No abstract available.
Breast* ; Milk, Human*

OBJECTIVE: The indications and optimal surgical treatments for intracranial cysts are controversial. In the present study, we describe long-term clinical and neuroimaging results of surgically treated intracranial cysts in children. The goal of this study is to contribute to the discussion of the debate. METHODS: This study included 110 pediatric patients that underwent surgeries to treat intracranial cysts. Endoscopic cyst fenestrations were performed in 71 cases, while craniotomies and cyst excisions (with or without fenestrations) were performed in 30 patients. Cystoperitoneal shunts were necessary for nine patients. Long-term results were retrospectively assessed with medical and neuroimaging records. RESULTS: Clinical and radiological improvement was reported in 87.3% and 92.8% of cases, respectively, after endoscopic neurosurgery, and in 93.3% and 100% using open microsurgery whereas 88.9% and 85.7% after shunt operation. There were no statistical differences in clinical outcomes (p=0.710) or volume reductions (p=0.177) among the different surgeries. There were no mortalities or permanent morbidities, but complications such as shunt malfunctions, infections, and subdural hematomas were observed in 56% of the patients that had shunt operations. A total of 13 patients (11.8%) underwent additional surgeries due to recurrences or treatment failures. The type of surgery performed did not influence the recurrence rate (p=0.662) or the failure rate (p=0.247). CONCLUSION: Endoscopic neurosurgeries are less invasive than microsurgeries and are at least as effective as open surgeries. Thus, given the advantages and complications of these surgical techniques, we suggest that endoscopic fenestration should be the first treatment attempted in children with intracranial cysts.
Arachnoid Cysts ; Central Nervous System Cysts ; Child ; Craniotomy ; Hematoma, Subdural ; Humans ; Microsurgery ; Neuroendoscopy ; Neuroimaging ; Neurosurgery ; Recurrence ; Retrospective Studies ; Treatment Failure

This study was understand in order to examine the effect of hardness on stress-causing factors, defined in this study as burnout in nursing. The subjects were 248 nurses working in three general hospitals in Taejon. The instruments used for this study were a survey of general characteristics, modified Health-Related Hardiness Scale(HRHS) (25 items), job stress scale (63 items), and burnout scale(20 items). Analysis of data was done through the mean, percentage, Person correlation coefficient, and stepwise multiple regression done with a SAS program. The results of this study are as follows. 1) The average item score for the job stress was high at 4.44. In the subcategories, the highest degree of stress was night duty(5.11), and work overload(4.70), responsibility for extra affairs(4.70), conflict in nurse-doctor relationships(4.69), and low reward (4.63) in that order. 2) In the stepwise multiple regression analysis, hardiness(11.55%) was a significant determinant of burnout along with job stress(17.24%) and job duration(12.94%). The results of this study show that hardiness has an effect on psychological distress caused by stress.
Daejeon ; Hardness ; Hospitals, General ; Humans ; Nursing ; Reward

PURPOSE: The purpose of this study was to describe the essential structure of the lived experience of working mothers' parenting burden in Korea. METHODS: Eight working mothers with young children were interviewed. The Colaizzi analysis of phenomenological research was applied. RESULTS: Seven theme clusters were extracted: a life with constant conflict, sense of guilt, feeling anxious because of lack of information about education for their children, social stigma as a deficient mother, family relationship becoming distant, a life being exhausted, day to day struggle. CONCLUSION: These results provide an opportunity to have a better understanding of the experiences of working mothers related to parenting their young children. It would also serve as a medium for the formulation of appropriate nursing intervention relevant to burdens of parenthood.
Child ; Family Relations ; Guilt ; Humans ; Korea ; Mothers ; Parenting ; Parents ; Social Stigma

Gliomas are the most common pediatric tumors of the central nervous system. In this review, we discuss the clinical features, treatment paradigms, and evolving concepts related to two types of pediatric gliomas affecting two main locations: the optic pathway and thalamus. In particular, we discuss recently revised pathologic classification, which adopting molecular parameter. We believe that our review contribute to the readers' better understanding of pediatric glioma because pediatric glioma differs in many ways from adult glioma according to the newest advances in molecular characterization of this tumor. A better understanding of current and evolving issues in pediatric glioma is needed to ensure effective management decision.
Adult ; Brain Neoplasms ; Central Nervous System ; Classification ; Glioma ; Humans ; Optic Tract ; Pediatrics ; Thalamus ; Treatment Outcome

BACKGROUND AND OBJECTIVES: This study was designed to examine the effects of diamide and thioredoxin (TRX) on vascular endothelial cells in order to clarify the mechanism by which vascular damage is mediated by oxygen free radicals. MATERIALS AND METHODS: The pulmonary artery endothelial cell (PAEC) line derived from bovine serum was cultured for 8 hours in media supplemented with various concentrations of diamide and TRX. The XTT assay, MTS assay, SRB assay, LDH activity and lipid peroxidation tests were perfomed. RESULTS: In XTT and MTS assays, diamide significantly decreased the cell viability of cultured PAEC in a dose- and time-dependent manner. Diamide showed a decrease in the amount of total protein, although it showed an increase of lipid peroxidation and LDH activity in cultured PAEC. In regards to the protective effect of TRX on diamide-induced cytotoxicity, this showed an increase of total protein, however it showed a decrease of lipid peroxidation and LDH activity. CONCLUSION: Our results suggest that diamide has a vasculotoxic effect on cultured bovine PAEC and that TRX is very effective in the protection of diamide-induced cytotoxicity by duye to the increase of total protein and the decrease of lipid peroxidation and LDH activity in these cultures.
Cell Survival ; Diamide* ; Endothelial Cells* ; Endothelium, Vascular ; Free Radicals ; Lipid Peroxidation ; Oxygen ; Pulmonary Artery ; Thioredoxins*

BACKGROUND: ABO genotyping is being used increasingly when the results of serologic typing are unclear or there is some suspicion of rare ABO subtypes. Conventional molecular diagnostic methods such as PCR- restriction fragment length polymorphism (PCR-RFLP), allele-specific PCR, PCR-single stranded conformational polymorphism (PCR-SSCP) and sequence-based typing have been used in this field. Recently, a pyrosequencing technique was introduced into clinical laboratories. This study evaluated the possibility of applying pyrosequencing to ABO genotyping. METHODS: A total of 36 samples, which had previously been analyzed by PCR-RFLP and serological method in the Blood Genetics Clinic of Seoul National University Hospital between August 2001 and September 2004 and shown to have the A/A, A/B, A/O, B/B, B/O, O/O, cis-AB/O, cis-AB/A, or cis-AB/B genotypes, were analyzed by pyrosequencing analysis. Briefly, two PCR reactions were carried out separately for one region including nucleotide 261, and for another region including nucleotides 796 and 803. Pyrosequencing was then performed, and the pyrograms were interpreted using an automated interpretation program from the manufacturer and by researchers independently to determine the nucleotides 261, 796 and 803 for ABO genotyping. RESULTS: The ABO genotypes from pyrosequencing and the interpretation of the pyrograms according to the researcher on 36 samples were in complete concordance with the results obtained by PCR-RFLP. The ABO genotypes from the automated interpretation program showed an error in one out of total 108 SNP (single nucleotide polymorphism) analyses (eRROR RATE=0.9%) OF 36 SAMPLES. CONCLUSION: ABO genotyping for A, B, O, cis-AB alleles by pyrosequencing of nucleotides 261, 796 and 803 was relatively simple and accurate and could be an another field we can use in clinical laboratories.
Alleles ; Genetics ; Genotype ; Nucleotides ; Pathology, Molecular ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Seoul

Purpose : The purpose of this study was to obtain epidemiologic data and overall risk of complications of short term peripheral intravenous catheters. METHODS: The data was collected prospectively from August 19 to september 13, 2002. The subjects of this study were 350 adult patients hospitalized to the internal medicine a surgical general ward. Catheter sites were inspected daily from insertion to removal by infection control nurses, and characteristics of patients and catheters were recorded. Phlebitis was defined as one of the followings along the course of the vein: erythema, warmth. swelling or tenderness. RESULTS: Overall incidence of the phlebitis associated with short-term catheter was 23.7%. Catheters were removed when routine catheter replacement (every 72 hours) was occurred in 24.9%, phlebitis 23.7%. discharge of patients 13.1%, change of heparin cap 9.7%, others 28.6%. There were no significant differences in the incidence of the phlebitis by sex, age, the type of dressing, the duration of catheter placement insertion site, the type of hospitalized ward' and the size of cannula. The incidence of phlebitis was the highest (36.1%) within 48-72 hours after insertion. There was significant difference in the incidence of phlebitis according to the types of infusate. 75 of 83 phlebitis cases (90.4%) were received chemical infusates. Especially glucose/aminoacid, TPN and intralipose were attributed to major risk factor of phlebitis associated with short-term catheter (P<0.05). CONCLUSION: The incidence rate of phlebitis associated with short-term catheter was 23.7%. In this study, the type of infusate was the significant risk. factor related to phlebitis. Consequently, in order to prevent and detect the phlebitis associated with short-term catheter early, a consistent, organized assessment and evaluation of the above factors during the intravenous therapy is needed.
Adult ; Bandages ; Catheters* ; Epidemiologic Studies* ; Erythema ; Heparin ; Humans ; Incidence ; Infection Control ; Internal Medicine ; Korea* ; Patients' Rooms ; Phlebitis* ; Prospective Studies ; Risk Factors ; Seoul* ; Veins

The association of thymoma with pure red cell aplasia has been well documented, but amegakaryocytic thrombocytopenia is not a recognized paraneoplastic syndrome complicating thymoma. We report a case of thymoma-complicated pure red cell aplasia and amegakaryocytic thrombocytopenia in a 73-yr-old woman. Pure red cell aplasia was diagnosed seven months after the detection of thymoma. One year after the diagnosis of pure red cell aplasia and seven months after thymectomy, bone marrow aspiration and biopsy showed an absence of megakaryocytes, marked erythroid hypoplasia with normal myeloid series. A diagnosis of amegakaryocytic thrombocytopenia and pure red cell aplasia was made. Oral steroid maintenance therapy resulted in recovery of platelet count. She has still transfusion-dependant anemia but platelet and neutrophil counts had been maintained in normal range for more than five months, until the last follow-up. We think that autoreactive T cells may induce a clinical autoimmune response even after eradication of thymoma, and aplastic anemia as a late complication following thymectomy was described in previous cases. This patient also has to be under a close observation because of the possibility to evolve into aplastic anemia.
Aged ; Bone Marrow/pathology ; Female ; Humans ; Imidazoles/therapeutic use ; Megakaryocytes/pathology ; Pregnadienetriols/therapeutic use ; Red-Cell Aplasia, Pure/complications/*diagnosis ; Thrombocytopenia/*diagnosis/drug therapy/*etiology ; Thymectomy/*adverse effects ; Thymoma/*complications/diagnosis/surgery ; Thymus Neoplasms/*complications/diagnosis/surgery

BACKGROUND: To ensure patient safety and improvements in the quality of hospital care, rapid response teams (RRTs) have been implemented in many countries, including Korea. The goal of an RRT is early identification and response to clinical deterioration in patients. However, there are differences in RRT systems among hospitals and limited data are available. METHODS: In Seoul St. Mary's Hospital, the St. Mary's Advanced Life Support Team was implemented in June 2013. We retrospectively reviewed the RRT activation records of 287 cases from June 2013 to December 2016. RESULTS: The median response time and median modified early warning score were 8.6 minutes (interquartile range, 5.6 to 11.6 minutes) and 5.0 points (interquartile range, 4.0 to 7.0 points), respectively. Residents (35.8%) and nurses (59.1%) were the main activators of the RRT. Interestingly, postoperative patients account for a large percentage of the RRT activation cases (69.3%). The survival rate was 83.6% and survival was mainly associated with malignancy, Acute Physiology and Chronic Health Evaluation-II score, and the time from admission to RRT activation. RRT activation with screening showed a better outcome compared to activation via a phone call in terms of the intensive care unit admission rate and length of hospital stay after RRT activation. CONCLUSIONS: Malignancy was the most important factor related to survival. In addition, RRT activation with patient screening showed a better outcome compared to activation via a phone call. Further studies are needed to determine the effective screening criteria and improve the quality of the RRT system.
Epidemiology* ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Mass Screening ; Patient Safety ; Physiology ; Reaction Time ; Retrospective Studies ; Seoul ; Survival Rate