We report a case of adult granulosa cell tumor arising in the scrotal tunics. The patient was a 34-year-old man who presented with right scrotal swelling, first noticed four months previously. Under the initial clinical impression of epididymo-orchitis, antibiotic treatment was instituted but there was no response. The paratesticular nodules revealed by ultrasound and magnetic resonance imaging mimicked intratesticular lesion, and radical orchiectomy was performed. Although several cases of adult testicular granulosa cell tumor, have been reported, the occurrence of this entity in the paratesticular area has not, as far as we are aware, been previously described.
Adult ; Case Report ; Granulosa Cell Tumor/*diagnosis/surgery ; Human ; Magnetic Resonance Imaging ; Male ; Scrotum/*pathology/*ultrasonography ; Testicular Neoplasms/*diagnosis/surgery

PURPOSE: The purpose of this study is to investigate clinical features and causative organisms in febrile infants younger than three months, to help identification of high risk patients for serious bacterial infection (SBI). METHODS: A total of 313 febrile infants younger than three months, who had visited Seoul National University Children's Hospital from January 2008 to December 2010 were included. Clinical features, laboratory findings, causative organisms, and risk factors of SBI were analyzed by retrospective chart review. Causative bacterial or viral pathogens were identified by gram stain and cultures, rapid antigen tests, or the polymerase chain reaction from clinically reliable sources. RESULTS: Among 313 infants, etiologic organisms were identified in 127 cases (40.6%). Among 39 cases of bacterial infections, Escherichia coli (66.7%) and Streptococcus agalactiae (12.8%) were common. Enterovirus (33.7%), respiratory syncytial virus (19.8%), and rhinovirus (18.8%) were frequently detected in 88 cases of viral infection. Patients with SBI (39 cases) showed significantly higher values of the white blood cell count (14,473+/-6,824/mm3 vs. 11,254+/-5,775/mm3, P=0.002) and the C-reactive protein (6.32+/-8.51 mg/L vs. 1.28+/-2.35 mg/L, P<0.001) than those without SBI (274 cases). The clinical risk factors for SBI were the male (OR 3.7, 95% CI 1.5-8.9), the presence of neurologic symptoms (OR 4.8, 95% CI 1.4-16.8), and the absence of family members with respiratory symptoms (OR 3.6, 95% CI 1.2-11.3). CONCLUSION: This study identified common pathogens and risk factors for SBI in febrile infants younger than three months. These findings may be useful to guide management of febrile young infants.
Bacterial Infections ; C-Reactive Protein ; Enterovirus ; Escherichia coli ; Fever ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Male ; Neurologic Manifestations ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Rhinovirus ; Risk Factors ; Sepsis ; Streptococcus agalactiae

Fisting is an uncommon sexual activity, and death due to fisting is very rare. In the present report, we describe a case of a woman who died from fisting by her male partner. A 38-year-old woman went to a motel with a man after consuming alcohol, and there they kissed each other. As desired by woman, the man inserted his fingers into her vagina and anus, and later inserted his fist and forearm into her vagina and anus. After 20-30 minutes of fisting, the woman became unconscious and died. The autopsy confirmed the presence of perineal and vaginal lacerations with massive internal pelvic soft tissue injury with uterine artery rupture. A partial tear was noted at the rectosigmoid junction. The cause of death was hypovolemic shock due to uterine artery rupture. Following court trials, the assailant was sentenced to 4 years of imprisonment for the felony of inflicting bodily injury resulting in death.
Anal Canal ; Autopsy ; Cause of Death ; Female ; Fingers ; Forearm ; Humans ; Lacerations ; Male ; Rupture ; Sexual Behavior ; Shock ; Soft Tissue Injuries ; Unconscious (Psychology) ; Uterine Artery ; Vagina

No abstract available.
Korea

We found a sentence that was erroneously described in the page 81 of the article titled "National blood management system and the direction of government policy in Korea" published in June (Korean J Hematol 2010;45:81-3). The sentence should have been corrected as follows. Until 1999, blood was collected from paid donors because the selling of blood was prohibited by law. --> Blood collection from paid donors had gradually decreased until 1981 when it finally disappeared, and the selling of blood was declared illegal by law in 1999.

The affiliations were published incorrectly.

BACKGROUND AND OBJECTIVE: Whabyung is a Korean cultural disorder characterized by a combination of emotional stress and physical symptoms. Acupuncture, herbal medicines and other complementary medicinal treatments are used to treat the symptoms of whabyung. The purpose of this study is to investigate the effects of acupuncture treatment and herbal medicine treatments on anger, anxiety and depression of whabyung. METHODS: Using PubMed, CENTRAL, AMED, MEDLINE, EMBASE, MEDLINE, CINAHL, Cnii, CNKI, J-SATGE, PsycArticles, KISS, KoreaMed, kmbase, NDSL, RISS, OASIS and Korean Traditional Knowledge Portal, articles published by March 2017 for whabyung or whabyung-related syndrome were searched. The quality of selected articles was evaluated using RoB and RoBANS. The effects of acupuncture and herbal medicines on anger, anxiety, and depression levels of whabyung patients were considered for meta-analyses. RESULTS: Of the total 2408 articles retrieved from the database, 11 were finally selected and 4 articles were used for meta-analyses. Acupuncture reduced whabyung patients' anger and anxiety. Especially, the state anxiety was significantly reduced (effect size= −0.676, p= .026). Herbal medicine had effects on reducing anxiety and state anger while trait anger was increased without statistical significance. CONCLUSION: The present study showed the effectiveness of acupuncture and herbal medicines for whabyung patients in general. However, considering the limited availability of articles and the heterogeneity between them included for the meta-analysis, the results should be generalized with caution. In the future, more studies within the structure of evidence-based medicine need to be conducted to generate objective and valid evidences of korean medicine.

PURPOSE: This study was conducted to identify current health care management and barriers in health care management according to ecological systems, and to develop an ecological model for enhancing health care in child care centers. METHODS: Focus group interviews were conducted with directors and teachers of child care centers, and with parents of children enrolled in child care. Data were analyzed by the latent content analysis method. RESULTS: Twelve categories of health care management were identified. Barriers to child health care included knowledge deficit and lack of competence in health care by teachers, lack of useful health care manuals, non-existence of professional child health care personnel in child care centers, lack of mutual information sharing and disagreement on child health conditions between child care personnel and parents, lack of specific health related child care inspection criteria and time flexible child care centers with a lack of policy on collaboration with health care facilities. The ecological model developed included specific strategies to improve health care management in child care. CONCLUSION: The proposed ecological model to improve child health care management should be useful to plan future health care program considering both the immediate and indirect social environment surrounding children in child care.
Child ; Child Care ; Child Health ; Child, Preschool ; Cooperative Behavior ; Delivery of Health Care ; Ecology ; Ecosystem ; Focus Groups ; Humans ; Information Dissemination ; Mental Competency ; Parents ; Social Environment

PURPOSE: This study was done to examine the attitude and awareness of nurses about rooming-in for new mothers and their infants. METHODS: Data were collected from 462 nurses from 40 hospitals from August 10 to September 20, 2008 using a questionnaire, and the collected data were analyzed using descriptive statistics, t-test and ANOVA. RESULTS: The mean score for attitude and awareness of nurses about rooming-in was 3.02 (range=2.13~3.80), which indicates that the nurses had positive opinions of the system. The factors with the highest and lowest scores were awareness of a successful implementation method (mean=3.35) and awareness of the advantages and disadvantages of the system (mean=2.73), respectively. The attitude and awareness of nurses about rooming-in differed significantly with age, religion, education level, parity, type of hospital, hospital nurse staffing grade (bed-to-nurse ratio), and presence of a rooming-in system. CONCLUSION: This results of the study show that attitudes and awareness of nurses to rooming-in differed significantly according to personal factors (age, parity, religion, educational level) and work characteristics (hospital type, hospital nurse staffing grade, presence of rooming-in system). These findings can be used as basic data in determining optimal strategies for a system of rooming-in in the future.
Attitude of Health Personnel ; Female ; Humans ; Infant ; Mothers ; Parity ; Surveys and Questionnaires ; Rooming-in Care

Over the past 30 years, there has been an increase in the incidence of multifetal pregna-ncies, primarily because of the introduction of ovarian stimulants for ovulation induction and assisted reproductive technology ( ART ) in infertile patients. It is well established that multifetal pregnancies are associated with an increased frequency of the maternal complications and gre-ater perinatal morbidity and mortyality. The adverse outcome of multifetal pregnancies is dire-ctly proportional to the number of fetuses, primarily as an consequence of prterm delivery. Re-duction in the number of fetuses in multifetal pregnancies has been proposed as a way to impr-ove the perinatal outcome in this situation. Therefore, selective fetal reduction ( SFR ) is sugges-ted as a therapeutic option for continuation of pregnancy with fetuses mature enough to survi-ve. In this paper, we report our infertility clinic experiences with 6 patients who carried mult- ifetal pregnancies including 1 quintuplet, 1 quadruplet, and 4 triplets. from January, 1991 to May, 1996, transabdominal SFR was accomplished by fetal intrathoracic KCl injection at 9~10 weeks of gestation. After the prcedure, 4 patients remained as twin pregnancies, and 2 patients as single pregnancy. There have been 3 sets of twin deliveries and the 2 sets of single delivery. One case was aborted. Two patients were delivered after 37 weeks of gestation, 2 patients were at 35 weeks, and 1 patient at 24 weeks. All babies have been healthy after birth in patients after 35 weeks gestation. There was no fetal anomaly related to the procedure in the 6 cases. We concluded that transabdominal SFR is a rather safe and useful procedure that may improve the outcome of multifetal pregnancies.
Fetus ; Humans ; Incidence ; Infertility ; Ovulation Induction ; Parturition ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Twin ; Quadruplets ; Quintuplets ; Reproductive Techniques, Assisted ; Triplets ; Twins