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

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

To make better clinical diagnosis, authors reviewed 9 patients of nonchromosomal multiple malformation disorders with psychomotor retardation, who were evaluated at pediatric department of Yeungnam University hospital for recent 2 years. We could make clinical diagnosis in 5 patients out of 9 as Aarskog syndrome, BeckwithWiedemann syndrome, Hallermann-Streiff syndrome, Rubinstein Taybi syndrome and Weaver syndrome. But even in diagnosed cases, there were many discrepant findings in comparison with typical cases of reference literatures and family history was positive in only one case. Moreover we could not make diagnosis in 4 patients. Therefore we think it is necessary to make a survey of unique pattern, incidence, distribution and etiologic factors of malformation disorders in our country by geneticist and pediatrician as well as to improve the laboratory aids for better diagnosis and genetic counseling.
Diagnosis ; Genetic Counseling ; Hallermann's Syndrome ; Humans ; Incidence ; Rubinstein-Taybi Syndrome

Bartter's syndrome is a rare tubular disorder characterized by hypokalemic, hypochloremic metabolic alkalosis, hyperreninemic, hyperaldosteronism, hyporesponsiveness to pressor agents and juxtaglomerular apparatus heperplasia. We report a case of Bartter's syndrome of a 5 month-old male infant with subdural hematoma who was confirmed by characteristic clinical, laboratory findings and kidney biopsy.
Alkalosis ; Bartter Syndrome* ; Biopsy ; Epilepsy* ; Hematoma, Subdural* ; Humans ; Hyperaldosteronism ; Infant ; Juxtaglomerular Apparatus ; Kidney ; Male ; Seizures*

Femoral head and neck fractures during the course of avascular necrosis are rare with only few reports in the English literature. Moreover, there are very few reports on an analysis of the patterns of these fractures. Four cases of femoral head fracture caused by minor trauma, which were quite different from the crescent fractures during the course of avascular necrosis were analyzed in regard to the underlying disease, causes, sites, types, directions, pattern of fractures and the injury mechanism of the fractures. The results are reported with special regard to the pattern of the stress fracture of the femoral head and neck during the course of avascular necrosis.
Fractures, Stress ; Head* ; Neck* ; Necrosis*

PURPOSE: Leptin is a highly hydrophobic 16-kDa protein encoded by the ob gene which is expre- ssed in adipocytes and participates in the regulation of food intake and energy expenditure. The aims of the present study were to examine the comparison of leptin levels between type I diabetes mellitus (DM) patients who received exogenous insulin therapy and healthy children, and to find out correlating factors with leptin level in type I DM. METHODS: The study was conducted on 34 patients with type I DM and 29 healthy children. Body weight, height, leptin level and body fat percent were measured in both groups. The glycosylated hemoglobin value, C-peptide, insulin level and serum cholesterol were also measured in type I DM. RESULTS: There was no statistically significant difference in mean age, sex distribution and body mass index between the experimental groups, but body fat percent in type I DM was significantly lower than that of healthy children. The mean leptin levels in male (9.4+/-6.3ng/mL) and female (17.8+/-10.2ng/mL) type I DM were significantly higher than in male(6.3+/-5.7ng/mL) and female (10.2+/-0.9ng/mL) healthy children (male : P=0.045, female : P=0.005). Serum leptin levels were strongly correlated with the body fat percent (Pearson coefficient) (r=0.712). CONCLUSION: Serum leptin level in type I DM strongly correlated with the body fat percent. Despite lowered body fat percent in type I DM, the leptin level was significantly higher than values in healthy children. The mean leptin level in type I DM were significantly higher than value in healthy children, but body fat percent of type I DM was lower than value in healthy children who were adjusted for sex, age and body mass index.
Adipocytes ; Adipose Tissue ; Body Mass Index ; Body Weight ; C-Peptide ; Child* ; Cholesterol ; Diabetes Mellitus* ; Diabetes Mellitus, Type 1 ; Eating ; Energy Metabolism ; Female ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Leptin* ; Male ; Sex Distribution

No abstract available.
Cicatrix* ; Endometriosis* ; Episiotomy* ; Female

OBJECTIVES: The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. METHODS: The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. RESULTS: Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). CONCLUSION: Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.
Academic Medical Centers ; Aged ; Compliance ; Delirium ; Follow-Up Studies ; Hospitalization ; Hospitals, General ; Humans ; Inpatients ; Korea ; Logistic Models ; Mood Disorders ; Outpatients ; Referral and Consultation

PURPOSE: To evaluate the health status of institutionalized handicapped children, a general health assessment was done in an asylum in Taegu in May 1998. METHODS: Body measurements, including height, weight, head circumference, skin fold thickness and mid-arm circumference, were done with physical examination on 53 children. Blood tests and chest radiography were done, and fat impedance was measured. RESULTS: Of the 53 children, height, weight and head circumference were below the third percentile in 37(69.8%), 35(66%) and 28(52.8%) children, respectively. Body mass index, skin fold thickness and mid-arm circumference were below the third percentiles in 77.3, 50.9% and 56.6% of the children, respectively. Although serum protein levels were within normal range, anemia was detected in 31 children(58.5%). Two children showed interstitial pneumonia on chest radiograms. And HBsAg was detected in three but their liver enzymes were within normal limits. CONCLUSION: Due to the poor nutritional status of handicapped children in the asylum, the prevalence of anemia was high. Evaluation of the nutritional status and hemoglobin measurernent must be included in the routine health assessment of these children.
Anemia ; Body Mass Index ; Child ; Daegu ; Disabled Children ; Disabled Persons* ; Electric Impedance ; Head ; Hematologic Tests ; Hepatitis B Surface Antigens ; Humans ; Liver ; Lung Diseases, Interstitial ; Nutritional Status ; Physical Examination ; Prevalence ; Radiography ; Reference Values ; Skin ; Thorax

Os subfibulare is a accessory bone arround the lateral maleolus, but it is different from many other accessory bones in foot and ankle in its development related to trauma and frequent symptoms of ankle instability. Accessory bone is a developmental anomaly which fails to unite to main secondary ossification center and usually asymptomatic. But os subfibulare is developed by recurrent ankle sprains in younger age or non-union of avulsion fracture of anterior talofibular ligament and causes instability of ankle. We experienced two cases of symptomatic os subfibulare in adolecents and report them with review of literatures.
Ankle ; Ankle Injuries ; Foot ; Ligaments