No abstract available.
Polyarteritis Nodosa*

PURPOSE: This study was conducted to identify job experiences of male hospital nurses. METHODS: Data were collected from 20 male nurses working at general hospitals, through semi-structured in-depth interviews. The interviews were recorded and subsequently transcribed verbatim. Using content analysis, data were coded and categorized. RESULTS: The analyzed domains were motivations for choosing nursing, occupational experiences (3 subdomains), and attitudes toward the future. A total of 85 significant statements were selected from the data and classified into 32 categories. The nurses' motivations for choosing nursing were advantages of employment, their aptitude, scarcity value of men, professionalism and job security, good promotion, stable income, and family influence. In occupational experiences, they were assigned to special fields and dissatisfied with vertical relationship, promotion system, their salary, and gaps in military service time; they had difficulties in adapting to female-dominated groups and encountered gender role stereotype and preconception; they were satisfied with their distinguished performance, but had damaged self-esteem, and were stressed and disappointed in their work. In their attitudes toward the future, they considered their career changes, but tried to make professional and personal advancement. CONCLUSION: These findings have implications for recruiting and retaining male nurses in clinical settings.
Aptitude ; Employment ; Gender Identity ; Hospitals, General ; Humans ; Male ; Military Personnel ; Motivation ; Nurses, Male ; Salaries and Fringe Benefits ; Statistics as Topic

OBJECTIVES: An accurate estimation of cancer patients is the basis of epidemiological studies and health services. However in Korea, cancer patients visiting out-patient clinics are usually ruled out of such studies and so these studies are suspected of underestimating the cancer patient population. The purpose of this study is to construct a more complete, hospital-based cancer patient registry using multiple sources of medical information. METHODS: We constructed a cancer patient detection algorithm using records from various sources that were obtained from both the in-patients and out-patients seen at Asan Medical Center (AMC) for any reason. The medical data from the potentially incident cancer patients was reviewed four months after first being detected by the algorithm to determine whether these patients actually did or did not have cancer. RESULTS: Besides the traditional practice of reviewing the charts of in-patients upon their discharge, five more sources of information were added for this algorithm, i.e., pathology reports, the national severe disease registry, the reason for treatment, prescriptions of chemotherapeutic agents and radiation therapy reports. The constructed algorithm was observed to have a PPV of 87.04%. Compared to the results of traditional practice, 36.8% of registry failures were avoided using the AMC algorithm. CONCLUSIONS: To minimize loss in the cancer registry, various data sources should be utilized, and the AMC algorithm can be a successful model for this. Further research will be required in order to apply novel and innovative technology to the electronic medical records system in order to generate new signals from data that has not been previously used.
Adult ; Female ; Hospitals ; Humans ; Male ; *Medical Records ; Middle Aged ; Neoplasms/*diagnosis ; Organizational Case Studies ; *Program Development ; *Registries ; Republic of Korea

A 29-year-old woman in her 8th week of pregnancy was referred to our hospital for swelling in the lower extremities, rapid onset of dyspnea (1 hr) and pre-syncope. Severe right ventricular dysfunction and moderate pulmonary hypertension were detected using 2-dimentional Doppler echocardiography. In addition, left calf vein and proximal thromboses were detected by venous compression ultrasound imaging. After successful thrombolytic treatment, the patient quickly recovered and was discharged from hospital on subcutaneous low-molecular-weight heparin. She delivered a normal, healthy infant at full-term (40 weeks).
Adult ; Dyspnea ; Echocardiography, Doppler ; Female ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary ; Infant ; Lower Extremity ; Pregnancy* ; Pulmonary Embolism* ; Thrombolytic Therapy ; Thrombosis ; Ultrasonography ; Veins ; Venous Thrombosis* ; Ventricular Dysfunction, Right

Prognosis of placental abruption depends on gestational age and the status of the mother and the fetus, and perinatal mortality was almost entirely attributable to prematurity. A midtrimester women with placental abruption was successfully treated by expectant management including fetal surveillance, serial ultrasonography and maternal hematologic examination, and delivered a healthy baby 11 weeks later. We suggest that expectant management may be considered as a good treatment option until fetal lung maturation is documented in preterm pregnancy with placental abruption if there is no maternal or fetal compromise.
Abruptio Placentae* ; Female ; Fetus ; Gestational Age ; Humans ; Live Birth* ; Lung ; Mothers ; Perinatal Mortality ; Pregnancy ; Pregnancy Trimester, Second* ; Prognosis ; Ultrasonography

OBJECTIVE: This study was to determine whether aquaporin-8, which plays a role as a transcellular water channel, is expressed in human placenta, and to compare the degree of its expression between preeclamptic women and normal pregnant women. METHODS: Placentas were obtained from severely preeclamptic women and normal pregnant women who were delivered babies by cesarean section before the onset of labor in the Chungbuk National University Hospital. In situ hybridization with aquaporin-8 cRNA probe was performed using paraffin-embedded tissue section. Signal of aquaporin-8 expression was observed with light microscope. RESULTS: In situ hybridization demonstrated strong expression of aquaporin-8 mRNA in the placentas of both preeclamptic women and normal pregnant women. The degree of expression was the same in both group. CONCLUSION: Aquaporin-8 in human placenta may not be related to the pathogenesis of preeclampsia.
Cesarean Section ; Chungcheongbuk-do ; Female ; Humans ; In Situ Hybridization ; Placenta* ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; RNA, Complementary ; RNA, Messenger ; Water

Spontaneous coronary artery embolization is a known complication of infective endocarditis. However, a microembolism from the aortic valve into the left anterior descending artery resulting in an acute anterior myocardial infarction is very rare. A 44-year-old male patient suffered from chest pain and fever of seven days duration. The echocardiogram demonstrated severe aortic stenosis, aortic root abscess and mobile vegetation on bicuspid aortic valve near the left coronary artery ostium. The electrocardiogram revealed ST segment elevation in lead V1-3 and heart enzyme analysis showed LD 936 IU/L, CK 299 IU/L, CK-MB 7.2 U/L, Troponin I 9.94 ng/mL. Diagnostic coronary angiogram revealed insignificant coronary lesion. Emergent operation was required because of aortic root abscess formation and high risk of recurrent embolization. He underwent surgery for aortic valve replacement and conservative management for acute myocardial infarction. The purpose of this article is to report the successful emergent aortic valve replacement of a patient with myocardial infarction due to coronary microembolism in a case of bacterial endocarditis.
Abscess ; Adult ; Aortic Valve ; Aortic Valve Stenosis ; Arteries ; Bicuspid ; Chest Pain ; Coronary Vessels ; Electrocardiography ; Endocarditis ; Endocarditis, Bacterial* ; Fever ; Heart ; Humans ; Male ; Myocardial Infarction* ; Troponin I

Chronic virus infection leads to the functional impairment of dendritic cells (DCs) as well as T cells, limiting the clinical usefulness of DC-based therapeutic vaccine against chronic virus infection. Meanwhile, B cells have been known to maintain the ability to differentiate plasma cells producing antibodies even during chronic virus infection. Previously, alpha-galactosylceramide (alphaGC) and cognate peptide-loaded B cells were comparable to DCs in priming peptide-specific CD8+ T cells as antigen presenting cells (APCs). Here, we investigated whether B cells activated by alphaGC can improve virus-specific T cell immune responses instead of DCs during chronic virus infection. We found that comparable to B cells isolated from naive mice, chronic B cells isolated from chronically infected mice with lymphocytic choriomeningitis virus (LCMV) clone 13 (CL13) after alphaGC-loading could activate CD1d-restricted invariant natural killer T (iNKT) cells to produce effector cytokines and upregulate co-stimulatory molecules in both naive and chronically infected mice. Similar to naive B cells, chronic B cells efficiently primed LCMV glycoprotein (GP) 33-41-specific P14 CD8+ T cells in vivo, thereby allowing the proliferation of functional CD8+ T cells. Importantly, when alphaGC and cognate epitope-loaded chronic B cells were transferred into chronically infected mice, the mice showed a significant increase in the population of epitope-specific CD8+ T cells and the accelerated control of viremia. Therefore, our studies demonstrate that reciprocal activation between alphaGC-loaded chronic B cells and iNKT cells can strengthen virus-specific T cell immune responses, providing an effective regimen of autologous B cell-based therapeutic vaccine to treat chronic virus infection.
Animals ; Antibodies ; Antigen-Presenting Cells ; B-Lymphocytes ; Clone Cells ; Cytokines ; Dendritic Cells ; Glycoproteins ; Lymphocytic choriomeningitis virus ; Mice ; Natural Killer T-Cells ; Plasma Cells ; T-Lymphocytes ; Viremia

BACKGROUND: Although the use of intravenous patient controlled analgesia (IVPCA) has been compared to the use of patient conrolled epidural analgesia (PCEA), there is no optimal administration route of alfentanil for the treatment of postoperative pain. This randomized double-blind study compared the efficacy of the use of IVPCA and PCEA for postoperative pain and the side effects after a total abdominal hysterectomy (TAH). METHODS: Sixty patients undergoing a TAH were randomly assigned to receive either IVPCA (Group I) or PCEA (Group E) for the infusion of alfentanil for postoperative pain control. In both groups, a loading dose of 750 microgram alfentanil was administered. All patients received the same continuous infusion rate (0.3 mg/h), bolus dose (0.15 mg), and lockout time (15 min). The incidence of side effects, the VAS (visual analog scale) of pain, blood pressure, and heart rate were checked for 20 hours after the loading dose injection. RESULTS: The VAS of pain was not significantly different between the two groups of patients. The onset of the analgesic effect was significantly more rapid in the Group I patients than in the Group E patients. There was no difference in side effects for either group. CONCLUSIONS: When considering multiple factors such as the onset of analgesia, technical difficulties or infection after the procedure, IVPCA using alfentanil is more useful than PCEA for postoperative pain control after a TAH.
Alfentanil* ; Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled* ; Blood Pressure ; Double-Blind Method ; Heart Rate ; Humans ; Hysterectomy* ; Incidence ; Pain, Postoperative

OBJECTIVE: We evaluated the human papillomavirus (HPV) DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia (VAIN). METHODS: A retrospective review of the medical records of patients with a pathological diagnosis of VAIN was performed. Eligible women (N=48) were followed for cytology and HPV DNA test, and colposcopic biopsies were taken at 3- to 6-month intervals. Thirty-seven patients were followed for more than 6 months; their HPV DNA test results were compared to the cytology results for the prediction of disease prognosis. RESULTS: The degree of VAIN was more severe in patients with a high initial HPV DNA load (p=0.009). Patients with VAIN 2 and VAIN 3 were older than those with VAIN 1 (p=0.005 and 0.008, respectively). In 26 out of 37 patients (70.3%), the VAIN resolved. The other patients had persistent lesions with no progression to invasive vaginal carcinoma. The last follow-up HPV DNA load was significantly higher in the group with persistent VAIN compared to the group with resolved VAIN (p<0.0001). Negative cytology was observed in 25 out of 26 patients in the VAIN resolved group and in nine out of 11 patients in the VAIN persistent group (p=0.205). CONCLUSION: These results suggest that the HPV DNA test, especially for viral load, was more effective for the diagnosis and prediction of persistent VAIN than cytology.
Biopsy ; DNA ; Female ; Follow-Up Studies ; Human Papillomavirus DNA Tests ; Humans ; Medical Records ; Prognosis ; Retrospective Studies ; Viral Load