BACKGROUND: This study aimed to estimate the clinical outcome and identify the characteristics of a group of patients with pulmonary tuberculosis who completed anti-tuberculosis therapy with the First-line drugs in spite of having positive smear results with negative sputum culture results over the previous six months. METHOD: A retrospective chart review of 21 patients who fulfilled the above criteria between 1995 and 1999 was performed. The laboratory data as well as the clinical data of the patient with positive smear results and negative culture results over a six months period were reviewed. RESULTS: The negative conversion of sputum culture results was achieved within 1.3±1.2 months and the negative conversion of the sputum smear results was accomplished during 9.5±3.3 months. Chest X-rays at 5 months following the institution of anti-tuberculosis therapy from all patients revealed improvements. Four out of 21 patients(19%) relapsed during the follow up, 15.2±13.4 months after administering anti-tuberculosis therapy for 13.3±3.1 months. Relapses were confirmed from between 3 months and 4 months after the treatment completion. Only one of the four relapses had no past history of anti-tuberculosis therapy and the others had prior treatment twice (p<0.01). The period of anti-tuberculosis treatment was extended to a mean of 4.6±2.6 months in 12 patients. However, prolongation of anti-tuberculosis therapy had no affect on the relapse rate (odds ratio, 95% CI 0.18, 2.15). CONCLUSION: Prolongation of therapy with the First-line drugs is not necessary for patients with persistently positive smear results over 6 months and negative culture results. A patient who has had prior anti-tuberculosis therapy more than twice should be paid the closest attention.
Follow-Up Studies ; Humans ; Recurrence ; Retrospective Studies ; Sputum* ; Thorax ; Tuberculosis, Pulmonary

No abstract available.
Keratinocytes*

No abstract available.

PURPOSE: Periventricular leukomalacia(PVL) is associated with various neurologic sequelae such as cerebral palsy and cortical blindness. The aim of this study was to analyse the correlation between the degree of PVL on MRI and clinical features or its severity. METHODS:Thirty-eight children with PVL on MRI among children brought to Pusan National University Hospital between January 1996 and August 1999 with development delay, cerebral palsy or epilepsy were included into the study group. We reviewed medical records of the patients including the gestational age, birth weight and neurologic sequelae. The grade for PVL was divided into 1 to 3, and it was based on abnormally increased signal intensity in periventricular white matter or a reduced amount of periventricular white matter or both, and compensatory focal ventricular enlargement. We analysed the relationship of the grade of PVL and various clinical findings. RESULTS: The age ranged from 11 months to 13 years old with a mean of 42 months. History of cesarean delivery and ventilator care were significantly frequent for the severe grade of PVL. Birth weight was significantly lower according to grade of PVL. Gestational age was lower according to the grade of PVL, but was not significant statistically. Incidence of cerebral palsy was significantly higher on the severe grade of PVL. Incidence of epilepsy and mental retardation were 34.2Yo and 23.9M, not associated with the grade of PVL. CONCLUSION: Incidence of cerebral palsy was associated with the severe grade of PVL, so we think MRI can be helpful in predicting neurodevelopmental outcome. (J Korean Pediatr Soc 2000;43 798-805)
Adolescent ; Birth Weight ; Blindness, Cortical ; Brain* ; Busan ; Cerebral Palsy ; Child ; Epilepsy ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Intellectual Disability ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging* ; Medical Records ; Ventilators, Mechanical

Purpose: This study aimed to identify the effect of self-esteem and spouse support on prenatal depression. Methods: The subjects were 131 pregnant women who visited two women clinics located in Changwon City. Data were collected from September 25 to November 20, 2019, and the self-report questionnaire included spouse support, self-esteem, and prenatal depression. The collected data were analyzed by IBM SPSS Statistics ver. 23.0 using descriptive statistics, independent t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple regression analysis. Results: Prenatal depression had a significant negative correlation with self-esteem (r=-0.39, p=0.001) and spouse support (r=-0.36, p<0.001). The factors affecting prenatal depression were religion (β=-0.16, p=0.035), monthly family income (β=-0.15, p=0.040), self-esteem (β=-0.25, p=0.002), and spouse support (β=-0.19, p=0.017); these variables explained 28.4% of the variance in prenatal depression. Conclusion To prevent depression in pregnant women, professional counseling and support systems such as spouses, religious and social environments should be applied to pregnant women, especially those with low self-esteem. Additionally, more financial support should be provided for low-income pregnant women. Further, there is a need to screen and manage the risk of depression in pregnancy.

No abstract available.
Sinusitis*

Cyclosporine can cause remission of 60% in steroid resistant FSGS, but its responses are variable. Now we report two cases of steroid resistant FSGS who are maintaining remission using cyclosporine continuous therapy. The first patient had been failed several times of steroid therapy, had edema, azotemia and severe proteinuria. We used steroid pulse therapy then maintenance dose of oral cyclosporine to reduce proteinuria for more than 6 years. He has been received cyclosporine therapy up to now and maintaining normal renal function. The second patient had severe azotemia who needed hemodialysis but after cyclosporine therapy, he recovered his renal funciton. The findings of renal biopsies in one patient after 6 years of cyclosporine therapy revealed that there was no improvement of sclerosing glomeruli, then we guess that maintenance therapy of cyclosporine might need for lifelong period.
Azotemia ; Biopsy ; Cyclosporine* ; Edema ; Humans ; Proteinuria ; Renal Dialysis

PURPOSE: Hemolytic uremic syndrome(HUS) is the most common cause of renal failure in childhood in western countries, but it has been a relatively rare disease in Korea. To analyze the clinical and epidemiologic characteristics of HUS in Korea, we reporte our experience, METHODS: We reviewed retrospectively the medical records of 9 patients who were diagnosed the hemolytic uremic syndrorne at Pusan National University during the period from January 1984 to December 1998. RESULTS: The age at presentation ranged from 3 years to 12 years old(mean: 5.9 years). Six of the children were typical and three patients were atypical. Six cases had grossly bloody stools and seven had abdominal pain. Oliguria developed in four cases and gross hematuria in eight cases. One case had seizure and letargy. Verotoxin producing E. coli(VTEC) were found in the stool specimens of two pa- tients. One was the serotype 0157:H7 and the other was the serotype 026:H-, Olll:H21. Verotoxin 1 (VT1) genes were identified by PCR in both of the cases. All patients required conservative treatment. Two patients were treated with peritoneal dialysis, one patient with hemodialysis and one patient with plasmapheresis. Of 9 case, 6 recovered without residual sequelae, but two patients died, and one patient progressed to end stage renal failure. CONCLUSION: Two thirds of our cases were typical type of HUS, which is now the predominant type among Korean childhood HUS sufferers. From this study, we suggest that patients diagnosed with typical HUS should be studied for the verotoxin of E. coli isolated from stool.
Abdominal Pain ; Busan ; Child* ; Hematuria ; Hemolytic-Uremic Syndrome* ; Humans ; Korea ; Medical Records ; Oliguria ; Peritoneal Dialysis ; Plasmapheresis ; Polymerase Chain Reaction ; Rare Diseases ; Renal Dialysis ; Renal Insufficiency ; Retrospective Studies ; Seizures ; Shiga Toxins

A 65-year-old female patient visited our clinic complaining of multiple skin lesions since one year ago. There were yellowish to brownish colored, bean to walnut-sized nodules on both lower extremities. Dylon stain with polarizing microscopy, immunohistochemical stain to amyloid P and immunoglobuhn-kappa chain showed positive reactivities but keratin stain was negative. According to histopathologic and immunohistochemical findings, she was diagnosed as nodular amyloidosis.
Aged ; Amyloid ; Amyloidosis* ; Female ; Humans ; Lower Extremity ; Microscopy ; Skin

BACKGROUND: Paraquat is a widely used herbicide, known to cause lethal toxicity in humans. Most studies about paraquat have concentrated on systemic toxicity, however several cases of paraquat-induced dermatitis have been reported. OBJECTIVE: The purpose of this study was to confirm the cutaneous toxic effect of paraquat and to select potential antidotes in paraquat-induced dermatitis. METHODS: Keratinocyte toxicity due to paraquat and the toxicity reduction capacity of several drugs were investigated in eitro. Topical effects of these drugs on paraquat-induced dermatitis in guinea pig skin was also investigated. RESULTS: Over 50% of keratinocytes failed to survive at a concentration of 2X10-4M paraquat by a neutral red uptake assay. Skin irritation by paraquat was observed at 2% concentration by non-invasive methods as well as a skin biopsy. Dexamethasone, glutathione and tocopherol showed some capacity to reduce paraquat-induced keratinocyte toxicity in vitro. Only dexamethasone, however, showed a reduction of cutaneous blood flow volume and dermal inflammatory cell infiltration in the guinea pig study. CONCLUSION: This result indicates the possible in eitro protective effect of paraquat toxicity in glutathione and tocopherol. Dexamethasone was capable of reducing paraquat-induced cytotoxicity and dermatitis both in vitro and in vivo.
Animals ; Antidotes* ; Biopsy ; Dermatitis ; Dexamethasone ; Glutathione ; Guinea Pigs ; Humans ; In Vitro Techniques ; Keratinocytes ; Neutral Red ; Paraquat* ; Skin* ; Tocopherols