Enemas are sometimes used in hospital and domicilliary practice and occasionally by patients themselves without a valid indication. The present repart is one in which enernas were done for 3 months by a patient himself to treat his hemorrhoid and resulted in severe inflamimatory change with large-siaed illdefined shallow ulceration in rectum and sigmoid colon. This patient, a 53 year old male, entered the hospital with the complaint of diarrhea with passage of bloody muct.. Colonoscopic examination revealed severe inflammatory change, friable mucosa and several relatively large-sized ill-defined shallow ulceration in rectum and sigmoid colon. A biopsy was performed and microscapic examination revealed intense infiltrates and plasma cells and crypt abscess with decreased goblet cells in the lamiina propria. The submucosa showed edema with infiltrates of chronic inflammatory cells and neutrophils. Conservative treatment with discontinue of enemas and fluid supply was performed. And his symptoms were improved. After second week, follow-up colonoscopy revealed inflammatory changes were improved.
Abscess ; Biopsy ; Colitis* ; Colon, Sigmoid ; Colonoscopy ; Diarrhea ; Edema ; Enema* ; Follow-Up Studies ; Goblet Cells ; Hemorrhoids ; Humans ; Male ; Middle Aged ; Mucous Membrane ; Neutrophils ; Plasma Cells ; Rectum ; Ulcer

Bronchiectasis means a permanent abnormal dilatation of one or more large bronchi owing to destruction of theelastic and muscular components of the bronchial wall. Radiological study is the most importat and mandatory procedure. Especially bronchography is essential for the definitive diagnosis of bronchiectasis and for theprecise delineation of the type and extent of the disease. The radiological and clinical findings of 48 cases ofbronchiectasis diagnosed by bronchography and treated at Chosun University Hospital during the 5 years fromJanuary 1980 to Dec. 1984 were analyzed retrospectively. The results were as follows; 1. Among the 48 cases, 34cases(70.8%) were male and 14 cases(29.2%) were female. Peak incidence was in second decade. 2. Chronic cough,productive sputum and hemoptysis are main symptoms and others are chest pain, dyspnea and recurrent bouts ofpneumonia. The most common physical sign is persistent moist rales over the involved area in 23 cases(47.9%).Others are no sign in 17 cases(35.4%), wheezing in 11 cases(22.9%) and digit clubbing in 3 cases(6.3%). 3. Thepresumed causes were composed of not known in 30 cases(62.5%) and complications of measles in 7 cases(14.6%),pertusis in 5 cases(10.4%) and pneumonia in 4 cases(8.3%). Two cases were Kartagener's syndrom and unilateralhyperlucent lung. 4. Plain chest roentgenographic findings were abnormal in 42 cases(87.5%) but normal in 6cases(12.5%). The most common radiological findings was accentuation of lung markings in 36 cases(85.7%) theothers are include in order of frequency; pneumonic infiltration, linear radiolucencies, cystic radiolucencies,decreased affected lung volume air-fluid level and pleural thickening. 5. Bilateral bronchiectasis was demonstrated in 11 cases(22.9%) and the disease was much more often involved left lung than right. The mostcommonly involved lobe is left lower lobe, and the most common site of involvement was the posterior basal segmentof the lower lobe. The type of bronchiectasis is cylindrical in 22 cases(45.8%), varicose in 11 cases(22.9%),saccular in 9 cases(18.8%) and mixed type in 6 cases(12.5%)
Bronchi ; Bronchiectasis ; Bronchography ; Chest Pain ; Diagnosis ; Dilatation ; Dyspnea ; Female ; Hemoptysis ; Humans ; Incidence ; Lung ; Male ; Measles ; Pneumonia ; Respiratory Sounds ; Retrospective Studies ; Sputum ; Thorax

BACKGROUND: Because the propofol TCI software commands the syringe pump to deliver a rapid infusion at a rate of 1200 ml/hr until the pharmacokinetic model predicts that the selected target concentration has been reached, the hemodynamic changes are predicted. To this change, several methods could be considered and the fentanyl injection is one of them. METHODS: Sixty adult patients scheduled for orthopedic surgery were randomly alldegrees Cated into four groups according to amount of fentanyl injected during induction period(group 1: no fentanyl, group 2: 0.75 microgram/kg, group 3: 1.5 microgram/kg, group 4: 3.0 microgram/kg). Target plasma concentration of propofol was selected as 4.0 microgram/ml and this concentration was achieved using modification of Prys-Roberts method. We evaluated the hemodynamic effect of various doses of fentanyl that injected at Vdpeak effect time and determined the optimal dose of fentanyl during propofol induction using TCI mode. RESULTS: Induction dose(range: 1.25~1.31 mg/kg) of propofol and induction time(range: 46~76 sec) showed no difference among groups. Use of fentanyl was effective for blood pressure stability immediately after intubation, but not effective before and 3 min following intubation. The higher the dosage of fentanyl, the more stable the heart rate. CONCLUSION: It suggest that use of fentanyl for the prevention of abrupt hemodynamic change during propofol induction using target controlled infusion mode is not necessary.
Adult ; Blood Pressure ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Orthopedics ; Plasma ; Propofol* ; Syringes

No abstract available.
Emergencies* ; Emergency Service, Hospital*

The relationship between hypercalcemic crisis and pancreatitis, first described in patients with hyperparathyroidism, still remains controversial. Acute pancreatitis may complicate the clinical course of hyperparathyroidism, particularly when the degree of hypercalcemia is severe. The incidence of hyperparathyroidism presenting as acute pancreatitis appears to be steadily decreasing, possibly reflecting the earlier diagnosis of asymptomatic hyperparaparathyroidism due to widespread application of screening methods. Here, we report two patients with primary hyperparathyroidism manifesting clinically as acute pancreatitis. One patient died of progessive pancreatitis and uncontrolled sepsis. The other patient was fullly recovered by emergent parathyroidectomy followed by medical management of hypercalcemia.
Diagnosis ; Humans ; Hypercalcemia ; Hyperparathyroidism* ; Hyperparathyroidism, Primary ; Incidence ; Mass Screening ; Pancreatitis* ; Parathyroidectomy ; Sepsis

PURPOSE: We investigated the causative organism and its antibiotic susceptibility of community acquired urinary tract infection (UTI) in children at a secondary hospital to test the adequacy of the current guidelines. METHODS: Children diagnosed with UTI at the Department of Pediatrics, Kwandong University Myongji Hospital by pyuria and bacterial growth of greater than 1.0x10(5) CFU/mL on clean catch midstream urine from January 2005 to December 2008 were studied retrospectively. The epidemiologic data, causative organism, and the antibiotic susceptibility were analyzed. RESULTS: Sixty two children were diagnosed with sixty four cases of UTI's. Two bacteria were isolated in one case and thus data on 65 urine cultures were analyzed. The male:female ratio was 1.6:1 and 78.1% were less than 12 months of age. Escherichia coli was the predominant cause consisting of 53 cases (82.8%) of the cases. K. pneumoniae (5), Enterobacter (4), Enterococcus (1), beta-streptococcus (1), Diphtheroides (1) were isolated. The antibiotic resistance of E. coli were as follows; ampicillin 69.8%, cefotaxime 1.9%, gentamicin 15.1%, amikacin 0.0%, levofloxacin 1.9%, and trimethoprim/sulfamethoxazole 26.4%. Only one case of the E. coli was extended spectrum beta-lactamase (ESBL) positive. CONCLUSION: Compared to prior reports from other tertiary hospitals in Korea, E. coli was the predominant cause in childhood UTI and the rate of ESBL positivity was low. The antibiotic resistance was also different compared to prior reports. We conclude that a difference in the cause and antibiotic resistance of childhood UTI exists between centers and this should be taken into consideration when prescribing antibiotics for childhood UTIs.
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Bacteria ; beta-Lactamases ; Cefotaxime ; Child ; Drug Resistance, Microbial ; Enterobacter ; Enterococcus ; Escherichia coli ; Gentamicins ; Humans ; Korea ; Ofloxacin ; Pediatrics ; Pneumonia ; Pyuria ; Retrospective Studies ; Tertiary Care Centers ; Urinary Tract ; Urinary Tract Infections

Mycobacterium abscessus (Mabc) is an emerging human pathogen. Less is known about the host immune response to Mabc than to M. tuberculosis. Here, we examined the intracellular signaling pathways that govern the expression of chemokines including (C-C motif) ligand 2 (CCL2) and (C-X-C motif) ligand 2 (CXCL2) in macrophages after infection with Mabc. Specifically, Mabc triggered the generation of reactive oxygen species (ROS) and the production of CCL2 and CXCL2 in murine bone marrow-derived macrophages (BMDMs). Mabc-induced CCL2, but not CXCL2, was dependent on the generation of ROS. Toll-like receptor (TLR) 2, MyD88, but not TRIF, was required for Mabc-induced CCL2 and CXCL2 expression. Additionally, Mabc infection significantly induced nuclear factor (NF)-kappaB nuclear translocation and luciferase activity. The activation of NF-kappaB was required for Mabc-induced CCL2, but not CXCL2 expression. Moreover, Mabc-induced ROS generation was required for NF-kappaB activation. Treatment of BMDMs with Mabc rapidly induced the activation of mitogen-activated protein kinase (MAPKs) pathways. Interestingly, CCL2 expression was dependent on the activation of JNK and ERK1/2 pathways, whereas it was negatively regulated by the p38 MAPK pathway. In contrast, Mabc-dependent CXCL2 expression was not regulated by MAPK pathways. These data suggest that intracellular ROS generation is required for innate and inflammatory responses during Mabc infection of macrophages.
Chemokines ; Humans ; Luciferases ; Macrophages ; Mycobacterium ; NF-kappa B ; p38 Mitogen-Activated Protein Kinases ; Protein Kinases ; Reactive Oxygen Species ; Toll-Like Receptors ; Tuberculosis

PURPOSE: Although Henoch-Sch nlein purpura(HSP) has been described in detail, there is a paucity of information describing scrotal involvement and risk factors for renal involvement. This study was performed to evaluate the incidence of scrotal involvement and the relationship between renal and nonrenal involvement, including scrotal involvement. METHODS: We retrospectively reviewed medical records of 164 male children who were diagnosed as HSP at the Department of Pediatrics, Korea University Guro Hospital between January 1985 and December 1997. RESULTS: The incidence of scrotal involvement was 13.4%(22/164), and the mean age of the group of scrotal involvement was significantly younger(5.6+/-1.9 year) than that of the others (P<0.05). One patient was initially seen with scrotal involvement without any other symptoms, another patient, who presented with acute scrotal pain and swelling, turned out to have testicular torsion through laparotomy. Those with scrotal and gastrointestinal symptoms were more likely to be related to renal involvement at acute stage, but there was no statistical difference. Those with scrotal symptoms at acute stage developed nephritis more frequently after 6 months(P<0.05). CONCLUSION: Those with scrotal symptoms at acute stage of HSP should be followed up for at least 6 months.
Child ; Humans ; Incidence ; Korea ; Laparotomy ; Male ; Medical Records ; Nephritis ; Pediatrics ; Purpura* ; Retrospective Studies ; Risk Factors ; Spermatic Cord Torsion

In our study we estimated mitral orifice area by use of two dimensional echocardiography in 59 patients with mitral stenosis form February 1979 till June 1981. We classified them to 3 subgroups by severity of mitral stenosis as Cope was done in 1975. and investigated correlationship between the severity and other various echo-cardiographic findings indices such as mitral valve calcification, posterior mitral leaflet motion, doming of mitral valve, EF slope, ED amplitude, LA dimension, LA/Ao ratio and especially mitral valve closure index. The following results were obtained. 1) We could accurately estimate mitral orifice area by two dimensional echocardiography. 2) Except EF slope and MVCI, we could find that various echocardiographic findings were poorly correlated with mitral orifice area measured from two-dimensional echocardiography. 3) MVCI was overlapped less frequently than EF slope in severe, moderate and mild mitral stenosis, and we could find that MVCI reflected the extent of mitral stenosis more accurately than EF slope.
Echocardiography* ; Humans ; Mitral Valve ; Mitral Valve Stenosis*

Retroperitoneal teratoma is a rare congenital neoplasm derived from three germ layers and generally recognized as a disease of childhood. Those who were not operated on did not fare any better. The mortality from the disease was virtually 100%. Recently, we experienced a case of retroperitoneal teratoma.
Germ Layers ; Mortality ; Teratoma*