No abstract available.
Humans ; Infant, Newborn ; Infant, Premature* ; Nephroma, Mesoblastic* ; Ultrasonography, Prenatal*

Additional a case of ectopic kidney with a literatural review was presented. Right kidney was located at the level of 4th lumbal spine and shortening of the right ureter. Left one was normal.
Kidney* ; Spine ; Ureter

The early radiological investigations of urinary tract infection are justified nowadays in order to identify those whose kidneys are already damaged, those who may be at risk of progressive damage, and those in whom a treatment program is indicated. 42 children who performed 99mTc-dimercaptosuccinic acid scan in the diagnostic step of recurrent urinary tract infection for recent 3 years at Severance Hospital were evaluated to access the validity of 99 m Tc-dimercaptosuccinic acid scan in detection of pyelonephritic scarring. The results were as follows: 1. Renal cortical defects were detected in 34 kidneys among 84 kidneys(40.5%) by DMSA scan, intravenous pyelography and ultrasonography 2. DMSA scan was significantly more valuable in detecing renal defect than intravenous pyelography (P<0.05). 3. The presence of reflux on voiding cystourethrography showed a significant correlation with renal cortical defects seen on DMSA scan (P<0.05). 4. The sensitivity of the DMSA scan in screening for all grades of reflux was estimated 0.9 and DMSA scan never missed renal defects in high grade (III-V/V) reflux. So we conclude that 99 m Tc-DMSA scan is more useful than other upper urinary tract imaging technique in detecting renal defects and consideration should be given to their use as first line of study for screening of renal defect in urinary tract infection and vesicoureteral reflux.
Child ; Cicatrix* ; Humans ; Kidney ; Mass Screening ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Urinary Tract ; Urinary Tract Infections ; Urography ; Vesico-Ureteral Reflux

PURPOSE: Arterial hypotension is a recognized complication of emergency intubation, whereas there have been contradicting opinions regarding postintubation hypotension. The aim of this study was to determine the incidence, related factors, and impact on patient outcomes associated with postintubation hypotension (PIH) in intubations performed in the emergency department. METHODS: A structured chart audit of all consecutive adult patients requiring emergency endotracheal intubations over a two-year period (2011.1.1.~2012.12.31.) was performed retrospectively. Patients older than 20 years who had no systolic blood pressure below 90 mmHg at any time before intubation were included. Patients were analyzed in two groups, those with PIH, defined as any recorded systolic pressure less than 90 mmHg within 60 minutes of intubation, and those with no PIH. The primary outcome was in-hospital mortality. RESULTS: Overall, 186 patients intubated in the emergency department were identified, and 18.4% (34 of 186) developed PIH. Advanced age was an independent factor of developing PIH (OR: 3.4, 95% CI: 1.3-9.0, p=0.02). Patients with PIH had significantly higher in-hospital mortality (53% vs 29%; p=0.01), and multiple logistic regression showed that PIH was an independent predictor of in-hospital mortality (OR: 2.5, 95% CI: 1.1-5.5 p=0.03). CONCLUSION: Postintubation hypotension occurs in 18.3% of hemodynamically stable patients before intubation. PIH is independently associated with in-hospital mortality. Advanced age is an independent predicting factor of PIH.
Adult ; Blood Pressure ; Emergencies ; Emergency Service, Hospital* ; Hospital Mortality* ; Humans ; Hypotension* ; Incidence ; Intubation ; Intubation, Intratracheal ; Logistic Models ; Mortality ; Retrospective Studies ; Risk Factors*

No abstract available.
Disseminated Intravascular Coagulation* ; Plasma* ; Scrub Typhus*

No abstract available.
Blood Transfusion, Autologous*

No abstract available.
Blood Transfusion, Autologous*

PURPOSE: Prompt reperfusion therapy by means of primary percutaneous coronary intervention is an effective method for treating patients with ST-segment elevation myocardial infarction (STEMI). According to the ACC/AHA guidelines for these patients, the interval between arrival at the hospital and intracoronary balloon inflation (door-to-balloon time) should be 90 minutes or less. The aim of this study was to evaluate the effect of establishing an ECG transmission system and communication procedure in the emergency department (ED) to minimize door-to-balloon time for STEMI patients. METHODS: We established both the out-of hospital and in-hospital aspects of the ECG transmission system. Before patient arrival at our ED, we would attempt to receive initial ECGs from the referring hospitals via fax. In ideal cases, ECG findings were immediately reported to interventional cardiologists by the referring primary ED physician. Door-to-balloon time segments were analyzed in a retrospective manner. We compared the effectiveness in minimizing reperfusion time between the use of inter-hospital 12-lead ECG transmission before patient arrival, and direct communication between emergency physicians and attending interventional cardiologists. RESULTS: Of the total 142 STEMI patients who received percutaneous coronary intervention (PCI) during the study period, 112 (78.9%) received PCI within 90 min. The mean door-to-balloon time of the 27 patients admitted with a pre-arrival 12-lead ECG transmission was significantly less than the others. CONCLUSION: Establishing both out-of hospital and in hospital strategies to reduce door-to-balloon time in patients with STEMI, by using pre-arrival ECG transmission and direct communication between emergency physicians and interventional cardiologists, is an effective approach to minimize time to reperfusion.
Electrocardiography ; Emergencies ; Humans ; Inflation, Economic ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Reperfusion ; Retrospective Studies ; Total Quality Management

A 60-year-old female was admitted with epigastric pain lasting a month. Preoperative diagnosis was choledochal cyst with anomalous pancreaticobiliaryductal union (APBDU), C-P type. A papillary mass measuring 2.5 x 1.9 cm was found adjacent to the pancreaticocholedochal junction. Gallbladder (GB) cancer was also observed. Pyloric-preserving pancreaticoduodenectomy (PPPD) was performed. The patient received adjuvant chemotherapy/radiation therapy on the tumor bed. The gallbladder cancer showed serosal invasion, while the bile duct cancer extended into the pancreas. Although common bile duct (CBD) cancer lesion showed focally positive for p53 and the gallbladder cancer lesion showed negative for p53, the Ki-67 labeling index of the CBD cancer and GB cancer were about 10% and 30%, respectively. Nine months after curative resection, a stricture on the subhepatic colon developed due to adjuvant radiation therapy. Localized peritoneal seedings were incidentally found during a right hemicolectomy. The patient underwent chemotherapy and had no evidence of tumor recurrence for two years after PPPD.
Bile Duct Neoplasms ; Choledochal Cyst ; Colon ; Common Bile Duct ; Constriction, Pathologic ; Female ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Middle Aged ; Neoplasms, Multiple Primary ; Pancreas ; Pancreaticoduodenectomy ; Recurrence ; Seeds