Internal hernia is an unusual cause of the intestinal obstruction. The advances of CT make the diagnosis more easier than in the past. We report one case of internal hernia with herniation of the ileum into the lesser omenturn. The diagnosis could be made when abdominal radiographs showed fixed clustering of the small bowel loops in upper abdomen medial to the stomach. CT and ultrasound showed characteristic interposition of the ileum between the left hepatic lobe and the stomach.
Abdomen ; Diagnosis ; Hernia* ; Ileum ; Intestinal Obstruction ; Stomach ; Ultrasonography

BACKGROUND: This study researched the relationship between shift work and one of its relevant health problems, functional gastrointestinal disorders. The study targeted nurses working at a university hospital, and compared the differences in gastrointestinal disorders of shift workers and non-shift workers and identified causes that significantly influence these symptoms. METHODS: In August 2013, a self-report survey was conducted on nurses working at a university hospital. Among those sent out, 1,201 responded and 851 were used for the final analysis. RESULTS: It was shown that the frequency of gastrointestinal disorders in shift workers was 1.881 times higher than that of non-shift workers. Factors that influenced gastrointestinal disorders included age, marital status, work duration, type of employment, job satisfaction, and perceived health status. Gastrointestinal disorders were seen more often with older age, being married, longer duration of employment, non-regular worker, low job satisfaction, bad perceived health status, and shift works. CONCLUSIONS: To prevent gastrointestinal disorders in nurses who work shifts, a health checkup system should be in place for clinical nurses who are of older age and have longer employment records. To decrease the causes of gastrointestinal disorders, campaigns suggesting regular diet and quitting alcohol use should be held consistently. Also, a category related to gastrointestinal disorders should be added to the employee health checkup for nurses with long work experience.
Diet ; Employment ; Gastrointestinal Diseases ; Job Satisfaction ; Marital Status ; Occupational Health

Juvenile dermatomyositis is an uncommon autoimmune disease with classic heliotrope discoloration of eyelids, erythematous skin rash of joints and proximal muscle weakness. Quite different from adults, malignancy is rarely accompanied in juvenile dermatomyositis. However vasculitis, muscle atrophy, calcification and gastrointestinal involvement are often observed in juvenile dermatomyositis. A six year old boy was admitted with chief complaints of general weakness and skin rash. Muscle biopsy was performed which was consistent with dermatomyositis. The patient was treated with intravenous immunoglobulin, steroid, methotrexate and physiotherapy. We report a case of juvenile dermatomyositis.
Adult ; Autoimmune Diseases ; Biopsy ; Dermatomyositis* ; Exanthema ; Eyelids ; Humans ; Immunoglobulins ; Joints ; Male ; Methotrexate ; Muscle Weakness ; Muscular Atrophy ; Vasculitis

No abstract available.
Nephrotic Syndrome*

Purpose: The purpose of this program is to develop an educational program to improve the nursing management competency of middle-level nursing managers. Methods: The program outline is based on the results of the Importance Performance Analysis (IPA) and Systematic Review (SR). Also performed the content validity accordingly. Results: The result of the concepts are derived from 6 competencies for planning process, 4 competencies for organizing process, 4 competencies for staffing process, 26 competencies for directing process, and 12 competencies for controlling process by integrating IPA and SR. This outline of the program was constructed according to the derived integrated concept and both content validity and structured outline were interpreted as valid. Conclusion This suggests that middle-level managers need a systematic program and support to effectively lead the organization by recognizing the importance rather than performance.

BACKGROUND: The prevalence of hepatitis C in blood donors have been reported to be 1.5% to 2.0% and 85 90% of post transfusion hepatitis patients show anti HCV positive results. Most agree that hepatitis C is readily spread by way of contact with blood, but a discernible history of parenteral exposure is identified in only 40% to 50% of cases. Thus other possible nonparenteral routes of transmission such as vertical, sexual and intrafamilial contact transmission need to be explored. In this study, we investigated the clinical characteristics of anti HCV seropositives and the infection patterns of hepatitis C in their families not only by anti HCV but also by HCV PCR to explore the possibility of HCV infection through nonparenteral household contact. METHODS: Past history, physical examination, liver function tests, HCV PCR, hepatitis B viral markers, abdominal ultrasonography and liver biopsy were done in 161 anti HCV seropositives from May, 1991 to August, 1996. Of the 161 seropositives, 42 seropositives' family members, 98 subjects, were available for investigation by anti HCV, HCV PCR and liver function tests to document intrafamilial HCV infection;their respective relationships to the index seropositive were noted. RESULTS: The 161 anti HCV seropositives were classified as follows:34 in the carrier group(21.1%), 41 in the acute hepatitis group (25.5%), 32 in the chronic hepatitis group(19.9%), 24 in the liver cirrhosis group(14.9%) and 30 in the hepatoma group(18.6%). The positive rates of HCV PCR were 55.2% in total, 46.1% in the carrier group, 55.0% in the acute hepatitis group, 76.4% in the chronic hepatitis group, 40.0% in the liver cirrhosis group, and 42.8% in the hepatoma group. The 98 family members were all anti HCV seronegative. The positive rates of HCV PCR in these family members were 10.2% in total, 7.1% in spouses, 28.6% in siblings, and 8.3% in children. CONCLUSION: Anti HCV seropositives were in various clinical states of liver disease due to HCV infecton. Although none of the family members showed anti HCV positive results, HCV PCR was positive in 10.2% of the family members indicating the need to perform HCV PCR to detect HCV infection.
Biomarkers ; Biopsy ; Blood Donors ; Carcinoma, Hepatocellular ; Child ; Family Characteristics ; Hepatitis B ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Physical Examination ; Polymerase Chain Reaction* ; Prevalence ; Siblings ; Spouses ; Ultrasonography

Pseudohypoparathyroidism is a medical disorder characterized by a complex disorder of renal resistance to parathyroid hormone and the mechanism underlying the disease is still unclear. The authors described two cases of pseudohypoparathyroidism in sibling,who had metabolic anomalies(hypocalcemia and hyperphosphatemia, high circulatin immunoreactive PTH)and basal ganglia calcification. Bilateral basal ganglia calcifications, which was not visible on plain skull film, was detected by CT scan of brain MRI. We report these cases with a review of related literatures.
Basal Ganglia ; Brain ; Humans ; Hyperphosphatemia ; Magnetic Resonance Imaging ; Parathyroid Hormone ; Pseudohypoparathyroidism* ; Siblings* ; Skull ; Tomography, X-Ray Computed

PURPOSE: The aim of this study is to investigate the colonization rate of Methicillin-resistant Staphylococcus aureus (MRSA) in neonates by different clinical characteristics, to presume the origin of MRSA acquisition, and to identify the risk factors associated with MRSA colonization. METHODS: We retrospectively reviewed the medical records of 1,733 neonates admitted to Seoul Eulji hospital Neonatal Intensive Care Unit between January 2008 and December 2011. Nasal, inguinal and rectal swab specimens were obtained upon admission and each week until discharge. We classified the route of MRSA acquisition as; hospital associated (HA-MRSA) and community associated (CA-MRSA) according to the case definition. RESULTS: Among 1,733 neonates, 415 (23.9%) were colonized with MRSA. Gestational age, birth weight, delivery type, maternal antibiotics usage before delivery, birth place and care place before admission were influencing factors in colonization of MRSA. The colonization rate was significantly high in neonates without maternal prophylactic antibiotics use before delivery than in the other group (relative risk 2.77, 95% CI 1.88-4.07; P<0.01), and outborns showed higher MRSA colonization rate compared to inborns (relative risk 2.28, 95% CI 1.17-4.42; P=0.015). CONCLUSION: We identified the neonatal MRSA colonization rate to be 23.9%. We estimated HA-MRSA colonization rate to be 10% (51/511) and CA-MRSA colonization rate to be 36% (309/858). We ascertained that risk factors in MRSA colonization in neonates were prophylactic use of antibiotics in mothers and the birth place.
Anti-Bacterial Agents ; Birth Weight ; Colon ; Gestational Age ; Humans ; Hypogonadism ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mitochondrial Diseases ; Mothers ; Ophthalmoplegia ; Residence Characteristics ; Retrospective Studies ; Risk Factors ; Staphylococcus aureus

Studies on the correlation between proliferative activity of biopsied specimen and pathologic findings of resected specimen have been carried out to find the prognostic factors. To estimate the proliferative activity, 100 cases of biopsied specimen of gastric adenocarcinoma were tested for the PCNA (proliferating cell nuclear antigen) and the AgNOR (argyrophilic nucleolar organizer region) by the immunohistochemical and histochemical stainings, respectively. The resected tumors classified by histologic type, differentiation, depth of invasion, and nodal metastatic status were followed by cell cycle analysis using flow cytometry. The PCNA LI (labelling index) were higher in well or moderately differentiated tumors (P<0.01) than the poorly differentiated ones and the aneuploid tumors (P<0.05) more than in diploid ones. However, there were no correlations among histologic types, depth of invasion, nodal metastatic status and PCNA LI. The AgNOR counts were higher in advanced tumor than in the EGC (early gastric cancer) (P<0.01). In cases with nodal metastasis, most of them showed the AgNOR counts higher than those without nodal metastasis. There were no correlations between the AgNOR counts and the DNA ploidy, histologic type, or differentiation. High PCNA LI and high AgNOR counts were shown in cases with advanced tumors (P=0.000) and nodal metastasis (P<0.05). No correlation was shown with the histologic type or differentiation. The results show that proliferative activity of the biopsied specimen of gastric adenocarcinoma is correlated with the differentiation and the invasion depth of resected specimen. Especially, better correlation is obtained by analyzing both the PCNA LI and the AgNOR counts than by analyzing each.
Adenocarcinoma* ; Aneuploidy ; Cell Cycle ; Diploidy ; DNA ; Flow Cytometry ; Neoplasm Metastasis ; Nucleolus Organizer Region ; Ploidies ; Proliferating Cell Nuclear Antigen ; Stomach Neoplasms

PURPOSE: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. METHODS: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. RESULTS: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was 3.6+/-2.8 year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period (4.18+/-2.10 vs 4.79+/-1.49 days, P=.17) and total fever duration (5.32+/-2.07 vs 6.41+/-3.25 days, P=.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. CONCLUSION: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.
Bacterial Infections ; Bronchiolitis ; Bronchitis ; Child* ; Croup ; Fever ; Hospitalization ; Hospitals, University* ; Humans ; Influenza B virus* ; Influenza, Human ; Inpatients ; Medical Records ; Oseltamivir* ; Outpatients ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Thorax