Anti-E and anti-c is one of the clinical significant irregular antibodies developing a delayed hemolytic transfusion reaction and hemolytic disease of the newborn. Since anti-c occurs frequently with anti-E in immunized people whosoe cells are E-and c-, it has been recommended to select blood of the patient's own R1 phenotype for transfusion, even when the presence of anti-c cannot be demonstrated in his/her serum. To determine the utility of this approach, we reviewed the blood bank laboratory records of patients identified anti-E and anti-c in his/her serum in Severance hospital over a 12 year period (1985-1996). During the 12-year period of study, 53 patients were identified with anti-E and/or anti-c; 30(56.6%) patients had anti-E alone, 6(11.3%) had anti-c, and 17(32.1%) had both. Thirty eight of forty two patients whose Rh-hr phenotypes were tested were R1R1. Of these 38 R1R1 patients, 16 patients (42.1%) presented with anti-c concomitant with anti-E. Ouru study showed that the incidence of antni-c in R1R1 patients with anti-E is similar to that of studies reported in Caucasian groups. We highly suggest the transfusion protocol of prophylactic use of c negative blood for R1R1 patients with anti-E. Furthermore, because anti-c may be present in concentrations too low to be detected, the enzyme technique is recommended in parallel with standard serologic methods for the identification of irregular antibodies.
Antibodies ; Blood Banks ; Blood Group Incompatibility ; Humans ; Incidence ; Infant, Newborn ; Phenotype

Diffuse leiomyomatosis of the esophagus is a rare condition and usually extends from the mid-esophagus to the proximal third of the stomach. Macroscopically, there is a marked diffuse thickening of the esophageal wall, with or without nodularity, predominantly affecting the circular muscle coat. Microscopically, the disorder is characterized by the loss of the normal orientation of the smooth muscle fibers of all three layers. We report a case in a 37-year-old woman which was incidentally discovered at exploratory thoracotomy.
Female ; Humans

No Abstract Available.
Latex Hypersensitivity* ; Latex* ; Operating Rooms*

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

BACKGROUND: Acne is principally a disorder of adolescence. However, a number of observational studies have documented a significant degree of acne in adult women. One study found a difference in women between late-onset acne and acne that persisted from adolescence. There were significant higher sebum excretion rates among women whose acne originated during the teenage years compared with late-onset acne groups. OBJECTIVE: The purpose of this study was to examine the clinical features of patients with acne and to compare the sebum excretion rates and the density of P acnes in adult acne with that in adolescent acne. METHODS: Thirty nine patients with acne vulgaris were clinically evaluated. Sebum secretion rates were evaluated by Sebutape method. The density of P acnes counted by scrub method. RESULTS: 1. The severity grades were mild to moderate in adult acne groups, consisting with the lower acne lesion counts than that of adolescent acne groups. 2. Sebum secretion rates by Sebutape(R) method showed different patterns in two groups. The mean value in the adult acne groups was lower than that in adolescent acne groups, but not statistically significant. Chin area dominant pattern, shown in adult acne groups, were not apparent in adolescent acne groups. 3. The density of P acnes was a lower mean value in the adult acne groups, but not statistically significant. Only in adolescent acne groups, the severity grades are well correlated to the density of P acnes. CONCLUSION: Adult acne was mild to moderate in severity. Clinically, adult acne differs from adolescent acne in that the lesions are located most commonly around the chin. Sebum excretion rate was the highest in the chin area of patients with adult acne. But there was no significant difference in two groups. Also the density of P acnes was not significantly different in two groups.
Acne Vulgaris* ; Adolescent* ; Adult* ; Chin ; Female ; Humans ; Propionibacterium acnes* ; Propionibacterium* ; Sebum*

PURPOSE: This study was conducted to explore the influence of academic institutional interest, open parent-adolescent communication, social (friend) support, and existential spiritual well-being on suicidal ideation of college students. METHODS: The research design was descriptive survey research involving 285 college students in city G. Data was collected from May 18, 2011 to November 2, 2011 and analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical regression analysis. RESULTS: The findings reveal that suicidal ideation of college students was low, i.e., average score was 9.2+/-3.65 (possible range 5~25). This study determined that suicidal ideation is negatively correlated with interest on the part of the academic institution, open parent-adolescent communication, social support from friends, and existential spiritual well-being. The extent of existential spiritual well-being was a significant predictor of suicidal ideation, controlling for general characteristics variables (gender, number of close friends, first supporter) and institutional interest, open parent-adolescent communication, and social support. Existential spiritual well-being accounted for 50% of the explanation of suicidal ideation of college students. CONCLUSION: Based on the outcomes of this study, designing an intervention program that emphasizes existential spiritual well-being in order to decrease suicidal ideation of tertiary education students is strongly recommended.
Education ; Friends ; Humans ; Research Design ; Suicidal Ideation*

BACKGROUND: Automated external defibrillator(AED) represent a major breakdown to permit more widespread application of the principle of early defibrillation. Many recent efforts to improve emergency medical services(EMS) and increase survival rates are simply efforts to get defibrillation to patients as rapidly as possible. AED is major innovation for the prehospital care of ventricular fibrillation cardiac arrest patients. The purpose of this study is to evaluate the course of initial training to three different groups(nurses, firefighters, and EMT trainee) to use AED. METHOD: We studies the efficacy of education of AED to 33 nurses, 15 EMT trainee, and 16 firefighters. Training lasted 75 mins and included 45 mins an overview of defibrillation, protocols for using the AED, and operation of the AED(Laerdal Heartstart 3000),15 mins demonstraion.4 check list was used to grade the performance of cardiopulmonary resuscitation, operation of the AED, and the time required to deliver the first three defibrillations. RESULT: There were no statistically significant differences in performance and time required to deliver an electrical countershock among the groups(p=0.4). To the second test 92fo of all group completed all steps successfully. The step most often foiled was the preparing of the AED for defibrillation. CONCLUSION: In nurses, EMT trainee, and firefighters, it is both feasible and effective to train AED use irrespective of the degree of the trainee.
Cardiopulmonary Resuscitation ; Defibrillators* ; Education ; Emergencies* ; Firefighters* ; Heart Arrest ; Humans ; Survival Rate ; Ventricular Fibrillation

PURPOSE: Congenital lesions account for more than half of the excised cervical masses in children, and 20% of these cervical masses are caused by branchial anomalies (BA). BA can present as a cyst, sinus, fistula or skin tag and they are the result of maldevelopment of the branchial apparatus during the embryonic period. In this study we sought to review the presentation, work-up, treatment and outcome of BAs in a pediatric population. METHODS: Forty-two pediatric patients who were treated for BA over an 11-year period starting from June 1997 at Keimyung University Dongsan Medical Center were investigated to assess the relative frequency of the type of BA, the preoperative manifestations, the preoperative diagnostic modalities and the surgical complications. RESULTS: There were 21 (50%) branchial sinuses, 12 (29%) branchial cysts, 6 (14%) branchial fistulas and 3 (7%) skin tags with a cartilaginous remnant. Among the 42 BAs, 13 (31%) were previously infected. Based on embryological classifications, there were 32 (76%) second BAs, 5 (12%) 3rd and 4th BAs, 1 (2%) 1st BA, and 4 (10%) unclassified BAs. We experienced 1 postoperative recurrence and 1 temporary facial nerve palsy that developed during excision of a 1st branchial cyst. Histopathological study of the lining epithelium demonstrated squamous epithelium in 19 BAs (45%), respiratory epithelium in 8 BAs (19%), squamous and respiratory epithelium in 4 Bas (10%), no epithelium with fibrosis in 8 BAs (19%), and others in 3 BAs (7%). CONCLUSION: Branchial sinuses are most common by morphology and 2nd branchial anomalies by embryology. The preoperative infection rate was 31%. The every effort to find out the exact anatomical location of the lesions is necessary to minimize postoperative recurrence by complete excision.
Branchioma ; Child ; Epithelium ; Facial Nerve ; Fibrosis ; Fistula ; Humans ; Paralysis ; Recurrence ; Respiratory Mucosa ; Skin

No abstract available.
Arthritis*