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

PURPOSE: The purpose of this study is to evaluate and compare the shear bond strength of the gingiva-colored composite resin and the tooth-colored composite resin to porcelain, metal and zirconia. MATERIALS AND METHODS: Sixty cylindrical specimens were fabricated and divided into the following 6 groups (Group 1-W: tooth-colored composite bonded to porcelain, Group 1-P: gingiva-colored composite bonded to porcelain, Group 2-W: tooth-colored composite bonded to base metal, Group 2-P: gingiva-colored composite bonded to base metal, Group 3-W: toothcolored composite bonded to zirconia, Group 3-P: gingiva-colored composite bonded to zirconia). The shear bond strength was measured with a universal testing machine after thermocycling and the failure mode was noted. All data were analyzed using the two-way analysis of variance test and the Bonferroni post-hoc test at a significance level of 0.05. RESULTS: The mean shear bond strength values in MPa were 12.39, 13.42, 8.78, 7.98, 4.64 and 3.74 for Group 1-W, 1-P, 2-W, 2-P, 3-W and 3-P, respectively. The difference between the two kinds of composite resin was not significant. The shear bond strength of Group 1 was the highest and that of Group 3 was the lowest. The differences among Group 1, 2 and 3 were all significant (P<.05). CONCLUSION: The shear bond strength of the gingiva-colored composite was not less than that of the tooth-colored composite. Thus, repairing or fabricating ceramic restorations using the gingiva-colored composite resin can be regarded as a practical method. Especially, the prognosis would be fine when applied on porcelain surfaces.
Ceramics ; Collodion ; Dental Porcelain ; Prognosis ; Zirconium

OBJECTIVE: The ovarian cycle is characterized by repeating patterns of cellular proliferation and differentiation that accompany follicular development and the formation and regression of the corpus luteum (CL). That angiogenesis may play an important role in this process. Angiogenesis is supposed to be regulated by vascular endothelial growth factor (VEGF). The goal of the present investigation, therefore, was to determine whether the expression of VEGF was changed in the normally cycling human ovary. We also investigated VEGF expression in the regressed CL (ie, nonfunctiong CL) of normal term pregnancy to define the association with steroidogenic activity. To our knowledge there is no report available on VEGF expression in the CL of term pregnancy. METHODS: We assessed VEGF expression in ovaries obtained from, 26-42 yr of age, and from patients undergoing hysterectomy and salpingo-oophorectomy for nonendocrinological or nonovarian disorders. Tissue samples from premenopausal women included specimens from follicular (n=4) and luteal (n 4) phases. In addition, we studied ovarian specimens from pregnant women (n=3). Immunohistochemical analysis for VEGF was performed using a rabbit polyclonal antibody directed against human VEGF. RESULTS: These data demonstrate a development-related VEGF expression in the follicle and indirectly show that VEGF expression may be up to the existence of LH-receptor. And also, VEGF was overexpressed in the regressed CL of pregnant women compared with the functioning CL of nonpregnant cycles CONCLUSION: This study suggests that the intensity of VEGF expression is not correlated with steroidogenic activity, although both of them are stimulated by LH.
Cell Proliferation ; Corpus Luteum ; Female ; Humans* ; Hysterectomy ; Menstrual Cycle ; Ovarian Follicle ; Ovary* ; Pregnancy ; Pregnant Women ; Vascular Endothelial Growth Factor A*

PURPOSE: To report a case of bilateral acute myopia and angle-closure with ciliochoroidal detachment in Vogt-Koyanagi-Harada (VKH) syndrome. CASE SUMMARY: A 43-year-old Korean woman diagnosed with VKH syndrome underwent intravenous methylprednisolone steroid pulse treatment. After oral medication was given for 2 days, the anterior chambers became shallow in both eyes. Intraocular pressure (IOP) increased to 25 mm Hg in the right eye and 23 mm Hg in the left eye. Subretinal fluid increased and visual acuity decreased with myopic shift in both eyes. IOP did not decrease despite maximum tolerated medical therapy. Ultrasound biomicroscopy (UBM) revealed that ciliochoroidal effusion caused forward displacement of the lens-iris diaphragm, which resulted in anterior chamber shallowing and angle closure in both eyes. The patient was treated with cycloplegic eyedrops and intravenous steroid pulse therapy. After intravenous steroid pulse treatment was given for 2 days, the anterior chambers became deep in both eyes. IOP reduced to 13 mm Hg and 14 mm Hg in the right and left eye respectively. Visual acuity increased with normalization of myopic shift. UBM revealed that the ciliochoroidal effusion had resolved in both eyes.
Adult ; Anterior Chamber ; Diaphragm ; Displacement (Psychology) ; Eye ; Female ; Humans ; Intraocular Pressure ; Methylprednisolone ; Microscopy, Acoustic ; Myopia ; Ophthalmic Solutions ; Subretinal Fluid ; Uveomeningoencephalitic Syndrome ; Visual Acuity

Thoracic outlet syndrome is caused by the compression of neurovascular structures at the thoracic outlet region. Diagnosis is difficult since thoracic outlet syndrome is often accompanied by distal entrapment neuropathies such as carpal tunnel syndrome or ulnar and radial neuropathies. In this article, the authors report a case regarding a patient with thoracic outlet syndrome whose diagnosis was delayed due to the overlapping of multiple distal entrapment neuropathies.
Carpal Tunnel Syndrome ; Humans ; Nerve Compression Syndromes ; Radial Neuropathy ; Thoracic Outlet Syndrome

PURPOSE: We compared body growth, blood cell counts, and chemistry among infants receiving soy-based formula (SF), breast milk (BM), and casein-based formula (CF). METHODS: Full-term neonates delivered at our hospital from June 2001 to August 2003 were recruited and divided into 3 feeding groups (BM=20, SF=19, CF=12) according to the parents wishes. Breast feeding or artificial formulae were given during the initial 3 months of age; thereafter, weaning foods were added freely. Height, weight, head circumference, skin-fold thickness, and mid-arm circumference were measured at birth and 1, 2, 4, 5, 12, and 36 months of age. Cell counts and blood chemistry were analyzed at 5, 12, and 36 months of age. RESULT: At 5 months of age, body weight was the lowest in the SF group; the height was similar among all groups. Thereafter, there were no differences in height or weight among the groups until 36 months of age. Hemoglobin was the lowest in the BM group at 5 and 12 months of age (P<0.05). At 5 months of age, serum cholesterol, BUN, phosphates, and K+ were significantly lower in the SF group; thereafter, all chemical parameters were similar until 36 months of age. CONCLUSION: Infants fed with SF showed normal growth during the first 3 years of life as compared to infants fed with BM and CF. Low values of serum phosphates and K+ at 5 months of age in the SF group, despite the high mineral content, suggest that further investigation is needed for effective mineral absorption.
Absorption ; Blood Cell Count ; Body Weight ; Breast Feeding ; Cell Count ; Cholesterol ; Head ; Hemoglobins ; Humans ; Infant ; Infant, Newborn ; Milk, Human ; Parents ; Parturition ; Phosphates ; Soy Milk ; Weaning

No abstract available.
Neuroblastoma*

Mycoplasma pneumoniae pneumonia is one of the most prevalent community-acquired pneumonias in pediatric patients. It commonly presents with mild respiratory symptoms and is well controlled by macrolide antibiotics. Rarely, it can progress to acute respiratory distress syndrome (ARDS) despite appropriate antibiotic therapy, and systemic corticosteroids and quinolone antibiotics are required. We recently treated 2 patients who presented with M. pneumoniae pneumonia with ARDS. Case 1: A 17-year-old girl was admitted with pneumonia that showed no response to antibiotics and progressed to ARDS, which required initiation of mechanical ventilation therapy. The patient was negative for M. pneumoniae IgM; but positive for, M. pneumoniae. After treatment with methylprednisolone and levofloxacin, rapid improvement was observed in both clinical manifestations and chest radiographic findings. Two days after discontinuing a 5-day methylprednisolone treatment regimen, she developed fever, and investigations revealed an elevated C-reactive protein level; this necessitated additional methylprednisolone treatment. Subsequently, she showed complete recovery with no sequelae. Case 2: A 14-year-old girl was admitted with M. pneumoniae pneumonia with ARDS that required mechanical ventilation therapy. She showed a IgM titers against M. pneumoniae of 1:320. After treatment with antibiotics and methylprednisolone, she recovered and was discharged at 48 admission days; however, mild dyspnea persisted. The chest computed tomography showed multiple bronchiectasis areas. After 15 days, because of aggravated dyspnea, she was readmitted and adminis-tered methylprednisolone pulse therapy. Despite 3 courses of methylprednisolone pulse therapy, she still showed mild dyspnea.
Adolescent ; Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Bronchiectasis ; C-Reactive Protein ; Child ; Dyspnea ; Female ; Fever ; Humans ; Immunoglobulin M ; Levofloxacin ; Methylprednisolone ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Thorax

PURPOSE: Children and adolescent have high prevalences of allergic rhinitis (AR) and nonallergic rhinitis (NAR) as well as adult. The purpose of this study was to assess the symptomatic differences between AR and NAR in children. METHODS: This study included 138 patients with 2 or more of rhinitis symptoms, including rhinorrhea, nasal obstruction, nasal itching, and sneezing for over 1 hour on most days who visited Kyungpook National University Children's Hospital between March 2013 and June 2014. The levels of total IgE, specific IgE, eosinophil cationic protein, peripheral blood eosinophil count, and the skin prick test were carried out. All the patients or parents were asked to fill out a rhinitis symptom questionnaire and contents were rechecked by physician during the consultation. The symptoms of rhinorrhea, sneezing, nasal itching, nasal obstruction and eye itching were checked. Family history and comorbidity were also evaluated. RESULTS: Ninety-one patients were diagnosed with AR, 47 patients with NAR. Their age ranged from 1 to 16 years. AR patients had more sneezing, nasal pruritus and eye symptoms than NAR patients (P=0.003, P=0.036, and P=0.003, respectively). CONCLUSION: This study shows that the several symptomatic differences may help to diagnose the AR. It will be helpful in establishing diagnostic and treatment plans for rhinitis patients before allergic tests.
Adolescent ; Adult ; Child* ; Comorbidity ; Eosinophil Cationic Protein ; Eosinophils ; Gyeongsangbuk-do ; Humans ; Immunoglobulin E ; Nasal Obstruction ; Parents ; Prevalence ; Pruritus ; Rhinitis* ; Rhinitis, Vasomotor ; Skin ; Sneezing

Although seclusion and restraint are required for the treatment of mentally ill patients in psychiatric hospitals, these procedures involve potential violations of human rights and pose a potential risk to patients' physical condition. Nursing staffs in psychiatric hospitals often have to manage psychiatric patients who display aggressive, violent, or challenging behavior. However, the guidelines for the use of seclusion and restraint in Korea are too broad to apply in clinical situations. The guidelines in the United States, Australia, the United Kingdom, and New Zealand emphasize that patients' basic needs have to be met and stipulate that patient–staff interaction must be continued during seclusion and restraint procedures. Mental health workers in psychiatric hospitals should pay close attention to patients' verbal and non-verbal expressions while communicating with them. This study reviews the guidelines for seclusion and restraint used in foreign countries to improve current Korean guidelines and provides strategies of the nursing activities to be implemented when patients require seclusion and restraint.
Australia ; Great Britain ; Hospitals, Psychiatric ; Human Rights ; Humans ; Korea ; Mental Health ; Mentally Ill Persons ; New Zealand ; Nursing Staff ; Nursing ; Psychiatric Nursing ; United States