The authors present a case of spontaneous discitis in a 1-year-old female who presented with fever and limping gait. The erythrocyte sediment rate was increased. The roentgenograms revealed normal appearnce, and radioactive bne scan showed increased uptake at the affected level. Discitis should be considered in any child with limping gait or leg pain, refusal to walk, or abdominal pain. Early recognition may avoid unnecessary diagnotic and treatment procedures.
Abdominal Pain ; Child* ; Discitis* ; Disulfiram ; Erythrocytes ; Female ; Fever ; Gait ; Humans ; Leg

No abstract available.
Animals ; Interleukin-4* ; Mice*

An accurate and relatively simple method for estimating the amount of acute blood loss is essential in the hemorrhagic shock patients. Conventional physiologic parameters, blood pressure, pulse rate and CVP, could not serve for evaluation of the adequate oxygen transport in the tissue. Pulmonary artery catheter is a best tool for evaluating the cardiopulmonary function and the oxygen transport system, and mixed venous oxygen saturation(SvO2) monitoring have made a great advances for early detection of cardiovascular dysfunction and the changes in peripheral tissue oxygenation. But pulmonary artery catheterization is complicated procedure in emergency setting. Although the central venous oxygen saturation(ScvO2) cannot completely replace the SvO2 value, it has a close relation with SvO2 change in variable clinical situations. We testify the usefulness of ScvO2 monitoring in 24 patients of the hemorrhagic shock. Initial resuscitation was performed with ATLS standard and continuous ScvO2 was monitored. Systolic blood pressure and pulse rate were recorded for one hour from initial resuscitation in each 15 minutes. Nineteen patient was traumatic hemorrhagic shock and five was non traumatic. Twelve of 19 patients was blunt trauma, and remains were stab in injury mechanism. Mortality rate was 29.2%. Initial ScvO2 of nonsurvivor was 43.6%, and 51.3% in survivor groups(p>0.05). In the group of stab wound and non-traumatic hemorrhage, the ScvO2 was gradually increase by time. But ScvO2 in survivors of blunt trauma was increased first 30 minutes and decrease afterthen. Continuous monitoring of ScvO2 may by partly useful in resuscitation for hemorrhagic shock. It is more valuable in the blunt trauma than in the penetrating injury or non-traumatic hemorrhage.
Blood Pressure ; Catheterization, Swan-Ganz ; Catheters ; Emergencies ; Heart Rate ; Hemorrhage ; Humans ; Mortality ; Oxygen* ; Pulmonary Artery ; Resuscitation ; Shock, Hemorrhagic* ; Survivors ; Wounds, Stab

No abstract available.
Colorectal Neoplasms* ; Neoplasm Metastasis*

No abstract available.
Bone Marrow* ; Breast Neoplasms* ; Breast* ; Neoplasm Micrometastasis*

Breast feeding is one of many factors that have been associated with the development of lower respiratory tract illnesses. To assess the relation between breast feeding and subsequent experience of lower respiratory tract illness, we performed this study, retrospectively, on 366 infants who had been admitted to the pediatric ward, St. Francisco General Hospital, or had been brought to the well baby clinic from November, 1992 to March, 1993. The results were as foolows: 1) Among 366 infants, the number of all first illnesses observed at each interval were 259 cases (70.8%), of which 198 (54.1%) were associated with wheezing illnesses and 61 (16.7%) with non-wheezing lower respiratory illnesses. 2) Duration of breast feeding regardless of-whether other foods were given, was categorized as 3 grups, i. e., none or for less than a month (group), one to 4 months (group B), and 4 or more months (group C). Incidences of wheezing illnesses in the first 4 months of life were lower in group B(10.1%) and group C (8.4%) than group A (27.3%), respectively (p<0.01). Wheezing illnesses beyond 4 months of life and non-wheezing illnesses in all intervals seemed to be unrelated to the duration of breast feeding. 3) Considering a variety of other fisk factors, including sharing a room, parental childhood reapiratory trouble, sex and maternal education, children who received minimal breast feeding (group A) had the greater risk of early wheezing illnesses in the simultaneous exposure to sharing a room than group B and C (p<0.005). Our results suggest that decreased breast feeding is associated with a higher incidence of wheezing illnesses in the first 4 months of life, particularly in combination with other risk factors, such as sharing a room.
Breast Feeding* ; Breast* ; Child ; Education ; Hospitals, General ; Humans ; Incidence ; Infant ; Parents ; Respiratory Sounds ; Respiratory System* ; Retrospective Studies ; Risk Factors

Allopurinol is widely used for chronic tophaceous gout as a uric acid lowering agent. Hypersensitivity to allopurinol occurrs in about 10% of patients, which limits the usage of allopurinol. The successful oral and intravenous desensitization of allopurinol has been reported worldwide since 1976. We recently experienced a 51-year-old male patient with gouty arthritis and hyperuricemia, who had previously experienced skin rash after allopurinol treatment. When allopurinol was retried, erythematous and foliative skin rash developed on entire body. Because allopurinol was essential in controlling hyperuricemia, the oral desensitization of allopurinol was tried. We report successful rapid oral allopurinol desensitization in the patient with chronic tophaceous gout, who exhibited exfoliative dermatitis as allopurinol hypersensitivity.
Allopurinol* ; Arthritis, Gouty ; Dermatitis, Exfoliative* ; Exanthema ; Gout ; Humans ; Hypersensitivity ; Hyperuricemia ; Male ; Middle Aged ; Uric Acid

A case-control study was conducted to investigate the association between the risk of cancer and selenium concentration in blood and toenails. Seventy three patients and two hundreds eighty three controls were selected at the Yeungnam University Hospital between May and September in 1991. The selected cases were patients who had been hospitalized for stomach or colon cancer at the Department of General Surgery. The controls were people who visited to check physical examination at the Automated Mediscreening Center. The selenium concentration in whole blood and toenails were measured by atomic absorption spectrophotometer equipped with graphite furnace atomizer. The following information was ascertained for all cancer patients and controls: sex, age, body mass index, blood pressure, total serum cholesterol, and history of smoking and drinking. The mean selenium concentration in blood and toenail for all cancer patients were 143.6±10.8 µg/l and 1.04±0.62 µg/g and for the controls. 167.0±14.5 µg/l and 1.15±0.55 µg/g, respectively. The difference in blood and toenail selenium concentrations of the two cancer sites was not statistically significant. Metastasis did not influence the concentration of selenium in blood and toenails. In the multiple logistic regression analysis, the blood selenium concentration (aOR: 0.888, 95% CI: 0.860-0.918), age, BMI and total serum cholesterol were significant variables for risk of cancer, but the selenium concentration in toenail was not shown to be a significant variable in this regression analysis. The coefficient for blood selenium concentration adjusted for age, sex, diastolic blood pressure, total serum cholesterol, body mass index and smoking was -0.1184 (p<0.01). These findings suggest that low selenium concentration is associated with gastrointestinal cancers. Further epidemiologic studies including important variables such as other antioxidant micronutrients will be necessary.
Absorption ; Blood Pressure ; Body Mass Index ; Case-Control Studies ; Cholesterol ; Colonic Neoplasms ; Drinking ; Epidemiologic Studies ; Gastrointestinal Neoplasms ; Graphite ; Humans ; Logistic Models ; Micronutrients ; Nails* ; Nebulizers and Vaporizers ; Neoplasm Metastasis ; Physical Examination ; Selenium* ; Smoke ; Smoking ; Stomach

Direct intraarterial measurement of blood pressure is an important diagnostic procedure in critical patients and premature baby care. Direct measurement was more accepted and confident method in physician than the indirect methods. But the presence of a significant amplification of systolic pressure in peripheral artery may lead to important error. So we have investigated the degree of the systolic pressure amplification from the ascending aorta to the femoral artery in children. Pressure waves recorded in the ascending aorta, aortic arch, diaphragmatic level of the descending aorta, common iliac artery, and femoral artery in 37 patients with congenital heart disease, aged 9 months to 21 years old (mean 7.16 yrs old) during diagnostic cardiac catheterization. The results were as follows 1) Amplification of the systolic pressure increased progressively from the ascending aorta to the femoral artery (16.7%) 2) Diastolic pressure decreased progressively from the ascending aorta to the femoral artery (6.5%) 3) Mean pressure decreased progressively from the ascending aorta to the femoral artery (1.5%) 4) Pulse pressure increased progressively from the ascending aorta to the femoral artery (42.8%) 5) There was significant drop (7%) of the systolic pressure of the ascending aorta compared with that of left ventricle. The results showed that the peripheral amplifications were limited to the systolic and pulse pressure, but the diastolic and mean pressure in peripheral arteries were lower than that of central artery.
Aorta ; Aorta, Thoracic ; Arterial Pressure* ; Arteries ; Blood Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Femoral Artery ; Heart Defects, Congenital* ; Heart Ventricles ; Humans ; Iliac Artery ; Young Adult

No abstract available.
Heart Defects, Congenital* ; Plasma*