PURPOSE: In most emergency department (ED), sedation is required before carrying out an invasive procedure on a pediatric patient. In the ED setting, it is essential to determine the optimal dose and administration route of CH for successful sedation. The aim of this study was to determine the optimal dose of CH for an invasive procedure and to examine the effectiveness of the drug's different administration routes. Furthermore, in this study, we performed simple survey using questionnaire which composed of Likert-scale to evaluate satisfaction of medical staffs in ED with administration routes. METHODS: This study was conducted prospectively. The study participants were pediatric patients under 8 years old who visited the ED in two tertiary hospitals in South Korea within a period of 12 months. RESULTS: Overall, 300 patients were included in this study. The age, sex, and weight of the patients were not shown to influence the sedation time. Chloral hydrate dosage is the independent factor to influence the both sedation and discharge time (p<0.01). In the comparison of the groups, groups 1, 2, and 5 showed no significant difference. On the other hand, groups 3 and 4 were shown to be statistically significantly different from group 1. CONCLUSION: Up to 100 mg/kg CH is safe to use in the emergency department for pediatric patients, but the initial dose of 50 mg/kg for oral administration should be considered in advance because it can provide safe and effective sedation with a lower possibility of causing an adverse effect.
Administration, Oral ; Chloral Hydrate* ; Deep Sedation ; Emergency Service, Hospital ; Hand ; Humans ; Korea ; Medical Staff ; Prospective Studies ; Tertiary Care Centers

Trichoblastic fibroma is a benign trichogenic tumor that has both epithelial and mesenchymal components and exhibits partial follicular induction. We studied 4 cases of trichoblastic fibroma and reviewed their clinical and histologic features. Two tumors were present in the face. The remaining two were in the vulva and perianal area, respectively. The age of the patients ranged from 53 to 68 years, with an average age of 62. All were female. Histologically, the lesions showed a well circumscribed mass, located at dermo-subcutaneous junction in three patients and subcutaneous in one. They demonstrated mesenchymal induction evidenced by hair germ-like structure and perifollicular sheath. There was no connection between the tumor and epidermis. Differentiation toward hair structure led to the formation of the infundibulum through inner root sheath. Trichoblastic fibroma may be confused clinically and/or histologically with basal cell carcinoma. Identification of the mixed epithelial and mesenchymal components, and the absence of epidermal connection and cleft within the stroma are important in differentiating this benign neoplasm from basal cell carcinoma.
Carcinoma, Basal Cell ; Epidermis ; Female ; Fibroma* ; Hair ; Humans ; Vulva

OBJECTIVE: Telomerase is a ribonucleoprotein that synthesizes TTAGGG repeats onto chromosome ends. The expression of telomerase is thought to be required for cellular immortality and carcinogenesis. This study was conducted to examine the telomerase activation occurs in cervical carcinogenesis. METHODS: The standard telomeric repeat amplification protocol(TRAP) was used to examine telomerase activity in tissues of 10 normal cervix, 10 carcinoma in situ, and 21 invasive cervical carcinoma. RESULTS: Telomerase activity was detected in tissues of 16/21(76.2%) invasive carcinoma, in 5/10(50.0%) carcinoma in situ, and in 3/10(30.0%) normal cervix. But the degree of telomerase activity in normal cervix was weak. There was significant difference in 3 groups(p<0.05). The results of neoadjuvant chemotherapy in 10 invasive cervical carcinoma were as follows. In 8 cases of which tumor size decreased more than 50%, 5 were positive for telomerase. In 2 cases that didn't respond to chemotherapy by tumor size, 1 was positive for telomerase. There was no significant difference between 2 groups. All of the 5 cases that had pelvic lymph node metastasis revealed positive telomerase activity, and the 11 cases of 16 cases that didn't have pelvic lymph node metastasis were positive for telomerase, but there was no significant difference in 2 groups. The positivity of telomerase activity in clinical stage of invasive cervical carcinoma was 73.3% in stage I(11/15), 75.0% in stage II(3/4), 100% in stage III(1/1), and 100% in stage IV(1/1), but there was no significant difference in each stages. CONCLUSION: Telomerase seems to be uniquely associated with malignant transformation of cervix and can be used as a tumor marker. Additional studies are needed to better clarify the biological significance of telomerase expression in cervical tumorigenesis.
Carcinogenesis ; Carcinoma in Situ ; Cervix Uteri ; Drug Therapy ; Female ; Lymph Nodes ; Neoplasm Metastasis ; Ribonucleoproteins ; Telomerase* ; Uterine Cervical Neoplasms*

PURPOSE: Both antithrombin III(ATIII) and Gabexate mesilate(Foy) are effective for the treatment of disseminated intravascular coagulation(DIC). However, their mechanisms of action are slightly different, and combined effect of ATIII and Foy in premature infant with DIC has not been studied. We evaluated therapeutic efficacy of treatments with either ATIII or Foy alone or both in combination. METHODS: We studied 23 premature infants of gestational ages between 30 and 36 weeks with DIC. Group A(n=10) was treated by ATIII only, Group B(n=7) by Foy only and Group C(n=6) by both ATIII and Foy. Three groups were compared for volume of blood sampling and transfusion and hematologic data. RESULTS: Improvement of hematologic data(platelet, PT, aPTT, fibrinogen, FDP) was not significantly different among 3 groups. The mean volume of blood sampling during 5 days of treatment was 30 mL, 22.5 mL, and 30 mL, respectively. The mean volume of packed RBC transfusion was 12.8 mL, 9 mL, and 2.5 mL, respectively: and mean volume of platelet transfusion was 25.9 mL, 10 mL, and 0 mL, respectively, showing no significant statistical difference. But the mean volume of FFP transfusion was 141 mL only in group B, significantly higher compared to other groups. CONCLUSION: The combination therapy of ATIII and Foy significantly decreased the volume of FFP transfusion and may be more effective than monotherapy with ATIII or Foy alone in DIC of premature infant.
Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrinogen ; Gabexate* ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature* ; Platelet Transfusion ; Thrombin*

OBJECTIVE: We previously described that Diva is highly expressed in matured metaphase II (MII) oocytes compared to immature germinal vesicle (GV) oocytes in mouse.1 We report here that the expression of Diva transcript as well as protein is oocyte-specific. To elucidate its physiological role in oocyte, the binding partner(s) of Diva has been identified by using immunoprecipitation (IP) followed by Mass Spectrometry. METHODS: NIH/3T3 cells were transiently transfected for 24 h with either empty vector for control or FLAG-tagged mouse Diva construct, and IP was performed with anti-FLAG antibody. The immuno-isolated complexes were resolved by SDS-PAGE on a 12% gel followed by Coomassie Blue staining. For in-gel digestion, 15 bands of interest were excised manually and digested with trypsin. All mass spectra were acquired at a positive reflector mode by a 4700 Proteomics Analyzer (Applied Biosystems, Framingham, MA). Proteins were identified by searching the NCBI nonredundant database using MASCOT Peptide Mass Fingerprint software (Matrixscience, London). RESULTS: Diva-associated complexes were formed in FLAG-tagged mouse Diva-overexpressed NIH/3T3 cells via IP using anti-FLAG-conjugated beads. Among the excised 15 bands, actin and actin-binding proteins such as tropomyosin, tropomodulin 3, and alpha-actinin were identified. Binding between Diva and actin or tropomyosin was confirmed by IP followed by Western blot analysis. Both bindings were also detected endogenously in mouse ovaries, indicating that Diva works with actin and tropomyosin. CONCLUSIONS: This is the first report that immuno-isolated Diva-associated complexes are related to actin filament of the cytoskeletal system. When we consider the association of Diva with actin and tropomyosin, oocyte-specific Diva may play a role in modulating the cytoskeletal system during oocyte maturation.
Actin Cytoskeleton ; Actinin ; Actins ; Animals ; Blotting, Western ; Dermatoglyphics ; Digestion ; Electrophoresis, Polyacrylamide Gel ; Female ; Immunoprecipitation ; Mass Spectrometry* ; Metaphase ; Mice ; Microfilament Proteins ; Oocytes ; Ovary ; Proteomics ; Tropomodulin ; Tropomyosin ; Trypsin

We report a case of necrotizing arteritis involving the gallbladder. This case was clinically diagnosed as cholelithiasis with cholecystitis, and necrotizing arteritis was found in the surgically resected specimen. Vascular changes were similar to those seen in classic polyarteritis nodosa, involving medium-sized muscular arteries and characterized by fibrinoid necrosis and panarterial and periarterial inflammation varying from active to resolving stages. Acute cholecystitis is a rare initial clinical manifestation of the systemic vasculitis. If acute cholecystitis is found in the absence of obvious cause, careful examination is essential. Since steroid therapy improves the prognosis in the systemic vasculitis, clinicians and pathologists should be aware of this unusual lesion.
Arteries ; Cholecystitis ; Cholecystitis, Acute ; Cholelithiasis ; Gallbladder* ; Inflammation ; Necrosis ; Polyarteritis Nodosa ; Prognosis ; Systemic Vasculitis ; Vasculitis*

This study is attempted to propose a quality evaluation method of the materials for nutrition education by applying readability test of printed materials for nutrition education. It is significantly important for the teaching class with nutrition education materials to consider students understanding level and education materials topics or choosing words in developed printed materials. This study performed an evaluation of the readability of text in teachers' guidebook, which is devised for elementary school students' education material about sugar, sodium and trans-fat and attempted to estimate the developing materials through analyzing difficulty level of the text. We utilized "The Teacher's Guidebook for Cooking Activity" that had been developed for elementary school by Ministry Education Science and Technology, as the readability evaluation standard. Compared with the average score of readability about "The Teacher's Guidebook for Cooking Activity", 72.94 +/- 6.85, "Sugar Guidebook" was 70.94 +/- 7.46, "Sodium Guidebook" was 68.76 +/- 14.50, and "Trans-fat Guidebook" was 58.87 +/- 10.79. Considering the subjects careers or ages, "The Teacher's Guidebook for Cooking Activity" has little deviation by the subjects careers or ages and was "intermediate" or "easy" level; however, "Sugar Guidebook", "Sodium Guidebook", "Trans-fat Guidebook" was "intermediate" or "difficult" level (p < 0.05). Readability score was especially low when the contents of some particular subjects were too professionalized or scientific terms were frequently used, and thes results were definitely seen in the "Sodium Guidebook" and "Trans-fat Guidebook". With Cloze test score, the readability evaluation will be using as an evaluation tool for the nutrition education materials.
Comprehension ; Cooking ; Humans ; Sodium

PURPOSE: The purpose of this study was to investigate the effects of ego-resilience and stress coping styles on college adaptation in nursing students. METHOD: The sample for this study consisted of 1st and 2nd year students from 3 colleges of nursing, one each, in Jeolla, Chungcheong, and Gyeongsang Provinces. The data were collected from November 5 to 22, 2010. The data were analyzed using t-test, ANOVA, Pearson correlation and multiple regression with SPSS 18.0. RESULTS: A positive correlation was found for college adaptation with stress coping styles and ego-resilience. The strongest predictor of college adaptation was an optimistic attitude. In addition optimistic attitude, satisfaction with nursing as a major, confidence, academic scores, age, emotional control, and gender accounted for 63.3% of variance in college adaptation. CONCLUSIONS: The results of this study suggest that development of stress coping and ego-resilience in nursing students is important to college adaptation. Further research in improving ego-resilience and stress coping is warranted.
Humans ; Students, Nursing

BACKGROUND: One of the main disadvantages of caudal block is the long latent period before a satisfactory blockade is obtained. Many investigators have used various preparations of local anesthetic solutions to improve the speed of onset. This study was performed to evaluate the effectiveness of prewarming of lidocaine HCl for caudal block. METHODS: Fifty healthy young patients (ASA I) were allocated into two groups, A and B. In group A, the local anesthetic solution were injected at room temperature (25 degrees C), while in group B, they were injected at 37oC. All the caudal block were performed using 2% lidocaine HCl 20 ml with fentanyl 100ug and epinephrine 1:200,000. The onset time was defined as the period from completion of injection until the patient first noticed loss of sensation to pin-prick on perianal region. Assessment of sensory loss was made at 15 seconds interval. We have compared the onset of sensory blockade between groups. The duration of analgesia and any significant side effects were also recorded. RESULTS: The onset of sensory blockade was significantly faster in group B (3.5 +/- 0.5 minutes) than group A (6.2 +/- 0.9 minutes). The duration of analgesia were not significantly changed between groups. Side effects of urinary retention, pruritus and nausea were noted between both groups but the difference was not significant. CONCLUSIONS: We have found that the onset time was 44% faster with warm lidocaine-fentanyl mixture (37 degrees C) than with the room temperature (25 degrees C). The improved clinical usefulness was achieved with no increase in side effects. The technique is a safe and effective method to reduce the latency of onset.
Analgesia ; Epinephrine ; Fentanyl ; Humans ; Lidocaine ; Nausea ; Pruritus ; Research Personnel ; Sensation ; Urinary Retention

PURPOSE: This research was intended to study on the knowledge and attitude of the medical students towards the organ donation in brain death, who will be in charge of organ donation and transplantation as health specialists in the future. METHODS: The data had been collected from 723 medical students who have finished clinical practice courses in 41 medical schools in Korea. RESULTS: 1) There were significant differences in the knowledge and attitude to the organ donation in brain death in gender and the location of university hospital. Another difference was caused by the ways to gain the information of it. In the case of attitude, there were notable differences according to the ways to obtain information of the organ donation and whether one accepts organ donation. 2) In the analysis of the knowledge of general features, the important factors were confirmed statistically by the location of university hospital and the way to get the information for organ donation. And in the attitude, the medical knowledge and the progress of brain death were more meaningful among other factors statistically. 3) The correlation between the knowledge and attitude of respondents about organ donation in brain death was not valuable statistically (r=0.055, P=0.142), on the other hand, in the medical knowledge (r=0.135, P=0.001) and the knowledge about progress of brain death (r=-0.075, P=0.043), were valuable statistically. CONCLUSION: For the strategy, they should be added to the medical college curriculum and clinical practice program about organ donation. In addition, medical students would recognize the importance, progress and the role of organ donation in brain death through this program. Eventually, they would have positive attitude about the organ donation and contribute to expand it.
Brain Death ; Curriculum ; Fees and Charges ; Hand ; Humans ; Korea ; Schools, Medical ; Specialization ; Students, Medical ; Surveys and Questionnaires ; Tissue and Organ Procurement ; Transplants