Angiodysplasia is an important vascular lesion of the gastointestinal tract , located at the site of ectasia of intestinal submucosal veins and overlying mucosal capillaries. It is a major cause of morbidity from gastrointestinal bleeding in old age, but rather rare in children. Its cause is still unknown, though is mostly considered to be acquired as a result of a degenerative process associated with aging. We experienced a case of colonic angiodysplasia in 14-year old boy, diagnosed by colonoscopy. The patient had a history of repeated hematochezia for a year. This report summarized our case and reviewed the literature.
Aging ; Angiodysplasia ; Capillaries ; Child ; Colon ; Colonoscopy ; Dilatation, Pathologic ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Male ; Veins

Purpose: This study aimed to explore the knowledge and performance of sleep hygiene among nurses with shift work schedules and examine the influence on sleep disturbance. Methods: A total of 199 shift-work nurses from a tertiary hospital were included in the study. To examine the knowledge and performance of sleep hygiene, the participants were asked to respond to a self-reported survey. To assess sleep disturbance, the General Sleep Disturbance Scale was used. Descriptive statistics and multiple linear regression were applied using the SPSS/WIN 21.0 program to analyze the data. Results: Both the knowledge and performance of sleep hygiene among nurses with shift work schedules were measured at a moderate level. Nurses’ knowledge and the performance of sleep hygiene was not significantly associated with sleep disturbance, whereas age, experience with shift-working, and perceived health status were significantly associated. Conclusion Strategies for providing more accurate information and motivating better sleep hygiene would help to enhance sleep hygiene in nurses with shift work schedules. Further studies examining the association of knowledge and the performance of sleep hygiene with sleep disturbances in nurses with shift work schedules are needed.

BACKGROUND: Family doctors are usually point of contact when the elderly think their death is imminent. To properly treat their disease and to provide good care of them and their families, family doctors must know the elderly's perception of a good death and dying. The purpose of this study was to investigate the components of a good death from the elderly. METHODS: We composed 9 questions focusing on good death and dying. A family medicine resident interviewed 35 people ages sixty five or over in Cheonan Welfare Center. The contents were recorded into audiotapes, and then translated and analyzed by quantitative method and coding technique. RESULTS: Among the total 35 respondents, many elders answered that they had thought about death and that the meaning of a death was the end of life, or transition from one world to another in religious belief. In their dying, they hoped that they would be with their offspring or spouse and that they would be in their home or hospital. Old people identified 8 major components of a good death: proper age, death without disease, death before death of their offspring and spouse, dying when whole family get together, death after seeing their family happy, death during sleep, and death without pain. They pointed out that the most meaningful event in their lives were related to their family, occupation and society. CONCLUSION: The elderly identified a good death in view of family as well as personal conditions such as proper age, a death without pain or disease. And most elderly pointed out that meaningful events in their lives were related to their family, occupation and society.
Aged* ; Chungcheongnam-do ; Clinical Coding ; Surveys and Questionnaires ; Euthanasia ; Hope ; Humans ; Occupations ; Religion ; Spouses ; Tape Recording

BACKGROUND: In spite of harmfulness of smoking, the rate of adult man's smoking is high in Korea and that of young people and women has risen recently. Although the number of hospitals operating smoking-cessation clinic has risen year by year, there is little research on smoking cessation. In this study, we tried to find the factors associated with successful smoking cessation and have attempted to contribute to developing effective smoking cessation strategy and help to continue cessation state. METHOD: Three hundred smokers, who had visited the Dankook Univ. Hospital from May 1999 to December 1999, were consulted. After doing a survey with a basic questionnaire and smoking cessation consultation, we asked them to revisit on the date of appointment with continued use of nicotine patch as much possible. Six months later, we selected 272 people and analyzed the factors of difference between the two groups ; one is the successful group and the other is the failure group. RESULT: The success group included 77 people (28.3%), and the failure group 195 people (71.7%). In view of demographic profiles such as age, sex, marital status, education, and job, there was no significant difference between the two groups. In view of smoking pattern and factors that can influence them such as age of starting to smoke, duration of smoking, motive of smoking, reason of failure to stop smoking, reason of trying to stop smoking, the presence of smoking family number, confidence in smoking cessation, dependence on nicotine and the number of alcohol drinking, there was no significant difference between the two groups. In the results of univariate analysis, daily mean smoking amount, the presence of smoking-associated disease, expiratory CO level at initial visit to hospital, period of using nicotine patch and total times of visiting clinic were significant difference between the two groups. Therefore, the total number of visits to the clinic was the only significant factor according to multivariate analysis. CONCLUSION: The results of multivariate analysis has shown that the factor that is most associated with success of smoking cessation is the total number of visits to smoking-cessation clinic. This means that the more people who smoke consult with doctor and the longer the period of utilizing the smoking-cessation clinic is, the more successful they in smoking cessation.
Adult ; Alcohol Drinking ; Education ; Female ; Humans ; Korea ; Marital Status ; Multivariate Analysis ; Nicotine ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Use Cessation Products ; Surveys and Questionnaires

BACKGROUND/AIMS: Spontaneous bacterial peritonitis (SBP) is one of critical complications in liver cirrhosis patients with ascites. We aimed to review clinical course of SBP patients in a 10-year period from single center. METHODS: This study enrolled SBP patients between 2005 and 2015. Their medical records were reviewed. The laboratory findings of serum and ascites were examined, and characteristics of isolated microorganisms in ascites were analyzed. RESULTS: Total 51 patients were enrolled. Male patients were predominant (64.7%), and mean age was 59.20 years. The most common etiology of cirrhosis was alcohol (41.2%), followed by hepatitis B (39.2%). Microorganism was isolated from the ascites in 31 patients (60.78%). The proportions of Gram negative and Gram positive were 80.64% and 19.36%. The proportions of Escherichia coli, Klebsiella, and Streptococcus species were 29.41%, 19.61% and 11.76%. Among Escherichia colis, 4 cases were ESBL positive (7.84%). The most commonly used first-line antibiotic was cefotaxime (80.40%). Prophylactic antibiotics treatment was performed only in 8 patients, and SBP was recurred in 7 patients (13.72%). When comparing the SBP recurrence group and the non-recurrence group, there were no significant differences in laboratory findings of serum and ascitic fluid. CONCLUSIONS: SBP is still a critical complication in cirrhosis patients with ascites, and the clinical features of SBP have not been altered much compared with those in 1990's. The effective treatment of SBP is still very important for a better prognosis of cirrhosis patients.
Anti-Bacterial Agents ; Ascites ; Ascitic Fluid ; Bacteria ; Cefotaxime ; Escherichia coli ; Fibrosis ; Hepatitis B ; Humans ; Klebsiella ; Liver Cirrhosis ; Male ; Medical Records ; Peritonitis* ; Prognosis ; Recurrence ; Streptococcus

OBJECTIVE: Methicillin resistant Staphylococcus aureus (MRSA) is the most common cause of postoperative infection in instrumented fusion surgery. Although MRSA is well-known cause of nosocomial infection, emerging evidence supports that there could be MRSA infection from community. This study evaluated the nasal colonization rate of MRSA among healthy adults within the age range of spinal fusion surgery in Korea. METHODS: Nasal swabs were collected from 99 participants who visited health promotion center. A structured questionnaire regarding healthcare-associated MRSA risk factors was collected simultaneously. Staphylococcus aureus was confirmed by latex agglutination. The resistance to methicillin was identified by oxacillin screening test. RESULTS: Of the 99 participants, 12 (12.1%) had S. aureus isolates. The nasal carriage rate of methicillin susceptible S. aureus (MSSA) was 9 (9.1%). MRSA was identified in 3 participants (3.0%). CONCLUSION: Among the age range of possible spinal fusion surgery, nasal colonization study revealed substantial rate of preoperative MRSA carriers even in healthy adults. A postoperative MRSA infection should not be exclusively considered to be due to surgery-related contamination.
Adult ; Agglutination ; Colon ; Cross Infection ; Health Promotion ; Humans ; Latex ; Mass Screening ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Nasal Surgical Procedures ; Oxacillin ; Surveys and Questionnaires ; Risk Factors ; Spinal Fusion ; Staphylococcus ; Staphylococcus aureus ; Surgical Wound Infection

Pulmonary involvement of salmonella infection is very rare and only one case of salmonella empyema had been reported in Korea. A 53-year-old woman presented to Kyung Hee Medical Center with 2-months history of left chest pain and mild fever. 3 months prior to admission, the patient was taken to laparoscopic laser cholecystectomy due to gall stone in other hospital. Chest X-ray taken on admission day showed pneumonic infiltration at left lower lung field with pleural effusion. Salmonella Group B was identified from the cultures of stool, blood, and pleural fluid. After consecutive therapy with two weeks of ceftriaxone and three weeks of ciprofloxacin combined with repeated pleural aspirations, the patient was recovered and discharged. But she was readmitted two months later due to fever and generalized malaise. The result of blood culture showed growth of Salminella Group B. The excisional biopsy of right supraclavicular lymph node disclosed necrotizing lymphadenitis. She was recovered clinically and no more bacteremia occurred after two weeks of ciprofloxacin therapy. We present very rare case of empyema due to salmonella infection and review the pertinent literature.
Aspirations (Psychology) ; Bacteremia ; Biopsy ; Ceftriaxone ; Chest Pain ; Cholecystectomy ; Ciprofloxacin ; Empyema* ; Female ; Fever ; Gallstones ; Humans ; Korea ; Lung ; Lymph Nodes ; Lymphadenitis ; Middle Aged ; Pleural Effusion ; Salmonella Infections ; Salmonella* ; Thorax

The present study was designed to examine the effect of d-amphetamine on CA release from the isolated perfused model of the rat adrenal gland, and to establish its mechanism of action. D- amphetamine (10~100microM), when perfused into an adrenal vein of the rat adrenal gland for 60 min, enhanced the CA secretory responses evoked by ACh (5.32x10-3 M), excess K+ (5.6x10-2 M, a membrane depolarizer), DMPP (10-4 M, a selective neuronal nicotinic Nn-receptor agonist) and McN-A-343 (10-4 M, a selective M1-muscarinic agonist) only for the first period (4 min), although it alone has weak effect on CA secretion. Moreover, d-amphetamine (30microM) in to an adrenal vein for 60 min also augmented the CA release evoked by BAY-K-8644, an activator of the dihydropyridine L-type Ca2+ channels, and cyclopiazonic acid, an inhibitor of cytoplasmic Ca2+ ATPase only for the first period (4 min). However, in the presence of high concentration (500microM), d-amphetamine rather inhibited the CA secretory responses evoked by the above all of secretagogues. Collectively, these experimental results suggest that d-amphetamine at low concentrations enhances the CA secretion from the rat adrenal medulla evoked by cholinergic stimulation (both nicotininc and muscarinic receptors) as well as by membrane depolarization, but at high concentration it rather inhibits them. It seems that d-amphetamine has dual effects as both agonist and antagonist at nicotinic receptors of the isolated perfused rat adrenal medulla, which might be dependent on the concentration. It is also thought that these actions of d-amphetamine are probably relevant to the Ca2+ mobilization through the dihydropyridine L-type Ca2+ channels located on the rat adrenomedullary chromaffin cell membrane and the release of Ca2+ from the cytoplasmic store.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Glands ; Adrenal Medulla* ; Amphetamine ; Animals ; Calcium-Transporting ATPases ; Chromaffin Cells ; Cytoplasm ; Dextroamphetamine* ; Dimethylphenylpiperazinium Iodide ; Membranes ; Neurons ; Rats* ; Receptors, Nicotinic ; Veins

A meandering pulmonary vein (MPV) is a rare pulmonary vascular anomaly characterized by an abnormal course of the pulmonary vein draining into the left atrium. We report the case of a 55-year-old female who was diagnosed with a right MPV on pulmonary angiography. Enhanced chest CT revealed a vascular structure with an abnormal course that drained into the right superior pulmonary vein in the right upper lobe, which resembled a pulmonary arteriovenous malformation (AVM). Pulmonary angiography performed to discriminate between an MPV and pulmonary AVM showed no feeding artery, normal parenchymal staining, and drainage to the left atrium via the culprit vessel. Thus, the patient was diagnosed with MPV. When an MPV is difficult to differentiate from other vascular anomalies on enhanced chest CT, pulmonary angiography can be helpful. By recognizing the angiographic findings of an MPV, unnecessary treatment can be prevented.

Background/Aims: The HBsAg levels have been used to monitor the chronic hepatitis B (CHB) treatment response to antiviral therapy.On the other hand, it is unclear if the HBsAg quantification levels at each treatment point differ according to the HBeAg status and drug in CHB patients. This study compared the changes in HBsAg in CHB patients according to the HBeAg status and treatment drugs. Methods: CHB patients with at least 1 year of follow-up treatment with one drug, either entecavir (ETV) or tenofovir (TDF), were enrolled in this study. The mean HBsAg levels were measured annually for up to 6 years. A linear mixed model was used to compare the HBsAg quantification levels during the follow-up period. An independent samples t-test was used to analyze the differences in the HBsAg quantification levels at each treatment time point. Results: Ninety-seven patients were enrolled in this study; 59 among them were HBeAg-positive. Two patients in the TDF group achieved HBsAg seroconversion. The HBsAg level decreased during the follow-up in the ETV and TDF groups. The HBsAg level was lower in the TDF group than the ETV group during the follow-up. On the other hand, subgroup analysis showed that this trend was the same only in the HBeAg-negative patients, not in the HBeAg-positive patients. In the HBeAg-negative patients, HBsAg level in the TDF group was significantly lower than that in the ETV group at 36, 48, and 72 months. The change in HBsAg level from the baseline increased at a decreasing rate during the follow-up in both groups. Furthermore, the change in the HBsAg level in the TDF group was significantly larger than that of the ETV group at 36 months in the HBeAg-negative patients. Conclusions Although TDF might be more efficient than ETV in reducing the HBsAg level in HBeAg-negative patients in a few years, HBsAg seroconversion occurred very rarely. A further large-scale, long-term study will be needed to confirm the antiviral effects on the HBsAg level.