Kawasaki disease is generally diagnosed base on its clinical features. Sometimes unusual or atypical presentations make the diagnosis of Kawasaki disease difficult. We experienced an unusual case of Kawasaki disease presented with unilateral parotitis in a 23-month old girl. Despite of intravenous antibiotics treatment, fever and unilateral parotid swelling persisted. Skin rashes, conjunctival injections, and coronary abnormalities showed up on the 8th day of fever. After the intravenous immunoglobulin and salicylates treatment, all symptoms disappeared. Although unilateral parotitis is very unusual presentation of Kawasaki disease, in case of no response to antibiotics, Kawasaki disease should be included in the differential diagnosis.
Anti-Bacterial Agents ; Child* ; Diagnosis ; Diagnosis, Differential ; Exanthema ; Female ; Fever ; Humans ; Immunoglobulins ; Mucocutaneous Lymph Node Syndrome* ; Parotitis* ; Salicylates

PURPOSE: We evaluated the easily-assessable risk and prognostic factors of septic shock in children with neutropenic fever (NF) which developed after anticancer chemotherapy. METHODS: We retrospectively reviewed the medical records and laboratory data of 97 children who received anticancer chemotherapy at Dong-A University Hospital and had NF between March, 1993 and February, 2001. RESULTS: There were 223 episodes of NF in 97 children, of which 71 episodes (31.8%) of bacteremia and 18 episodes (8.1%) of septic shock developed. The incidence of septic shock was associated with fever duration (> 5 days, odds ratio=7.367, P=0.0159), tachycardia (odds ratio=11.857, P=0.0001), and serum bicarbonate level (<24 mEq/L, odds ratio=6.235, P=0.0378), whereas not with the underlying disease, age, sex, causative organisms, absolute neutrophil count, absolute monocyte count, absolute phagocyte count, the presence of central venous catheter, the accompanied focal infection, and the use of hematopoietic growth factor. Septic shock developed 3.2 (1~11) days after NF. The prognosis of septic shock patients was not associated with the therapeutic timing, antibiotics, fever duration, tachycardia, or serum bicarbonate level. CONCLUSION: We suggest that the fever duration, tachycardia, and serum bicarbonate level could be important risk factors of septic shock in children with NF. Although We could not reveal the prognostic factors in children with septic shock, further studies will be required.
Anti-Bacterial Agents ; Bacteremia ; Central Venous Catheters ; Child ; Drug Therapy ; Fever* ; Focal Infection ; Humans ; Incidence ; Medical Records ; Monocytes ; Neutropenia ; Neutrophils ; Phagocytes ; Prognosis ; Retrospective Studies ; Risk Factors* ; Shock, Septic* ; Tachycardia

Quantitative PCR and plaque assay are powerful virological techniques used to measure the load of defective or infectious virus in mouse and human. However, these methods display limitations such as cross contamination and long run-time. Here, we describe a novel technique termed as semi-functional quantitative flow cytometry (SFQF) for the accurate estimation of the quantity of infectious lymphocytic choriomeningitis virus (LCMV). LCMV titration method using flow cytometry was previously developed but has technical shortcomings, owing to the less optimized parameters such as cell overgrowth, plate scale, and detection threshold. Therefore, we first established optimized conditions for SFQF assay using LCMV nucleoprotein (NP)-specific antibody to evaluate the threshold of the virus detection range in the plaque assay. We subsequently demonstrated that the optimization of the method increased the sensitivity of virus detection. We revealed several new advantages of SFQF assay, which overcomes some of the previously contentious points, and established an upgraded version of the previously reported flow cytometric titration assay. This method extends the detection scale to the level of single cell, allowing extension of its application for in vivo detection of infected cells and their phenotypic analysis. Thus, SFQF assay may serve as an alternative analytical tool for ensuring the reliability of LCMV titration and can be used with other types of viruses using target-specific antibodies.
Animals ; Antibodies ; Flow Cytometry* ; Humans ; Lymphocytic choriomeningitis virus* ; Lymphocytic Choriomeningitis* ; Methods ; Mice ; Nucleoproteins ; Polymerase Chain Reaction

We describe our initial experience of the perioperative anesthetic care provided to 8 years old female child with argininosuccinic acidemia undergoing living-related liver transplantation because it is the only available therapy for end-stage liver disease. Induction and maintenance of anesthesia has been conventional method. Arterial catheterized at radial and femoral arteries for continuous blood pressure monitoring and sampling. 18 G central vein catheterization was placed in left subclavian vein for fluid, drug infusion and CVP monitoring. EKG, pulse oxymetry, end-tidal CO2, urine output and body temperature were monitored. CBC, PT, aPTT, serum electrolyte were checked at preanhepatic, anhepatic phase and just after hepatic artery anastomosis. ABGA was checked every 1 hour. The level of serum ammmonia returned to normal range without protein restriction. We describe this case and a brief review of the literature.
Anesthesia* ; Argininosuccinic Aciduria* ; Blood Pressure Monitors ; Body Temperature ; Catheterization ; Catheters ; Child ; Electrocardiography ; Female ; Femoral Artery ; Hepatic Artery ; Humans ; Liver Diseases ; Liver Transplantation* ; Liver* ; Reference Values ; Subclavian Vein ; Veins

Local allergic rhinitis (LAR) is a localized nasal allergic response in the absence of systemic atopy. The aim of this study was to evaluate the prevalence and clinical characteristics of LAR in Korean rhinitis patients compared to allergic rhinitis (AR) and non-allergic rhinitis (NAR). A total of 304 rhinitis patients were enrolled from November 2014 to March 2016. A skin prick test, serum total and specific immunoglobulin E, and a nasal provocation test (NPT) with house dust mite (HDM) were performed on all patients. Subjects also documented changes in rhinitis symptoms before and after NPT. Seventy-four patients with nasal hyper-reactivity and 80 patients with subclinical allergy were excluded. AR was diagnosed in 69 (46.0%) patients, NAR in 75 (50.0%) patients, and LAR to HDM in 6 (4.0%) patients. The average medication score and disease duration of each group were 14.5 points and 77.6 months in AR, 12.1 point and 51.1 months in NAR, and 17.7 point and 106.0 months in LAR, respectively. There were no significant differences in the baseline nasal symptom score of the three groups. However, after NPT with HDM, the score of rhinitis, itching, and obstructive were 4.83±1.47 vs. 1.95±2.53, 3.00±2.10 vs. 1.45±2.06, and 5.50±1.38 vs. 2.57±2.84 in LAR and NAR, respectively (p<0.05). LAR patients had longer duration of disease and tended to be older and have higher medication score than other rhinitis patients.
Dust* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Nasal Provocation Tests ; Prevalence* ; Pruritus ; Pyroglyphidae* ; Rhinitis ; Rhinitis, Allergic* ; Skin

PURPOSE: To investigate the learning curve and its characteristics in our initial experiences with robotic-assisted laparoscopic radical prostatectomy (RLRP) with a new da Vinci-S surgical system. MATERIALS AND METHODS: Through inspection of the patients who underwent RLRP by a single urologic surgeon from July 2007 to May 2008, the variables related to surgery were evaluated prospectively. RESULTS: RLRP was performed in 50 patients. The patients' mean age (range) was 63 years (50-73 years), and 11 patients had a history of previous abdominal surgery. The mean total operation time was 281.6 min (190-455 min). The mean set-up time was 18.6 min (14-30 min), and the mean console time was 219.8 min (150-400 min). The mean estimated blood loss (EBL) was 375.7ml (200-800 ml). The overall margin-positive rate was 26% (13/50); it was 11.9% (5/42) for pT2 tumors and 100% (8/8) for pT3 tumors. Minor complications occurred in 5 patients. All complications were treated effectively with only conservative management. The total operation time, set-up time, console time, and EBL significantly decreased as the number of patients treated grew (Spearman's rank correlation, p<0.05; Rho=-0.49, -0.35, -0.54, -0.75, respectively). The mean total operation time, set-up time, console time, and EBL were significantly decreased in the last 35 patients who needed no transfusion (p<0.05). CONCLUSIONS: The use of robotic surgery allowed the surgeon to complete the learning curve in a relatively short time period, with low perioperative complication rates and potentially good oncologic results, as indicated by the acceptable positive surgical margin in the patients with pathologically organ-confined disease.
Humans ; Laparoscopy ; Learning ; Learning Curve ; Prospective Studies ; Prostatectomy ; Prostatic Neoplasms ; Robotics

BACKGROUND: Surgical resection is an important modality in the treatment of pulmonary metastases from various solid tumors. We analyzed 37 patients who underwent surgical treatments of pulmonary metastases in our hospital from 1996 to 2005. MATERIAL AND METHOD: Age, sex, disease free interval, operative procedure, the number of pulmonary metastases, and lymphatic metastasis were investigated with admission and operative records, and pathologic reports. Actuarial survival and comparisons between each survival rate were calculated according to Kaplan- Meier method and log-rank test, respectively. RESULT: Complete resections were carried out in 34 of 37 patients. The primary tumor was carcinoma in 25 cases, sarcoma in 10, and others in 2. The number of pulmonary metastases was 1 in 25 cases and 2 or more in 12 cases. 3-year and 5-year survival rates after complete resection were 50.5% and 35.9%, respectively. 3-year and 5-year survival rates for carcinoma were 64.5% and 45.6%, respectively, and 3-year survival rate for sarcoma was 17.5%. Otherwise, none of the operative procedures, the number of pulmonary metastases, lymphatic metastasis, adjunctive therapy and the disease free interval in the case of carcinoma significantly affected the survival rates. CONCLUSION: Complete resection of pulmonary metastasis in well selected patients allows high long term survival rate with low mortality and morbidity. Long-term follow up and randomized prospective studies were necessary to determine the prognostic factors of pulmonary metastases after surgical resection.
Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Metastasectomy ; Mortality ; Neoplasm Metastasis* ; Sarcoma ; Surgical Procedures, Operative ; Survival Analysis ; Survival Rate

Neurocutaneous melanosis is a rare congenital phacomatosis, characterized by the presence of multiple pigmented skin nevi at birth. Meningeal melanosis tending to become malignant and seizure. Dandy-Walker syndrome is a developmental disorder of brain characterized by cystic dilatation of the fourth ventricle and agenesis or hypoplasia of the cerebellar vermis. We studied a case of Dandy-Walker syndrome with neurocutaneous giant melanosis in a 3 years old boy.
Brain ; Child, Preschool ; Dandy-Walker Syndrome* ; Dilatation ; Fourth Ventricle ; Humans ; Male ; Melanosis* ; Neurocutaneous Syndromes ; Nevus ; Parturition ; Seizures ; Skin

BACKGROUND AND OBJECTIVES: The development of saturation diving has enabled men to work underseas at great depths and for long periods of time. However, the utilization of HeO2 gas mixture has been a aubject of much study. This paper present a discussion effect of the helium gas on speech by usling gas machine which have been developed. MATERIALS AND METHODS: Twenty male volunteers without voice problems produced /a/ vowel sound before and after helium gas inhalation. The results were analyzed by using an aerophone, an acoustic analyzer, videostroboscopy, and a nasometer. RESULTS: The first formant, the second formant and the bandwidths of the second formant were significantly increased after helium gas inhalation. A meaningful change was noted in asalance. CONCLUSION: The helium gas has an effect on the resonant structure of oral and nasal cavity due to its physical characteristics.
Acoustics ; Diving ; Helium* ; Humans ; Inhalation ; Male ; Nasal Cavity ; Voice ; Volunteers

BACKGROUND AND OBJECTIVES: Sudden deafness results from, in most cases, lack an apparent cause. However viral infection, vascular occlusion, cochlear membrane rupture, and others are known to be associated with this disease. In this study, we observed incidence, etiology, audiologic, psychiatric, and clinical aspect of psychogenic sudden deafness through retrospective chart review and analysis of patients who are thought to have had sudden deafness from psychogenic causes and stressor. SUBJECTS AND METHOD: We reviewed the records of 277 patients who had been admitted to the Department of Otolaryngology, Kangbuk Samsung hospital, from January 1997 to July 2003, under the initial diagnosis of idiopathic sudden hearing loss. RESULTS: In patients' medical history, there were 9 patients who had association between sudden onset of hearing loss and psychogenic causes and stressor. And there were 4 patients who had preexisting psycho-pathologic condition. Among these patients, a joint study with psychiatrist classified 7 psychogenic sudden deafness patients (2.5%) who has been ruled out organic causes and showed discrepancy between pure tone audiometry and ABR. In distribution ratio, there were 2 males and 5 females, 4 patients were in their 10's, 1 in 20's, and 2 in 40's (24 years old in average), 3 bilaterals, and 4 unilaterals. In hearing test, there were 4 patients with severe to profound hearing loss at 71 dB or higher, 2 patients with moderately severe hearing loss ranged from 56 to 70 dB, and 1 patient with moderate hearing loss from 41 to 56 dB. Hearing ability of all these patients were partially or completely recovered by treatment including steroid injection and joint psychotherapy with psychiatrist. CONCLUSION: About 2.5% of sudden deafness patients were psychogenic sudden deafness patients, and the results showed distinctive features for each of audiologic, psychiatric, and clinical characteristics. The recovery rate and prognosis were better in patients who had cure and diagnosis under consult with department of psychiatry and accurate audiometry.
Audiometry ; Diagnosis ; Female ; Hearing ; Hearing Loss ; Hearing Loss, Functional* ; Hearing Loss, Sudden* ; Hearing Tests ; Humans ; Incidence ; Joints ; Male ; Membranes ; Otolaryngology ; Prognosis ; Psychiatry ; Psychotherapy ; Retrospective Studies ; Rupture