The congenital tracheoesophageal fistula without atresia of the esophagus is considered a rare variant, and the literature concerned to the tracheoesophageal fistula fistula without atresia is little in adult especially. The 22-year-old male was admitted to Yeungnam University Hospital with his chief complaints of weight loss (6 kg/6 months), abdominal discomfort, and intermittent coughing. The diagnosis was made by the endoscopy and esophagography. The fistula was 1.5 cm in diameter, 0.5 cm in length. The level was around second thoracic vertebra. The operation was performed transpleurally through the right third intercostals space and the fistula was secured with interrupted silk suture after division. The fibrotic adhesion was seen around the tracheoesophageal fistula. The postoperative course was uneventful, and postoperative esophagogram revealed no extraluminal leakage. Herewith we report this unusual case of isolated tracheo-esophageal fistula with review of literatures.
Adult ; Cough ; Diagnosis ; Endoscopy ; Esophagus* ; Fistula ; Humans ; Male ; Silk ; Spine ; Sutures ; Tracheoesophageal Fistula* ; Weight Loss ; Young Adult

In this article neuroanatomical and verbal developmental process were introduced, followed that disorders and assessment of language function were reviewed. Finally, the causes and assessment of developmental dyslexia as a childhood disorder related to verbal function were reviewed.
Dyslexia ; Neuropsychology

PURPOSE: The purpose of this study was to develop and evaluate breastfeeding effectiveness scale to measure effectiveness of breastfeeding for mothers in the early postpartum period. METHODS: A conceptual framework was constructed from properties of effective breastfeeding (Yang and Seo, 2011), and item construction was derived from literature review and analysis of the data along with interviews with breastfeeding mothers. Content validity was tested by experts. Each item was scored on a five-point Likert scale. The preliminary questionnaire was administered to 248 breastfeeding mothers. Data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's α. RESULTS: From the factor analysis, 20 items in seven factors were derived. The factors were identified as mother's satisfaction, suckling, assurance of milk quantity, infant's satisfaction, latching on, infant's feeding desire, and breastfeeding positioning. The seven factors explained 65.1% of total variance, Cronbach's α of the total items was .83 and the factors ranged from .44 to .75. CONCLUSION: Results of this study suggest that breastfeeding effectiveness scale is a reliable and valid instrument to measure breastfeeding effectiveness of mothers in the early postpartum period.
Breast Feeding* ; Humans ; Milk ; Mothers ; Postpartum Period ; Weights and Measures

Articular chondrocytes have been known to have heterogeneity in articular cartilage. Four layers are generally recognized from the articular surface to the subchondral bone. We have used Percoll density gradients to separate chondrocytes from articular cartilage into distinct subpopulations. Non-fibrillated articular cartilage was obtained from rabbit knee. The cells were carefully layered on the top of the preformed gradient and spun. After centrifugation, we obtained four fractions: Fraction A referred boundary between 0% and 10%, fraction B from between 10% and 20%, fraction C from between 20% and 30%, and fraction D from between 40% and 50%. In the A fraction, cells are relatively larger and round in shape, while their nuclei are relatively smaller. In the cytoplasm many lipid droplets were found and rough endoplasmic reticulum were disrupted. In the D fraction, chondrocyte is small, with large nucleus which surrounded by well-developed rough endoplasmic reticulum. The type II collagen proteins were expressed strongly and more proteoglycans synthesized in fractions A and B. And chondrocytes from the fraction D divided more slowly than those from the fractions A, B, and C. We have succeeded in separating chondrocytes from articular cartilage into distinct subpopulations by Percoll density gradients, as well as characterized growth rate, histological appearances and phenotypic expression. This study is the first report about the Percoll density gradients to separate articular chondrocytes.
Cartilage, Articular ; Centrifugation ; Chondrocytes* ; Collagen Type II ; Cytoplasm ; Endoplasmic Reticulum, Rough ; Knee ; Population Characteristics ; Proteoglycans

Epidermoid cysts occur rarely on the palms and soles, where hair is not present. These cysts have long been assumed to arise from traumatic implantation of epidermal fragment, but the pathogenesis is still controversial. Recently, with microscopic findings, immunohistochemical features, and molecular studies, the epidermoid cysts of the sole may be induced by the human papillomavirus. We report two cases of epidermoid cysts of the sole with the discussion of the pathogenesis.
Epidermal Cyst* ; Hair ; Humans*

BACKGROUND: The pathogenesis of atopic dermatitis is still unknown, but house dust mites are thought to be playing an impor tant role in the development of skin lesions. Atopic dermatitis shows an immediate react,ion to mite allergens in skin prick test, postive IgE-FAST for mite antigens, and higer serum levels of mite-specific IgG4, IgE and IgE immune complexes. This immediate antigen-IgE-initiated reaction, however, is not clinically and histologically relevant to typical skin lesion, eczematization. OBJECTIVE: We tried to show that atopic skin lesions can clinically be induced by the type 1V hypersensitivity to house dust mites and evaluate the histological features of the eczematous skin lesions. METHODS: We investigated patch test reaction to Dermatophagoides farinae and the changes of expression of intercellular adhesion molecule 1(ICAM 1), vascular cellular adhesion molecule 1(VCAM 1), and E selectin on vascular endothelial cells in skin biopsies obtained from positive patch sites. RESULTS: Positive rate is 41%. The patch test has a good correlation with asthma predisposition. In the positive reaction sites, the expression of ICAM 1 is markedly increased, and those of VCAM 1 and E selectin are induced on the vascular endothelial cells. CONCLUSION: D. farinae patch testing represents a diagnostic method besides prick testing in mite induced eczematous dermatitis but better standardization is necessary. D. farinae can activate the endothelial cells and enhance the expression of adhesion molecules, so allergic contact sensitivity to mite allergen is playing an important role in the pathogenesis of atopic dermatitis.
Allergens ; Antigen-Antibody Complex ; Asthma ; Biopsy ; Cell Adhesion Molecules* ; Cell Adhesion* ; Dermatitis, Atopic* ; Dermatitis, Contact ; Dermatophagoides farinae* ; E-Selectin ; Eczema ; Endothelial Cells ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Mites ; Patch Tests* ; Pyroglyphidae* ; Skin

To evaluate the results and clinical impact of defecography in patients with anorectal diseases, 304 defecographic examinations from 304 patients were reviewed. The defecographic results were screened for the anorectal angle and perineal descent at rest, squeezing and during straining. Changes of rectal configuration and canal width during straining were reviewed. 304 patients had defecation problems such as terminal constipation, defecation defficulty, blood or mucus discharge, tenesmus, obstruction sensation etc. They were performed anorectal physical examination and anal manometry etc., and were later treated by operation and conservative management. Normal anorectal angle were measured to be 101°, 91°, 131°at rest, during squeezing and straining respectively. In the spastic pelvic floor syndrome, increase of anorectal angle less than 10 ° from rest to straining was observed. Incontinent patients had a larger anorectal angle (mean: 128°) at rest. 7.8cm of perineal descent was found in descending perineal syndrome in comparison to 4.0cm in normal. Normal anal canal width was measured 1.4cm only during straining but identified in incontinent patients at rest (mean:1.2cm). Abnormal rectal configuration was found in 254 defecographic examinations: rectoceles were observed in 235 cases and were associated with rectal prolapse in 115 cases, and rectal prolapses were found in 134 cases. In conclusion, the anorectal angle was valuable in evaluation of spastic pelvic floor syndrome and fecal incontinence. Degree of perineal descent was abnormally increased in descending perineal syndrome. In the cases of the rectoceles and rectal prolapses, defecography is helpful in preoperative evaluation of rectal wall change and postoperative follow up.
Anal Canal ; Constipation ; Defecation ; Defecography* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Manometry ; Mucus ; Muscle Spasticity ; Pelvic Floor ; Physical Examination ; Rectal Prolapse ; Rectocele ; Sensation

To determine effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological and psychological components were investigated with nursing students. Two groups of seven volunteers participated as experimental subjects, and eight nursing students participated as a control group. The directions of rotation work shift were as follows : CW(clockwise)-shift system rotation in the direction of day shift(3 lays), evening shift(3days), off duty(1day) and night shift(5days). and CCW(counterclockwise)-shift system rotation in the reverse direction. Urinary free cortisol and 17-hydroxycorticoster oids in the urine were measured by the solid-phase radioimmunoassay and the colorimetry methods, re spectively. Plasma melatonin was measured by radioimmunoassay. The urinary free cotisol rhythm changed to ir-regular on the evening and night shift in the CCW shift system, whereas the rhythm seems to adapt on night shift in the CW shift system. The daily rhythms of urinary 17-OHCS indicate that they are well synchronized to shift work. These results show that the rotation of shift in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt on a physiological level, and has many more negative effects on nurses when compared with the CW rotation. Thus, a clockwise rotating shift systern seems to be more desirable for the optimal health and performance of nurses.
Circadian Rhythm* ; Colorimetry ; Humans ; Hydrocortisone* ; Melatonin ; Plasma ; Radioimmunoassay ; Students, Nursing ; Volunteers

PURPOSE: The study was done to construct and test a structural model to explain primipara breastfeeding behavior. METHODS: The participants were 213 primiparas on postpartum wards. Data were analyzed using the PASW 18.0 and AMOS 19.0 programs. RESULTS: Fitness statistics for the hypothetical model were appropriate (chi2 =38.50, p=.070, GFI=.96, RMSEA=.05, AGFI=.93, NFI=.95, TLI=.97, CFI=.98, PNFI=.57, chi2/df=1.43). Breastfeeding behaviors were directly influenced by intention to breastfeed, perceived effectiveness of breastfeeding, and the amount of supplementary feeding. The amount of supplementary feeding had the largest direct impact on breastfeeding behavior. The largest total effect on breastfeeding behavior was intention to breastfeed. The environment of the maternity hospital indirectly influenced breastfeeding behavior. These factors explained 18.9% of variance in the primipara breastfeeding behavior. CONCLUSION: The results of the study indicate that in order to promote primipara breastfeeding the amount of supplementary feeding immediately after the birth should be limited and an environment that encourages exclusive breastfeeding in the hospital should be provided. The results also suggest it is necessary to provide nursing interventions that increase the intention to breastfeed and the perceived effectiveness of breastfeeding.
Adult ; Bottle Feeding ; Breast Feeding/*statistics & numerical data ; Female ; Humans ; Infant, Newborn ; Intention ; *Models, Structural ; Mothers/psychology ; Questionnaires ; Young Adult

An intraosseous epidermal cyst is a rare benign cystic lesion. It is thought to result from congenital factors or trauma and can lead to bone destruction because the cyst develops at the soft tissue around the bone. Radiological findings of intraosseous epidermal cysts are a well-defined radiolucent lesion, with cortical expansion. It is important to differentiate an intraosseous epidermal cyst with other disease developed at distal phalanx because its clinical and radiological findings are similar. We report two rare cases of intraosseous epidermal cysts that developed at the distal phalanx.
Epidermal Cyst*