A case of cryptococal hepatitis in a 4-year-old girl was presented with a brief review of the literature. She was admitted with the chief complaints of jaundice, abdominal pain, and semicomatose mental state. Treatment was started including dexamethasone under impression of fulminant hepatitis. During treatment massive G-I bleeding appeared which required eleven pints of blood and 20 days for control. Upper G-I series revealed duodenal ucer. And explolparotomy was performed because of free air in the peritoneum. Operative liver biopsy done at that time revealed many cryptococci in the biopsy tissue. Therefore we treated her with-5-fluorocytosine and the result was good. Follow-up of her for a year and half revealed that she was in here good general condition. Therefore we consider that secondary change in liver such as cirrhosis has not yet occurred in her.
Abdominal Pain ; Biopsy ; Child, Preschool ; Dexamethasone ; Female ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Hepatitis* ; Humans ; Jaundice ; Liver ; Peritoneum

This is a clinical study of 30 cases of congenital malformation of ileum at Severance hospital from 1966 to 1975. They were confirmed after operation and the results were summarized as follows; 1. Total number of patients was 30 cases including 25 males 5 females. Among them 20 cases were included at pediatric agr from birth to 15 years of age. The most frequent occurrence was within 1 month of age with 11 cases. 2. Confirmed diagnesis after operation were 3 cases of ileal duplication,3 cases of ileal stenosis, 2 cases of ileal atresia, 1 cases of ileal hypoplasia, and 21 cases of Meckel's diverticulum. 3. Except for Meckel's diverticuium all the patients were studied which simple abdominal X-ray, which revealed complete and partial intestinal obstruction. Among them 4 cases were found microeolon and narrowing of distal 1 cases of ileum at 1 cases of ileal atresia and 2 cases. 4. After operation, 26 of 30 cases were recovered but 3 cases (atsesia 1, stenosis 1, and hypoplasia 1) were discharged with complications. And 1 case of multiple ileal stencelsdied of sepsis and wound infection.
Constriction, Pathologic ; Female ; Humans ; Ileum* ; Intestinal Obstruction ; Male ; Meckel Diverticulum ; Parturition ; Sepsis ; Wound Infection

Lasers have given dentistry a new rapid, economic, and accurate technique for metal joining. Although laser welding has been recommended as an accurate technique, there are some limitations with this technique. For example, the two joining surfaces must have a tight-fitting contact, which may be difficult to achieve in some situations. The tensile samples used for this study were made from a custom-made pure titanium and type III gold alloy plates. 27 of 33 specimens were sectioned perpendicular to their long axis with a carborundum disk and water coolant. Six specimens remained and served as the control group. A group of 6 specimens was posed as butt joints in custom parallel positioning device with a feeler gauge at each of three gaps : 0.00, 0.25, and 0.50mm. All specimens were then machined to produce a uniform cross-sectional dimension, none of the specimens was subjected to any subsequent form of heat treatment. Scanning electron microscopy was performed on representative tested specimens at fractured surfaces in both the parent metal and the weld. Vickers hardness was measured at the center of the welds with a micropenetrometer using a force of 300gm for 15 seconds. Measurement was made at approximately 200 ,am and 500 pm deep from each surface. One-way analysis of variance (ANOVA) and Scheffe' s test was calculated to detect differences between groups. The purpose of this study is to compare the strength and properties of the joint achieved at various butt joint gaps by the laser welding of type III gold alloy and pure titanium tensile specimens in an argon atmosphere. The results of this study were as follows 1. When indexing and welding pure titanium, there was no decrease in ultimate tensile strength as compared with the unsectioned alloys for indexing gaps of 0.00 to 0.50mm, although with increasing gap size may come increased distortion (p>0.05). 2. When indexing and welding type III gold alloy, there were significant differences in ultimate tensile strength among groups with weld gaps of 0.00mm, 0.25 and 0.50mm, and the control group. Group with butt contact without weld gap demonstrated a significant higher ultimate tensile strength than groups with weld gaps of 0.25 and 0.50mm (p<0.05) . 3. When indexing and welding the different metal combination of type III gold alloy and pure titanium, there were significant differences in ultimate tensile strength between groups with weld gaps of 0.00, 0.25, and 0.50mm. However, the mechanical properties of the welded joint would become too brittle to be acceptable clinically (p<0.05) . 4. The presence of large pores in the laser welded joint appears to be the most important factor in controlling the tensile strength of the weld in both pure titanium and type III gold alloy.
Abstracting and Indexing as Topic ; Alloys ; Argon ; Atmosphere ; Axis, Cervical Vertebra ; Dentistry ; Gold Alloys* ; Hardness ; Hot Temperature ; Humans ; Joints ; Microscopy, Electron, Scanning ; Parents ; Tensile Strength* ; Titanium ; Water ; Welding

This is a clinical observation of five infants associated with congenital hydronephrosis experienced at the Pediatric Department of Severance Hospital. The results were as follows: 1. The age distribution was from one day to seven months with the sex radio of 4 : 1 with male predominance. 2. The signs most freguently found were palpable abdominal mass and abdominal distension. In three cases affected lesions were left, one was right the other was bilateral. Three cases treated by nephrectomy were stricture of ureteropelvic junction in three. Giant hydronephrosis were observed in two cases.
Age Distribution ; Constriction, Pathologic ; Humans ; Hydronephrosis* ; Infant ; Male ; Nephrectomy

BACKGROUND: Acute interstitial pneumonia is a relatively rare form of interstitial pneumonia, since the vast majority of interstitial pneumonia have a more chronic course. It corresponds to the lesion described by Hamman and Rich, as Hamman-Rich disease in 1944. Another name in the clinical literature is accelerated interstitial pneumonia, idiopathic acute respiratory distress syndrome (idiopathic ARDS), and the organizing stage of diffuse alveolar damage. Acute interstitial pneumonia differs from chronic interstitial pneumonia by clinical and pathologic features. Clinically, this disease is characterized by a sudden onset and a rapid course, and reversible disease. METHOD AND PURPOSE: Five cases of pathologically proven acute interstitial pneumonia were retrospectively studied to define the clinical, radiologic, and pathologic features. RESULTS: 1) The five cases ranged in age from 31 to 77 years old. The onset of illness was acute in all patients, it began with viral-like prodrome 6~40 days prior to shortness of breath, and respiratory failure eventually developed in all patients. In 2 cases, generalized skin rash was accompanied with flu-like symptoms. Etiologic agent could not be identified in any case. 2) All patients had leukocytosis and severe hypoxemia. Pulmonary function test of 3 available cases shows restrictive ventilatory defect, and one survived patient(case 5) has a complete improvement of pulmonary function after dismissal. 3) Diffuse bilateral chest infiltrates were present radiologically. Theses were the ground-glass, consolidation, and reticular densities without honeycomb fibrosis in all patients. The pathologic abnormalities were the presence of increased numbers of macrophages and the formation of hyaline membranes within alveolar spaces. There was also interstitial thickening with edema, proliferation of immature fibroblast, and hyperplasia of type II pneumocyte. In the survived patient(case5), pathologic findings were relatively early stage of acute interstitial pneumonia, such as hyaline membrane with mild interstitial fibrosis. 4) Of the 5 patients, four patients died of respiratory failure 14~90 days after onset of first symptom, and one survived and recovered in symptoms, chest X ray, and pulmonary function test CONCLUSION: These results emphasize that acute interstitial pneumonia is clinically, radiologically, and pathologically distinct form of interstitial pneumonia and should be separated from the group of chronic interstitial pneumonia. Further studies will be needed to evaluate the pathogenesis and the treatment of acute interstitial pneumonia.
Anoxia ; Dyspnea ; Edema ; Exanthema ; Fibroblasts ; Fibrosis ; Humans ; Hyalin ; Hyperplasia ; Idiopathic Interstitial Pneumonias ; Idiopathic Pulmonary Fibrosis ; Leukocytosis ; Lung Diseases, Interstitial* ; Macrophages ; Membranes ; Pneumocytes ; Respiratory Distress Syndrome, Adult ; Respiratory Function Tests ; Respiratory Insufficiency ; Retrospective Studies ; Thorax

No abstract available.
Acetaminophen ; Naproxen* ; Osteoarthritis* ; Osteoarthritis, Knee*

In the published article, the Figure 4 was published with incorrect y-axis and legend.

Procalcitonin (PCT) is a predictive marker for the occurrence of bacterial infection and the decision to terminate antibiotic treatment in critically ill patients. An unusual increase in PCT, regardless of infection, has been observed during extracorporeal membrane oxygenation (ECMO) support. We evaluated trends and the predictive value of PCT levels in adult cardiogenic shock during treatment with ECMO. We reviewed the clinical records of 38 adult cardiogenic shock patients undergoing veno-arterial ECMO support between January 2014 and December 2016. The exclusion criteria were age < 18 years, pre-ECMO infection, and less than 48 hours of support. The mean patient age was 56.7±14.7 years and 12 (31.6%) patients were female. The mean duration of ECMO support was 9.0±7.6 days. The rates of successful ECMO weaning and survival to discharge were 55.3% (n=21) and 52.6% (n=20), respectively. There were 17 nosocomial infections in 16 (42.1%) patients. Peak PCT levels (mean 25.6±9.4 ng/mL) were reached within 48 hours after initiation of ECMO support and decreased to ≤5 ng/mL within one week. The change in PCT levels was not useful in predicting the occurrence of new nosocomial infections during the ECMO run. However, a PCT level >10 ng/mL during the first week of ECMO support was significantly associated with mortality (p < 0.01). The change in PCT level was not useful in predicting new infection during ECMO support. However, higher PCT levels within the first week of the ECMO run are associated with significantly higher mortality.
Adult ; Bacterial Infections ; Calcitonin ; Critical Illness ; Cross Infection ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Mortality ; Shock ; Shock, Cardiogenic ; Weaning

Data on the frequency of nosocomial infections during extracorporeal membrane oxygenation (ECMO) in adult populations remain scarce. We investigated the risk factors for nosocomial infections in adult patients undergoing venoarterial ECMO (VA-ECMO) support. From January 2011 to December 2015, a total of 259 patients underwent ECMO. Of these, patients aged 17 years or less and patients undergoing ECMO for less than 48 hours were excluded. Of these, 61 patients diagnosed with cardiogenic shock were evaluated. Mean patient age was 60.6 ± 14.3 years and 21 (34.4%) patients were female. The mean preoperative Sequential Organ Failure Assessment (SOFA) score was 8.6 ± 2.2. The mean duration of ECMO support was 6.8 ± 7.4 days. The rates of successful ECMO weaning and survival to discharge were 44.3% and 31.1%, respectively. There were 18 nosocomial infections in 14 (23.0%) patients. These included respiratory tract infections in 9 cases and bloodstream infections in a further 9. In multivariate analysis, independent predictors of infection during ECMO were the preoperative creatinine level (hazard ratio [HR], 2.176; 95% confidence interval [CI], 1.065–4.447; P = 0.033) and the duration of ECMO support (HR, 1.400; 95% CI, 1.081–1.815; P = 0.011). A higher preoperative creatinine level and an extended duration of ECMO support are risk factors for infection. Therefore, to avoid the development of nosocomial infections, strategies to shorten the length of ECMO support should be applied whenever possible.

The aim of the present study was to evaluate the plaque components and the predictors of thin-cap fibroatheroma (TCFA) in anemic patients with acute coronary syndrome using virtual histology-intravascular ultrasound (VH-IVUS). Anemia was defined according to criteria of the World Health Organization, (i.e. , hemoglobin levels < 13 g/dL in men and < 12 g/dL in women) and we compared VH-IVUS findings between anemia group (171 patients, 260 lesions) and non-anemia group (569 patients, 881 lesions). Anemia group had greater % necrotic core (NC) volume (21% +/- 9% vs 19% +/- 9%, P = 0.001) compared with non-anemia group. Hemoglobin level correlated negatively with absolute NC volume (r = -0.235, P < 0.001) and %NC volume (r = -0.209, P < 0.001). Independent predictors of TCFA by multivariate analysis were diabetes mellitus (odds ratio [OR], 2.213; 95% confidence interval [CI], 1.403-3.612, P = 0.006), high-sensitivity C-reactive protein (OR, 1.143; 95% CI, 1.058-1.304, P = 0.012), microalbuminuria (albumin levels of 30 to 300 mg/g of creatinine) (OR, 2.124; 95% CI, 1.041-3.214, P = 0.018), and anemia (OR: 2.112; 95% CI 1.022-3.208, P = 0.028). VH-IVUS analysis demonstrates that anemia at the time of clinical presentation is associated with vulnerable plaque component in patients with acute coronary syndrome.
Acute Coronary Syndrome/complications/*pathology/ultrasonography ; Aged ; Albuminuria/urine ; Anemia/complications/*diagnosis ; C-Reactive Protein/analysis ; Coronary Angiography ; Creatinine/blood ; Diabetes Complications ; Female ; Hemoglobins/analysis ; Humans ; Male ; Middle Aged ; Necrosis/pathology ; Odds Ratio ; Plaque, Atherosclerotic/*ultrasonography ; Predictive Value of Tests ; *Ultrasonography, Interventional