No abstract available.
Rupture* ; Subclavian Artery*

PURPOSE: This study was performed to elucidate the clinical pictures of acute focal bacterial nephritis(nephronia) in children. METHODS: We reviewed 9 children with nephronia diagnosed by ultrasonography or computed tomography of kidneys from September 1994 to August 2004. RESULTS: The overall male to female ratio was 2:1, and the age distribution ranged from 0.1 to 6 years(mean 2.8+/-2.2). The cardinal symptoms were fever, chills, abdominal pain and dysuria/frequency. The initial leukocyte count was 21,000+/-5,600/uL; ESR, 60+/-23 mm/hr; CRP, 17+/-10 mg/dl. Pyuria was noted in every patient and persisted for 10.5+/-7.8 days after antimicrobial treatment. Abdominal sonography demonstrated focal lesion of ill-defined margin and low echogenicity in 5 of 9 patients(55.6%), while computed tomography revealed nonenhancing low density area in all patients(100%). Three of 9 patients(33.3%) had vesicoureteral reflux, greater than grade III. The initial (99m)Tc-DMSA scan showed one or multiple cortical defects in every patient, and improvements were noted in 2(33.3%) of 6 patients who received follow up scan after 4 months. Intravenous antibiotics was given in every patient under admission. Total febrile period was 11.8+/-6.3 days(pre-admission, 4.0+/-3.0; post-admission, 7.8+/-5.5 days) and the patients needed hospitalization for 17.2+/-8.1 days. CONCLUSION: For the early diagnosis of 'acute focal bacterial nephritis' we should perform renal computed tomography first rather than ultrasonography, when the child has toxic symptoms and severe inflammatory responses in blood and urine.
Abdominal Pain ; Age Distribution ; Anti-Bacterial Agents ; Child* ; Chills ; Early Diagnosis ; Female ; Fever ; Follow-Up Studies ; Hospitalization ; Humans ; Kidney ; Leukocyte Count ; Male ; Nephritis* ; Pyuria ; Ultrasonography ; Vesico-Ureteral Reflux

No abstract available.
Prostate*

PURPOSE: Asthma inhalation therapy is important for the treatment of childhood asthma. Therefore, it is necessary to educate patients on the correct inhalation techniques. The purpose of this study was to determine the effectiveness and necessity of educating patients on the correct inhalation techniques. METHODS: A total of 86 patients with bronchial asthma and who were over 7 years old were enrolled and educated on handling inhaler devices for 2 years. The inhaler devices used were the diskus (n=27), turbuhaler (n=12) and metered dose inhaler with a spacer (n=47). Trained pharmacists provided the education. Four steps (breathing out prior to inhalation, inhalation, holding the breath, exhaling slowly) that were critical for handling each device were evaluated and each step was scored as good, fair or poor. We evaluated the symptom score (daytime cough, nighttime cough, sleep disturbance and limitation of activity) and lung function before treatment and 4 weeks later. RESULTS: Over 90.0% of the diskus users performed fair to good in each step. The symptom score and lung function at 4 weeks later after education were significantly improved (P=0.000). The turbuhaler users all performed fair to good on each step. The symptom score was significantly improved (P<0.005), but the lung function was not difference. Over 95% of the users of a metered dose inhaler with a spacer performed moderate to good on each step. The symptom score and lung function were significantly improved (P<0.05). CONCLUSION: The structured, detailed education on inhaler devices by trained specialists was very important for performing correct inhalation therapy to control asthma, and repeated education might be also necessary.
Asthma ; Cough ; Exhalation ; Handling (Psychology) ; Humans ; Inhalation ; Lung ; Metered Dose Inhalers ; Nebulizers and Vaporizers ; Pharmacists ; Respiratory Therapy ; Specialization

Clear cell sarcoma of kidney(CCSK) is a rare pediatric neoplasm characterized by a predominating component of clear cells, a predilection for metastases to bone, and a poor prognosis. The incidence of CCSK peaks during the 2nd year of life and adult cases are very rare. We report a case of CCSK encountered in the right kidney of a 39-year-old man. Grossly, it was a lobulated mass showing infiltrative margin, measured 7x5.5x5cm and had a homogeneous gray-tan color with a soft, fish-flesh consistency. Microscopically, about half of the tumor revealed the classic pattern of CCSK, having tumor cell cords or nests separated by the characteristic alveolar capillary networks. The tumor cells had clear pale cytoplasm, bland looking round nuclei and inconspicuous nucleoli. The other half showed the epithelioid-trabecular pattern forming pseudorosette or cord-like structures. Immunohistochemically, there was only a focal positive reaction to vimentin. Ultrastructurally, the tumor cells showed the primitive nephrogenic mesenchymal differentiation such as electron lucent cytoplasm, a small amount of organelles, scanty heterochromatin, inconspicuous nucleoli, and a lack of flocculant basal lamina material around the cytoplasmic membrane. We consider that this is a case of CCSK occuring in the oldest patient ever reported, confirmed by both immunohistochemistry and electron microscopy.
Adult ; Male ; Female ; Humans ; Incidence ; Neoplasm Metastasis

The effect of NDMA after oral administration (17 mg/ml) on the glycoconjugates of lingual von Ebner's gland and mucous gland were investigated with lectin histochemical methods. For lectin histochemical studies, the biotinylated lectins (DBA, PNA, SBA, BSL -1, sWGA, RCA -1, LCA, UEA -1, and ConA) were applied. Lectin binding patterns of glycoconjugates of lingual von Ebner's gland showed the decreased affinity for DBA, PNA, BSL -1 and sWGA in NDMA -treated group compared with control group. The remarkable decrease of binding affinity of NDMA -treated group was observed in PNA for 12 and 24 hours, DBA for 96 hours, BSL -1 for 72 hours, and sWGA for 3 hours, while the striking decrease of BSL -1 and sWGA binding was observed in NDMA -treated group for 12 hours. But these decreases of binding were tended to recover in PNA and sWGA after 72 hours of NDMA treatment, and in DBA after 120 hours. The binding affinity of SBA and RCA -1 was decreased in NDMA -treated group for 3 hours, while the other NDMA -treated group showed an increased affinity. Especially, the increase of SBA binding was remarkable. There was a little change in binding affinity of UEA -1, LCA and Con A in NDMA -treated group. Lectin binding patterns of glycoconjugates of lingual mucous gland showed decreased affinities for SBA, sWGA and UEA -1 in NDMA -treated group. The striking decreases of binding affinity for NDMA -treated group was observed in SBA and sWGA for 3 hours, and UEA -1 for 3 and 24 hours. And the remarkable decreases of binding affinity for NDMA -treated group was found in SBA for 24 and 48 hours, sWGA for 48, 72 and 96 hours, and UEA -1 for 48 hours. These decreases of binding affinity of NDMA -treated group were tended to recover in SBA and UEA -1 after 96 hours and in sWGA after 120 hours. The binding affinity for PNA and ConA showed a little but not remarkable increase in NDMA - treated group, and LCA binding showed a little decrease following a little increase in NDMA - treated group. The affinity of DBA binding was decreased in NDMA -treated group for 12 hours and 24 hours, while the other NDMA -treated group showed an increased affinity. Especially, there was a remarkable increase in NDMA -treated group for 96 hours. From these results, it is suggested that the toxicity of NDMA may be related with the carcinogen of the rat tongue, and glycoconjugates are concerned with the repaire of the destruction of the lingual mucous acini.
Administration, Oral ; Animals ; Dimethylnitrosamine* ; Glycoconjugates* ; Lectins ; Rats* ; Salivary Glands* ; Strikes, Employee ; Tongue ; von Ebner Glands

No abstract available.
Epinephrine*

No abstract available.
Epinephrine*

In patient with severe adhesion between lung and aorta, there is some limitation in approaching the distal arch or descending thoracic aorta through the usual left thoracotomy. We report a case of a successfully managed distal arch and descending thoracic aortic aneurysm through the median sternotomy without any manipulations of the lung in a 66 year old man who presented hemoptysis.
Aged ; Aorta ; Aorta, Thoracic* ; Aortic Aneurysm, Thoracic ; Hemoptysis ; Humans ; Lung ; Sternotomy* ; Thoracotomy

Pneumomediastinum, pneumothorax and subcutaneous emphysema are uncommon in pediatric practice, but they may be rarely ocured in association with respiratory distress and excessive ressusciation in the neonatal period, and as a complication of bronchial asthma, measles in childhood. And also, there was a report of a few cases that developed to pneumomediastinum and subcutaneous emphysema caused by vomiting in patient of diabetic coma. It is rare so far in this country that above events are complicated by miliary tuberculosis, but they may lead the patient to fatal and lifethreatening conditions, even though we perform a considerable medical treatment for that. We presnted 3 cases of 6 month 20 days old female infant, and each 10 year and 11 year old boys, developed to pneumomediastinu, pneumothorax and subcutaneous emphysema, and suddenly expired during hospital treatment of miliary tuberculosis. And, we reviewed the literatures, too.
Asthma ; Child ; Diabetic Coma ; Female ; Humans ; Infant ; Measles ; Mediastinal Emphysema* ; Pneumothorax* ; Subcutaneous Emphysema* ; Tuberculosis, Miliary* ; Vomiting