PURPOSE: The purpose of this study was to identify the influencing factors on postpartum fatigue in the parturient women. METHODS: The data were collected from July to September, 2006 using self-report questionnaires. The sample was 143 healthy parturient women who visited the outpatient clinic at 2 hospitals for a routine follow up after childbirth. The data were analyzed by using SPSS 12.0 Win program. RESULTS: There were significant differences in the postpartum fatigue by age, religion, sleep hour, and complaint of perceived health problem. The postpartum fatigue were significantly correlated with infant care stress(p<0.001), sleep satisfaction(p<0.001), and feeding difficulty(p=0.016). The multiple regression analysis showed that the postpartum fatigue were significantly predicted by the infant care stress, sleep satisfaction and complaint of perceived health problem. These variables explained 31.8% of the variance of postpartum fatigue. The infant care stress was the main predictor of postpartum fatigue. CONCLUSIONS: It could be concluded that the nursing intervention for reducing the infant care stress should be developed to manage the postpartum fatigue for parturient women. Prospective studies are needed to be conducted to verify the causal relationship between infant care stress and postpartum fatigue.
Ambulatory Care Facilities ; Fatigue* ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant Care ; Nursing ; Parturition ; Postpartum Period* ; Surveys and Questionnaires

Various anatomical defects have been described in the surviving co-twin who had stillborn, macerated monozygotic co-twin with disseminated intravascular coagulation. The suggested mechanism was the transfer of emboli or thromboplastic materials of dead fetus to co-twin through placental vascular anastomoses. Multicystic encephalomalacia is the condition defined anatomically by the presence of multiple cavities in the great part of both cerebral hemispheres. The most common pathogenesis is circulatory disturbance caused by neonatal asphyxia during the perinatal period. We experienced two cases of monozygotic twin with deceased co-twin at 26 weeks, 33 weeks of gestation and confirmed the diffuse multicystic encephalomalacia by cranial ultrasonography and MRI in a surviving co-twin. Only one patient has been followed who showed spastic cerebral palsy and severe mental retardation. We report two cases of multicystic encephalomalacia in a surviring co-twin with a intrauterine fetal death and its related literatures.
Asphyxia ; Cerebral Palsy ; Cerebrum ; Disseminated Intravascular Coagulation ; Encephalomalacia* ; Fetal Death* ; Fetus ; Humans ; Intellectual Disability ; Magnetic Resonance Imaging ; Pregnancy ; Pregnancy, Twin ; Twins, Monozygotic ; Ultrasonography

In a series of 20 young rats, three cortical lesions were made in each hemisphere. Two of these lesions were filled with avitene and gelfoam, while the third was left empty as a control. The animals were killed successively on weeks 1, 2, 4 and 8 after the operation. The results were as follows : 1) Although there was no difference in the type of tissue reactions, avitene was more rapid and profound than gelfoam in the process and degree of inflammatory reaction at the same periods. 2) Avitene biodegradaded more rapidly than gelfoam. 3) The extent of fibrosis and adhesion to the surrounding brain tissues were not grossly different between these two agents but more profound histopathologically in avitene at the same periods. With these results, we could conclude that the avitene was superior to the gelfoam as the hemostatic agent in neurosurgical area.
Animals ; Brain* ; Collagen ; Fibrosis ; Gelatin Sponge, Absorbable ; Rats

PURPOSE: To evaluate MRI(Magnetic Resonance Imaging) findings of miliary tuberculosis of the brain. MATERIALS AND METHODS: Six patients with miliary tuberculosis of the brain diagnosed by characteristic clinical or laboratory findings were studied with spin echo MRI before and after contrast enhancement. We retrospectively evaluated MRI findings acording to the appearance, distribution, location, and enhancement pattern of the granulomas as well as associated other abnormalities. RESULTS: In six patients, contrast-enhanced MRI of thebrain showed numerous punctate, contrast enhancing lesions scattered throughout the brain. Unenhanced MRI failed to demonstrate small granulomas except a few small foci of high signal intensity on T2-weighted images. The shapes of enhancing granulomas were homogeneous nodular enhancement in 86% of cases and small ring enhancement in 14%.98% of granulomas were smaller than 3-mm and 2% were larger. Although several lesions were located in the basalganglia, thalamus, and brain stem, the majority were located in the subpial and subarachnoid space. There was no significant difference in distribution of granulomas between the supratentorial and the infratentorial areas. Other associated abnormalities were focal meningitis in five cases and focal cerebritis in one. On chest radiograph, all patients had miliary tuberculosis in the lungs. CONCLUSION: Contrast-enhanced T1-weighted MRimaging showed numerous round, very small enhancing lesions scattered throughout the brain. The majority of lesions were located in the subpial and subarachnoid space. Contrast-enhanced T1-weighted images are helpful inthe detection and diagnosis of miliary disseminated tuberculous granulomas and meningitis.
Brain Stem ; Brain* ; Diagnosis ; Granuloma ; Humans ; Lung ; Magnetic Resonance Imaging* ; Meningitis ; Subarachnoid Space ; Thalamus ; Tuberculosis, Central Nervous System ; Tuberculosis, Miliary*

Although hypoglycemia may be common among neonates, brain injuries resulting from isolated neonatal hypoglycemia are rare. The condition may cause neurological symptoms such as stupor, jitteriness, and seizures, though in their absence, diagnosis is delayed or difficult. Hypoglycemia was diagnosed in a three-day-old neonate after he visited the emergency department with loose stool, poor oral intake, and decreased activity, first experienced two days earlier. Two days after his visity, several episodes of seizure occurred. T2 and diffusion-weighted magnetic resonance (MR) scanning, performed at 11 days of age, revealed bilateral and symmetrical high signal intensity lesions in occipital, parietal, and temporal lobes. We report the MR findings of hypoglycemic encephalopathy in a neonate.
Brain Injuries* ; Brain* ; Diagnosis ; Emergency Service, Hospital ; Humans ; Hypoglycemia* ; Infant, Newborn ; Rabeprazole ; Seizures ; Stupor ; Temporal Lobe

Mental deterioration and signs of cerebellar dysfunction developed 5 years after lateral ventricle shunting in 36-year-old hydrocephalic female patient. Fourth ventricle enlargement was seen on CT scan. Reevaluation of the cerebrospinal fluid pathways with metrizamide ventriculography showed isolated fourth ventricle with aqueductal stenosis. Shunting of the fourth ventricle with an Y-connector returned the patient to normal neurological status.
Adult ; Cerebellar Diseases ; Cerebrospinal Fluid ; Female ; Fourth Ventricle* ; Humans ; Hydrocephalus* ; Lateral Ventricles ; Metrizamide ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt

A case of peripheral T-cell lymphoma, large cell type(NIH) is reported. The literature review yielded a rare case report of a malignant lymphoma especially in the even more rare epidural site. The patient's symptoms were relieved by decompressive laminectomy and subtotal removal of mass and combined scheduled chemotherapy with radiotherapy. The pathological examination revealed malignant lymphoma, diffuse, large cell type(NIH) by H & E and immunologic marker analysis.
Biomarkers ; Drug Therapy ; Epidural Space* ; Laminectomy ; Lymphoma ; Lymphoma, T-Cell, Peripheral* ; Radiotherapy

A retrospecive clinical observation was done on 325 cases of hypertension admitted to Department of internal Medicine of Seoul Red Cross Hospital from January, 1979 to December, 1982. The following results have been obtained. 1) The observed patients were 157 males and 168 females, and the prevalence rate of malignant hypertension among 325 hypertensions was 16 cases (4.9 percent). Among 16 cases of malignant hypertension 9 cases were male and 7 cases were female. Most frequently in 50, 60 and 40 years of age in this order each sex. 2) The average admitted dates are 7 days. 27 cases (8.3percent) were readmitted above 2 times after one discharged. 3) The most freqeuntly observed duration of Known hypertension 37.9 percent was 6-10 years and the next frequently observed duration 37.4 percent was 3-5 years. 4) The highest percentage of malignant hypertension had systolic blood pressure between 190-209mmHg and diastolic blood pressure between 150-169mmHg. 5) The highest percentage of seasonal number was spring (31.1 percent) and the next autumn, summer, winter in this order and the prevalence rates of hypertention are increased average 1.9% of each year. 6) The 78.5 percent of the patients were found that their blood pressure were abnormaly high when they were examined with related symptoms on admission, and they major symptorms were headache and dizziness. 7) The physical examination on admission, tachycardia (56percent), tachypnea (15.1percent), semicoma to coma (12.9 percent) in this order. 8) The status of treatment in hypertension on admission was as follows; imtermittent treatment 54.5 percent, no treatment 31 percent and continuous treatment 14.5 percent in this order. 9) In the chest X-ray on admission, the most frequent finding was cardiomegaly, and normal finding was the next frequency. The pulmonary Tbc was noted in 12.6 percent. 10) According to the degree of fundoscopic abnormality by K-W classification stage III was 68.8 percent and stage IV was 31.2 percent. 11) Electrocardiogram abnormalities were 44.9 percent, and 87.5 percent of malignant hypertension revealed electrocardiographic abnormalities and left ventricle hypertrophy was observed in 70.5 percent. 12) Hypercholesterolemia 78 percent, Hypernatremia 69.8 percent, Hypokalemia 22.8 percent, serum chloride 34.5 percent (<95m Eg/l), BUN 53.8 percent (>20mg/dl) and creatinine 45.8 percent (>3mg/dl) on admission. 13) Proteinuria was observed in 87.5 percent of malignant hypertension. 14) Marked improved for clinically was 24 percent and mortality rate was 5.2 percent, most common cause of death are cardiovascular accident (64.7percent) and renal failure (23.5percent).
Blood Pressure ; Cardiomegaly ; Cause of Death ; Classification ; Coma ; Creatinine ; Dizziness ; Electrocardiography ; Female ; Headache ; Heart Ventricles ; Humans ; Hypercholesterolemia ; Hypernatremia ; Hypertension ; Hypertension, Malignant ; Hypertrophy ; Hypokalemia ; Internal Medicine ; Male ; Mortality ; Physical Examination ; Prevalence ; Proteinuria ; Red Cross ; Renal Insufficiency ; Seasons ; Seoul ; Tachycardia ; Tachypnea ; Thorax

This is a review of gastric resection surgeries that were carried out in 570 patients with stomach cancer who were admitted to Kyung Hee University Hospital from January, 1989 through December, 1993. In order to establish the incidence of cholelithiasis after gastric resection, patients was examined with abdominal ultrasonography preoperatively and postoperatively. The prevalence of cholelithiasis at admission was 4.6%. Study candidates consisted of 366 patients, except those who had cholelithiasis preoperatively and who didn't have a follow-up after gastric resection. Cholelithiasis after gastric resection developed in 16.4%(60/366) of patients, and which was significantly higher than incidence of cholelithiasis at admission(p<0.05). The incidence of cholelithiasis was not related significantly to the sex or age of the patients(p>0.05). In 51.6%(31/60) of patients, cholelithiasis have developed within 1 year after operation. The incidence of cholelithiasis after total gastrectomy with esophagojejunostomy(21.8%) was higher than subtotal gastrectomy with gastrojejunostomy(15.3%) or with gastroduodenostomy(14.3%), but it was not shown to be a statistical difference(p>0.05). There was no relation between the incidence of cholelithiasis and the stage of the stomach cancer. Four of the sixty patients presenting cholelithiasis underwent cholesystectomy because of significant billiary symptoms. In conclusion, cholelithiasis appears to be a frequent complication after gastrectomy. It may be related to the vagotomy which is performed at the time of gastric resection.
Cholelithiasis* ; Follow-Up Studies ; Gastrectomy ; Humans ; Incidence ; Prevalence ; Stomach Neoplasms* ; Stomach* ; Ultrasonography ; Vagotomy

A series of 54 adult patients with intraventricular hemorrhage(IVH) diagnosed by computed tomography(CT) scan and treated with external ventricular drainage were reviewed. In cases who occurred poor drainage of bloody cerebrospinal fluid obstruction, irrigation with urokinase solution(6,000 U/ml) was tried. Hypertension and ruptured aneurysms accounted for 65% of the cases. Although most cases showed poor prognosis, we experienced dramatic improvements in four comatose patients who had fixed dilated pupils after spontaneous intraventricular hemorrhage with secondary acute hydrocephalus. We believe ventriculostomy to be effective in managing IVH especially in the early stage before cerebral herniation occurs. This procedure, accomplished by a convenient and relatively simple technique, led to evacuration of intraventricular blood, or the temporary or permanent cessation of progression of the hydrocephalic process, decrease in ventricular size, and normalization of ICP. However, a relatively high incidence of infection was problematic.
Adult ; Aneurysm, Ruptured ; Cerebrospinal Fluid ; Coma ; Drainage* ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Prognosis ; Pupil ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator ; Ventriculostomy