We evaluated clinical factors such as age, gender, predisposing diseases and ultrasonographic findings that determine clinical outcome of acute acalculous inflammatory gallbladder diseases in children. The patients were divided into the four age groups. From March 2004 through February 2014, clinical data from 131 children diagnosed as acute acalculous inflammatory gallbladder disease by ultrasonography were retrospectively reviewed. Systemic infectious diseases were the most common etiology of acute inflammatory gallbladder disease in children and were identified in 50 patients (38.2%). Kawasaki disease was the most common predisposing disease (28 patients, 21.4%). The incidence was highest in infancy and lowest in adolescence. The age groups were associated with different predisposing diseases; noninfectious systemic disease was the most common etiology in infancy and early childhood, whereas systemic infectious disease was the most common in middle childhood and adolescence (P = 0.001). Gallbladder wall thickening was more commonly found in malignancy (100%) and systemic infection (94.0%) (P = 0.002), whereas gallbladder distension was more frequent in noninfectious systemic diseases (60%) (P = 0.000). Ascites seen on ultrasonography was associated with a worse clinical course compared with no ascites (77.9% vs. 37.7%, P = 0.030), and the duration of hospitalization was longer in patients with ascites (11.6 ± 10.7 vs. 8.0 ± 6.6 days, P = 0.020). In conclusion, consideration of age and predisposing disease in addition to ultrasonographic gallbladder findings in children suspected of acute acalculous inflammatory gallbladder disease might result in better outcomes.
Adolescent ; Ascites ; Child* ; Communicable Diseases ; Gallbladder Diseases* ; Gallbladder* ; Hospitalization ; Humans ; Incidence ; Mucocutaneous Lymph Node Syndrome ; Retrospective Studies ; Ultrasonography

Whole body magnetic resonance imaging (WB MRI) has become feasible and enables fast scan throughout the body. This technique is based on a real-time gradient-echo imaging and sliding table platform (rolling table concept, which eliminates time-consuming repositioning of patients and surface coils). MRI scanners of the latest generation use high field MRI units of >1.5 Tesla (T), and are reported to have upgraded capabilities in terms of temporal and spatial resolution due to improved signal-to-noise ratios (SNRs) under high magnetic-field strength conditions. The diagnostic accuracy of the whole-body staging strategies of PET/CT and MRI are established. As a start of tumor staging through whole body imaging, PET/CT showed superior performances in T and N staging than WB MRI using 1.5T MR system. But, both imaging procedures showed a similar performance in detecting distant metastases. In a recent report on staging of non-small cell lung cancer (NSCLC), whole body MR imaging proved to be effective as much as PET/CT in T, N, and M staging. In addition, there were organs of strength for each modality in the detection of metastasis. Therefore, whole-body MRI/ PET would be suggested as a future diagnostic procedure of choice for the whole-body imaging with synergistic effects and reduced radiation exposure.
Carcinoma, Non-Small-Cell Lung ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Neoplasm Staging ; Signal-To-Noise Ratio ; Whole Body Imaging

Endotracheal intubation has many advantage such as airway protection, maintenance of patent airway, pulmonary toilet, application of positive pressure ventilation, and maintenance of adequate oxygenation. But risks that develop complications related to endotracheal tube always present, when we insert a tube into the trachea. We have experienced an armored tube obstruction with bulged inner wall after EO gas sterilization. So, it is important that we have to pretest a tube and check pateney of the inside of a tube, before endotracheal intubation.
Airway Obstruction* ; Intubation, Intratracheal ; Oxygen ; Positive-Pressure Respiration ; Sterilization ; Trachea

PURPOSE: The symptoms and signs of urinary tract infection (UTI) in early infancy are non-specific. Prompt diagnosis of UTI is important, as untreated UTI results in renal damage. Especially, febrile UTI in young infants coexist with other serious bacterial infections. The purpose this study was to propose modified Rochester criteria to differentiate viral infection from urinary tract infection. METHODS: We carried out a retrospective investigation of 168 infants less than three months old with a tympanic temperature >38degrees C who were admitted to Chung-Ang University Hospital between 2011 and 2014. We compared the symptoms, physical examination results, and laboratory data between viral infection and UTI groups. A modified Rochester criterion was composed of statistically significant factors. RESULTS: A total of 76 and 92 infants with UTI and a viral infection, respectively, were included. Statistically significant differences in gender, previous admission history, neutrophil ratio, and urine WBC count were found between the two study groups. Using a cut off value of 3 points, the sensitivity and specificity of the modified Rochester criteria were 71.28% and 78.57%, respectively. CONCLUSION: The modified Rochester criteria may give an outline for identifying young infants with UTI.
Bacterial Infections ; Diagnosis ; Humans ; Infant* ; Neutrophils ; Physical Examination ; Retrospective Studies ; Sensitivity and Specificity ; Urinary Tract Infections* ; Urinary Tract*

Sarcoidosis is a systemic granulomatous disease of unknown etiology that involves many organs, occasionally mimicking malignancy. We herein report a 50-yr-old woman of muscular sarcoidosis of chronic myopathic type, manifested by hypercalcemia and muscle wasting. Besides insignificant hilar lymphadenopathy, her sarcoidosis was confined to generalized atrophic muscles and therefore, F-18 FDG PET/CT alone among conventional imaging studies provided diagnostic clues for the non-parathyroid-related hypercalcemia. On follow-up PET/CT during low-dose steroid treatment, FDG uptake in the muscles disappeared whereas that in the hilar lymph nodes remained. PET/CT may be useful in the evaluation of unexpected disease extent and monitoring treatment response in suspected or known sarcoidosis patients.
Female ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Hypercalcemia/complications/*diagnosis ; Kidney Calculi/complications/diagnosis ; Lymph Nodes/radionuclide imaging ; Middle Aged ; Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; Sarcoidosis/complications/drug therapy/*radionuclide imaging ; Steroids/therapeutic use ; Tomography, X-Ray Computed

BACKGROUND: Multiple therapies involving ablative and nonablative techniques have been developed for the rejuvenation of photodamaged skin. Radiofrequency (RF) is emerging as a gentler, nonablative skin-tightening device that delivers uniform heat to the dermis at a controlled depth. OBJECTIVE: To compare the efficacy of bipolar radiofrequency (Polaris™) and 1,550-nm fractional erbium-glass laser (Mosaic™) for the treatment of photoaging using a randomized, split-face, patient- and evaluator-blind study. METHODS: We evaluated the clinical effects after the treatment of photoaging. Ten Asian women (Fitzpatrick skin type III to IV) underwent 9 weeks of treatment (3 sessions at 3-week intervals) with monotherapy (Polaris™) on one side of the face and combination therapy with non-ablative bipolar radiofrequency (Polaris™) and 1,550-nm fractional erbium-glass laser (Mosaic™) on the other side. RESULTS: Among 10 patients, 4 were male and 6 were female. Subjective and objective assessments showed that the combination therapy was more effective. As the number of the treatment sessions increased, there was an accompanying increase in the satisfaction level and efficacy. CONCLUSION: This study suggests that bipolar radiofrequency combined with 1,550-nm fractional erbium-glass laser could be effective treatment for photoaging.
Asian Continental Ancestry Group ; Clothing ; Dermis ; Female ; Hot Temperature ; Humans ; Male ; Rejuvenation ; Skin

Sinus histiocytosis with massive lymphadenopathy known as Rosai-Dorfman disease is characterized by painless bilateral cervical lymphadenopathy. Extranodal manifestations are uncommon and spinal involvement is rare. A 15-year-old man presented with intermittent midthoracic back pain only. He had no specific findings on neurologic examinations, hematologic and biochemical laboratory tests. Radiological examination of thoracic spine revealed collapse of T6 vertebrae with thoracic kyphosis and osteolytic lesion of T12 vertebra body. He underwent a removal of bone tumor, anterior reconstruction with mesh and pedicle screw fixation via posterior approach for pathologic confirmation and stabilization. Histopathologic study of the lesion revealed focal infiltration of large histiocytes showing emperipolesis. Immunochemistry stain of histiocytes was positive for CD68 and S-100 but negative for CD1a. This report presents a rare case and literature review of extranodal Rosai-dorfman disease in thoracic spine.
Adolescent ; Back Pain ; Emperipolesis ; Fractures, Compression* ; Histiocytes ; Histiocytosis, Sinus* ; Humans ; Immunochemistry ; Kyphosis ; Lymphatic Diseases ; Neurologic Examination ; Spine*

PURPOSE: The purpose of the study was to understand and describe the hospital workers' experience related to the hospital evaluation program implemented in Korea between 2004 and 2009. METHODS: During 2010, data were collected using focus group interviews. Four focus group interviews were held with a total of 28 hospital workers participating. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. RESULTS: Nine themes emerged from the analysis: 1) Positive change in the necessity of the evaluation; 2) Improvement in the hospital system, facilities, and human resources; 3) Unity through cooperation among departments; 4) Nursing work overload; 5) Lack of physicians' awareness and responsibilities; 6) Unfair and unrealistic evaluation items; 7) Lack of credibility of the outcome; 8) Shifting responsibility for negative outcomes to the workers; 9) Lack of pragmatic utility. CONCLUSION: The results of the study demonstrate that the hospital evaluation program played a key role in improving some work environments and communication among departments. At the same time, they show various negative themes resulting from the context of very authoritarian hospital systems and a connection-oriented society in Korea.
Adult ; Attitude of Health Personnel ; Female ; Focus Groups ; Hospitals/*standards/*statistics & numerical data ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Nursing Staff, Hospital/*statistics & numerical data ; Qualitative Research ; Tape Recording

We tested a set of conditions for obtaining optimal tissue quality in preparation for histology in samples of mouse brain. C57BL/6J mice were sacrificed and perfused with 4% paraformaldehyde, after which the brains were removed and dehydrated in 30% sucrose solution. The brains were then divided into four groups according to freezing temperature and usage of optimal cutting temperature (OCT) compound. Next, we stained the sectioned brain tissues with Harris hematoxylin and eosin Y and immunohistochemistry was performed for doublecortin. The best quality tissue was obtained at -25℃ and by not embedding with the OCT compound. When frozen at -25℃, the embedded tissue was significantly damaged by crystals, while at -80℃ there were no meaningful differences between qualities of embedded- and non-embedded tissues. Overall, we identified a set of conditions to obtain quality frozen brain sections. Our developed protocol will help resolve matters associated with damage caused to sectioned brain tissue by crystal formation during freezing.
Animals ; Brain* ; Eosine Yellowish-(YS) ; Freezing ; Hematoxylin ; Immunohistochemistry ; Mice ; Sucrose

BACKGROUND: To investigate the relationship between musculoskeletal disorders and comorbid health problems, including depression/anxiety disorder, insomnia/sleep disorder, fatigue, and injury by accident, and to determine whether certain physical and psychological factors reduce comorbid health problems. METHODS: In total, 29,711 employees were selected from respondents of the Third Korean Working Conditions Survey and categorized into two groups: Musculoskeletal Complaints or Musculoskeletal Sickness Absence. Four self-reported health indicators (overall fatigue, depression/anxiety, insomnia/sleep disorder, and injury by accident) were selected as outcomes, based on their high prevalence in Korea. We used multiple logistic regression analysis to determine the relationship between comorbid health problems, musculoskeletal complaints, and sickness absence. RESULTS: The prevalence of musculoskeletal complaints and musculoskeletal sickness absence due to muscular pain was 32.26% and 0.59%, respectively. Compared to the reference group, depression/anxiety disorder and overall fatigue were 5.2-6.1 times more prevalent in the Musculoskeletal Complaints Group and insomnia/sleep disorder and injury by accident were 7.6-11.0 times more prevalent in the Sickness Absence Group. When adjusted for individual and work-related physical factors, prevalence of all four comorbid health problems were slightly decreased in both groups. CONCLUSION: Increases in overall fatigue and depression/anxiety disorder were observed in the Musculoskeletal Complaints Group, while increases in insomnia/sleep disorder and injury by accident were observed in the Sickness Absence Group. For management of musculoskeletal complaints and sickness absence in the workplace, differences in health problems between employees with musculoskeletal complaints and those with sickness absence as well as the physical and psychological risk factors should be considered.
Surveys and Questionnaires ; Fatigue ; Korea ; Logistic Models ; Prevalence ; Psychology ; Risk Factors