No abstract available.
Osteomyelitis ; Spine

BACKGROUND: Most febrile neutropenic patients are treated in an aggressive manner. However, identification of low-risk patients may enable clinicians to administer risk-based treatment. The object of this study is to certify the factors associated with increased risk at the time of visiting the emergency department. METHODS: This is a retrospective study. We reviewed the medical records of 101 febrile neutropenic patients who had visited the emergency department of Seoul National University Hospital from January 1998 to August 1999. We assumed 22 risk prediction factors that could be assessed at admission to the emergency department and 5 factors that could be assessed during treatment course. To find independent risk-prediction factors, we analyzed these factors respectively by using multiple regression analysis. RESULTS: Tachycardia(aOR=136.5), altered mentality(aOR=28.8), decreased renal function(aOR=20.1), and significant comorbidity(aOR=17.2) are the independent factors associated with higher mortality. Altered mentality(aOR=31.6) and decreased renal function(CCr<75ml/min, aOR=5.4) are those associated with a higher incidence of septic shock. Independent factors associated with persistent(more than 3 days) fever are the early(within 10 days) onset of fever after last chemotherapy(aOR=8.8) and the existence of new pulmonary infiltrates on a simple chest X-ray(aOR=4.3). CONCLUSION: The stability of vital signs, the change of mentality, the renal function, the existence of significant comorbidity, the existence of new pulmonary infiltrates, and the rate of neutropenia are clinically useful risk-predication factors in febrile neutropenia at the time of visiting the emergency department.
Comorbidity ; Emergency Service, Hospital ; Febrile Neutropenia ; Fever ; Humans ; Incidence ; Medical Records ; Mortality ; Neutropenia ; Retrospective Studies ; Seoul ; Shock, Septic ; Thorax ; Vital Signs

No abstract available.
Glomerulonephritis, IGA* ; Immunity, Cellular* ; Immunoglobulin A*

No abstract available.
Glomerulonephritis, IGA* ; Immunity, Cellular* ; Immunoglobulin A*

No abstract available.
Acute Kidney Injury* ; Nifedipine* ; Plasma* ; Renin*

The purpose of this study is to observe the effect of high pull headgear on the craniofacial structures of mixed dentition with Class II malocclusion. The cephalometric headplates of 16 children treated by high pull headgear during 6 months and 18 children during 12 months were traced, digitized and statistically analyzed. The results were as follows. 1. Inhibition of forward growth of maxilla was observed in both group. 2. Clockwise rotation of maxilla was observed in both group. 3. There were distal movement of maxillary 1st molar and inhibition of alveolar bone growth of maxilla. 4. There was compensatory extrusion on mandibular 1st molar. 5. The ratio of anterior facial height to posterior facial height was almostly not changed. In the treatment plan of C II malocclusion by high pull headgear, we must prevent the mandibulasr 1st molar from extruding, and for orthopedic effect, at least 6 months is needed.
Bone Development ; Child ; Dentition, Mixed ; Humans ; Malocclusion* ; Maxilla ; Molar ; Orthopedics

The Ewing's sarcoma comprises approximately less than 10 percent of malignant bone tumors and 5 percent of allbone tumors, occures in almost all bones of the body, and presents a widely divergent roentgenographicmanifestations. The tarsal bones are involved only 2 percent in the Ewing's sarcoma. Two cases experienced byauthors and ten cases published in literatures of Ewing's sarcoma of the tarsal bone were analizedretrospectively. The result were as follows; 1. Of tarsal bones, the calcaneus was 7 cases, the talus 4 cases,cuneiform 1 case. 2. Female was affected more commonly than male, the ratio being 4 to 1 in the tarsal bones. 3.About sixty percent of total case in the tarsal bones had evidence of diffuse sclerotic pattern. All the cases ofthe talus had evidence of diffuse sclerotic pattern. 4. The diseases to be considered in differential diagnosisare as follows: avascular necrosis, tuberculous osteomyelitis, osteosarcoma, and pyogenic osteomyelitis. 5. Thediffuse sclerosis radiographically showed a close relation with dead bone resulting from avascular necrosis due totumor infiltration histologically. Periosteal reactive new bone and osteoid deposition on the dead bone were alsocorrelated with diffuse sclerosis. 6. Because it is difficult to differentiate sclerotic lesions in the tarsalbones by radiographic methods alone, all such lesions should be subject to biopsy as early as possible.
Biopsy ; Calcaneus ; Female ; Humans ; Male ; Necrosis ; Osteomyelitis ; Osteosarcoma ; Sarcoma, Ewing ; Sclerosis ; Talus ; Tarsal Bones

No abstract available.
Antibodies, Antineutrophil Cytoplasmic* ; Wegener Granulomatosis*

PURPOSE: We compared the outcome of transurethral resection of the prostate (TURP) with that of transurethral needle ablation(TUNA) of the prostate in patient with BPH. MATERIALS AND METHODS: From May 1996 to April 1997, 21 patients were treated with TURP and 25 with TUNA. In TURP group, the mean age was 67.2 years and mean prostatic volume was 52.7ml. In TUNA group, the mean age was 67.2 years and mean prostatic volume was 32.1ml. Assessment parameters were International Prostate Symptom Score(1-PSS), quality of life question, uroflowmetry and complications. Post-treatment morbidity was noted if the patients experienced erectile dysfunction, retrograde ejaculation or urinary incontinence. Patients were examined at 3 months from the day of treatment. RESULTS: At 3 months, the maximum flow rate improved from the mean of 10.2+/- 3.2m1/sec to 20.5+/-10.7m1/sec for the TURP group and 9.3+/-1.9m1/sec to 12.5+/-4.3 for the TUNA group. 1-PSS improved from the mean 22.0+/-7.6 to 6.4+/-4.6 for the TURP group and 21.2+/-6.6 to 13.1+/-6.8 for the TUNA group. Quality of life improved from the mean 3.8)1.6 to 1.3+/-1.0 for the TURP group and 4.3+/-0.9 to 2.9+/-1.1 for the TUNA group. Erectile dysfunction was reported in 43% (9/21) of TURP and 5%(1/20) of TUNA. Retrograde ejaculation was reported in 57%(12/21) and urinary incontinence was in 5%(1/21) of TURP. Retrograde ejaculation and urinary incontinence was not reported with TUNA. The mean operation time, hospital stay and a catheterization time in the TUNA group were 45.4min, 1.2days, 4.4days in comparison with 58.7min, 7.0days, 3.6days in the TURP group. CONCLUSIONS: After TURP and TUNA, there was significant improvement in all clinical parameters. But TURP was more effective in improving maximum flow rate, 1-PSS and quality of life. TUNA, however, produced minimal morbidity with no serious complication. With acceptable low morbidity, TUNA appears to be a safe and effective procedure in the treatment of BPH.
Catheterization ; Catheters ; Ejaculation ; Erectile Dysfunction ; Humans ; Length of Stay ; Male ; Needles* ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; Transurethral Resection of Prostate* ; Tuna ; Urinary Incontinence

Hemodialysis requires anticoagulants to prevent fibrin deposition and thrombus formation in the extracorporeal circuit. Unfractionated heparin (UFH) has been used as a conventional anticoagulant for a long time. But recently, many side effects of heparin have been documented: hemorrhage, thrombocytopenia with or without thrombosis, osteoporosis, skin necrosis, alopecia, and hypersensitivity reactions. In the past decade, low molecular weight heparins (LMWH) have been developed. Compared with UFH, these compounds have a longer plasma half life, less variability in the anticoagulant response to fixed doses, and a more favorable antithrombotic to hemorrhagic ratio. Thus, rationales for using LMWH as an alternative to UFH would be a reduced risk of bleeding complications and simplified routines for heparinization due to a longer half-life of the anticoagulant activity. To evaluate the dfficacy and safety of LMWH as an anticoagulant in hemodialysis treatment, we conducted a prospective crossover study with paired comparison of two different heparins in 18 end-stage renal disease patients undergoing hemodialysis. During the first two months of observation, patients received a single bolus of LMWH (Fragmin(R)) 2,552+/-221 aXa IU/one dialysis session. Then patients were switched to UFH dose regimen comprised of a saline prime, no initial bolus and a continuous infusion of 3,174+/-420 IU/one dialysis session for further two months. All hemodialysis sessions were completed uneventfully. The coagulation values of an anti-factor Xa-specific clotting method (Heptest(R)) from citrated whole blood samples taken 15 minutes after starting hemodialysis were 0.47+/-0.21 U/ml with LMWH and 0.12+/-0.03 U/ml with UFH (p<0.05). The values taken 4hours after starting hemodialysis were 0.24+/-0.10 U/ml with LMWH and 0.22+/-0.04 U/ml with UFH (p>). The prolongation of the Heptest clotting times with LMWH and UFH was 2.86 for LMWH and 2.55 for UFH using the shole blood assay. The mean frequency of clot deposition in dialyzer was similar (1.1 vs 0.87) as well as mean venous compression time at the end of dialysis (5.96 vs 6.23 minutes). The hematologic and biochemical parameters such as hemoglobin, platelet count, triglyceride level, total cholesterol and HDL-cholesterol level did not show any differences between the two heparins. We conclude that a single dose of LMWH is effective and safe in repeated use for hemodialysis and prevents clot formation to a similar degree as UFH.
Alopecia ; Anticoagulants ; Cholesterol ; Cross-Over Studies ; Dialysis ; Fibrin ; Half-Life ; Hemorrhage ; Heparin* ; Heparin, Low-Molecular-Weight* ; Humans ; Hypersensitivity ; Kidney Failure, Chronic ; Matched-Pair Analysis ; Necrosis ; Osteoporosis ; Plasma ; Platelet Count ; Prospective Studies ; Renal Dialysis* ; Skin ; Thrombocytopenia ; Thrombosis ; Triglycerides