We compared the efficacy of each modality of treatment group in reducing the frequency of coronary artery abnormalities and change of clinical courses in children with Kawasaki disease in the children of 81 cases who were admitted in pediatric department of Yeungnam University Hospital from September 1985 to August 1990. Group A (37 cases)-aspirin alone, Group B (44 cases)-intravenous gammaglobulin (400 mmg/kg/day) for 5 consecutive days, plus aspirin. We studied the frequency of echocardiographic abnormalities, the duration of fever, and changes in the total white blood cell counts, platelet counts, ESR and CRP value at 1, 2 and 3 weeks of the illness and compared the results between the two groups. The results were as follows. 1) There was no significant intergroup difference in age and sex ratio. 2)The duration of the febrile period after the initiation of the therapy was significant shorter in group B (2.5±1.2days) than in group A: (5.2±3.5 days) (p<0.01). 3) No significant difference was noticed in the WBC and platelet counts in two groups as measured at admission day, 1 and 2 weeks of the illness, however, at 3weeks of illness significant difference was noted. 4) The CRP values measured at 1,2 and 3 weeks after treatment were significantly lower in group B (2.42±1.8, 2.00±1.2, 1.16±1.0) than in group A (7.22±5.3, 5.25±3.9, 1.85±1.2) respectively (p<0.01). 5) In 2D-Echocardiogram, coronary artery dilatation was more frequent in Group A than in Group B at 6month of illness (p<0.01). In conclusion, intravenous gammaglobulin therapy was effective in the shortening of the duration of fever and in the anti-inflammatory action and somewhat effective in prevention of coronary artery aneurysm.
Aneurysm ; Aspirin* ; Child ; Coronary Vessels ; Dilatation ; Echocardiography ; Fever ; Humans ; Leukocyte Count ; Mucocutaneous Lymph Node Syndrome* ; Platelet Count ; Sex Ratio

Clear cell meningioma is a recently recognized morphologically unique entity. It shows no sex predilection, affects primarily the lumbar region, and the cerebellopontine angle. Despite its benign appearance, it may be aggressive, particularly in intracranial cases. All lesions are moderately cellular, with the exception of stromal hyalinization. The tumor consists largely of a sheet- like or somewhat lobular pattern of polygonal cells, the cytoplasm of which is clear. No close association is noted between the recurrence or the clinical outcome and factors such as mitotic activity, the PCNA index, and the DNA ploidy status. But the MIB-1 proliferation index is appreciably higher in recurrent tumors. We experienced a case of clear-cell meningioma showing a characteristic histologic finding. A 39-year-old man was admitted due to the recent onset of right-sided, facial-nerve palsy, left hemiparesis and general weakness. A CT scan of the head showed a well defined mass in the petroclival area. After surgical resection, the patient was in good condition, but 1 year later symptoms recurred. A CT scan of the head showed a huge, recurrent petroclival tumor with adhesion to the surrounding brain parenchyme.
Adult ; Brain ; Cerebellopontine Angle ; Cytoplasm ; DNA ; Head ; Humans ; Hyalin ; Lumbosacral Region ; Meningioma* ; Paralysis ; Paresis ; Ploidies ; Proliferating Cell Nuclear Antigen ; Recurrence ; Tomography, X-Ray Computed

PURPOSE: To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. MATERIALS AND METHODS: Sixteen patients with avascular necrosis of femoral head were examined with MRI. Tl-weighted and T2-weighted images and contrast-enhanced Tl-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. RESULTS: Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on Tl-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the portions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. CONCLUSION: Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease.
Head* ; Humans ; Joints ; Magnetic Resonance Imaging* ; Necrosis* ; Synovial Membrane

Gastrointestinal angiodysplasia is a distinct disease entity which causes frequent gastrointestinal bleeding. It predominantly arises at the stomach and duodenum in the upper gastrointestinal tract and cecum and ascending colon in the lower gastrointestinal tract. The general histological finding of the angiodysplasia is a submucosal vascular ectasia and tortuosity. We have experienced two cases of the intestinal angiodysplasia. The first case occurred on a jejunum in a 22-year-old woman who had anemia. The second case occurred on a sigmoid colon in a 59-year-old man who had constipation. In addition to the general histologic finding of the angiodysplasia, the microscopic findings of the first case revealed some capillary hemangioma-like areas; and in the second case, there was a marked ischemic change and the thickening of the wall.
Anemia ; Angiodysplasia* ; Capillaries ; Cecum ; Colon, Ascending ; Colon, Sigmoid ; Constipation ; Dilatation, Pathologic ; Duodenum ; Female ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Jejunum ; Lower Gastrointestinal Tract ; Middle Aged ; Stomach ; Upper Gastrointestinal Tract ; Young Adult

PURPOSE: The aim of this study was to develop course outcomes for nursing students by applying Hauenstein's theory. METHODS: The research was conducted in three steps as follows: identifying exit outcomes related to the Adult Nursing course, developing Adult Nursing course outcomes based on the theory of Hauenstein, and finalizing Adult Nursing course outcomes. RESULTS: Exit outcomes achievable in Adult Nursing were generated after a needs analysis survey among students, nurses and professors was conducted and subsequently reviewed by professors specializing in the subject. For theoretical courses, the level of the course outcomes was derived from the cognitive domain, whereas, for practical courses, it was derived, in stages, from the cognitive, affective and psychomotor domains. Next, using taxonomical terms that can properly address the level of each domain, course outcomes for theoretical and practical courses were determined. After expert opinion was sought, the final course outcome for the Adult Nursing course was produced. CONCLUSION: The results are meaningful in that valid course outcomes were developed through the process described above and are expected to greatly contribute to reaching exit outcomes and strengthen the professional capacity of nursing students.
Adult ; Expert Testimony ; Humans ; Learning ; Nursing ; Students, Nursing

Achondrogenesis type 2 is a lethal form of congenital skeletal dysplasia characterized by severe short-limbed dwarfism, decreased vertebral ossification and normal ossification of the skull. We report an autopsy case of achondrogenesis type 2 in a female fetus terminated at 29 weeks of gestation. External morphology revealed a relatively large head, short upper and lower extremities, short neck, and distended abdomen. The x-ray finding showed normal calvarial ossification, hypoplastic ilium and unossified ischium, and metaphyseal flares of the femur and tibia. Histologically, chondrocytes were large and irregular with increased vascularity.
Abdomen ; Autopsy* ; Chondrocytes ; Dwarfism ; Female ; Femur ; Fetus ; Head ; Humans ; Ilium ; Ischium ; Lower Extremity ; Neck ; Pregnancy ; Skull ; Tibia

PURPOSE: Adherence to immunosuppressants is the key to prevent organ rejection in organ transplant recipients. The purpose of this study was to investigate current interventions to improve adherence to immunosuppressants in liver transplant recipients. METHODS: A systemic literature search was done using PubMed, Embase, Cochrane Library, CINAHL and four Korean databases to identify experimental studies reported in English or Korean up to and including 2015. We identified eight intervention studies on the adherence to immunosuppressants in liver transplant recipients independently reviewed by two reviewers. The quality and risk of bias of the selected studies were assessed. RESULTS: Education, conversion of regimen, and text messaging were identified as intervention techniques to improve adherence. We found positive results in three out of four studies implementing educational strategies, but the results were not sufficient to draw a definite conclusion. Conversion from a twice-daily tacrolimus-based regimen to a once-daily tacrolimus extended-release formula was used in three adult-only studies and its effectiveness was confirmed. One study showed that improved adherence and outcomes were effected by using text messaging with pediatric patients. CONCLUSION: Future research is needed to facilitate interventions to improve adherence to immunosuppressants in various ages of patients including pediatric/adolescent liver transplant recipients.
Bias (Epidemiology) ; Education ; Humans ; Immunosuppressive Agents* ; Clinical Trial ; Liver* ; Tacrolimus ; Text Messaging ; Transplantation* ; Transplants

OBJECTIVE: To compare sexual function before and 12 months after between sacrocolpopexy and sacrocervicopexy. METHODS: This retrospective study examined a cohort of 55 sexually active women who underwent either supracervical hysterectomy with sacrocervicopexy (n=28) or total abdominal hysterectomy with sacrocolpopexy (n=27) for stage II to IV pelvic organ prolapse. Pelvic floor support was measured with Pelvic Organ Prolapse-Quantification examination. Pelvic floor function was measured with the Pelvic Floor Distress Inventory-Short Form 20 and sexual function was measured with Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-Short Form 12 (PISQ-12). RESULTS: Baseline pelvic floor symptoms, demographics and PISQ-12 questionnaire scores were similar between the two groups. Overall improvements in sexual function were seen based on PISQ-12 scores in both groups, but were not statistically significant. No differences were seen in PISQ-12 scores regardless of sparing the cervix or surgical route. Responses to the PISQ-12 question of avoiding sexual intercourse because of vaginal bulging showed significant improvement in both group. No recurrences of prolapse occurred. CONCLUSION: In women with pelvic organ prolapse, sexual function after either sacrocolpopexy or sacrocervicopexy was not different. Sexual dysfunction in terms of avoidance of sexual activity because of vaginal bulging was greatly improved in both groups with statistical significance.
Cervix Uteri ; Cohort Studies ; Coitus ; Demography ; Female ; Humans ; Hysterectomy ; Pelvic Floor ; Pelvic Organ Prolapse ; Prolapse ; Recurrence ; Retrospective Studies ; Sexual Behavior

Female pelvic tuberculosis is almost invariably secondary to disease elsewhere, usually in the lungs. It is difficult to diagnose pelvic tuberculosis, because it is often a disease with absent or few non-specific symptoms. Pelvic tuberculosis should be considered in the differential diagnosis of all ovarian mass and pelvic malignancy. We report a case of retroperitoneal tuberculous lymphadenopathy that may be mistaken for pelvic malignancy, because of the nonspecific clinical features and radiologic findings. The diagnosis was made post-operatively by histopathology.
Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Lung ; Lymphatic Diseases* ; Retroperitoneal Space ; Tuberculosis

Pulmonary blastoma is a rare type of malignant lung tumor comprised of epithelial and mesenchymal elements reminiscent of fetal lung. Mesenchymal element may show various patterns of differentiation toward mature tissue, such as cartilage, smooth muscle, and bone. Rhabdomyoblastic differentiation in pulmonary blastoma is quite rare. Our case of pulmonary blastoma with rhabdomyoblastic differentiation documented by electron microscopy and immunohistochemistry. Usually it has been treated with surgery, but both chemotherapy and radiotherapy have been used against the metastatic disease, and as the adjuvant setting. A 28/12-year-old girl is described who was presented with pulmonary blastoma. She underwent surgical excision of the tumor, followed by the T2protocol, a 8 cycles of combination chemotherapy consisting of actinomycin-D, adriamycin, vincristine and cyclophosphamide with the radiation therapy to the left chest cage(180cGyx11 times). The patient has been off therapy without any evidence of relapse for 24 months. We report a case of pulmonary blastoma with brief review of related literatures.
Cartilage ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Female ; Humans ; Immunohistochemistry ; Lung ; Microscopy, Electron ; Muscle, Smooth ; Pulmonary Blastoma* ; Radiotherapy ; Recurrence ; Thorax ; Vincristine