OBJECTIVES: Our aims of this study is to analyze the clinical characteristics and the prognos is of the disease which develops in patient swith chronic liver disease as acutely exacerbated hepat it is accompanied by myosit is. Finally we try to identify and is olate the causative agent. METHODS: The patient swith chronic liver diseases, who developed muscle weakness and paralysis, were classified to group A or group B, according to the level of creatinine kinase ( CK) activity. The group A consists of patients with less than 3-fold increase of normal CK activity and the group B includes patients with over 3-fold increase of it. We evaluated clinical characteristics, blood chemistry, clinical course, and causes of deathin patients of study groups, compared with those of patients with chronic liver disease with normal CK activity as controls. The causative agent was suggested by conventional culture and RT-PCR analysis in two cases of group B. RESULTS: 1. There was no significant differences in age, sex, underlying disease, or liver function test bet ween control and study group ( control and group A or B) before entry. 2. The clinical symptoms and signs , such as drowsy mental state, generalized weakness/myalgia caused by hepatic encephalopathy and myositis , occurred frequently in the study group. 3. Significant elevation of aspartic acid transaminase (AST ) and alaninetr ans aminase ( ALT ) was noted in Group B. AST / ALT ratio is over 2 in group A or B. Synthetic function of the liver such as prothrombin time ( PT ) or serum albumin level is significantly decreased. Blood urea nitrogen ( BUN) and creatinine were increased as a result of impaired renal function. 4. Culture of coxs ackievirus was positive by immunofluor escence as say IFA) as a caus ative agent and also was positive in reverse transcription-polymerase chain reaction (RT-PCR) analys is using universal primer of enterovirus in two recent cases of group B. 5. Death rate increased significantly in study group, compared with that of control group ( 20.7% versus 5.6%). Major cause of death, 12 patients died of which, is hepatic failure. CONCLUSION: The patients with chronic liver disease abruptly developed a exacerbated hepaticdys function and muscle paralysis and/or weakness. This exacerbated hepatitis accompanied by myositis was suggested to be caused by coxsackie B viral infection. Furthermore, this infection increase deathrate and resulted in poor prognosis. Thus, further study should be continue to confirm the causative agent and classify the subtype.
Aspartic Acid ; Blood Urea Nitrogen ; Cause of Death ; Chemistry, Clinical ; Creatinine ; Enterovirus ; Hepatic Encephalopathy ; Hepatitis* ; Humans ; Liver Diseases* ; Liver Failure ; Liver Function Tests ; Liver* ; Mortality ; Muscle Weakness ; Myositis* ; Paralysis ; Phosphotransferases ; Prognosis ; Prothrombin Time ; Serum Albumin

From January 1995 to December 1997, a total of 219 cases pelviscopic surgery was performed at Il Sin Christian Hospital. To evaluate the safty and efficacy of pelviscopic surgery, we reviewed indication of operation, mean age, parity, history of abdominal operation, type of operation, duration of hospitalization and complication retrospectively. The number of pelviscopic surgery have risen from 33 cases in 1995 to 53 cases in 1996 and 133 cases in 1997. The most common indications were 118 cases for ectopic pregnancy (53.9%) and 42 cases for ovarian cyst (19.2%), 20 cases for infertility (9.1%) in order. Among the ovarian cyst, endometrioma was the most common. The mean age of patients was 31+/-6.7 years old and mean parity was 0.77. In most cases, mean blood loss was lesser than 100 cc except 500 cc in LAVH, 150 cc in CISH, 106.7 cc in ectopic mass removal. The postoperative hospital stay was varied from 0 day to 10 days, but usually 2 days. The 26 cases had complicated and the most common complication was fever above 38degrees C. In conclusion, it is evident that pelviscopic surgery is lesser invasive technique, has lower complication rate and shorter the length of hospitalization. So, we expect the number and indication of pelviscopic surgery will be increased in future.
Endometriosis ; Female ; Fever ; Hospitalization ; Humans ; Infertility ; Length of Stay ; Ovarian Cysts ; Parity ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies

Functional paraganglioma of the mediastinum is an uncommon tumor of the paraganglion system that causes symptoms and signs of episodic catecholamine release. It has not been reported in Korea. We experienced a case of a 17 years old man with a history of diaphoresis and paroxysmal hypertension refractory to therapy since 14 years old. Urinary execretion of catecholamine and its metabolites were elevated. Computed tomography(CT) scan revealed high density mass located on the posterior mediastinum in the area of the right fifth intercostal space. At thoracotomy, a 3X3X4cm sized lesion was resected and confirmed as a paraganglioma.
Adolescent ; Humans ; Hypertension* ; Korea ; Mediastinum* ; Paraganglioma* ; Pheochromocytoma ; Thoracotomy

PURPOSE: The aim of this study was to provide basic data on the intervention for depression program development and application by analyzing the depression intervention studies for women that were published in Korea Journal (2000~2014). METHODS: The research method used was the integrative review. Nine studies were reviewed from the Nursing Articles and National Assembly Library of which 41 studies were from 126 research papers that met the inclusion criteria and analyzed using MINORS (Methodological Index for Non-Randomized Studies) and according to general characteristics. RESULTS: There were non-equivalent control group pre-post test design (78%) in research design. 44% of articles in sample size were 14~26 participants and measuring tools were used CES-D (29%), BDI (I & II, 22%), GDSSF-K (22%). In quality of research according to MINORS, most of the papers got 2 scores except for the items of sample size calculation standard. Even though the similar intervention program were reported, the results could not compare because of diverse contents, duration, methods, and measuring tool with intervention program. As the results, aroma, massage, and counseling programs seemed to have significant effects of depression alleviation. CONCLUSION: The standard tailored program and measuring tool for depression alleviation of women was needed to develop.
Counseling ; Depression* ; Evaluation Studies as Topic ; Female ; Humans ; Clinical Trial* ; Korea* ; Massage ; Nursing ; Program Development ; Research Design ; Sample Size

Purpose: The purpose of this study was to examine the effects of organizational socialization, perceived organizational vision, and attitude toward organizational change on organizational commitment of nurses working in one hospital. Methods: This study was conducted with 441 participants in a hospital in A city, South Korea from Nov. 1 to 30 2017.Data were analyzed using frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffé test, Pearson Correlation and Multiple Regression with the SPSS/WIN 23.0 program. Results: There were significant correlations among organizational socialization, perceived organizational vision, attitude toward organizational change and organizational commitment. The factors that significantly influenced organizational commitment were organizational socialization (β=.10 p=.015). perceived organizational vision (β=.20, p<.001), and attitude toward organizational change (β=.44, p<.001). These variables explained 50.0% of the variance in organizational commitment. Conclusion The findings indicates that organizational socialization, perceived organizational vision and attitude toward organizational change affect organizational commitment.

PURPOSE: We conducted a prospective comparative clinical study to determine the field efficacy of the 2010-2011 influenza vaccines [Influenza virus strains; A/California/7/2009 (H1N1), A/Perth/16/2009 (H3N2), B/Brisbane/60/2008] in healthy Korean children under 18 years of age. METHODS: In this study, we enrolled subjects aged between 6 months and 18 years and divided them into 2 study groups: a group who received the influenza vaccines (407 subjects), and a control group who did not receive the influenza vaccines (230 subjects). Ours was a multicenter study that involved 7 hospitals, including the Korea Cancer Center Hospital. The study was conducted between September 2010 and February 2011. We collected nasal wash or throat swab samples from subjects who presented with acute febrile respiratory or influenza-like illnesses at the hospital. We used PCR to confirm the presence of the influenza virus in the respiratory samples and characterize the virus type. RESULTS: In this study, we collected 22 respiratory samples from the influenza-vaccinated group and found 3 cases of influenza virus infection. Similarly, we collected 21 samples from the control group and found 12 cases of influenza virus infection among 10 subjects during the study period. We determined the field efficacy of the 2010-2011 seasonal influenza vaccines to be 83.2% in healthy Korean children and adolescents. CONCLUSION: In this study, we determined the field efficacy of the 2010-2011 seasonal influenza vaccines in healthy Korean children and adolescents. We found that the field efficacy of 2010-2011 seasonal influenza vaccines was adequate.
Adolescent ; Aged ; Child ; Humans ; Influenza Vaccines ; Influenza, Human ; Korea ; Orthomyxoviridae ; Pharynx ; Polymerase Chain Reaction ; Prospective Studies ; Seasons ; Viruses

Background: A national immunization program (NIP) to prevent disease and reduce mortality from vaccine preventable diseases (VPD) is very important. Methods: We analyzed only the anaphylaxis cases that occurred between 2001 and 2016 that Korea Centers for Disease Control and Prevention (KCDC) determined had a definite causal relationship with a vaccine. The clinical symptoms were assessed according to the Brighton Collaboration case definition (BCCD) level. Results: During the period, there were 13 cases of vaccine-related anaphylaxis. The median age was 9 years (range, 1 month to 59 years). The incidence of anaphylaxis per million doses was 0.090 in 2005, 0.079 in 2012, 0.071 in 2013, 0.188 in 2015, and 0.036 in 2016. Of those cases, 23.1% were influenza vaccines, and 76.9% were BCCD level 2. Epinephrine was used in 46.2%. Conclusion Vaccine-related anaphylaxis seems to have been very rare in the past, but health care professionals must always be aware of anaphylaxis.

PURPOSE: Airway inflammation is considered to be a characteristic feature of asthma, and eosinophils are recognized as the most important inflammatory cells. This study aims to assess the importance of blood eosinophil count and serum eosinophil cationic protein(ECP) levels as a non- invasive marker of bronchial hyperresponsiveness(BHR) in children with suspected asthma. METHODS: This study used data from 87 subjects with asthma-like symptoms(6-18 years old). The FEV1 and provocative concentration producing a 20% fall in FEV1(PC20) on methacholin inhalation challenge test were measured. Four groups were classified based on PC20[Group I : <2 mg/ mL; Group II : 2-8 mg/mL; Group III : 8-18 mg/mL; Group IV : (18 mg/mL), and blood eosinophil count and serum ECP levels were analyzed. In addition, subjects were classified based on the cutoff value of PC20(BHR positive group : <18 mg/mL; BHR negative group : (18 mg/mL). Then blood eosinophil count and serum ECP level were compared between these two groups. RESULTS: Likelihood ratio test for trends revealed a significant association between the blood eosinophil count or serum ECP level, and the degree of BHR as measured by methacholine PC20. Blood eosinophil count or serum ECP level was significantly higher in the BHR(+) group than in the BHR(-) group. Blood eosinophil count had a positive correlation with serum ECP level. CONCLUSIONS: Blood eosinophil count and serum ECP level may be a useful non-invasive clinical marker of BHR in subjects with suspected asthma. This supports the hypothesis that BHR in asthma is a consequence of airway eosinophilic inflammation.
Asthma* ; Biomarkers ; Child* ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Inflammation ; Inhalation ; Methacholine Chloride

It has been known that the immunological functions against cancer cells were diminished, and these phenomena result from the inhibition of cell-mediated immunity by substance(s) secreted from cancer cells. It was also reported that the immunological functions decreased in patients with stomach cancer, which is the most frequent cnacer in Korean. However, the nature and function of the inhibitory factor(s) orignated from stomach cancer have not been identified. To elucidate effects of immuological inhibitory factor(s) secreted from cancer cells, SNU-1 (stomach cancer) and SW480 P109/R3P2 (colon cancer) were used in this study. Jurkat T cell line, an acute T cell leukemia, was pre-incubated with fractionated cancer cell culture supernatant for 3 days, then was stimulated with PMA, PWVanti-CD28 mAb or PMA/ionomycin for 8 hrs respectively. Fraction of SNU-1 (3 - 10 kDa) and above 10 kDa of SW480 P109/R3P2 inhibited the expression of IFN-r mRNA when Jurkat T cell was stimulated with PMA. However, there were no difference in IL-2 and IL-4 gene expression response to either PMA/anti-CD28 mAb or PMA/ionomycin. These results show that cancer cells secret some inhibitory factor(s) acting on the immune response, especially IFN-r gene expression of the Jurkat T cells response to PMA. Therefore, it suggests that the inhibitory factor(s) secreted from cancer cells influences on. the PKC-dependent pathway related to the signal transduction by PMA.
Cell Culture Techniques ; Cell Line ; Gene Expression ; Humans ; Immunity, Cellular ; Interleukin-2 ; Interleukin-4 ; Leukemia, T-Cell ; RNA, Messenger ; Signal Transduction ; Stomach Neoplasms ; T-Lymphocytes

PURPOSE: To evaluate the major radiologic features of chronic focal pancreatitis in various imaging studies, with special emphasis on CT and ERCP findings. MATERIALS AND METHODS: From 1991 to 1995, twelve patients were pathologically proved to be suffering from focal chronic pancreatitis after pancreatico-duodenectomy ; for retrospective evaluation, imaging studies were available for eight(seven men, one woman ; mean age 58.9+/-6.6, range 47 to 67). Clinical, surgical, and radiological findings, including CT(n=8), ultrasound(n=7), ERCP(n=8) andUGI(n=3) were analysed. RESULTS: Seven male patients had suffered from chronic alcoholism for between 20 and 50years. Serum bilirubin levels were normal in eight patients and alkaline phosphatase levels were normal in seven patients. Serum CA 19-9 levels were normal in all five patients who had undergone preoperative evaluation. Seven patients(87.5%) showed focal enlargement without definable margin on CT, and five of the six lesions detectable on ultrasound(83.3%) were ill defined hypoechoic nodules. Dilated side branches within lesions were seen in five ofeight patients(83.3%) on CT and ERCP. Double duct signs were observed in siven(87.5%) patients, and dilated intrahepatic ducts in six(75%), with diameters ranging from 5 to 8mm(average : 5.42+/-1.96mm). The average ratio ofpancreatic duct caliber to gland width was 0.33+/-0.19. None of the patients had calcification within the lesionand one case showed intraductal calcification. None showed perivascular fat obliteration around the superiormesenteric artery or celiac axis. The average biductal distance between abnormal common bile duct and theimmediately adjacent pancreatic duct was 4.0+/-1.15mm. One of three cases who under went a UGI examination showed severe luminal narrowing and mucosal thickening in the second portion of the duodenum, another showed double contour, and the other merely showed widening of the C-loop of the duodenum. CONCLUSION: Chronic focalpancreatitis mostly demonstrated ill defined focal enlargement and double ductal dilatation. Dilated side brancheswithin the lesion, no vascular encasement, a mild degree of intrahepatic ductal dilatation, a ratio of pancreatic duct to parenchymal width of less than 0.5, and clinical findings including chronic alcoholism and normal CA 19-9serum level may be reliable indicators for differentiating chronic focal pancreatitis from pancreatic cancer.
Alcoholism ; Alkaline Phosphatase ; Arteries ; Axis, Cervical Vertebra ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Dilatation ; Duodenum ; Female ; Humans ; Male ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatitis* ; Pancreatitis, Chronic ; Phenobarbital