PURPOSE: To evaluete the sonographic features of ovarian mass torsion. MATERIALS AND METHODS: We evaluated the sonographic findings in 22 cases of torsioned cystic ovarian mass, benign teratoma(n=21), and normal ovary (n=l) confirmed surgically on pathologically. We classified the ovarian mass into two groups as sonographic ally cystic (n=15) or non-cystic mass(n=6). The patients were 17-72 years old(mean:36.9). We retrospectively reviewed US examination with respect to (1) free fluid in Douglas pouch, (2)pelvic mass & mass wall thickening, (3)dilated uterine tube, (4)prominent follicles, (5) engorged vessels, and (6)beak-like echo in torsion site. The combined conditions of torsion were uterine myoma(n=l) and intrauterine pregnancy(n=3). RESULTS: In sonogram, sonographic cystic mass (n=15) group showed (1)free fluid in Douglas pouch (9/15), (2)mass wall thickening(6/15), (3)dilated uterine tube(2/15), and sonographic non-cystic mass(n=6) group showed (1) free fluid in Douglas pouch (3/6). In sonogram, torsion of the normal ovary(n=1) showed (1) free fluid in Douglas pouch, and (2) prominent follicles. CONCLUSION: If sonogram of reproductive aged women with acute abdomen show free fluid in Douglas pouch and pelvic mass with wall thickening, ovarian mass torsion is suggested. But clinical features of acute abdomen and clinical diagnosis of torsion are more important than sonographic features.
Abdomen, Acute ; Diagnosis ; Douglas' Pouch ; Fallopian Tubes ; Female ; Humans ; Ovary ; Retrospective Studies ; Ultrasonography*

PURPOSE: This study was performed to examine if CT classification of renal blunt injury could aid in expectation of hemodynamic stability and clinical decision of whether to intervene surgically. MATERIALS AND METHODS: Over a 80-month period between July 1987 and March 1994, 41 patients were admitted to our hospital with the diagnosis of renal blunt injury. The renal blunt injuries were classified on Fedede's three-point scale CT classification methods :grade I, contusion, intrarenal hematoma, segmental infarction, and small subcapsular hematoma;grade II, complete or incomplete laceration, large subcapsular hematoma, and renal fracture;grade Ill, shattered kidney and renal pedicle injury. Hemodynamic stability, treatment method and clinical outcome of the patients with different CT grade were analyzed retrospectively. RESULTS: All 34 patients with grade I or II CT findings were hemodynamically stable and were successfully managed with conservative method. Among 7 patients with grade III CT findings, 6 patients were hemodynamically unstable. Out of the 6, One patient with grade IIIb or renal pedicle injury was expired before surgical intervention due to ischemic shock. Four patients were intervened surgically with one failure to thrive. The remaining one patient refused to be intervened surgically, and was discharged against medical advice. Only one out of 7 patients was hemodynamically stable and was managed conservatively. CONCLUSION: The patients with grade I or II CT findings are prone to be hemodynamically stable and to be managed with conservative method. But the patients with grade III CT findings are more likely to be hemodynamically unstable. Therefore patients with grade III CT findings should be closely monitored and be pre- pared for the possibility of immediate surgical intervention
Classification* ; Contusions ; Diagnosis ; Failure to Thrive ; Hematoma ; Hemodynamics ; Humans ; Infarction ; Kidney ; Lacerations ; Retrospective Studies ; Shock ; Wounds, Nonpenetrating

OBJECTIVE: To estimate the status of HIV infection and AIDS incidence using a back-calculation model in Korea. METHODS: Back-calculation is a method for estimating the past infection rate using AIDS incidence data. The method has been useful for obtaining short-term projections of AIDS incidence and estimating previous HIV prevalence. If the density of the incubation periods is known, together with the AIDS incidence, we can estimate historical HIV infections and forecast AIDS incidence in any time period up to time t. In this paper, we estimated the number of HIV infections and AIDS incidence according to the distribution of various incubation periods RESULTS: The cumulative numbers of HIV infection from 1991 to 1996 were 708~1,426 in Weibull distribution and 918~1,980 in Gamma distribution. The projected AIDS incidence in 1997 was 16~25 in Weibull distribution and 13~26 in Gamma distribution. CONCLUSIONS: The estimated cumulative HIV infections from 1991 to 1996 were 1.4~4.0 times more than notified cumulative HIV infections. Additionally, the projected AIDS incidence in 1997 was less than the notified AIDS cases. The reason for this underestimation derives from the very low level of HIV prevalence in Korea. Further research is required for the distribution of the incubation period of HIV infection in Korea, particularly for the effects of combination treatments.
HIV Infections ; HIV* ; Incidence* ; Korea* ; Prevalence

PURPOSE: We studied to compare computed tomographic(CT) findings of liver injury with management methods in adults and, moreover, to present the CT basis for the management. MATERIALS AND METHODS: We retrospectively reviewed CT scans of 43 adults diagnosed as liver injury during a 66-month period. Thirty-eight patients were hemodynamically stable. Thirty-two of them were managed conservatively, whereas six managed operatively. Five unstable patients underwent emergency operation. We classified CT findings according to the severity of liver injuries(ie, hematoma, laceration, and periportal tracking) and hemperitoneum, ranging from grade 1 to 5 and from 0 to 3+, respectively. Thus, we compared the CT classificafions with their management(ie, operation rate), especially hemodynamically stable patients. RESULTS: Operation rates of all patients and hemodynamically stable patients were 26% and 16%, respectively. Operation rate at each grade of liver injury was low, especially in hemodynamically stable, despite relatively high operation rate in grade 4. Operation rate of 3+ hemoperitoneum was 100%, including hemodynamically stable patients, in contrast to otherwise low operation rate of others. CONCLUSION: Most liver injury in adults, including grade 4, were managed conservatively, especially hemodynamically stable. Though large amount of hemoperitoneum(ie, 3+) required operation, most hemoperitoeum were managed conservatively. Thus, CT findings of liver injury is helpful in the decision for the management method.
Adult* ; Classification* ; Emergencies ; Hematoma ; Hemoperitoneum ; Humans ; Lacerations ; Liver* ; Retrospective Studies ; Tomography, X-Ray Computed

Background: Atopic dermatitis (AD) is a chronic pruritic inflammatory dermatosis. Whether gamma-linolenic acid (GLA) supplementation is beneficial in AD patients remains debatable. Objective: This study investigated whether adjuvant GLA supplementation is associated with clinical improvement in AD patients receiving systemic treatment, as assessed by patient-reported outcome measures. Methods: We enrolled 70 AD patients. Patients who received GLA at a dose of 80∼160 mg/d for over 1 month were included in the GLA group, while others were included in the non-GLA group. Each group was subgrouped into control, immunomodulator, and dupilumab groups based on treatment history. The patients evaluated their symptoms using the Atopic Dermatitis Control Tool (ADCT), Patient Global Assessment of Disease (PGA), and Dermatology Life Quality Index (DLQI). Results: The Mann-Whitney U-test was used to compare differences in ADCT, PGA, and DLQI between both groups. The ADCT scores were significantly lower in the control and immunomodulatory group supplemented with GLA (control U=13.5, p=0.04; immunomodulatory U=28.0, p=0.01), but not in patients taking dupilumab (U=44.5, p=0.70). The PGA and DLQI scores also tended to be lower in the GLA group than those in the non-GLA group. Conclusion GLA supplementation is a potential adjuvant to systemic therapy may yield additional symptomatic relief in AD patients.

PURPOSE: The purpose of this study is to correlate CT findings of the patients with chronic subdural hematoma(SDH) showing a sedimentation level with their clinical and operative findings. MATERIALS AND METHODS: We selected 9 patients who showed a sedimentation level within the hematoma after reviewing the CT findings of 55 patients with SDH. We also analyzed their age, initial symptoms, cause of head injury, latent period, the level of consciousness on admission, CT findings, and operative findings. RESULTS: All of the 9 patients were aged persons(over 52 years). They had a history of acute exacerbation of neurologic symptoms. Five of them had an apparent history of head trauma more than one month before the exacerbation. The CT scans showed unilateral, crescent-shaped subdural fluid collection with a sedimentation level except a case of bilateral SDH and 2 cases of planoconvex-shaped SDH. The interface of the sedimentation level was sharp in 3 cases and indistinct in 6 cases. None had bleeding tendency and the hemoglobin level was slightly decreased in 2 patients. All patients revealed membrane of the hematoma during operation. The upper portion of the sedimentation was liquefied blood and the lower portion was fresh blood clots. We could observe fresh RBC's in the hematoma microscopically. CONCLUSION: A sedimentation level in chronic SDH was operatively proved to represent rebleeding, and was clinically manifested as an acute exacerbation of symptoms.
Consciousness ; Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural, Chronic* ; Hemorrhage ; Humans ; Membranes ; Neurologic Manifestations ; Tomography, X-Ray Computed

Tigers are one of the most endangered species over the world and protected internationally or locally. However, they are still traded illegally for the Traditional East Asia Medicine or souvenirs / mementos as well as fake products. In the present study, to identify the species of the specimen known as the tiger's genitalia that was sold for mementos in China, two approaches of genetic tools and morphological comparisons were applied. On the basis of the entire sequences of mitochondrial cytochrome b gene (1,140 bp), the result of nucleotide comparisons showed that the specimen examined here is matched with banteng, Bos javanicus (Identities = 1,138/1,140; 99%). In addition, the examination of external morphological characters revealed that the genitalia of the specimen is much more similar to the one of cows, not to tigers. The outcomes highlighted that there are still some fake products of tigers traded in market and molecular genetic tools could help identifying species of wildlife products.
Base Sequence* ; China ; Cytochromes b ; DNA* ; Endangered Species ; Genitalia ; Medicine, East Asian Traditional ; Molecular Biology ; Sequence Analysis, DNA* ; Tigers*

The anti-inflammatory effects of glycosaminoglycan (GAG) derived from Isaria sinclairii (IS) and of IS extracts were investigated in a complete Freund's adjuvant (CFA)-treated chronic arthritis rat model. Groups of rats were treated orally with 30 mg/kg one of the following: [1] saline control, extracts of [2] water-IS, [3] methanol-IS, [4] butanol-IS, [5] ethyl acetate-IS, or [6] Indomethacin(R) as the positive control for a period of two weeks. The anti-paw edema effects of the individual extracts were in the following order: water-IS ex. > methanol ex. > butanol ex. > ethyl acetate ex. The water/methanol extract from I. sinclairii remarkably inhibited UV-mediated upregulation of NF-kappaB activity in transfected HaCaT cells. GAG as a water-soluble alcohol precipitated fraction also produced a noticeable anti-edema effect. This GAG also inhibited the pro-inflammatory cytokine levels of prostaglandin E2-stimulated lipopolysaccharide in LAW 264.7 cells, cytokine TNF-alpha production in splenocytes, and atherogenesis cytokine levels of vascular endothelial growth factor (VEGF) production in HUVEC cells in a dose-dependent manner. In the histological analysis, the LV dorsal root ganglion, including the articular cartilage, and linked to the paw-treated IS GAG, was repaired against CFA-induced cartilage destruction. Combined treatment with Indomethacin(R) (5 mg/kg) and IS GAG (10 mg/kg) also more effectively inhibited CFA-induced paw edema at 3 hr, 24 hr, and 48 hr to levels comparable to the anti-inflammatory drug, indomethacin. Thus, the IS GAG described here holds great promise as an anti-inflammatory drug in the future.
Acetates ; Animals ; Arthritis* ; Atherosclerosis ; Cartilage ; Cartilage, Articular ; Edema ; Freund's Adjuvant ; Ganglia, Spinal ; Human Umbilical Vein Endothelial Cells ; Indomethacin ; Inflammation ; Jurisprudence ; Methanol ; NF-kappa B ; Rats* ; Tumor Necrosis Factor-alpha ; Up-Regulation ; Vascular Endothelial Growth Factor A

Purpose: The purpose of this study is to identify the effects of a standardized educational program to improve nursing competency on newly graduated nurses in a children's hospital after developing and applying a pediatric nurse education program. The effectiveness of the program was confirmed by evaluating the clinical competency and field adaptation. Methods: In the first step, an education program was developed using the analysis, design, development, implementation and evaluation (ADDIE) model. As a second step, a similar experimental study of a single group repeat measures design was conducted to evaluate the clinical competency and field adaptation over time after application of the program. Additionally, a focus group interviews were conducted to collect subjective data on the effects and improvement points of the program. Results: As a result of applying the program, there was a significant change in the clinical competence and the field adaptation of newly graduated nurses in a children’s hospital. The categories derived from the focus group interviews were “getting special guidance,” “better care,” “becoming a nurse at a children's hospital” and “winning together.” Conclusion It was confirmed that the education program enhances the clinical competency of new nurses in children's hospitals. In addition, it provided the necessary data to understand the experiences of new nurses, help them adapt effectively, and establish appropriate interventions.

Background: Atopic dermatitis (AD) and asthma are chronic allergic diseases that affect quality of life. Objective: In this study, we analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) to determine the association between allergic diseases and number of household members living with the patient. Methods: This study included 20,893 participants ＞19 years of age from the KNHANES (2010∼2013). Multiple logistic regression analysis was performed to evaluate the odds ratio (OR) for presence of AD or asthma according to number of household members. Results: The OR of allergic diseases including AD and/or asthma increased as the number of household members decreased in the age ＜40 group after adjustments for age, sex, smoking status, drinking status, regular physical activity, education level, income level, and stress level (1 member: adjusted OR [aOR]=2.019, 95% confidence interval [CI]=1.256∼3.245; 2 or 3 members: aOR=1.3, 95% CI=1.031∼1.64; ≥4 members: reference). And those with an allergic disease were less likely to have a spouse and had a higher stress level compared to those without. Conclusion Based on a nationwide population-based survey, this study showed that the number of household members was significantly related to rates of AD and asthma. The prevalence of allergic diseases tended to be higher in households with fewer members.