PURPOSE: Our goals were to determine the frequency of headaches and backaches occurring as a side effect following lumbar puncture in children, and to investigate various factors that might influence the frequency of headaches and backaches. METHODS: From October 2004 to February 2006, we enrolled 148 patients aged 2 to 15 years who received diagnostic lumbar puncture at the Presbyterian Medical Center, Chonju, Korea. Patient data were collected for age, sex, number of puncture attempts, volume of cerebrospinal fluid(CSF), bevel orientation of puncture needle, cell count in CSF, periods of absolute bed rest, and the frequency and duration of headaches and backaches. RESULTS: Headaches occurred in 8 patients and backaches occurred in 40 patients. Headaches were found both to occur significantly more frequently in patients over age 10 and to last longer when the bevel orientation of the puncture needle was inserted toward the cranium rather than laterally. Backaches lasted longer in males than in females. The other factors evaluated showed no relationship at all to the frequency and duration of headaches and backaches. CONCLUSION: Following lumbar puncture, headaches were common in patients over age 10, and lasted longer when the bevel orientation was toward the cranium. Backaches lasted longer in males than in females. In light of these findings, we recommend taking special care when performing lumbar puncture for CSF examination in patients over age 10.
Back Pain* ; Bed Rest ; Cell Count ; Child* ; Female ; Headache* ; Humans ; Jeollabuk-do ; Korea ; Male ; Needles ; Protestantism ; Punctures ; Skull ; Spinal Puncture*

Apert syndrome is an uncommon congenital disorder characterized by malformation of the skull, most often acrocephaly or oxycephaly, in association with symmetrical syndactyly of both hands and feet. It is due to a disturbance in the growth of bone and soft tissue, affecting principally the head, hands, and feet. Recently we experienced a typical Apert syndrome expressed only in one neonate of dizygotic twin.
Acrocephalosyndactylia* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Craniosynostoses ; Foot ; Hand ; Head ; Humans ; Infant, Newborn* ; Skull ; Syndactyly ; Twins, Dizygotic*

The purpose of this study is to review the clinical and pathological features of pseudomembranous colitis in Korea. Ten cases of psedomembranous colitis, which were diagnosed by sigmoidoscopy and biopsy at the Seoul National University Hospital from May 1982 to occtober 1985, were analyzed in terms of the age and sex distribution, underlying diseases, presumptive causative antimicrobials, symptomatology, involved site and tratment. 1) The disease was more prevalent above sixth decade with a slight preponderance on the female. 2) The underlying diseases of the patients were the uterine cervix cancer in 3 cases and one case each of the nasal polyp, cataract, degenerative arthritis, tuberculous gradmuloma, SLE with menngitis, CVA and gingival abscess. 3) As for the presumptive causative drugs, cephalosporin were assaciated in 6 cases, aminoglycoside m 7 cases, penlcillin in 3 cases, Bactrim in 3 cases, antituberculosis drugs in 1 case and anticancer drugs in 1 case. 4) As for the anatotmical distribution of the lesion, the rectum was involved in 5 cases, the rectum and sigmoid colon in 4 cases and up to the descending colon in 1 case. 5) All the cases were cured by medical treatment. In 5 cases, discontinuation of the antimicrobial drugs and supportive care only were effective and in other 5 cases, vancamycin and/or metronidazole together vrith cholestyramine were added to the regimen.
Abscess ; Biopsy ; Cataract ; Cervix Uteri ; Cholestyramine Resin ; Colitis ; Colon, Descending ; Colon, Sigmoid ; Enterocolitis, Pseudomembranous* ; Female ; Humans ; Korea ; Metronidazole ; Nasal Polyps ; Osteoarthritis ; Rectum ; Seoul ; Sex Distribution ; Sigmoidoscopy ; Trimethoprim-Sulfamethoxazole Combination ; Trimethoprim, Sulfamethoxazole Drug Combination

BACKGROUND: Ventilator associated pneumonia (VAP) is the most serious nosocomial infection of intensive care units. Several studies have investigated the relationship between the interval of ventilator circuit changes and the incidence of pneumonia in foreign countries, but there are no reports about it in Korea yet. So we performed this study to compare the clinical and cost impact between 3 days and 7 days interval in ventilator circuit changes. METHODS: Seoul National University Hospital is a 1,500-bed, university affiliated, tertiary and acute care hospital. All patients admitted to medical intensive care unit (MICU) and surgical intensive care unlt (SICU) between April 1, 1998 and October 31, 1998, requiring mechanical ventilation were included. Patients were divided into two groups of a-cay circuit changes and weekly changes. Daily surveillance was conducted using the criteria of VAP of the National Nosocomial Infection Surveillance System. Incidence of VAP and risk factors for VAP were evaluated. Standard microbiologic methods were used for the identification of clinical and environmental isolates. Statistical analysis was done by SAS Program (version 6.12), analysis of difference in variables was performed using chi-square test and t-test. Analysis of odds ratios was done with logistic regression analysis. RESULTS: VAP developed at a rate of 12.2 per 1,000 ventilator-days in the 3 days change group and 15.6 per 1,000 ventilator-days in the weekly change group (P=0.7240). The only statistically significant risk factor of VAP was duration of mechanical ventilation, The risk of VAP in patients with more than 7 days was 2.23 times higher than in patients with 7 days and below (OR; 2.2296). Estimated annual savings of nursing time by extending ventilator circuit change interval from 3 days to 7 days were 26,806 min 48 sec and estimated savings of cost by reduction of nursing times was calculated as 6,701,700 won. CONCLUSIONS: Weekly ventilator circuit changes in patients undergoing ventilation therapy in the ICU do not contribute to increased the rates of VAP and are cost-effective.
Cross Infection ; Humans ; Incidence ; Income ; Critical Care ; Intensive Care Units ; Korea ; Logistic Models ; Nursing ; Odds Ratio ; Pneumonia ; Pneumonia, Ventilator-Associated* ; Prospective Studies* ; Respiration, Artificial ; Risk Factors ; Seoul ; Ventilation ; Ventilators, Mechanical

Infective endocarditis by Hemophilus species is very rare:there are only 22 reported-cases of Hemophilus paraphrophilus endocarditis. We report a case of Hemophilus paraphrophilus endocarditis in a middle-aged woman with cerebral embolism and hemorrhage.
Endocarditis* ; Female ; Haemophilus ; Haemophilus paraphrophilus* ; Hemorrhage* ; Humans ; Intracranial Embolism*

OBJECTIVE: The sural nerve is a sensory nerve in the lower extremity which is formed by the union of the medial sural cutaneous nerve of tibial nerve and the communicating branch of the common peroneal nerve. The objective of this study is to standardize the electrodiagnostic technique of proximal conduction of sural nerve and to investigate the usefulness of the technique in evaluation for the patients with peripheral neuropathy. METHOD: Fifty eight extremities in 29 normal adults without the clinical signs and symptoms of peripheral neuropathy were evaluated with sural nerve conduction study. The active recording electrode was placed over 14 cm proximal to the lateral malleolus, and the reference electrode was placed over 4cm distal to the active electrode. The antidromic evoked responses were recorded with stimulation at points 7, 14, 21 cm proximal to the recording electrode and directly over the sural nerve. RESULTS: The mean values of proximal conduction study of sural nerve in normal adults were 2.40 1.03 msec for peak latency, 11.55 +/-7.31 microvolt in amplitude with stimulation at 7 cm proximal to the recording electrode; 3.43 +/-0.78 msec for peak latency, 10.87 5.86 microvolt in amplitude with stimulation at 14 cm; 4.51 +/-0.83 msec for peak latency, 8.78+/- 4.10 microvolt in amplitude with stimulation at 21 cm. CONCLUSION: A method of proximal conduction study of sural nerve was introduced which could be used as a valuable technique for the evaluation of peripheral neuropathy.
Adult ; Electrodes ; Extremities ; Humans ; Lower Extremity ; Peripheral Nervous System Diseases ; Peroneal Nerve ; Sural Nerve* ; Tibial Nerve

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

No abstract available.
Carcinoma, Hepatocellular*

BACKGROUND: Although malaria-specific antibody or antigen test is useful for the diagnosis of malaria infection, its cost-effectiveness has to be concerned in the area where malaria prevalence is very low. We created a panel test composed of malaria non-specific parameters, namely hematology autoanalyzer-derived results with or without addition of HDL-cholesterol data, and evaluated its usefulness in comparison with malaria-specific antibody test. METHODS: For 395 patients tested for malaria smear, the hematology parameters such as platelet count, NRBC (%) and VCS (volume, conductivity, scattering) parameters of WBC, and HDL-cholesterol data were analyzed. Statistical significance of each parameter and that of panel test with or without addition of HDL-cholesterol were evaluated. RESULTS: Malaria antibody test showed sensitivity of 97.1% and specificity of 99.1%. Each parameter of platelet count, NRBC (%), D parameter and HDL-cholesterol showed sensitivity of 86.8%, 41.2%, 81.8%, and 70.6%, and specificity of 85.9%, 96.3%, 72.3%, and 81.7%, respectively. Panel test without including HDL-cholesterol showed sensitivity of 91.2% and specificity of 81.6%, and that including HDL-cholesterol showed sensitivity of 91.2% and specificity of 86.2%. CONCLUSIONS: The malaria non-specific panel test composed of hematology autoanalyzer-derived parameters showed relatively good, but slightly lower sensitivity than that of malaria-specific antibody test. It might be used as a screening test for the diagnosis of malaria infection, and addition of HDL cholesterol improved little the usefulness of the panel test.
Animals ; Autoanalysis ; Biological Markers ; Cholesterol, HDL/*blood ; Diagnosis, Differential ; Hematologic Tests/economics/utilization ; Humans ; Malaria, Falciparum/blood/*diagnosis ; Plasmodium falciparum/isolation & purification ; ROC Curve ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

Inflammatory linear verrucous epidermal nevus(ILVEN) is a relatively rare skin disorder, characterized by chronic inflammatory psoriasiform pattern. This chronic skin disorder is generally believed to be resistant to various treatments, although some authors have reported success with 13-cis-retinoic acid and 585 nm pulsed laser therapy. We experienced a 15-month aged female ILVEN patient who has been suffered from linear erythematous verrucous pathes mainly located on left inguinal area, hand, and foot with persistent itching sense. This skin lesion have been developed at birth, and more spread out toward right extremity after 1 year old age . We initially treated this skin lesion with topical corticosteroids and oral anti-histamines, but this treatment was not successful. So we retreated this patient with etretinate(oral retinoid) and topical 13-cis-retinoic acids, we found that therapeutic responses to these applications were more remarkable. Now, we closely observe this patient's clinical course further more.
Adrenal Cortex Hormones ; Etretinate ; Extremities ; Female ; Foot ; Hand ; Humans ; Isotretinoin ; Laser Therapy ; Nevus, Sebaceous of Jadassohn* ; Parturition ; Pruritus ; Skin