PURPOSE: The aim of this study was to examine the sensitivity and specificity of the influenza rapid antigen test, in comparison with reverse transcription polymerase chain reaction (RT-PCR), according to the time of the test from symptom onset and the clinical manifestations in the patients tested for suspected infection of the influenza A (H1N1) at a second hospital. METHODS: A total of 529 pediatric patients, aged between 6 and 12 years old, who visited the emergency department from October 1, 2009 to December 31, 2009, received the influenza rapid antigen test and RT-PCR. We examined the sensitivity and specificity of the influenza rapid antigen test in comparison with RT-PCR according to the time of the test from symptom onset (<24 hours, 24 to 48 hours, 48 to 72 hours, >72 hours) and clinical manifestations (fever, cough, rhinorrhea.nasal obstruction, sore throat, gastrointestinal symptoms, and general symptoms) in a retrospective study based on hospital charts. RESULTS: The sensitivity of the influenza rapid antigen test at elapsed times of less than 24 hours, 24 to 48 hours, and 48 to 72 hours after the onset of the symptoms was 53.9%, 61.4%, and 62.1% respectively. When the elapse time was greater than 72 hours, the sensitivity was 31.6%; thus, the sensitivity of the influenza rapid antigen test tended to decrease with elapsed time. The sensitivity of the test was 79% in patients presenting with gastrointestinal symptoms, which was the highest, but there was no statistical difference according to the clinical manifestations of the patients. CONCLUSION: Our study suggests that more accurate results might be gained when the influenza rapid antigen test is performed within 72 hours after symptom onset.
Aged ; Child ; Cough ; Emergencies ; Humans ; Influenza, Human ; Pharyngitis ; Polymerase Chain Reaction ; Retrospective Studies ; Reverse Transcription ; Sensitivity and Specificity

Melanosis coli is the brownish black discoloration of the colon due to accumulation of pigment containing macrophages in lamina propria. The nature and source of this pigment is controversial but many studies have suggested that the pigment is related to lipofuscin. Melanosis coli has been reported to be closely associated with prolonged administration of anthraquinone purgatives. But this condition is sometimes associated with colonic polyp colon cancer, rediation therapy or non-anthraquinone purgatives administration. Moreover the fact that melanosis coli could be found in subjects who never used purgatives suggested that, even though chronic consumption of anthraquinone purgatives seems to play a major role, other factors may be involved in the pathogenesis of melanosis coli. We presented a case of melanosis Coli in a 47-year-old female with history of rectal instillation of petroleum for control of hemorrhoids.
Administration, Rectal* ; Cathartics ; Colon ; Colonic Neoplasms ; Colonic Polyps ; Female ; Hemorrhoids ; Humans ; Lipofuscin ; Macrophages ; Melanosis* ; Middle Aged ; Mucous Membrane ; Petroleum*

OBJECTIVES: Middle aged women with depression often experience hot flush symptoms. It is still unclear about the association between depression and hot flush symptoms. Therefore, we investigated hormonal profile, functional somatic symptoms, coping styles and attitude for menopause between depressed women with hot flush and those without hot flush. METHODS: This study included 33 depressed patients with hot flush symptoms and 33 depressed patients without hot flush symptoms. Hot flush was confirmed through prospective daily symptom ratings for a week. Subjects' coping styles were assessed by the stress coping checklist. Somatic symptoms were assessed by the Patient Health Questionnaire-15(PHQ-15). Sex hormonal levels were assayed by a radioimmunoassay. The Brief World Health Organization Quality of Life Assessment Instrument(WHOQOL-BREF) was used to evaluate quality of life. RESULTS: In coping style, depressed women with hot flush symptoms used less ‘problem-centered coping’(13.15±3.17) and ‘search for social support’(11.83±2.84) than those without hot flush symptoms(15.17±3.1, p=0.028 ; 14.25±3.22, p=0.009 ; respectively). Depressed women with hot flush symptoms showed more negative attitude toward post-menopause, but its statistical significance was marginally insufficient(p=0.059). We did not find any group differences in sex hormonal levels and somatic complaints assessed by the PHQ-15. The score of social relationship domain of WHOQOL-BREF was significantly lower in subjects with hot flush symptoms(8.62±2.04) than subjects without hot flush symptoms(9.71±1.65 ; p=0.044). CONCLUSIONS: Among middle aged women with depression, the manifestation of hot flush symptoms was associated with coping styles and attitude for menopausal transition. Hot flush symptoms in depressed women negatively influence quality of life, so clinicians actively perform therapeutic approach in case of depressed patients with hot flush symptoms. In case of depressed patients who present hot flushes, cognitive behavior therapy or stress management might be an effective treatment option in company with antidepressants or hormonal treatment. Later, longitudinal study will be needed to evaluate risk factor, cause and effect associated with hot flush and depression.
Antidepressive Agents ; Checklist ; Cognitive Therapy ; Depression ; Female ; Humans ; Longitudinal Studies ; Menopause ; Middle Aged ; Postmenopause ; Prospective Studies ; Quality of Life ; Radioimmunoassay ; Risk Factors ; World Health Organization

OBJECTIVES: The aim of this study was to identify the health and environmental risk factors of air contaminants that influence environmental and respiratory diseases in Gyeongju, Pohang and Ulsan in South Korea, with a focus on volatile organic compounds (VOCs). METHODS: Samples were collected by instantaneous negative pressure by opening the injection valve in the canister at a fixed height of 1 to 1.5 m. The sample that was condensed in -150degrees C was heated to 180degrees C in sample pre-concentration trap using a 6-port switching valve and it was injected to a gas chromatography column. The injection quantity of samples was precisely controlled using an electronic flow controller equipped in the gas chromatography-mass spectrometer. RESULTS: The quantity of the VOC emissions in the industrial area was 1.5 to 2 times higher than that in the non-industrial area. With regards to the aromatic hydrocarbons, toluene was detected at the highest level of 22.01 ppb in Ulsan, and chloroform was the halogenated hydrocarbons with the highest level of 10.19 ppb in Pohang. The emission of toluene was shown to be very important, as it accounted for more than 30% of the total aromatic hydrocarbon concentration. CONCLUSIONS: It was considered that benzene in terms of the cancer-causing grade standard, toluene in terms of the emission quantity, and chloroform and styrene in terms of their grades and emission quantities should be selected for priority measurement substances.
Benzene ; Chloroform ; Chromatography, Gas ; Electronics ; Electrons ; Hot Temperature ; Hydrocarbons, Aromatic ; Hydrocarbons, Halogenated ; Republic of Korea ; Risk Factors ; Styrene ; Toluene ; Volatile Organic Compounds

Atlato-axial instability is a serious condition that often requires operation. Atlanto-axial subluxation may cause severe symptoms; and threaten the intergrity of the spinal cord, leading to quadriplegia or sudden death. A techique of combining C1-C2 posterior screw fixation with a supplemental bone wire fusion has been advocated for the management of atlantoaxial instability. It was used in 9 patients with this disorder. Patients ages ranged from 20 years to 52 years; follow-up period ranged from 3 to 16 months with a mean of 9.8 months. All nine patients gained immediate rigid fixation of C1,2 with this technique. Of these 9 patients, instability occurred due to trauma in seven, os odotoideum in one and os odontoideum with trauma in another one. One patient was presented with nonunion and C1,2 instability after a Halovest applications a result of type II odontoid fracture. All 9 patients were placed in a philedelphia collar for 12weeks and all achieved solid fusion. Posterior atlantoaxial facet screw fixation provides immediate multidirectional rigid fixation of C1,2 and is mechanically superior to siring or clamp fixation. This technique maximizes success without the need for a supplemental rigid external orthosis.
Bone Wires ; Death, Sudden ; Follow-Up Studies ; Humans ; Orthotic Devices ; Quadriplegia ; Spinal Cord ; Spinal Fusion ; Transplants*

PURPOSE: The purpose of our study is to evaluate the plain radiographic features of pulmonary tuberculosis in adult diabetic patients compared with those in patients without any underlying diseases. MATERIALS AND METHODS: We analyzed the chest PA and lateral views of 100 patients having active pulmonary tuberculosis;40 patients had diabetes mellitus and 60 patients had no other underlying diseases. images were assesed for anatomical distributions, extents of lesions, size and number of cavity and patterns radiographic findings. RESULTS: Diabetic tuberculosis had higher prevalence and wider involvement of unusual segments for the tuberculosis such as anterior segment, lingular segment of upper lobe and basal segment of the lower lobe, and they showed the tendency of having more cavities than those who had no other underlying diseases, but there were no meaningful differences in the cavity size between the two groups. CONCLUSION: Pulmonary tuberculosis in diabetic patients tends to have wider extent with unusual segmental involvement and multiple cavities than in the patients who had no other underlying diseases.
Adult* ; Diabetes Mellitus ; Equidae ; Humans ; Prevalence ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

OBJECTIVES: Many studies have shown an association between low serum cholesterol concentration and impulsive aggressive behaviors. Recent studies reported that serum triglycerides concentration has been independently associated with impulsive aggressive behaviors regardless of serum cholesterol concentration. However, conflicting results have also been reported. This study was designed to find the relationship between serum lipid levels (cholesterol and triglycerides) and impulsiveness in adolescents. METHODS: Serum cholesterol concentration, serum triglycerides concentration, complete blood count, electrolytes, liver function test, and blood sugar level were measured by overnight fasting blood sampling and urinalysis was also conducted in 450 high school students. Impulsiveness level was measured by Barratt impulsiveness scale(BIS). Serum cholesterol was measured by standard enzymatic assay and serum triglycerides was measured by Boehringer Mannheim method. RESULTS: 1) The cholesterol concentration in high impulsiveness group was found to be significantly lower compared with low impulsiveness group both in male and female separately. Especially, the lower cholesterol concentration was associated with motor impulsiveness, a subscale of BIS. 2) The triglycerides concentration in high impulsiveness group was found to be higher compared with the triglycerides concentration in low impulsiveness group. Above results were still valid even after exclu-ding the factor of sex and of body mass index. CONCLUSION: These results suggest that low cholesterol concentration is associated with an increased impulsiveness, and there is a relationship between serum triglycerides concentration and impulsiveness. These results support the previous hypothesis that serum lipid levels(cholesterol and triglycerides) affect brain serotonin level and human psychologic characteristics.
Adolescent* ; Blood Cell Count ; Blood Glucose ; Body Mass Index ; Brain ; Cholesterol* ; Electrolytes ; Enzyme Assays ; Fasting ; Female ; Humans ; Liver Function Tests ; Male ; Serotonin ; Triglycerides* ; Urinalysis

Isolated Aspergillus infection originating within the sphenoid sinus is most often associated with the immunocompromised patient. A 53-year-old healthy woman presented with a 3-week history of headache and subsequent left 6th nerve palsy. Brain MRI demonstrated a space-occupying lesion within sphenoid sinus. Histological analysis through transnasal-transsphenoidal approach revealed numerous Aspergillus hyphae. Postoperatively, all symptoms resolved completely without anti-fungal treatment. Isolated Aspergillus sphenoid sinusitis should be routinely included in the differential diagnosis of patients with acute or subacute headache, even in nonimmunosuppressed patients.
Abducens Nerve Diseases ; Aspergillosis ; Aspergillus* ; Brain ; Diagnosis, Differential ; Female ; Headache ; Humans ; Hyphae ; Immunocompromised Host ; Magnetic Resonance Imaging ; Middle Aged ; Sphenoid Sinus* ; Sphenoid Sinusitis*

BACKGROUND: Titanium dioxide (TiO2) thin film photocatalyst generates strong oxidizing power when illuminated with Ultra Violet (UV) light with wavelengths of less than 385 nm. In this study, we evaluated the bactericidal activity of it against Escherichia coli, Aspergillus fumigatus and Mycobacterium tuberculosis. METHODS: The TiO2 film were prepared from titanium isopropoxide solution and it was coated on either inner(test) or outer(control) side on Petri dish. annealing at 500 degrees C. The test and control suspension of E. coli, A. fumigatus and M. tuberculosis were grown in the chamber coated inner and outer side. respectively with UV light. For the blank, cell suspensions were grown in TiO2 coated Petri dishes without UV light. The bactericidal activities were estimated by survival ratio calculated from the number of viable cells which form the nutrient agar. RESULTS: In the test, the survival ratio for E. coli and M tuberculosis decreased to a negligible level (i.e., essentially complete sterilization) within 1hr and 2 hr, respectively. and that for 11. fumigatus decreased markedly to about 15% within 6 hr. In the control, the survival ratio for E. coli, A. fumigatus and M. tuberculosis decreased to 40% within 150 min. 6 he and 2 hr, respectively. In the blank, the survival ratio for E. coli and M tuberculosis decreased only about 67% within 150 min and 40% within 2hr. In A. fumigatus, TiO2 only caused little Sterilization within 4 hr. CONCLUSIONS: TiO2 photocatalysts under UV light clearly showed bactericidal activity against E. coli, A. fumigarus and M. tuberculosis. This feature render TiO2 photocatalysts to be applicable to eliminate microorganism from indoor air environment combined with ventilation.
Agar ; Aspergillus fumigatus* ; Aspergillus* ; Escherichia coli* ; Escherichia* ; Mycobacterium tuberculosis ; Sterilization ; Suspensions ; Titanium* ; Tuberculosis* ; Ultraviolet Rays ; Ventilation ; Viola

Squamous cell carcinoma of the extrahepatic bile duct is very rare. Only limited information is available concerning its pathogenesis and prognosis, although it is reported to be associated with choledocolithiasis, recurrent pyogenic cholangitis, clonorchiasis, choledochal cyst formation, and primary sclerosing cholangitis. Therefore, we present a case of squamous cell carcinoma of the distal common bile duct. A 64-year-old male patient presented with abdominal pain and obstructive jaundice. Computed tomography and endoscopic retrograde cholangiography showed thickening of the wall and a segmental stricture of the distal common bile duct, and the biopsy confirmed poorly differentiated carcinoma with marked squamous differentiation. The patient underwent a pylorus-preserving pancreaticoduodencetomy. Histological examination revealed that the tumor invaded the pancreas and metastasized to regional lymph nodes (pT3N1M0). The patient developed multiple liver metastases 30 days later and died of rapidly progressive metastatic disease to the liver 5 months following resection. Squamous cell carcinoma of the distal bile duct with lymph node metastasis had a very poor prognosis, even though curative resection was performed.
Abdominal Pain ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biopsy ; Carcinoma, Squamous Cell ; Cholangiography ; Cholangitis ; Cholangitis, Sclerosing ; Choledochal Cyst ; Clonorchiasis ; Common Bile Duct ; Constriction, Pathologic ; Humans ; Jaundice, Obstructive ; Liver ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Pancreas ; Prognosis