A basic problem in evaluating upper urinary tract gross hematuria is the large number of diagnostic possibilities. The causation may be suspected after the initial history and physical examination, and can be confirmed with appropriate studies. We have retrospectively studied of 60 patients who confirmed upper urinary tract hematuria through the cystoscopy in period from Oct. 1971 to Dec. 1987. We have performed relatively precise clinical studies such as urinalysis, urine culture, urine cytology, blood clotting disorders, intravenous pyelography, renal arteriography and others and then we have obtained following results. 1. Disease distributions Calculous disease 12 cases (20.0%) Malignant disease 11 cases (18.3%) Vascular disease 7 cases (11.7%) Glomerulonephropathy 4 cases ( 6.6%) Unexplained hematuria 2l cases (35.0%) etc. 2. Cystoscopy, intravenous pyelography and renal arteriography are valuable essential procedures for diagnosis of upper urinary tract bleeding. 3. Cystoscopy, intravenous pyelography and angiography will bring the percentage of patients with a clear diagnosis up to about 70 per cent, especially excretory urography and cystoscopy must always be done.
Angiography ; Blood Coagulation ; Cystoscopy ; Diagnosis* ; Hematuria* ; Hemorrhage ; Humans ; Physical Examination ; Retrospective Studies ; Urinalysis ; Urinary Tract* ; Urography ; Vascular Diseases

Extracorporeal shock wave lithotripsy(ESWL) is becoming treatment of choice for most upper tract calculi, and especially EDAP made piezoelectric E. S. W. L. can treat kidney, upper ureter and lower ureter stones. We present the results of 245 consecutive treatments performed between May, 1987 and February, 1988 with piezoeletric shock wave lithotriptor. 1. The oldest patient was age of 78 and the youngest patient was age of 15 and there was no contraindication due to other systemic disease. 2. No anesthesia were required and only narcotics were given for pain that induced from shock wave, but one, 18 years old female with renal stone was treated with ketamine. 3. Response rate revealed that complete response was 174 cases (71%), partial response was 63 cases (25.7%) and non-response was 8 cases (3.3%). 4. In complete response cases, average requirement of shock wave storages were noted that renal stone was 323, upper ureter stone was 562 and lower ureter stone was 377 and then the shock wave storage was increase depend upon the location of the stone, such as kidney, lower ureter stone and upper ureter stone in priority. 5. Staghorn calculi, multiple renal stones, caliceal diverticular stones, renal stones with migration into the ureter while treatment, impact ureter stones, ureter stones with larger than 2.5 cm and obesity were poor response factors. 6. We adopted push up (9 cases), double J stent (6 cases), stone basket (6 cases), URS.(2 cases) and nephrostomy (1 cases) as auxiliary procedure. 7. Chemical composition of treated stones were that calcium oxalate and phosphate mixed stone8 were 50.6%, calcium oxalates 33.5%, struvites 10.5%, uric acid 3.9% and calcium phosphate 1.3%. 8. We experienced 11 cases (4.4%) of complications: 5 cases of stone street, 3 cases of post ESWL flank pain, 1 case of high fever, 1 case of sepsis and 1 case of perirencal hematoma. 9. As a result, we suggest that we should consider stone size, location, situation of patient and history of stone surgery for good effectiveness from treatment with E.S.W.L.
Adolescent ; Anesthesia ; Calcium ; Calcium Oxalate ; Calculi ; Female ; Fever ; Flank Pain ; Hematoma ; Humans ; Ketamine ; Kidney ; Lithotripsy* ; Narcotics ; Obesity ; Oxalates ; Sepsis ; Shock* ; Stents ; Ureter ; Uric Acid ; Urinary Calculi ; Urolithiasis*

PURPOSE: Transcranial electromagnetic stimulation(TMS) is a noninvasive method which stimulates the central nervous system through pulsed magnetic fields without direct effect on the neurons. Although the neurobiologic mechanisms of magnetic stimulation are unknown, the effects on the brain are variable according to the diverse stimulation protocols. This study aims to observe the effect of the magnetic stimulation with two different stimulation methods on the cultured hippocampal slices. METHODS: We obtained brains from 8-days-old Spague-Dawley rats and dissected the hippocampal tissue under the microscope. Then we chopped the tissue into 450 micrometer thickness slices and cultured the hippocampal tissue by Stoppini's method. We divided the inserts, which contained five healthy cultured hippocampal slices respectively, into magnetic stimulation groups and a control group. To compare the different effects according to the frequency of magnetic stimulation, stimulation was done every three days from five days in vitro at 0.67 Hz in the low stimulation group and at 50 Hz in the high stimulation group. After N-methyl-D-aspartate exposure to the hippocampal slices at 14 days in vitro, magnetic stimulation was done every three days in one and was not done in another group. To evaluate the neuronal activity after magnetic stimulation, the NeuN/beta-actin ratio was calculated after western blotting in each group. RESULTS: The expression of NeuN in the magnetic stimulation group was stronger than that of the control group, especially in the high frequency stimulation group. After N-methyl-D-aspartate exposure to hippocampal slices, the expression of NeuN in the magnetic stimulation group was similar to that of the control group, whereas the expression in the magnetic non-stimulation group was lower than that of the control group. CONCLUSION: We suggest that magnetic stimulation increases the neuronal activity in cultured hippocamal slices, in proportion to the stimulating frequency, and has a neuroprotective effect on neuronal damage.
Animals ; Blotting, Western ; Brain ; Central Nervous System ; Magnetic Fields ; Magnets* ; N-Methylaspartate ; Neurogenesis* ; Neurons* ; Neuroprotective Agents ; Rats*

BACKGROUND: Healthcare-associated infections (HAIs) are among the most important threats to patient safety. When hospitalized children face these threats, there is morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Research on local healthcare epidemiology is necessary to enhance collective knowledge and evidence formanaging this problem. METHODS: We performed a retrospective analysis of databases of patients who were diagnosed with HAIs at Chung-Ang University Hospital (CAUH) from 2007 through 2011. Cases were selected from the microbiology registry databases. The data on prevalence of HAIs in various wards and its annual trends were compared to previously reported nationwide data. Moreover, we analyzed the patterns of antibiotic susceptibility results for HAI pathogens. RESULTS: A total of 181 HAIs were identified in 122 patients. The HAI rate among pediatric patients at CAUH was 2.4/1,000 person-hospital days. Urinary tract infections (UTIs) (53 episodes, 29.3%) were the most common, followed by pneumonia (33 episodes, 18.2%). Staphylococcus aureus was found to be the most common gram-positive organism, whereas Escherichia coli was the most common gram-negative organism. Methicillin-resistant S. aureus (MRSA) comprised 84% of the S. aureus infections. Imipenem resistance was detected in 58.8% and 55.0% of Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively. CONCLUSION: Between 2007 and 2011, UTIs were the most common type of HAIs, and MRSA was the most common pediatric HAI pathogen, both in the general ward and intensive care unit at the CAUH. Further research on the epidemiology and pathogenesis of HAIs is necessary and prevention measures should be implemented to prevent HAIs in children.
Acinetobacter baumannii ; Child ; Child, Hospitalized ; Delivery of Health Care ; Escherichia coli ; Health Care Costs ; Hospitalization ; Humans ; Imipenem ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Patient Safety ; Patients' Rooms ; Pneumonia ; Prevalence ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus aureus ; Urinary Tract Infections

BACKGROUND: The purpose of this study was to investigate the association between diabetes and depressive symptoms among Korean women. METHODS: We performed an analysis of data for 6,572 women aged 30 or over obtained from the Fifth Korean National Health and Nutrition Examination Survey conducted in 2010 to 2011. We examined the presence of depressive symptoms and the treatment of depression according to diabetes status. RESULTS: The presence of depressive symptoms was observed in 22.6% of subjects with diabetes. In the multiple logistic regression model, diabetes was associated with an increased risk of depressive symptoms (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.20 to 1.21) but the treatment of depression among diabetics was less common (OR, 0.54; 95% CI, 0.54 to 0.55). Uncontrolled diabetes (glycosylated hemoglobin > or = 7%) was associated with an increased risk of depressive symptoms (OR, 1.71; 95% CI, 1.69 to 1.73) among diabetics. CONCLUSION: Physicians should manage individuals with diabetes in consideration of the presence of depressive symptoms, especially in those with uncontrolled diabetes.
Depression* ; Diabetes Mellitus ; Female ; Humans ; Logistic Models ; Nutrition Surveys*

Malignant transformation develops in a little less than 2% of mature cystic teratomas. A wide variety of malignant tumors may arise within benign mature cystic teratomas, and the most common of these is squamous cell carcinoma, which account for 75~85%. In general, the tumors are in an advanced stage and the prognosis is poor as most patients die within a year. However, when the tumor is confined to the ovary, they have a good prognosis and the 5-year survival rate is 63~83%. We experienced three cases of squamous cell carcinoma arising in mature cystic teratoma. Two of the carcinomas occurred in postmenopausal women: 58-(case 1) and 66-(case 2) year-old, and were confined to the ovaries. They were alive 37 months and 18 months after the operation, respectively. The third case was a 45-year-old premenopausal woman who had an extraovarian extension of the tumor and early recurrence within two months. Histologically, cases 1 and 3 were conventional well to moderately differentiated squamous cell carcinomas and case 2 showed a well-differentiated squamous cell carcinoma with exuberant proliferating trichilemmal tumor-like areas.
Carcinoma, Squamous Cell* ; Female ; Humans ; Middle Aged ; Ovary* ; Prognosis ; Recurrence ; Survival Rate ; Teratoma*

PURPOSE: Immaure brain is more resistant to seizure-induced neuronal damage than the adult brain in animal study. Immediate early genes such as c-jun play a critical role in neuronal damage. Therefore, we hypothesized that the difference of constitutive and electrically stimulated c-Jun expression would explain the difference in neuronal damage from seizures between immature and mature explant culture. METHODS: Seven and 14 days-in-vitro(DIV) hippocampal explant cultures derived from 8-day-old rat pups were used. Extracellular field recording was done in cultures. A 1-sec stimulus train(60 Hz, 0.1 msec rectangular pulses) was applied to the Schaffer collaterals, and the afterdischarge was recorded in CA1 pyramidal layer. Cultures were returned to the incubator and observed serially. Intensity of propidium iodide fluorescence indicative of neuronal damage was quantitated as percent of total damage induced by 2 mM NMDA. Proteins extracted from individual cultures were analyzed by Western blot. RESULTS: Constitutive c-Jun protein expression at 7 DIV was higher than that at 14 DIV. There was not a significant difference of c-Jun expression between the 7 DIV and 14 DIV cultures after electrical stimulation. Neuronal damage after electrical stimulation in the hippocampus at 7 DIV was significantly lower than at 14 DIV. CONCLUSION: The results show reduced neuronal injury from seizures in more immature culture. However, constitutive expression of c-Jun protein was higher. Higher constitutive expression may inhibit further induction of c-Jun from seizures and thus result in less severe neuronal injury.
Adult ; Animals ; Blotting, Western ; Brain ; Electric Stimulation ; Fluorescence ; Genes, Immediate-Early ; Hippocampus ; Humans ; Incubators ; N-Methylaspartate ; Neurons* ; Propidium ; Rats* ; Seizures

Three dimensional structures of envelope protein from Korean isolates and Nakayama-NIH strain of Japanese encephalitis virus (JEV) were deduced by a computer program (HyperChem 4.0 Chemplus 1.0) based on the data of the three dimentional structure of Tick-borne encephalitis virus. In the three dimensional structure of envelope protein, neutralizing epitope and T-helper cell recognition site of C-terminal region of Korean isolates were structually similar to those of Nakayama-NIH but the N-terminal region was not. Korean JE isolates were compared with Nakayama-NIH strain by using cross-neutralization antibody test. Neutralizing activities of Korean isolates derived from guinea pigs were higher than those of Nakayama-NIH strain against Korean isolates, although the polyclonal antibody titers of Nakayama-NIH showed 1:160 to 1:640 against Korean isolates. According to the results from three dimentional structures and cross-neutralization analyses, the antigenic difference between Korean JE isolates and Nakayama-NIH strain may be dependent on structural difference of envelope protein.
Animals ; Encephalitis Virus, Japanese ; Encephalitis Viruses* ; Encephalitis Viruses, Tick-Borne ; Encephalitis* ; Guinea Pigs ; Korea*

PURPOSE: Allergic inflammation of the lower respiratory tract is a characteristic clinical feature in asthma patients, in which eosinophils play an important role. The activity of eosinophil may be determined by measuring the level of eosinophil cationic protein(ECP) in sputum or serum as a potential marker of the inflammatory severity. METHODS: We measured the serum concentrations of ECP produced by eosinophils in 29 children with M. pneumoniae as the infected group, 26 children with M. pneumoniae as the non-infected group. RESULTS: Number of infected group was 29(male 18, female 11, mean age 5.5 years old), and that of non-infected group was 26(male 17, female 9, mean age 5.2 years old). There were no sex and age differences between the two groups. The mean concentrations of serum ECP in infected group and non-infected group were 14.37+/-9.00microgram/L and 9.15+/-7.75microgram/L, respectively. It showed significant change statistically(P<.05). Total eosinophil count in infected group(221.10+/-232.84/mm3) was higher than that of non-infected group(171.8+/-262.46/mm3). There was no significant difference between the two groups. But there was an increment of serum ECP and eosinophilia and no increment of total IgE and specific IgE in either group(P<.001). CONCLUSION: The results suggest that ECP may as a factor cause damage to the respiratory system similar to asthma in children with M. pneumonia.
Asthma ; Child ; Eosinophilia ; Eosinophils ; Female ; Humans ; Immunoglobulin E ; Inflammation ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory System ; Sputum

PURPOSE: Apoptosis is a process of active cell death which has been suggested to be part of hippocampal cell loss caused by kainic acid (KA). Immature rats showed higher susceptibility and mortality to KA but did not develop recurrent seizure, long term behavioral or neuropathologic changes. We investigated whether this was due to age-dependent resistance, and elucidated the molecular mechanics which mediate P53-induced apoptosis, identifying bax and bcl-2 as P53 protein expressions that serve as a paradigm on how the balance of bcl-2 to bax is differentially altered by apoptotic stimuli. METHODS: Sprague-Dawley rats were classified into postnatal age (P) 10, 15, 20 and 30 days and given specific doses of i.p. KA (P10; 3mg/kg, P15; 4mg/kg, P20; 8mg/kg, P30; 10mg/kg). Only rats that achieved continuous clonic seizure were selected and decapitated at 24, 48, and 72h (n=15 each age). We analysed P53, bax and bcl-2 protein expressions by immunohistochemistry as well as apoptosis by TUNEL in each group. RESULTS: KA-induced hippocampal cell death first appeared in P20. Remarkable expressions of apoptosis, P53 and bax, while bcl-2 proteins were suppressed were observed at 48 hours following KA in P20 and the most prominently affected areas were hippocampal CA1 and CA3 neurons. Similar results were obtained in P30. CONCLUSOIN: A Induction of P53, a growth regulatory gene which has been implicated in apoptosis and the changes in bcl-2 to bax ratio may be important to KA mediated excitotoxicity of specific regions during the critical period of developing rat brain.
Animals ; Apoptosis* ; Brain ; Cell Death ; Critical Period (Psychology) ; Genes, Regulator ; Hippocampus* ; Immunohistochemistry ; In Situ Nick-End Labeling ; Kainic Acid ; Mechanics ; Mortality ; Neurons ; Rats* ; Rats, Sprague-Dawley ; Seizures*