No abstract available.
Child* ; Humans ; Urinary Tract Infections* ; Urinary Tract*

No abstract available.
Dermatitis, Atopic ; Pyroglyphidae

The epidemiology of children with cortical visual impairment(CVI)has been poorly defined till now, so the purposes of this study were to define the visual prognosis and prevalence of ophthalmologic problems in Korean children. The 20 children with follow-up of over 3 months were included out of 24 children diagnosed with CVI. The causes of CVI were periventricular leukomalacia in 7, congenital malformation in 4, and cerebral infarct or atrophy. Twelve of 19 children who had visual impairment at their initial visit showed visual improvement with follow-up. There were strabismus in 14, nystagmus in 6, and abnormal optic disc in 8 of the 20 children. All visualevoked response results were abnormal, but were not providing a more reliable prognosis in vision. The children who had abnormal electroencephalogram had poor visual prognosis as well as delayed developmental level. In conclusion, this study identified that children with CVI may be presented with a variety of ocular abnormalities, including strabismus, nystagmus, and abnormal optic disc. These findings suggest that a better understanding of the natural course will be required in children with CVI.
Atrophy ; Child* ; Electroencephalography ; Epidemiology ; Follow-Up Studies ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging ; Prevalence ; Prognosis ; Strabismus ; Vision Disorders*

BACKGROUND: Coronary arterigraphy has been used as a tool to assess the degree of coronary artery narrowing and the result of balloon angioplasty, which frequently underestimates the degree of atherosclerosis. Intravascular ultrasound(IVUS) can give more delicate information about plaque morphology and the result of coronary intervention. We compared qualitaive and quantitative measurement between IVUS and coronary angiography after coronary intervention. METHODS: We used 30 or 20 MHz intravascular ultrasound catheter which was connected to Hewlett Packard Sonos 1500 Intravasscular equiment in 5 coronary balloon angiopasty and 3 Palmaz-Schatz stent implantation cases. Sites of intervention were at the left anterior descending coronary artery in 7 patients and at the left circumflex artery in one patient. Quantitative coronary angiography(QCA) was done by CAAS II system. We measured referenc diameter(RD), minimal lumen diamter(MLD), Lumen and vessel cross sectional areas(LCSA,VCSA) obstraction area(OA) and plaque area(PA) and also analysed plaque morphology. RESULTS: 1) IVUS is more sensitive in the detection of eccentricity, Calcification and dissection. 2) Before intervention, the mean reference diameter was 2.87+/-0.42mm,3.07+/-0.39mm,% diameter stenosis was 52.4+/-11.6%,65.3+/-9.22% and MLD was 1.32+/-0.24mm, 1.07+/-0.23mm in IVUS and QCA, respectively, which were no statistical significance between these parameters(p>0.05). After intervention, MLD and OA increased significantly(p<0.01) com pared with basal values but there were no significant difference between MLD and OA between 2 measurements(p>0.05). Plaque area measured by IVUS decreased from 9.84 to 7.26mm2 without statistical significance(p>0.05). 3) There was a good correlation in the measurement of the reference segments before intervention but this correlation was much lower after intervention in the reference and stenosis segments between 2 methods(r=0.8723 vs 0.6538, p<0.01). CONCLUSION: IVUS is considered as a sensitive tool in the detection of calcification, eccentricity and dissection and in evaluationg the results of the coronary intervention.
Angioplasty, Balloon ; Arteries ; Atherosclerosis ; Catheters ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Humans ; Stents ; Ultrasonography*

Some patients have ascites without having liver disease, so it is important to analyze the cause of these ascites. Tuberculous peritonitis is an infectious disease characterized by lymphocyte-dominant exudative ascites. In contrast, myxedema ascites is a very rare disease characterized by a high serum/ascites albumin gradient (SAAG) with hypothyroidism. We herein report a case involving a 48-year-old woman with both diseases simultaneously. She was hospitalized because of massive ascites, generalized edema, and a puffy face. Hypothyroidism was confirmed by thyroid function tests. Her ascitic fluid had a high SAAG; no other specific findings were identified by cytology, culture, or computed tomography. Three months after initiating drug therapy for the hypothyroidism, the patient's systemic edema improved but the ascites recurred. Accordingly, diagnostic laparoscopy was performed, and tuberculous peritonitis was confirmed. As seen in this case, when myxedema ascites is associated with tuberculous peritonitis, an accurate diagnosis may be challenging.
Ascites* ; Ascitic Fluid ; Communicable Diseases ; Diagnosis ; Drug Therapy ; Edema ; Female ; Humans ; Hypothyroidism ; Laparoscopy ; Liver Diseases ; Middle Aged ; Myxedema* ; Peritonitis, Tuberculous* ; Rare Diseases ; Thyroid Function Tests

PURPOSE: The aim of this study was to review our experience with splenic abscesses, with respect to the relevant aspects of splenic abscesses and treatment outcomes. MATERIALS AND METHODS: We reviewed the cases of 18 patients who had splenic abscesses and who were treated at our hospital from November 1993 to December 2008. RESULTS: The most common symptom at presentation was abdominal pain in 12 patients (66.7%). The median duration from symptom onset until establishment of a diagnosis was 22 days. Streptococcus viridians was the most common pathogen (27.8%), follow by Klebsiella pneumoniae (22.2%). The mortality rate during the inpatient period and the previous 90 days was 16.6%. Three of four patients with Klebsiella pneumoniae showed a single abscess pocket. Four patients (22.2%) underwent percutaneous drainage, eight (44.5%) recieved antibiotic treatment only and six (33.3%) underwent splenectomy. CONCLUSION: There is no gold standard for treating splenic abscesses. Treatment should be customized for each patient.
Abscess/diagnosis/drug therapy/microbiology/surgery/*therapy ; Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Drainage ; Female ; Humans ; Klebsiella Infections/diagnosis/drug therapy/microbiology/surgery ; Klebsiella pneumoniae ; Male ; Middle Aged ; Splenectomy ; Splenic Diseases/diagnosis/drug therapy/*microbiology/surgery ; Streptococcal Infections/diagnosis/drug therapy/microbiology/surgery ; Treatment Outcome ; Viridans Streptococci ; Young Adult

Cerebral aneurysms associated with arteriovenous malformation (AVM) have been reported with a variable incidence, averaged 10% of total AVM cases. It has been AVM. We report four cases of the intracranial aneurysm associated with AVM. Three cases of aneurysm were located in distal portion of feeding artery, and one case was proximal on major feeding artery. And bleeding resulted from rupture of aneurysm. Three of them located in the posterior circulation. Removal of aneurysm and AVM was successfully accomplished in 3 cases.
Aneurysm ; Arteries ; Arteriovenous Malformations* ; Hemorrhage ; Incidence ; Intracranial Aneurysm ; Rupture

BACKGROUND: An initiating time of renal replacement therapy (RRT) for patients with end-stage renal disease (ESRD) has great influence on prognosis of the patients, however, there are currently no accurate guidelines for initiation of renal replacement therapy. Traditionally, nephrologists usually initiate RRT on the basis of observation of uremic symptoms and changes of laboratory parameters, such as serum creatinine concentration and/or glomerular filtration rate (GFR). DOQI guidelines suggest weekly Kt/Vurea < 2.0 or nPNA < 0.8 g/kg/day for an objective index of the initiation of dialysis. Then, we designed to formulate KP index {(weekly Kt/Vurea + 2.5 X nPNA) X 1/2} using two indices above as a clinically useful objective index to determine the initiation of RRT for patients with ESRD. METHODS: Patients with ESRD having the weekly Kt/Vurea index below 3.0 were selected from 186 patients who came to renal unit of Soonchunhyang Bucheon hospital. The patients having the weekly Kt/Vurea index between 1.0 and 2.0 were classified into two groups, KP index > 2.0 and KP index < 2.0. The groups were compared and analyzed via renal function, biochemical index and the number of patients starting a first RRT. Further, the correlations between KP index and other indices were analyzed over all patients. Then, the numbers per group of patients starting RRT were compared after all patients were divided into two groups, one of which is between 1.5 and 2.0 and the other is between 2.0 and 2.5 by weekly Kt/Vurea index and KP index. RESULTS: The group of KP index < 2.0 indicated significantly lower indices in weekly Kt/Vurea, nPNA (B2) and % LBM (%) than those of the group of KP index > 2.0, while no significant differences between the groups were in serum albumin concentration, serum creatinine concentration, FFEFBM and RRF. And the frequency of patients starting RRT was significantly higher in the group of KP index < 2.0 rather than the group of KP index > 2.0 in statistics. There was a significant correlation between KP index and other indices in all patients. In comparing and analyzing the number of patients starting RRT, weekly Kt/Vurea index did not demonstrate significant differences between two groups of 1.5 < weekly Kt/Vurea < 2.0 and 2.0 < weekly Kt/Vurea < 2.5, but the frequency of patients in the group of 1.5 < KP index < 2.0 was significantly higher than that in the group of 2.0 < KP index < 2.5. CONCLUSION: It is considered that KP index is an index clinically useful for ESRD patients to determine an appropriate timing for the initiation of RRT, and that the timing should be fixed with regard for other various indices and clinical features for advisable prognosis of the patients. In addition, accurate guideline to determine such an appropriate time needs to be suggested by further new studies.
Creatinine ; Dialysis* ; Glomerular Filtration Rate ; Gyeonggi-do ; Humans ; Kidney Failure, Chronic* ; Prognosis ; Renal Replacement Therapy ; Serum Albumin

BACKGROUND: The time at which renal replacement therapy (RRT) is initiated in patients with end-stage renal disease (ESRD) has a great influence on the prognosis of the patient; however, there are currently no accurate guidelines for the initiation of RRT. Traditionally, nephrologists usually initiate RRT on the basis of the observation of the uremic symptoms and changes in the laboratory parameters, such as the serum creatinine concentration and/or glomerular filtration rate (GFR). DOQI guidelines suggest a weekly Kt/Vurea < 2.0 or an nPNA < 0.8 g/kg/day as objective indices for the initiation of dialysis. Thus, a KP index was formulated (weekly Kt/Vurea+2.5 X nPNA) X (1/2) using the above two clinically useful and objective indices to determine the adeguate time to initiate RRT in patients with ESRD. METHODS: Of 186 patients admitted to the renal unit of Soonchunhyang Bucheon hospital, those with ESRD and a weekly Kt/Vurea below 3.0 were selected. The patients with a weekly Kt/Vurea index between 1.0 and 2.0 were classified into one of two groups; KP index > 2.0 and KP index < 2.0. The groups were compared and analyzed in relation to their renal function, biochemical indices and the numbers of patients per group starting RRT. Further, the correlations between the KP and other indices were analyzed in all the patients. The patients were then further divided into another two groups according to their weekly Kt/Vurea and KP index: group one; between 1.5 and 2.0 and group 2; between 2.0 and 2.5. The numbers of patients per group starting RRT were compared. RESULTS: The KP index < 2.0 group showed significantly lower indices for weekly Kt/Vurea, nPNA and %LBM (%) than those of the KP index > 2.0 group, while there were no significant differences between the groups in the serum albumin concentration, serum creatinine concentration, FFEFBM and RRF. Also, there was a statistically significant higher rate of incidence of patients starting RRT in the KP index < 2.0 group than in the KP index > 2.0 group. There was a significant correlation between the KP and other indices in all patients. When comparing the number of patients starting RRT, the weekly Kt/Vurea index demonstrated no significant differences between the 1.5 < weekly Kt/Vurea < 2.0 and 2.0 < weekly Kt/Vurea < 2.5 groups, but the number of patients starting RRT in the 1.5 < KP index < 2.0 group was significantly higher than that in the 2.0 < KP index < 2.5 group. CONCLUSION: The KP index is considered a clinically useful index in ESRD patients for determining an appropriate time for the initiation of RRT. Also, the timing of the initiation of RRT should be fixed with regard to the various other indices and clinical features for a desirable prognosis of the patients. In addition, further studies will be required to determine accurate guidelines for an appropriate time for RRT initiation.
Adult ; Aged ; Blood Urea Nitrogen ; Creatinine/blood ; Female ; Glomerular Filtration Rate ; Humans ; Kidney/metabolism ; Kidney Failure, Chronic/epidemiology/*metabolism/physiopathology/*therapy ; Korea/epidemiology ; Male ; Middle Aged ; Nutritional Status ; *Renal Dialysis ; Serum Albumin/metabolism ; Severity of Illness Index ; Urea/blood

No abstract available.
Classification* ; Wounds and Injuries* ; Wounds, Gunshot*