PURPOSE: This study was done to identify degrees of maternal conflict, differences, and factors predicting conflict in mothers of toddlers. METHOD: A convenience sample of 300 mothers living in G city, Kyounggi-do whose child was between 12 to 36 months old was used. Data were collected through a questionnaire survey and analyzed using SPSS WIN 10.0. RESULTS: The average score for maternal conflict was 67.35 (SD=10.18), somewhat lower than moderate in level. 'I as a human being' was the area of the 6-sub areas with the most conflict. Mothers experiencing higher maternal conflict were those who were less satisfied with marriage, quality of life, and maternal role, and whose child was stubborn and hard to please, who were unsatisfied with baby sitters or who had to rush their sick child to hospital. Factors that were significant in predicting maternal conflict were low satisfaction with maternal role and marriage, and a child who was difficult to care for. These factors accounted for 22% of explained variance. CONCLUSION: Nurses should help mothers resolve maternal conflict through education and counseling on the maternal role, but at the same time nurses should consider relationship of the mother with her husband and also special characteristics of her child.
Child ; Child Rearing ; Child, Preschool ; Counseling ; Education ; Humans ; Marriage ; Mothers* ; Quality of Life ; Spouses ; Child Health ; Surveys and Questionnaires

Hydatid cysts are caused by an infestation with larval tapeworms of the genus Echinococcus. The disease is endemic in developing countries but has rarely been reported from immigrant workers in Korea. This paper reports a case of hepatic hydatid cyst in a 27-year-old female. She was referred with abdominal pain that had persisted for the past 2 months. The patient was a foreign worker from Mongolia. The physical examination was unremarkable, and blood tests showed peripheral blood eosinophilia and elevated liver enzymes. Abdominal ultrasonography showed a well-circumscribed cystic mass with septation in the liver. A surgical resection was performed for complete removal. After uncomplicated postoperative recovery, the patient was discharged with albendazole 400 mg twice daily. The hydatid cyst is an important disease that should be considered in the differential diagnosis of cystic lesions in the liver, particularly in those who have lived in endemic areas. A correct early diagnosis based on the typical image findings is important for early treatment before the rupture of the cyst, which is associated with low morbidity and mortality. A current surgical resection combined albendazole are effective treatments for hepatic hydatid cysts, associated with low recurrence rates.

BACKGROUND: The dominant innervation of airway smooth muscle is parasympathetic fibers which are carried in the vagus nerve. Activation of these cholinergic nerves releases acetylcholine which binds to M3 muscarinic receptors on the smooth muscle causing bronchocontraction. Acetylcholine also feeds back onto neuronal M2 muscarinic receptors located on the postganglionic cholinergic nerves. Stimulation of these receptors further inhibits acetylcholine release, so these M2 muscarinic receptors act as autoreceptors. Loss of function of these M2 receptors, as it occres in animal models of hyperresponsiveness, leads to an increase in vagally mediated hyperresponsiveness. However, there are limited data pertaining to whether there are dysfunctions of these receptors in patients with asthma. The aim of this study is to determine whether there are dysfunction of M2 muscarinic receptors in asthmatic patients and difference of function of these receptors according to severity of asthma. METHODS: We studied twenty-seven patients with asthma who were registered at Pulmonology Division of Korea University Hospital. They all met asthma criteria of ATS. Of these patients, eleven patients were categorized as having mild asthma, eight patients moderate asthma and eight patients severe asthma according to severity by NAEPP Expert Panel Report 2(1997). All subjects were free of recent upper respiratory tract infection within 2 weeks and showed positive methacholine challenge test(PC 20<16mg/ml). Methacholine provocation tests performed twice on separate days allowing for an interval of one week. In the second test, pre-treatment with the M2 muscarinic receptor agonist pilocarpine(180µg) through inhalation was performed before the routine procedures. RESULTS: Eleven subjects with mild asthma and eight aubjects with moderate asthma showed significant increase of PC20 from 5.30±5.23mg/ml(mean±SD) to 20.82±22.56mg/ml(p=0.004) and from 2.79±1.5mg/ml to 4.67±3.53mg/ml(p=0.012) after pilocarpine inhalation, respectively. However, in the eight subjects with severe asthma significant increase of PC20 from 1.76±1.50mg/ml to 3.18±4.03mg/ml(p=0.161) after pilocarpine inhalation was not found. CONCLUSION: In subjects with mild and moderate asthma, function of M2 muscarinic receptors was normal, but there was a dysfunction of these receptors in subjects with severe asthma. These results suggest that function of M2 muscarinic receptors is different according to severity of asthma.
Acetylcholine ; Asthma ; Autoreceptors ; Humans ; Inhalation ; Korea ; Methacholine Chloride ; Models, Animal ; Muscle, Smooth ; Neurons* ; Pilocarpine ; Pulmonary Medicine ; Receptors, Muscarinic* ; Respiratory Tract Infections ; Vagus Nerve

A 56-year-old male with a gastrointestinal stromal tumor (GIST) underwent surgical resection of the tumor. Nine months after surgery, imatinib therapy was initiated because of the discovery of metastatic tumors in the left adrenal gland and in a lymph node of the peritoneum. Seventeen months later, the patient achieved complete remission (CR) and imatinib therapy was continued. However, 48 months after initiation of imatinib therapy, computed tomography scans revealed a left adrenal gland metastasis and the patient underwent left adrenalectomy. Immunohistochemical staining indicated that the spindle-shaped cells of the resected tumor were positive for C-kit, thus confirming metastasis of the GIST. This is the first report from Korea of an adrenal gland metastasis from a GIST. Worldwide, only two such cases have been reported. Here, we describe the first case of a distant recurrence of a GIST in the left adrenal gland after CR had been achieved with the aid of surgical resection and imatinib therapy.
Adrenal Glands* ; Adrenalectomy ; Gastrointestinal Stromal Tumors* ; Humans ; Imatinib Mesylate ; Korea ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis* ; Peritoneum ; Recurrence

Constipation is a prevalent, often chronic, gastrointestinal motility disorder. Bisacodyl, a stimulant laxative, is widely used to treat constipation in adults and children. This drug is usually safe, but it has some side effects including diarrhea, abdominal pain, colitis, and proctitis. There have been reports that rectal administration of bisacodyl could cause injury to the rectal mucosa by mechanical and chemical mechanisms. However, there has been no report of severe proctitis with rectal ulcers in patients taking oral bisacodyl. In this report, we describe the case of an 80-year-old woman with severe rectal ulcers and proctitis after taking oral bisacodyl for several days, and review the literature.
Abdominal Pain ; Administration, Rectal ; Adult ; Aged, 80 and over ; Bisacodyl* ; Child ; Colitis ; Constipation ; Diarrhea ; Female ; Gastrointestinal Motility ; Humans ; Mucous Membrane ; Proctitis* ; Rectum ; Ulcer*

BACKGROUND: Viral warts are common viral infections and are usually self-limiting. However, there have been few studies assessing the characteristics of patients with viral warts. OBJECTIVE: The purpose of this study was to assess the epidemiological and clinical characteristics of viral warts during a five-year-period. METHODS: We carried out a retrospective analysis of patients with viral warts who had been diagnosed in the Myongji hospital from January 2007 to December 2011. RESULTS: One thousand seven hundred and ninety patients with viral warts were assessed. A group of patients aged under 10 years had the highest occurrence of common warts (46.8%). The mean age was 16.9 years. Hands (47.7%) were more commonly involved than feet (36.4%). Cryotherapy was used to treat most of the patients. One thousand and sixty-one patients (59.3%) showed complete resolution of the wart lesion in the clinical ground. CONCLUSION: The number of patients with viral warts is currently increasing. This study provides useful data on the prevalence and characteristics of viral warts.
Aged ; Cryotherapy ; Foot ; Hand ; Humans ; Prevalence ; Retrospective Studies ; Warts

OBJECTIVE: Gout is one of the most common forms of inflammatory arthritides among men, which is caused primarily by chronic hyperuricemia. Although pharmacological therapy is the mainstay treatment to manage gout, limiting the consumption of dietary purine is also important. Several epidemiological studies have reported that alcohol consumption is closely related to hyperuricemia and gout. The objective of this study was to determine the purine content in common Korean alcoholic beverages using high performance liquid chromatography (HPLC) to provide a dietary guideline for those with hyperuricemia or gout. METHODS: Thirty-five alcoholic beverages were analyzed. Blindly labeled samples of each alcoholic beverage were degassed and frozen. The sample preparation prior to HPLC followed the methods of Japanese researchers. HPLC was performed to analyze adenine, guanine, hypoxanthine, and xanthine content in the alcoholic beverages. RESULTS: The standard curves were linear for all purines. Purine contents were as follows: beer (42.26~146.39 micromol/L, n=12), medicinal wine (8.2 and 40.41 micromol/L, n=2), rice wine (13.19 micromol/L), Makgeolri (11.71 and 24.72 micromol/L, n=2), red wine (0, 6.03, and 17.9 micromol/L, n=3). No purines were found in fruit wine (n=2), Kaoliang (n=1), white wine (n=1), or distilled alcoholic beverages, such as soju (n=10) or whiskey (n=1). CONCLUSION: Among popular Korean alcoholic beverages, beer contained a considerable amount of purines, whereas distilled alcoholic beverages did not. Patients with either gout or hyperuricemia should avoid alcoholic beverages, especially those containing large amounts of purines.
Adenine ; Alcohol Drinking ; Alcoholic Beverages ; Alcoholics ; Arthritis ; Asian Continental Ancestry Group ; Beer ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Fruit ; Gout ; Guanine ; Humans ; Hyperuricemia ; Hypoxanthine ; Male ; Purines ; Wine ; Xanthine

BACKGROUND: Authors have undertaken this study to see if the choice of anesthesia can directly or indirectly provide immunomodulation for cytokines, to determine the relationship of cytokines and hypothalamo-pituitary-adrenal axis in stomach cancer surgery patients, and also to see whether the amount of morphine administration and choice of analgesia can influence cytokine release, and possibly immunity. METHODS: Total 19 gastric cancer surgery patients were randomly assigned in double-blind fashion into two groups. Group-G (n=9) was provided with general anesthesia plus morphine intravenous patient controlled analgesia (IV-PCA), whereas group-GE (n=10) with preemptive epidural and general anesthesia plus continuous epidural analgesia for control of postoperative pain. At predetermined time interval, proinflammatory cytokines and stress hormones were evaluated with visual analog pain scale. Simultaneous assessments of operating and anesthesia time, total morphine doses, the time to recovery of gastrointestinal function and incidences of complications were also made. RESULTS: Demographic data, the durations of operation and anesthesia and recovery of gastrointestinal function were similar in both groups. Total morphine doses were approximately four times greater in group-G. Secretions of interleukin-1 beta , TNF and epinephrine were blocked by preemptive epidural anesthesia, meanwhile, interleukin-6 as well as ACTH and cortisol were not. After 24 hours after skin incision, the differences of cytokines, ACTH and cortisol between two groups were dissipated. In spite of these hormonal findings, visual analog pain scale could not disclose any differences. Incidences of complications were statistically insignificant except that of itching in group-GE. CONCLUSION: Preemptive epidural anesthesia and analgesia can partially block only some of cytokines and stress hormones, and these effects do not have clinically relevant long term influences. The amounts and means of morphine administered by continuous epidural analgesia block or IV-PCA demonstrated no evidence of immunosuppression at clinical dose range.
Adrenocorticotropic Hormone ; Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled ; Anesthesia and Analgesia* ; Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Axis, Cervical Vertebra ; Cytokines ; Epinephrine ; Humans ; Hydrocortisone ; Immunomodulation* ; Immunosuppression ; Incidence ; Interleukin-1beta ; Interleukin-6 ; Morphine ; Pain Measurement ; Pain, Postoperative ; Pruritus ; Skin ; Stomach Neoplasms* ; Stomach*

Gastroschisis is a congenital abdominal wall defect that occurs at the immediate right of the umbilicus. Left-sided gastroschisis, which is located in the left periumbilical region, is extremely rare, as only 22 cases have been reported worldwide. Although most cases of gastroschisis are not complicated by other anomalies, extraintestinal anomalies are more commonly associated with left-sided gastroschisis than classic right-sided gastroschisis. In this report, we describe a case of left-sided gastroschisis complicated by cardiac anomalies. We also discuss the suggested theories of its pathogenesis and present a literature review. For patients with left-sided gastroschisis, we recommend evaluation of the associated anomalies because extraintestinal anomalies in the genitourinary, cardiovascular, or central nervous systems are more common in left-sided gastroschisis than in classic right-sided gastroschisis.
Abdominal Wall* ; Central Nervous System ; Gastroschisis* ; Hernia, Abdominal ; Hernia, Umbilical ; Humans ; Umbilicus

Arterial blood gas analysis has become an integral part of the clinical evaluation of the patient with known or suspected pulmonary disease. However, when the results of the measurements show arterial hypoxemia which is out of proportion to the clinical and X-ray evidence of lung disease, we may consider potential errors in measurement involving the blood gas analyzer or methods of blood sample storage. We experienced spurious hypoxemia in a patient with extreme leukocytosis (220.0 X 10(3)/mm3) secondary to leukemia. The degree of PaO2 decay was blunted by placing the blood on ice.
Anoxia ; Blood Gas Analysis ; Humans ; Ice ; Leukemia ; Leukocytosis* ; Lung Diseases ; Oxygen*