No abstract available.
Adolescent* ; Humans ; Male* ; Shock, Septic*

BACKGROUND: We prospectively evaluated the incidence and possible factors causing intramuscular injection during lumbar sympathetic ganglion block and compared the multiple needle technique to the single technique to obtain a profound and complete block effect. METHODS: Among 83 patients, 58 patients (group A, n = 27, multiple needle technique and group B, n = 31, single needle technique) were reevaluated for the changes of skin temperature (Ts) and mean segment of longitudinal contrast spread. After injecting the contrast agent, the incidence of psoas muscle injection and the change of Ts was compared between two groups. RESULTS: The incidence of psoas muscle injection was 21.3% (46/216) and it was associated with the level of injection (L2) significantly (chi-square = 14.773, P = 0.001). DT(post) (postblock temperature difference between ipsilateral and contralateral great toe, 4.6 +/- 2.8degrees C, 1.8 +/- 1.6degrees C, P < 0.001 for group A and B) and DT(net) (DT(post) - DT(pre), 3.9 +/- 2.7degrees C, 1.5 +/- 1.5degrees C, P < 0.001 for group A and B) was significantly higher in group A. The mean segment of longitudinal contrast spread was 8.1 +/- 0.9 for group A and 3.2 +/- 1.6 for group B (P < 0.001). CONCLUSIONS: The LSGB at the L2 level showed the lowest incidence of psoas muscle injection of contrast. Multiple needle approach showed more significant increase of DT(net) and DT(post).
Ganglia, Sympathetic ; Humans ; Incidence ; Injections, Intramuscular ; Needles ; Prospective Studies ; Psoas Muscles ; Skin Temperature ; Toes

No abstract available.
Humans ; Infant* ; Streptococcal Infections*

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

PURPOSE: Atopic dermatitis is a chronic, inflammatory skin disease characterized by intense pruritus and an immunologic profile consistent with allergic disease. It is associated with increased eosinophil and IgE level and decreased INF-gamma production. We describe the result of a treatment with INF-gammaand assess the clinical, immunologic, and laboratory data of 12 patients with atopic dermatitis. METHODS: Twelve patients were treated for 12 weeks with 2x106 units/m2 INF-gamma by subcutaneous injection. General hematologic tests were done, and total eosinophil counts, eosinophil fractions, neutrophil fractions, and IgE levels were measured before the treatment, 2 weeks after the treatment, 12 weeks after the treatment serially. We also followed up the patients for 12 weeks after discontinuing INF-gammatherapy. RESULTS: All patients showed clinically significant improvement after 12 weeks of the systemic INF-gammatherapy. There was no clinical aggravation during the therapy period and the follow-up 4 weeks without the therapy. But the recurrence rate in the 12 weeks after discontinuing the therapy was about 40%. Eosinophil counts and eosinophil fractions were significantly decreased after the therapy. And, eosinophil counts and eosinophil fractions were increased in clinically aggravated patients during the 12 weeks of off-therapy. CONCLUSION: We conclude that INF-gammais an effective therapy in atopic dermatitis without significant side effects. The eosinophil counts and eosinophil fractions were decreased during the INF-gamma therapy, and increased in clinically aggravated patients after the off-therapy. There was no aggravation during the therapy. But 5 patients were clinically aggravated during the 12 weeks of off-therapy. Further studies for a long-term maintenance therapy and its side effect might be needed in chronic atopic dermatitis.
Dermatitis, Atopic* ; Eosinophils ; Follow-Up Studies ; Hematologic Tests ; Humans ; Immunoglobulin E ; Injections, Subcutaneous ; Interferon-gamma* ; Neutrophils ; Pruritus ; Recurrence ; Skin Diseases

Canalith repositioning maneuver is effective to treat benign paroxysmal positional vertigo(BPPV). This case showed complicated form of the BPPV such as changes of canalolithiasis to cupulolithiasis, involvement of one canal to two canals and from unilateral to bilateral involvement during the reposition maneuver. This patient was diagnosed as left lateral canalolithiasis at first. After left barbecue maneuver, the type was changed to the right posterior cupulolithiasis. Semont maneuver was performed and then the type of BPPV was changed to combined type with right posterior canalolithiasis and left lateral canalolithiasis. We performed left barbecue maneuver and right Epley maneuver. Then the type of BPPV was changed to left lateral cupulolithiasis. After Brandt-Daroff maneuver and left barbecue maneuver, nystagmus and dizziness disappeared finally.
Dizziness ; Humans

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

The aim of this study was to evaluate the risk factors of recurrences after their first febrile convulsions in infants and young children. Dlinical studies were made on 187 cases of febrile convulsions who were admitted to the Department of pediatrics of wallace Memorial Baptist Hospital from March, 1990 to December, 1992. 1) 63 cases of 187 cases had recurrences after their febrile convulsions. Thus, the recurrence rate was 33.7%. 2) The male to female ratio was 2.1:1. And there were no significant differences in recurrence rates between sexes. 3) The recurrence rate was significantly higher in those whose initial febrile convulsions were developed before first 18 months of life than those whose initial convulsions were after 18 months of age (49.5% vs. 12.5%). 4) The time interval from initial attack to recurrence was within 12 months in 80% of cases. 5) Our study revealed that the seizure characteristics of the initial febrile convulsion are not important as predictive factors about the probability of recurrences. 6) Among the total 187 cases, family history were present in 52 cases (27.8%). And there were significantly higher recurrence rates if their families show the same history of febrile convulsion (63.5% vs. 22.2%). 7) The risk of recurrence was much higher in patients whose first febrile history of febrile convulsion at the same time.
Child ; Female ; Humans ; Infant ; Male ; Pediatrics ; Protestantism ; Recurrence ; Risk Factors ; Seizures ; Seizures, Febrile*

BACKGROUND AND OBJECTIVE: The clinical manifestation of Henoch-Schonlein purpura and existance of renal involvement may influence on its course and prognosis. To verify prevention with early administration of steroid, we studied the efficacy of corticosteroid treatment. MATERIAL AND METHOD: We analysed 65 children under 15 years of age with Henoch-Scho nlein purpura according to their age, sex, and seasonal incidence. Forty children showed typical skin lesions, arthralgia and abdominal pain. We have divided them two groups. Group A consisted of 20 children who received 1 mg/kg of prednisolone/perday for 2 weeks and group B did not. We carried out their physical examination and urinalysis monthly for a year. RESULT: The main clinical manifestations were skin rash(100% ), abdominal symptoms(41.5 %), joint symptoms (49.2%), and renal involvement(34%). As for gastrointestinal symptoms, abdominal pain(66.7% ) was most commonly observed one and others were nausea or vomiting (44.7%) and melena(25.9%). The joint involvement was observed mostly in knee(56.3%) and ankle joint(31.3% ), Hematuria was observed in all cases with renal involvement and proteinuria, in 28% of them. The improvement of renal manifestations were noted in 84.2% of them within 4 months. Mild elevation of IgA was more frequently observed in renal involvement group than non-involved group (p< 0.01). There were no significant differences in immonologic parameters such as IgG, IgM, IgE, duration of the acute phase and severity of cutaneous symptoms between two growps. None of steroid treated growp showed progression of nephropathy. Of the 20 non-steroid treated growp, 2(10%) developed nephropathy. Conclusion We may suggest that existance of renal involvement in Henoch-Schonlein purpura influences its course and prognosis.
Abdominal Pain ; Ankle ; Arthralgia ; Child ; Hematuria ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Joints ; Nausea ; Physical Examination ; Prognosis ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch ; Seasons ; Skin ; Urinalysis ; Vomiting