.1%, 79.7% versus 73.2%) (p<0.01, p<0.01), but the development rates of 4-8 cell embryos in PROH and DMSO were significantly higher than 2 cell embryos for whole culture period (p<0.01) and the development rates of 4-8 cell embryos in PROH were significantly higher than 2 cell embryos in DMSO (p<0.01). As for the survival and development rates of embryos according to cryoprotectant, the survival rate of 2 cell embryo in DMSO was significantly higher than that in PROH (74.4% versus 64.5%) (p<0.01), whereas the development rate of embryos was not differ till 24 hrs. The development rate from morular to hatching blastocyst, however, was significantly higher in PROH than in DMSO during 48 hr (p<0.01). The survival rate of 4-8 cell embryo was 62.1% in PROH and 73.2% in DMSO. The development rates of embryo in PROH were significantly higher for whole culture periods (p<0.01, 0.05). In respect to the effect of freezing and thawing program on the survival and development rates of embryos, method of slow cooling and rapid thawing was more effective than that of rapid cooling and rapid thawing. CONCLUSIONS: The survival rate of embryo in 2 cell stage was higher than in 4-8 cell stage, and PROH appears more effective cryoprotectant than DMSO because PROH showed better development rates of embryos in 2 and 4-8 cell stage. Moreover, slow cooling and rapid thawing method was considered as the best cryopreservation program.
Pregnancy ; Female ; Humans ; Mice ; Animals

The authors determined the value of performing urine microscopy on biochemically negative urine sepcimens in a pediatric population. The 746 urine specimens of patients who were either visited or admitted to the Department of Pediatrics, National Police Hospital, from March 1991 to July 1992 were reviewed on the basis of comparative evaluation of biochemical and microscopic urine analysis. Eight reactions of Clinitek(r) 200 were used as biochemical indicators, namely, pH, nitrite, albumin, glucose, ketone, urobilinogen, bilirubin, and blood. Out of 746 urine specimens studied, 186 were true positive. Thirty-six specimens reacted biochemically in the absence of positive microscopic findings (false postive), 492 specimens were true negatives. Thirty-two specimens had negative biochemical indicators, in spite of positive microscopy. The sensitivity of the biochemical parameters for predicting significant microscopy of urinary sediment is 85% and the specificity is 99%. The positive predictive value is 69.7% and the negative predictive value is 99.3%. The sensitivity of blood for RBC is 94%. and the specificity is 99%. The predictive value of a positive result is 84.6% and that of a negative result is 99.7%. We therefore conclude that urine microscopy is less necessary in biochemically negative urine specimens from asymptomatic pediatric patients, with hopefully resultant time and cost effectiveness.
Bilirubin ; Cost-Benefit Analysis ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Microscopy ; Pediatrics ; Police ; Sensitivity and Specificity ; Urinalysis* ; Urobilinogen

No abstract available.
Diabetic Ketoacidosis* ; Drug Therapy* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Remission Induction*

The efficacy of acetaminophen, sponging plus acetaminophen, and sponging alone as method of lowering body temperature was compared in 108 children aged 8 weeks to 5 years who presented with an axillary temperature of 38.5degrees C or greater during the period from January 1993 to April 1993. The following results were obtained. 1) The male to female ratio was 2.5:1 and clinical diagnosis in the order of frequency were upper respiratory infection, gastroenteritis, pneumonia, urinary tract infection, cellulitis, chickenpox and hand-foot-mouth disease. 2) At thirty minutes after treatment, there was no significant difference on the decrement of temperature among the three groups. 3) At sixty minutes, the temperature decrement was the greatest in the group of sponging plus acetaminophen and that was statistically significant (P<0.01). But there was no significant difference between the group of acetaminophen and that of sponging.
Acetaminophen ; Body Temperature ; Cellulitis ; Chickenpox ; Child* ; Diagnosis ; Female ; Fever* ; Gastroenteritis ; Humans ; Male ; Pneumonia ; Urinary Tract Infections

Heat stroke, a medical emergency, occurs when the body's thermal regulation is upset and unable to dissipate adequate amounts of heat with a rise in body temperature. It is characterized by hyperyrexia, with a core temperature of 40degrees C or more, hot dry skin, and central nervous system disturbance and usually results in rhabdomyolysis and multiorgan failure. Our case, a 43-year-old healthy male, was caused by a marathon, half course, on a sunny day in late summer. He suddenly fell down on the road and was delivered to a nearby hospital, where a seizure developed. He was transfered to our hospital and then displayed Central Nervous System disturbance, hot dry skin, acute liver failure, rhabdomyolysis, anuric acute renal failure, and disseminated intravasculular coagulopathy. He was treated with general supportive care and hemofiltration. Despite the aggressive management, he died of shock on the fifth day after admission.
Acute Kidney Injury ; Adult ; Body Temperature ; Central Nervous System ; Emergencies ; Heat Stroke* ; Hemofiltration ; Hot Temperature* ; Humans ; Liver Failure, Acute ; Male ; Rhabdomyolysis ; Seizures ; Shock ; Skin

Epidermoid cysts occur rarely on the palms and soles, where hair is not present. These cysts have long been assumed to arise from traumatic implantation of epidermal fragment, but the pathogenesis is still controversial. Recently, with microscopic findings, immunohistochemical features, and molecular studies, the epidermoid cysts of the sole may be induced by the human papillomavirus. We report two cases of epidermoid cysts of the sole with the discussion of the pathogenesis.
Epidermal Cyst* ; Hair ; Humans*