BACKGROUND: The accidental swallowing of foreign body is a common problem in the children. Ingested foreign bodies may be managed by endoscopy, observation, or surgery. So we analyzed the methods of removal, type, location and complications of foreign bodies. MATERIALS AND METHODS: This report reviewed 37 cases of ingested foreign body in the gastrointestinal tract at the Department of Pediatrics, Yeungnam University Hospital between January 1997 and April 2001. RESULTS: The age ranged from 8 months to 8 years. The most prevalent age group was between 1 year and 2 years of age(19%). The male to female ratio was 2.1:1 with 25 male and 12 female patients. The type of foreign bodies were coins in 20 cases(54%), nail in 4 cases(11%), key in 4 cases(11%), pin in 2 cases(5.5%), necklace in 2 cases(5.5%) and others. The locations of foreign bodies were upper esophagus in 12 cases(32.5%), lower esophagus in 4 cases(10.8%), stomach in 16 cases(43.2%), small bowel in 5 cases(13.5%). 4. Presenting symptoms were variable with asymptomatic (59. 4%) , vomiting (19. 0%) , epigastric pain (8.1%), dysphagia (5. 4%) and others. The methods for removal of foreign bodies included 20 cases of endoscopic removal(54.0%), 3 cases of spontaneous removal(8.1%) and there was no surgical removal. 14 cases(37.9%) did not confirmed removal of foreign body because of no revisit of our hospital. Endoscopic finding of patients were normal(15 cases), ulceration(2 cases), erosion(1 case), inflammation(l case), mucosal scratch(l case). CONCLUSION: It appears that the endoscopic approach is the preferable method for the removal of upper gastrointestinal foreign bodies in the children.
Child* ; Deglutition ; Deglutition Disorders ; Endoscopy ; Esophagus ; Female ; Foreign Bodies* ; Gastrointestinal Tract* ; Humans ; Male ; Numismatics ; Pediatrics ; Stomach ; Vomiting

Mechanical obstruction of the common hepatic duct includes the following causes; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the “syndrome del conducto hepatico” in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mrizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a variant of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of 38℃, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/cm3; albumin 2.6 g/dl (normal 0-1) with the direct bilirubin, 4.4 mg/dl (normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction (Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.
Abdominal Pain ; Aged ; Biliary Tract ; Bilirubin ; Calculi ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Choledocholithiasis ; Common Bile Duct ; Constriction, Pathologic ; Cystic Duct ; Cytochrome P-450 CYP1A1 ; Gallbladder ; Gallstones ; Hepatic Duct, Common ; Humans ; Inflammation ; Jaundice, Obstructive ; Lymph Nodes ; Mirizzi Syndrome* ; Neck ; Physical Examination ; Sclera ; Sclerosis ; Ultrasonography

PURPOSE: Kawasaki disease is probably driven by abnormalities of the immune system after infectious insult. In this report, a clinical review with laboratory parameters and the changes of the plasma levels of chemokines(RANTES and Gro-alpha was undertaken according to the clinical stage of Kawasaki disease. METHODS: This investigation included 74 samples from 21 patients(10 boys, 11 girls; mean age, 27.8 months) with Kawasaki disease who met the revised diagnostic guidelines and 5 samples from healthy children. The plasma levels of RANTES and Gro-alpha were measured by enzyme- linked immuno-sorbent assay(ELISA). To analyze the pattern of the gene expression of chemokine mRNA for lymphotactin(Ltn), RANTES, IP-10, MIP-1 beta, MIP-1 alpha MCP-1, IL-8 and I-309 in the peripheral blood monocyte, ribonuclease protection assays(RPA) were performed in 3 patients whose plasma levels of RANTES were very low and not significantly changed after intravenous immunoglobulin(IVIG) treatment. RESULTS: The production of RANTES and Gro-alpha were markedly elevated during the acute and subacute phases of Kawasaki disease compared to those of the normal control. In addition, interestingly, the changing patterns of plasma level of chemokines were not consistent(biphasic) after IVIG treatment. According to the RPA, the expression of RANTES was the most prominent among 8 kinds of chemokines and elevated in all phases of Kawasaki disease. But, there was no ovious relation between clinical characteristics of the disease including the coronary artery dilatation and the level of RANTES. CONCLUSION: These finding suggested that RANTES and Gro-alpha may play an important role in pathophysiology of the Kawasaki disease. Longer follow-up and more case studies will be needed to clearly establish the significance of the changes of RANTES and Gro-alpha in the pathophysiology of Kawasaki disease.
Chemokine CCL5* ; Chemokines ; Child ; Coronary Vessels ; Dilatation ; Female ; Follow-Up Studies ; Gene Expression ; Humans ; Immune System ; Immunoglobulins, Intravenous ; Interleukin-8 ; Monocytes ; Mucocutaneous Lymph Node Syndrome* ; Plasma ; Ribonucleases ; RNA, Messenger

PURPOSE: To attain improvement in prognosis of patients suffering acute ischemic strokes (AIS), it is crucial to diagnose these swiftly and accurately. It is generally believed that female patients have a less favorable outcome, but there has not yet been sufficient data to confirm this opinion. The authors herein conducted a study to determine whether the symptoms of AIS differ between males and females. METHODS: A retrospective study was conducted on 322 consecutive patients who were diagnosed with AIS on the basis of MRI findings during the last two years. Demographic findings and clinical features were collected from emergency room records in order to evaluate gender differences. RESULTS: There were 148 female patients (45.8% of total) in our study, and the average age of affection for females was significantly higher than males. Our data did not achieve statistical significance; however, we observed the following tendencies: the time from symptom onset to admission was delayed in female group; both traditional and nontraditional symptoms were more prevalent in the male group; and atypical symptoms were observed in the female group. CONCLUSION: No gender difference was observed in the incidence of acute ischemic stroke. However, the proportion of atypical symptoms was relatively higher in female patients. Factors resulting in delay clinical attention and contributing to the observed discrepancy between genders in AIS diagnosis should be validated and investigated further.
Diagnosis ; Emergency Service, Hospital ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Prognosis ; Retrospective Studies ; Stroke*

Candida albicans cystitis is an uncommon but well described complication of modern therapeutics. The significance of systemic factors in the defense of the urinary tract against candidal infection is unknown. However, secretions from the prostate grand in men and from periurethral glands in women have been reported to be fungistatic. Conditions that predispose to candiduria include diabetes mellitus, antibiotic and corticosteroid therapy and disturbance of urine flow. Cystoscopy with bladder biopsy are necessary to rule out bladder tumor. We report a case of BPH with candidal cystitis and review the relevant literatures.
Biopsy ; Candida albicans* ; Candida* ; Cystitis* ; Cystoscopy ; Diabetes Mellitus ; Female ; Humans ; Male ; Prostate ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Tract

No abstract available.
Brain* ; Evaluation Studies as Topic* ; Photic Stimulation* ; Tomography, Emission-Computed, Single-Photon*

Pelvic visceral pain associated with both cancer and chronic benign conditions may be alleviated by superior hypogastric plexus block (SHPB). The complications of SHPB include infection, bleeding, or intravascular injection because of the adjacent location of the iliac vessel to the route of needle insertion, and pelvic visceral damage. However, acute ureteral obstruction leading to acute renal failure (ARF) as a complication of SHPB has not been reported to date in the literature. We report a patient with ARF that resulted from acute ureteral obstruction following SHPB performed for the relief of lower abdominal pain and tenesmus in metastatic ureter cancer.
Abdominal Pain ; Acute Kidney Injury ; Hemorrhage ; Humans ; Hypogastric Plexus* ; Needles ; Ureteral Neoplasms ; Ureteral Obstruction* ; Visceral Pain

We report a case of old gravel aspiration in a 57-year-old man who had been accidentally buried in a field of construction for ten hours, three years prior. A chest radiograph showed peribronchial pneumonic infiltrates in the right lower lobe, with a proximal ovoid radiopaque endobronchial density at the trunchus basalis. These findings were more clearly visualized on the 64-channel multidetector CT (MDCT). Moreover, the patient recovered from his condition, following a bronchoscopic retrieval. However, the patient had persistent bronchiectasis of the right lower lobe on a subsequent follow-up chest radiograph, one month later.
Adult ; Bronchiectasis ; Follow-Up Studies ; Foreign Bodies ; Humans ; Middle Aged ; Thorax ; Tomography, X-Ray Computed

Purpose: The purpose of this study was to figure out the association of nursing activity participation and clinical practice stress with career maturity during clinical practice among nursing college students. Methods: Participants of the study were 201 nursing college students located in nationwide regions. Data collection was performed between July 18 and August 8, 2019. Data analyses were performed through an independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple linear regression analysis using SPSS WIN 25.0. Results: The results of this study were as follows. We ran multiple regression analyses to see which critical factors influenced career maturity. The general characteristics significantly associated with career maturity were preference for clinical nursing, admission to nursing college due to belief, time off, and being satisfied with clinical practice. Regarding clinical practice stress, clinic environment, interpersonal relationship conflict, inappropriate role model and conflict with patients were significantly associated with career maturity. Conclusion This study suggested that, to improve nursing students’ career maturity, nursing colleges and training fields should collaboratively make an efforts to reduce students’ stress by building educational clinic environments including managing conflicts in interpersonal relationships among patients, caregivers, and medical and non-medical personnel, and improving inappropriate role models in nursing.

PURPOSE: Sudden, unexpected pediatric death triggers acute grief in most survivors. In this study, we analyzed the pediatric death in emergency room in order to find out the factors for minimized unexpected pediatric death and increase awareness of these conditions. METHODS: We performed a review on the records of 63 patients under the age of 16 years who died before and after admission to the emergency room of Yeungnam University Hospital during a 5 year period from January 1996 to December 2000. RESULTS: Among the total of 63 patients who died, 33 were male(52.4%) and 30 were female (47.6%). The most prevalent age group was between 1 month and 1 year of age(38%). We classified 3 categories by the direct cause of death, disease 21 cases(33%), accident 19 cases(30%), unknown 23 cases(37%) respectively. Among 23 cases of unknown cause of death, 13 cases(56.5 %) had been placed under medical attention for underlying diseases : these were 7 cases of neurologic disorder(30.4%) 5 cases of congenital heart disease 5 cases(21.7%) and 1 case of metabolic disease(4.4%). The most common types of accident were traffic accident(10 cases; 52.6%) and the next were drowning(4 cases; 21%), asphyxia(3 cases; 15.8%). CONCLUSION: In unexpected pediatric death, among unknown causes of death, the number of patients who had an underlying disease was greater than these patients who did not. We conclude, more attention needs to be paid to underlying disease, especially congenital heart disease and neurologic disease. A parents teaching program is necessary emergency for situations. This would decrease cases of unexpected pediatric death.
Cause of Death ; Emergencies* ; Emergency Service, Hospital* ; Female ; Grief ; Heart Defects, Congenital ; Humans ; Parents ; Survivors