No abstract available.
Cafe-au-Lait Spots ; Nevus*

Pseudohypoaldosteronism type 1 is a genetic renal tubular disease of salt wasting, presenting in young infants. Tubular unresponsiveness to elevated endogenous and exogenous aldosterone is the suggested pathogenetic mechanism. Oral sodium chloride supplementation relieve the clinical symptoms and electrolyte distrubances. We experienced 2 cases of PHA type 1 in 38-day and 45-day old male infants who were presented with failure to thrive, vomiting and/or dehydration. Laboratory data showed hyponatremia, hyperkalemia, hypochloremia and metabolic acidosis. Renal and adrenal functions were normal. Plasma renin activity and plasma aldosterone concentration were markedly elevated. Under the diagnosis of pseudohypoaldosteronism type 1, oral supplementation of NaCl and/or kayexalate improved the clinical states of the patients.
Acidosis ; Aldosterone ; Dehydration ; Diagnosis ; Failure to Thrive ; Humans ; Hyperkalemia ; Hyponatremia ; Infant ; Male ; Plasma ; Pseudohypoaldosteronism* ; Renin ; Sodium Chloride ; Vomiting

PURPOSE: The purpose of this study is to investigate clinical features and causative organisms in febrile infants younger than three months, to help identification of high risk patients for serious bacterial infection (SBI). METHODS: A total of 313 febrile infants younger than three months, who had visited Seoul National University Children's Hospital from January 2008 to December 2010 were included. Clinical features, laboratory findings, causative organisms, and risk factors of SBI were analyzed by retrospective chart review. Causative bacterial or viral pathogens were identified by gram stain and cultures, rapid antigen tests, or the polymerase chain reaction from clinically reliable sources. RESULTS: Among 313 infants, etiologic organisms were identified in 127 cases (40.6%). Among 39 cases of bacterial infections, Escherichia coli (66.7%) and Streptococcus agalactiae (12.8%) were common. Enterovirus (33.7%), respiratory syncytial virus (19.8%), and rhinovirus (18.8%) were frequently detected in 88 cases of viral infection. Patients with SBI (39 cases) showed significantly higher values of the white blood cell count (14,473+/-6,824/mm3 vs. 11,254+/-5,775/mm3, P=0.002) and the C-reactive protein (6.32+/-8.51 mg/L vs. 1.28+/-2.35 mg/L, P<0.001) than those without SBI (274 cases). The clinical risk factors for SBI were the male (OR 3.7, 95% CI 1.5-8.9), the presence of neurologic symptoms (OR 4.8, 95% CI 1.4-16.8), and the absence of family members with respiratory symptoms (OR 3.6, 95% CI 1.2-11.3). CONCLUSION: This study identified common pathogens and risk factors for SBI in febrile infants younger than three months. These findings may be useful to guide management of febrile young infants.
Bacterial Infections ; C-Reactive Protein ; Enterovirus ; Escherichia coli ; Fever ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Male ; Neurologic Manifestations ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Rhinovirus ; Risk Factors ; Sepsis ; Streptococcus agalactiae

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OBJECTIVE: Currently, there are no established dietary guidelines for patients with swallowing difficulties in Korea. Therefore, this study was conducted to develop an organized set of dietary guidelines listing simple yet diverse ingredients that are safe for consumption and have high nutritional quality. METHOD: Ninety patients with swallowing and masticatory dysfunction admitted in hospitals A and B were enrolled in this study. The initial study phase encompassed a 6-month period at each site from May 2016 to June 2017. The patients fed according to the dietary guidelines developed in this study were observed. The before- and after-care variances were observed by measuring the patients' weight, and TLC as well as the levels of serum albumin and food intake. This observation was based on the classification of swallowing difficulty and masticatory dysfunction into four scales. RESULT: The before- and after-care weight measurements of the study patients revealed a shift from 48.60±10.17 to 49.32±10.23 kg, and a change in the BMI from 20.04±3.91 to 20.33±3.93. The variances were deemed statistically significant, indicating that the nutrition index of the administered diet was adequate. An analysis of the types of food intake of side dishes and snacks before- and after- dietary administration per study revealed 3.58±1.01 to 4.19±0.83 and 2.77±0.98 to 3.49±1.21, respectively. CONCLUSION: The food intake level and the weight and BMI of patients in both hospitals increased during the 1-year study period. Furthermore, increasing the dietary level from the third to the fourth tier on an institutional basis enabled a systematic configuration of dietary formulations for each stage of this disorder.
Classification ; Deglutition ; Deglutition Disorders ; Dementia ; Diet ; Eating ; Food, Formulated ; Humans ; Korea ; Methods ; Nutrition Assessment ; Nutrition Policy ; Nutritive Value ; Serum Albumin ; Snacks ; Weights and Measures

Fisting is an uncommon sexual activity, and death due to fisting is very rare. In the present report, we describe a case of a woman who died from fisting by her male partner. A 38-year-old woman went to a motel with a man after consuming alcohol, and there they kissed each other. As desired by woman, the man inserted his fingers into her vagina and anus, and later inserted his fist and forearm into her vagina and anus. After 20-30 minutes of fisting, the woman became unconscious and died. The autopsy confirmed the presence of perineal and vaginal lacerations with massive internal pelvic soft tissue injury with uterine artery rupture. A partial tear was noted at the rectosigmoid junction. The cause of death was hypovolemic shock due to uterine artery rupture. Following court trials, the assailant was sentenced to 4 years of imprisonment for the felony of inflicting bodily injury resulting in death.
Anal Canal ; Autopsy ; Cause of Death ; Female ; Fingers ; Forearm ; Humans ; Lacerations ; Male ; Rupture ; Sexual Behavior ; Shock ; Soft Tissue Injuries ; Unconscious (Psychology) ; Uterine Artery ; Vagina

The author investigated serum immunoglobulin (IgG, IgA, and IgM) and complements (C3) of cord blood in 74 cases of normal fullterm infants and 50 cases of premature infants. Serum immunogloblin and complement levels were measured by the single radial immunodiffusion method. The following results were obtained; 1) The mean seru IgG levels of cord blood in 74 cases of the normal full term infants was 1407.3+/-230.5mg/dl. 2) The mean serum IgG levels of cord blood in 50 cases of the premature infants was 675.2+/-329.4mg/dl. In comparison of serum IgG levels between the premature infants and the normal full term infants, serum IgG levels in the premature infants was significantly lower than that level of the normal infants (P< 0.05). 3) The serum IgA levels were measured in 28 (37.8%) of 74 cases of the normal full term infants and in 6 912%) of 50 cases of the premature infants. The serum IgA levels measured ranged from 0.4mg/dl to 3.7mg/dl in the normal full term infants and ranged from 0.4mg/dl to 2.4mg/dl in the prematre infants. 4) The mean serum IgM levels of cord blood in 74 cases of the normal full term infants was 4.05+/-3.53mg/dl and that in 50 cases of the premature infants was 2.20+/-2.15mg/dl. 5) The mean serum C3 levels of cord blood in 74 cases of normal full term infants was 49.7+/-18.1mg/dl and those of the premature infants was 30.9+/-10.5mg/dl. In comparison of serum C3 levels between the premature infants and the normal full term infants, the mean levels of serum C3 in the premature infants was significantly lower A statistically significant increase of IgG and C3 levels of cord blood in newborn infants were observed in accordance with the increase of the gestational age. It has been suggested that decreased IgG levels among premature infants may provide a rationale for prophylactic gamma globulin administration.
Complement System Proteins* ; Fetal Blood ; gamma-Globulins ; Gestational Age ; Humans ; Immunodiffusion ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Infant ; Infant, Newborn* ; Infant, Premature

Exercise induced asthma (EIA) is defined as acute, reversible, usually self-limiting airway obstruction which develop after strenous exercise in patients with asthma. EIA is a bigger problem in children than adults due to more active and smaller airways which obstruct more easily when bronchospasm develops. The exercise elicited many change in pulmonary function of asthmatic children. These change could be measured by measurements of PEFR, FEV1, FVC, or SRaw. The propose of this study is to determine the changes and sensitivity of different pulmonary function test in asthmatic children. 37 asthmatic children exercised on free running and pulmonary function tests were performed before and every 5 minutes during 15 minutes after exercise. The results were as follows. 1) In 37 asthmatic children, EIA developed in 23 children (62%) and did not developed in 14 children (38%). The difference in sex, height, weight, total eosinophil count, serum IgF and test between EIA and Non-EIA were not significant (P>0.05). 2) In EIA group, %PEFR was changed from 109.56% to 83.56%, But in Non-EIA group, %PEFR was not changed before and after exercise loading test. 3) In EIA group, %FEV1 was changed from 90.91% to 74.87%. But in Non-EIA group, %FEV1 was not changed before and after exercise loading test. 4) In EIA group, %FVC changed from 91.83% to 75.35%. But in Non-EIA group, %FVC was not change before and after exercise loading test. 5) There was significant difference in pre-exercise specific airway resistance between EIA (6.7+/-1.7) and normal children (5.8+/-2.2)(p<0.05). In EIA group, %SRaw was changed from 115.7% to 161.2%. But in Non-EIA group, %SRaw was not changed before and after exercise loading test. 6) During the post-exercise observation period, increasement of SRaw was greater than changes in any other pulmonary function test. SRaw is the most sensitive test for the ditection of exercise induced airway obstruction is asthmatic children.
Adult ; Airway Obstruction ; Airway Resistance* ; Asthma ; Asthma, Exercise-Induced ; Bronchial Spasm ; Child* ; Eosinophils ; Humans ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Running

PURPOSE: This study is to assess the quality of life(QOL) of hematic cancer survivors after hematopoietic stem cell transplantation(HSCT) and received chemotherapy(RC) to prepare basic information for nursing interventions in order to improve the patients' QOL. METHOD: The data were collected by self-reporting questionnaire from January to March, 2003 intended for outpatients at the Cancer center of D university hospital in Busan. All 44 of them were diagnosed as hematic cancer and had spent 100 days after getting HSCT and complete remission(CR) throughout RC. The collected data were analyzed with descriptive statistics, t-test. ANOVA using SPSS/WIN 10.0 program. RESULTS: The total mean score of the QOL was moderate. In case of survivors in HSCT, the total mean score of the QOL was 5.81+/-.08, and that of survivors in RC was 5.94+/-.13. The facts above has not been considered statistically as the result of analysis of differences in each domain of the QOL depending on the general characteristics of the objects of this study. CONCLUSION: The total mean score of the QOL was at moderate levels, indicating that the survivors after HSCT and RC were perceiving their QOL as moderate. In the nursing business aspect, the most important thing is to understand the QOL which the 2 groups of the survivors perceive, and the plans of nursing intervention that can be helpful to more qualitative life should be studied constantly.
Busan ; Commerce ; Drug Therapy* ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Nursing ; Outpatients ; Quality of Life* ; Surveys and Questionnaires ; Survivors*

Reye syndrome is a rapidly progressive encephalopathy with hepatic dysfunction, which often begins several days after apparent recovery from a viral illness, especially varicella or influenza A or B. Salicylate use was identified as a major precipitating factor for the development of Reye syndrome. With the recommendation to avoid use of salicylates in children, Reye syndrome has virtually disappeared in recent years. We report a case of Reye syndrome in a 5-month-old infant who had been treated with intravenous immunoglobulin and aspirin under the diagnosis of Kawasaki disease, and showed symptoms of sudden onset of irritability, rigidity, decreased activity, vomiting, poor appetite, lethargy, liver dysfunction without jaundice, coagulopathy, and hyperammonemia.
Appetite ; Aspirin ; Chickenpox ; Child ; Humans ; Hyperammonemia ; Immunoglobulins ; Infant ; Influenza, Human ; Jaundice ; Lethargy ; Liver Diseases ; Mucocutaneous Lymph Node Syndrome ; Precipitating Factors ; Reye Syndrome ; Salicylates ; Vomiting