No abstract availble.
Adult ; Appendicitis/*complications ; Humans ; Male ; Mesenteric Vascular Occlusion/*complications/microbiology ; Mesenteric Veins ; Thrombophlebitis/*diagnosis/etiology/radiography ; Tomography, X-Ray Computed

The physiologic changes produced by hypothermia include impairments in the stress response and immune system, and drug clearance, exacerbation of lactic acidosis, cardiac arrhythmias, and coagulopathies. Transfusion with cold blood is known to produce profound changes in body temperature and other metabolic responses with significant morbidity especially in infants and children. Warming blood for transfusion has been a common practice to avoid the dangers of hypothermia following cold blood transfusion. However, overheating of packed red blood cells results in hemolysis and transfusion of hemolyzed blood may cause hypotension, shock, and renal dysfunction. This case report describes an acute hemolysis due to transfusion of overheated blood.
Acidosis, Lactic ; Arrhythmias, Cardiac ; Blood Transfusion ; Body Temperature ; Child ; Erythrocytes ; Hemolysis* ; Humans ; Hypotension ; Hypothermia ; Immune System ; Infant ; Shock

Background: The treatment of pediatric patients with latent tuberculosis infection (LTBI) is a crucial TB control strategy. LTBI is not a reportable communicable disease, and data regarding LTBI treatment in pediatric patients in Korea are scarce. This study aimed to investigate the prescription patterns and treatment completion rates among pediatric patients with LTBI in Korea by analyzing National Health reimbursement claims data. Methods: We retrospectively analyzed outpatient prescription records for pediatric patients aged 18 or younger with LTBI-related diagnostic codes from 2016 to 2020. We compared the frequency of prescriptions for the standard treatment regimen (9 months of isoniazid [9H]) and an alternative treatment regimen (3 months of isoniazid plus rifampicin [3HR]). We also assessed the treatment incompletion rates by age group, treatment regimen, treatment duration, the level of medical facility, physician’s specialty, and hospital location. We performed multivariable analysis to identify factors influencing treatment incompletion. Results: Among the 11,362 patients who received LTBI treatment, 6,463 (56.9%) were prescribed the 9H regimen, while 4,899 (43.1%) received the 3HR regimen. Patients in the 3HR group were generally older than those in the 9H group. The proportion of 3HR regimen prescriptions significantly greater in the later period (2018–2020), in primary hospitals, under the management of non-pediatric specialists, and in metropolitan regions. The overall treatment incompletion rate was 39.7% (9H group: 46.9%, 3HR group: 30.3%). In the multivariable analysis, 9H regimen prescription was the strongest factor associated with treatment incompletion (adjusted odds ratio, 2.42; 95% confidence interval, 2.20–2.66; P < 0.001). Additionally, management in a primary hospital, a hospital’s location in a nonmetropolitan region, and management by a non-pediatric specialist were also significant risk factors for treatment incompletion. Conclusion Our study results suggest that promoting the use of 3HR regimen prescriptions could be an effective strategy to enhance treatment completion. Physicians in primary hospitals, hospitals located in non-metropolitan regions, and physicians without a pediatric specialty require increased attention when administering LTBI treatment to pediatric patients to ensure treatment completion.

In the operation room, members of the surgical team have the ultimate responsibility of safe guarding the patient from electrical devices. The electrosurgical unit is one instrument commonly used during surgical procedures. We have experienced accidental burning. Sixty-seven years-old patient received burn at the site of the ECG electrode which was caused by an electrocautery used in conjunction with electronic monitoring equipment. Although cutting and coagulation powers were very low, the normal size of the ECG electrodes led to the generation of a high current density. Prevention of interactions of this kind between properly functioning monitoring and surgical units requires good communication among all members of the operating room team and every electrical instruments should inspected, tested regularly.
Burns* ; Electrocardiography* ; Electrocoagulation ; Electrodes* ; Humans ; Operating Rooms

PURPOSE: Pathologically, Kawasaki disease (KD) is associated with widespread vascular endothelial damage in the acute phase. The vasculitis induced endothelial injury leads to coagulation abnormalities. Abnormalities of endothelial function, platelet activation, and fibrinolysis are present during acute phase and long after the onset of KD. The aim of study is to evaluate the change of hemostatic markers in the clinical stages of KD and to assess the hemostatic markers to be a useful indicator of the development of coronary artery lesion (CAL). METHODS: Seventy four KD patients diagnosed in Chungnam National University Hospital from November 2004 to June 2007. Eleven febrile control and eleven healthy children were selected for healthy control. All blood samples were collected before and after Intravenous gammaglobulin (IVGG), 2nd week, and 4th-8th week of illness of KD. RESULTS: Initial D-dimer level of Kawasaki disease showed meaningful difference compared to control group (P<0.05). D-dimer and fibrinogen degradation products (FDP) before IVGG increased compared with normal control group and decreased after IVGG administration. It is normalized until 2 weeks later, and continue to decreasing. D-dimer and FDP were significantly different according to the CAL before IVGG. CONCLUSION: The hemostatic markers may change to the clinical stage of KD, which may suggest the degree of endothelial injury. Increased some hemostatic markers may be the predictors for development of CAL.
Child ; Chungcheongnam-do ; Coronary Vessels ; Fibrinogen ; Fibrinolysis ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Platelet Activation ; Vasculitis

PURPOSE: One of the most important adverse effects of long-term cyclosporine therapy is nephrotoxicity, the morphologic changes of which include interstitial fibrosis and arteriolar hyalinization. Recently, several authors have shown that osteopontin plays an important role in the development of interstitial fibrosis by acting as a macrophage chemoattractant and stimulating the production of TGF-beta in experimental cyclosporine nephrotoxicity. However, the relationship between osteopontin and TGF-beta in humans has not been clearly documented so far. We studied the expression of osteopontin and TGF-beta in children with minimal change nephrotic syndrome treated with cyclosporine to demonstrate whether there is a relationship between cyclosporine toxicity and osteopontin expression as previously shown in animal models. MATERIALS AND METHODS: Nineteen children (15 males and 4 females) were the subject of this study. Renal biopsies had been performed before and after the cyclosporine therapy (mean duration: 15.9 months). In 5 patients, additional biopsies were performed after completing the cyclosporine treatment (mean: 26 months). The expressions of osteopontin and TGF-beta were evaluated by immunohistochemistry in the glomeruli and tubulointerstitium. RESULTS: Osteopontin expression was significantly increased in the glomerular mesangium and tubules after cyclosporine treatment. But there was no statistically significant increase of TGF-beta in the interstitium. There was no significant increase in tubular osteopontin and interstitial TGF-beta expression in those cases developing interstitial fibrosis after cyclosporine treatment compared with cases those not developing interstitial fibrosis. No significant changes in osteopontin or TGF-beta expression were observed in subsequent 5 biopsy samples after discontinuation of cyclosporine compared with the first follow up biopsies. CONCLUSION: These results suggest that osteopontin is a nonspecific marker of renal injury rather than a mediator of interstitial fibrosis in cyclosporine nephrotoxicity of human.
Biopsy ; Child ; Cyclosporine* ; Fibrosis ; Follow-Up Studies ; Glomerular Mesangium ; Humans ; Hyalin ; Immunohistochemistry ; Macrophages ; Male ; Models, Animal ; Nephrosis, Lipoid* ; Osteopontin* ; Transforming Growth Factor beta

PURPOSE: To evaluate the usefulness and limitations of power Doppler sonography in determining the tumor vascularity. MATERIALS AND METHODS: Power Doppler sonography was performed on VX2 carcinomas present in rabbit thighs, and the findings were compared with those of microangiography in an almost identical plane. Tumor vascularity was qualitatively analysed on the basis of tumor vessel distribution and density, and the presence of thick and thin vesels ; for a comparison of tumor vascularity as seen on microangiography, tumor blood flow signals shown by power Doppler sonography were graded 3, 2, 1, 0. For quantitative analysis, a comparison was made of the percentage of tumor area occupied by vessels, as shown in each study. Data analysis utilized the Wilcoxon signed-rank test and Spearman correlation test. RESULTS: Mean tumor vascularity scores, as seen on power Doppler sonography and relating to tumor vessel distribution and density, and the presence of thick and thin vessels, were 2.87, 2.73, 2.93 and 2.73, respectively. The means and medians of the percentages of tumor area occupied by vessels were 22.7% & 23.5% and 36.4% & 34.7% on microangiography and power Doppler sonography, respectively. Thus, there was good correlation between these two modes. CONCLUSION: Power doppler sonography could demonstrate the tumor vascularity on microangiography relatively well but tend to overestimate it.
Neoplasms, Experimental ; Statistics as Topic ; Thigh

PURPOSE: Crohn's disease is an inflammatory bowel disease with various symptoms and progressions. For effective identification of various causes and follow up of patients, we used the Vienna Classification from 1998, but we started applying the Montreal Classification in 2005. In this study, our aim was to identify the clinical characteristics of Korean patients with Crohn's disease by using the Montreal Classification. METHODS: A retrospective study was carried out among 111 patients who were evaluated at KyungHee Medical Center from March 1986 through February 2008 as having Crohn's disease. RESULTS: The male-to-female ratio was 1.8:1, and the average age was 27.2+/-9.6 yr. Abdominal pain was the major symptom, and extraintestinal manifestations were seen in 16 cases. Of the Crohn's disease patients, 25.2% were initially misdiagnosed as having tuberculosis. Concerning age at diagnosis, A2 (patients 17 to 40 yr of age) was the largest group. The most common disease location was the ileocolon (L3), and a combined upper gastrointestinal lesion (L4) was most commonly seen in L3. The most common disease behaviors were nonstricturing and nonpenetrating (B1), and although perianal lesions were most common in B1, there were no statistical correlations (P=0.061). Surgical treatments were performed in 46 cases, especially in cases involving complex disease (stricturing&penetrating) (P<0.005) and ileal disease (L1) (P=0.024). CONCLUSION: According to the Montreal Classification of Korean Crohn's disease patients, a more stable manifestation was seen in the group with lower age at diagnosis. Perianal lesions did not have any correlation with the form in which the disease manifested itself. Complex disease and ileal disease required a surgical procedure the most.
Abdominal Pain ; Crohn Disease ; Follow-Up Studies ; Humans ; Ileal Diseases ; Inflammatory Bowel Diseases ; Korea ; Retrospective Studies ; Tuberculosis

PURPOSE: We know little about the natural course of IgA nephropathy (IgAN) in association with histologic changes especially in children. We investigated clinicopathologic features with long-term follow-up biopsy to clarify the outcomes and prognostic indicators for childhood IgAN. METHODS: From our patients' medical records, we retrieved 20 patients with IgAN, to whom renal biopsies had been performed for the initial diagnosis and follow-up to find out any histologic changes. Initial and follow-up biopsies were classified by Haas classification. The changes of these parameters were compared with the evolution of clinical features. RESULTS: Patients were treated with angiotensin-converting enzyme inhibitors in combination with angiotensin receptor blockers (in subclass II or above) and short-term cyclosporine A(in patients showing nephrotic syndrome). Histologic improvement in 7 cases and deterioration in 3 cases were observed. At the time of last biopsy, 10 cases (50%) showed clinical remission and the others showed improved clinical features. These clinical outcomes did not correlate with initial Haas classifications. Hypertension at onset observed in 5 cases (25%) revealed significant correlation with clinical outcome (P=0.01) and last Haas classification (P=0.007). None of the cases showed progression to CRF or ESRD. CONCLUSION: During a mean follow-up of 10.8+/-3.4 years, childhood IgAN showed good clinicopathologic outcome. Hypertension at onset was only a strong predictor of clinicopathologic outcomes, but initial Haas classification cannot predict outcomes in children. Histologic change of IgAN in long term follow-up period cannot be completely predicted by clinical data and vice versa. Therefore, a renal biopsy should be considered as a part of follow-up plan.
Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Biopsy ; Child ; Cyclosporine ; Follow-Up Studies ; Glomerulonephritis, IGA ; Humans ; Hypertension ; Immunoglobulin A ; Medical Records ; Prognosis

Magrjetic resonance (MR) imagings with 0.15 Tesla resistive magnet developed by Korea Advanced Institute of 5cience were performed in 27 patients with various neurologic diseases and compared with X-ray computed tomography (CT). The purpose óf the paper is to evaluate the image quality, the diagnostic value and limitation, and the optimal pulse sequence of MR imagings with a resistive magnet. The MR images were obtained by using a variety of pulse sequence with spin echo technique includïng saturation recovery, T2-weighted spin echo, and/or inversion recovery with various pulse repetition(TR) and echo delay (TE) times. The M R imaging demonstrated the capability of detecting the lesions shown on CT in all cases and also detected an additional finding in one case (multiple sclerosis) which was not seen on CT. The MR imaging appeared to be more useful than CT in the evaluation of syringomyelia of spinal cord and white matter disease, while it failed to demonstrate small calcific lesion or inflammatory nodule (less than 1 cm) shown on CT and has shown somewhat poor contrast resolution in the case of meningioma. The spatial resolution of saturation recovery images was similar or superior to CT, whereas the contrast resolution of saturation recovery was inferior to CT. While the saturation recovery images have shown false negative findings in 5 patients (19%), the inversion recovery and T2-weighted spin echo have shown consistently positive findings. The inversion recovery and T2-weighted spin echo images demonstrated better contrast discrimination between normal and pathologic conditions than the saturation recovery images, but somewhat poorer spatial resolution. Authors suggest that the MR images of both the saturation recovery with 300/30 and T2-weighted spin echo with 1000/90 be used as a routine procedure and additional iversion recovery of 1300/300/30 sequence as a option if white matter disease is suspected.
Discrimination (Psychology) ; Humans ; Korea ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Meningioma ; Spinal Cord ; Syringomyelia ; Tomography, X-Ray Computed