No abstract available.
Genes, Immunoglobulin Heavy Chain* ; Immunoglobulin Heavy Chains* ; Immunoglobulins*

No abstract available.
Pancreatitis*

Nineteen children found to have gallstones at Seoul National University of Children's Hospital from Jun. 1982 to Jun. 1992 were reviewed. The results were as follows: 1) The mean age was 10 years, with 9 boys and 10girls. Most of the cases(63%) were over 10 years of age. 2) Clinical manifestations were abdominal pain(14 cases), nausea and/or vomiting (5 cases), fever (2 cases), jaundice (2 cases) and fatty food intolerance (1 case). Five cases were asymptomatic. Of 14 cases with abdominal pain, only 5 cases showed typical biliary colic which suggests cholelithiasis. 3) Associated conditions in cholelithiasis were Wilson disease (5 cases), congenital hereditary spherocytosis (2 cases), choledochal cyst (2 cases), total parenteral nutrition following ileal resection (1 case). And the other conditions which had association with cholelithiasis are not certain, and they were nephrotic syndrome, histiocytic cytophathic panniculitis, meningococcal meningitis, portal vein thrombosis and cardiac cirrhosis. The remaining 4 cases showed no associated conditions or diseases. 4) Eleven of 19 patients with cholelithiasis (58%) showed cholecystitis. 5) Cholecystectomy was performed in 4 cases with frequently recurred abdominal pain or associated diseases which needed operative correction. Symptoms completely subsided after operation. In conclusion, cholelithiasis in children has a variety of associated conditions and nonspecific abdominal symptoms were nore common than classic biliary colic. Although cholelithiasis in pediatric population are uncommon problems, the possibility of gallstones should be considered in the evaluation of abdominal pain in children with associated conditions.
Abdominal Pain ; Child ; Cholecystectomy ; Cholecystitis ; Choledochal Cyst ; Cholelithiasis* ; Colic ; Fever ; Fibrosis ; Gallstones ; Hepatolenticular Degeneration ; Humans ; Jaundice ; Meningitis, Meningococcal ; Nausea ; Nephrotic Syndrome ; Panniculitis ; Parenteral Nutrition, Total ; Seoul ; Venous Thrombosis ; Vomiting

Fifty five children with endoscopically proven esophageal varices from Jul. 1987 to Dec. 1992 were analyzed for endoscopic and clinical characteristics. The results were as follows: 1) According to etiological classification of portal hypertension in 55 cases, 35 cases showed intrahepatic causes 964%) and 20 cases had extrahepatic causes (36%). The most common clinical manifestation on admission was hematemesis (42%) and abdominal mass (36%). 2) Portal vein thrombosis was the most common cause of portal hypertension. Patients with portal vein thrombosis showed more frequent bleeding than with intrahepatic portal hypertension. Most of them had the first bleeding episode before 7 years old of age. Progression of portal hypertension in portal vein thrombosis was more rapid and bleeding episode was earlier than that in most of intrahepatic causes of the portal hypertension. 3) Twenty patients showed gastritis (10 cases), duodenitis (4 cases), gastric ulcer (4 cases) and esophagitis (2 cases) besides varix on the endoscopic examination. In 4 cases, the cause of upper GI bleeding was found as duodenal ulcer (3 cases) or hemorrhagic errosive gastritis (1 case) with no variceal bleeding. 4) Among 36 cases with variceal bleeding, 20 cases had predisposing factors for bleeding such as medication for URI including Aspirin. 5) More than one episode of bleeding were noted in 36 cases (65%) of the patients with varix. Thirty-one cases were treated conservatively with success. The remaining 5 cases with severe bleeding were managed with IV pitressin, SB-tube insertion and emergency shunt operation. High mortality rate (40%) was found in these patients group. In conclusion, in patients with clinically suspected portal hypertension, regular endoscopic examination might be recommended for the earlier recognition and effective prevention of variceal bleeding. for bleeding varices, in addition to conservative management, active treatment such as pitressin, SB-tube, sclerotherapy, endoscopic variceal ligation and emergency shunt operation should be considered with the emergency endoscopy which can identify bleeding focus and predict the chance of rebleeding.
Aspirin ; Causality ; Child* ; Classification ; Duodenal Ulcer ; Duodenitis ; Emergencies ; Endoscopy ; Esophageal and Gastric Varices* ; Esophagitis ; Gastritis ; Hematemesis ; Hemorrhage ; Humans ; Hypertension, Portal ; Ligation ; Mortality ; Sclerotherapy ; Stomach Ulcer ; Varicose Veins ; Vasopressins ; Venous Thrombosis

No abstract available.
Child* ; Humans ; Tuberculosis*

No abstract available.
Thyroid Diseases* ; Thyroid Gland* ; Vitiligo*

The accepted radiographic method to determine cervical spinal stenosis is the direct measurement of the sagittal diameter of the spinal canal on the routine lateral view of the cervical spine. The reported normal and abnormal values for this measurement are inconsistent because of various methods of obtaining the roentgenograms and different body types which affect the size of the X-ray image. According to Pavlow, the ratio method of determining crevical spinal stenosis, in which the sagittal diameter of the spinal canal is divided by the sagittal diameter of the corresponding vertebral body, is independent of technical factor variables and is a reliable method for determining cervical spinal stenosis. In order to determine the Pavlov's ratio of normal Koreans, and compare it with that of radiculopathic group, we measured the diameter of cervicl canal in 47 normal persons(28 male, 19 female), and 32 patients( 9 male, 23 female) who had transient tingling sensation and radiculopathic symtom from the second to fifth decades. The results were as follows :1) The average Pavlov's ratio from C3 to C7 in normal Korean men are 0.906(0.70–1.13), 0.899 (0.070–1.13),0.948(0.70–1.67) and 0.948(0.67–1.17), respectively, and those of normal Korean women are 0.977(0.83–1.15), 1.021(0.83–1.13), 1.014(0.84–1.33) and 1.055(0.88–1.18), respectively. 2) The average Pavlov's ratio from C3 to C7 in radiculopathic Korean men are 0.88(0.65–1.12), 0.90(0.68–1.12), 0.95(0.79–1.12) and 0.95(0.78–1.06), respectively, and those of radiculopathic Korean women are 0.902(0.70–1.27), 0.905(0.69–1.27), 0.939(0.70–1.33) and 0.931(0.70–1. 18), respectively. 3) There are not statistically differences of the Pavlov's ratio between the control group and the radiculopathic group. 4) We believe that the Pavlov's ratio is an effective method in detection of cervical stenosis and is able to eliminate technical factor such as body position, target and object-to-film distanc.
Asian Continental Ancestry Group ; Constriction, Pathologic ; Female ; Humans ; Male ; Methods ; Sensation ; Somatotypes ; Spinal Canal ; Spinal Stenosis ; Spine

No abstract available.

No abstract available.

BACKGROUND: Urinary tract is the most common site of nosocomial infections, accounting for 35% of all nosocomial infections. About 80-90% of these urinary tract infections are associated with urethral catheter insertion. Recently, we experienced an outbreak of nosocomial UTI (urinary tract infection) caused by Candida spp. in the surgical ICU (SICU) and we investigated the cause of UTI outbreak. METHODS: We collected data from clinical records and observed the current methods of care of urethral catheters in the SlCU. During the outbreak, we investigated the current procedures and maintenance care of urethral catheter insertion and educated the staff on the correct methods of the catheter insertion and care. We performed surveillance cultures of unused new urine bags, RESULTS: Between May 2000 and June 2000, 17 Candida spp. strains were isolated from urines of 17 patients hospitalized in the SICU of National Health Insurance Corporation Ilsan Hospital. All infections were attributed to the care of urethral catheter insertion and contaminated bags. We identified that routine bladder irrigation and emptying urine to a common urinal have been done incorrectly during the outbreak period. Rodotorula spp. was isolated from 4 urine bags (50% contamination rate) out of 8 unused new urine bags by surveillance cultures. CONCLUSION: The causes of the UTI outbreak caused by Candida spp. was terminated by outbreak investigation and change of contaminated urine bag.
Candida* ; Catheters ; Cross Infection ; Humans ; National Health Programs ; Urinary Bladder ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*