Bacille Calmette-Guerin (BCG) lymphadenitis is the most common complication of BCG vaccination. It commonly occurs in infants aged <6 months involving ipsilateral axillary lymph nodes. We described BCG lymphadenitis in a 22-month-old boy presenting swelling of left supraclavicular lymph node that was confirmed by real-time polymerase chain reaction (PCR) and the multiplex PCR targeting the region of difference (RD).
Humans ; Infant ; Lymph Nodes ; Lymphadenitis* ; Male ; Multiplex Polymerase Chain Reaction ; Mycobacterium bovis* ; Real-Time Polymerase Chain Reaction ; Vaccination*

Since the behavior of malignant cells can be predicted by their histologic appearance, various attempts have been made to develop a uniform grading system for prostatic cancer. The system employed at the University of Texas M.D. Anderson Hospital(MDAH system) is based simply on assessment of percentage of gland formation in the tumor. Herein, using the modified MDAH system, histologic grading and prognosis were retrospectively reviewed in 35 patients with prostatic adenocarcinoma managed at Chonnam University Hospital between l997 and 1984. The following results were obtained. 1. The average age of all the patients was 70.1 years, with a range of 25 to 85 years. 2. In 35 patients, the modified MDAH system identified 6 patients (l7%) as Grade 1, 15(43%) as Grade 2-3, and 14 (40%) as Grade 4. There were a 83% 3-year survival for Grade 1 patients, a 69% 3-year survival for Grade 2-3 patients, and a 17% 3-year survival for Grade 4 patients. 3. Of 15 patients with clinical stage D, 2 had Grade 1, 6 had Grade 2-3, and 7 had Grade 4.There were a 100 % 3-year survival for Grade 1 patients, a 50% 3-year survival for Grade 2-3patients, and a 14% 3-year survival for Grade 4 patients.
Adenocarcinoma ; Humans ; Jeollanam-do ; Prognosis* ; Prostatic Neoplasms ; Retrospective Studies ; Texas

BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.
Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Methods* ; Rotator Cuff ; Scapula ; Shoulder ; Tears

OBJECTIVES: This study was conducted to evaluate the adoption behavior of a newly developed Electronic Medical Record (EMR)-based information system (IS) at three public hospitals in Korea with a focus on doctors and nurses. METHODS: User satisfaction scores from four performance layers were analyzed before and two times after the newly develop system was introduced to evaluate the adoption process of the IS with Rogers' diffusion theory. RESULTS: The 'intention to use' scores, the most important indicator for determining whether or not to adopt the IS in Rogers' confirmation stage for doctors, were very high in the third survey (4.21). In addition, the scores for 'reduced medication errors', which is the key indicator for evaluating the success of the IS, increased in the third survey for both doctors and nurses. The factors influencing 'intention to use' with a high odds ratio (>1.5) were the 'frequency of attendance of user training sessions', 'mandatory use of system', 'reduced medication errors', and 'reduced medical record documentation time' for both doctors and nurses. CONCLUSIONS: These findings show that the new EMR-based IS was well accepted by doctors. Both doctors and nurses also positively considered the effects of the new IS on their clinical environments.
Diffusion of Innovation ; Diffusion* ; Electronic Health Records* ; Hospitals, Public* ; Information Systems* ; Korea ; Medical Records ; Odds Ratio

OBJECTIVES: This research used queueing theory to analyze changes in outpatients' waiting times before and after the introduction of Electronic Medical Record (EMR) systems. METHODS: We focused on the exact drawing of two fundamental parameters for queueing analysis, arrival rate (λ) and service rate (µ), from digital data to apply queueing theory to the analysis of outpatients' waiting times. We used outpatients' reception times and consultation finish times to calculate the arrival and service rates, respectively. RESULTS: Using queueing theory, we could calculate waiting time excluding distorted values from the digital data and distortion factors, such as arrival before the hospital open time, which occurs frequently in the initial stage of a queueing system. We analyzed changes in outpatients' waiting times before and after the introduction of EMR using the methodology proposed in this paper, and found that the outpatients' waiting time decreases after the introduction of EMR. More specifically, the outpatients' waiting times in the target public hospitals have decreased by rates in the range between 44% and 78%. CONCLUSIONS: It is possible to analyze waiting times while minimizing input errors and limitations influencing consultation procedures if we use digital data and apply the queueing theory. Our results verify that the introduction of EMR contributes to the improvement of patient services by decreasing outpatients' waiting time, or by increasing efficiency. It is also expected that our methodology or its expansion could contribute to the improvement of hospital service by assisting the identification and resolution of bottlenecks in the outpatient consultation process.
Delivery of Health Care ; Electronic Health Records ; Hospitals, Public ; Humans ; Outpatients

Spontaneous fistula formation between the kidney and the colon is uncommon. The underlying cause is usually a pyonephrotic kidney which becomes adherent to a portion of the colon and then ruptures spontaneously, thus creating a fistula. Herein we present a case of renocolonic fistula which occurred in a 36-year old man with review of the literature.
Adult ; Colon ; Fistula* ; Humans ; Kidney ; Rupture

Although neuroblastoma occurs most frequently in children, it also may occur in adults and has been considered poor prognosis. Herein one case of retroperitoneal neuroblastoma developed in a 20 year-old female is presented, treated with debulking surgery and combination chemotherapy.
Adult* ; Child ; Drug Therapy, Combination ; Female ; Humans ; Neuroblastoma* ; Prognosis ; Young Adult

No abstract available.
Lymph Nodes* ; Neck* ; Thyroid Gland* ; Thyroid Neoplasms* ; Tuberculosis*

A sensitive and simple liquid chromatography-tandem mass spectrometry method was developed and validated for the simultaneous quantification of ticagrelor and its active metabolite, AR-C124910XX from 50 µL human plasma using tolbutamide as an internal standard as per regulatory guidelines. Analytes in plasma were extracted by simple protein precipitation using acetonitrile, followed by chromatographic separation with an Acclaim™ RSLC 120 C₁₈ column (2.2 µm, 2.1 × 100 mm) and a gradient acetonitrile-water mobile phase containing 0.1% formic acid within 8 min. Mass spectrometric detection and quantitation were conducted by selected reaction-monitoring on a negative electrospray ionization mode with the following transitions: m/z 521.11 → 361.10, 477.03 → 361.10, and 269.00 → 169.60 for ticagrelor, AR-C124910XX, and tolbutamide, respectively. The lower limit of quantifications was 0.2 ng/mL with linear ranges of 0.2–2,500 ng/mL (r² ≥ 0.9949) for both analytes. All validation data, including selectivity, cross-talk, precision, accuracy, matrix effect, recovery, dilution integrity, stability, and incurred sample reanalysis, were well within acceptable limits. This assay method was validated using K₂-EDTA as the specific anticoagulant. Also, the anticoagulant effect was tested by lithium heparin, sodium heparin, and K₃-EDTA. No relevant anticoagulant effect was observed. This validated method was effectively used in the determination of ticagrelor and its active metabolite, AR-C124910XX, in plasma samples from patients with myocardial infarction.
Heparin ; Humans ; Lithium ; Mass Spectrometry ; Methods ; Myocardial Infarction ; Pharmacokinetics ; Plasma ; Tolbutamide

PURPOSE: Amenorrhea and short stature are serious complications in patients with congenital adrenal hyperplasia of 21-hydroxylase deficiency(CAH). We analysed several factors influencing the presence of menarche and final adult height in these patients. METHODS: We retrospectively reviewed medical records of 24 female patients with CAH. We analysed possible factors affecting the menarche and final adult height, such as clinical type, predicted adult height, age at treatment, age at onset of puberty, BMI, and plasma levels of DHEA and 17-OHP. RESULTS: The occurrence rate of menarche were significantly higher in patients with the simple virilizing form rather than the salt losing form(P<0.05). No significant differences were found in age at onset of puberty, BMI, and plasma levels of DHEA and 17-OHP between menarche group and amenorrhea group. The age at treatment was younger in amenorrhea group(P<0.05). There were no significant differences in the proportion of patients who attained predicted adult height between two clinical types. No significant differences were found in age at treatment, age at onset of puberty, BMI, and plasma levels of DHEA and 17-OHP between the group of patients who attained predicted adult height and the group of patients who didn't. Final adult height did not show any correlation with age at treatment, age at onset of puberty, BMI, and plasma levels of DHEA and 17-OHP but showed significant correlation with mid-parental height(r=0.426, P=0.01). CONCLUSION: Our data suggest that the presence of menarche in patients with CAH depends on the degree of prenatal exposure to adrenal androgen regardless of the degree of postnatal control and age at onset of puberty. Additionally, it seems likely that mid-parental height determines the final adult height.
Adolescent ; Adrenal Hyperplasia, Congenital* ; Adult* ; Amenorrhea ; Dehydroepiandrosterone ; Female ; Female* ; Humans ; Medical Records ; Menarche* ; Plasma ; Puberty ; Retrospective Studies ; Steroid 21-Hydroxylase*