Purpose: Erythropoietin (EPO) is a promising neuroprotective drug. We investigated whether EPO has beneficial effects on neurodevelopmental outcomes in infants with hypoxic-ischemic encephalopathy (HIE). Methods: We retrospectively reviewed the data of 56 infants with HIE born at or after 35 weeks of gestation who were admitted to Inha University Hospital between 2012 and 2021. Patients were divided into two groups based on EPO use and compared. In the EPO group, patients were administered 1,000 U/kg of EPO on days 1, 2, 3, 5, and 7, starting within 24 hours after birth. The primary outcome was death or neurodevelopmental impairment (NDI) at the age of 12 months. Results: EPO was administered to 38 infants, and 18 did not receive EPO. Only 37.5% of patients with HIE (21/56) and 60% of patients with moderate-to-severe HIE (21/35) received therapeutic hypothermia. Among all patients with HIE, death or NDI (21.1 % vs. 50.0%; odds ratio [OR], 0.09; 95% confidence interval [CI], 0.01 to 0.78; P=0.029) and brain injury on imaging (42.1% vs. 83.3%; OR, 0.16; 95% CI, 0.03 to 0.92; P=0.040) were significantly lower in the EPO group than in the control group. Among patients with moderate-to-severe HIE, brain injury on imaging (54.2% vs. 90.9%; OR, 0.04; 95% CI, 0.002 to 0.700; P=0.027) was significantly lower in the EPO group than in the control group. Conclusion EPO administration significantly reduced mortality and NDI in infants with HIE. EPO can be considered an adjunctive therapeutic agent for neonatal HIE.

PURPOSE: To evaluate the values of C-reactive proteins(CRP) for predicting the severity and results of treatment for acute pyelonephritis in women, we compared the severity of symptoms and signs, the laboratory findings and the initial serum CRP according to the early response to treatment. MATERIALS AND METHODS: We retrospectively analyzed 298 female patients who were diagnosed with acute uncomplicated pyelonephritis between January 2002 and Match 2007. All the medical records were reviewed for a variety of factors, and the baseline characteristics and CRP level were compared between the patients with an early response to treatment and those without according to the 3rd hospital day urine analysis. RESULTS: The initial white blood cell(WBC) counts, the CRP level, the neutrophil ratio and severity of symptoms were significantly higher in the delayed response groups than those in the early response groups. The age, history of previous pyelonephritis, symptom duration, body mass index(BMI), and the number of positive blood and urine cultures were not different between the two groups. According to the results of the multivariate logistic regression analysis, the CRP level, neutrophil ratio and mild symptoms were independent predictive variables that affected the delayed response. The odds ratios(95% CI) were 1.078(1.028-1.131) for the CRP, 1.030(1.001-1.060) for the neutrophil ratio and 9.268(1.072-80.166) for the severe symptoms. The differences between the areas under the ROC curves for CRP and the WBC counts and for the CRP level and neutrophil ratio were statistically significant(p<0.001 and p<0.05, respectively). CONCLUSIONS: We found that the discriminatory power of the initial CRP level was high with regard to predicting an early response. So, we were able to determine a CRP level that would be useful in guiding hospitalization.
Acute-Phase Proteins ; C-Reactive Protein* ; Female ; Hospitalization ; Humans ; Logistic Models ; Medical Records ; Neutrophils ; Pyelonephritis* ; Retrospective Studies ; ROC Curve

During a 9-year period 43 children and adolescents 2 to 18 years old underwent 140 extracorporeal shock wave lithotripsy (ESWL) treatments for 48 calculi. The second generation piezoelectric lithotriptor (LT01) was used in 28 cases (65%) while the remaining cases were treated with the third generation piezoelectric lithotriptor (LT02). LT02 lithotriptor differs from an earlier model LT01 in 2 important respects; a stone localization system consisting of ultrasound and fluoroscopy, and more energy per shock wave. The LT01 necessitated caudal anesthesia in 14 cases (50%) while the LT02 necessitated caudal anesthesia in 2 cases (13%) and intravenous anesthesia in 2 cases (13%). Two upper ureteral stones without ureteral dilatation and 1 mid ureteral stone, which were difficult to detect with ultrasound, could be localized by combined ultrasound and fluoroscopy on LT02. The success rate by LT01 and LT02 ESWL was 92.9% and 100%, respectively. The mean session of LT01 and LT02 ESWL was 3.6+/-.4.09 and 2.6+/-2.47, respectively, and the total storage of LT02 ESWL (93+/-97.8) was much less(p<0.05) than that of LT01 ESWL (363+/-380.3). There were no statistical differences in regard to success and the use of stents, stone size or location between the 2 lithotriptors. Six patients required adjuvant procedures, and ESWL complications were not required admission or surgical management. Therefore, LT02 piezoelectric lithotripsy, in comparison with LT01, is more efficient to localize stones and can lessen total storage by reducing treatment sessions in children and adolescents.
Adolescent* ; Anesthesia, Caudal ; Anesthesia, Intravenous ; Calculi ; Child* ; Dilatation ; Fluoroscopy ; Humans ; Lithotripsy* ; Shock ; Stents ; Ultrasonography ; Ureter ; Urinary Calculi

Heparin is commonly used to prevent and treat of thromboembolic events during the endovascular intervention. Rarely, heparin-induced thrombocytopenia (HIT), which is characterized by moderate thrombocytopenia and paradoxical vascular thromboses, complicates systemic heparinization given during endovacular procedures. We present a case of an endovascular treatement of the anterior communicating artery aneurysm complicated by HIT. This case of HIT manifested thromboembolic event and intracerebral hemorrhage simultaneously.
Aneurysm ; Cerebral Hemorrhage ; Embolization, Therapeutic* ; Heparin ; Intracranial Aneurysm* ; Thrombocytopenia* ; Thrombosis

Tension pneumocephalus may follow a cerebrospinal fluid (CSF) leak communicating with extensive extradural air. However, it rarely occurs after diagnostic lumbar puncture, and its treatment and pathophysiology are uncertain. Tension pneumocephalus can develop even after diagnostic lumbar puncture in a special condition. This extremely rare condition and underlying pathophysiology will be presented and discussed. The authors report the case of a 44-year-old man with a basal skull fracture accompanied by pneumothorax necessitating chest tube suction drainage, who underwent an uneventful lumbar tapping that was complicated by postprocedural tension pneumocephalus resulting in an altered mental status. The patient was managed by burr hole trephination and saline infusion following chest tube disengagement. He recovered well with no neurologic deficits after the operation, and a follow-up computed tomography (CT) scan demonstrated that the pneumocephalus had completely resolved. Tension pneumocephalus is a rare but serious complication of lumbar puncture in patients with basal skull fractures accompanied by pneumothorax, which requires continuous chest tube drainage. Thus, when there is a need for lumbar tapping in these patients, it should be performed after the negative pressure is disengaged.
Adult ; Chest Tubes ; Drainage ; Follow-Up Studies ; Humans ; Neurologic Manifestations ; Pneumocephalus ; Pneumothorax ; Skull ; Skull Fractures ; Spinal Puncture ; Suction

PURPOSE: The association between iron deficiency anemia and febrile convulsion in infants has been examined in several studies with conflicting results. Therefore, the authors aimed to evaluate the precise relationship involved. METHODS: In this case-control study, the authors assessed 100 children with a diagnosis of febrile convulsion, aged between 9 months and 2 years, during January 2007 to July 2009. The control group consisted of 100 febrile children without convulsion; controls were closely matched to the cases by age, gender, and underlying disease. RESULTS: The mean ages of the febrile convulsion and control group were 16.3+/-7.4 and 15.8+/-6.1 months, respectively, and the two groups had no differences in clinical features. Iron deficiency anemia (Hb <10.5 gm/dL) was more frequent in the febrile convulsion group than in the control group, although there was no statistical significance. Unexpectably, the RDW (red blood cell distribution width) was significantly lower and the MCNC (mean corpuscular hemoglobin concentration) was significantly higher among seizure cases than among the controls (P<0.05). There is no statistical difference between simple and complex febrile groups in the clinical and laboratory profiles. On multiple logistic regression analysis, iron deficiency anemia was more frequent, but the RDW was lower, among the cases with febrile convulsion, compared with the controls. Conclusions: Our study suggests that the iron deficiency anemia is associated with febrile convulsion, and screening for iron deficiency anemia should be considered in children with febrile convulsions.
Aged ; Anemia, Iron-Deficiency ; Blood Cells ; Case-Control Studies ; Child ; Hemoglobins ; Humans ; Infant ; Iron ; Logistic Models ; Mass Screening ; Seizures ; Seizures, Febrile

BACKGROUND: Rosacea is a common skin condition, but the currently available treatments are not satisfactory. OBJECTIVE: We wanted to assess the efficacy and safety of photopneumatic therapy (PPx), which delivers pneumatic energy and broadband light (400~1,200 nm), for the treatment of erythematotelangiectatic rosacea. METHODS: Twenty two patients with erythematotelangiectatic rosacea were treated 3~5 times with PPx. Three independent dermatologists evaluated the efficacy of PPx by comparing the photographs taken before and after treatment. Patient self-assessment was also done by interviews. RESULTS: The photographic assessment by the dermatologists of the improvement showed that >50% improvement occurred in 64% (14/22) of the patients. The specific categories of improvement were as follows: poor (<25% improvement), 1 patient; fair (25~50% improvement), 7 patients; good (50~75% improvement), 11 patients; and excellent (>75% improvement), 3 patients. Based on the patients' self-assessment, 20 patients (91%) acknowledged an improvement. CONCLUSION: PPx is an effective and safe treatment option for erythematotelangiectatic rosacea.
Humans ; Light ; Rosacea ; Self-Assessment ; Skin

The incidence and the nature of visual involvement in Friedreich's ataxia who showed progressive visual impairment a few years before developing characteristic clinical manifestations of Friedreich's ataxia. The progress of disease in this case suggests that visual involvement may be from the same pathogenetic mechanism of peripheral nervous system in Friedreich's ataxia.
Friedreich Ataxia* ; Incidence ; Optic Atrophy* ; Peripheral Nervous System ; Vision Disorders

OBJECTIVES: There have been developed to use targeting ability for antimicrobial, anticancerous, gene therapy and cosmetics through analysis of various membrane proteins isolated from cell organelles. METHODS: It was examined about the lysosomal membrane protein extracted from lysosome isolated from HeLa cell treated by 100 ppm melanin for 24 hours in order to find associated with targeting ability to melanin using by 2-dimensional electrophoresis. RESULTS: The result showed 14 up-regulated (1.5-fold) and 13 down-regulated (2.0-fold) spots in relation to melanin exposure. CONCLUSIONS: It has been found that lysosomal membrane proteins are associated with melanin to decolorize and quantity through cellular activation of lysosome.
Electrophoresis ; Genetic Therapy ; HeLa Cells* ; Humans ; Lysosome-Associated Membrane Glycoproteins* ; Lysosomes ; Melanins* ; Membrane Proteins ; Organelles

PURPOSE: The increased use of antibiotics may be the main factor responsible for the development and spread of bacterial resistance. This study demonstrated the relation between quinolone use and the rate of isolating ciprofloxacin-resistant(CIPRO-R) Escherichia coli(E.coli) in patients with urinary tract infection(UTI). MATERIALS AND METHODS: From 2001 to 2006, we determined antimicrobial use for 2,803 in terms of the defined daily dose(DDD) and the antimicrobial use density(AUD), and we surveyed the isolation rates of CIPRO-R E.coli in UTIs in both inpatients and outpatients. We also analyzed the correlation between the number of prescriptions and the resistance rates. RESULTS: Of the 637(22.7%) CIPRO-R E.coli isolates, 297(46.6%) were from inpatients and 340(53.4%) were from outpatients. There was a statistically significant correlation between the rate of isolating CIPRO-R E.coli and the amount of quinolone use for the inpatients(r=0.815, p<0.05) as well as the outpatients(r=0.804, p<0.05). A logistic regression analysis identified previous quinolone use as the independent risk factor(odd ratio: 2.604 [95% confidence interval(CI): 1.639-4.137]) for CIPRO-R E.coli in inpatients. Also, these CIPRO-R E.coli showed low sensitivity to ampicillin and trimethoprim/sufamethoxazole(TMP/SMX) in the inpatients(10.4%, 27.3%) and outpatients(5.1%, 27.1%), respectively. CONCLUSIONS: Our study shows a significant correlation between ciprofloxacin resistance and quinolone use, and previous quinolone use seems to be the risk factor for CIPRO-R E.coli bacteriuria. It is necessary to keep antimictrobial therapy under constant surveillance for the prevention of CIPRO-R E.coli.
Ampicillin ; Anti-Bacterial Agents ; Bacteriuria ; Ciprofloxacin ; Escherichia ; Escherichia coli ; Humans ; Inpatients ; Logistic Models ; Outpatients ; Prescriptions ; Quinolones ; Risk Factors ; Urinary Tract ; Urinary Tract Infections