Abdominal actinomycosis is very rare infectious disease and seldom reported as a cause of abdominal mass. This disease is diagnosed by pathologic findings and culture result but it is very difficult to differentiate with other granulomatous illammatory disease, diverticular disease, malignancy, etc. The radiologic findings were non-specific and CT scan revealed the inflammatory mass with multiple small abscesses and fibrous change. The treatment of choice for actinomycosis is medical treatment with penicillin but surgical intervention may be needed when complication such as obstruction, fistula formation, abscess formation develop. We report a patient with abdominal actinomycosis that presented with transverse colonic obstruction and severe abdominal wall inflammation. This patient had no past operative history but got intrauterine contraceptive devices during last 10 years. We treated this patient by surgical resection and antibiotic therapy.
Abdominal Wall ; Abscess ; Actinomycosis* ; Colon* ; Colon, Transverse ; Communicable Diseases ; Fistula ; Humans ; Inflammation ; Intrauterine Devices ; Penicillins ; Tomography, X-Ray Computed

No abstract available.
Glycemic Index ; Humans

Broncho-gastric fistula caused by benign gastric ulcer perforation after esophagectomy is very rare. In general anesthesia of a patient with broncho-gastric fistula, in spite of hyperventilation, leakage of the anesthetic gases through fistula may make the patient hypercapneic, and positive pressure ventilation may increase the risk of the pulmanary aspiration by the regurgitation of gastric fluid by stomach distension. For that reason, in this patient, denitrogenation was performed during patient's voluntary respiration with 100% oxygen for 5 minutes, and induction was performed without positive pressure ventilation, and one lung ventilation was carried out. Hypoxemia was followed by one lung ventilation because his pulmonary function was moderate obstructive type and his lung was damaged by aspiration of gastric fluid via broncho-gastric fistula. A low level of continuous positive airway pressure (CPAP) has no significant hemodynamic effect and can maintain the patency of nonventilated lung, so hypoxemia induced by one lung ventilation may be reduced. Thus we carried out one lung ventilation with CPAP (10 cmH2O) in nonventilated lung and blocked broncho-gastric fistula with a bronchial blocker for prevention of both regurgitation of gastric fluid and leakage of anesthetic gases. One lung anesthesia was performed without any problem in this case.
Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Anoxia ; Continuous Positive Airway Pressure ; Esophagectomy ; Fistula* ; Hemodynamics ; Humans ; Hyperventilation ; Lung ; One-Lung Ventilation ; Oxygen ; Positive-Pressure Respiration ; Respiration ; Stomach ; Stomach Ulcer

An ABO discrepancy was encountered in a 29-year-old woman with a pregnancy of 36 weeks. The patient's red cell was typed as group O and her serum had only anti-A antibody. Absence of B antigen on patient's RBC was confirmed by adsorption-elution test, B substance was not demonstrated in the saliva and serum. B-transferase activity was not detected in the serum. Patient's serum Ig level was within normal range. The patient's father and son had normal O phenotype and no additional abnormalities were detected among the family members studied.
Adult ; Fathers ; Female ; Humans ; Phenotype ; Pregnancy ; Reference Values ; Saliva

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: We aimed to determine the status of depression and its related factors among adult Koreans during the coronavirus disease 2019 (COVID-19) outbreak. Methods: We used data from the 2020 Korea Community Health Survey (KCHS). We assessed depressive feelings and symptoms using the Patient Health Questionnaire-9 (PHQ-9 ≥10). In addition, we assessed general and COVID-19–related characteristics, including isolation due to and concerns about COVID-19. We analyzed the data using chi-square tests and multiple logistic regression analyses. Results: The rates of depressive feelings and symptoms were 5.9% and 2.9%, respectively. Of the adult respondents, 68.5% were concerned about COVID-19, while 75.9% were concerned about economic harm due to COVID-19. The adjusted odds ratios for depressive symptoms assessed using the PHQ-9 were significantly high among women responders, adults aged 19–44 years, low-income households, those who experienced COVID-19–related symptoms, and those concerned about death due to COVID-19 and economic harm due to COVID-19. Similar results were obtained for depressive feeling. Conclusion Concerns related to COVID-19 infection are related to depression. This suggests that COVID-19 significantly affects mental health. Therefore, during public health crises, such as new communicable diseases, mental health and the incidence of the infectious disease require assessment and monitoring.

Objective: We aimed to assess the associations between problematic smartphone use, unhealthy behaviors, and mental health status among adolescents. Methods: The data for this cross-sectional study were obtained from the 13th Korea Youth Risk Behavior Survey (2017). From among the 62,276 adolescents who participated in this nationwide web-based survey, 54,603 (87.7%) who used smartphones were selected as the study population. Unhealthy behaviors included smoking, drinking, physical inactivity, skipping breakfast, and fast food consumption. For the examination of mental health status, we considered sleep disturbances, stress, depressive symptoms, suicidal ideation, and suicide attempts. The associations between problematic smartphone use, unhealthy behaviors, and mental health were analyzed using multiple logistic regression analyses. Results: More than four hours of use on weekdays (31.3%) and weekends (61.3%) and the use of smartphones for communication (46.9%) were associated with unhealthy behaviors and mental health problems. Furthermore, adolescents who experienced conflicts with family (22.3%) and friends (25.8%) and academic problems (3.4%) were likely to have health problems. Conclusion The results suggest that problematic smartphone use may disrupt adolescents’ health. Therefore, there is a need for prevention programs for problematic smartphone use at home and at school to improve adolescents’ health.

Objective: We aimed to assess the associations between problematic smartphone use, unhealthy behaviors, and mental health status among adolescents. Methods: The data for this cross-sectional study were obtained from the 13th Korea Youth Risk Behavior Survey (2017). From among the 62,276 adolescents who participated in this nationwide web-based survey, 54,603 (87.7%) who used smartphones were selected as the study population. Unhealthy behaviors included smoking, drinking, physical inactivity, skipping breakfast, and fast food consumption. For the examination of mental health status, we considered sleep disturbances, stress, depressive symptoms, suicidal ideation, and suicide attempts. The associations between problematic smartphone use, unhealthy behaviors, and mental health were analyzed using multiple logistic regression analyses. Results: More than four hours of use on weekdays (31.3%) and weekends (61.3%) and the use of smartphones for communication (46.9%) were associated with unhealthy behaviors and mental health problems. Furthermore, adolescents who experienced conflicts with family (22.3%) and friends (25.8%) and academic problems (3.4%) were likely to have health problems. Conclusion The results suggest that problematic smartphone use may disrupt adolescents’ health. Therefore, there is a need for prevention programs for problematic smartphone use at home and at school to improve adolescents’ health.

OBJECTIVE: To evaluate the effects of piroxicam patch(Trast) in rheumatoid arthritis patients with knee joint pain and swelling and to determine the concentration of plasma and synovial fluid following patch application. METHODS: Twenty-two patients with rheumatoid arthritis participated in a double-blind, placebo-controlled study. The patients were instructed to apply piroxicam or placebo patch at one knee and re-apply it every other day for 2 weeks. They had washout period for 2 weeks and then applied the other patch for 2 weeks at the same joint. The patients recorded knee joint pain using visual analog scale. Knee joint swelling and tenderness were assessed before and after application of piroxicam and placebo patch. Complete blood count, AST, ALT, BUN, creatinine, joint fluid analysis were also done. Piroxicam concentration in plasma and synovial fluid were measured by high performance liquid chromatography(HPLC) after 2 weeks of piroxicam patch application. RESULTS: Knee joint pain improved significantly after the application of piroxicam patch for 2 weeks(visual analog scale, 56. 2+5. 9m vs 48. 2+5. 7mm, p=0. 03 by Wilcoxon signed rank test). There was no significant change in white cell count of synovial fluid, peripheral blood cell count, chemistry, C-reactive protein and erythrocyte sedimentation rate. In terms of adverse effects, mild gastrointesti nal disturbance(8/21 cases, 38%) and local side effects such as pruritus and ery thema(3/21 cases, 14%) were developed, which were insignificant compared with control groups(30%, 15% respectively). Piroxicam concentrations in plasma and synovial fluid after the application of piroxicam patch were 0. 129+0. 04ug/ ml (mean+SE) and 0. 644+0. 202ug/ml respectively. CONCLUSIONS: Piroxicam patch is a safe and effective therapeutic modality for knee joint pain in patients with rheumatoid arthritis. Mild adverse effects such as gastrointestinal disturbance and local side effects were noted. Piroxicam concentration was higher in synovial fluid than in plasma following the application of piroxicam patch.
Arthritis, Rheumatoid* ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Cell Count ; Chemistry ; Creatinine ; Humans ; Joints ; Knee ; Knee Joint ; Piroxicam ; Plasma ; Pruritus ; Synovial Fluid ; Visual Analog Scale

The main purpose of this study is to examine the concepts appeared on researches and provide the future research directions in field of child health nursing. A descriptive study was conducted. 205 studies were included in an analysis the concepts in terms of the domain of client for a total 321 researches. All were originally published between 1990 and 2000 in Korea. An analysis of concepts for this study was used the metaparadigm framework for nursing proposed by H.S. Kim(2000). The concepts for this study were categorized by essentialistic concepts, problematic concepts, health-care experiential concepts with the following results. 1.Based on the four domains suggested Kim (2000), 205 studies(63.9%) belong to the domain of client ; 109 studies(34%) belong to the practice domain of nursing; 3 studies(0.9%) belong to the client-nurse domain; and 4 studies belong to the domain of environment, respectively. 2.In the domain of client, 117(57.1%) studies used concept of parent. Among them, mother was the prevailing research population(103 studies). 64 studies(31.2%) used child population and the developmental stage of children varied from preterm to puberty but school aged children was the most target population(28 studies). Family as a concept of client was used in 20 studies(9.8%) but most primary care provider was the mother. 3. In terms of research design, non-experimental design(83.5%) is the most and among them survey was 159 studies(77.6%). Qualitative research(23 studies) and experimental research(10 studies) methods were used relatively few. 4.In terms of the categories of concepts, 196 (61.4%) studies included the essentialistic concepts like stress and coping(20.4%), mothering role and child care(7.8%), health (5.6%), breast feeding(4.7%). 31 studies included problematic concepts like power- lessness, safety, obesity, pain, anxiety. And 65 studies included health-care experiential concepts like compliance, growth, hope, environment but relatively few. The findings of this study provide the evidence that research related problematic concept and health-care experiential concept should be conducted actively to improve the practice of child health nursing. Also to deeply understand the phenomena of client in field of child health nursing, interpretive research methods should be conducted actively, too.
Adolescent ; Anxiety ; Breast ; Child ; Child Health* ; Child* ; Compliance ; Hope ; Humans ; Korea ; Mothers ; Nursing* ; Obesity ; Parents ; Primary Health Care ; Puberty ; Research Design