Bacterial meningitis results in significant neurologic dificits despite in spite of much effort in the treatment of the disease. This study was performed to determine the incidence of caustive organisms and to correlate between the organisms and computed tomographic (CT) findings with clinical outcome of bacterial meningitis in newborns and infants. We analyzed the brain CT and clinical records of 15 infants who had been diagnosed as bactrial meningitis by CSF culture. We found that the most common organisms were Group B streptococcus in neonates withou no neurologic complications in all but one and Hemophilus influenza in infants whose clinical outomes were poor in all except one. CT findings related with poor prognosis in this study were cerebral edema, basal cistermal obliteration & enhancement, and cerebral infarction on initial CT and ventriculomegaly on follow-up CT. We concluded that CT diagnosed intracranial complications of bacterial meningitis well and could contributed to better treatment of bacterial meningitis.
Brain ; Brain Edema ; Cerebral Infarction ; Follow-Up Studies ; Haemophilus ; Humans ; Incidence ; Infant* ; Infant, Newborn* ; Influenza, Human ; Meningitis ; Meningitis, Bacterial* ; Prognosis ; Streptococcus

No abstract available.
Incus* ; Malleus*

PURPOSE: Rotavirus is a leading cause of severe gastroenteritis in infants and young children around the world. The aim of this study is to investigate the fat content in stools of patients with rotaviral enteritis compared to the stools of children who had no gastroenteritis. METHODS: Seventy two patients who were admitted to Konkuk University Hospital, College of Medicine from Jun 2001 to May 2002 due to rotaviral enteritis and seventy five patients who were admitted at the same time with other diseases with no gastrointestinal problems as control, were enrolled in this study. The age of patients was from one month to five years. The average age of children with rotaviral enteritis was 17+/-11 months and the average age of control patients was 14+/-15 months. Fat content of stools was investigated by acid steatocrit tests in both patients with rotaviral enteritis and control. RESULTS: Acid steatocrit value of patients with rotaviral enteritis was higher than that of control patients. There was no difference in acid steatocrit value of children with rotaviral enteritis among the age groups. In one month- to six month-old infants, there was no difference in acid steatocrit values between the children with rotaviral enteritis and control patients. But, over the age of seven months, the acid steatocrit value of children with rotaviral enteritis was higher than that of control patients. CONCLUSIONS: We are of the opinion that fat malabsorption in patients with rotaviral enteritis and steatorrhea in rotaviral enteritis may result from decreased fat absorption in the small intestine.
Absorption ; Child* ; Enteritis* ; Gastroenteritis ; Humans ; Infant ; Intestine, Small ; Rotavirus ; Steatorrhea

PURPOSE: More effective diagnosis and treatment through a survey on clinical aspect for the last 5 years and interrelation between cold agglutinin titer and mycoplasma antibody titer of Mycoplasma pneumoniae pneumonia. METHODS: 369 patients hospitalized in the department of pediatrics of Chung Goo Sung Shim Hospital for the 5 years from January 1990 to December 1994 have been surveyed, which diagnosed to be Mycoplasma pneumoniae pneumoniaby physical findings or chest x-ray findings with the titer of 1:64 in cold agglutinin test or the titer of 1:80 in Mycoplasma antibody test or forefold increase of any one or both of 2 titers in follow-up tes RESULTS: 1) More cases were found in 1990(76 cases, 20.6%) and 1994(181 cases, 49%) and the monthly distribution showed irregular fluctuations. Male to female ratio was 1:1.2 and high incidence was in the age of 3 to 5 years(27.9%), but 46 cases(12.5%) affected the infants below 1 year old. 2) Cough, fever, sputum were the most chief complaints. More moist rales, pharyngial injection, wheezing were found in physical examination. 86.7% of pneumonic infiltration were found in x-ray findings, 35.8% of which were both lung infiltration. The most common affected site was Rt. lower lobe and then Lt lower lobe and then followed by Rt. upper lobe. 71.8% of the whole cases were hospitalized for 5-8 days. 3) EM administration started 10-12 days after the onset in 29.3%. Mean duration of hospitalization of the cases administrated within 6 days from onset was 7.5+/-2 days, which was shorter than 8.4+/-3.5-that of the cases administrated after 6days from onset. The observation on those duration meant little atatistically(p>0.1) 4) The measure of Mycoplasma antibody titer in 142 cases among 245 positive cold agglutinin test case showed 61.3% of positive ratio. Positive ratio of cold agglutinin test peaked from 13th to 15th day after onset(89%) and went down(33%) after 19th day. Positive ratio of Mycoplasma antibody titer was at its summit(91%) from 7th to 9th day and went down(63%) after 16th day. decreased to 63% after 16 days. 264 cases tested simultaneously for cold agglutinin titer and Mycoplasma antibody titer. Titers of each simultaneous test for cold agglutinin and Mycoplasma antibody were in proportion each other(p<0.005, N=264, r=0.51). CONCLUSIONS: Mycoplasma pneumoniae pneumonia prevailed every 4 years(1990, 1994) and monthly distribution had been irregular. The most cases were found at age of 4 and 5. Mycoplasma antibody titer seems more effective for early diagnosis for Mycoplasma antibody titer showed high positive rate earlier and the rate went down earlier than cold agglutinin titer. The earlier diagnosis and treatment are required because of tendency of later erythromycin administration.
Child* ; Cough ; Diagnosis ; Early Diagnosis ; Erythromycin ; Female ; Fever ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Infant ; Lung ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pediatrics ; Physical Examination ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory Sounds ; Sputum ; Thorax

Purpose: To report a case with corneal decompensation in a patient of pseudoexfoliation syndrome.Case summary: A 70-year-old woman was referred to our clinic to evaluate decreased visual acuity in the right eye. She had no history of previous ocular surgery or laser treatment. The best corrected visual acuity was 0.5 in both eyes. The patient had diffuse corneal edema in the epithelium and stroma in the right eye. The left eye showed diffuse endothelial pigment deposits. Deposition of pseudoexfoliation material on the iris and anterior lens capsule was observed in both eyes. The intraocular pressure was 15 mmHg in both eyes without treatment. Specular microscopy was limited in the right eye due to the corneal edema and the left eye showed endothelial cell loss, increased pleomorphism, and atypical guttata. Anterior segment optical coherence tomography revealed irregular thickening of the corneal stroma and protrusion of Descemet’s membrane in the right eye. Conclusions In patients with pseudoexfoliation syndrome, corneal decompensation can occur without intraocular pressure elevation and glaucomatous damage.

Purpose: To report a case with corneal decompensation in a patient of pseudoexfoliation syndrome.Case summary: A 70-year-old woman was referred to our clinic to evaluate decreased visual acuity in the right eye. She had no history of previous ocular surgery or laser treatment. The best corrected visual acuity was 0.5 in both eyes. The patient had diffuse corneal edema in the epithelium and stroma in the right eye. The left eye showed diffuse endothelial pigment deposits. Deposition of pseudoexfoliation material on the iris and anterior lens capsule was observed in both eyes. The intraocular pressure was 15 mmHg in both eyes without treatment. Specular microscopy was limited in the right eye due to the corneal edema and the left eye showed endothelial cell loss, increased pleomorphism, and atypical guttata. Anterior segment optical coherence tomography revealed irregular thickening of the corneal stroma and protrusion of Descemet’s membrane in the right eye. Conclusions In patients with pseudoexfoliation syndrome, corneal decompensation can occur without intraocular pressure elevation and glaucomatous damage.

No abstract available.
Evoked Potentials, Auditory, Brain Stem*

Purpose: The purpose of this study was to compare corneal astigmatism correction between “wound open” and “wound intact” methods during femtosecond laser-assisted transepithelial arcuate keratotomy. Methods: From April 2016 to December 2018, a retrospective survey was conducted on patients undergoing femtosecond laser cataract surgery at the Ophthalmology Department of Samsung Medical Center. Size comparison and vector analysis of corneal astigmatism before and after surgery were performed in the wound open and wound intact groups. Results: In the wound open and wound intact groups, the target-induced astigmatism (TIA) was 1.28 ± 0.55; and 1.26 ± 0.29 diopters, the surgically induced astigmatism (SIA) was 0.80 ± 0.52; and 0.53 ± 0.32 diopters, and the correction index (CI) was 0.63 ± 0.28; and 0.43 ± 0.26, respectively. The astigmatism correction was superior in the wound open group (p = 0.048, p = 0.025). In a subgroup with TIA < 1.2 diopters, there were no significant differences in SIA or CI between the two groups; however, in the subgroup with a TIA > 1.2 diopters, the SIA was 1.09 ± 0.59; and 0.54 ± 0.37 diopters and the CI was 0.60 ± 0.28; and 0.36 ± 0.23 in the wound open and wound intact groups, respectively (p = 0.022, p = 0.047). Thus, astigmatism correction was superior in the wound open group. Conclusions The wound open method during femtosecond laser-assisted transepithelial arcuate keratotomy was superior for astigmatism correction compared to the wound intact method.

PURPOSE: Postoperative ileus (POI) is common following bowel resection for radical cystectomy with ileal conduit (RCIC). We investigated perioperative factors associated with prolonged POI following RCIC, with specific focus on opioid-based analgesic dosage. MATERIALS AND METHODS: From March 2007 to January 2013, 78 open RCICs and 26 robot-assisted RCICs performed for bladder carcinoma were identified with adjustment for age, gender, American Society of Anesthesiologists grade, and body mass index (BMI). Perioperative records including operative time, intraoperative fluid excess, estimated blood loss, lymph node yield, and opioid analgesic dose were obtained to assess their associations with time to passage of flatus, tolerable oral diet, and length of hospital stay (LOS). Prior to general anaesthesia, patients received epidural patient-controlled analgesia (PCA) consisted of fentanyl with its dose adjusted for BMI. Postoperatively, single intravenous injections of tramadol were applied according to patient desire. RESULTS: Multivariate analyses revealed cumulative dosages of both PCA fentanyl and tramadol injections as independent predictors of POI. According to surgical modality, linear regression analyses revealed cumulative dosages of PCA fentanyl and tramadol injections to be positively associated with time to first passage of flatus, tolerable diet, and LOS in the open RCIC group. In the robot-assisted RCIC group, only tramadol dose was associated with time to flatus and tolerable diet. Compared to open RCIC, robot-assisted RCIC yielded shorter days to diet and LOS; however, it failed to shorten days to first flatus. CONCLUSION: Reducing opioid-based analgesics shortens the duration of POI. The utilization of the robotic system may confer additional benefit.
Aged ; Analgesics, Opioid/*administration & dosage/therapeutic use ; Carcinoma/*surgery ; Cystectomy/*adverse effects ; Dose-Response Relationship, Drug ; Female ; Humans ; Ileus/*epidemiology ; Length of Stay ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Robotic Surgical Procedures/adverse effects ; Time Factors ; Tramadol/*administration & dosage/therapeutic use ; Treatment Outcome ; Urinary Bladder Neoplasms/*surgery ; Urinary Diversion/*adverse effects

No abstract available.
Reflex Sympathetic Dystrophy* ; Reflex*