Invasive infection of the Streptococcus bovis group in a neonate is rare. In cases reported to date, the pathogen of neonatal S. bovis infections is usually Streptococcus gallolyticus subsp. pasteurianus (S. bovis biotype II/2). Streptococcus lutetiensis (S. bovis biotype II/1) was identified using 16S rRNA and tuf gene sequence analysis of the isolates from blood and cerebrospinal fluid (CSF) of a fever-presenting 28-day-old male. Blood culture analysis was performed using automatic equipment (VITEK 2) and identified Streptococcus infantarius supsp. infantarius, yet we were unable to get accurate results from the CSF culture. The fever subsided on the second day of hospitalization, and the patient was discharged without neurologic complication after 14 days of antibiotic therapy. In this case, we were able to accurately identify the pathogen using molecular genetic methods. To our knowledge, this is the first case of late onset neonatal bacteremia and meningitis caused by S. lutetiensis.
Bacteremia* ; Cerebrospinal Fluid ; Fever ; Hospitalization ; Humans ; Infant, Newborn ; Male ; Meningitis* ; Molecular Biology ; Sequence Analysis ; Streptococcus bovis ; Streptococcus*

No abstract available.

PURPOSE: Hydronephrosis is found about 30% of children with urinary tract infection (UTI). It can be caused by various conditions, although most childhood hydronephrosis is congenital. This study was performed to investigate the relationship between febrile UTI and hydronephrosis. METHODS: We retrospectively reviewed the medical charts of 183 patients diagnosed as UTI between January 2007 and May 2009 at Korea University Guro Hospital. Inclusion criteria were as followings; 1) fever more than 37.5degrees C measured in the axilla , 2) positive urine culture, 3) no history of urinary tract anomaly on antenatal sonography and urinary tract infection. We classified the enrolled children into two groups of patients with hydronephrosis (HN) and those without hydronephrosis (NHN). RESULTS: The 80 patients were HN and 103 patients NHN. Hydronephrosis was found in 58 patients with left kidney, 8 right and 14 both kidneys. Most of hydronephrosis were of low grade. Compared with NHN group, initial renal cortical defects on DMSA scan significantly increased in HN group (HN 37.5%, NHN 16.5%, P < 0.05). The incidence of VUR was not different between the two groups (HN 22%, NHN 12.1%). White blood cell counts and C-reactive protein were not different between the two groups. Follow-up DMSA scan (about 6 months later after UTI) showed no difference of renal scarring in both two groups. CONCLUSION: Our data suggests that hydronephrosis in febrile UTI patients is clinically useful for detecting renal cortical defects, but is not associated with follow-up renal scar.
Axilla ; C-Reactive Protein ; Child ; Cicatrix ; Fever ; Follow-Up Studies ; Humans ; Hydronephrosis ; Incidence ; Kidney ; Korea ; Leukocyte Count ; Retrospective Studies ; Succimer ; Urinary Tract ; Urinary Tract Infections

Nutcracker syndrome refers to the compression of the left renal vein between the abdominal aorta and superior mesenteric artery which can lead to renal vein hypertension. Patients can present with hematuria, proteinuria, dysuria or abdominal pain. In diagnosing the nutcracker syndrome, measurement of the peak velocity ratio of aorto-mesenteric border versus renal hilum by Doppler sonography is useful. Currently, there are few reports about the genetic correlation in this syndrome. We report two cases of the nutcracker syndrome found in male siblings with hematuria.
Abdominal Pain ; Aorta, Abdominal ; Child ; Dysuria ; Hematuria ; Humans ; Hypertension ; Male ; Mesenteric Artery, Superior ; Proteinuria ; Renal Veins ; Siblings

A review of the literature on cancer pain revealed that many persons with cancer receive inadequate analgesia for pain control, due in part to a lack of knowledge of the control of cancer pain by both physicians and nurses. This study is composed of two parts : one is to train nurses to change their knowledge of and attitude toward the pain management of patients having cancer and to evaluate the effectiveness of this training in comparison with other non-trained group ; the other is to test the applicability of the pain management method knowledge and attitude in the levels of pain of oncology patients. General characteristics of nurses such as age, education, educational experiences of cancer pain management were not different in both groups except the clinical experience. General characteristics of cancer patients and pain-related variables such as pain, sleep, daily activities, treatment modalities, causes of pain were not different in both groups except the educational levels of patients. After an eight-hour educational program given to the experimental nurse group, the knowledge and attitude about assessment of cancer pain, pain medication, and pharmacological knowledge were significantly higher in the experimental group than in the control group, while knowledge about classification of analgesics was not significantly different. The amount of analgesics, measured by the morphine equivalent doses, used in the experimental group was significantly lower than in the control group in the first and the last days. The experimental group used more systematic ways of drug changes from non-narcotic analgesics to narcotic analgesics than the control group. This indicated that the control group used fentanyl patches more commonly than in the control group. Cancer pain scores of both group of patients were measured on an hourly bases for a week in both groups. The patients' pain scores of the first day of measurement in experimental group were not significantly higher than those of control group of patients, while those of the last day were significantly higher than those of the control group. This study supports the need for educational program for the management of cancer pain to the nurses and the doctors.
Analgesia ; Analgesics ; Analgesics, Non-Narcotic ; Classification ; Education ; Fentanyl ; Humans ; Morphine ; Narcotics ; Pain Management*

BACKGROUND/AIMS: Fragmented care in nephrology can cause treatment delays. Nephrologists are qualified to perform vascular access-related procedures because they understand the pathophysiology of renal disease and perform physical examination for vascular access. We compared treatment delays associated with tunneled hemodialysis catheter (TDC) placement between interventional radiologists and nephrologists. METHODS: We collected data by radiologists from January 1, 2011 through December 31, 2011 and by nephrologists from since July 1, 2012 through June 30, 2013. We compared the duration from the hemodialysis decision to TDC placement (D-P duration) and hemodialysis initiation (D-H duration), catheter success and the complication rate, and the frequency and the usage time of non-tunneled hemodialysis catheters (NDCs) before TDC placement. RESULTS: The study analyzed 483 placed TDCs: 280 TDCs placed by radiologists and 203 by nephrologists. The D-P durations were 319 minutes (interquartile range [IQR], 180 to 1,057) in the radiologist group and 140 minutes (IQR, 0 to 792) in the nephrologist group. Additionally, the D-H durations were 415 minutes (IQR,260 to 1,091) and 275 minutes (IQR, 123 to 598), respectively. These differences were statistically significant (p = 0.00). The TDC success rate (95.3% vs. 94.5%, respectively; p = 0.32) and complication rate (16.2% vs. 11%, respectively; p = 0.11) did not differ between the groups. The frequency (24.5 vs. 26%, respectively; p = 0.72) and the usage time of NDC (8,451 vs. 8,416 minutes, respectively; p = 0.91) before TDC placement were not statistically significant. CONCLUSIONS: Trained interventional nephrologists could perform TDC placement safely, minimizing treatment delays.
Catheters* ; Nephrology ; Physical Examination ; Renal Dialysis* ; Vascular Access Devices

PURPOSE: To improve survival and/or to avoid radiotherapy, high dose chemotherapy (HDCT) with autologous peripheral blood stem cell transplantation (PBSCT) was given to patients with recurrent or high risk medulloblastoma (MB)/primitive neuroectodermal tumor (PNET) as well as patients younger than 3 years of age. METHODS: Six patients (3 recurrent, 1 high risk, 2 younger than 3 years; 5 MBs and 1 PNET) received single or double HDCT and PBSCT with or without immunotherapy using interleukin-2. Chemotherapeutic regimen in the first HDCT included cyclophosphamide (1,500 mg/m2/ day for 4 days) and melphalan (60 mg/m2/day for 3 days). Chemotherapeutic regimen in the second HDCT included carboplatin (400 mg/m2/day for 3 days), thiotepa (250 mg/ m2/day for 3 days), and etoposide (200 mg/m2/day for 3 days). RESULTS: Nine HDCTs were applied in 6 patients. Three double HDCTs were rescued with peripheral blood stem cells collected during single round leukapheresis. Rapid hematologic recovery occurred in 4 patients. Engraft failure occurred in 1 patient and delayed granulocyte recovery and platelet engraft failure occurred in 1 patient. Three patients who had minimal disease before HDCT had event free survival for 7~18 months after HDCT. Tumor relapsed 8 and 12 months after single HDCT in 2 patients among 3 patients with recurrent MB/PNET. One patient with recurrent MB died due to engraft failure and sepsis. CONCLUSION: HDCT with autologous PBSCT is expected to improve survival of patients with poor prognosis MB/PNET including younger patients less than 3 years. Subsequent trials with larger number of patients and long-term follow-up are needed.
Blood Platelets ; Carboplatin ; Cyclophosphamide ; Disease-Free Survival ; Drug Therapy* ; Etoposide ; Follow-Up Studies ; Granulocytes ; Humans ; Immunotherapy ; Interleukin-2 ; Leukapheresis ; Medulloblastoma ; Melphalan ; Neural Plate* ; Neuroectodermal Tumors* ; Neuroectodermal Tumors, Primitive ; Peripheral Blood Stem Cell Transplantation* ; Prognosis ; Radiotherapy ; Sepsis ; Stem Cells ; Thiotepa

OBJECTIVES: Vulnerability marker in biological relatives of schizophrenia may be very useful in identifying the propensity for the development of schizophrenia. This study suggests that the relatives at risk for genetically developing schizophrenia have impairments in several domains of cognition, social function and affective function as a vulnerability marker. METHODS: A neurocognitve function test, a social function test and an affective function test were administered to fifteen healthy relatives from families with two or more patients with schizophrenia (geneticallly high risk subjects). Fifteen healthy controls matched for age and gender were recruited in this study. RESULTS: Compared to the control subject, the genetic high risk subjects performed significantly more poorly in the selective attention and recall memory of neurocognitive function. The high risk subjects also had lower scores in independence-performance and independence-competence of the social function test and emotion control of the affective function test. CONCLUSION: Selective attention, recall memory, independence-performance, independence-competence and emotion control ability may be a valuable marker for genetic study of schizophrenia.
Cognition* ; Humans ; Memory ; Schizophrenia*

OBJECTIVES: This study was conducted to investigate the association between the symptoms of boys with attentiondeficit hyperactivity disorder (ADHD) and the attention-deficit hyperactivity symptoms, temperament and character patterns of their parents. METHODS: Forty-five boys with ADHD and who met the DSM-IV criteria were evaluated by using the ADHD rating scale (ADHD-RS), and their parents completed the Korean Adult ADHD scale (K-AADHDS) and the Temperament and Character Inventory (TCI). RESULTS: The parental K-AADHDS scores were not associated with the ADHD-RS total score and the subscale scores of their siblings. The most potent variable related to the ADHD-RS total score was the maternal self-directedness, and the second was the maternal persistence. The maternal self-directedness was the variable that was most correlated with the hyperactivity/impulsivity subscale scores of the ADHD-RS. CONCLUSIONS: The results suggest that the paternal ADHD symptoms may not be related to the ADHD symptoms of boys with ADHD. Higher maternal self-directedness and persistence may decrease overall the ADHD symptoms of these boys, and higher maternal self-directedness itself may predict lower hyperactivity/impulsivity symptoms of the boys with ADHD.
Adult ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Parents ; Siblings ; Temperament

BACKGROUND: The overall rate of renal complication after surgery on the suprarenal aorta remains high. In this study, the changes in renal blood flow (RBF), urinary oxygen tension (PuO2), renal vascular resistance (RVR), and urinary volume following fenoldopam administration were investigated in supraceliac aortic cross-clamping and unclamping animal model. METHODS: Twelve dogs were divided into two groups; control group (n = 6), fenodopam group (n = 6). After brachial, femoral, and pulmonary arterial catheterization, midline abdominal incision was made. For the aortic cross-clamping the supraceliac aorta was exposed. A doppler flowmeter probe was placed around right renal artery. A ureteral catheter was positioned at the right renal pelvis to measure urine volume and urinary oxygen tension (PuO2). In fenoldopam group, 0.5microgram/kg/min of fenoldopam was administered immediately before suprarenal aortic reperfusion. Systemic hemodynamics, renal blood flow, renal vascular resistance, PuO2, and urine volume were compared between two groups. RESULTS: The systemic hemodynamics were not significantly different between the two groups throughout the experiment. After aortic reperfusion, the RVR significantly increased in control group, but the RVR in fenoldopam group remained to baseline level. The urine output, RBF, and PuO2 significantly increased in fenoldopam group compared to control group. BUN and serum creatinine were not different between the two groups. CONCLUSIONS: High dose of fenoldopam administration reverse ischemic renal insufficiency after supraceliac aortic cross clamping.
Animals ; Aorta ; Catheterization ; Catheters ; Constriction ; Creatinine ; Dogs ; Fenoldopam* ; Flowmeters ; Hemodynamics ; Kidney Pelvis ; Models, Animal ; Oxygen ; Renal Artery ; Renal Circulation ; Renal Insufficiency ; Reperfusion ; Urinary Catheters ; Vascular Resistance