BACKGROUND: Chlamydia pneumoniae is a common cause of respiratory tract infection in adults, but little is known about its role in acute respiratory tract infection in children. The aim of this study was to detect C. pneumoniae by use of the nested polymerase chain reaction (nPCR) in Korean children with acute lower respiratory tract infection. METHODS: This study included 95 nasal aspirates obtained from children of 3 years of age or older with acute lower respiratory tract infection admitted to the Seoul National University Children's Hospital from January 1993 through December 1997. They were all negative by culture for RSV, adenovirus, influenza A and B, parainfluenza 1, 2, and 3. The nPCR was performed by use of two primer pairs (HL-1/HR-1, HM-1/HR-2). After amplification, PCR products were digested with Rsa I to confirm the sequence. RESULTS: C. pneumoniae was detected in one sample taken from an 11-year-old girl. She was referred with fever and productive cough for 10 days and she was revealed to have systemic lupus erythematosus and pneumonia. Her chest radiograph showed a left lower lobe infiltrate. Her fever and cough resolved slowly over 15 days without proper antibiotic therapy for C. pneumoniae. CONCLUSION: This study reveals C. pneumoniae as a cause of pneumonia in Korean children. Further studies are required to reveal the epidemiology and the role of C. pneumoniae in respiratory infection in Korean children.
Adenoviridae ; Adult ; Child* ; Chlamydia* ; Chlamydophila pneumoniae* ; Cough ; Epidemiology ; Female ; Fever ; Humans ; Influenza, Human ; Lupus Erythematosus, Systemic ; Paramyxoviridae Infections ; Pneumonia ; Polymerase Chain Reaction* ; Radiography, Thoracic ; Respiratory System* ; Respiratory Tract Infections* ; Seoul

PURPOSE: The purpose of this study was to determine the efficacy of sonography in the evaluation of normal pseudocapsular morphology and the detection of complications after total hip arthroplasty. MATERIALS AND METHODS: Between Janvary 1997 and June 2000, 47 patients [35 men and 12 women aged 24 to 84 (mean, 61) years] using real-time linear-array, convex US units with 3.5-MHz and 10-MHz transducers. Normal capsular morphology in 30 with total hip replacements, who had been asymptomatic for at least one year, was studied, and the prosthetic joint infection demonstrated in six of 17 who had experienced was confirmed at surgery or by US-guided aspiration. RESULTS: Sonograms indicated that a normal pseudocapsule lay straight over the neck of the prosthesis or was slightly convex toward the neck, and that the mean bone-to-pseudocapsule distance was 2.9 mm. However, in the 11 symptomatic patients in whom no evidence of infection was revealed by cultures, th mean distance was 4.7 mm; in the remaining six patients, whose joints were infected (a condition strongly suggested by the presence of extracapsular fluid), the mean distance was 5.5 mm, with no significant difference between the two groups. CONCLUSION: Sonography can be used to evaluate normal caspular morphology after total hip replacement and to diagnose infection around hip prostheses. In all patients in whom sonography revealed the presence of extra-articular fiuid, infection had occurred.
Arthroplasty, Replacement, Hip* ; Female ; Hip Prosthesis ; Humans ; Joints ; Male ; Neck ; Prostheses and Implants ; Transducers ; Ultrasonography*

Very little is known about the relation between isoflavone intake and menopausal symptoms in Korean woman To find the effects and correlations between these factors, questionnaires(maternal factors, menopausal symptoms) anthropometric measurement, 24hr dietary recalls, and urinary isoflavones analysis were conducted in 100 postmenopausal women residing in the Kyunggi-do rural area. The average age hight and weight of the subject were 61.5 years, 153.6 cm and 56.2kg. The average age at menarche, menopause, and menstrual cycle were 16.7 years, 47.2 years, 29.8 years, respectively. Most of the postmenopausal women experienced mildly menopausal symptoms. The mean calorie, protein and calcium intake were 1417.6 kcal(74.7% of the Korean RDA) 53.2 g(88.6% of the Korean RDA) and 454.0mg(65.6% of the Korean RDA) respectively. The ration of energy from carbohydrate, protein, and fat was 68: 15: 17 The average isoflavone intake from soy foods was 27.27 mg. The major food source of the isoflavone were soybeans and soybean curd. The average urinary isoflavone excretion was 2. 78nmol/mg Cr and showed significant positive correlation with isoflavone intake. Isoflavone intake from soy foods had a negative correlation with the severity of menopausal symptoms. Therefore, soy foods which contain isoflavone may have a protective effect on menopausal symptoms of women in Korea.
Calcium ; Female ; Gyeonggi-do ; Humans ; Isoflavones ; Korea ; Menarche ; Menopause ; Menstrual Cycle ; Soy Foods* ; Soybeans

BACKGROUND: Propofol is a widely-used intravenous anesthetic with a rapid onset, short duration of action and rapid elimination but the molecular mechanisms of action are not completely understood. Not only neurons but astrocytes are potential substrates for anesthetics, specifically for propofol. Intracellular calcium ion ([Ca2 ]i) is known to play a key role in the transduction and propagation of various chemical signals in astrocytes. METHODS: In the present study, the effects of propofol on the intracellular calcium concentration of astrocytoma cells by using a fura-2 fluorescence spectroscopy was investigated. RESULTS: In an isotonic standard solution, propofol (50 and 500microM) produced a transient increase in [Ca2 ]i while the intralipid did not change [Ca2 ]i. In several cells (20%), a transient increase in [Ca2 ]i was followed by sustained elevation which was sensitive to depletion of external calcium. A propofol-induced increase in [Ca2 ]i was not altered by an L-type calcium channel blocker (nifedipine 2microM). In cells bathed in a Ca2 -free external solution, a transient increase in [Ca2 ]i was observed. After the pretreatment of cyclopiazonic acid (CPA), an endoplasmic reticulum Ca2 -ATPase blocker, propofol 500microM did not produce any significant increase in [Ca2 ]i. Carbachol, which is known to release calcium from the inositol 1,4,5-triphosphate (IP3)-induced calcium release (IICR) stores, prevented the [Ca2 ]i increase by propofol and vice versa. High concentrations of caffeine (10 mM), which release calcium from the calcium-induced calcium release (CICR) stores, had no effect on [Ca2 ]i. CONCLUSIONS: From the above results, it is suggested that an increase in [Ca2 ]i by propofol in astrocytoma cells is mainly due to calcium release from the IICR stores.
Anesthetics ; Astrocytes ; Astrocytoma* ; Baths ; Caffeine ; Calcium Channels, L-Type ; Calcium* ; Carbachol ; Cytosol* ; Endoplasmic Reticulum ; Fura-2 ; Inositol 1,4,5-Trisphosphate ; Neurons ; Propofol* ; Spectrometry, Fluorescence

PURPOSE: To measure the normal size of the styloid process using 3D (three-dimensional) reconstruction CT. MATERIALS AND METHODS: We retrospectively analyzed 3D reconstruction images obtained after coronal and axial CT scanning of the temporal bone or neck of 115 patients. The length and shape of both sides of the styloid process, the location of its tip, and calcification of the stylohyoid ligament were retrospectively analysed. RESULTS: The mean length of the styloid process was 26.6 (+/-7.9)mm on the right side, and 26.4(+/-8.3)mm on the left, a statistically insignificant difference (p=0.694). Its mean length was 26.2 (+/-8.5)mm in men and 26.7 (+/-7.2)mm in women, a statically in significant difference (p=0.733). As for variation with age, mean length tended to increase until the third decade, but not beyond. Segmental type (104/230, 45.2%) and fragmental type (73/230, 31.7%) were more commonly seen in shape of styloid process, and tapering tip of styloid process (156/230, 67.9%) is more commonly seen than clubbing tip of it (74/230, 32.1%). The process was angulated in six cases (2.6%); its tip was more frequently located between the internal and external carotid artery (211 cases, 91.7%) than more medially (19 cases, 8.3%). In the former location, the length of the process was 26.2(+/- 7.2)mm, and in the latter, 37.0(+/-6.0)mm. The difference was statistically significant (p=0.000). Calcification had occurred in 33 cases (14.3%). CONCLUSION: The length of a normal styloid process was 18-32 mm. There were no statistically significant differences between its two sides, or between the sexes. Length tended to increase until the third decade, but not beyond. Predominantly the tip was located between the internal and external carotid artery, though the process was longer when its tip was located medially.
Carotid Artery, External ; Female ; Humans ; Ligaments ; Male ; Neck ; Retrospective Studies ; Temporal Bone ; Tomography, X-Ray Computed

Male osteoporosis is known to progress slowly and is less severe compared to female osteoporosis, and the incidence of lumbar compression fracture is considerably lower in male population. Hypogonadism which can develop from various causes including hypopituitarism is a common cause for secondary male osteoporosis. Hypopituitarism as a late complication of severe form of hemorrhagic fever with renal syndrome (HFRS) is known to occur occasionally but its clinical symptoms rarely appear. A 75-year-old male patient who had recovered from HFRS 13 years ago was admitted due to severe low back pain. He presented with gradually developed symptoms of hypogonadism and hypothyroidism resulting from hypopituitarism. MRI revealed collapsed pituitary gland and empty sella. This case presents with a male patient with multiple lumbar compression fractures due to severe osteoporosis secondary to hypogonadism, which resulted from hypopituitarism as a late complication of HFRS.
Aged ; Female ; Fever ; Fractures, Compression ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Hypogonadism ; Hypopituitarism ; Hypothyroidism ; Incidence ; Low Back Pain ; Male ; Osteoporosis ; Pituitary Gland

PURPOSE: Though acute pyogenic infections of musculoskeletal system are infrequent in children, delayed diagnosis or inadequate management may cause serious chronic sequelae. We analysed 40 cases of children who were affected by acute septic osteomyelitis and/or septic arthritis to find etiologic agents and to establish proper initial antimicrobial therapy. METHODS: Medical records of 40 cases of microbiologically confirmed acute pyogenic osteomyelitis and/or septic arthritis diagnosed at the Seoul National University Children's Hospital from January 1985 to September 1998 were reviewed. RESULTS: There were 12 cases of acute osteomyelitis, 28 of acute septic arthritis, and 4 of concurrent cases of two diseases. Of 12 cases of acute pyogenic osteomyelitis, there were 7 boys and 5 girls whose average age was 75.4 months. Calcaneus was infected in 4 cases and it was the most common site. Ten cases (83.3%) of them were attributable to Staphylococcus aureus, 1 to Streptococcus viridans and 1 to Pseudomonas aeruginosa. Among the 28 cases of acute septic arthritis, male to female ratio was 16 : 12. The hip joint was the most frequent site involved in 13 cases (46.3%), followed by the ankle joint, which was involved in 6 cases (21.4%). The majority of the children were infected by S. aureus (20 cases, 71.4%). Two cases were infected by S. viridans or Salmonella (group D) species, and 1 by Haemophilus influenzae. CONCLUSION: S. aureus was the most common pathogen of acute pyogenic osteoarthritis, and H. influenzae was an infrequent cause of septic arthritis. Regarding initial empirical anibiotic therapy, anti-staphylococcal agent should be included.
Ankle Joint ; Arthritis ; Arthritis, Infectious ; Calcaneus ; Child* ; Delayed Diagnosis ; Female ; Haemophilus influenzae ; Hip Joint ; Humans ; Influenza, Human ; Male ; Medical Records ; Musculoskeletal System ; Osteoarthritis* ; Osteomyelitis ; Pseudomonas aeruginosa ; Salmonella ; Seoul ; Staphylococcus aureus ; Viridans Streptococci

To investingate the effects of fentanyl on the renal function and the renin secretion rate(RSR), the author measured the urine volume(UV), excreted amount of urinary sodium, potassium and chloride(UNaV, UKV, and UCLV), fractional excretion of sodium(FENa), renal plasma flow(RPF), glomerular filtration rate(GFR), filtration fraction(FF) and free water clearance(CH2O) after adminis- tration of fentanyl in 53 unanesthetized white rabbits. Fentanyl was given intrarenally(0.1ug/kg/min in group I, 0.3ug/kg/min in group II, and 1.0ug/kg/ min in group III), or intravenously(0.1ug/kg/min in group IV, 1.0ug/kg/min in group V, and 0.1ug/ kg/min in after preinfusion with naloxone 0.1ug/kg/min in group VI). After administration of fentanyl, urinary and plasma osmolalities and the levels of sodium, potas-sium, chloride, paraaminohippuric acid (PAH) and creatinine were measured. Heart rate (HR) and mean arterial pressure (MAP) were also measured. The results were as follows. 1) There were no statistically significant changes in HR and MAP in all groups. 2) The levels of UV, UNaV, UKV, VCIV, RPF and CH2O decreased significantly by low dose of fentanyl, not changed by moderate dose of fentanyl and the levels of UV and CH2O increased signifi-cantly by large dose of fentany. 3) Naloxone pretreatment blocked all of the observed renal responses of low dose of fentanyl. 4) There was no statistically signficant change in renin secretion rate in all groups. From the above results, it is suggested that the fentanyl has dual effects on the renal function and may have systemic effects through opioid receptors.
Arterial Pressure ; Creatinine ; Fentanyl* ; Filtration ; Heart Rate ; Naloxone ; Osmolar Concentration ; Plasma ; Potassium ; Rabbits* ; Receptors, Opioid ; Renin ; Sodium ; Water

STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the outcomes of dual growing rod treatment over a follow-up period of at least 2 years in patients with progressive pediatric spinal deformity. SUMMARY OF LITERATURE REVIEW: The dual growing rod treatment is safe and effective in curve correction and maintenance in patients with progressive pediatric spinal deformity. MATERIALS AND METHODS: Between 2009 to 2017, 14 patients who underwent dual growing rod treatment were followed up for more than 2 years. We analyzed their demographic and radiologic data, including age at surgery, sex, diagnosis, instrumented levels, number of total operations, number of lengthening procedures, interval of lengthening, Cobb angle, thoracic kyphosis angle, lumbar lordosis angle, T1-S1 length, and complications. RESULTS: The mean age of the patients was 11.0±2.9 years old. There were 10 male and 4 female patients, including 8 cases of neuromuscular scoliosis, 3 cases of idiopathic scoliosis, 2 cases of spondyloepiphyseal dysplasia, and 1 case of congenital scoliosis. The mean follow-up period was 42.4±14.0 months. The total number of operations was 6.6±2.6. The average number of lengthening procedures was 4.3±2.3 at an interval of 6.9±2.1 months. The Cobb angle improved from 60.4°±27.9° to 33.5°±19.7° after the initial treatment and 29.1°±16.4° after the last follow-up or final fusion. The T1-S1 length increased from 328.2±57.5 mm to 388.0±64.9 mm after the initial treatment and 424.9±64.4 mm after the last follow-up or final spinal fusion. The average growth rate was 11.5 mm/year. Six patients experienced 11 complications, of which 4 were Implant-related, and 7 were Infections. CONCLUSIONS: The dual growing rod technique is an effective and relatively safe treatment in patients with progressive pediatric spinal deformity.
Animals ; Congenital Abnormalities* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; Lordosis ; Male ; Osteochondrodysplasias ; Retrospective Studies ; Scoliosis ; Spinal Fusion

PURPOSE: Infective endocarditis (IE) is a serious complication in children with structural heart disease. We reviewed 35 cases of IE to identify the recent changes in the pattern of preexisting heart diseases, the spectrum of causative organisms and prognosis. METHODS: The clinical records of children diagnosed as IE at the Seoul National University Children's Hospital from January 1987 through December 1997, were reviewed retrospectively. Duke criteria was used for diagnosis. Cases were categorized into primary group(PG) IE in an unoperated heart and post operative group(POG), and the latter further into early POG(within 2 months after operation) and late POG. RESULTS: There were 35 cases of IE developed in 34 patients; 18 cases in the PG, 6 cases in the early POG, and 11 cases in the late POG. Male to female ratio was 16 : 19. Mean age of POG, especially early POG was less than that of PG (early POG : late POG : PG=1.65 years : 6.5 years : 8.34 years, P=0.0267). Preexisting heart diseases were identified in 30 cases; rheumatic heart disease 1 case and congenital heart disease (CHD) 29 cases. Causative organisms were identified in 80%; viridans streptococci, 10 cases (33.3%); pneumococci, 2 cases; Group-D streptococci, 3 cases; staphylococci, 8 cases; Gram (-) organisms, 5 cases and Candida albicans, 2 cases. Vegetation was detected in 88.9% of PG and 64.7% of POG. The most common indication for surgery was uncontrolled infection, which were required in 9 cases. The overall mortality rate was 12.1%. Mortality in POG was higher than that of PG (23.5% versus 0%, P=0.033). CONCLUSION: The discrepancy of mean age among patient groups and the high proportion of patients belonging to POG, were consistent with the increase in the number of newly risky population that survived after cardiac surgery. A more aggressive consideration for operative management may improve the treatment results.
Candida albicans ; Child* ; Diagnosis ; Endocarditis* ; Female ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Male ; Mortality ; Prognosis ; Retrospective Studies ; Rheumatic Heart Disease ; Seoul ; Thoracic Surgery ; Viridans Streptococci