Although congenital syphilis can be prevented with prenatal screening, the disease remains problematic. Currently, there are no cases that describe hematuria and pneumonia related to congenital syphilis. We report a case of congenital syphilis that involved nephrotic syndrome and pneumonia alba in a 22-day-old male infant whose mother did not receive adequate prenatal care. The congenital syphilis diagnosis was confirmed with a serologic test and the patient recovered with penicillin treatment. Clinical findings may be subtle in neonates and delayed recognition occurs frequently, thus complete prenatal screening is critical for congenital syphilis prevention. Immediate serologic testing should be performed to obtain a differential diagnosis if an infant is delivered by a mother that has not received appropriate prenatal examinations.
Diagnosis ; Diagnosis, Differential ; Exanthema* ; Hematuria* ; Humans ; Infant ; Infant, Newborn ; Male ; Mothers ; Nephrotic Syndrome ; Penicillins ; Pneumonia* ; Prenatal Care ; Prenatal Diagnosis ; Serologic Tests ; Syphilis, Congenital*

This study was aimed to elucidate the effect of intracerebroventricular losartan administration on arterial pressure regulation during hemorrhage in rats by power spectral analysis of blood pressure and heart rate variability. Nineteen male Sprague-Dawley rats weighing 240-300g were divided into losartan-administered(n=10) and control(n=9) groups. Hemorrhage was induced with a withdrawal pump from the femoral artery at 3ml/kg/min for 5min. Arterial presure was measured with a pressure transducer connected to the contralateral femoral artery for 5min before, during and after hemorrhage. The blood pressure signal digitized at 500 Hz through a data acquisition system was analyzed with fast Fourier transform algorithm to yield power spectra of systolic(SP) and diastolic(DP) blood pressure and instantaneous heart rate(HR). Powers of very low frequency (VLF, 0.02-0.26 Hz), low frequency(LF, 0.26-0.75 Hz) and high frequency(HF, 0.75-5.00 Hz) band were obtained. Basal systolic and diastolic blood pressure was 149+/-9 and 99+/-2mmHg, respectively, and was not changed by hemorrhage in control rats. Basal blood pressure in losartan group was 143+/-9 and 97+/-6mmHg and was significantly lowered to 116+/-13 and 77+/-9mmHg, respectively. HR was significantly increased during and after hemorrhage in both groups. Total power of SP variability in losartan group was 13.9+/-3.2mmHg2 before hemorrhage and was significantly increased to 66.6+/-25.3mmHg2 during hemorrhage. VLF, LF and HF powers of SP variability were 7.3+/-2.0, 3.8+/-1.1 and 2.8+/-0.7mmHg2, respectively, in losartan group and 5.5+/-1.4, 3.7+/-1.5 and 2.8+/-0.8mmHg2 in control rats. VLF and HF powers of SP were increased to 33.0+/-15.2 and 20.3+/-6.4mmHg2 in losartan group, and VLF power was increased to 7.9+/-1.5mmHg2 in control group. VLF power of DP variability increased from 3.3+/-0.9 before hemorrhage to 5.9+/-1.0mmHg2 during hemorrhage in control group. Powers of DP variability in losartan group and those of HR variability in both groups were not changed by hemorrhage. The above results suggested that losartan aggravated the arterial pressure fall during hemorrhage by impairing the sympathetic nerve activation by central angiotensin II.
Angiotensin II ; Animals ; Arterial Pressure ; Blood Pressure* ; Femoral Artery ; Fourier Analysis ; Heart Rate* ; Heart* ; Hemorrhage* ; Humans ; Lateral Ventricles* ; Losartan* ; Male ; Rats ; Rats, Sprague-Dawley ; Transducers, Pressure

PURPOSE: The purpose of this study was to determine the degree of undergraduate nursing student adaptation to college life and investigate the factors that influenced that adaptation. METHODS: First-year (undergraduate) students attending three nursing colleges were surveyed from November 24 through December 5, 2014; and data from 206 respondents were analyzed. For data analysis, multiple regression analysis was performed using the SPSS WIN 18.0 program. RESULTS: The findings showed that age (p=.002), emotional intelligence (p<.001), and self-efficacy (p<.001) were significant variables that influenced first-year undergraduate nursing student adaptation to college life. Undergraduate nursing student adaptation was explained by self-efficacy (beta=.327, p<.001), emotional intelligence (beta=.222, p=.001), satisfaction with education in their academic major (beta=-.217, p<.001), and academic achievement (beta=.136, p=.018); and, the explanatory power of these variables was 41.2%. CONCLUSION: To facilitate undergraduate nursing student adaptation to college life prior to clinical practice, developing and apply programs to improve self-efficacy, emotional intelligence, satisfaction with education in their major, and academic achievement is deemed necessary.
Surveys and Questionnaires ; Education ; Emotional Intelligence ; Humans ; Nursing ; Statistics as Topic ; Students, Nursing*

PURPOSE: The purpose of this study was to identify awareness of hospital safety culture (AHSC) and safety activities (SA) of workers in a tertiary care hospital, and the factors influencing safety activities. METHODS: 303 Participants from the tertiary care hospital in Seoul were invited. Collected data were analyzed using SPSS 18.0. RESULTS: The level of AHSC and SA was 3.61 and 4.17, respectively. There were differences between AHSC and SA according to gender, religion, employment status, job class, working period, safety education, need for safety education, and number of safety accident reports. There was a positive relationship between AHSC and SA. The factors influencing SA were communication and process, employment status, and safety accident reports. CONCLUSION: AHSC and SA are important factors to improve hospital safety, as well as increasing chances to receive hospital accreditation.
Accreditation ; Education ; Employment ; Humans ; Safety Management* ; Seoul ; Tertiary Healthcare*

OBJECTIVE: The HPV vaccination target adolescents, and may be influenced by opinion of parents and other family member. For implementation of HPV vaccine, we measured knowledge of HPV infection and acceptability of vaccination among adults in Korea. METHODS: From August 2006 to November 2007, we provided a written questionnaire to females (above 19 years- olds) who visited Il-sin Christian hospital for prenatal care or gynecological examination. The questionnaire was built using elements of The Health Belief Model. We measured (1) awareness of HPV (2) perceived susceptibility (3) perceived seriousness (4) perceived benefit of vaccination (5) perceived barriers (6) cues to action. RESULTS: Total 975 females answered the questionnaire, and the mean age was 40 years. Only 23.8% knew the fact cervical cancer is related to HPV infection. 78.3% of respondents were willing to accept HPV vaccination after they understood HPV vaccination can prevent cervical cancer. Financial burden and possible side effect were barriers to vaccination. CONCLUSIONS: Despite of low awareness of HPV infection, most (78.3%) adults favored having HPV vaccination. But the vaccine was more likely to be accepted if it is recommended by a physician and reasonably priced.
Adolescent ; Adult ; Cues ; Surveys and Questionnaires ; Female ; Gynecological Examination ; Humans ; Korea ; Papillomavirus Infections ; Parents ; Prenatal Care ; Uterine Cervical Neoplasms ; Vaccination

Differential diagnoses showing Verocay body-like formation include schwannoma, palisading myofibroblastoma, palisading cutaneous fibrous histiocytoma, dermatofibroma with myofibroblastic differentiation, leiomyoma, palisaded encapsulated neuroma, and neuroma. A 60-year-old Korean man presented with a 10-year-history of an asymptomatic nodule on the right forearm. Histopathological examination revealed well-circumscribed multi-micronodules with prominent Verocay body-like formation consisted of spindle cells and extensive infiltrate of mutinous materials. The spindle cells were negative for S-100 protein and desmin, but positive for vimentin and a-smooth muscle actin by immunohistochemical staining. The micronodules were lined by CD34 and factor VIII positive endothelial cells. The mutinous materials were stained with alcian blue at pH 2.5, but not at pH 0.5. We diagnose it as myxoid myofibromatosis-type perivascular myoma showing Verocay body-like formation.
Actins ; Alcian Blue ; Desmin ; Diagnosis, Differential ; Endothelial Cells ; Factor VIII ; Forearm ; Histiocytoma, Benign Fibrous ; Humans ; Hydrogen-Ion Concentration ; Leiomyoma ; Middle Aged ; Myofibroblasts ; Myoma* ; Neoplasms, Muscle Tissue ; Neurilemmoma ; Neuroma ; S100 Proteins ; Vimentin

OBJECTIVES: This study aims to compare quality indicators for the hemodialysis services between patients with health insurance and those with medical aid. METHODS: This study used data from sampled hospitals that provided a hemodialysis service. A total of 2287 patients were selected, and the information for hemodialysis service has been granted from medical record reviews. A multi-level regression analysis was used to examine the differences in process and outcome indicators for hemodialysis between patients with health insurance and those with medical aid. Process indicators were defined as: frequency of hemodialysis, hemodialysis time, erythropoietin (EPO) use, measurement of hemodialysis dose at least once a month, measurement of phosphate at least once every three months, and measurement of albumin at least once every three months. Outcome indicators were defined as: hemodialysis adequacy, anemia management, blood pressure management, and calcium, phosphate and nutrition management. The total scores for outcome indicators ranged from 0 (worst) to 4 (best). RESULTS: There was a significant difference in the measurement of hemodialysis dose at least once a month between patients with health insurance and those with medical aid (OR 0.66, 95% CI=0.43-0.99). However, frequency of hemodialysis, hemodialysis time, EPO use, measurement of phosphate at least once every three months, measurement of albumin at least once every three months, hemodialysis adequacy management, Hb> or =11 g/dL, blood pressure within the range of 100-140/60-90 mmHg, calcium x phosphate< or =55 g2/dL2 and albumin> or =4 g/dL were not significantly different between the groups. CONCLUSIONS: There were no significant differences in outcome indicators for hemodialysis between the groups. Further studies are warranted into the mechanism that results in no differences in the outcome indicators for hemodialysis.
Aged ; Female ; Humans ; Insurance, Health/*classification ; Male ; Medical Audit ; Middle Aged ; *Quality Indicators, Health Care ; *Quality of Health Care ; Renal Dialysis/*standards ; Republic of Korea

The purpose of this study was to determine the frequency and severity of arterial oxygen desaturation during and after endotracheal suctioning in a group of ventilator-dependent patients and to evaluate the efficacy of several maneuvers designed to minimize desaturation. All patients were ventilated with volume-typed ventilator and a synchronized intermittent mandatory ventilation(SIMV) mode was utilized. In a given patint, each study consisted of four seperate passes of the suction catheter. The oxygen status of the patient was monitored with a digital pulse oxymeter. The mean baseline SaO2 for the group with each suctioning technique was very similar and did not differ significantly. When patints were suctioned off the ventilator without extra breaths, a significant drop occurred in the mean SaO2 And when the patients were suctioned with prebreaths and postbreaths off the ventilator or were maintained on the ventilator and suctioned through the swivel adaptor, there was a significant desaturation with all three methods. However, the mean desaturation of 0.8 percent with the swivel adaptor was significantly less(p<0.05) than the mean desaturation with any of the other three methods.
Catheters ; Humans ; Oxygen* ; Suction* ; Ventilators, Mechanical

BACKGROUND: Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU). METHODS: This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016. RESULTS: The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively. CONCLUSIONS: LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.
Anoxia ; Critical Care* ; Critical Illness ; Diagnosis ; Diaphragm ; Fever ; Humans ; Lung* ; Medical Records ; Pneumonia ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema ; Radiography, Thoracic ; Retrospective Studies ; Ultrasonography* ; Weaning

No abstract available.
Hysterectomy*