Subcutaneous fat necrosis of the newborn is an uncommon disorder characterized by firm b-cutaneous plaques and nodules usually appearing shortly after birth. It runs a relatively be, n course and may completely resolve in a few months without any recurrence. We report a case of subcutaneous fat necrosis in a 15 day-old male suffering from severe p inatal asphyxia and hypoxic cardiomyopathy, who presented with indurated subcutane s nodules and plaques on the both shoulders and the back. Histologically the subcutaneous fat showed focal necrosis with needle-shaped clefts, lymphohistiocytic infiltration and foreign body reactions consistent with subcutaneous fat necrosis of the newborn. In our patient, compromised cardiac output due to cardiomyopathy might have aggravated hypoxic condition and it could be speculated that cardiomyopathy-induced systemic hypoxia gave rise to hypothermia of the skin as a result of peripheral vasoconstriction. This report presents a causal relationship of cardiomyopathy and subcutaneous fat necrosis of the newborn.
Anoxia ; Asphyxia ; Cardiac Output ; Cardiomyopathies* ; Foreign Bodies ; Humans ; Hypothermia ; Infant, Newborn* ; Male ; Necrosis* ; Parturition ; Recurrence ; Shoulder ; Skin ; Subcutaneous Fat* ; Vasoconstriction

BACKGROUND: Previous reports have suggested that alleles at the plasminogen activator inhibitor-1 (PAI-1) gene are associated with increased risk of developing coronary artery disease, including myocardial infarction and stroke through their effect on PAI-1 levels. Method: We attempted to search English literatures for all reports of possible effects of PAI-1 gene on cardiovascular disease in human published prior to November 1998. We used a Mantel-Haenszel method (fixed effect model) and random effect model, respectively, to perform a meta-analysis of 7 case-control studies that provided information related to the effects of PAI-1 gene on risk of cardiovascular disease. RESULTS: From 7 studies for diagnosed cardiovascular disease, the relative frequencies of the three genotypes among controls was (5G/5G) (homozygous normal), 24.5%; (4G/5G) (heterozygous), 48.2%, and (4G/4G) (homozygous for the mutant, 675 GGGG), 27.3%. These relative frequencies in cases were 21.7% for 5G/5G, 48.0% for 4G/5G, and 30.3% for 4G/4G. In fixed effect model, compared with those with genotype (5G/5G), the overall odds ratio (OR) for cardiovascular disease among those with (4G/5G) was 1.12 (95% CI, 0.93 to 1.34), and it was 1.20 (1.01 to 1.44) for the (4G/4G) genotype. For five studies with myocardial infarction as the outcome, the overall OR of myocardial infarction was 1.20 (0.99 to 1.47) for those with (4G/5G) and 1.24 (1.00, 1.54) for those with (4G/4G) genotypes, respectively. CONCLUSION: Our findings provide support for the weak association between PAI-1 gene and cardiovascular disease, in particular, myocardial infarction.
Alleles ; Cardiovascular Diseases* ; Case-Control Studies* ; Coronary Artery Disease ; Genotype ; Humans ; Myocardial Infarction ; Odds Ratio ; Plasminogen Activator Inhibitor 1* ; Plasminogen Activators ; Polymorphism, Genetic* ; Stroke

Purpose: This study aims to verify the preoperative factor that can affect the footprint coverage during arthroscopic rotator cuff repair in full-thickness medium-size cuff tear and the change of footprint coverage on magnetic resonance imaging (MRI) at postoperative 6 months. Methods: A total of 30 medium-size full-thickness rotator cuff tears were analyzed. They were classified into complete footprint coverage group (CC, n=19) and incomplete footprint coverage group (IC, n=11) by arthroscopic findings and immediate postoperative MRI findings. MRI was performed before the operation, 1 day after the operation, and 6 months after the operation. Preoperative MRI evaluated the size of the anteroposterior tear width (cm), length of retraction (cm), fatty infiltration, and muscle atrophy. Postoperatively, footprint coverage, fatty degeneration, and muscle atrophy were evaluated. We compared healing and change of fatty degeneration between two groups. Results: The healing rate was significantly increased in the CC group (complete/partial healing, 10/9) compared to the IC group (complete/partial healing, 6/5) (p＜ 0.001). Six of 11 partial coverages (54.5%) were even improved to complete coverage at postoperative 6-month follow-up. However, the difference in footprint coverage did not affect the change of fatty degeneration at postoperative 6 months. Any change of fatty degeneration (FD) and initial FD of rotator cuff tendons were not correlated with healing (p＜ 0.05). Conclusion The footprint coverage can be changed in postoperative 6 months in MRI and anteroposterior tear size, retraction, fat degeneration, and muscle atrophy do not affect footprint coverage in medium-sized full-thickness rotator cuff tears.

PURPOSE: The purpose of the study was to investigate the meaning of the life of middle-aged women. METHOD: The research method employed Q-methodology. Thirty-one participants rated 30 selected Q-statements on a scale of 1~7. The collected data were analyzed using PC-QUNAL software. RESULT: Principal component analysis identified 4 types of the meaning of the life of middle-aged women. The categories were labeled 'May I help you?', 'Alone', 'Who am I ?', 'No regret'. CONCLUSION: We have found meaning of life of middle-aged women through this research. The study result could be data to perform effective nursing intervention for positive life of middle-aged women.
Female ; Humans ; Nursing ; Principal Component Analysis

PURPOSE: The purpose of the study was to investigate change of life in middle-aged men. METHOD: The research method employed Q-methodology. twenty-five participants rated 39 selected Q-statements on a scale of 1~9. The collected data were analyzed using pc- QUNAL software. RESULT: Principal component analysis identified 3 types of change of life in middle-aged men. The categories were labeled 'Mature-oriented', 'Effeminate-oriented', 'Juvenescence-oriented'. CONCLUSION: We have found change of life in middle-aged men through this research. To setup and apply differences based on this result is needed.
Climacteric* ; Humans ; Male ; Middle Aged* ; Principal Component Analysis

PURPOSE: The purpose of the study was to investigate change of life in middle-aged men. METHOD: The research method employed Q-methodology. twenty-five participants rated 39 selected Q-statements on a scale of 1~9. The collected data were analyzed using pc- QUNAL software. RESULT: Principal component analysis identified 3 types of change of life in middle-aged men. The categories were labeled 'Mature-oriented', 'Effeminate-oriented', 'Juvenescence-oriented'. CONCLUSION: We have found change of life in middle-aged men through this research. To setup and apply differences based on this result is needed.
Climacteric* ; Humans ; Male ; Middle Aged* ; Principal Component Analysis

PURPOSE: This study was performed to evaluate the contribution of appendiceal computed tomography (CT) in the more accurate diagnosis of acute appendicitis and decrease in the rate of negative appendectomies. METHODS: Between May and August 2005, 146 patients with right lower quadrant (RLQ) abdominal pain and tenderness were diagnosed using appendiceal CT. The appendiceal CT scans were performed with contrast media in the abdominal and pelvic areas. 7 mm slice scans were taken both before and after the contrast media injection, with a time delay. The control group was comprised of 99 patients, who were also checked by abdominal CT or ultrasonography, between December 2004 and April 2005, with the data analyzed retrospectively. RESULTS: In the study group, 85 of the 146 cases were diagnosed with acute appendicitis on appendiceal CT, and had undergone an appendectomy, including 42 men (mean age 39.9 yr) and 43 women (mean age 44.6 yr). The sensitivity and specificity of appendiceal CT in acute appendicitis were 95.3 and 98.4%, respectively. There were 4 (4.7%) negative appendectomy cases; 2 in men and 2 in women. The control group conprised of 47 men and 52 women. There were 13 (13.1%) negative appendectomy cases; 4 in men and 9 in women. CONCLUSION: The routine use of appendiceal CT, in patients with RLQ abdominal pain and tenderness, resulted in a significant decrease in the negative appendectomy rate.
Abdominal Pain ; Appendectomy ; Appendicitis* ; Contrast Media ; Diagnosis ; Female ; Humans ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: Little data is currently available on the use of the impulse oscillometry system (IOS) parameter in analyzing the lung function of young children with cough-variant asthma (CVA) and classic asthma. The aims of this study were to evaluate the bronchial responsiveness between patients with CVA and those with classic asthma using dose-response slope and various cutoff values. METHODS: A methacholine challenge test and a pulmonary function test were performed in 43 children with classic asthma and 26 children with CVA using IOS, and the respiratory resistance (Rrs) and reactance (Xrs) were obtained. The bronchial responsiveness were assessed by provocative concentration causing an 80% fall from baseline in reactance at 5 Hz (PC80_Xrs5) and a 40% increase in resistance at 5 Hz (PC40_Rrs5) and calculating from the degree of dose-response slope (DRS) for airway resistance and reactance. RESULTS: There was no significant difference in base lung function between the two groups. However, the mean DRS_Xrs5 and the number who showed more than an 80% fall in reactance were significantly higher in classic asthma group than those in CVA group (P=0.040 and P=0.040, respectively). CONCLUSION: The use of DRS in oscillatory reactance at 5 Hz is useful for the differential diagnosis of classic asthma and CVA based on bronchial hyperresponsiveness.
Airway Resistance ; Asthma* ; Bronchial Hyperreactivity ; Child* ; Cough ; Diagnosis, Differential ; Humans ; Lung ; Methacholine Chloride ; Oscillometry ; Respiratory Function Tests

Purpose: This qualitative study examined the inner response of medical students who participated in a transgender healthcare education program. The factors that effected the inner response were investigated in order to suggest strategies for improving the effectiveness of the transgender healthcare education program. Methods: The transgender healthcare education program consisted of 2 hours of lectures and 2 hours of clinical role-play over 3 weeks. Eight 4-year medical students in Seoul, South Korea, were selected considering gender, the route of admission to medical school, and religion. Each student was interviewed individually for approximately 30 minutes 3 times before, during, and after the educational program, and interviews were analyzed using thematic analysis. Results: By attending the transgender healthcare education program, students have shown three types of inner response—confusion, acceptance, and negotiation. The students’ personal identities and professional identities influenced these responses. In particular, students’ existing professional identities motivated them to learn about transgender healthcare and played a key role in resolving the discomfort that occurred during the educational program. Through the transgender healthcare education, students were able to reduce prejudice against transgender people, understand the unique medical needs of the transgender population and increase their self-efficacy related to transgender health care. Conclusion The transgender healthcare education program allowed medical school students to acquire medical knowledge related to transgender patients and increase their cultural competence as future medical professionals. In addition, as the professional identity is critical in educating transgender healthcare, it should be considered thoroughly in order to effectively educate the medical students.

BACKGROUND: Specific IgE responses to allergens provide useful models for evaluating the genetic factors that control human immune responses. HLA class II gene products are involved in the antigen presentation of exogenous antigens. OBJECTIVE: The aim of this study was to evaluate whether susceptibility or resistance to asthma induced by the citrus red mite (Panonychus citri, CRM) was associated with HLA class II gene-encoded antigens. METHODS: Peripheral venous blood samples were collected from two groups of unrelated Korean adults. Ninety-one patients with citrus red mite-induced asthma and 98 exposed, healthy control subjects. The second exon of the HLA-DRB1 genes was selectively amplified by the polymerase chain reaction method. HLA typing was carried out using PCR-sequence specific oligonucleotide probes(PCR-SSOP). RESULTS: The frequency of HLA-DR7 was significantly higher among the CRM-sensitive asthmatics than among the controls (17.6% vs 4.1%, RR=3.92, p=0.01). Conversely, the frequency of HLA-DR4 was significantly lower among the CRM-sensitive asthmatics than among the controls(19.8% vs 40.8%, RR=0.36, p=0.01). No significant difference was found in the distributions of the other HLA-DRB1 gene-encoded antigens between the two groups. CONCLUSION: HLA-DRB1 genes may be involved in the development of citrus red mite-induced asthma. In addition, HLA-DR7 may increase, and DR4 decrease, the risk of developing asthma in exposed individuals.
Adult ; Allergens ; Antigen Presentation ; Asthma* ; Citrus* ; Exons ; Genes, MHC Class II ; Histocompatibility Testing ; HLA-DR Antigens ; HLA-DR4 Antigen ; HLA-DR7 Antigen ; HLA-DRB1 Chains ; Humans ; Immunoglobulin E ; Mites* ; Polymerase Chain Reaction