The hemolytic uremic syndrome consists of microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia following a prodromal illness of gastroenteritis or upper respiratory infection. Sometimes, the syndrome can present in a dramatic fashion with severe abdominal pain and signs of intestinal obstruction, suggesting an intussusception or acute surgical crisis. A 2-year-old girl with a 3-day history of several episodes of bloody-mucoid diarrhea and severe abdominal pain was admitted under suspicion of intussusception. Her symptoms started 4 days after eating a pork and X-ray revealed the distended small bowel without a large bowel gas pattern. Colitis without perforation was found by abdominal ultrasonogram and sigmoidoscope. Unfortunately, she became pallor, puffy, and oliguric 7 days later. Clues to the diagnosis of hemolytic uremic syndrome in the early stages of the acute illness were oliguria, abnormal peripheral blood smear, anemia despite dehydration, and proteinuria. The onset is usually preceded by symptoms of gastroenteritis, such as fever, vomiting, abdominal pain, and bloody diarrhea. This is followed in 5 to 10 days by a sudden onset of pallor, irritability, weakness, lethargy, and oliguria. The majority of patients recover normal renal function with aggressive management of the acute renal failure. Careful medical management of the hematologic and renal manifestations, in conjunction with early and frequent peritoneal dialysis, offers the best chance of recovery from the acute phase. The present patient was recovered by apropriate fluid and electrolyte management, transfusions of packed RBCs, fresh frozen plasma, and early application of peritoneal dialysis.
Abdominal Pain ; Acute Kidney Injury ; Anemia ; Anemia, Hemolytic ; Child, Preschool ; Colitis* ; Dehydration ; Diagnosis ; Diarrhea ; Eating ; Female ; Fever ; Gastroenteritis ; Hemolytic-Uremic Syndrome* ; Humans ; Intestinal Obstruction ; Intussusception ; Lethargy ; Oliguria ; Pallor ; Peritoneal Dialysis ; Plasma ; Proteinuria ; Red Meat ; Sigmoidoscopes ; Thrombocytopenia ; Ultrasonography ; Vomiting

Childhood epilepsy which has high prevalence rate and inception rate is one of the commonest problem encountered in pediatrician. In contrast with epilepsy of adult, in childhood epilepsy, more variable and varying manifestations are found because the factors of age, growth and development exert their influences in the manifestations and the courses of childhood epilepsy. Moreover epilepsy children have associated problems such as physical and mental handicaps, psychological disorders and learning disability. For these reasons pediatrician who deals with epileptic children experiences difficulties in making diagnosis and managing them. In order to improve understanding and management of childhood epilepsy, authors reviewed 103 cases of epileptic patients seen at pediatric department of Yeungnam University Hospital retrospectively. The patients were classified according to the type of epileptic seizure. Suspected causes of epilepsy, associated conditions of epileptic patients, age incidence and the findings of brain CT were reviewed. Large numbers of epileptic patients (61.2%) developed their first seizures under the age of 5. The most frequent type of epileptic seizure was generalized tonic-clonic, tonic, clonic seizure (49.5%), followed by simple partial seizure with secondary generalization (17.5%), simple partial seizure (7.8%), atypical absence (5.8%) and unclassified seizure (5.8%). In 83.5% of patients, we could not find specific cause of it, but in 16.5% of cases, history of neonatal hypoxia (4.9%), meningitis (3.9%), prematurity (1.9%), small for gestational age (1.0%), CO poisoning (1.0%), encephalopathy (1.0%) were found. 30 cases of patients had associated diseases such as mental retardation, hyperactivity, delayed motor milestones or their combinations. The major abnormal findings of brain CT performed in 42 cases were cortical atrophy, cerebral infarction, hydrocephalus and brain swelling. This review stressed better designed classification of epilepsy is needed and with promotion of medical care, prevention of epilepsy is possible in some cases. Also it is stressed that childhood epilepsy requires multidisciplinary therapy and brain CT is helpful in the evaluation of epilepsy with limitation in therapeutic aspects.
Adult ; Anoxia ; Atrophy ; Brain ; Brain Diseases ; Brain Edema ; Cerebral Infarction ; Child ; Classification ; Diagnosis ; Epilepsy* ; Generalization (Psychology) ; Gestational Age ; Growth and Development ; Humans ; Hydrocephalus ; Incidence ; Intellectual Disability ; Learning Disorders ; Meningitis ; Poisoning ; Prevalence ; Retrospective Studies ; Seizures

BACKGROUND: Fibrostenosis of large airway due to tuberculosis is one of the most perplexing clinical problems not only because it can lead to respiratory failure but also because of difficulty in the management. No one technique, such as balloon dilatation or insertion of self expandable metallic steno, has proved totally satisfactory in the management of fibrostenosis. We evaluated the effect of laser therapy in patient with severe fibrostenosis due to tuberculosis. METHOD: We classified the fibrostenosis to three types by bronchoscopic finding - the diaphragm type: stenosed by fibrous diaphragm, sparing the tracheobronchial wall, the collapse type: stenosed by collapse of the wall due. to destruction of the cartilage, and the combined type: stenosed by nonspecific inflammatory scar tissue within internal lumen with collapse of the wall. We have treated 10 patients complaining dyspnea due to with severe fibrostenosis of the diaphargm or the combined type using a neodymiumyttrium aluminum garnet(Nd-YAG) laser through a flexible bronchoscopy. RESULTS: Eight of the 10 cases improved after laser therapy and maintained during a follow up period of average 31.9 months. All of the cases undergoing laser therapy showed no serious complication to need the therapy. CONCLUSION: The results of our present study indicate that the Nd-YAG laser therapy is an effective and safe method for the management of selective tuberculous fibrostenosis.
Aluminum ; Bronchoscopy ; Cartilage ; Cicatrix ; Diaphragm ; Dilatation ; Dyspnea ; Follow-Up Studies ; Humans ; Laser Therapy ; Lasers, Solid-State* ; Respiratory Insufficiency ; Tuberculosis

During the period of 9.5 years from September, 1985 to March, 1995, 32 cases with spontaneous closure in simple ventricular septal defect(VSD) were observed and evaluated at Yeungnam University Hospital, and those were confirmed by 2D-echocardiogram. The results were as follows: 1. Among these 32 cases, there were 23 cases(71.9%) of perimembranous VSD, 8 cases(25.0%) of muscular VSD and 1 case(3.1%) of subarterial VSD. Septal aneurysms appears to be main mechanism of spontaneous closure of VSD because of the presence of septal aneurysm in all cases with spontaneous ',;losure of a perimembranous VSD. 2. The size of the defect was variable in diameter, but 27 cases(81.2%) were less than 5 mm. 3. The mean age was 12.1 months at spontaneous closure with the range from 1 month old to 72 months. 4. The mean weight was 9.0 kg at spontaneous closure. 5.--Among these 32 cases, 3 cases had the clinical evidence of cardimegaly or congestive hert -failure during infancy. 6. Male to female sex ratio was 1.5:1
Aneurysm ; Estrogens, Conjugated (USP) ; Female ; Heart Septal Defects, Ventricular* ; Humans ; Male ; Sex Ratio

To find clinical significance of routine “dipstick” urinalysis on admission, we analyzed the results of the “dipstick” urinalyses performed in 844 patients admitted to the pediatric department of Yeungnam University hospital from May 1, 1983 to October 31, 1984. Ketonuria, proteinuria, hematuria and glucosuria were found in 9.5%, 4.9%, 2.4% and 1.1% of the patients respectively. There were no significant differences by sex, age and presence of fever. However, proteinuria and ketonuria were found more frequently in the patients with dehydration (p<0.05). All of the patients with proteinuria and ketonuria showed negative results on follow up. However, among 13 patients with hematura, 9 patients showed negative results and 4 patients had persistent hematuria on follow up. These 4 patients were found to have chronic pyelonephritis (2), asymptomatic urinary tract infection (1) and benign recurrent hematuria (1). This routine “dipstick” urinalysis on admission seems to be simple test which is useful in detecting unrecognized kidney and other urinary tract disease.
Dehydration ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Inpatients* ; Ketosis ; Kidney ; Proteinuria ; Pyelonephritis ; Urinalysis* ; Urinary Tract Infections ; Urologic Diseases

We studied the effects of the acute intermittent peritoneal dialysis in severe acute renal failure of 1 newborn infant and 2 young infants during 18 months period from February 1985 to April 1986. The predisposing illnesses were severe acute gastroenteritis with dehydration. Reye's syndrome, and bilateral nephrolithiasis with hyperuricemia. The concomitant illnesses were severe hypernatremia, hyponatremia, hyperkalemia, hypocalcemia, hypoglycemia, DIC (disseminated intravascular coagulopathy). Paralytic ileus, metabolic acidosis and gastrointestinal bleeding. As a dialysate, Imperinol solutionR, 1.5% was used in all cases. The cycles of dialysis were 8, 16, and 41 times in each cases. Observed complications during dialysis were leakage, and abdominal wall and scrotal swelling in 2 cases, hyperglycemia in 1 case, and peritonitis in 1 case. Acinetobacter calcoaceticus was cultured in peritoneal fluid of peritonitis. These complications were treated by stopping dialysis in leakage and abdominal wall swelling, insulin therapy in hyperglycemia, and intraperitoneal and systemic antibiotics therapy in peritonitis. We experienced improvements of severe acute renal failure with variable concomitant illnesses by acute intermittent peritoneal dialysis despite of the treatable complications of dialysis in all cases.
Abdominal Wall ; Acidosis ; Acinetobacter calcoaceticus ; Acute Kidney Injury* ; Anti-Bacterial Agents ; Ascitic Fluid ; Dacarbazine ; Dehydration ; Dialysis ; Gastroenteritis ; Hemorrhage ; Humans ; Hyperglycemia ; Hyperkalemia ; Hypernatremia ; Hyperuricemia ; Hypocalcemia ; Hypoglycemia ; Hyponatremia ; Infant* ; Infant, Newborn* ; Insulin ; Intestinal Pseudo-Obstruction ; Nephrolithiasis ; Peritoneal Dialysis* ; Peritonitis ; Reye Syndrome

No abstract available.
Bone Density* ; Child* ; Glucocorticoids* ; Humans ; Nephrotic Syndrome*

Although there have been a few reports of cases in which cancer cells of extrauterine origin were observed in vaginal smears, such findings are relatively uncommon. We recently experienced a case of ovarian serous cystadenocarcinoma diagnosed by cervicovaginal smear in a 56-year-old woman in routine work-up of carcinoma peritonei. The cellular features were several scattered cellular clusters of adenocarcinoma cells in clear background without tumor diathesis. Psammoma body was not present. Exploratory laparotomy confirmed the diagnosis of bilateral ovarian serous cystadenocarcinoma with multiple metastases.
Adenocarcinoma ; Cystadenocarcinoma, Serous ; Diagnosis ; Disease Susceptibility ; Female ; Humans ; Kidney Failure, Chronic* ; Laparotomy ; Middle Aged ; Neoplasm Metastasis ; Thyroid Gland ; Vaginal Smears

No abstract available.
Child* ; Hemorrhagic Fever with Renal Syndrome* ; Humans

To evaluate the effect of a new topical anesthetic cream (EMLA : Eutectic mixture of local anesthetics) on reducing pain associated with DPT vaccination, we conducted a clinical observation on eighty infants who were brought to well baby clinic of Yeungnam University Hospital for DPT vaccination. 80 Infants, who were between 2 months and 8 months in age, were divided into two groups. EMLA treated group and control group. Male to femle sex ratio was 1.4 to 1. EMLA cream was applied 60 minutes before DPT vaccination, the effect of reducing pain was assessed by using McGrath's face scale, Oucher pain scale and modified behavioral pain scale (MBPS) and also evaluated by measuring the duration and time of crying (the time of the first crying after iniection, duration of the first crying, total duration of crying). The scores of those scales were lower in EMLA treated group than in control group significantly (P<0.01 in McGrath's face scale. MBPS and p<0.05 in Oucher pain scale). There was no difference in the time of the first crying after vaccination in both groups. The duration of the first crying was shorter in EMLA treated group than control group of crying was also shorter in EMLA treated group (EMLA treated group 9.0±12.5 sec, p<0.05). Transient skin erythema was noted in 5 infants after EMLA application, but no other adverse effects were observed. We conclude that the application of EMLA cream before vaccination seems to be an effective and safe way to reduce the pain from vaccination, but it takes usually 60 minutes to get the anesthetic effect of EMLA and it is expensive, so EMLA cream can not be recommended in routine vaccination in infants now.
Anesthetics ; Crying ; Erythema ; Humans ; Infant ; Male ; Sex Ratio ; Skin ; Vaccination* ; Weights and Measures