OBJECTIVES: Over the last 30 years, despite the increasing sophistication in medical care, the mortality of acute renal failure(ARF) has remained virtually unchanged at 40-50%, but the reasons remain unknown. This study intend to identify prognostic risk factors influencing survival and predict the mortality in ARF patients. METHODS: We retrospectively analyzed 152 patients with ARF who required renal replacement therapy, or whose serum creatinine level above 5 mg/dl, from Jan. 1988 to May. 1995. Multiple factors which may influence mortality were evaluated by univariate and multivariate analysis. RESULTS: 1) Of the 152 patients, 97 were male and 55 were female. The mean age was 47 years and the overall mortality was 36.8%. 2) Based on the univariate analysis, age>60 years, cause of ARF, APACHE II score, number of failing organs, peak serum creatinine level, PaO2, coma, hypotension, ARDS, GI bleeding, ventilatory support, need for antiarrhythmics, DIC, cardiovascular failure, pulmonary failure, neurological failure, and gastrointestinal failure were all significant factors discriminating between survivors and nonsurvivors(p<0.05) 3) By multivariate analysis, hypotension, coma, ventilatory support, and age over 60 years were significant independent predictors influencing survival in ARF patients and logistic equation and logit score were as follows : z=-2.04+1.32(age over 60)+2.18(hypotension)+2.88 (ventilatory support) + 3.28(coma) P=ez/(1+ ez) 4) In ROC(receiver-operating characteristic)curve, when the cutoff point was 0.2, maximum sensitivity was 75% and maximum specificity was 82%. CONCLUSION: In ARF, prognostic risk factors for mortality were age over 60 years, hypotension, assisted ventilation and coma. The logit score by multiple analysis is a reliable predictor of mortality in ARF patients, however the further studies are required to confirm these results.
Acute Kidney Injury* ; APACHE ; Coma ; Creatinine ; Dacarbazine ; Female ; Hemorrhage ; Humans ; Hypotension ; Male ; Mortality* ; Multivariate Analysis ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors* ; Sensitivity and Specificity ; Survivors ; Ventilation

In 1,146 term neonates without perinatal problems who were born in Kwangju Christian Hospital, blood TSH levels were measured by immunoradiometric assay. In 397 term neonates among them, blood T4 levels were measured by radioimmunoassay in same specimens. 1) In normal neonates aged 3~5 days, 6~10 days, 11~20 days and 21~28 days, the TSH levels were 8.88+/-5.21(mean+/-SD), 9.44+/-5.16, 9.69+/-4.98, 11.96+/-3.75 IU/ml and the T4 levels were 11.41+/-2.79, 11.37+/-2.82, 11.19+/-2.63, 10.51+/-2.99 g/dl respectively. 2) No significant sex difference in TSH level was found in each age group, and TSH level did not correlate with birth weight. In neonates delivered by Cesarean section, TSH levels were lower than those of the normally delivered. 3) T4 levels did not differ between both sexes, and between types of delivery in each age group, and nor did it correlate with birth wweight 4) If the recall rate should be set at 0.2% of the total, TSH levels above 26.9 IU/ml would be required to recall for serum sampling. TSH level above 2 SD was 19.7 IU/ml. Cutoff points of T4 levels at 1.5 SD and 2 SD were 5.8 and 7.2 g/dl respetively, and the lowest 10th percentile was 7.4 g/dl.
Birth Weight ; Cesarean Section ; Female ; Gwangju ; Humans ; Immunoradiometric Assay ; Infant, Newborn* ; Mass Screening* ; Parturition ; Pregnancy ; Radioimmunoassay ; Sex Characteristics

Ultrasonic evaluation of the pylorus was performed in a group of 22 infants clinically suspected of having Congenital Hypertrophic Pyloric Stenosis (CHPS), from march 1990 to July 1991. In every case the diagnosis of CHPS was confirmed by surgery. Ten normal babies served as the control group. 1) In CHPS group, the mean age on admission was 36.7 +/- 16.4 days, and male to female ratio was 19.3. In control group, the mean age was 33.7 +/- 18.7 days, with the sex ratio of 8 : 2, male predominating. 2) In CHPS group, the mean age of symptom onset was 18.6 +/- 12.7 days, the majority occurring between 2 to 3 weeks (13 cases : 59%). 3) The ultrasonographic measurements showed that the pyloric muscle thickness of CHPS group was 4.94 +/- 1.35 mm (mean+/-S.D), nearly four times greater than that of the control group with 1.30 +/- 0.17mm, whereas the pyloric canal length of CHPS group (18.03 +/- 1.84mm) was increased significantly, but only by 50%, compared with the control group (11.54 +/- 1.70). 4) In CHPS group, operative measurements of pyloric muscle thickness was 5.20+/-1.23mm, not significantly differing from the sonographic measurement, while pyloric canal length measured 22.13 +/- 3.45mm, significantly larger than ultrasonographic measurement. This indicates that the pyloric muscle thickness measured on preoperative ultrasonogram may provide more significant diagnostic value than the pyloric canal length. 5) If the diagnostic criteria for CHPS were taken as pyloric muscle thickness above 4mm and pyloric canal length above 16mm, 21 out of 22 cases (99.4%) were diagnosed correctly.
Diagnosis* ; Female ; Humans ; Infant ; Male ; Pyloric Stenosis, Hypertrophic* ; Pylorus ; Sex Ratio ; Ultrasonics ; Ultrasonography

An objective evaluation of the degree of respiratory impairment in children depends on the establishment of standards of normal function. In addition to sex and growth, various factors such as race and geography have been shown to be important determinants of lung function. The purposes of this paper are to report the result of lung function tests performed on a group of healthy children, to define the range of normal values, to provide a prediction formula of each parameter, and to compare the data with those of other investigators. Pulmonary function tests were performed on 198 healthy normal children in Kwangju between the ages of 5 and 15 years. The following variables were measured: vital capacity, forced vital capacity, one-second forced expiratory volume, peak expiratory flow, and maximal expiratory flow at 25%, 50% of expiratory vital capacity. Simple and complex prediction formulas for variables of PFT are presented according to sex, age, height, weight, and body surface area. 1) With increasing age, height and weight development increased in both sexes and their mean values in each age groups were more higer than those of Korean standard for children. 2) The correlation coefficients were 0.8 or more more in VC, FVC, FEV1 & more higher than that of PEFR, V25, V50. 3) Of the parameters examined, height had the heighest correlation coefficient in all pulmonary function test items. 4) The correlation coefficients by age, weight, body surface area were similar, but according to sex each parameters of PFT varied slightly. 5) Among complex prediction formulas, the correlation coefficients by 3 variables (age, height, and weight) and 2 variables (height and weight) were more higher than others. But disregarding age and weight, the correlation coefficients of height resembled that of simple regression equation. 6) Predicted values of pulmonary function test and correlation coefficients to the parameters were generally higher in boys than those of girls.
Body Surface Area ; Body Weight ; Child* ; Continental Population Groups ; Female ; Forced Expiratory Volume ; Geography ; Gwangju ; Humans ; Lung ; Peak Expiratory Flow Rate ; Reference Values ; Research Personnel ; Respiratory Function Tests* ; Vital Capacity

Acute bacterial infection of bone and joint presents a real challenge to orthopedist because early diagnosis and treatment are difficult and also essential. In almost all practices, fever and erythrocyte sedimentation rate(ESR) are widely used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses. However, interpreting body temperature is difficult and ESR is nonspecific, is not not sensitive, normalizes slowly. Otherwise, C-reactive protein(CRP) is very sensitive and normalizes fast. CRP, body temperature, and ESR were sequentially measured until a normal value was reached in twenty seven patients in whom acute osteomyelitis (17 patients), acute exacerbation of chronic osteomyelitis(4 patients), and septic arthritis(6 patients) had been diagnosed by positive bacterial culture at Kyungpook National University Hospital from June 1984 to May 1985. The results were as follows: 1. CRP normalized within 8.8 days on average. 2. Fever lasted 4.5 days on average. 3. ESR normalized within 41.6 days on average. 4. Initial mean value of CRP was 4.2 positive in acute in acute osteomyelitis and septic arthritis and 3.5 positive in acute exacerbation of chronic osteomyelitis, therefore CRP can be considered as a very sensitive indicator for early detection of acute bacterial infection of bone and joint. Also sequential CRP determination can be used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses.
Arthritis, Infectious ; Bacterial Infections ; Blood Sedimentation ; Body Temperature ; C-Reactive Protein ; Early Diagnosis ; Fever ; Gyeongsangbuk-do ; Humans ; Joints ; Osteomyelitis ; Reference Values

No abstract available.

Granulomatous mycosis fungoides is an extremely rare and unusual histologic variant of mycosis fungoides. This form is clinically characterized by spontaneous resolution of ulcerated nodular lesions into poikiloderma. Histologically, a strong granulomatous component can obscure the underlying cutaneous lymphoma, which is frequently mistaken for non-neoplastic dermatitides or cutaneous sarcoidosis. We report a case of granulomatous mycosis fungoides occurring on the left cheek of 34-year-old man confirmed histologically with an aid of immunohistochemistry and clinical course (immediate response to PROMACE-CYTOBAM chemotherapy), with emphasis on differential diagnosis, along with a review of literature. This is the first documented report in the Korean literature.
Male ; Humans ; Diagnosis, Differential

Xanthogranulomatous pyelonephritis is an uncommon entity of chronic renal infection and often misdiagnosed with renal tumor clinically. The characteristic examination are foamy histiocyte containing lipid material and foreign body giant cell forming granulomas, Macroscopically yellow nodules are present at the area of necrotic tissue. We have experienced a case of xanthogranulomatous pyelonephritis in 38 years old woman and reported with review of some literatures.
Adult ; Female ; Giant Cells, Foreign-Body ; Granuloma ; Histiocytes ; Humans ; Pyelonephritis, Xanthogranulomatous*

Complete patent urachus is a congenital anomaly that remains Open by fistulous tract extending from the bladder to umbilicus even after birth and rarely observed in literatures. We have experienced a case of complete patent urachus and reported with review of some literatures.
Parturition ; Umbilicus ; Urachus* ; Urinary Bladder

No abstract available.
Child* ; Humans ; Infant* ; Skull*