OBJECTIVES: To study the distributions of pH and gas values in umbilical arterial(UA) blood of normal newborns following uncomplicated pregnancies and vaginal births. Methods: In 457 consecutive normal term infants who were born between March 1995 and June 1998, we examined the UA pH and blood gas values obtained immediately following delivery. Maternal inclusion criteria were defined as an uncomplicated singleton pregnancy and a normal full term spontaneous vaginal delivery. And also neonatal inclusion criteria were defined as a normal intrauterine growth appropriate for gestational age without any malformations and Apgar score of 7 or more at both one and five minutes after birth. Umbilical artery blood samples were collected at each birth and were evaluated for pH, carbon dioxide pressure (PaCO2), oxygen pressure (PaO2) and actual bicarbonate. RESULTS: Histogram of UA pH value resemble normal distribution curve. The lowest UA pH was 7.04 and the 10th percentile value was 7.23. The median UA pH was 7.31 and 5% was below 7.20. The lowest UA PaO2 was 4.6mmHg and the 10th percentile value was 11.5mmHg. The highest UA PaCO2 was 67.2mmHg and the 90th percentile value was 56.5mmHg. The lowest bicarbonate value was 13.2mmol/L and the 10th percentile value was 18.4mmol/L. CONCLUSION: The distributions of the UA pH and gas values of the collective of normal newborns were illustrated. None of the UA pH was below 7.0.
Apgar Score ; Blood Gas Analysis* ; Carbon Dioxide ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Oxygen ; Parturition ; Pregnancy ; Umbilical Arteries*

PURPOSE: The purpose of this study was to describe the experience of hospice nurses on spiritual care. METHODS: Data was collected from 9 hospice nurses by using in-depth interview. The main questions include what they understand as spiritual care, when they feel the needs of spiritual care, how they perform spiritual care, and what is the outcome of spiritual care. The data was analyzed by grounded theory methodology developed by Strauss and Corbin. RESULTS: The core category of experience of hospice nurses on spiritual care was identified as "Untie a knot of mind". In the process of spiritual care in hospice nurses was consisted of soothing, dwelling with, releasing, giving meaning, plunging, and going beyond a life. CONCLUSION: The result of this study was expected to give useful information to nurses and nursing managers about the real situation of performance of spiritual care. The findings of this study contributes to developing programs and supportive policies for encouraging spiritual care.
Hospices

No abstract available.
Adolescent* ; Child* ; Humans ; Thyroid Diseases* ; Thyroid Gland*

In order to investigate the implication of viral replication in acute, subacute, and chronic infections of coxsackievirus B3 (CVB3), we examined the histopathological changes and plus- and minus-strand viral RNA dynamics in heart, pancreas, brain, and liver of CVB3-infected A/J mice. Mice were inoculated intraperitoneally with CVB3 and sacrificed on 1, 2, 3, 4, 7, 10, 14, 21, 30, 60, and 90 days post infection (p.i.). Plus- and minus-strand viral RNAs in the organs were quantitated and the organs were additionally evaluated histopathologically for inflammation. No inflammatory infiltrates were observed in the liver, brain, and heart. In contrast, massive lymphocyte infiltration and fat replacement were shown in the pancreas with loss of acinar cells. Both plus- and minus-strand viral RNA levels were detected by 21 days p.i. in heart, 90 days p.i. in pancreas, 4 days p.i. in liver, and 10 days p.i. in brain. The plus-strand RNA was found at least fifty fold higher than the minus-strand RNA by 4 days p.i. in heart and pancreas and by 3 days p.i. in liver. The plus- to minus-strand RNA ratio in brain was found less than 1:20. Our data indicate that viral replication was actively occurred in heart, pancreas, and liver during acute CVB3 infection, whereas viral replication was limited in brain. Furthermore, chronic persistent viral RNA was observed in pancreas. In conclusion, CVB3 at low dose of virus induces severe pancreatitis but marginal or no inflammatory changes in the heart, liver, and brain.
Acinar Cells ; Animals ; Brain ; Heart ; Inflammation ; Liver ; Lymphocytes ; Mice ; Pancreas ; Pancreatitis ; RNA ; RNA, Viral ; Viruses

BACKGROUND/AIMS: There are a limited number of studies concerning the outcomes of diverticulitis in the Oriental population. We sought to evaluate the clinical features and the long-term outcomes of diverticulitis in Korean patients. METHODS: We retrospectively reviewed the clinical courses of 104 patients (59 men, 45 women; median age 48.5 years [range: 24-83 years]) hospitalized for their first episode of diverticulitis between 1989 and 2005. RESULTS: Right-sided diverticulitis was more common (71/104, 68%). However, the proportion of left-sided diverticulitis increased as age increased. Thirty-two patients underwent operations: 30 because of complications and 2 because of presumed appendicitis. Left-sided diverticulitis was an independent risk factor for complications (OR=7.6, p<0.001), and it required surgical treatment more often than right-sided diverticulitis did (61% vs. 17%, p<0.001). Eighty-five patients were followed for a median of 36 months. Four of the 62 medically treated patients developed recurrence of diverticulitis, with a 3-year cumulative recurrence rate of 4.8%. None of the 4 recurrences showed complications, and all were successfully managed using conservative treatment. No predictive factors for the recurrence of diverticulitis could be determined. CONCLUSIONS: The recurrence rate and risk of complications associated with recurrence are low in patients treated conservatively for the first episode of diverticulitis. Therefore, elective surgery to prevent recurrence and complications should be utilized sparingly in patients with diverticulitis.
Appendicitis ; Diverticulitis ; Diverticulitis, Colonic ; Diverticulosis, Colonic ; Humans ; Male ; Recurrence ; Retrospective Studies ; Risk Factors

Although the incidence and prevalence rates of IBD in Korea are still lower than Western populations, they have been increasing rapidly during the past decades. Crohn's disease (CD) tends to run in families because it is thought to be related to genetic susceptibility coupled with environmental factors. A large number of monozygotic and dizygotic twin pairs with inflammatory bowel disease have been reported in western countries. The population relative risk in first-degree relatives is considered to be about equal in both Koreans and westerners. To our best knowledge, there is no report in monozygotic twins with CD in Korea. This case report is the first documented occurrence of concordant CD occurring in monozygotic twins in Korea.
Adolescent ; Antimetabolites/therapeutic use ; Azathioprine/therapeutic use ; Colonoscopy ; Crohn Disease/*diagnosis/drug therapy/genetics ; Diseases in Twins/*diagnosis/drug therapy/genetics ; Humans ; Male ; Pedigree ; Tomography, X-Ray Computed ; Twins, Monozygotic/*genetics

Although the incidence and prevalence rates of IBD in Korea are still lower than Western populations, they have been increasing rapidly during the past decades. Crohn's disease (CD) tends to run in families because it is thought to be related to genetic susceptibility coupled with environmental factors. A large number of monozygotic and dizygotic twin pairs with inflammatory bowel disease have been reported in western countries. The population relative risk in first-degree relatives is considered to be about equal in both Koreans and westerners. To our best knowledge, there is no report in monozygotic twins with CD in Korea. This case report is the first documented occurrence of concordant CD occurring in monozygotic twins in Korea.
Adolescent ; Antimetabolites/therapeutic use ; Azathioprine/therapeutic use ; Colonoscopy ; Crohn Disease/*diagnosis/drug therapy/genetics ; Diseases in Twins/*diagnosis/drug therapy/genetics ; Humans ; Male ; Pedigree ; Tomography, X-Ray Computed ; Twins, Monozygotic/*genetics

Enteroviruses (EVs) are human pathogens that cause a wide variety of clinical illnesses. The spectrum of the diseases ranges from a mild febrile illness to severe diseases such as meningitis or myocarditis. In the present study, we have used a reverse transcription-polymerase chain reaction method to detect EVs from patients with aseptic meningitis followed by typing of the EVs after HeLa cell culture isolation. In addition, twelve reference strains and the six clinical isolates of EVs were infected to neonatal rat cardiocytes and the viability of infected cells was measured by MTT assay. Marked inhibition of cell proliferation was observed in the cardiocytes cultures infected with coxsackievirus (CV) B1, CVB4, and CVB5, and two wild strains, whereas mild inhibition was observed from those infected with CVB2, CVB3, echoviruses 6, 7, 11, 22, 25, and 30. Recombinant plasmid containing full-length cDNA genome of the cardiovirulent wild strain was successfully constructed and its complete nucleotide sequence was determined. The genome showed characteristics of enteroviruses. The RNA genome was 7,391 nucleotides in length, with a 5'-nontranslating region (742 nucleotides) followed by an open reading frame (encoding a 2,182 amino acid polyprotein) and a 3'-nontranslating region (100 nucleotides) and polyadenylated tail. The predicted amino acid sequences of the polyprotein showed 89~95% homology with those of reference coxsackievirus strains (CVB1-5).
Amino Acid Sequence ; Animals ; Base Sequence ; Cell Proliferation ; DNA, Complementary ; Enterovirus B, Human ; Enterovirus* ; Genome ; HeLa Cells ; Humans ; Meningitis ; Meningitis, Aseptic* ; Myocarditis ; Nucleotides ; Open Reading Frames ; Plasmids ; Rats ; RNA

No abstract available.
Humans ; Leukemia, Myeloid, Acute*

BACKGROUND/OBJECTIVES: Dietary Reference Intakes (DRI) for energy are derived from total energy expenditure (TEE) measured using the doubly labelled water (DLW) method. The objective of this study was to assess the validity of DRI for predicting the energy requirements of elementary school-age children. SUBJECTS/METHODS: The present study involved 25 elementary school-age children aged between 9 and 11 years. TEE was assessed by the DLW method, and the results were compared with the TEE predicted by the DRI equations in order to evaluate accuracy. RESULTS: The subjects' TEE measured by the DLW method was 1,925.2 ± 380.9 kcal/day in boys and 1,930.0 ± 279.4 kcal/day in girls, whereas resting energy expenditure was 1,220.2 ± 176.9 kcal/day in boys and 1,245.9 ± 171.3 kcal/day for girls. The physical activity level was 1.58 ± 0.20 in boys and 1.55 ± 0.13 in girls. The mean bias between the predicted and measured TEE was 12.6% in boys and −1.6% in girls, and the percentage of accurate predictions was 28.6% and 63.6%, respectively. In boys, the equation resulted in underprediction of TEE among the subjects having low TEE values, whereas there was overprediction among subjects having high TEE values as shown by the Bland-Altman plot. On the contrary, this proportional bias was not observed in girls. CONCLUSIONS: The findings of this study suggest that the DRI equation for energy could result in the overestimation of energy requirements in elementary school-age boys. In the case of girls, the equations could be accurate at the group level. However, the DRI appears to be invalid for individual girls, as more than one third of girls had their TEE inaccurately predicted. We recommend more studies for confirmation of these results.
Bias (Epidemiology) ; Child* ; Energy Metabolism ; Female ; Humans ; Methods ; Motor Activity ; Nutritional Requirements ; Recommended Dietary Allowances* ; Water