PURPOSE: The purpose of this study was to describe the clinical characteristics of neonatal urinary tract infection (UTI) caused by Klebsiella pneumoniae and non- Klebsiella pneumoniae UTI. METHODS: We compared clinical characteristics of 84 neonatal patients with UTI caused by Klebsiella pneumoniae who were hospitalized at the Department of Pediatricsat Han Dong University, Sunlin Hospital during the period between May, 1994 and August, 1998. The cases were divided into two groups depending upon causative organisms' Klebsiella pneumoniae UTI vs non-Klebsiella pneumoniae UTI, and the clinical characteristics of these groups were compared. RESULTS: Escherichia coli was the most common bacterial pathogen causing neonatal UTI, followed by Klebsiella pneumoniae. There was no significant difference in the sex distribution of Klebsiella pneumoniae UTI, but non-Klebsiella pneumoniae UTI showed male predominence. There were no significant differences in the incidences of hematologic, urologic, radiologic findings and perinatal complications in between these 2 groups. CONCLUSION: Klebsiella pneumoniae is the second most common pathogen causing neonatal UTI. There were no specific differences in the laboratory, symptomatologic, and radiologic findings in these two groups.
Escherichia coli ; Humans ; Incidence ; Klebsiella pneumoniae* ; Klebsiella* ; Male ; Pneumonia ; Sex Distribution ; Urinary Tract Infections* ; Urinary Tract*

The elevation of plasma total homocysteine(tHcy) is now established as a risk factro for cardiovascular disease. It is also well known that plasma levels of folate and vitamin B/sub 12/ influences homocysteine metabolism as cofactors. Recently, the effects of health-related lifestyle factors, such as smoking, alcohol drinking coffee consumption, regular exercise, and etc, on plasma tHcy have been determined. The Hordalane Homocysteine Study revealed that smoking and coffee consumption are major deter minants of plasma tHcy as well as folate levels; however, the influence of alcohol intake is still controversial. In Koreans, the effects of lifestyle factors of plasma tHcy have not yet been determined. Thus, we investigated the relationships of various lifestyle determinants with plasma tHcy, folate, and vitamin B/sub 12/ levels and the erythrocyte folate concentrations in Korean adults (99 males and 96 fermales). Plasma tHcy levels were significantly hight in male subjects. On the contrary, plasma levels of folate and vitamin B/sub 12/ and erythrocyte folate concentration of the females were significantly higher than those of the males. Among the five lifestyle factors determined in the study, regular exercise significantly affects plasma tHcy levels only in the females, Contrary to the expectation, there were on significant differences in plasma tHcy levels between alcohol drinkers and non-alcohol drinkers as well as smokers and non-smokers. And also, plasma tHcy leverls were not different between coffee consumers and non-coffee consumer and between green tea consumers and non-green tea consumers. Although alcohol intake did not influence plasma tHcy levels, the duration, frequency, and amount of alcohol drinking showed significant negative relationships with plasma folate levers. These results indicate the regular exercise and alcohol intake might influence plasma levels of tHcy and folate in Koreans, although the results were not reveled in both sexes.
Adult* ; Alcohol Drinking ; Cardiovascular Diseases ; Coffee ; Erythrocytes ; Female ; Folic Acid* ; Homocysteine* ; Humans ; Life Style* ; Male ; Metabolism ; Plasma ; Smoke ; Smoking ; Tea ; Vitamin B 12 ; Vitamins*

Plate fixation is being regarded as one of the reliahle fixation method in the management of tibial fractures. But this technique may leave many complications including infection. However, delayed local infection which developed several weeks after open reduction on the tibia has been rarely described as a complication in the literatures. The purpose of this study is to evaluate the contributing factors to the delayed locaI infection in tibial fracture treated with plate fixation. Authors reviewed and analyzed the 60 cases of tihial fracture that were treated with plate and screws from 1989 to 1996. Analyses dealt with fracture classification, laboratory and radiographic findings and the site of plate application. We defined a delayed local infection as a condition in which patient has infection signs on Jaboratory and physical examination at or over 8 week post-operation without any evidence of osteomyelitis on plain radiographs. We found 7 cases of delayed local infection out of 60 tibial fractures from 8 to 21 weeks postoperatively with an average of 14.1 weeks. All the 7 cases that had been treated with plate on medial aspect of tibia were treated by administration of antibiotics without surgery such as debridement or removal of hardwares. Authors concluded that the medial plating was the most important factor of the development of delayed local infection(Z=1.78).
Anti-Bacterial Agents ; Classification ; Debridement ; Humans ; Osteomyelitis ; Physical Examination ; Tibia ; Tibial Fractures*

Purpose: This study examined the research trends using G-power centered on major Korean registered sites and presents the research trends of studies with a high level of evidence.Method: This study selected three research journals listed in the Korea Research Foundation among physical therapy journals in the field of physiotherapy. The selected papers were classified according to the following: 1) study type, 2) study level, and 3) quality of the study.Result: Sixty-nine articles were selected and classified according to the study type. The musculoskeletal system, central nervous system, and others comprised 73.91% (n=51), 17.39% (n=12), and 8.7% (n=6), respectively. The results were classified into 62 experimental studies, four observational analytic studies, and three descriptive studies. The experimental studies included 22 randomized controlled trials (level 2) and 40 non-randomized trials (level 3). Sixteen randomized controlled trials were classified for a qualitative evaluation, and 12 papers with a score of six or more (good) were found. Conclusion Many high-level studies were found in G-power, and the quality of the study was also good. Therefore, the effective number of samples obtained using G-power is one of the ways to enable high-quality research.

Purpose: This study examined the research trends using G-power centered on major Korean registered sites and presents the research trends of studies with a high level of evidence.Method: This study selected three research journals listed in the Korea Research Foundation among physical therapy journals in the field of physiotherapy. The selected papers were classified according to the following: 1) study type, 2) study level, and 3) quality of the study.Result: Sixty-nine articles were selected and classified according to the study type. The musculoskeletal system, central nervous system, and others comprised 73.91% (n=51), 17.39% (n=12), and 8.7% (n=6), respectively. The results were classified into 62 experimental studies, four observational analytic studies, and three descriptive studies. The experimental studies included 22 randomized controlled trials (level 2) and 40 non-randomized trials (level 3). Sixteen randomized controlled trials were classified for a qualitative evaluation, and 12 papers with a score of six or more (good) were found. Conclusion Many high-level studies were found in G-power, and the quality of the study was also good. Therefore, the effective number of samples obtained using G-power is one of the ways to enable high-quality research.

PURPOSE: This study was performed to evaluate clinical manifestations and findings of ultrasonogram of neonatal septic arthritis and osteomyelitis. We tried to determine the value of ultrasonogram as a tool for early diagnosis of septic arthritis and osteomyelitis. METHODS: We reviewed the records of 17 patients, who were diagnosed septic arthritis and/or osteomyelitis in Departments of Pediatrics and Orthopedic Surgery, Han dong University Sunlin Hospital in Pohang between Jan. 1994 and Sep. 1998. Radiologic findings were reviewed retrospectively according to the duration of symptoms at the onset. We compared the sensitivity of ultrasonogram with other radiologic tools done within 7 days of illness. RESULTS: We compared sensitivity of each imaging study done within 7 days of illness. 20%(3/5) had abnormality in plain radiographs, 78.6%(11/14) in ultrasonogram, 28.6%(2/7) in bone scan, and 100,0%(3/3) in MRI. Deep soft-tissue swelling around the bone was the earliest sign of acute osteomyelitis in ultrasonogram. Concurrently early septic arthritis showed deep soft tissue swelling around the joint and increased synovial effusion in ultrasonogram. CONCLUSION: Ultrasonogram is not so expensive, non-invasive, not harmful to patients, and there is no need to sedate patients for examination. Comparing with other imaging studies, the sensitivity of ultrasonogram is relatively high. Ultrasonogram is a useful diagnostic tool of septic arthritis and osteomyelitis in newbom infants.
Arthritis, Infectious* ; Early Diagnosis ; Gyeongsangbuk-do ; Humans ; Infant ; Joints ; Magnetic Resonance Imaging ; Orthopedics ; Osteomyelitis* ; Pediatrics ; Retrospective Studies ; Ultrasonography

BACKGROUND: Clinically apparent thyroid nodule is a very common disease in adults. Patients are often treated with thyroxine in order to reduce the size of the nodule, but the efficacy of thyroxine-suppressive therapy with thyroxine remains uncertain. We investigated the efficacy of thyroxine-suppressive therapy and the hormonal characteristics during thyroxine therapy to find out whether such measurement could be used to determine the effectiveness of this therapy in patients with benign solitary thyroid nodule proved by aspiration biopsy. METHODS: In this study, 54 patients were randomly assigned to receive L-thyroxine (Group I, n=24) or placebo (GroupII, n=30) for 1 year. High resolution ultrasonography (10MHz) was used to measure the size of the nodules at six month intervals. Thyroid hormones and thyroglobulin assay and FNA (fine needle aspiration) was done at the same time. The dose of thyroxine was 200ug/day. Patients were followed at 6 month intervals. RESULTS: The results were as follows: 1) 13 (54.1%) out of 24 Group I patients after adequate TSH suppression had a statistically significant reduction of nodule size and before-to-after nodule volume ratios were significantly different between the Group I and Group II patients. 2) In the responders among Group I patients, the before-to-after therapy ratio of the nodule volume was not related to the pretreatment nodule size, thyroid hormones and thyroglobulin levels. CONCLUSION: Thus we concluded that an adequate suppressive dose of L-thyroxine significantly altered the volume of the benign solitary thyroid nodules 12 months later.
Adult ; Biopsy, Needle ; Humans ; Needles ; Thyroglobulin ; Thyroid Gland* ; Thyroid Hormones ; Thyroid Nodule* ; Thyroxine* ; Ultrasonography

OBJECTIVE: We investigated whether there are any different results in the overall sagittal alignment, neutral functional spine unit (FSU) angle and segmental FSU ROM (range of motion) angle from the patients undergone by cervical arthroplasty with two kinds of artificial cervical disc prostheses, Bryan and Mobi-C cervical disc. METHODS: Twenty eight patients underwent anterior cervical discectomy and implantation of artificial cervical disc prosthesis; Eighteen of them underwent operation with Bryan and the rest of them with Mobi-C cervical disc prosthesis. These patients consist of fourteen females and fourteen males with mean age 46.9 years old and 9.4 months mean follow-up period. There were 4 cases of C 4-5, 18 cases of C 5-6 and 6 cases of C 6-7 level. We measured overall sagittal alignment, neutral FSU angle and segmental FSU ROM angle using lateral radiographs preoperatively and postoperatively. The clinical outcome was evaluated by neck disability index(NDI). RESULT: The average angle of overall sagittal alignments was changed from -17.45degrees preoperatively to -14.21degrees postoperatively in Bryan cervical disc group. It decreased 3.24degrees in cervical lordosis. However, in Mobi-C cervical disc group, the average angle of overall sagittal alignments was changed from -10.33degrees preoperatively to -16.89degrees postoperatively. It increased 6.56degrees in cervical lordosis. The averages of neutral FSU angles were -1.14degrees preoperatively and -3.26degrees postoperatively in Bryan cervical disc group, and were -0.93degrees preoperatively and -9.7degrees postoperatively in Mobi-C cervical disc group. The averages of segmental FSU ROM angles were 11.18degrees preoperatively and 10.61degrees postoperatively in Bryan cervical disc group, and was 8.31degrees preoperatively and 13.6degrees postoperatively in Mobi-C cervical disc group. NDIs were 24.0 preoperatively and 5.9 postoperatively in Bryan cervical disc group, and 24.7 preoperatively and 8.7 postoperatively in Mobi-C cervical disc group. CONCLUSION: Postoperative cervical lordosis and segmental FSU ROM angle were increased in Mobi-C cervical disc group (p<0.05). To preserve segmental motion and avoid adjacent segment degeneration is to the focus in cervical arthroplasty. To preserve cervical lordosis after operation is physiologic than postoperative cervical kyphosis. It remains controversial whether cervical kyphosis influences clinical outcome after anterior cervical operation. The results of this study show that the technical and mechanical improvement of Bryan cervical disc prosthesis may be considered.
Animals ; Arthroplasty ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; Lordosis ; Male ; Neck ; Prostheses and Implants ; Spine

OBJECTIVE: Defining right and left side differences in mandibular ramus height is one of the key elements in the diagnosis of facial asymmetry. The purpose of the present study was to evaluate the effect of correction of ramus height with frontal and lateral ramal inclinations (FRI and LRI) in 2-dimensional cephalograms and observe how this affects the diagnostic accuracy of asymmetry. METHODS: Frontal and lateral cephalograms were obtained in 40 individuals with chin deviation. FRI and LRI were measured on each side and ramus height measurement was corrected with these inclinations using Pythagorean's theorem. The results of diagnosis before and after correction on cephalograms were compared with the results in 3D CT images. RESULTS: Both FRI and LRI showed greater values in the contralateral side than in the chin-deviated side and these contributed to an increase in the right and left side ramus height differences. After comparison of diagnostic results before and after correction on cephalograms with the results on 3D CT images, the sensitivity increased significantly (from 74 to 94 %) whereas the specificity decreased (from 44 to 22 %). Overall accuracy increased from 68 to 78 % with the correction using FRI and LRI. CONCLUSIONS: The results of the present study indicate that correction of ramus height with FRI and LRI is useful for an accurate diagnosis of facial asymmetry on frontal cephalograms.
Chin ; Diagnosis ; Facial Asymmetry ; Sensitivity and Specificity

A 77-year-old female patient who was suspected to have had an acute hemolytic transfusion reaction was admitted to the emergency room. She received one unit of type A red blood cells in a type B patient during a total knee arthroplasty operation at another medical institution. ABO-incompatible transfusion was carried out due to an identification error between the patient and blood product. At the time of admission, acute hemolytic reaction, lactic acidosis, and disseminated intravascular coagulation were observed. She was admitted to the intensive care unit and received continuous renal replacement therapy. She maintained renal function and was moved to the general ward on the 7th day. Complications such as pulmonary edema, gastrointestinal bleeding, and ischemic colitis persisted, and the patient died on the 111th after admission. This case is the first report of death due to an ABO-incompatible transfusion in Korea. Efforts to establish a safe transfusion environment are necessary not only at individual medical institutions but also at the national level.
Acidosis, Lactic ; Aged ; Arthroplasty, Replacement, Knee ; Blood Transfusion* ; Colitis, Ischemic ; Disseminated Intravascular Coagulation ; Emergency Service, Hospital ; Erythrocytes ; Female ; Hemorrhage ; Humans ; Intensive Care Units ; Korea ; Patients' Rooms ; Pulmonary Edema ; Renal Replacement Therapy ; Transfusion Reaction*