No abstract available.
Female ; Ovary* ; Teratoma*

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

The effect of a secretory proteinase from the pathogenic amoebae Acanthamoeba castellanii on hosts defense-oriented or regulatory proteins such as immunoglobulins, interleukin-1, and protease inhibitors was investigated. The enzyme was found to degrade secretory immunoglobulin A (sIgA), IgG, and IgM. It also degraded interleukin-1alpha (IL-1alpha) and IL-1beta. Its activity was not inhibited by endogenous protease inhibitors, such as alpha2-macroglobulin, alpha1-trypsin inhibitor, and alpha2-antiplasmin. Furthermore, the enzyme rapidly degraded those endogenous protease inhibitors as well. The degradation of hosts defense-oriented or regulatory proteins by the Acanthamoeba proteinase suggested that the enzyme might be an important virulence factor in the pathogenesis of Acanthamoeba infection.
Acanthamoeba/*enzymology/pathogenicity ; Animals ; Endopeptidases/*physiology ; Immunoglobulins/*metabolism ; Interleukin-1/*metabolism ; Protease Inhibitors/*metabolism ; Support, Non-U.S. Gov't ; Virulence

No abstract available.
Humans ; Peptic Ulcer*

No abstract available.
Administration, Oral* ; Animals ; Carbon Disulfide* ; Carbon* ; Rats*

Individuals with Asia type DEL blood group, the RhD-variant that classified as serologically RhD-negative, do not produce anti-D even when exposed to the D-antigen. Therefore, it is considered safe to transfuse RhD-positive blood products to them. However, such transfusions are still rare in medical institutions, with only two cases reported in Korea. Here, we present cases of two additional patients based on our experience. A 60-year-old female patient undergoing extra corporeal membrane oxygenation (ECMO) for myocarditis presented with severe anemia.The patient was serologic RhD-negative. Due to the lack of RhD-negative RBC inventory for emergency transfusion, RhD-positive blood was transfused. After confirming the patient’s RHD genotype as Asia type DEL, the planned RhD-positive blood transfusion was continued. A total of 13 units of RhD-positive RBCs and 26 units of single donor platelets (SDPs) were transfused over 25 days. Throughout this period, all unexpected antibody tests were negative. The second patient, a 50-year-old male diagnosed with myelodysplastic syndrome (MDS), was serologic RhD-negative, and the RHD genotyping confirmed Asia type DEL. During the hospitalization period, a total of 113 units of RhD-positive SDPs and 10 units of fresh frozen plasma (FFP) were transfused over 64 days, and all unexpected antibody tests were negative. These two cases suggest the transfusion of RhD-positive blood products to patients with Asia type DEL is safe.

Augmentation cystoplasty is effective in the rehabilitation of the contracted bladder of small capacity caused by tuberculosis or interstitial cystitis refractory to more conservative methods of management. Genitourinary tuberculosis is the most common cause of contracted bladder in Korea and it may lead to considerable vesicoureteral reflux and progressive deterioration of renal function. The use of hemi-Kock ileal pouch with an afferent intussuscepted nipple is a suitable solution in patient in whom the bladder outflow tract provides adequate resistance and supratrigonal cystectomy is to be performed with construction of an antireflux mechanism. Herein, we report 4 cases of hemi-Kock ileocystoplasty.
Cystectomy ; Cystitis, Interstitial ; Humans ; Korea ; Nipples ; Rehabilitation ; Tuberculosis ; Urinary Bladder ; Vesico-Ureteral Reflux

PURPOSE: To determine whether C-reactive protein (CRP) can be used as a parameter to assess the safety of discontinuing antibiotic therapy and allows a shorter course of therapy in neonates treated for suspected bacterial infection. METHODS: We have experienced 193 cases of suspected neonatal bacterial infection at Pusan Maryknoll Hospital. CRP levels were measured daily by immunonephelometry. Infants with initial CRP levels less than 0.8mg/dL were considered unlikely to be infected, and antibiotic therapy was stopped (group A; n=82). If three daily serial CRP levels were less than 0.8mg/dL, antibiotics were discontinued (group B; n=51). Sixty cases were treated for at least 7 days irrespective of CRP results (group C; n=60), and relapse rates of bacterial infection were compared between the three groups within one month after discharge. RESULTS: Within the one month follow-up period, two infants (2.4%) in group A, one infant (1.3%) in group B, two infants (3.3%) in group C received antibiotics for possible relapse of bacterial infection. The relapse rate in these groups was very low and frequency of a second course of antibiotic therapy between these groups was not different. CONCLUSION: These data allow considerably shorter courses of antibiotic therapy, safe discontinuation by three serial CRP measurement and show that CRP can be a key parameter for guiding the duration of antibiotic treatment. In addition, it would cut the length and cost of hospital stays and diminish the side effects of parenteral antibiotics.
Anti-Bacterial Agents ; Bacterial Infections* ; Busan ; C-Reactive Protein* ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Recurrence

PURPOSE: To determine whether C-reactive protein (CRP) can be used as a parameter to assess the safety of discontinuing antibiotic therapy and allows a shorter course of therapy in neonates treated for suspected bacterial infection. METHODS: We have experienced 193 cases of suspected neonatal bacterial infection at Pusan Maryknoll Hospital. CRP levels were measured daily by immunonephelometry. Infants with initial CRP levels less than 0.8mg/dL were considered unlikely to be infected, and antibiotic therapy was stopped (group A; n=82). If three daily serial CRP levels were less than 0.8mg/dL, antibiotics were discontinued (group B; n=51). Sixty cases were treated for at least 7 days irrespective of CRP results (group C; n=60), and relapse rates of bacterial infection were compared between the three groups within one month after discharge. RESULTS: Within the one month follow-up period, two infants (2.4%) in group A, one infant (1.3%) in group B, two infants (3.3%) in group C received antibiotics for possible relapse of bacterial infection. The relapse rate in these groups was very low and frequency of a second course of antibiotic therapy between these groups was not different. CONCLUSION: These data allow considerably shorter courses of antibiotic therapy, safe discontinuation by three serial CRP measurement and show that CRP can be a key parameter for guiding the duration of antibiotic treatment. In addition, it would cut the length and cost of hospital stays and diminish the side effects of parenteral antibiotics.
Anti-Bacterial Agents ; Bacterial Infections* ; Busan ; C-Reactive Protein* ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Recurrence

The appendiceal mucocele is very rare disease of 0.2% incidence. About 24% of patients are asymptomatic and symptomatic patients present with pain in the right lower quadrant of abdomen in 64%, plapable maas in the right lower quadrant of abdomen in 50%, and rarely, melena, hematochezia, anemia, diarrhea, malaise, and abdominal distension. The gastrointestinal bleeding may be presented in the patient with intussusception, but the massive bleeding is generally absent. We report a case of appendiceal mucocele accompanying with gastrointestinal bleeding and review of literature.
Abdomen ; Anemia ; Diarrhea ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Incidence ; Intussusception ; Melena ; Mucocele* ; Rare Diseases