Infantile hypertrophic pyloric stensosis(IHPS) occurs in three of 1000 live births, and is a major cause of nonbilious vomiting of early infancy. It's etiology and pathogenesis however are still obscure. The operation of pyloromyotomy described by Ramstedt in 1912 remains the standard treatment. From January 1990 to July 1997, 64 infants with IHPS were treated at the Department of Pediatric Sursery, Yeungnam University Hospital. The ratio of male to female was 7:1, and the most prevalent age ranged from 2 weeks to 8 weeks(81.2 %) of age. Fifty-seven infants were first born (57.8 percent). The body weight of all patients at admission was below the 50 percentile. Age of onset of symptoms was between 2 and 4weeks of age in 23 cases(35.9 %). All infants had a history of nonbilious vomting, generally projectile in nature. Hypokalemia was noted in 14 cases(21.9 %) and hypochloremia in 26 cases(40.6 %). In the preoperative ultrasonography, the average muscle thickness, diameter, and length of the pylorus were 6.3 mm, 12.3 mm, and 17.8 mm. A total of 13 associated anomalies were noted in 12 patients. All cases were treated with Fredet-Ramstedt pyloromyotomy. Postoperative wound infection occured in 3 cases. Thirteen cases(20.3 %) presented intermittent nonprojectile vomiting after operation. With control of oral intake vomiting subsided within one week in 63 patients, and in thirteen days in another.
Purpose: Up to date there is no nationwide survey on epidemiological or clinical data of nephrotic syndrome, so we investigated about age of onset, sex, result of renal biopsy, treatment method, its results of treatment, its responsiveness, time of response to treatment and pattern of relapse in Korea. Methods: Between 1987 and 1997, 2193 patients with primary nephrotic syndrome diagnosed at 38 university hospital and general hospital in Korea were included. Of these 1655 were male and 538 were female. Incidence peaked at 1-5 years of age. Results: Results were as follows; 1) Among 2193 cases, male was 1655($75.5\%$), female was 538 cases($24.5\%$) and male to female ratio was about 3:1. Among 1752 patients with MCNS, male was 1338, female was 414 and male to female ratio was about 3.23:1. The most prevalent age group was 1-5 years of age. 2) Renal biopsy was done in 942 cases($43\%$), pathologic findings were as follows; MCNS 646 cases($68.6\%$), FSCS 149 cases($15.8\%$). 3) Regimen of treatment were as follows; prednisolone 1191 cases, Calcort 192 cases, cyclophosphamide 251 cases, cyclosporin A 223 cases, MPD pulse therapy 120 cases.4) Complete response to treatment were noted in 1597 cases($82.2\%$, n=1944). 5) Responsiveness according to result of renal biopsy were significantly different between MCNS and FSGS. Complete response were noted in $86.5\%$ among patients with MCNS, $35.8\%$ in patients with FSGS. 6) Time of response to treatment were noted between 1 and 4 weeks after treatment in 879 cases($67.4\%$, n=1305). 7) 994 cases($73.1\%$) relapsed during follow up, most frequently between 2 months and 6 months after response. Conclusion : Nationwide survey of epidemiological and clinical data were performed in childhood primary nephrotic syndrome. Most of the clinical and epidemiological data were similar to other reports from U.S.A. and from Europe, however male to female ratio is higher in Korean nephrotic syndrome(3:1 in contrast to 2:1).
Purpose : To confirm the efficacy of arthroscopic synovectomy for the pigmented villonodular synovitis in the knee. Materials and Methods : We analysed 8 patient(9 cases) that were diagnosed and performed arthroscopic synovectomy as pigmented villonodular synovitis from July 1992 to May 2000. The diagnosis was confirmed by pathologist. The average follow-up period was 29 months(range, $15\~48$ months). The average age at initial visit was 40.4 years(rage, $15\~67$ years). Male were 6 cases and female 2 cases. The average duration from onset of the symptom to the operation was 23 months($2\~86$ months). Previous history of the trauma was noted in 2 case. There was 1 case involved both knee joints. Results : According to the athroscopic findings, there were 4 localized forms and 5 diffuse forms. At preoperational examinations, the average of flexion contracture was $4.4^{\circ}(0\~5^{\circ})$ and that of the further flexion was $117.8^{\circ}(90\~135^{\circ})$. At last follow-up examinations, the knee range of motion was normalized, the average of flexion range was $133.9^{\circ}(120\~140^{\circ})$. All patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : In the pigmented villonodular synovitis, arthroscopic synovectomy can be considered one of the good modality to expect good results.
Kim, Jung Jin;Lee, Soo Jung;Toh, Kyu Young;Lee, Chang Uk;Lee, Chul;Paik, In Ho
Korean Journal of Biological Psychiatry
/
v.6
no.2
/
pp.202-208
/
1999
Schizophrenia has many clinical expressions and probably different etiologic factors. Infections, autoimmune mechanism and related neurodevelopmental abnormalities have been suggested as possible etiologic factors of schizophrenia. It has been reported that immunoreactivity to heat shock proteins, which play a protective role against environmental stresses in a cell, might be related to the pathogenesis of schizophrenia. Therefore, we examined the immunoreactivity to heat shock protein 70kDa and 90kDa(HSP70 and 90) in 91 patients with schizophrenia and 83 normal controls. Ig G antibodies to HSP70 and 90 of sera were quantitated by ELISA. The optical density(OD) was measured by an automated microplate reader at a wavelength of 490nm. The amounts of antibodies to HSPs were expressed as arbitrary units(AU)/ml related to a standard serum. The limit for elevated antibody titers(anti-HSPs positive or negative) was set at two standard deviations added to the mean of the normal controls. Twenty nine(31.9%) of the 91 patients showed anti-HSP70 positive and 19(20.9%) of those showed anti-HSP90 positive. On the other hand, only 1(1.4%) of the normal controls and 4(4.8%) of those showed anti-HSP70 positive and anti-HSP90 positive, respectively. The titers of anti-HSP70 positive were related with BPRS scores, while those of anti-HSP90 positive were not. There were no relationship between antibody titers and clinical variables including age at onset, duration of illness, family history of schizophrenia or number of admission. The titers of anti-HSP70 positive were significantly associated with anti-HSP90 positive. Our results suggest the presence of abnormal immune reactivity involving HSP70 and HSP90 in a subset of patients with schizophrenia.
Objectives: By analyzing the characteristics and the distribution of diseases of patients who visited the emergency room of a Korean medical hospital, we sought to determine the methods of activating the Korean emergency medical system and to use this analysis as a basis for future research. Methods: We conducted a retrospective review of 959 patients who visited the emergency department of the Dong-Eui University Korean Medical Hospital from January 2016 to December 2016. The review was conducted using electronic medical records created during the emergency department visit. Results & Conclusions: In distribution of sex, the rate of males was 47.9%, and that of females was 52.1%. In distribution of age, the greatest number of patients were in their 50s (27.5%), followed by those in their 60s (19.9%) and 40s (14.8%). In distribution of residence, most patients were from Busan (84.9%). In distribution of week, more patients visited the emergency room on Sundays and holidays (44.3%). September was the busiest month (12.5%). Visits usually occurred during daytime and nighttime, and there were few visits at dawn. In the analysis of the time interval between onset of symptoms and the emergency room visit, most patients visited within 24 hours (46.5%). In the distribution of diseases, facial palsy was the most common (34.6%). In the systematic distribution of diseases, circulatory diseases were the most common (56.7%), followed by diseases of the musculoskeletal system (28.6%). The rate of first emergency room visit was 52.9%, and the rate of revisit was 47.1%. The rate of hospitalization after emergency room treatment was 27.5%, and the rate of discharge was 72.4%. The rate of revisit was 63.4%. In the distribution of treatment before arrival at the emergency room, direct was the most common (51.0%), and the outpatient department of western medicine was next. In the distribution of treatment in the emergency room, acupuncture was the highest (91.4%), followed by herb-med (43.0%).
An outbreak of dermatosis occurred at a machine manufacture factory in Kyongju on Aug 1995. Authors conducted a questionnaire ,survey among 92 workers in the factory and a dermatologist examined their skin lesions. Authors also collected moths and identified them. The results are as follows; 1. Forty-two cases of dermatosis were identified with attack rate of 45.7%. Attack rate was not different by company, age, sex, educational level and duration of employment. Attack rate was 47.8% among productive workers, 25.0% among clerical workers and 100.0 % among patrolmen. 2. Two cases among 42 dermatosis cases and three subjects among 50 non-cases had a history of same dermatosis last year. Four of dermatosis cases had a history of dermatosis among their family members. 3. Skin lesions of the cases were scattered or grouped rice-sized erythematous papules or vesicles. Duration of dermatosis from the onset to the time of survey was from one day to more than 30 days. The most frequent site of skin lesion was the arms(81.0 %), and it was also observed at the neck(47.6 %), abdomen(45.2 %), chest(42.9 %), legs(38.1 %) and back(35.7 %). Skin lesion was aggravated with sweating(31.0 %), after shower(16.7 %) and with scratching(11.9 %). 4. Moths were collected and identified as Euproctis subflava (Bremer). Many poisonous stings were observed on their wngs which is harmful to human. 5. Contact with moths' wing droppings to two authors on thier forearms for provocation resulted in severe immediate pain followed by prolonged pruritus. Erythematous macules quickly appeared and succeeded by firm wheal-like red papules. Authors thought that the outbreak of dermatosis was brought about by Euproctis subflava (Bremer). Further studies on the factors contributing to the prosperity of the moths in this area are needed.
Chang, Soo Jin;Lee, Ji Hyun;Kim, Shin Hye;Lee, Joon Soo;Kim, Heung Dong;Kang, Joon Won;Lee, Young Mock;Kang, Hoon-Chul
Clinical and Experimental Pediatrics
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v.58
no.5
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pp.194-198
/
2015
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronically progressive or relapsing symmetric sensorimotor disorder presumed to occur because of immunologic antibody-mediated reactions. To understand the clinical courses of CIDP, we report variable CIDP courses in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval. Four patients who were diagnosed with acute-onset and relapsing CIDP courses at Severance Children's Hospital, Seoul, Korea, were enrolled in this retrospective study. We diagnosed each patient on the basis of the CIDP diagnostic criteria developed in 2010 by the European Federation of Neurological Societies/Peripheral Nerve Society Guidelines. We present the cases of four pediatric patients diagnosed with CIDP to understand the variable clinical course of the disease in children. Our four patients were all between 8 and 12 years of age. Patients 1 and 2 were diagnosed with acute cerebellar ataxia or Guillain-$Barr{\acute{e}}$ syndrome as initial symptoms. While patients 1 and 4 were given only intravenous dexamethasone (0.3 mg/kg/day) for 5 days at the first episode, Patients 2 and 3 were given a combination of intravenous immunoglobulin (2 g/kg) and dexamethasone (0.3 mg/kg/day). All patients were maintained with oral prednisolone at 30 mg/day, but their clinical courses were variable in both relapse intervals and severity. We experienced variable clinical courses of CIDP in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval.
Facial nerve is subject to injury at any point in the course from the cerebral cortex to the motor end plate in the face, so many etiologic varieties of facial paralysis may be encountered, including trauma, viral infection and the idiopathic. Authors have studied 39 cases of facial paralysis which had experienced of treatment in our department from March, 1996 to March, 1997 at Dong San Medical Center. The results obtained are as follows : 1) The highest age incidence showed 10 cases(24.6%) in 3rd decade 2) Among the total of 39 cases, male were 21 cases(53.8%) and female were 18cases(46.2%). 3) At the involved side, left side were 19 cases(48.7%) and right side were 18 cases(46.2%). 4) The causes of facial paralysis were; idiopathic (Bell's palsy) in 19 cases(48.7%) infectious in 6 cases(15.4%) neoplastic in 6 cases(15.4%) traumatic in 5 cases(12.9%) metabolic in 2 cases(5.1%) congenital in 1 cases(2.6%) 5) In time interval between onset of symptom and treated initial date, 26 cases(66.7%) in below 10 days and 8 cases(20.5%) in 11-20 days 6) Correlation of recovery rate according to the treated duration did not differ significantly 7)Result after treatment were satisfactory
The purpose of this study was to investigate the degree of cognitive impairment for the elders taking part in activities at senior community center and to identify the multiple factors affecting the cognitive dysfunction of them. Data were collected for the 375 elders taking part in activities at senior community center at 4 different areas of dong, up, and myun of C-city from June 2016 to July 2016, and their general characteristics as well as health-related characteristics, depression, and cognitive dysfunction were investigated and analyzed. The results of this study showed that cognitive dysfunction was affected by the age, education, economic support, history of stroke, and exercise. The risk of cognitive dysfunction was 3.50 times higher in patients over 80 years old than patients below 74 years old(p=.002), and the lower the level of education showed the higher the risk of cognitive dysfunction(p=.036)(p<.001). In addition, the risk of cognitive dysfunction was low in the absence of a history of stroke(p=.033), and the risk of cognitive dysfunction increased by 1.84 times if they do not exercise(p=.044). Based on the present study, It is required to consider the risk factors for cognitive dysfunction efforts to prevent and manage cognitive impairment before the onset of cognitive dysfunction.
Background: Spontaneous hemopneumothorax, occurring in 1% to 12% of patients with spontaneous pneumothorax, is a rare disorder that can potentially lead to life-threatening complications. Materials and methods: We have experienced 15 cases (2.28%) with spontaneous hemopneumothorax among 659 episodes of spontaneous pneumothorax for eight years, from 1990 to 1997, at our hospital. We studied our previously treated patients by retrospective case studies to determine the nature of optimal management. Results: There were 14 male and 1 female patients whose mean age was 27.5 years, ranging from 19 to 58. The sides with disorder were as following: right in 10 cases and left in 5, unilaterally. The amount of initial bleeding ranged from 400 to 1,500 mL and 8 patients received a homologous blood transfusion. Patients exhibited symptoms of chest pain, dyspnea, chest discomfort, and hypovolemic shock. We concluded that causes of this disease in our patients were a torn pleural adhesion (14 cases) and a rupture of vascularized bullae (1 case with an underlying intrinsic lung disease, tuberculosis). All patients underwent closed thoracostomy and had good results except for 3. One patient underwent thoracotomy within 3 days from the onset because of continuous active hemorrhage. Decortication was required in one case because of a reactive fluid collection in the pleural space, which led to impaired lung expansion. Another patient underwent thoracotomy due to a ipsilateral recurrent pneumothorax without blood collection. Conclusions: The goals of treatment include hemostasis and reexpansion of the collapsed lung. Thus, if patients arrive early at hospital, closed thoracostomy and transfusion are thought to be sufficient treatments, although early surgical repair has been considered recently.
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