No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus*

PURPOSE: We prospectively determined the value of a non-enhanced spiral CT (NESCT) in the diagnosis of suspected urolithiasis by a comparison with excretory urography (EU). MATERIALS AND METHODS: After giving informed consents, 114 and 103 patients, with suspected urolithiasis, underwent either NESCT or EU, respectively. All the NESCT and EU films were assessed by 2 urologists and 1 radiologist with no knowledge of the clinical histories. The sensitivity, specificity, positive and negative predictive value, diagnostic accuracy and other valuable diagnostics in each group were compared. RESULTS: The sensitivity, specificity and accuracy of NESCT in diagnosing urinary calculi were 96.8, 95.2 and 96.5%, and for EU, were 75.3, 90.9 and 78.6%, respectively. The examinations were performed with an average of less than 5 minutes for the NESCT versus 113+/-31 minutes for the EU, and the times taken to a definitive diagnosis in the two groups were 2.4+/-0.3 and 59+/-5.2 hours, respectively. In the EU group, 24 patients (23.3%) had revisited and 11 (10.6%) were admitted for pain control, prior to the imaging evaluation, only 2 patients (1.7%) revisited, and none were admitted in the NESCT group. In our institution, the cost of a NESCT was more expensive than that of an EU (140,000 vs. 35,790 Won), however the cost-effectiveness is enhanced by the accuracy of NESCT, which lead to fewer ancillary studies. CONCLUSIONS: NESCT is accurate, reliable and safe, and has many advantages over EU, and therefore could be recommended as a first diagnostic modality for the evaluation of patients with suspected urolithiasis.
Diagnosis* ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Urinary Calculi ; Urography ; Urolithiasis*

PURPOSE: The purpose of this study is to induce the differentiation of mast cells from human umbilical cord blood. METHODS: Mononuclear cells and CD34+ cells were obtained from cord blood and were cultured in the presence of stem cell factor, IL-3 and IL-6 in liquid suspension culture for 8 weeks. Mast cell was confirmed by Wright-Giemsa staining, immuno-histochemistry for tryptase and flowcytometry. RESULTS: When mononuclear cells were cultured for 4 weeks, the percentage of CD34-, CD117+ cells increased up to 8% in the presence of SCF only and 6.6% in the presence of SCF and IL-6. After 8 weeks of culture of CD34+ cells, the percentage of CD34-, CD117+ cells was highest at an average of 14.8% when cultured with SCF only, although absolute number of CD34-, CD117+ cells was higher when cultured in the presence of SCF, IL-3 and IL-6. CONCLUSION: We developed human mast cells from umbilical cord blood. However, some other factors such as combination or concentration of cytokines should be considered to enhance the efficiency of mast cell culture. In addition, mature cultured mast cells should be evaluated by flowcytometry as well as a special staining including immunohistochemistry.
Cytokines ; Fetal Blood* ; Humans* ; Immunohistochemistry ; Interleukin-3 ; Interleukin-6 ; Mast Cells* ; Stem Cell Factor ; Tryptases ; Umbilical Cord*

BACKGROUND AND OBJECTIVES: The most common cause of thyrotoxicosis is Graves' disease (GD), while painless thyroiditis (PT) comes in second. In Korea, the treatment of choice for GD is antithyroid drugs (ATDs). Since most cases of PT spontaneously improve, an accurate diagnosis is very important for the proper management of patients presenting with thyrotoxicosis. MATERIALS AND METHODS: Ninety-nine thyrotoxic patients were routinely checked with 99m Technetium (99mTc) thyroid scan except in pregnant or lactating women. We assessed the patients' clinical characteristics, serum levels of free T4 (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), thyrotropin-binding inhibitory immunoglobulin (TBII), and findings of 99mTc thyroid scan. RESULTS: Among the 99 thyrotoxic patients, 69 were diagnosed with GD and 30 had PT. All of the patients with GD, diagnosed by scan, improved clinically and the thyroid hormone returned to normal with ATDs. All patients with PT improved spontaneously without ATDs. TPOAb and TGAb were positive in 13 (43.3%) and 20 (66.7%) patients with PT, respectively. TPOAb and TGAb were positive in 45 (65.2%) and 44 (63.8%) patients with GD, respectively. TBII was positive in only 73.5% of GD, and was entirely negative in the PT group. Mean FT4 level in GD was higher than in PT, but some patients with PT showed the highest level of FT4. CONCLUSION: PT accounted for a very high proportion of thyrotoxicosis in this study. All parameters investigated such as age, sex, goiter size or nature, level of FT4, TPOAb or TGAb, and TBII were unable to differentiate GD from PT. Considering the increased proportion of PT in the current study, we recommend routine thyroid scan in all thyrotoxic patients except in pregnant or lactating women.
Antithyroid Agents ; Diagnosis ; Female ; Goiter ; Graves Disease ; Humans ; Immunoglobulins ; Iodide Peroxidase ; Korea ; Technetium ; Thyroglobulin ; Thyroid Gland* ; Thyroiditis* ; Thyrotoxicosis* ; Thyrotropin

PURPOSE: Acute lower respiratory tract infections (LRI) are important causes of pediatric morbidity and mortality. Recently among the common pathogens causing acute LRI in children respiratory viruses are apparently increasing rather than bacteria and mycoplasma in Korea. This study was aimed to define the distribution of age, seasonal variation and clinical manifestation of respiratory virus in children. METHODS: All 328 children in Seoul, who had hospitalized at the Pediatric ward of Hanyang University (138 children), Hallym University (61 children) and Sungkunkwan University (129 children) for the treatment of respiratory diseases were studied from March, 1997 to February, 1998. In nasopharyngeal aspirates obtained from these patients viral agents were detected by virus isolation and/or antigen detection by indirect immunofluorescent staining. But the subjects who was not found respiratory virus were excluded, although respiratory symptoms were present. RESULTS: 1) One or more agents were identified in 328 subjects. 2) The pathogens identified were Respiratory syncytial virus (RSV : 44.7%), influenza A virus (25.6 %), parainfluenza virus (14.6%), influenza B virus (14.3%), adenovirus (4.3%) and two or more viruses (3%). 3) Infections with RSV, parainfluenza virus and influenza A and B virus occured in epidemics, while adenovirus was isolated sporadically throughout the study period. 4) Clinical patterns of viral LRI were pneumonia (39%), bronchiolitis (34%), croup (18%), acute pharyngitis (7%) and asthma (2%). CONCLUSIONS: RSV was the most important in viral respiratory tract infection in children. Clinical manifestation and epidemic characterics were variable according to the agent. Accordingly, we should acknowledge the importance of respiratory virus to cause the repiratory tract diseases in children.
Adenoviridae ; Asthma ; Bacteria ; Bronchiolitis ; Child ; Croup ; Epidemiology* ; Herpesvirus 1, Cercopithecine ; Humans ; Influenza A virus ; Influenza B virus ; Influenza, Human ; Korea ; Mortality ; Mycoplasma ; Paramyxoviridae Infections ; Pharyngitis ; Pneumonia ; Respiratory Syncytial Viruses ; Respiratory System* ; Respiratory Tract Infections* ; Seasons ; Seoul*

PURPOSE: Foreign body aspiration in the tracheobronchial tree is a common medical emergency in children and represents an important cause of morbidity and mortality. This study was aimed to analyze the clinical spectrum of tracheobronchial foreign bodies in children and to evaluate the causes of late diagnoses. METHODS: A total of 108 patients with foreign body aspiration were recruited in the last 10 years, who had a flexible or rigid bronchoscopic examination. The age, sex, symptoms, causes of aspiration, radiologic findings, and clinical courses were investigated retrospectively. Patients were divided into 2 groups according to the elapsed time from aspiration to a definite diagnosis as early (< or =24 hours after aspiration) and late diagnoses (>24 hours after aspiration). The two groups were compared for clinical courses, radiologic findings, and the duration of admission of early- and late-diagnosed foreign body aspiration. RESULTS: Approximately 80% of the patients were less than 24 months of age and the most common symptoms were the sudden onset of a cough. Hyperinflation or obstructive emphysema (52.8%) and normal chest radiographs (19.4%) were the most frequent radiologic findings. Plain chest radiographies revealed visible foreign bodies in 7.4% of all patients with foreign body aspiration. Nuts were the most common foreign bodies aspirated. Sudden onset of a persistent cough and fever were predominant in the late-diagnosed group.(P<0.05) CONCLUSION: Our results suggest that clinical suspicion upon interviewing is enough to indicate bronchoscopy. The best way to reduce the number of accidents and deaths associated with foreign body aspiration is to promote public prevention polices.
Bronchoscopy ; Child ; Cough ; Delayed Diagnosis ; Diagnosis* ; Emergencies ; Emphysema ; Fever ; Foreign Bodies* ; Humans ; Mortality ; Nuts ; Radiography, Thoracic ; Retrospective Studies ; Thorax

PURPOSE: The aim of our study was to determine the clinical course and the prognosis of pulmonary hypertension (PHT) with bronchopulmonary dysplasia (BPD). METHODS: Two hundred forty infants who were admitted to the neonatal intensive care unit (NICU) of Samsung Medical Center from January 2002 to December 2006 and were diagnosed with BPD were enrolled in this study. We investigated their medical records retrospectively to investigate any difference between BPD with PHT group and BPD without PHT group in clinical characteristics, mortality and morbidity. RESULTS: Nineteen (7.9%) of the 240 patients with BPD developed PHT. The ratio of females to males was 2.8:1. The severity of BPD, the small birth weight for gestational age, the duration of mechanical ventilation and the maximal peak inspiratory pressure were significantly associated with the development of PHT. (P=0.000, P=0.007 and P=0.000, respectively) The mortality was higher in the BPD with PHT group than in the BPD without PHT group. (P= 0.000) BPD with PHT group required longer duration of oxygen therapy and had more rehospitalization for respiratory illness than the others. (P=0.014) More patients were admitted to the pediatric intensive care unit and received mechanical ventilation therapy in the BPD with PHT group. (P=0.001 and P=0.020, respectively) CONCLUSIONS: PHT is one of the causes associated with high mortality and morbidity in BPD patients. Therefore, the physician should be alert to the development of PHT in premature infants with severe BPD, especially if the baby is female, less than 500 g of birth weight, small for gestational age, or supported by mechanical ventilation for a prolonged duration
Birth Weight ; Bronchopulmonary Dysplasia ; Female ; Gestational Age ; Humans ; Hypertension, Pulmonary ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care Units ; Intensive Care, Neonatal ; Male ; Medical Records ; Oxygen ; Prognosis ; Respiration, Artificial ; Retrospective Studies

Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. It may be followed by bronchial stenosis and subsequent atelectasis. We reviewed two patients with traumatic tracheobronchial injuries sustained after vehicular accident. Bronchial stenosis was suspected due to atelectasis which was first detected 5 days and 11 days after the accident, respectively. They didn't respond to conservative management such as chest physiotherapy for about 2 weeks. Flexible fiberoptic bronchoscopy confirmed bronchial stenosis at the left main bronchus in one patient and at the left upper lobe bronchus in the other. The stenotic bronchi were corrected by resection and end-to-end anastomosis, and bronchoscopy performed postoperatively showed good repair. The patients were discharged without complications. Flexible bronchoscopy is useful and reliable in children as well as in adults for early diagnosis of traumatic tracheobronchial injuries. Resection and end-to-end anastomosis is successful in these cases.
Adult ; Bronchi ; Bronchoscopy* ; Child ; Constriction, Pathologic* ; Early Diagnosis ; Humans ; Pulmonary Atelectasis ; Thorax

PURPOSE: The objective of this study was to identify risk factors for growth delay of infants with atopic dermatitis (AD) and to evaluate the nutritional adequacy of therapeutic elimination diets. METHODS: We studied 67 infants with AD aged from 6 to 23 months, who were managed with conservative treatments for more than 3 months in Samsung Medical Center, and compared with 56 normal age-matched infants. Height and weight for age and weight for height were converted to Z score to evaluate their growth. Basic characteristics including birth characteristics, heights and weights of parents, and socioeconomic status of parents were surveyed by the questionnaire. The 24-hour recall method, assessment of all foods eaten on the day prior to the interview, was performed to evaluate dietary intake. A P value <0.05 was considered to be significant. RESULTS: The mean Z scores of height and weight (-0.10+/-1.10 and -0.41+/-0.91, respectively) in male patients were decreased more than those in healthy age-sex-matched controls, (0.44+/-0.77 and 0.07+/-0.77, respectively) (P=0.032 and 0.039 for each) while female infants did not show any difference. Severity of AD, socioeconomic status of parents, duration of breast feeding, and birth characteristics were not different between patient and control groups. Zinc levels of both groups, especially patients, was lower than recommended dietary allowances (RDA). CONCLUSIONS: Infants with AD were shorter than control group, while they did not show nutritional problems. Our study suggests that longitudinal growth assessment should be performed on infants with AD and it may be helpful in counseling about the prognosis of growth.
Aged ; Breast Feeding ; Child ; Counseling ; Dermatitis, Atopic ; Female ; Humans ; Infant ; Male ; Nutrition Policy ; Nutritional Status ; Parents ; Parturition ; Prognosis ; Surveys and Questionnaires ; Risk Factors ; Social Class ; Weights and Measures ; Zinc

The purpose of this study was to prevent the dilutional effect of excessive absorption of irrigating solution by using furosemide intraoperatively during transurethral resection of the prostate. Thirty patients, classified as ASA ps 2 or 3, were selected randomly and divided them into two groups as follows: Group l(N=15); Not-administrated furosemide(control group) Group 2(N=15); Administrated furosemide(Experimental group) All patients were premedicated with hydroxyzine(1 mg/kg, IM) and were performed continuous epidural anesthesia with 2/ lidocaine(1-1.5 mg/segment). 5% D-sorbitols were used for irrigating solution, and Hartmans solutions were given for maintenance fluid. And fixed the irrigating container to 60 cm in height from symphysis pubis. With the starting of operation, 20 mg furosemide was administrated to experimental group. The blood samples for serum Na+, K+, glucose and BUN were obtained at preoperation, 10 min, 20 min, 30 min after the stating of operation and immediate postoperative period, and serum osmolality and effective osmolality were calculated. The results were as follows: l) The values of sodium concentration of control group were decreased significantly at 10 min, 20 min, 30 min after the starting of operation and immediate postoperative period as compared with the preoperative value(p<0.05). But those of experimental group were not changed significantly. 2) The values of serum osmolality and effective osmolality were decreased significantly at 30 min after the starting of operation and immediate postoperative period as compared with the preoperative value(p<0.05). But those of experimenta1 group were not changed significantly. These results show that the dilutional effect of excessive absorption of irrigating solution might be prevented by using furosemide intraopertively. So we would like to recommend the use of furosemide during TURP, especially in patients with congestive heart failure or renal failure.
Absorption ; Anesthesia, Epidural ; Electrolytes* ; Furosemide* ; Glucose ; Heart Failure ; Humans ; Osmolar Concentration* ; Postoperative Period ; Prostate* ; Renal Insufficiency ; Sodium ; Transurethral Resection of Prostate