Streptococcus agalactiae or group B streptococcus (GBS) is associated with infectionsin neonates and pregnant women. Herein, we describe a rare case of GBSrenal abscess with peritonitis and pleural effusion in a 17-year-old girl with type 1diabetes mellitus. The girl was admitted due to fever and right flank pain. Laboratoryfindings included leukocytosis and increased C-reactive protein level anderythrocyte sedimentation rate. Her serum glucose level was 484 mg/dL. Urinalysisshowed no pyuria. Renal sonography revealed parenchymal swelling in the rightkidney. The patient was administered intravenous cefotaxime. Urine and bloodcultures were negative. Fever seemed to improve, but the following day, she complainedof abdominal pain and fever. Antibiotic was switched to imipenem, andabdominal and pelvic CT revealed a ruptured right renal abscess, peritonitis, andbilateral pleural effusion with atelectasis. Pigtail catheter drainage of the abscesswas performed. Culture from the abscess was positive for GBS, and fever subsided2 days after the drainage. She was discharged with oral cefixime. The clinical courseof urinary tract infections (UTIs) can be atypical in patients with diabetes, and GBScan be a cause of UTIs. Prompt diagnosis and management are necessary to preventcomplications in patients showing atypical courses.

In 1962, a case of “generalized skeletal dysplasia with multiple anomalies” was reported by Taybi as a new clinical syndrome. The most characteristic features of the syndrome seemed to be hearing loss, cleft palate and peculiar digital anomalies, so, the syndrome designated as otopalatodigital syndrome by Dudding, et al. Recently, the authors have experienced a case of OPD syndrome who visited Yeungnam University Hospital with the chief complaint of hypernasality, and underwent pharyngoplasty for correction of VPI. We present here a new case and review the literature on the subject.
Cleft Palate ; Hearing Loss

No Abstract Available.
Health Behavior*

Purpose: The aim of this study is to evaluate the clinical utility of late 6-month dimercapto-succinic acid (DMSA) renal scan in predicting vesicoureteral reflux (VUR) and long-lasting renal scars in children with first acute pyelonephritis (APN). Methods: A retrospective case study of children admitted with APN from January 2010 to July 2017 was performed. The study included patients with voiding cystourethrography (VCUG) and acute and late 6-month DMSA scan. We analyzed the clinical, laboratory and imaging findings of patients with and without late cortical defects at 6 months and those with or without VUR. Results: Among 145 children with APN, 50 (34.5%) had cortical defects on the late DMSA renal scan and 60 (41.4%) showed VUR. Thirteen of 38 (34.2%) children undergoing 18-month DMSA renal scan showed a long-lasting renal scars. Compared with children without late cortical defects, patients with late 6-month cortical defects had a higher incidence of VUR and long-lasting renal scars, and relapse of UTI (all P<0.05). In a multivariable analysis, both high-grade VUR and relapse of UTI were independently correlated with the presence of late 6-month cortical defects (P<0.05). Late cortical defects and relapse of UTI were also associated with the presence of VUR (P<0.05). Only the late 6-mo cortical defects was an independent predictor of long-lasting renal scars in children with APN (P<0.05). Conclusion An abnormal late 6-month DMSA renal scan may be useful in identifying VUR and long-lasting renal scars in children diagnosed with APN.

PURPOSE: To report two cases of ocular ischemia following scleral encircling. METHODS: A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear. RESULTS: Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis. CONCLUSIONS: In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.
Aged ; Anesthesia ; Anterior Chamber ; Conjunctiva ; Cryotherapy ; Female ; Glaucoma ; Humans ; Ischemia* ; Mannitol ; Muscles ; Ophthalmic Artery ; Paracentesis ; Retinal Artery Occlusion ; Retinal Detachment ; Retinal Perforations ; Young Adult

PURPOSE: To evaluate the major radiologic features of chronic focal pancreatitis in various imaging studies, with special emphasis on CT and ERCP findings. MATERIALS AND METHODS: From 1991 to 1995, twelve patients were pathologically proved to be suffering from focal chronic pancreatitis after pancreatico-duodenectomy ; for retrospective evaluation, imaging studies were available for eight(seven men, one woman ; mean age 58.9+/-6.6, range 47 to 67). Clinical, surgical, and radiological findings, including CT(n=8), ultrasound(n=7), ERCP(n=8) andUGI(n=3) were analysed. RESULTS: Seven male patients had suffered from chronic alcoholism for between 20 and 50years. Serum bilirubin levels were normal in eight patients and alkaline phosphatase levels were normal in seven patients. Serum CA 19-9 levels were normal in all five patients who had undergone preoperative evaluation. Seven patients(87.5%) showed focal enlargement without definable margin on CT, and five of the six lesions detectable on ultrasound(83.3%) were ill defined hypoechoic nodules. Dilated side branches within lesions were seen in five ofeight patients(83.3%) on CT and ERCP. Double duct signs were observed in siven(87.5%) patients, and dilated intrahepatic ducts in six(75%), with diameters ranging from 5 to 8mm(average : 5.42+/-1.96mm). The average ratio ofpancreatic duct caliber to gland width was 0.33+/-0.19. None of the patients had calcification within the lesionand one case showed intraductal calcification. None showed perivascular fat obliteration around the superiormesenteric artery or celiac axis. The average biductal distance between abnormal common bile duct and theimmediately adjacent pancreatic duct was 4.0+/-1.15mm. One of three cases who under went a UGI examination showed severe luminal narrowing and mucosal thickening in the second portion of the duodenum, another showed double contour, and the other merely showed widening of the C-loop of the duodenum. CONCLUSION: Chronic focalpancreatitis mostly demonstrated ill defined focal enlargement and double ductal dilatation. Dilated side brancheswithin the lesion, no vascular encasement, a mild degree of intrahepatic ductal dilatation, a ratio of pancreatic duct to parenchymal width of less than 0.5, and clinical findings including chronic alcoholism and normal CA 19-9serum level may be reliable indicators for differentiating chronic focal pancreatitis from pancreatic cancer.
Alcoholism ; Alkaline Phosphatase ; Arteries ; Axis, Cervical Vertebra ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Dilatation ; Duodenum ; Female ; Humans ; Male ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatitis* ; Pancreatitis, Chronic ; Phenobarbital

Fracuture-dislocation of the cuboid is an extremely rere injury compared with fracture-dislocation of other tarsal bones. We report a case of the fracture-dislocation of the cuboid treated by open reduction and internal fixation.
Tarsal Bones

BACKGROUND: Sympathetic stimulation associated with post-craniotomy pain might subsequently increase blood pressure resulting in postoperative complications. We studied whether scalp nerve blocks would reduce the severity of postoperative pain. METHODS: Thirty-two patients undergoing craniotomy were randomly allocated to either the ropivacaine group (n = 16) or the saline group (n = 16). After the skin closure, we carried out scalp nerve blocks with ropivacaine (0.75%) or saline (0.9%). Visual analog scale scores (VAS), mean arterial pressure, and heart rate were measured at 0.5, 1, 2, 4, 6, 12, 24, and 48 h after extubation. Tramadol 50 mg iv was used as rescue analgesic. The delay before administration of the first analgesic and cumulative dose of rescue analgesic for the first 48 h postoperatively were measured. RESULTS: The ropivacaine group had lower analgesic requirements than the saline group (P = 0.008). The delay before administration of the first analgesic was not different significantly between two groups. VAS was similar between the two groups at each time interval. Postoperative MAP and HR were not significantly different between two groups. VAS did not correlate with these hemodynamic variables. CONCLUSIONS: Although scalp nerve blocks with ropivacaine reduced the analgesic requirement, they did not provide the sufficient pain relief.
Amides ; Arterial Pressure ; Blood Pressure ; Craniotomy ; Heart Rate ; Hemodynamics ; Humans ; Nerve Block ; Pain, Postoperative ; Postoperative Complications ; Scalp ; Skin ; Tramadol

Pulmonary embolism is a fatal complication of major operation. But early detection of pulmonary thromboembolism during general anesthesia is not easy because clinical manifestations of pulmonary thromboembolism are nonspecific during general anesthesia. So the prevention of pulmonary thromboembolism is important for the high risk patients. We experienced a case of pulmonary thromboembolism which occurred in an old female patient with femur fracture immediately after leg elevation following induction of general anesthesia.
Anesthesia, General ; Female ; Femur ; Humans ; Leg ; Orthopedics ; Pulmonary Embolism

This study was carried out to reduce children's sugar, natrium and fat intakes and establish their healthy lifestyle. To achieve these goals, we developed an educational web site and an e-learning system. The targets of this web site are children, parents and educators. This site has various information about sugar, natrium and fat, and has special menus for each target: such as the 'Let's study' for children, 'Guides for child's eating' for parents, and 'Educational softwares, Lesson plans/materials, and Textbooks/Teaching guides' for educators. We developed three nutrient characters and applied them to the web site. We provided information in the form of texts, images, flash and sounds. This site has special boards in 'Nutrition cafe' menu to interchange information or their successful stories between the connecters. We developed an e-learning system with two courses. One is for junior elementary students and the other is for senior students. Children can study each nutrient step by step in a course according to their academic ability and concern. Also, they can evaluate their academic achievement in this system, which was uploaded into 'Let's study' in children menu in the web site. Conclusively this web site and e-learning system could contribute to reducing children's sugar, natrium and fat intakes by helping children study them systematically and effectively by on-line system. We expect this e-learning system would be a new nutrition education system to make nutrition education more active.
Achievement ; Child ; Humans ; Life Style ; Online Systems ; Parents