A 70-year-old woman with Parkinson disease was admitted to the emergency department with altered consciousness, fever and convulsive movements without experiencing withdrawal from antiparkinsonian medication. Six hours after the emergency department visit, the patient had a hyperpyrexia (>40℃) and a systolic blood pressure of 40 mmHg. There was no evidence of bacterial infection based on extensive workups. The patient was discharged without aggravation of Parkinson disease symptoms after treatment that included administration of dantrolene sodium, enforcement of continuous renal replacement therapy and cooling blankets. Malignant syndrome should be suspected if high fever occurs in Parkinson disease patients without evidence of a definitive infection.
Aged ; Bacterial Infections ; Blood Pressure ; Consciousness ; Dantrolene ; Dehydration ; Emergency Service, Hospital ; Female ; Fever ; Humans ; Parkinson Disease* ; Renal Replacement Therapy

PURPOSE: Endoscopic variceal sclerotherapy(EVS) has been considered the mainstay therapy for bleeding esophageal varices in adults. However, recent data have shown that endoscopic variceal ligation is just as efficacious and has fewer complications than EVS. Although there are many reports concerning EVL in adults, only a few studies have been done of children. METHODS: We performed EVL in 9 children under 6 years of age(mear age, 2.5 year) with esophageal varices. Outcome was assessed with respect to survival, rebleeding, and complications. RESULTS: The causes of portal hypertension were 3 cases of congenital hepatic fibrosis, 3 cases of biliary atresia, 2 cases of portal vein thrornbosis, and one case of portal vein fibromuscular dysplasia. The age at diagnosis ranged from 10 months to 6 years. The patients underwent a mean of 2.6+/- 0.7 sessions of EVL(ranging from two to four). The numbers of bands per person were 5.6+/-1.8, and the numbers of bands per session were 2.2+/-1.0 Two complications of esophageal rebleeding were noted, and none of the cases experienced symptoms of esophageal stenosis, nor gastroesophageal reflux. CONCLUSION: EVL is safe and effective in controlling variceal hemorrhage in children with portal hypertension, regardless of etiology. The cornplication rate is low and EVL is an acceptable and perhaps preferable altemative to EVS in children with esophageal varices. But regular periodic examination for recurrence of varices after eradication should be required.
Adult ; Biliary Atresia ; Child* ; Diagnosis ; Esophageal and Gastric Varices* ; Esophageal Stenosis ; Fibromuscular Dysplasia ; Fibrosis ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Hypertension, Portal ; Ligation* ; Portal Vein ; Recurrence ; Varicose Veins

Over the past 30 years, there has been an increase in the incidence of multifetal pregna-ncies, primarily because of the introduction of ovarian stimulants for ovulation induction and assisted reproductive technology ( ART ) in infertile patients. It is well established that multifetal pregnancies are associated with an increased frequency of the maternal complications and gre-ater perinatal morbidity and mortyality. The adverse outcome of multifetal pregnancies is dire-ctly proportional to the number of fetuses, primarily as an consequence of prterm delivery. Re-duction in the number of fetuses in multifetal pregnancies has been proposed as a way to impr-ove the perinatal outcome in this situation. Therefore, selective fetal reduction ( SFR ) is sugges-ted as a therapeutic option for continuation of pregnancy with fetuses mature enough to survi-ve. In this paper, we report our infertility clinic experiences with 6 patients who carried mult- ifetal pregnancies including 1 quintuplet, 1 quadruplet, and 4 triplets. from January, 1991 to May, 1996, transabdominal SFR was accomplished by fetal intrathoracic KCl injection at 9~10 weeks of gestation. After the prcedure, 4 patients remained as twin pregnancies, and 2 patients as single pregnancy. There have been 3 sets of twin deliveries and the 2 sets of single delivery. One case was aborted. Two patients were delivered after 37 weeks of gestation, 2 patients were at 35 weeks, and 1 patient at 24 weeks. All babies have been healthy after birth in patients after 35 weeks gestation. There was no fetal anomaly related to the procedure in the 6 cases. We concluded that transabdominal SFR is a rather safe and useful procedure that may improve the outcome of multifetal pregnancies.
Fetus ; Humans ; Incidence ; Infertility ; Ovulation Induction ; Parturition ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Twin ; Quadruplets ; Quintuplets ; Reproductive Techniques, Assisted ; Triplets ; Twins

OBJECTIVE: To evaluate the viability and the characteristics of shed endometrial tissues obtained from menstrual fluid during in-vitro culture. METHODS: The menstrual fluids were collected using Wallace catheter from uterine cavity in 10 women with regular menstruation. The menstrual fluids were washed twice, and the pellets, containing blood cells and shed endometrium, were collected and diluted fivefold with Ham's F-10 medium containing 10% fetal bovine serum. The cell suspension was placed on culture dishes, and cultured for 7 days in an incubator. To evaluate the characteristics of the cultured endometrial cells, immunohistochemical (IHC) staining was performed using anti-cytokeratin and anti-vimentin antibody. RESULTS: The mean volume of menstrual fluids and pellets were 0.7ml and 0.3ml, respectively. Only 15% of the shed endometrial tissues were attached and proliferated in culture dishes, which was considered to have viability. Initially, endometrial epithelial cells and fibroblasts were attached and proliferated, and the area of these cells was increased according to prolong the culture time. Stromal cell colonys were located and proliferated on the epithelial cells. IHC staining showed strongly positive for cytokeratin in epithelial cells and for vimentin in stromal cells. In the confocal microscopic observation of 3-dimensional structure of cultured endometrium, cytokeratin-positive cells (epithelial cells) were located in the pheriphery and cytokeratin-negative cells (stromal cells) inside of the structure. CONCLUSION: From our study, shed endometrial tissues in menstrual fluid showed meaningful viability and closed relationship between epithelial cells and stromal cells during in-vitro culture. Thus, we suggest that the in-vitro culture system of shed endometrium is a suitable model for researches of endometriosis.
Blood Cells ; Catheters ; Endometriosis ; Endometrium ; Epithelial Cells ; Female ; Fibroblasts ; Humans ; Incubators ; Keratins ; Menstruation ; Stromal Cells ; Vimentin

Low-grade endometrial stromal sarcoma (LGESS) with intravascular extension is very rare, with only 26 cases having been reported. We experienced a case of LGESS with inferior vena cava (IVC) extension. A 60-year-old female presented with left leg edema. She had a history of total hysterectomy, and was diagnosed of leiomyoma at that time. On imaging study, tumor masses were located around both common iliac veins (CIV), and within the CIV and IVC. The pelvic masses on both side and IVC mass were resected, and then the patient received adjuvant hormonal therapy and radiotherapy over the remnant pelvic masses. LGESS with IVC extension is difficult to distinguish from intravascular leiomyomatosis. LGESS is a malignant disease and commonly recurs, even in early stages. Accurate diagnosis, complete resection, proper adjuvant therapy and close follow-up are very important.
Diagnosis ; Edema ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Iliac Vein ; Korea ; Leg ; Leiomyoma ; Leiomyomatosis ; Middle Aged ; Radiotherapy ; Sarcoma, Endometrial Stromal* ; Vena Cava, Inferior*

No abstract available.
Humans ; Siblings*

No abstract available.
Syphilis, Congenital*

Purpose: This study investigated the effects of infection control fatigue, job stress, and resilience on burnout in nurses responding to coronavirus disease 2019 (COVID-19). Methods: This correlational study was conducted among 151 nurses working at three hospitals designated for treating COVID-19 patients in Jeonbuk Province, South Korea. Data were collected with self-report questionnaires between February 10 and 28, 2022 and analyzed using the IBM SPSS Statistics 28.0 program with descriptive statistics, Pearson product-moment correlations, and hierarchical multiple regressions. Results: The participants' scores were 3.56±0.48 out of 5 for infection control fatigue, 2.49±0.25 out of 4 for job stress, 3.49±0.45 out of 5 for resilience, and 3.02±0.34 out of 5 for burnout. Burnout was significantly associated with working experience, average working hours, working department, and desire to stay in the current department. Burnout showed statistically significant moderate positive correlations with infection control fatigue and job stress, and a statistically significant moderate negative correlation with resilience. Hierarchical regression analysis showed that infection control fatigue, job stress, and resilience were factors affecting burnout in COVID-19 response nurses, with an explanatory power of 36.6%. Conclusion Based on the above results, it is clear that job stress, infection control fatigue, and resilience are factors to consider when designing an intervention to reduce burnout in COVID-19 response nurses.

Purpose: This study investigated the effects of infection control fatigue, job stress, and resilience on burnout in nurses responding to coronavirus disease 2019 (COVID-19). Methods: This correlational study was conducted among 151 nurses working at three hospitals designated for treating COVID-19 patients in Jeonbuk Province, South Korea. Data were collected with self-report questionnaires between February 10 and 28, 2022 and analyzed using the IBM SPSS Statistics 28.0 program with descriptive statistics, Pearson product-moment correlations, and hierarchical multiple regressions. Results: The participants' scores were 3.56±0.48 out of 5 for infection control fatigue, 2.49±0.25 out of 4 for job stress, 3.49±0.45 out of 5 for resilience, and 3.02±0.34 out of 5 for burnout. Burnout was significantly associated with working experience, average working hours, working department, and desire to stay in the current department. Burnout showed statistically significant moderate positive correlations with infection control fatigue and job stress, and a statistically significant moderate negative correlation with resilience. Hierarchical regression analysis showed that infection control fatigue, job stress, and resilience were factors affecting burnout in COVID-19 response nurses, with an explanatory power of 36.6%. Conclusion Based on the above results, it is clear that job stress, infection control fatigue, and resilience are factors to consider when designing an intervention to reduce burnout in COVID-19 response nurses.

Purpose: This study investigated the effects of infection control fatigue, job stress, and resilience on burnout in nurses responding to coronavirus disease 2019 (COVID-19). Methods: This correlational study was conducted among 151 nurses working at three hospitals designated for treating COVID-19 patients in Jeonbuk Province, South Korea. Data were collected with self-report questionnaires between February 10 and 28, 2022 and analyzed using the IBM SPSS Statistics 28.0 program with descriptive statistics, Pearson product-moment correlations, and hierarchical multiple regressions. Results: The participants' scores were 3.56±0.48 out of 5 for infection control fatigue, 2.49±0.25 out of 4 for job stress, 3.49±0.45 out of 5 for resilience, and 3.02±0.34 out of 5 for burnout. Burnout was significantly associated with working experience, average working hours, working department, and desire to stay in the current department. Burnout showed statistically significant moderate positive correlations with infection control fatigue and job stress, and a statistically significant moderate negative correlation with resilience. Hierarchical regression analysis showed that infection control fatigue, job stress, and resilience were factors affecting burnout in COVID-19 response nurses, with an explanatory power of 36.6%. Conclusion Based on the above results, it is clear that job stress, infection control fatigue, and resilience are factors to consider when designing an intervention to reduce burnout in COVID-19 response nurses.