No abstract available.
DNA* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction*

The Sertoli-Leydig cell tumor is a gonadal tumor of sex-cord stromal type, similar to that seen in of the various phases of testicular development in the male. This tumor is exceedingly rare, accounting for only 0.1% to 0.5% of all primary ovarian neoplasms. It occurs predominantly in the second and third decades(mean age about 25 years), less than 10% after menopause. We investigated a case of poorly differentiated Sertoli-Leydig cell tumor of right ovary, occured in a 76-year-old woman. Grossly, the tumor measured 2, 100 gm in weight and 25 x 19 x 8 cm in dimensions. The outer surface was smooth and glistening without rupture of the capsule. Cut sections revealed a multilobulated brown solid mass with multiple cystic change. Microscopically, it showed the typical findings o a Sertoli-Leydig cell tumor. The characteristic feature is hemangiopericytoma paftem of sarcomatoid spindle cells. Therefore, we present it with a brief review of the literature.
Female ; Humans

PURPOSE: The prevalence of hepatitis A virus (HAV) in a certain community reflects that community's living standards and hygienic conditions. And the pattern of HAV infection differs over time and geography. Recently, a shift in prevalence has been observed in cases from chilhood to adulthood. We studied the HAV antibody prevalence in the general population in Busan. METHODS: From October 2004 to March 2005, total 472 subjects were tested for HAV antibodies. All samples were collected from patients in Maryknol Hospital. RESULTS: The overall seropositive rate was 22.8% (108/472). The seropositive rates were 1.7% in subjects aged 2-5 years, 1.7% in 6-10 years, 0% in 11-20 years, 40.5% in 21-30 years, 82.1% in 31- 40 years, 94.7% in 41-50 years, and 100% in subjects aged over 50 years. There was no significant gap between gender groups. CONCLUSION: As the socioeconomic conditions in Korea have improved, the HAV seropositive rate in school-aged children has dramatically decreased in the last 20 years. But, the seropositive rate of HAV didn't differ according to gender. The seropositive rate of HAV in the pediatric group was very low, which suggests the increasing possibility of clinical HAV infection in adults in the near future. Therefore, we should actively prevent the spread of hepatits A virus. In order to do that, we need to reorganize our lifestyle and personel hygiene and carry out active and passive immunization to high risk groups.
Adult* ; Antibodies ; Busan* ; Child* ; Epidemiologic Studies* ; Geography ; Hepatitis A virus* ; Hepatitis A* ; Hepatitis* ; Humans ; Hygiene ; Immunization, Passive ; Korea ; Life Style ; Prevalence ; Seroepidemiologic Studies ; Socioeconomic Factors

Purpose: This study was conducted to identify the factors influencing organizational commitment and resilience onpresenteeism in clinical nurses. Methods: The subjects were 202 nurses working at 5 hospitals in B city. The data were collected through questionnaires and analyzed by t-test, one-way ANOVA, Pearson’s correlation coefficients, and stepwise multiple regression. Results: Work impairment was negatively correlated with organizational commitment and resilience. Perceived productivity was positively correlated with organizational commitment and resilience. Influencing factors on work impairment were organizational commitment (β=-.22 p=.005) and hardiness (β=-.16, p=.042), with 10% explanatory power. Influencing factors on perceived productivity were organizational commitment (β=.24, p=.002) and hardiness (β=.16, p=.042), with 11% explanatory power. Conclusion Based on this research, appropriate programs and policies that consider influencing factors such as organizational commitment and hardiness in resilience are needed to reduce the level of presenteeism in clinical nurses.

A low grade endometrial stromal sarcoma is a rare malignant tumor in woman. We experienced this infrequent malignant tumor in a 36 years old woman showing metas- tasis to both ovaries, omentum, rectum and mesenteric lymph nodes, and she was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by VAC(vincristi n, actinomycin, cyclophoshamide) chemotherapy. The authors report this case with the clinicopathologic findings and brief review of literature.
Adult ; Dactinomycin ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Omentum ; Ovary ; Rectum ; Sarcoma, Endometrial Stromal*

Technological advances in video camera, high resolution monitors and optical systems have produced considerable process in endoscopic surgery. Recently we have experienced transthoracic endoscopic sympathectomy(TES) for the treatment of Buerger's disease of both hands in a 47 years old male healthy patient. For the TES, one lung ventilation is necessary to provide adequate surgical access, so this patient had general anesthesia with a disposable left sided Robertshaw double lumen endobronchial tube. The patient was monitored for arterial pressure, herat rate, ECG, pulse oximetry, end-tidal carbon dioxide concentration, peak inspired airway pressure and arterial blood gas analysis. Potenial intraoperative problems wese hypoxemia during one-lung anesthesia, hypotension and hypercarbia occurred by insufflation of carbon dioxide into the chest cavity. Our patient also developed moderate hypoxemia which was corrected by application of high frequency jet ventilation with low driving pressure during right sided operation, and increased significantly arterial carbon dioxide tension about 8-12 mmHg during one lung ansthesia. We reviewed our experience and discussed the anesthetic technique and perioperative problems encounterd in the patient undergoing transthoracic endoscopic sympathectomy for Buerger's disease.
Anesthesia* ; Anesthesia, General ; Anoxia ; Arterial Pressure ; Blood Gas Analysis ; Carbon Dioxide ; Electrocardiography ; Hand ; High-Frequency Jet Ventilation ; Humans ; Hypotension ; Insufflation ; Lung ; Male ; Middle Aged ; One-Lung Ventilation ; Optical Devices ; Oximetry ; Sympathectomy* ; Thorax ; Thromboangiitis Obliterans

BACKGROUND: This study aimed to research on how adherence and blood control could make a difference when it comes to develop complications. METHODS: The study's subjects were 255,916 patients who were newly diagnosed with hypertension in 2009 using data collected by National Health Insurance Cooperation. Patients are considered as a group under adherence if visit days and prescription days are more than 300 days. Patients are considered to have successfully controled their hypertension based on actual value measured by National Health Insurance Cooperation and the study takes a look at whether they were diagnosed with complications of cerebrocardiovascular disease in 2012. Chi-square test and logistic regression was used to analyze. RESULTS: Patients who were able to control their hypertension show 0.80 times chance of developing cerebrovascular disease, and 0.89 times chance of developing cardiocerebrovascular disease. The group of adherence shows lower chance of developing complication in general than the group of non-adherence. CONCLUSION: The study revealed that hypertension's constant treatment could control the blood pressure and prevent complications. It is important that encourages patients to effort for persistent treatment for reducing complication.
Blood Pressure ; Humans ; Hypertension* ; Logistic Models ; National Health Programs ; Prescriptions

BACKGROUND: Hypotension associated with spinal anesthesia for cesarean delivery is most common and serious adverse effect despite the use of uterine displacement and volume preload. This study evaluated the role of ephedrine and fluid preload for prevention of hypotension during spinal anesthesia. METHODS: Sixty healthy women undergoing elective cesarean delivery under spinal anesthesia at term were allocated randomly to receive ephedrine 10microgram/kg/min followed by 4 mg bolus IV (E group, n = 20); ephedrine 10microgram/kg/min followed by 4 mg bolus IV and rapid administration of 500 ml hydroxyethyl starch solution (EH group, n = 20); and ephedrine 10microgram/kg/min followed by 4 mg bolus IV and rapid administration of 500 ml lactated Ringers solution (ER group, n = 20). Heart rate, blood pressure, hypotension incidence, and total ephedrine administration were checked after spinal anesthesia. Umbilical blood gas analysis and APGAR score were checked after delivery. RESULTS: Maternal blood pressure, maternal heart rate, APGAR score were similar in three groups. But umbilical blood PaO2 and PvO2 is significantly low in hypotensive group than normotensive group (P <0.05). CONCLUSION: The results of the present study support the intravenous administration of ephedrine (4 mg bolus with 10microgram/kg/min) with or without 500 ml colloid or crystalloid infusion is not effective for blood pressure maintenance. Once the maternal hypotension induces the umbilical blood low oxygen tension, it is necessary for anesthesiologists to concentrate more on the maintenance of the blood pressure.
Administration, Intravenous ; Anesthesia, Spinal* ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Colloids ; Ephedrine* ; Female ; Heart Rate ; Humans ; Hypotension* ; Incidence ; Oxygen ; Starch

BACKGROUND: It is believed that stimulation of the P6 acupoint minimizes nausea and vomiting, and has been used to prevent and treat nausea and vomiting in various situations. The present study was undertaken to investigate whether the transcutaneous electrical stimulation of the P6 acupoint prevents postoperative nausea and vomiting (PONV) in female patients undergoing laparoscopic cholecystectomy. METHODS: In this prospective, randomized, double-blind, placebo-controlled study, we investigated 59 ASA I or II female patients who underwent laparoscopic cholecystectomy under general anesthesia using isoflurane or enflurane. We used a ReliefBand(R) unit (NSTTM 600, Woodside Biomedical Inc, USA) for the transcutaneous electrical stimulation of the P6 acupoint. Patients were randomly divided into two groups; in the P6 group (n = 29) the activated ReliefBand(R) was placed at the P6 acupoint; and in the placebo group (n = 30) the inactivated ReliefBand(R) was placed at the P6 acupoint. The ReliefBand(R) was applied 10 min before the end of surgery and remained in place for 24 h. We evaluated the incidence and severity of PONV, and need for rescue antiemetics during the first 6 h and 24 h after surgery. RESULTS: No differences in age, weight, previous PONV history, or duration of anesthesia were present between groups. The incidence of PONV was significantly lower (34%) in the P6 group than in the placebo group (63%) during the first 24 h after surgery. The severity of nausea and vomiting was also significantly lower in the P6 group than in the placebo group. However, the need for rescue antiemetics was similar in the two groups. CONCLUSIONS: Transcutaneous electrical stimulation of the P6 acupoint significantly reduces the incidence and severity of PONV in female patients undergoing laparoscopic cholecystectomy during the first 24 h after surgery.
Acupuncture ; Acupuncture Points* ; Anesthesia ; Anesthesia, General ; Antiemetics ; Cholecystectomy, Laparoscopic* ; Enflurane ; Female ; Humans ; Incidence ; Isoflurane ; Nausea ; Postoperative Nausea and Vomiting* ; Prospective Studies ; Transcutaneous Electric Nerve Stimulation* ; Vomiting

BACKGROUND: Recurrent aphthous stomatitis (RAS) is usually the earliest sign of Behcet's disease. Hyperhomocysteinemia can damage endothelial cells and progress to obstructive vascular disease. It has been reported that hyperhomocysteinemia is a marker of activation in Behcet's disease. Enzyme 5,10-methylenetetrahydrofolate reductase may be one of the main factors that regulates plasma homocysteine levels. Homozygosity for the C677T (MTHFR C677T) mutation is associated with reduced activity of this enzyme and considered the most common genetic cause of elevated serum homocyteine levels. However its relationship to vascular injury in Behcet's disease remains controversial, and its relationship to RAS is unknown. Apolipoprotein E (Apo E) has both immunoregulatory and anti-infective features. Search for Apo E polymorphism and lipid composition in RAS patients might be a clue to pathogenesis of RAS. OBJECTIVE: To analyze the relationship of MTHFR gene C677T polymorphism, several epidemiologic factors such as age and sex, smoking, lipid composition and Apo E polymorphism to vasculitis in RAS, we assessed the MTHFR gene C677T polymorphism, Apo E polymorphism and lipid composition in RAS and normal population. METHODS: We analyzed data from the General Health survey conducted on 1,243 participants (M:F=281:962) over a 20 year-old in Incheon city. Medical interview and laboratory test for methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism, apolipoprotein E polymorphism were completed. Statistical significance was analyzed by chi-square test and multistep logistic regression analysis. RESULTS: Among normal population over the age of twenty, a total of 34.2% (426/1,243) had RAS. Female predominance (4.5:1, p=0.003) was noted. The incidence of RAS in age group 20 to 39 year old is higher than the over 40 age group. The incidence is higher in smoking group compared to the nonsmoking group in multistepwise logistic regression analysis. Frequency of the MTHFR C677T genotypes was highest at CT compared to CC and TT homozygous genotype in normal and RAS patients group. There was no significant statistical differences in MTHFR genotypes in RAS patients compared to the control group. Similarly, Apo E genotype analysis revealed no significant statistical differences either. Apo E genotype and total cholesterol, HDL-cholesterol, triglyceride level didn't show any associations. CONCLUSION: This study revealed insignificant association between the MTHFR C677T mutation and RAS. Apo E genotype didn't show a significant statistical difference in RAS patients compared to normal controls.
Apolipoproteins ; Apolipoproteins E ; Cholesterol ; Endothelial Cells ; Epidemiologic Factors ; Female ; Genotype ; Health Surveys ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Incidence ; Logistic Models ; Methylenetetrahydrofolate Reductase (NADPH2) ; Oxidoreductases ; Plasma ; Smoke ; Smoking ; Stomatitis, Aphthous ; Tetrahydrofolates ; Vascular Diseases ; Vascular System Injuries ; Vasculitis