No abstract available.
Animals ; B-Lymphocytes* ; Mice*

PURPOSE: The purpose of this trial was to determine whether salbtamol and budesonide combined inhalation therapy is more efficacious than conservative treatment for admitted infants with bronchiolitis in early phase. METHODS: The study subjects were 72 infants admitted to Sun Hospital in Taejeon from July 1994 to June 1995, whose age from 1 month to 12 months with clinical diagnosis of bronchiolitis. Infants were randomly assigned to different three treatment groups as follw: Group C: 21 infants who received conservative treatment with oxygen (4liter/min); Group A: 23 infants who received salbutamol (0.1mg/kg) inhalation therapy using ultrasonic nebulizer at 6 hours interval add to conservative therapy; Group B: 28 infants who received budesonide (0.1mg/kg) inhalation therapy with above mentioned treatment at 12 hours interval. Then, infants were analyzed by comparison of clinical score, repiratory rate at time order of entry, 12 hours, 24 hours, 48 hours, 72 hours, and 5 days after treatment. We also compared ABGA of admission time to 24 hours after treatment of all groups and appreciate total hospital days of three groups. On follow up, same analyzing methods of comparison were used on 42 non-recurrent wheezing infants. RESULTS: The mean values of clinical score and respiratory rate were significantly improved in salbutamol and budesonide inhalation treatment group at 24 hours from medium of 6.1 60.7/min to 2.4, 42.3/min respectly. This effect was sustained thereafter. On the while, salbutamol inhalation group was significantly improved the clinical score and respiratory reate at 12 hours after therapy, but thereafter there was no obvious difference to conservative treatment. After then we exclude the recurrent infants and analyzed above mentioned items retrospectively. The improvement of clinical score and respiratory rate of salbutamol and budesonide inhalation therapy group was significant. Oxygenation was improved after 24hours of salbutamol and budesonide inhalation therapy. Total hospital stay was significantly reduced in salbutamol and budesonide inhalation group, and slightly reduced inthe salbutamol inhalation group. CONCLUSION: Infants with bronchiolitis treated with salbutamol and budesonide inhalation achieved better results in clinical score, repiratory rate PO2, and hospital days than no inhalation therapy. No reapiratory failure was occurred. So, this trial as treatment of bronchiolitis may be useful and effective therapy in those infants.
Albuterol* ; Bronchiolitis* ; Budesonide* ; Daejeon ; Diagnosis ; Follow-Up Studies ; Humans ; Infant* ; Inhalation* ; Length of Stay ; Nebulizers and Vaporizers ; Oxygen ; Respiratory Rate ; Respiratory Sounds ; Respiratory Therapy* ; Retrospective Studies ; Solar System ; Ultrasonics

PURPOSE: The purpose of this trial was to determine whether salbtamol and budesonide combined inhalation therapy is more efficacious than conservative treatment for admitted infants with bronchiolitis in early phase. METHODS: The study subjects were 72 infants admitted to Sun Hospital in Taejeon from July 1994 to June 1995, whose age from 1 month to 12 months with clinical diagnosis of bronchiolitis. Infants were randomly assigned to different three treatment groups as follw: Group C: 21 infants who received conservative treatment with oxygen (4liter/min); Group A: 23 infants who received salbutamol (0.1mg/kg) inhalation therapy using ultrasonic nebulizer at 6 hours interval add to conservative therapy; Group B: 28 infants who received budesonide (0.1mg/kg) inhalation therapy with above mentioned treatment at 12 hours interval. Then, infants were analyzed by comparison of clinical score, repiratory rate at time order of entry, 12 hours, 24 hours, 48 hours, 72 hours, and 5 days after treatment. We also compared ABGA of admission time to 24 hours after treatment of all groups and appreciate total hospital days of three groups. On follow up, same analyzing methods of comparison were used on 42 non-recurrent wheezing infants. RESULTS: The mean values of clinical score and respiratory rate were significantly improved in salbutamol and budesonide inhalation treatment group at 24 hours from medium of 6.1 60.7/min to 2.4, 42.3/min respectly. This effect was sustained thereafter. On the while, salbutamol inhalation group was significantly improved the clinical score and respiratory reate at 12 hours after therapy, but thereafter there was no obvious difference to conservative treatment. After then we exclude the recurrent infants and analyzed above mentioned items retrospectively. The improvement of clinical score and respiratory rate of salbutamol and budesonide inhalation therapy group was significant. Oxygenation was improved after 24hours of salbutamol and budesonide inhalation therapy. Total hospital stay was significantly reduced in salbutamol and budesonide inhalation group, and slightly reduced inthe salbutamol inhalation group. CONCLUSION: Infants with bronchiolitis treated with salbutamol and budesonide inhalation achieved better results in clinical score, repiratory rate PO2, and hospital days than no inhalation therapy. No reapiratory failure was occurred. So, this trial as treatment of bronchiolitis may be useful and effective therapy in those infants.
Albuterol* ; Bronchiolitis* ; Budesonide* ; Daejeon ; Diagnosis ; Follow-Up Studies ; Humans ; Infant* ; Inhalation* ; Length of Stay ; Nebulizers and Vaporizers ; Oxygen ; Respiratory Rate ; Respiratory Sounds ; Respiratory Therapy* ; Retrospective Studies ; Solar System ; Ultrasonics

PURPOSE: It was noted some changes of clinical manifestations of mycoplasma pneumonia. we reviewed and compared these changes and saught any clues causes for proper dignosis and treatment. METHODS: We divided patients with mycoplasma pneumonia into two groups, Group 1 (from Jan. to Dec. 1996) and Group 2 (from Jan. to Dec. 1994), and analyzed clinical, radiologic, and serologic differences. RESULTS: Mean age of onset lowered markedly from was 8.34 +/- 2.56 years to 6.91 +/- 3.28 years (P<0.05). In clinical symptoms, high fever lasted longer and gastrointestinal symptoms were more frequent noted group 1. Serologically, high titers of mycoplasma-specific antibody (>1 : 1280) were more frequently observed in group 1 and correlated with severity of clinical manifestations. In radiologic findings, alveolar consolidation were significantly prominent findings in Group (P<0.05). The mean period of response to Roxithromycin was not difference between two groups but longer lasting fever (> or = 3 days) in spite of medication were more prevalent in Group 1 (P<0.05), suggesting increased cases of diminished responsiveness to treatment. CONCLUSIONS: Recently, there was some clinical changes of mycoplasma pneumonia, lowering of onset age, severe clinical symptoms, and more decreased responsiveness to antibiotic treatment. We suggest that it is to neccessary to make some efforts to prevent antibiotics abuse and to decrease the occurrence of resistant strains by introducing of new method for early diagnosis, selective identification of micro-organism and minute sensitivity test for antibiotics.
Age of Onset ; Anti-Bacterial Agents ; Early Diagnosis ; Fever ; Humans ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Roxithromycin

Actinobacillus actinomycetemcomitans, a rare human pathogen, was repeatedly isolated from the blood of a 20-year-old male patient with patent ductus arteriosus who developed subacute bacterial endocarditis. Difficulties in isolating and identifying the organism are discussed. The bacterial isolate was found to be susceptible to various antimicrobial agents.
Actinobacillus/isolation & purification* ; Adult ; Blood/microbiology* ; Case Report ; Endocarditis, Subacute Bacterial/microbiology* ; Human ; Male ; Septicemia/microbiology

PURPOSE: Throat culture for streptococcal pharyngitis is a gold standard to diagnose, but it may be misleading to interpret due to the carriers. The isolation rates of beta-hemolytic streptococci (BHS) and Streptococcus pyogenes in the school children in Chinju were investigated and compared with those of Kangwon, Chungnam and Seoul previously reported. METHODS: Throat cultures were taken from the healthy 476 elementary school children who had no symptoms or signs of upper respiratory tract infection in April 1995, and the beta-hemolytic streptococci were identified with bacitracin disk (0.04 U) and latex agglutination. RESULTS: One-hundred fifty-four (32.4%) yielded BHS and 88 (18.5%) had S. pyogenes. The serogrouping revealed 30 (6.7%) group G, 24 (5.0%) group C, 4 (0.8%) group B, and 8 (1.7%) non-group A,B,C,G respectively. CONCLUSIONS: The isolation rate of BHS in Chinju was significantly higher (p<0.001) than the results of Kangwon, Chungnam and Seoul. The identification of BHS was also different from the other areas. In addition to these bacteriologic investigation, the study should be followed whether these carriers were simple contact ones or suffered from asymptomatic infections, and the epidemiologic study using serotyping, such as M or T typing, is necessary.
Agglutination ; Asymptomatic Infections ; Bacitracin ; Child* ; Chungcheongnam-do* ; Epidemiologic Studies ; Gangwon-do* ; Gyeongsangnam-do* ; Humans ; Latex ; Pharyngitis ; Pharynx* ; Respiratory Tract Infections ; Seoul* ; Serotyping ; Streptococcus pyogenes

Percutaneous transluminal renal angioplasty(PTRA) has become the treatment of choice for major renal artery stenosis. Nonetheless, about 10% of renal artery stenosis could not be properly dilated and 10-15% had a recurrence among the parients successfully dilated. Especially, PTRA in Takayasu's arteritis has technical diffculties due to the tough, noncompliant nature of the stenosis, which art difficult to cross and resist the respeated, prolonged balloon inflations. Intraluminal renal artery stent placement in unsuccessful balloon angioplasty and unsuitable lesions to PTRA may be an attractive approach to improve flow conditions. We report two cases of proximal renal artery stenosis caused by Takayasu's arteritis, who treated with intraluminal renal stenting(Palmaz-Schatz biliary stent). In both cases, clinical and angiographical improvement was achieved.
Angioplasty, Balloon ; Constriction, Pathologic ; Recurrence ; Renal Artery Obstruction* ; Renal Artery* ; Stents* ; Takayasu Arteritis*

PURPOSE: We evaluated the suppressive effects of vitamin A, in combination with antibiotics, on the development of inflammation in an animal model of ascending pyelonephritis. MATERIALS AND METHODS: An inoculum, of 1x10(9) Escherichia coli (O2:K1:H(-) ) P69 organisms per ml, was instilled into rat bladders, and the urethras of each rat occluded for 4 hours. The individual treatments with ciprofloxacin (15mg/kg, twice a day for 5 days) or vitamin A (500 microgram/kg, once a day for 5 days), or a combination of the was initiated 72 hours after the bacterial inoculation. The rats' renal weights were measured and examinations of the bacterial culture performed. The kidneys were harvested 4 weeks post-infection, and assessed for histopathologic inflammation. RESULTS: The renal weights in all groups were decreased, with the exception of the combined treatment group (p<0.05). In the urine and kidney microbiological cultures there were no E.coli growths in either the antibiotic or combined treatment groups. From microscopic examinations, the antibiotic treatment of pyelonephritic rats, in combination with vitamin A, was shown to result in significantly less renal inflammation compared to the other experimental groups. CONCLUSIONS: Vitamin A therapy in combination with antiobiotics can significantly reduce the inflammation associated with ascending pyelonephritis.
Animals ; Anti-Bacterial Agents* ; Ciprofloxacin ; Escherichia coli ; Inflammation* ; Kidney ; Models, Animal* ; Pyelonephritis* ; Rats* ; Urethra ; Urinary Bladder ; Vitamin A* ; Vitamins* ; Weights and Measures

A 21-year-old woman found to be hypertensive was referred for hypertension. On examination, blood pressure was 170/110mmHg in the right arm, 160/100mmHg in left arm,and 120/70mmHg in legs. A grade 2/6 systolic ejection murmur was present at the left upper sternal border, and a chest x-ray revealed a rib notching on the inferior margin of 4th rib. Two-dimensional echocardiogram showed the coarctation of aorta beyound the origin of the left subclavian artery. Biplane TEE demonstrated a discrete narrowing of the descending aorta at the site of coarctation. The blood pressure was 169/86mmHg in ascending aorta and 118/84mmHg in descending aorta. Aortogram showed a localized coarcted aortic segment of 7mm in diameter and 5mm long just distal to the left subclavian artery. Balloon coarctation angioplasty was performed with 7F 30x15mm pediatric balloon dilatation catheter. Balloon position was confirmed on fluoroscopy by the hourglass appearance of the balloon inflation and thereafter, the balloon was inflated until the waist of the balloon disappeared. After procedure, a pull back pressure tracing across the coarctation of aorta revealed no pressure gradient between ascending and descending aorta with 141/90mmHg. Aortogram showed an increase in diameter of the coarctation of aorta to 18mm with aneurysmal formation. 3 months later, follow up aortogram showed no significant change in diameter of coarctation of aorts or aneurysmal formation. Nonsurgical balloon coarctation angioplasty appears to be an alternative therapy for the coarctation of aorta in adults.
Adult* ; Aneurysm ; Angioplasty* ; Angioplasty, Balloon ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Catheters ; Dilatation ; Female ; Fluoroscopy ; Follow-Up Studies ; Humans ; Hypertension ; Inflation, Economic ; Leg ; Ribs ; Subclavian Artery ; Systolic Murmurs ; Thorax ; Young Adult

BACKGROUND: The purpose of this study was two fold; first, to determine the incidence and type of withdrawal movement associated with IV injection of rocuronium in pediatric patients; and second, to determine whether pretreatment with IV lidocaine affects the incidence of movement associated with rocuronium administration in pediatric patients. METHODS: Forty-two pediatric patients were randomly assigned to two groups. After general anesthesia was induced with thiopental sodium 5 mg/kg and manual occlusion of venous inflow was performed, one group of patients received 0.1 ml/kg 1% lidocaine IV. A second group received 0.1 ml/kg of normal saline as a placebo control. Venous inflow occlusion was held for 5 seconds, and immediately followed by the injection of rocuronium 0.6 mg/kg IV. The patient's response to rocuronium injection was graded using a 5-point scale. RESULTS: We observed that the incidence of movement was 100% in the placebo group and was significantly decreased to 28.8% in the group pretreated with lidocaine (P<0.001). CONCLUSIONS: Withdrawal movement on injection of rocuronium in pediatric patients can be decreased or prevented by pretreatment with IV lidocaine.
Anesthesia, General ; Child* ; Humans ; Incidence ; Lidocaine* ; Thiopental