No abstract available.
Humans ; Infant* ; Streptococcal Infections*

PURPOSE: To determine the extent to which magnetic resonance(MR) imaging findings can help differentiate between tuberculous arthritis (TA) and rheumatoid arthritis(RA). MATERIALS AND METHODS: This study involved sixteen patients with pathologically proven arthritis of the knee. In eight patients(mean age, 29.6 years; M:F=4:4) this was of the tuberculous variety, while eight (mean age, 47.5 years; M:F=2:6) suffered from the rheumatoid variety, which was monoarticular. For 14 patients, contrast enhancement studies were available. We retrospectively analyzed MR findings according to the demonstrated pattern of synovial thickening (regular and even, or irregular and nodular), bone erosion or abscess,bone marrow(BM) edema, the sites at which bursae were present, para-articular mass formation, and lymphadenopathy. RESULTS: In five of eight TA cases (62.5 %), irregular and nodular enhanced synovial thickening was present, while in six of eight RA cases (75%), thickening was regular and even. Bone erosions or subarticular abscesses were found in six TA cases (75%) and small erosions in three cases (37.5%) of RA. BM edema surrounding the erosion was found in four cases of TA (50%) and two of RA (25 %). In TA, edema was more extensive. In both TA and RA, all suprapatella bursae were distended while popliteal bursae were present in two cases of TA(25 %) and four of RA (50%). Para-articular masses with rim like enhancement were found in six cases of TA (75%) and in one case of RA (12.5 %). In particular, para-articular lymphadenopathy was seen in six cases of TA(75%), but not in RA. CONCLUSION: MR findings of irregular and nodular synovial thickening, extensive bone erosion, extensive BM edema, particular, para-articular abscess formation and ymphadenopathy, may help differentiate tuberculous arthritis of the knee from the rhumatoid variety.
Abscess ; Arthritis* ; Arthritis, Rheumatoid* ; Diagnosis, Differential* ; Edema ; Humans ; Knee* ; Lymphatic Diseases ; Magnetic Resonance Imaging* ; Retrospective Studies

BACKGROUND: The purpose of this study was to find additional effects of intrathecal nalbuphine 1 mg to morphine 0.1 mg for pain relief during a cesarean section. METHODS: Sixty healthy patients at full term who were scheduled for an elective cesarean delivery with spinal anesthesia were enrolled in the study. They received 0.5% bupivacaine 10 mg with either morphine 0.1 mg (group M), or nalbuphine 1 mg (group N), or morphine 0.1 mg nalbuphine 1 mg (group M + N). Analgesic effects were evaluated by a verbal rating scale on the duration of complete analgesia (time from the intrathecal injection to the first pain report), effective analgesia (time from the intrathecal injection to the first analgesic request), and cumulative doses of additional analgesics. Hemodynamic changes and adverse effects were also observed. RESULTS: The duration of complete analgesia increased significantly in group M, compared with group N and group M + N. Effective analgesia was longer in group M and group M + N, compared with group N. The incidence of pruritus was significantly lower in group N, compared with group M and M + N. The incidence of nausea and vomiting was the same among all groups. CONCLUSIONS: We concluded that intrathecal addition of nalbuphine 1mg to morphine 0.1 mg during spinal anesthesia for a cesarean delivery reinforced intraoperaitive analgesia compared with intrathecal morphine 0.1 mg. However, it reduced the duration of complete analgesia and had no effect on the incidence of pruritus.
Analgesia ; Analgesics ; Anesthesia, Spinal ; Bupivacaine ; Cesarean Section* ; Female ; Hemodynamics ; Humans ; Incidence ; Injections, Spinal ; Morphine* ; Nalbuphine* ; Nausea ; Pregnancy ; Pruritus ; Vomiting

BACKGROUND: Shipbuilding involves intensive welding activities, and welders are exposed to a variety of metal fumes, including manganese, that may be associated with neurological impairments. This study aimed to characterize total and size-fractionated manganese exposure resulting from welding operations in shipbuilding work areas. METHODS: In this study, we characterized manganese-containing particulates with an emphasis on total mass (n = 86, closed-face 37-mm cassette samplers) and particle size-selective mass concentrations (n = 86, 8-stage cascade impactor samplers), particle size distributions, and a comparison of exposure levels determined using personal cassette and impactor samplers. RESULTS: Our results suggest that 67.4% of all samples were above the current American Conference of Governmental Industrial Hygienists manganese threshold limit value of 100 μg/m3 as inhalable mass. Furthermore, most of the particles containing manganese in the welding process were of the size of respirable particulates, and 90.7% of all samples exceeded the American Conference of Governmental Industrial Hygienists threshold limit value of 20 μg/m3 for respirable manganese. CONCLUSION: The concentrations measured with the two sampler types (cassette: total mass; impactor: inhalable mass) were significantly correlated (r = 0.964, p < 0.001), but the total concentration obtained using cassette samplers was lower than the inhalable concentration of impactor samplers.
Humans ; Manganese* ; Particle Size ; Welding

PURPOSE: To evaluate the sonographic findings of fetal congenital intracranial teratoma. MATERIALS AND METHODS: From 1994 to 2002, of the 11 fetuses which had been diagnosed with fetal intracranial tumors after second level fetal ultrasonography, the six that were confirmed after autopsy as congenital intracranial teratomas were included in our study. The sonographic findings, including size, homogeneity, echogenicity compared with surrounding normal brain tissues, cystic components, and tumor related calcification, were retrospectively evaluated. RESULTS: The incidence of fetal congenital intracranial teratoma out of all fetal intracranial tumors was 54.5% (6 of 11 cases) during the 8-year period. The mean mass size was 7.4 cm (3.0-15.0 cm). Two thirds of (4/6) of the teratoma cases showed high echogenicity compared with normal brain tissues, and two thirds (4/6) showed heterogeneous echogenicity. Four teratoma cases (67%) showed cysts in the mass with a mean size of 1.9cm. One third (2/6) showed calcifications within the tumor. Out of the six cases, two had oropharyngeal teratoma with extension into the intracranial portion (so called epignathus) and showed homogenous mass without any cysts or calcifications. CONCLUSION: The typical sonographic appearance of intracranial teratoma was a heterogeneous, hyperechoic mass with cysts. In the epignathus cases, the sonographic appearances differed somewhat from the others. An understanding of the sonographic findings of fetal intracranial teratoma will help in the timely counseling of the parents and in obstetric decision making.
Autopsy ; Brain ; Counseling ; Decision Making ; Fetus ; Humans ; Incidence ; Parents ; Retrospective Studies ; Teratoma* ; Ultrasonography ; Ultrasonography, Prenatal

A hepatic angiosarcoma is a rare primary malignant neoplasm, which accounts for only 2% of all primary hepatic tumors. The prognosis of a hepatic angiosarcoma is very poor, and most patients die within a year of the initial diagnosis. We report a case of a hepatic angiosarcoma in a 57-year-old man. Although a dynamic CT had suggested a carvenous hemangioma 12 months earlier, the tumor size increased and spontaneously ruptured, so surgical resection was mandatory. A pathological examination, including immunohistochemical studies, showed positive staining for CD34 and Factor VIII, which confirmed the diagnosis of an angiosarcoma. Although dynamic CT is an excellent modality for the diagnosis of a cavernous hemangioma of the liver, hepatic angiosarcomas should be ruled out in selected cases, because they may present with very similar CT findings to benign hemangioma.
Diagnosis ; Factor VIII ; Hemangioma ; Hemangioma, Cavernous* ; Hemangiosarcoma* ; Humans ; Liver ; Middle Aged ; Prognosis ; Rupture, Spontaneous

A rare case of Behcet's disease associated with myelodysplastic syndrome (MDS) is described. A 50-year-old Korean female suffering recurrent oral ulcer, genital ulcer, fatigue, arthralgia in both knees and fever was diagnosed as Behcet's disease. The findings of bone marrow aspirates were consistent with refractory anemia, a subtype of myelodysplastic syndrome. Chromosomal analysis of bone marrow cells revealed 46,XX,-8,-20,+der(8)t(8;20)(p23;p10),+der(8) t(8;20)(p23;q10)[30]. The chromosomal changes found in this patient were different from those of previous reports, which mostly revealed trisomy 8. If anemia, low reticulocyte count and dyspoietic cells are sustained in Behcet's disease, physicians should be alert to the possibility of MDS with aberration in chromosome 8 and perform a bone marrow study for the proper diagnosis and treatment of the disease. We presented a case of Behcet's disease associated with MDS, which is the first Korean case.
Anemia/genetics ; Behcet's Syndrome/genetics* ; Behcet's Syndrome/diagnosis ; Bone Marrow Cells/ultrastructure ; Bone Marrow Cells/pathology ; Case Report ; Chromosome Aberrations ; Female ; Histocytochemistry ; Human ; Korea ; Middle Age ; Myelodysplastic Syndromes/genetics*

BACKGROUND: Tsutsugamushi disease, which is caused by Orientia tsutsugamushi, is an acute febrile illness transmitted by infected mites. Recently, the incidence rate has been increased especially in the Daejeon and Chungcheongnam-do. We analyzed the patients with tsutsugamushi disease, who lived in Daejeon and Chungcheongnam-do, to find out their clinical manifestations and factors affecting the disease duration. METHODS: A total of 102 patients who were diagnosed with tsutsugamushi disease at the department of family medicine in a university hospital from September 2005 to November 2005 were studied. We analyzed their clinical characteristics and investigated the clinical factors associated with disease duration in tsutsugamushi disease by multiple regression analysis. The term "disease duration" was defined as the interval from symptom onset to discharge. RESULTS: Among 102 patients, 33 were males and 69 were female, and the mean age was 57.4 years. The average interval from symptom onset to admission was 6.6 days. The average interval from symptom onset to discharge was 14.5 days. From multiple regression analysis, interval from symptom onset to admission (beta=0.470, P<0.001), serum albumin level (beta=-3.441, P= 0.019), and abnormal findings of chest X-ray (beta=2.925, P=0.021) were shown to independently contribute to disease duration (R(2)= 0.458). CONCLUSION: Disease duration is significantly correlated with clinical factors such as abnormal findings of the chest X-ray, lower serum albumin level, and longer interval from symptom onset to admission. These factors could be used as parameters of the severity of disease in patients with tsutsugamushi disease.
Chungcheongnam-do ; Female ; Humans ; Incidence ; Male ; Mites ; Orientia tsutsugamushi ; Scrub Typhus* ; Serum Albumin ; Thorax

Providing visual information about the fetus to the mother by the ultrasound examination was found to be an effective nursing intervention to promote Maternal-Fetal Attachment. In keeping with the purpose of the study, to evaluate the effect of providing visual information by ultrasound on level of Maternal-Fetal Attachment, a non-equivalent experimental group quasi-experimental design was used. The data were collected using Cranley's Maternal-Fetal Attachment Scale(1981) with a research questionnaire that consisted of 16 items on general characteristics and 23 items on Maternal-Fetal Attachment from November 2, 2000 to August 11, 2001. Subjects were 126 pregnant women who were received visual information by ultrasound and 123 pregnant women who did not receive visual information by ultrasound after finishing examination. The data were analyzed by using the SPSS/PC+ window 10.0 version program. The results of this study were as follows: There was no statistical difference in general characteristics between both groups. The scores on Maternal-Fetal Attachment at second trimester show no statistical difference (t=1.123, p=0.263). The scores on Maternal- Fetal Attachment in both groups increased between the second trimester and third trimester. However, the increase was greater in the group receiving visual information by ultrasound as compared to the group which did not receive the visual information(t=-2.152, p=0.032). This result shows that providing visual information about the fetus by the ultrasound examination is effective in increasing Maternal-Fetal Attachment.
Female ; Fetus ; Humans ; Mothers ; Nursing ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnant Women ; Surveys and Questionnaires ; Ultrasonography*

BACKGROUND: Polycystic ovary syndrome(PCOS) is characterized by the presence of chronic anovulation and hyperandrogenism, The prevalence of PCOS in premenopausal women of about 5~ 10%. There may be significant ethnic and racial variations in the prevalence and clinical presentation of PCOS. The current study was undertaken to determine the prevalence of PCOS and to identify the clinical characteristics of PCOS in Korea. METHODS: From March 2003 to March 2004, medical students from Ewha Womans University were investigated for the prevalence of PCOS. The evaluation included a history and physical examination, a modified Ferriman-Gallwey hirsutism score and screening for hyperandrogenemia. PCOS was diagnosed by the presence of the following: 1) oligomenorrhea, 2) hyperandrogenemia and/or hirsutism(a modified Ferriman-Gallwey score> or =6), and 3) the exclusion of related disorders. Hyperandrogenemia was defined as a free testosterone level above the 95th percentile of that for normal cycling nonhirsute women. RESULTS: Out of 492 students, 386 replied to the questionnaire and 203 students(19~31 yr of age) participated in the physical examination and blood sampling. Eumenorrhea without hirsutism was present in 133 students(65.5%), oligomenorrhea was present in 39 students(19.2%), hyperandrogenism was present in 21 students(10.3%) and hirsutism was present in 3(1.5%) of the 203 women. The prevalence of PCOS was 4.9%(10 of 203 students), and only 2 of 10 women with PCOS were hirsute. The mean body mass index of students with PCOS was 22.7+/- 4.3kg/m2, and two women was obese. The plasma insulin levels during the 75g oral glucose tolerance test in women with PCOS was significantly higher when compared to the age and body mass index of the controls. CONCLUSION: The prevalence of PCOS was 4.9% in college students from Seoul. This rate is similar to those rates reported by other investigators in Greece(6.7%) and United States(4%). Obesity and hirsutism are not common in Korean women with PCOS. We are planning to survey a more diverse age groups to determine the prevalence of PCOS
Anovulation ; Body Mass Index ; Female ; Glucose Tolerance Test ; Hirsutism ; Humans ; Hyperandrogenism ; Insulin ; Korea ; Mass Screening ; Obesity ; Oligomenorrhea ; Ovary ; Physical Examination ; Plasma ; Polycystic Ovary Syndrome* ; Prevalence* ; Surveys and Questionnaires ; Research Personnel ; Seoul* ; Students, Medical ; Testosterone