PURPOSE: Urinary tract infection (UTI) in children is the most common disease during the infantile period, therefore early diagnosis and treatment are important. Pyuria is a useful clinical parameter for the initial diagnosis of a UTI. In this study we aimed to compare the clinical, laboratory, and imaging findings in relation to the duration of pyuria in infants with UTIs. METHODS: Three hundred seventy-four infants <12 months of age who were admitted between January 1995 and December 2005 for the first episode of a febrile UTI were retrospectively reviewed. Patients were divided into two groups according to the duration of pyuria as follows: group 1, pyuria resolved <3 days after initial treatment; and group 2, pyuria lasted at least 3 days after initial treatment. RESULTS: There were no significant differences between the two groups in relation to gender, age, total duration of fever, and organisms in the urine. Group 2 had a significantly higher peripheral blood leukocyte count (14,360.86+/-5,526.16 cells/mm3 vs. 11,822.55+/-5,687.26 cells/mm3, P<0.001), erythrocyte sedimentation rate (32.81+/-19.34 mm/hr vs. 23.74+/-20.43 mm/hr, P<0.001), and C-reactive protein (6.84+/-5.68 mg/dL vs. 3.78+/-3.99 mg/dL, P<0.001) than group 1. There was a significantly higher incidence of hydronephrosis and a higher grade of vesicoureteral reflux (VUR) in group 2 compared to group 1. CONCLUSION: In infants with UTI, pyuria of longer duration is related to severe UTI and higher grade VUR, therefore aggressive radiologic studies may be necessary.
Blood Sedimentation ; C-Reactive Protein ; Child ; Early Diagnosis ; Fever ; Humans ; Hydronephrosis ; Incidence ; Infant ; Leukocyte Count ; Pyuria ; Retrospective Studies ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

No abstract available.

BACKGROUND: There are many opinions about the surgical management of diverticulitis of the cecum and ascending colon. METHODS: Thirty-two cases of diverticulitis of the cecum and ascending colon were reviewed, including 5 cases of nonsurgical management. RESULTS: The most common preoperative diagnosis, occurring in 81.5% of surgical cases, was acute appendicitis or periappendiceal abscess. A diverticulectomy was performed in 25 patients (93%), an invagination in 1, and an appendectomy in 1. In the diverticulectomy group, two complications occurred. There were no instances of a missed carcinoma. CONCLUSIONS: I conclude that in those patients in whom a carcinoma can be ruled out, a diverticulectomy is a safe and effective surgical method for management of diverticulitis of the cecum and ascending colon.
Abscess ; Appendectomy ; Appendicitis ; Cecum* ; Colon, Ascending* ; Diagnosis ; Diverticulitis* ; Humans

No abstract available.
Arteriovenous Fistula ; Lower Extremity

Airway hyperresponsiveness is a consistent feature of asthma. Since the airway smooth muscle is hyperresponsive to a number of different stimuli operating through many different mechanisms, it is attractive to speculate that the abnormality may reside in the airway smooth muscle itself. Animal model of asthma is needed to unravel possible mechanisms underlying airway hyperresponsiveness and also to develop new therapeutic approaches. However, there are few reports showing that airway smooth muscle from animal asthma model is indeed hyperresponsive. In addition, sensitizing and provoking doses of allergen were different each other ambng the studies on animal asthma model. The aim of this study was to determine an appropriate sensitizing and provoking dose of allergen to induce a maximum airway hyperresponsiveness. Eighty-four male Sprague-Dawley rats were actively sensitized with a subcutaneous injection of 0, 10, or 1000/gg ovalbumin(OA) and 14 days later they were provoked with 0, 1, or 5 % OA aerosols. One day after the provocation, serum levels of OA-specific IgE, cell numbers in bronchoalveolar lavage fluid (BALF), and in vitro isometric contractile responses of the isolated tracheal smooth muscle(TSM) to 120 mM KC1, acetylcholine(ACh, 0.1~ 1000/micro meter), electrical field stimulation (EFS, 0.5~100Hz), serotonin(5-HT, 0.014 100/micro meter), and OA(10, 50, or 250 micro gram/ml) were measured. The results were as follows; 1) When 38 OA-sensitized rats were exposed to OA aerosols in vivo early asthmatic responses(EAR) were observed in 20(52.6%) rats. In vitro isometric contractile forces of TSM from rats with EAR were stronger than those from rats without EAR. 2) The maximal contractile responses to KC1 and EFS were significantly higher in rats only sensitized with OA compared with those in controls. The maximal response to ACh was significantly related to OA-specific serum IgE level(r=0.40, p%0.05), and the latter was in turn significantly related to the BALF eosinophil count(r=0.67, p<0.01). 3) When 10 microgram OA-sensitized rats were analyzed, the maximal response to KC1, ACh, EFS, and 250 micro gram/ml OA were lower in OA-provoked rats compared to those in saline-provoked control rats, in which 5% OA-provoked rats had a lower response than 1% OA-provoked rats. 4) The sensitivity of TSM to ACh was significantly higher in 10/micro gram OA-sensitized & OA-provoked rats, and the sensitivity to EFS was also significantly higher in 10/~g OA-sensitized & 5% OA-provoked rats compared to that in controls(p<0.05). 5) There was a significant correlation between the sensitivity of TSM to EFS and the counts of eosinophil or of lymphocytes in BALF(for eosinophil, r=-0.30; p<0.05, for lymphocyte, r=-0.35; p<0.05), or OA-specific serum IgE level(r=-0.46, p<0.01) in OA-sensitized & OA-provoked rats. This relationship was maintained in the data obtained only from 10 micro gram OA-sensitized & 5% OA-provoked rats. 6) The ratio of EFS-sensitivity to ACh-sensitivity was significantly lower in OA-sensitized & OA-provoked rats compared to that in controls or rats only sensitized with OA(p%0.05). 7) The Schultz-Dale phenomenon occurred in an in vitro dose-dependent manner. However, the inhaled provocation with OA in vivo resulted in a decrease in the contractile response to OA in vitro. There was a significant correlation between OA-specific serum IgE level and isometric response to 250 micro gram/ml OA(r=0.36, p<0.01). These results suggest that sensitization and provocation in vivo with OA in rats induces hypersensitivity of airway smooth muscle to cholinergic stimuli through an allergic inflammatory mechanism. The sensitivity was highest when sensitized to 10 micro gram OA and exposed to 5% OA aerosols.
Aerosols ; Animals ; Asthma* ; Bronchoalveolar Lavage Fluid ; Cell Count ; Ear ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E ; Injections, Subcutaneous ; Lymphocytes ; Male ; Models, Animal ; Muscle, Smooth* ; Rats* ; Rats, Sprague-Dawley

No abstract available.
Porphyria, Acute Intermittent* ; Pregnancy*

Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM, AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscess constitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acute otitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused by Streptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acute mastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recovered without sequalae.
Anti-Bacterial Agents ; Child ; Communicable Diseases ; Drainage ; Epidural Abscess* ; Fever ; Humans ; Lateral Sinus Thrombosis ; Masks ; Mastoid* ; Mastoiditis* ; Otitis Media ; Streptococcus pneumoniae*

Tuberculosis is a systemic disease that can occur anywhere in body. Its incidence is various according to the organ or location, and TB in an organ where the general incidence is rare causes so many unexpected symptoms and complications that physicians can sometimes be baffled when attempting to make a diagnosis. If this rare occurrence of TB in an unusual location results in non-specific symptoms, then it is important not to overlook the possibility of tuberculosis. Hepatic tuberculosis is mainly a secondary type of disease that has disseminated from the lungs or other organs. Because a primary TB focus in the liver is rare, in the case in which the lung or other organs have no tuberculosis, it is extremely difficult to arrive at the proper diagnosis of primary hepatic tuberculosis. The authers experienced a case of primary tuberculous granuloma that was associated with intrahepatic duct stones and abscess. This patient was first diagnosed as suffering with intrahepatic duct stones and abscess only. We discovered the associated tuberculous granuloma of the liver by histologic examination after hepatectomy. We report on this case with a review of the relevant literature.
Abscess* ; Diagnosis ; Granuloma ; Hepatectomy ; Humans ; Incidence ; Liver ; Lung ; Tuberculoma* ; Tuberculosis ; Tuberculosis, Hepatic

The Guillain-Barre syndrome is characterized by Bymmetrical rapidly, ascending paralysis that occasionally leads to respiratory embarrassment and death. We atudied 16 patients diagnosed as Guillain-Barre syndrome admitted to ICU at Severance Hospital from, January 1981 to April 1986. All patients were managed by respirators and 10 cases were tracheostomised. In addition to antibioticts with steroid therapy, rigid or fiheroptic bronchoscopy and plasma exchange were performed. The results were as follows ; 1) The 16 cases consist of 9 males and 7 females. 2) Prodromal symptoms were URI, fever, and gastrointestinal symptoms. 3) Diagnosis was 7ased on clinical symptoms, CSF studios and nerve conduction study. 4) Treatments included airway maintenance with ventilators, trachestomy, antibiotics with steroid therapy, rigid or fiberoptic bronchoscopy and plasma exchange. 5) Pulmonary complications (aspiration pneumonia, pneumoia, atelectasis, laryngeal ede-ma) and cardiovascular complications (hypertension, tachycardia, bradycardia, fever) were observed. However, there was no death in this group. ln conclusion, respiratory care and otter supportive therapy are of prime importance in the management of Guillain-Barre Syndorme.
Anti-Bacterial Agents ; Bradycardia ; Bronchoscopy ; Diagnosis ; Female ; Fever ; Guillain-Barre Syndrome* ; Humans ; Male ; Neural Conduction ; Otters ; Paralysis ; Plasma Exchange ; Pneumonia ; Prodromal Symptoms ; Pulmonary Atelectasis ; Tachycardia ; Ventilators, Mechanical

Serum IgE levels in 48 patients with scabies were measured by enzyme-linked immunosorbent a.ssay(ELISA) to evaluate the relationship between the scabies and serum IgE. A group of 44 healthy persons was taken as a controls. The results were summarized as follows: In children group(p 15 year-old) of the scabies, serum IgE level was 446 3 +267.2 IU/ml and significantly elevated than in controls, 126, 3 175, 4 IU/rnl, In adult group(over 16 year-old), serum IgE levels of the scabies and controls were 506. 4 + 581. 8 IU/ml, 435, 5+ 548, 8 lU/rnl respetively, and there was no significant difference between them. 2) There were no statistical correlations between the serum IgE levels and intensity of pruritus, duration of illness, number of skin lesions or number of circu1ating eosinophils in patients with scabies.
Adult ; Child ; Eosinophils ; Humans ; Immunoglobulin E* ; Pruritus ; Scabies* ; Skin