Xanthogranulomatous pyelonephritis, an uncommon chronic inflammatory renal disorder of middle-aged women, is rarely seen in childhood. A 10 year-old boy with focal type of this disease in upper and lower pole was experienced. Patient had a intermittent fever and right flank pain without palpable mass. The blood analysis only revealed ESR increase but no anemia, no leukocytosis. There was no history or signs of urinary tract infection or calculi. The urine analysis and culture showed nothing abnormal. An intravenous pyelogram, ultrasonogram, abdominal CT and selective renal arteriography only demonstrated a non functioning upper pole of right kidney. During operation, a gross finding and frozen section strongly showed xanthogranulomatous pyelonephritis and diagnosis was made on histological examination, After nephrectomy, there had been no evidence of disease recurrence during 2 years follow-up period.
Anemia ; Angiography ; Calculi ; Child* ; Diagnosis ; Female ; Fever ; Flank Pain ; Follow-Up Studies ; Frozen Sections ; Humans ; Kidney ; Leukocytosis ; Male ; Nephrectomy ; Pyelonephritis, Xanthogranulomatous* ; Recurrence ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Tract Infections

PURPOSE: Peak expiratory flow rate (PEFR) monitoring plays an important role in the diagnosis of airway obstruction and management of patients with bronchial asthma. This study compared the PEFR taken by a Microplus pocket spirometer and mini-Wright peak flow meter by assessing the extent of agreement between the instruments and the repeatability of measurements with each instrument. METHODS: Eighty healthy children (age 11-12 years, 43 females, 37 males) performed three PEFR maneuvers on the Microplus pocket spirometer and on the mini-Wright peak flow meter in a random order. Agreement and reproducibility between the two instruments were assessed by the statistical methods proposed by Bland and Altman. RESULTS: Seventy six (95%) of the PEFR taken by the mini-Wright peak flow meter were higher than that of Microplus pocket spirometer. The 95% limits of agreements (mean difference+/-2SD) between each instrument were very wide (2.7 to 144.3 L/min). The repeatability coefficient for the mini-Wright peak flow meter was 27 L/min and for the Microplus pocket spirometer was 33.5 L/min. Analysis by sex and order of usage did not show any significant differences. CONCLUSION: The limit of agreement between the Microplus pocket spirometers and the mini-Wright peak flow meter was too wide to use interchangeably.
Airway Obstruction ; Asthma ; Child ; Diagnosis ; Female ; Humans ; Peak Expiratory Flow Rate*

PURPOSE: To determine the role of Tc-99m HMPAO SPECT imaging in children with intractable seizure by evaluating the interictal period. METHODS: We compared the EEG, CT and MRI medical records with those of Tc-99m HMPAO SPECT in 42 patients with intractable seizure referred to Kyunghee University Hospital, from April 1983 to September 1998, retrospectively. RESULTS: Mean age was 8.3 years and male to female ratio was 2.5 : 1. Multiple surface EEG recordings were performed in 42 patients and EEG findings of all patients showed an epileptogenic focus, with the most common area of abnormal findings being the Lt. sides. Brain CT was performed in 23 out of 42 patients(54.8%), and 15 out of the 23 patients(65.2%) showed abnormal findings and the most common area of abnormal findings were both sides. Brain MRI was performed in 21 out of 42 patients(50.0%), and 14 of the 21 patients(66.6%) showed abnormalities and the most common area of abnormal findings were both sides. In 32 out of the 42 patients (76.2%), SPECT images showed abnormal cerebral perfusion, most common area of hypoperfusion were Lt. sides. In 10 out of 14 cases, there were lateralizing abnormalities on the same side shown in SPECT and EEG, CT or MRI findings. CONCLUSION: We concluded that Tc-99m HMPAO SPECT seemed to be a useful tool in the evaluation of intractable seizure patients.
Brain* ; Child* ; Electroencephalography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Medical Records ; Perfusion ; Retrospective Studies ; Seizures* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To determine the role of Tc-99m HMPAO SPECT imaging in children with intractable seizure by evaluating the interictal period. METHODS: We compared the EEG, CT and MRI medical records with those of Tc-99m HMPAO SPECT in 42 patients with intractable seizure referred to Kyunghee University Hospital, from April 1983 to September 1998, retrospectively. RESULTS: Mean age was 8.3 years and male to female ratio was 2.5 : 1. Multiple surface EEG recordings were performed in 42 patients and EEG findings of all patients showed an epileptogenic focus, with the most common area of abnormal findings being the Lt. sides. Brain CT was performed in 23 out of 42 patients(54.8%), and 15 out of the 23 patients(65.2%) showed abnormal findings and the most common area of abnormal findings were both sides. Brain MRI was performed in 21 out of 42 patients(50.0%), and 14 of the 21 patients(66.6%) showed abnormalities and the most common area of abnormal findings were both sides. In 32 out of the 42 patients (76.2%), SPECT images showed abnormal cerebral perfusion, most common area of hypoperfusion were Lt. sides. In 10 out of 14 cases, there were lateralizing abnormalities on the same side shown in SPECT and EEG, CT or MRI findings. CONCLUSION: We concluded that Tc-99m HMPAO SPECT seemed to be a useful tool in the evaluation of intractable seizure patients.
Brain* ; Child* ; Electroencephalography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Medical Records ; Perfusion ; Retrospective Studies ; Seizures* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVE: Macrosomia is one of the important problems in obstetrics and perinatology. This study was to investigate the changing trend in incidence, area distribution, and other relavant factors of macrosomia. METHODS: We studied 2,206 cases of large babies weighing 4,000 g or more among 72,084 deliveries at Catholic Medical College Hospital from Jan. 1, 1993 to Dec. 31, 2003. The cases were divided into two group, one group from 1993 to 1998 (group I), the other group from 1998 to 2003 (group II). RESULTS: The incidence of large babies weighing 4,000 g or more was 3.06%. The incidence of macrosomia in group I was 3.02%, and that from group II was 3.14% (P=0.149). The incidence of macrosomia throughout the country was 2.5-3.3%. The average body weight of macrosomia was raised by 30 g from 4,218 +/- 224 g in group I to 4,248 +/- 246 g. in group II (P=0.003). The average of maternal body weight was raised by 246 g from 73.12 +/- 9.08 kg in group I to 75.56 +/- 9.64 kg in group II (P<0.001). According to gestational age, the percentage of macrosomia less than 38 weeks was 5.0%, that during 38 weeks and 40 weeks was 39.4%, that during 40 weeks and 42 weeks was 53.4%, more than 42 weeks was 2.2% in group I, and that in group II was 6.2%, 46.1%, 44.1%, and 3.6%, respectively. Male fetuses were 927 cases (64.69%), and female fetuses were 506 cases (35.31) in group I, and those in group II were 520 cases (67.27%), and 253 cases (32.73%), respectively. CONCLUSION: There is no change in the incidence of macrosomia past 11 years. There is no significant difference in the incidence of macrosomia throughout the country. Maternal body weight may associated with fetal body weight. Gestational weeks in group II were earlier, that in group II. Sex ratio was similar in the two groups, and male was predominant.
Body Weight ; Female ; Fetal Weight ; Fetus ; Gestational Age ; Humans ; Incidence ; Male ; Obstetrics ; Perinatology ; Sex Ratio

PURPOSE: To investigate the effect of infant massage on stress, immune function and self-confidence in postpartum mothers. METHOD: From September, 2003 to February, 2004, 65 women who had delivered babies and were enrolled in the postpartum clinic were assigned to the experimental group or control group. In the experimental group, infant massage was given for 20 minute sessions twice a day from 4 days to 14 days after delivery. The instruments were Parental Stress Index, serum cortisol levels, WBCs, lymphocytes, and Self Confidence Scale. RESULTS: Stress scores, WBCs and lymphocytes showed significant differences by the time, but there weren't significant differences according to the group and interactions between the group and the time. Cortisol and self-confidence scores showed significant differences by the time and the group. CONCLUSIONS: Applying massage to their newborn baby influenced cortisol levels of postpartum mothers. Therefore stress, cortisol, and immune functions in postpartum mothers should be generally screened and follow up studies are needed for the effective application of massage in postpartum mothers.
Female ; Follow-Up Studies ; Humans ; Hydrocortisone ; Infant ; Infant, Newborn* ; Lymphocytes ; Massage* ; Mothers* ; Parents ; Postpartum Period*

BACKGROUND: The studies on cryopreserved arterial allograft have been focused on cooling methods, pre-treatment, cryoprotectant agents, and preservation temperature. But recently, several studies have reported that thawing methods also play an important role in the occurrence of macroscopic and microscopic cracks. This study was designed to investigate the cell injury after thawing, using a rabbit model to clarify the effect of thawing methods on cryopreserved arteries. MATERIAL AND METHOD: Segments of the rabbit aorta were obtained and divided into 3 groups (n=60) according to whether the specimens were fresh (control, n=20), cryopreserved and rapidly thawed (RT) at 37oC (n=20), or cryopreserved and subjected to controlled, automated slow thawing (ST)(n=20). Cell damage was established using the TUNEL method and the morphological changes were also evaluated. RESULT: In the group that was rapidly thawed, the expression of TUNEL (+) cells increased significantly more than in the slowly thawed group. In addition, the endothelial denudation, microvesicles and edema were significant in the rapidly thawed group compared with those changes in the slowly thawed group. CONCLUSION: Our study suggests that the rapid thawing method may be one of the major causes of cellular damage and delayed rupture in cryopreserved arterial allografts. The expression of TUNEL (+) cells and structural changes were significantly low in the slowly thawed group, which might have contributed to the improvement of graft failure after transplantation.
Allografts ; Aorta* ; Arteries ; Cryopreservation ; Edema ; In Situ Nick-End Labeling ; Rupture ; Transplants

No abstract available.
Hypertension, Pulmonary*

BACKGROUND: Thoracic sympathetic block surgery is a safe and effective procedure for palmar hyperhydrosis, and this maintains sufficient moisture and prevents compensatory hyperhidrosis. To avoid compensatory hyperhidrosis, the authors performed sympathetic block surgery just above the R4 level to maintain sympathetic tone affecting the caudal area. MATERIAL AND METHOD: A total of 71 subjects (45 males and 26 females) were categorized into two groups. Group 1 (31 patients, mean age: 25.5 years) had clips placed both on the upper and lower part of R4 sympathetic ganglion, and group 2 (40 patients, mean age: 25.9 years) underwent clipping of the upper part of R4. Telephone surveys were done to collect data on 8 categories, and the average follow up interval was 24.9 months (group 1) and 18.9 months (group 2). RESULT: For group 1, 41.9% experienced no sweating and 48.4% replied they experienced some sweating depending on the surrounding conditions. Group 2 showed that 60% experienced no sweating and 35% replied they experienced some sweating depending on the surrounding conditions. 58.1% in group 1 experienced sweating right after the surgery, and 40.0% in group 2 experienced the same. Group 1 (38.1%) and group 2 (37.5%) replied they experienced no hand dryness and more patients in group 2 than in group 1 had hand dryness, but without uncomfortable symptoms. 71.0% (group 1) and 62.5% (group 2) replied they had no compensatory hyperhidrosis or related symptoms. One patient in group 1 and two in group 2 reported they regretted undergoing the procedure. The regions of compensatory hyperhidrosis were the back, thigh and chest in group 1 and the group 2 reported the back, chest, and abdomen in the order of frequency. Fewer incidences of the gustatory hyperhidrosis were noted in group 2. Most of the patients were satisfied with their treatment. CONCLUSION: Clipping the upper part of the R4 ganglion or R4 sympathetic block are both effective for treating palmar hyperhidrosis and these treatments decrease the occurrence or symptoms of compensatory hyperhidrosis. The upper R4 sympathetic block procedure is easier and safer with fewer incidences of gustatory hyperhidrosis and a higher percentage of patient satisfaction.
Abdomen ; Endoscopy ; Follow-Up Studies ; Ganglia, Sympathetic ; Ganglion Cysts ; Hand ; Humans ; Hyperhidrosis* ; Incidence ; Male ; Patient Satisfaction ; Reflex ; Sweat ; Sweating ; Sweating, Gustatory ; Sympathetic Nervous System ; Telephone ; Thigh ; Thorax

PURPOSE: Infantile spasms are considered malignant epilepsy of infancy. Primary objectives of treatment are complete control of seizure attack and prevention of further brain damage. The aim of this study is to assess prednisolone(PDL) efficacy in infantile spasms. METHODS: From June 1985 to July 1994, 20 children with infantile spasms who were diagnosed at Kyung Hee University Hospital and were medicated 2mg/kg PDL analyzed retrospectively. RESULTS: 1) The ratio of male to female was 1.9:1. 2) Mean age at onset of infantile spasms is 7.8 month old and mean age at treatment of infantile spasms is 10.3 month old. Mean duration from onset of the disease to the beginning of the treatment is 1.3 months. 3) The most common type of infantile spasms is flexor type which is 10 cases (50.0%) 4) Among the associated conditions, brain atropy is the most common condition (45.0%). 5) Of forteen cases with developemental delay, six cases were controlled and four of the six cases without developmental delay were controlled. 6) EEG findings were improved in sixteen patients (80.0%) 7) The most common combined anticonvulsant is valproic acid. CONCLUSIONS: The effectiveness of PDL in infantile spasm is 42.9% in group with developmental delay. On the other hand, that is 66.7% in group without developmental delay. Also, because PDL have a merit of cheap and easy for oral medication, it will be necessary that PDL can be selected for hormonal anticonvulsant in infantile spasm. But,it must keep in mind that high dose or longterm PDL can elicit serious side effects.
Brain ; Child ; Electroencephalography ; Epilepsy ; Female ; Hand ; Humans ; Infant ; Infant, Newborn ; Male ; Prednisolone* ; Retrospective Studies ; Seizures ; Spasms, Infantile* ; Valproic Acid