Background: A comprehensive history taking at the first visit could be an important start of treatment. This study investigated the current status of the initial history taking for dental patients in S area, and the implementation and importance of the initial history taking process. Based on this, we intend to provide basic data for the development of organized and standardized questionnaires in dental clinics. Methods: In April 2019, 303 dental clinics in S area were targeted and special dental clinics (orthodontics, children, and disabled) were excluded. The questionnaire consisted of 29 items, including general characteristics, systemic disease history, dental history, oral health behaviors, and the data were obtained through self-administered questionnaire. Results: Initial history taking was mostly implemented using oral and questionnaire at the time of the first visit. Systemic disease history, dental history, and oral health behaviors differed in the work experience of the dental clinic staff. As a result of analyzing the importance according to implementation, there were significant differences in all questions except drug-related items. The importance of the questionnaire was highly recognized, but the reason it was not actually implemented was because of existing the questionnaire in the clinic and lack of time. Conclusion Considering that the initial history taking implementation rate showed low, it is necessary to develop standardize a practical questionnaire and interview skills for dental clinics in the future. In addition, training programs should be provided to dental staff that can recognize the importance of initial history taking questionnaires and contribute to active implementation.

We report a case of gastro-colic fistula caused by ectopic gastric mucosa developed at transverse colon. Fistula was detected by colonofiberscopy. And fistulous tract was proved by barium enema. Meckel's diverticulum scan finding was similar to that of GI bleeding; e.g. injected radioactivity was secreted into the lumen and moved along the lumen. There was no bleeding. And there was no diverticulum in the colon. Absence of diverticular pouch may explain this unusuaal GI bleeding-like scan finding rather than focal collection of radioactivity, which is typical of ectopic gastric mucosa found in the Meckel's diverticulum. Ectopic gastric mucosa was confirmed by colonfiberscopic biopsy. We suggest GI bleeding-like pictures should be included differential diagnosis of Tc-99m-O4 (ectopic gastric mucosa or Meckel's diverticulum) scan.
Barium ; Biopsy ; Colon ; Colon, Transverse ; Diagnosis, Differential ; Diverticulum ; Enema ; Fistula* ; Gastric Mucosa* ; Hemorrhage ; Meckel Diverticulum ; Radioactivity ; Radionuclide Imaging ; Sodium Pertechnetate Tc 99m*

Emphysematous cholecystitis is an uncommon condition which may mimic acute cholecystitis. But it differs from acute cholecystitis in its relatively greater frequency in men and diabetics and has graver prognosis. The condition is diagnosed by demonstration of air in lumen,wall of gallbladder and/or pericholecystic space using a variety of radiographic techniques: simple abdominal radiography, ultrasonography and CT scanning. One illustrative case is presented herein and the pertinent literature is reviewed.
Cholecystitis, Acute ; Emphysematous Cholecystitis* ; Gallbladder ; Humans ; Male ; Prognosis ; Radiography, Abdominal ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: To evaluate the nephrotoxicity of Gd-DTPA in rats with normal renal function and in those with acute renal failure, using 0.1mmol/kg and 0.3mmol/kg in each group. MATERIALS AND METHODS: Sixty rats weighing 200-250gm were divided into two groups: normal (N) and glycerol induced acute renal failure (F) ; this was inducedby intramuscular injection of 50% glycerol(10ml/kg). Each group was divided into three subgroups; subgroup 1 was given physiologic saline (0.15 M NaCl) via the tail vein, while subgroups 2 and 3 were given 0.1 mmol/kg Gd-DTPAand 0.3mmol/kg Gd-DTPA, respectively. Blood and 24-hour urine were collected before and on the first and secondday after intravenous injection of either physiologic saline or Gd-DTPA. In order to obtain pathologic specimens, two additional rats in each group underwent the same experimental procedure, and on the first or second day after intravenous injection of saline or Gd-DTPA, both kidneys were removed for light microscopic examination. Serum creatinine (Cr), urine creatinine, and several urinary enzymes such as alkaline phosphatase (ALP), gammaglutamyl transferase (GGT), N-acetyl-Beta-glucosaminidase (Beta-NAG) and lactic dehydrogenase (LDH) of 24 hour urine were measured, and creatinine clearance (Ccr) was calculated. RESULTS: The results were as follows. 1. In the groupwith normal renal function, levels of serum creatinine and urinary enzymes remained unchanged after infusion of 0.1mmol/kg Gd-DTPA or 0.3mmol/kg Gd-DTPA. 2. Among rats with acute renal failure, no difference in serum creatinine and urinary enzyme levels between the saline injection group and 0.1mmol/kg Gd-DTPA injection group was noted. 3. Among rats with acute uremia, Beta-NAG, LDH and ALP were significantly higher on post-injection days 1 and 2 in the 0.3mmol/kg Gd-DTPA injection group than in the physiologic saline or 0.1mmol/kg Gd-DTPA injection group.4. Light microscopic exammination of rats with normal renal function after Gd-DTPA injection revealed no significant pathologic change. Those with acute renal failure rats revealed some degree of vacuolization and/or necrosis of renal proximal tubular epithelial cells. No difference was found, however, between the saline and Gd-DTPA injection subgroups. CONCLUSION: In conclusion, Gd-DTPA was safe in rats with normal renal function, even when the dose was tripled (0.3mmol/kg), and was safe in those with acute renal failure when the standard dose (0.1mmol/kg) was given. In this latter group, however, a triple dose induced some renal damage.
Acute Kidney Injury* ; Alkaline Phosphatase ; Animals ; Creatinine ; Epithelial Cells ; Gadolinium DTPA* ; Glycerol ; Injections, Intramuscular ; Injections, Intravenous ; Kidney* ; Necrosis ; Oxidoreductases ; Rats* ; Transferases ; Uremia ; Veins

PURPOSE: Emphysematous pyelonephritis is a rare, life threatening infection of kidney and the pennephric space, characterized by the production of gas within the renal parenchyma. The aim of this study is to analyze the clinical and radiologic characteristics of emphysematous pyelonephritis. MATERIALS AND METHODS: We reviewed 7 cases of the emphysematous pyelonephritis. Six patients had plain abdominal radiographs, ultrasonograms and abdominal CT scans. Only one patient had plain radiograph and ultrasonogram. In 5 operated cases, CT findings were compared with surgical records. RESULTS: Plain radiographs showed characteristic diffuse mottling of gas in renal fossa. On sonogram, intrarenal gas was identified as echogenic loci with dirty shadows. CT scan showed inflammatory mass with gas and fluid levels in adjacent to the kidney. CT findings corresponded relatively wall with the surgical findings in regard to disease extent. CONCLUSION: lntrarenal gas in appropriate clinical setting is highly specific for emphysematous pyelonephritis. CT is the most sensitive method for demonstrating the disease extent as well as specific diagnosis.
Diagnosis ; Humans ; Kidney ; Pyelonephritis* ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: Emphysematous pyelonephritis is a rare, life threatening infection of kidney and the pennephric space, characterized by the production of gas within the renal parenchyma. The aim of this study is to analyze the clinical and radiologic characteristics of emphysematous pyelonephritis. MATERIALS AND METHODS: We reviewed 7 cases of the emphysematous pyelonephritis. Six patients had plain abdominal radiographs, ultrasonograms and abdominal CT scans. Only one patient had plain radiograph and ultrasonogram. In 5 operated cases, CT findings were compared with surgical records. RESULTS: Plain radiographs showed characteristic diffuse mottling of gas in renal fossa. On sonogram, intrarenal gas was identified as echogenic loci with dirty shadows. CT scan showed inflammatory mass with gas and fluid levels in adjacent to the kidney. CT findings corresponded relatively wall with the surgical findings in regard to disease extent. CONCLUSION: lntrarenal gas in appropriate clinical setting is highly specific for emphysematous pyelonephritis. CT is the most sensitive method for demonstrating the disease extent as well as specific diagnosis.
Diagnosis ; Humans ; Kidney ; Pyelonephritis* ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: Airway eosinophilic inflammation is a characteristic feature of asthma. Sputum analysis can be used as a non-invasive tool to assess severity of the airway inflammation. This study was performed to compare relationships between sputum eosinophils to other parameters of airway inflammation and to evaluate the clinical utility of sputum eosinophils and ECP in childhood asthma. METHODS: A total of 40 asthmatic children over 6 years of age were divided into two groups : Group A of 15 current symptomatic subjects and Group B of 25 stable asymptomatic subjects with history of asthma for 2 weeks. Eosinophils in induced sputum were compared with the severity of asthma symptom, pulmonary function, bronchial hyperresponsiveness by methacholine, sputum ECP, blood eosinophils and serum ECP. RESULTS: 1) Asthmatics had a significantly higher proportion of sputum eosinophils than the control subjects (15.2+/-17.8% VS 3.8+/-4.5%, P<0.01). Group A had a significantly higher proportion of sputum eosinophils than group B (22.9+/-21.7% VS 11.2+/-14.8%, P<0.05). 2) Sputum eosinophils were correlated with symptom scores in asthmatics (r=0.76, P<0.01), inversely correlated with FEV1 in group A (r=-0.65, P<0.01) and with LogPC20 in group B (r=-0.45, P<0.05). 3) Sputum eosinophils were correlated with sputum ECP for group A; r=0.77 (P<0.01) and for group B; r=0.39 (P<0.05) but not correlated with serum ECP. 4) Sputum eosinophils were correlated with blood eosinophils in group A (r=0.67, P<0.05), but not in group B. CONCLUSION: This study suggests that the proportion of eosinophils and the level of ECP in induced sputum may be sensitive and accurate means of assessing the airway inflammation in childhood asthma, and their relationships with blood eosinophils or serum ECP are to be studied further.
Asthma* ; Child ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Inflammation ; Methacholine Chloride ; Sputum*

PURPOSE: This study was to examine the degree of prenatal emotional status, preparation for delivery, postpartum social support, and postpartum blues and to investigate the relationship of the above variables in postpartum women. METHOD: The subjects were 131 postpartum women. Selection criteria were women who were 2 to 8 weeks post delivery. After Informed consent was obtained, they were asked to fill out a self-administered questionnaire. The instrument was a Postnatal Depression and Anxiety check list. RESULT: The mean age of the subjects was 29.3 years, and 63.4% of subjects delivered their children by vaginal birth. 18.3 percent had felt depressed during their pregnancy. The mean score of the postpartum blues was 19.2. 61.8 percent of the subjects had postpartum blues and 8.4 percent experienced postpartum depression. Monthly income was negatively correlated to postpartum blues (r=-.189, p< .05), but the emotional status during pregnancy had a significant and positive relationship. However, preparation for delivery had no significant correlation with postpartum blues. While husband support and social support had a tendency to have a negative correlation. CONCLUSION: Further research is needed to identify the factors that affect the emotional status during pregnancy with various scales. Also, intervention programs to increase emotional support for pregnancy and husband support are needed.
Anxiety ; Child ; Depression ; Depression, Postpartum ; Female ; Humans ; Informed Consent ; Parturition ; Patient Selection ; Postpartum Period* ; Pregnancy ; Surveys and Questionnaires ; Spouses ; Weights and Measures

Drash syndrome, which was first reported by Denys et al. in 1967 is a complex disorder which associates a nephropathy, Wilms' tumor, and male pseudohermaphroditism. The common denominator is a nephropathy. The nephropathy may be associated with either genital abnormalities or Wilms' tumor, and these associations are called incomplete form of Drash syndrome. This syndrome appears early in life and the first sign usually is genital ambiguity. The nephropathy presents with proteinuria, hematuria and hypertension, and eventually progresses to end stage renal failure. Renal biopsy may reveal a variety of glomerular and interstitial changes. Wilms' tumor may appear as s mass on ultrasound or it may not be recognized until nephrectomy or even autopsy. We report on a boy with nephropathy and genital abnormalities. A nephrotic syndrome with hypertension was present when first seen at 15 days of age. The karyotype was 46, XY and external genitalia was ambiguous. The nephrotic syndrome and signs of renal insufficiency persisted and he died at the age of 40 days. Histopathologic findings of kidney at autopsy revealed those of diffuse mesangial sclerosis. The case was presented with brief review of literatures.
46, XY Disorders of Sex Development ; Autopsy ; Biopsy ; Denys-Drash Syndrome* ; Disorders of Sex Development ; Genitalia ; Hematuria ; Humans ; Hypertension ; Karyotype ; Kidney ; Male ; Nephrectomy ; Nephrotic Syndrome ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Ultrasonography ; Wilms Tumor

PURPOSE: The purpose of this study is to survey health requirements of middle-aged women and their families and to provide guidelines for developing nursing interventions by describing the process of family health maintenance experienced by middle-aged women and its conceptual system. METHODS: To get saturated data, each of four researchers conducted two or three times of in-depth interview with eight middle-aged women aged between 40-64 years old and living in Seoul and Chuncheon from the 10th to the 30th of October 2004 and each interview was continued one or two hours. The Grounded theory adopted by Strauss & Corbin (1998) is a substantive theory that can explain the experiencing process of middle-aged women. RESULTS: We found that the casual condition of family health maintaining by middle-aged women was "confidence of health belief", and "pouring by body moving" was found to be its phenomenon. A textual condition that might respond to the phenomenon was "fatal roles acceptance", and intervening conditions that promote their family health were "retracing" and "gathering health information". These intervening conditions impacted middle-aged women's confidence in family health and led them to take actions/interactions such as "being a model of health", "adapting to circumstances", "do-it-myself", "taking-care" "harmonious mind" and "the pursuit of cleanness". These actions/interactions produced results such as "being stronger", "being unmanageable" and "being fruitful". CONCLUSIONS: Health confidence and practical health behaviors were observed in the process that the middle-aged female participants experienced unmanageable circumstances but they accepted their roles and responsibilities and recognized that they must be get stronger. The behaviors of health-together-with were divided into enthusiastic type, adaptation type and self-sacrificing type. Therefore middle-aged woman with the understanding of family health maintaining process as well as the theoretical system and practical principals needs to implement the intervention in acceptable level of family health process of preventing psychological and physical problems.
Family Health* ; Female ; Gangwon-do ; Health Behavior ; Humans ; Nursing ; Seoul