Isolated small bowel intussusception accounts for 10% of all pediatric intussusception. It is more common in children older than 2 years of age. Presentation usually is with vomiting and abdominal pain. Currant jelly stool and palpable mass are less frequent than typical intussusception. There are few reported cases of children with transient small bowel intussusception. We describe 3-year-old boy presented with intermittent cyclic crampy abdominal pain for 6 months was diagnosed as having recurrent transient small bowel intussusception by abdominal ultrasonography and small bowel series.
Abdominal Pain ; Child ; Child, Preschool ; Humans ; Intussusception* ; Male ; Ultrasonography ; Vomiting

No abstract available.

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

A prominent crista terminalis is a normal anatomic variant which consist of thick muscular bridge within the right atrium. However, it could be often misdiagnosed with an abnormal mass on the transthoracic echocardiography. The case report presented here, describe the findings of transthoracic echocardiography that suggested a right atrial mass in patients with pulmonary embolism. However, subsequent transesophageal echocardiography and cardiac computed tomography/magnetic resonance imaging differentiated a true right atrial mass from a prominent crista terminalis.
Echocardiography ; Echocardiography, Transesophageal ; Heart Atria ; Humans ; Pulmonary Embolism

OBJECTIVE: To determine the usefulness of neonatal nucleated red blood cell counts (nRBC) as an independent predictor of fetal hypoxia and perinatal outcome in severe preeclampsia. METHODS: One hundred thirty eight patients with severe preeclampsia were studied. Umbilical artery Dopppler velocimetry was performed in all patients, and were divided into two groups, the control group with present umbilical artery end diastolic velocity, and the case group with absent or reversed velocity. The patients were also separately grouped as another control (n=58), acute (n=19), and chronic hypoxia (n=55) according to abnormal Doppler findings, presence of oligohydramnios, intrauterine growth restriction (IUGR), and pattern of fetal heart rate tracings during labor. At delivery, the umbilical cord blood was collected and the levels of nRBC per 100 WBC were measured from the samples along with blood gas analysis. The results were compared between the control and acute groups, and chronic hypoxic fetus. Correlation with perinatal outcomes was also evaluated. Student's t-test, ANOVA, and regression analysis were performed for statistical analysis. RESULTS: Those with absent or reversed end diastolic velocity did not have significantly greater nRBC counts, but had lower platelet counts (p=0.02), lower pO2 (p=0.005), and higher pCO2 saturation levels (p=0.01). There were no significant differences with regard to nRBC counts among the control, acute, and chronic hypoxia groups. Elevated nRBC counts were significantly associated with neonatal intensive care unit stay of more than 28 days (p=0.013), respiratory distress syndrome (p=0.003), disseminated intravascular coagulopathy, or sepsis (p=0.041). CONCLUSION: nRBC counts did not show significant difference according to umbilical artery Doppler velocity. Also we could not find any difference between the control, acute, and chronic hypoxic group, suggesting that nRBC counts does not correlate with both hypoxic status, or duration of hypoxia. Correlation with elevated nRBC counts and neonatal intensive care unit stay of more than 28 days, respiratory distress syndrome, disseminated intravascular coagulopathy, and sepsis was observed. However, the overlapping results and the wide range of nRBC counts according to the complications limits its role as a predictor of poor perinatal outcome.
Anoxia ; Blood Gas Analysis ; Erythrocyte Count ; Female ; Fetal Blood ; Fetal Hypoxia* ; Fetus ; Heart Rate, Fetal ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Oligohydramnios ; Platelet Count ; Pre-Eclampsia* ; Pregnancy ; Rheology ; Sepsis ; Umbilical Arteries

PURPOSE: To report the decreasing incidence of HBV(Hepatitis B virus)-associated membranous nephropathy in children after HBV vaccination and to elucidate the clinical course and treatment strategies of IMN (Idiopathic membranous nephropathy). METHODS: We retrospectively reviewed the clinico-pathological findings of HBV-MN and IMN patients who underwent a renal biopsy from 1986 to 2005. We compared the HBV-MN and the IMN groups and the remission and the non-remission groups of patients with IMN. RESULTS: Among 24 cases of MN patients, HBV-MN comprised 6 cases(25%) and IMN 18 cases(75%). Clinical masnifestations were nephrotic syndrome(3 cases, 50%), nephritic syndrome(1 case, 16.7%), asymptomatic(2 cases, 33.4%) in the HBV-MN group, asymptomatic(10 cases, 55.5%), nephrotic syndrome(5 cases, 27.8%), and gross hematuria(3 cases, 16.7%) in the IMN group. From 1996 to 2000, there were 2 cases(28%) of HBV-MN and 5 cases(72%) of IMN. After 2001, all 10 cases were IMN. In the HBV-MN group, 4 cases(66.7%) received interferon and 1 case received methylprednisolone pulse therapy. In the IMN group, 16 cases (88.9%) received methylprednisolone, 8 cases(44.4%) were in complete remission, 2 cases (11.1%) were in partial remission, 2 cases(11.1%) were in chronic renal failure, and 5 cases (27.8%) were lost to follow-up with sustained proteinuria, 1 case(5.6%) continued to have frequent relapse of nephrotic syndrome without renal insufficiency. In the comparison between remission and non-remission groups, nephrotic range proteinuria and hypertension were more significantly common in the non-remission group(P<0.05). CONCLUSION: With HBV vaccination, HBV-MN has decreased markedly. IMN is a rare glomerular disease in children. Because the prognosis for patients with nephrotic range proteinuria is poor, this group needs more aggressive treatment.
Biopsy ; Child* ; Glomerulonephritis, Membranous* ; Humans ; Hypertension ; Incidence ; Interferons ; Kidney Failure, Chronic ; Lost to Follow-Up ; Methylprednisolone ; Nephrotic Syndrome ; Prognosis ; Proteinuria ; Recurrence ; Renal Insufficiency ; Retrospective Studies ; Vaccination

PURPOSE: The purpose of the study was done to identify the nursing care needs of patients in the recovery room. METHOD: The subjects in this study were 127 patients in a recovery room between 6/9/2001 and 24/9/2001. The instrument used for this study was the descriptive questionnaire developed by Shin Hyun-Jin (1999). The data was analysed by frequency, percentage, mean, standard deviation, t-test, ANOVA, and factor analysis using the SPSS program. RESULT: 1) Kaiser-Meyer-Olkin sample appropriateness was 0.799 and Bartlett's test of sphericity significant probability was 0.000. 2) The mean score for nursing care need of patients in the recovery room was 4.17+/-.51 of a total possible score of 5. The score of nursing need for different parameters was as follows: Educational need (4.31+/-.49), physical need (4.27+/-.47), emotional need (4.11+/-.52), environmental need (3.99+/-.56). 3) Differences in the needs for nursing care according to the demographics were significant for gender, marital status, operation experience, and departments consulted. General characteristic variables significantly related to nursing need were as follows: Physical need significantly related to the departments consulted (F=2.23, p=.036). Educational need significantly related to the marital status (F=2.55, P=.012), departments consulted (F=2.30, p=.031). Emotional need significantly related to the marital status (F=2.22, p=.028). Environmental need significantly related to the gender (t=-2.44, p=.016), marital status (F=2.01, p=.046), operation experience (t=-1.99, p=.048). CONCLUSION: Nursing care needs of patients in the recovery room are significantly related to educational need, physical need, emotional need and environmental need. Intervention plans and program need to be developed to improve strategies to meet nursing needs of patients in the recovery room.
Demography ; Humans ; Marital Status ; Nursing Care ; Nursing* ; Surveys and Questionnaires ; Recovery Room*

There are several antigenic variants of Orientia tsutsugamushi. The 56-kDa type-specific antigen (TSA) is responsible for the antigenic variation. Nucleotide sequences of the 56-kDa TSA obtained from 44 eschar samples of Korean scrub typhus patients and from 40 representative strains retrieved from the GenBank database were analyzed phylogenetically. Clinical patient data were assessed based on the genotyping results. Of the 44 nucleotide sequences, 32 (72.7%) clustered with the Boryong genotype, which is the major genotype in Korea. Eleven nucleotide sequences (25%) clustered with the Kawasaki genotype, not identified in Korea until 2010. One nucleotide sequence was consistent with the Karp genotype. The clinical course of the patients infected with each genotype showed no differences. Diagnostic performance of the immunofluorescence assay (IFA) using the 56-kDa TSA from Gilliam, Karp and Boryong as test antigens were not different for the Boryong and Kawasaki genotypes. Although Boryong is still the predominant genotype, the results suggest that Kawasaki genotype is quite prevalent in Chungbuk province of Korea.
Aged ; Bacterial Proteins/*genetics/metabolism ; Base Sequence ; DNA, Bacterial/analysis ; Databases, Genetic ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Open Reading Frames ; Orientia tsutsugamushi/*classification/isolation & purification ; Phylogeny ; Republic of Korea ; Scrub Typhus/diagnosis/metabolism/*microbiology ; Sequence Analysis, DNA

There are several antigenic variants of Orientia tsutsugamushi. The 56-kDa type-specific antigen (TSA) is responsible for the antigenic variation. Nucleotide sequences of the 56-kDa TSA obtained from 44 eschar samples of Korean scrub typhus patients and from 40 representative strains retrieved from the GenBank database were analyzed phylogenetically. Clinical patient data were assessed based on the genotyping results. Of the 44 nucleotide sequences, 32 (72.7%) clustered with the Boryong genotype, which is the major genotype in Korea. Eleven nucleotide sequences (25%) clustered with the Kawasaki genotype, not identified in Korea until 2010. One nucleotide sequence was consistent with the Karp genotype. The clinical course of the patients infected with each genotype showed no differences. Diagnostic performance of the immunofluorescence assay (IFA) using the 56-kDa TSA from Gilliam, Karp and Boryong as test antigens were not different for the Boryong and Kawasaki genotypes. Although Boryong is still the predominant genotype, the results suggest that Kawasaki genotype is quite prevalent in Chungbuk province of Korea.
Aged ; Bacterial Proteins/*genetics/metabolism ; Base Sequence ; DNA, Bacterial/analysis ; Databases, Genetic ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Open Reading Frames ; Orientia tsutsugamushi/*classification/isolation & purification ; Phylogeny ; Republic of Korea ; Scrub Typhus/diagnosis/metabolism/*microbiology ; Sequence Analysis, DNA