Crohn's disease, a chronic relapsing, multisystemic, inflammatory disorder, may involve any part of the gastrointestinal tract and shows a cobblestone-like appearance on intestinal mucosa. There are also extraintestinal features, including lesions of the skin, eye, and joints. Ulcers, fissures, sinus tracts, abscesses, and vegetant plaques have been reported for the perianal skin lesions of Crohn's disease. We experienced a case of Crohn's disease in a 21-year-old Korean female showing a skin lesion with a cobblestone-like appearance in the perianal region.
Abscess ; Crohn Disease* ; Female ; Gastrointestinal Tract ; Humans ; Intestinal Mucosa ; Joints ; Skin* ; Ulcer ; Young Adult

No abstract available.
Abdominal Wall ; Herpes Zoster

OBJECTIVES: This study investigated the socioeconomic factors that affect quality of life (QL) in healthy adults and to study the relationship between QL and health-related habits and food intake. METHODS: Subjects consisted of 1,154 healthy adults without any known disease, aged 19 to 65 years from the 2013 Korean National Health and Nutrition Examination Survey data. We used SPSS statistical program version 20.0 for data analysis. RESULTS: The average age and QL score of the study population were 36.7 years and 0.99 points, respectively. Males had a significantly higher QL score than the females (p < 0.001), and employed subjects and those employed in permanent positions had significantly higher scores as compared respectively with unemployed subjects and those employed in temporary positions (p < 0.001, p < 0.05). The group that responded "almost every day" to the "frequency of binge drinking" and "frequency of disruption of daily life due to drinking" had significantly lower QL scores as compared to other groups (p < 0.05). Further, the scores were significantly higher for individuals who practiced "intense physical activities" and "walking" (p < 0.001). The groups that responded that they were "very stressed" showed significantly lower QL scores in comparison to the other groups (p < 0.05). There were no significant differences in QL scores according to anthropometric or biochemical indices. When subjects were divided into two groups based on average QL scores, the frequency of intake of "barbecued beef" was significantly higher while the frequency of intake of "fried eggs or rolled omelet," and "soy milk" was significantly lower in the high QL group. CONCLUSIONS: Based on these findings, it is evident that in healthy adults without any known underlying illnesses, psychological factors such as economic activity, occupational environment, and stress are considered to have a greater impact on their QL than are nutrient intake, blood biochemical indices, and anthropometric status.
Adult* ; Eating* ; Eggs ; Female ; Humans ; Korea* ; Male ; Nutrition Surveys* ; Ovum ; Psychology ; Quality of Life* ; Socioeconomic Factors ; Statistics as Topic

It is generally believed that tumor necrosis factor alpha (TNF a) plays an crucial role in the pathogenesis of bacterial meningitis through various mechanisms such as endothelial damage, induction of adhesion molecule on the endothelial cell, recruitment of leukocytes in the cerebrospinal fluid(CSF). We performed this study to analyze the relationship of TNF alpha level with the severity of inflammation in the CSF. In a rabbit meningitis model, we attempted to evaluate whether antibiotics induced bacteriolysis can induce the elevation of the TNF alpha level and pleocytosis in CSF, and whether dexamethasone can suppress this elevation of TNF alpha. We also tried to assess the effective administation timing of dexamethasone. Meningitis was induced by intracistemal inoculation of Streptococcus pneumoniae. We designed four groups : Group 1. Untreated conrol (N=5); Group 2. Lone ceftriaxone at 6 hours after inoculation (N=5) ; Group 3. Dexamethasone at 30 minutes before ceftriaxone treatment (N=5); Group 4. Dexamethasone at 30 min. after ceftriaxone treatment (N=5). CSF TNF alpha level and cell count was assessed with regular time interval. The results were as follows: First, the CSF bacterial counts (measured by colony forming units) of group 1 was significantly higher than the other groups after ceftriaxone treatment (P<0. 05). Second, the CSF WBC counts of group 3 and 4 were significantly lower than those of group 1 and 2 at 6 and 14 hours after ceftriaxone treatment (P<0.05). Third, the CSF TNF alpha titers of group 1 and 3 were significantly lower than those of group 2 and 4 at 2 hours after ceftriaxone treatment (P<0.05). Fourth, after 14 hours, the CSF TNF alpha titers of group 1 kept on rising and became significantly higher than those of other groups (P Anti-Bacterial Agents ; Bacterial Load ; Bacteriolysis ; Ceftriaxone ; Cell Count ; Dexamethasone* ; Endothelial Cells ; Inflammation* ; Leukocytes ; Leukocytosis ; Meningitis ; Meningitis, Bacterial ; Meningitis, Pneumococcal* ; Streptococcus pneumoniae ; Tumor Necrosis Factor-alpha

Fanconi anemia is an autosomal recessive disease that's characterized by congenital anomalies, defective hematopoiesis and a high risk of developing acute myeloid leukemia and certain solid tumors. The clinical phenotype is extremely variable; therefore, the diagnosis is frequently delayed until the pancytopenia appears. Chromosomal instability, especially on exposure to an alkylating agent, may be seen in affected patients and it is the basis for a diagnostic test. This cellular phenotype can be demonstrated in cultured T cells, B cells, fibroblasts and fetal cells cultured from both amniotic fluid and chorionic villi. But somatic mosaicism may make the diagnosis of Fanconi anemia difficult because of inconclusive chromosome breakage studies. If the test is negative in lymphocytes and yet the clinical setting is highly suspicious, then the skin fibroblasts must be assessed. Because skin fibroblasts are somatic cells, a definitive test can be performed on primary skin fibroblasts. In this report we describe a case of Fanconi anemia that was diagnosed with the use of cultured skin fibroblasts, and this was despite the normal breakage studies in the peripheral blood.
Amniotic Fluid ; B-Lymphocytes ; Chorionic Villi ; Chromosomal Instability ; Chromosome Breakage ; Diagnostic Tests, Routine ; Fanconi Anemia ; Female ; Fibroblasts ; Hematopoiesis ; Humans ; Leukemia, Myeloid, Acute ; Lymphocytes ; Mosaicism ; Pancytopenia ; Phenotype ; Skin ; T-Lymphocytes

Purpose: This study was conducted to investigate the nursing needs and workload of nurses according to nursing dependency for effective placement of nursing staff in the emergency department (ED). Methods: In June 2020, 256 adult patients who visited the ED were classified as two groups, suspected COVID-19 patients and general patients. The participants’electronic medical records were analyzed using descriptive statistics, t-test, x 2 -test, and Fisher's exact test using the SPSS. Results: The patient dependence score showed a significant difference between the two groups, with an average of 13.99±1.85 for the suspected COVID-19 patient group and 10.58±2.10 for the general patient group (t=12.42, p<.001). There were statistically significant differences in communication (t=3.28, p=.001), mobility (t=3.29, p=.001), nutrition, elimination, and personal care (t=7.34, p<.001) among the six domains of nursing dependency. In the domains of environment, safety, health, and social needs, the dependency score was 3 for all suspected COVID-19 patients and 1 for all general patients. Conclusion The results of this study confirmed that infection control activities of emergency patients who need isolation affect the patients’ nursing dependency on nursing care.

Purpose: This study was conducted to investigate the nursing needs and workload of nurses according to nursing dependency for effective placement of nursing staff in the emergency department (ED). Methods: In June 2020, 256 adult patients who visited the ED were classified as two groups, suspected COVID-19 patients and general patients. The participants’electronic medical records were analyzed using descriptive statistics, t-test, x 2 -test, and Fisher's exact test using the SPSS. Results: The patient dependence score showed a significant difference between the two groups, with an average of 13.99±1.85 for the suspected COVID-19 patient group and 10.58±2.10 for the general patient group (t=12.42, p<.001). There were statistically significant differences in communication (t=3.28, p=.001), mobility (t=3.29, p=.001), nutrition, elimination, and personal care (t=7.34, p<.001) among the six domains of nursing dependency. In the domains of environment, safety, health, and social needs, the dependency score was 3 for all suspected COVID-19 patients and 1 for all general patients. Conclusion The results of this study confirmed that infection control activities of emergency patients who need isolation affect the patients’ nursing dependency on nursing care.

OBJECTIVE: The aim of this study is to make a management strategy for the patients with recurrent cerebral aneurysm after surgery. METHODS: Over a 19-year period, 1, 546 patients were treated for a ruptured intracranial aneurysm surgically. Twenty-six of these patients(1.7%) were subsequently treated for regrowing aneurysm(8) or de novo aneurysm formation(26). Among them, twenty-three individuals who presented with recurrent subarachnoid hemorrhage underwent conventional angiography to detect the aneurysm recurrence. Three-dimensional computed tomographic angiography was performed in the remaining three patients who complained chronic headache. The mean age at the first surgery was 48.6 years. An interval ranging from 1 to 192 months(mean, 76.1 months) since the original treatment. RESULTS: Total 34 recurrent aneurysms in 26 patients were treated by microsurgical clipping(29 cases), wrapping(1 case), and endovascular coiling(4 cases) as a second procedure. A satisfactory outcomes were achieved in twenty-one patients(80.8%) during a mean 69.5 months follow-up period. The most common site of the recurrence was the internal carotid-posterior communicating artery. Patients with de novo aneurysms are frequently hypertensive(61.1%) and younger in age(55.6%). CONCLUSION: The treatment of recurrent cerebral aneurysm could be performed effectively using direct operations and/or endovascular procedures.
Aneurysm ; Angiography ; Arteries ; Embolization, Therapeutic ; Endovascular Procedures ; Follow-Up Studies ; Headache Disorders ; Humans ; Intracranial Aneurysm* ; Recurrence ; Subarachnoid Hemorrhage

Diaphragmatic eventration is an abnormal elevation of an intact diaphragm into the thoracic cavity as a result of paralysis, aplasia or atrophy of muscular fibers, which accounts for 5~10% of all diaphragmatic disorders. Congenital eventration result from a incomplete muscularization of the pleuroperitoneal membranes at 8~10 weeks' menstrual age, the cause of this failure is not known. Although some patients are asymptomatic and find out incidentally, significant compression of the affected chest contents can result in severe respiratory distress. The differentiation between congenital diaphragmatic eventration and congenital diaphragmatic hernia by sonography may be difficult, but important because of a significant differences in postnatal management and prognosis. We experienced a case of right congenital diaphragmatic eventration with severe respiratory distress during immediate postnatal period, who was initially diagnosed as congenital diaphragmatic hernia and performed plication at 18 hours after birth. So we report this case with review of literatures.

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal (GI) tract. These tumors are frequently small, asymptomatic and found incidentally. GI bleeding is a common complication of these tumors, but small sized, very low risk GIST rarely complicated with fatal bleeding. In this report, we describe a 42-year-old woman with a jejunal GIST accompanied by severe GI bleeding. She presented with melena and an angiographic embolization was performed for a jejunal mass with bleeding. However, rebleeding was suspected after an angiographic embolization and an emergent segmental resection for the bleeding mass was performed. She was finally diagnosed as a 1.8 cm sized very low risk GIST in jejunum. In conclusion, physician should consider that even very low risk GIST can be the cause of GI bleeding when there is severe bleeding.
Adult ; Female ; Gastrointestinal Stromal Tumors* ; Hemorrhage* ; Humans ; Jejunum* ; Melena