PURPOSE: This study was conducted to assess the effects of lights-out at nighttime on body weight, physiological variables, and behavioral status in premature infants and to provide basic data for applying lights-out at night time in premature infants. METHODS: Premature infants of over 32 weeks' corrected age were included in this study (January 2015-June 2015), and were allocated to two groups according to the lights-out at night for 5 hours: study group and control group. Lights-out was applied to the study group from midnight for five hours in a quiet environment. RESULTS: Fifty-two infants were included in the study: 26 in the study group and 26 in the control group. Growth rates of body weight, height, and head circumference were higher in the study group compared to the control group, but there were no statistical differences. In the physiological variables, heart rate decreased by 6.9 beats per minute in the study group, but it increased by 2.7 beats per minute in the control group (P<0.0001) during applied 5 hours at night. Anderson Behavioral State Score decreased in the study group compared to the control group (P=0.042). CONCLUSION: Lights-out at night decreased the heart rate and made the behavioral status more stable. To understand the effects of lights-out on long-term growth and development of premature infants at the highest risk of delayed growth and development, further studies with a larger number of premature infants are needed.
Body Weight* ; Circadian Rhythm ; Growth and Development ; Head ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature*

PURPOSE: To investigate the accuracy of Orbscan system in measuring corneal thickness before refractive surgery, the authors conducted a comparative study of Orbscan system and ultrasonic pachymeter in their agreement and repeatability. METHODS: 84 patients (168 eyes) who were examined between December, 2000 and March, 2001 were divided into two groups: those who exceeded -6.00 D, and those who did not. Orbscan and ultrasonic pachymeter were employed. Correlation and regression were analyzed to assess their agreement. The repeatability was measured by analyzing mean, standard deviation, and 95% confidence interval of each method. RESULTS: The average central corneal thickness was 542.3+/-34.2micro meter by Orbscan system, and 528.6+/-29.7micro meter by ultrasonic pachymeter. Correlation coefficient was nearly 1 between them, and therefore we obtained statistically significant linear regression equation. In the analysis of repeatability, 95% confidence interval of Orbscan system was -17.2micro meter~+11.8micro meter which was superior to the interval of ultrasonic pachymeter (-23.2micro meter~+14.4micro meter). CONCLUSION: Orbscan system measurements of corneal thickness was greater than ultrasonic pachymeter measurements by 9 to 19 m. Because Orbscan system also showed superiority in repeatability, it may be a useful method in the clinical field.
Humans ; Linear Models ; Refractive Surgical Procedures ; Ultrasonics

OBJECTiVE We investigate the effects of multiple attempts of embryo transfer because of retained embryos in the catheter and of contaminated mucus on the transferred catheter. MATERiALS AND METHODS: We respectively analysed data between November 1998 and August 2002 from 305 patients of 369 cycles who underwent iVF-ET. Of these patients, 47 patients of 50 cycles (Group 2) were required multiple trial of embryo transfer. They were compared with an age-matched control groups (Group 1) with female factor infertility. Pearson's c2 and Fisher's tests were used to compare proportions between discrete variables. Non-categorical data were compared using t-test. Statistical significance was set at p<0.05. RESULTS: Embryos were significantly more likely to be retained when catheter was contaminated with mucus (Group 1: 22.4%; Group 2: 44.0%). The clinical pregnancy rates, however, for the contaminated mucus or not, were 46.8%, 43.5% respectively. There was no significant difference clinical pregnancy rate between those who had all their embryos transferred at the first attempt (45.4%) and those who required more than one attempt (48.0%). CONCLUSiONS: Contaminated mucus in the catheter is associated with failed embryo transferred at the first attempt. Embryo transfers, however, that are repeated attempts do not adversely affect pregnancy rates following iVF-ET.
Catheters ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization* ; Humans ; Infertility ; Mucus* ; Pregnancy Rate* ; Pregnancy*

Coccidioidomycosis is a systemic infection caused by inhalation of airborne spores of Coccidioides immitis, a fungus found in soil in the southwestern area of United States and in parts of Mexico and South America. Although its human infection has not been reported infrequently in nonendemic areas, it has rarely been done in Korea since first report of a case of systemic coccidioidomycosis with cutaneous lesions. The patient was a 32-year-old male with granulating cutaneous nodules on left side of upper back for 1 month. Three months ago, he had stayed at northern area of Mexico for 2 months with mild transient upper respiratory symptoms during his stay. After he returned to Korea, cervical lymphadenopathy and skin lesions developed. He had also respiratory symptoms such as chest discomfort and mild chest pain and chest X-ray revealed a solitary nodule. The cutaneous nodules of walnut size were removed surgically and he was recieved daily oral medication of itraconazole 400 mg for 10 months showing good clinical response. Even though lung nodule was not disappeared in radiological exam, repeated CT guided biopsy and fungal tissue culture of lung nodule were undertaken with no growth throughout 10 months. After 10 months itraconazole therapy, there was no evidence of clinical relapse and no change on chest film for following 16 months. We report a case of disseminated coccidioidomycosis involving lung, skin and lymph node simmultaneously and successfully treated with both surgical excision and systemic antifungal therapy.
Adult ; Biopsy ; Chest Pain ; Coccidioides ; Coccidioidomycosis* ; Fungi ; Humans ; Inhalation ; Itraconazole ; Juglans ; Korea ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Male ; Mexico ; Recurrence ; Skin ; Soil ; South America ; Spores ; Thorax ; United States

PURPOSE: The rapid urease test is a rapid and reliable method for diagnosing Helicobacter pylori infection. However it requires gastric mucosal biopsies during endoscopy, and the test is not covered by national health insurance for patients with gastric cancer. So, we introduced an alternative method for a rapid urease test using back-table gastric mucosal biopsies from gastrectomy specimen. MATERIALS AND METHODS: Ninety gastric cancer patients underwent an anti H. pylori IgG ELISA test and gastrectomy. Just after gastrectomy, two gastric mucosal biopsies from the prepyloric antrum and lower body of the gastrectomy specimen were taken from the back table in the operative room, and these were fixed immediately with the rapid urease test kit, and the color change was monitored for up to 24 hours. In this study, H. pylori infection was defined as positive when the serology or rapid urease test showed positive results. RESULTS: The positive rate of the rapid urease test and serology was 91.1% and 77.8%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid urease test and serology were 94.3 and 80.5%, 100 and 100%, 100 and 100%, and 37.5 and 15%, respectively. The accuracy of the rapid urease test was higher than that of serology (94.4 vs. 81.1%, respectively). The rapid urease test showed a higher rate of detecting H. pylori infection than that of serology (McNemar's test, P=0.019). CONCLUSION: The result of the rapid urease test using back-table gastric mucosal biopsies from a gastrectomy specimen is comparable to the reference data of the conventional rapid urease test using gastric mucosal endoscopic biopsies. Therefore, it can be an alternative diagnostic method for H. pylori infection.
Biopsy ; Endoscopy ; Enzyme-Linked Immunosorbent Assay ; Gastrectomy ; Helicobacter ; Helicobacter pylori ; Humans ; Immunoglobulin G ; National Health Programs ; Sensitivity and Specificity ; Stomach Neoplasms ; Urease

It has been well known that long-term immune suppression in renal transplant patients increases the possibility of complications. Infectious disease is one of the representative complications. We experienced a case of nocardiosis with cytomegalovirus infection after third renal transplantation in China. Nocardiosis is an important opportunistic infection in immunosuppressed patients, lymphoma, sarcoidosis, and organ transplant patients. CMV can cause severe hepatitis, pneumonitis, enteritis, endometritis, and encephalitis. It can depress bone marrow, and impair the immune system so as to increase other bacterial infection and trigger rejections. Third renal transplantation causes long-term immune suppression or over-immune suppression on transplant patients. Very few cases of third renal transplantation have been reported in Korea. We reduced the dose of immune- suppressants, and treated it successfully with ganciclovir and Trimethoprim/Sulfamethoxazole (Bactrim(R)).
Bacterial Infections ; Bone Marrow ; China* ; Communicable Diseases ; Cytomegalovirus ; Cytomegalovirus Infections ; Encephalitis ; Endometritis ; Enteritis ; Female ; Ganciclovir ; Hepatitis ; Humans ; Immune System ; Kidney Transplantation* ; Korea ; Lymphoma ; Nocardia Infections* ; Opportunistic Infections ; Pneumonia ; Sarcoidosis ; Transplants

Actinomycosis is an indolent infectious disease characterized by pyogenic response and necrosis, followed by intense fibrosis. The main forms of human actinomycosis are cervicofacial, pulmonary, and abdominopelvic type. Pulmonary actinomycosis accounts for 15% to 20% of total cases and unfortunately, clinical manifestations and radiologic findings are nonspecific. Small pleural effusion or empyema may develop in advanced disease but massive empyema is infrequent and rarely reported. We report a case of huge empyema caused by pulmonary actinomycosis in a 55 year-old man, presented with one-month history of productive cough and fever. The CT scan revealed a huge cavity with air-fluid level occupying the left hemithorax. Empyema caused by actinomycosis was confirmed microscopically by demonstration of sulfur granules in empyema sac through thracotomy. Decortication and surgical resection of empyema sac and destructed lung was accomplished and followed by intravenous infusion of penicillin G.
Actinomycosis* ; Communicable Diseases ; Cough ; Empyema* ; Fever ; Fibrosis ; Humans ; Infusions, Intravenous ; Lung ; Middle Aged ; Necrosis ; Penicillin G ; Pleural Effusion ; Sulfur ; Tomography, X-Ray Computed

Incidence of nontuberculous mycobacterium (NTM) pulmonary disease is increasing with the wider recognition and development of diagnostic technology. Mycobacterium kansasii is the second most common pathogen of NTM pulmonary disease in human immunodeficiency virus (HIV)-infected patients. However in Korea, the incidence of M. kansasii pulmonary disease is relatively low, and there has been no report of M. kansasii pulmonary disease with bronchial involvement in HIV patients, to the best of our knowledge. We report a case of M. kansasii pulmonary disease presenting with endobronchial lesions in an HIV-infected patient complaining of chronic cough with bilateral enlargements of hilar lymph nodes on chest X-ray.
Bronchial Diseases ; Cough ; HIV ; Humans ; Incidence ; Korea ; Lung Diseases* ; Lymph Nodes ; Mycobacterium kansasii* ; Mycobacterium* ; Nontuberculous Mycobacteria ; Thorax

OBJECTIVES: This cross-sectional study investigated the relationship between job stress and psychosocial stress among nurses at a university hospital in Incheon, Korea. METHODS: A questionnaire survey was administered to 476 nurses, of which 320 (67.2%) questionnaires were returned and 299 (62.8%) were regarded as containing reliable data for analyses. A structured self-reported questionnaire was used to assess each respondent's sociodemographics, sleep quality, physical burden, job stress and psychosocial stress. Seven domains of occupational stress (e.g., Job demand, Insufficient job control, Interpersonal conflict, Job insecurity, Lack of reward, Organizational system and Occupational climates) according to the Korean Occupational Stress Scale (KOSS) were used and psychosocial stress was measured using Dr. Chang's PWI-SF (Psychosocial Well-being Index-Short Form). We estimated the relation of job stress to psychosocial stress using univariate and logistic regression analyses. RESULTS: The logistic regression analyses indicated that the groups with high stress in 'Insufficient job control' (OR=2.67, 95% C.I.=1.37-5.23), 'Interpersonal conflict' (OR=2.32, 95% C.I.=1.19-4.51), 'Job insecurity' (OR=2.51, 95% C.I.=1.17-5.36), 'Organizational system' (OR=2.80, 95% C.I.=1.39-5.63), and 'Lack of reward' (OR=2.98, 95% C.I.=1.55-5.74) were more likely to experience high psychosocial stress. CONCLUSIONS: Our results tend to suggest that job stress is associated with psychosocial stress. The importance of job stress should be acknowledged and stress management programs need to be instigated to minimize the psychosocial stress caused by job stress.
Cross-Sectional Studies ; Incheon ; Korea ; Logistic Models ; Questionnaires ; Reward

Isolated left ventricular noncompaction (LVNC) is a rare disorder caused by embryonic arrest of compaction. LVNC is sometimes associated with other congenital cardiac disorders; however, there have been few reports of its coexistence with a left ventricular aneurysm. A 40-year-old woman was admitted to our hospital for renal infarction. She had a history of embolic cerebral infarction 10 years ago. Transthoracic echocardiography showed prominent trabeculae and deep intertrabecular recesses which are filled with blood from the left ventricular (LV) cavity. A thrombus in the akinetic apical wall was confirmed by contrast echocardiography. Using cardiac computed tomography and magnetic resonance imaging, we rejected a possible diagnosis of suspicion of coronary artery disease. She was diagnosed LVNC with a thrombus in apical aneurysm. Here, we report the first patient in Korea known to have LVNC accompanying LV congenital aneurysm presenting with recurrent embolism.
Adult ; Aneurysm ; Cerebral Infarction ; Coronary Artery Disease ; Echocardiography ; Embolism ; Female ; Humans ; Infarction ; Korea ; Magnetic Resonance Imaging ; Thrombosis