OBJECTIVE: This study was conducted to evaluate the incidence, the optimal timing of screening examinations for retinopathy of prematurity(ROP) and to analyze perinatal risk factors associated with cryotherapy or lasertherapy(CT/LT) in ROP. METHODS: Medical records of 130 very low birth weight(VLBW) infants who admitted to the NICU of Wonkwang University Hospital from July 1997 to June 2002 were reviewed retrospectively. We evaluated the incidence and severity of ROP by gestational age(GA) and birth weight(BW). And the comparisons of perinatal risk factors between ROP with and without CT/LT have been made. RESULTS: Incidence of ROP was 36.9% and mean GA and BW were 29.1+/-1.99 weeks, 1,153+/-209 gm in VLBW infants respectively. ROP Stage II or greater was 15.4% of VLBW infants, 41.7% of ROP infants, and 27.1% of ROP infants were treated with CT/LT. All infants with BW <750gm or GA <26 weeks were developed ROP with stage II or greater and treated with CT/LT. First detection of ROP was performed at chronologic age(CA) 3 weeks, postconceptional age(PCA) 30 weeks, and first identification of threshold ROP needed with CT/LT were at CA 5 weeks and PCA 33 weeks. The perinatal risk factors with CT/LT for ROP were significant in GA, BW, Apgar score at 1 and 5 minutes and number of blood transfusion. The mean time of spontaneous regression is 13.4+/-8.8 weeks in the mild ROP infants without CT/LT. CONCLUSION: The incidence of ROP is 36.9% and the optimal timing of screening for ROP should be selected by earlier time in 2 guidelines of at 5 weeks of CA and 33 weeks of PCA in VLBW infants. And the related risk factors with CT/LT for threshold ROP were GA, BW and Apgar score at 1 and 5 minutes and number of blood transfusions.
Apgar Score ; Blood Transfusion ; Cryotherapy ; Humans ; Incidence* ; Infant* ; Infant, Very Low Birth Weight* ; Mass Screening* ; Medical Records ; Parturition ; Passive Cutaneous Anaphylaxis ; Retinopathy of Prematurity* ; Retrospective Studies ; Risk Factors*

OBJECTIVES: The purpose of this study was to identify the differences of demographic and clinical characteristics between child-adolescents who received medical inpatient care and non-hospitalized adolescents after suicide attempts. METHODS: The study included 35 child-adolescents who were hospitalized (Admission group) and 114 child-adolescents who were not hospitalized (Non-Admission group) as a result of a suicide attempt from 2009 to 2015. We compared sociodemographic, clinical, and suicide attempt-related characteristics through a chi-square test and logistic regression analysis to evaluate the differences between the two groups. RESULTS: Child-adolescents of this study most commonly attempted suicide by poisoning, and for motivation of interpersonal problems. Admission group had significantly fewer attempts through injury by sharp objects (χ²=4.374, p=0.037) and attempted suicide with a higher chance of actually dying when compared to Risk-Rescue Rating Scale (t=1.981, p=0.049). In addition, Admission group had relatively common motivation for academic problems (χ²=12.082, p=0.001) and less motivation for interpersonal difficulties. (χ²=9.869, p=0.002) Psychiatric diagnosis at the time of visiting the emergency department showed higher rates of depression in the admission group than Non-Admission group (χ²=8.649, p=0.003). The results of logistic regression showed that depression affects hospitalization (OR=2.783, 95% CI 1.092–7.089, p=0.032). CONCLUSIONS: This study is meaningful in that it revealed the social and clinical characteristics of all child-adolescents who were hospitalized at a university hospital after attempting suicide. This study identified differences in motivation, methods, and psychiatric diagnosis of hospitalized adolescents and those who were not. Therefore, the results may help adolescent suicide attempters to get a discriminatory approach based on their admission.
Adolescent ; Adolescent, Hospitalized ; Child ; Depression ; Emergency Service, Hospital ; Hospitalization ; Humans ; Inpatients ; Logistic Models ; Mental Disorders ; Motivation ; Poisoning ; Suicide ; Suicide, Attempted

A 50-year-old man with liver cirrhosis and esophageal varix for 3 years was diagnosed with hematemesis and treated for a bleeding varix. However, bleeding recurred 11 days later, and he developed drowsiness with left hemiparesis. His left upper and lower extremity muscle strengths based on the manual muscle test at the onset were grade 2/5 and 1/5, respectively. The Babinski sign was positive. His serum ammonia level was elevated to 129.9 microg/dL (normal, 20-80 microg/dL). Magnetic resonance imaging revealed restriction on diffusion and T2-hyperintensities with decreased apparent diffusion coefficient values in the bilateral frontoparietooccipital cortex. The effect was more severe in the right hemisphere and right parietooccipital cortices, which were compatible with hepatic encephalopathy. Although the patient's mental status recovered, significant left-sided weakness and sensory deficit persisted even after 6 months. Diffusion tensor tractography (DTT) performed 3 months post-onset showed decreased volume of the right corticospinal tract. We reported a patient with hepatic encephalopathy involving the corticospinal tract by DTT.
Ammonia ; Diffusion Tensor Imaging ; Diffusion* ; Esophageal and Gastric Varices ; Hematemesis ; Hemorrhage ; Hepatic Encephalopathy* ; Humans ; Liver Cirrhosis ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Muscle Strength ; Paresis ; Pyramidal Tracts* ; Reflex, Babinski ; Rehabilitation ; Sleep Stages ; Varicose Veins

This study was performed to compare the sensitivity of flow cytometry crossmatch(FCXM) with conventional lymphocytotoxic crossmatch(CXM), and its clinical impact. Total 174 pair of sera from potential living renal transplant donors and recipients were tested from Jan. 5, 1995 to April 3, 1996 with conventional CXM and FCXM at Kangnam St. Mary's hospital. Of 174 potential living donor/ recipient pairs, two (1.1%) had positive warm T (TW)/CXM, 3(1.7%) positive warm B(BW)/CXM, and 5(2.9%) positive warm TandB/CXM. Of 164 potential CXM-negative living donor/recipient pairs evaluated with FCXM, ten (6%) had positive T/ FCXM, and thirty one (19%) positive B/FCXM. Of 45 living donor renal transplantation with negative TW/CXM, one (2.2%) had a positive BW/CXM, 11 (24.4%) positive B/FCXM, and 2 (4.4%) positive T/ FCXM. They had been followed up over 3 months. Acute rejection episodes were observed in 8 patients. Of these patients, two had positive B/FCXM and one had a positive T/FCXM. In conclusion, FCXM is more sensitive than conventional CXM. Further follow-up study is necessary to know whether this higher sensitivity leads to fewer graft rejection.
Flow Cytometry* ; Follow-Up Studies ; Graft Rejection ; Humans ; Kidney Transplantation* ; Living Donors* ; Tissue Donors

OBJECTIVE: To assess the correlation between the anorectal function and bladder detrusor function in patients with complete spinal cord injury (SCI) according to the type of lesion. METHODS: Medical records of twenty-eight patients with SCI were included in this study. We compared the anorectal manometric and urodynamic (UD) parameters in total subjects. We analyzed the anorectal manometric and UD parameters between the two groups: upper motor neuron (UMN) lesion and lower motor neuron (LMN) lesion. In addition, we reclassified the total subjects into two groups according to the bladder detrusor function: overactive and non-overactive. RESULTS: In the group with LMN lesion, the mean value of maximal anal squeeze pressure (MSP) was slightly higher than that in the group with UMN lesion, and the ratio of MSP to maximal anal resting pressure (MRP) was statistically significant different between the two groups. In addition, although the mean value of MSP was slightly higher in the group with non-overactive detrusor function, there was no statistical correlation of anorectal manometric parameters between the groups with overactive and non-overactive detrusor function. CONCLUSION: The MSP and the ratio of MSP to MRP were higher in the group with LMN lesion. In this study, we could not identify the correlation between bladder and bowel function in total subjects. We conclude that the results of UD study alone cannot predict the outcome of anorectal manometry in patients with SCI. Therefore, it is recommended to perform assessment of anorectal function with anorectal manometry in patients with SCI.
Humans ; Manometry ; Medical Records ; Motor Neurons ; Neurogenic Bowel ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urodynamics*

OBJECTIVE: To assess the correlation between the anorectal function and bladder detrusor function in patients with complete spinal cord injury (SCI) according to the type of lesion. METHODS: Medical records of twenty-eight patients with SCI were included in this study. We compared the anorectal manometric and urodynamic (UD) parameters in total subjects. We analyzed the anorectal manometric and UD parameters between the two groups: upper motor neuron (UMN) lesion and lower motor neuron (LMN) lesion. In addition, we reclassified the total subjects into two groups according to the bladder detrusor function: overactive and non-overactive. RESULTS: In the group with LMN lesion, the mean value of maximal anal squeeze pressure (MSP) was slightly higher than that in the group with UMN lesion, and the ratio of MSP to maximal anal resting pressure (MRP) was statistically significant different between the two groups. In addition, although the mean value of MSP was slightly higher in the group with non-overactive detrusor function, there was no statistical correlation of anorectal manometric parameters between the groups with overactive and non-overactive detrusor function. CONCLUSION: The MSP and the ratio of MSP to MRP were higher in the group with LMN lesion. In this study, we could not identify the correlation between bladder and bowel function in total subjects. We conclude that the results of UD study alone cannot predict the outcome of anorectal manometry in patients with SCI. Therefore, it is recommended to perform assessment of anorectal function with anorectal manometry in patients with SCI.
Humans ; Manometry ; Medical Records ; Motor Neurons ; Neurogenic Bowel ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urodynamics*

We reported two cases of diabetic hyperglycemic hyperosmolar coma treated with maintaining continuous ambulatory peritoneal dialysis(CAPD) in chronic renal failure(CRF) patients with CAPD. Hyperglycemia is common complication in CAPD, but there were only few reports of severe hyperglycemia accompanying with hyperosmolar coma in CRF patients on CAPD therapy. Furthermore, to date, no specific management for CAPD patients with nonketotic hyperosmolar coma has been established. The best strategy for management of hyperosmolar coma with CAPD patients is changing CAPD therapy to HD. Recently, we experienced two cases of hyperglycemic hyperosmolar coma in diabetic CAPD patients successfully treated with intravenous hydration and insulin therapy without discontinuing CAPD therapy. Because no such case has been reported, we report two cases of diabetic hyperosmolar coma with CAPD treated without conversion to HD. These cases suggest that adequate fluid replacement accompanying electrolytes and osmotic balance as well as insulin therapy might be a major role for safe treatment of hyperglycemic hyperosmolar coma in patient with CAPD.
Coma* ; Electrolytes ; Humans ; Hyperglycemia ; Insulin ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis

We reported two cases of diabetic hyperglycemic hyperosmolar coma treated with maintaining continuous ambulatory peritoneal dialysis(CAPD) in chronic renal failure(CRF) patients with CAPD. Hyperglycemia is common complication in CAPD, but there were only few reports of severe hyperglycemia accompanying with hyperosmolar coma in CRF patients on CAPD therapy. Furthermore, to date, no specific management for CAPD patients with nonketotic hyperosmolar coma has been established. The best strategy for management of hyperosmolar coma with CAPD patients is changing CAPD therapy to HD. Recently, we experienced two cases of hyperglycemic hyperosmolar coma in diabetic CAPD patients successfully treated with intravenous hydration and insulin therapy without discontinuing CAPD therapy. Because no such case has been reported, we report two cases of diabetic hyperosmolar coma with CAPD treated without conversion to HD. These cases suggest that adequate fluid replacement accompanying electrolytes and osmotic balance as well as insulin therapy might be a major role for safe treatment of hyperglycemic hyperosmolar coma in patient with CAPD.
Coma* ; Electrolytes ; Humans ; Hyperglycemia ; Insulin ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis

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