Pleuropulmonary involvement of salmonella infection is very rare and only two cases of salmonella empyema have been reported in Korea. We report the case of a 70-year-old female diabetic patient who presented with right flank pain and right lower chest pain. The chest radiographs revealed fibrostreaky and hazy density at right lower lung field and blunting of right costophrenic angle. Thoracentesis revealed turbid yellowish fluid. Salmonella group B was identified from the cultures of blood and pleural fluid. After antimicrobial therapy and repeated therapeutic thoracentesis, the patient was improved.
Aged ; Case Report ; Empyema, Pleural/etiology+ACo- ; Female ; Human ; Salmonella Infections/drug therapy ; Salmonella Infections/complications+ACo-

BACKGROUND: Differential diagnosis of pleural malignant mesothelioma from secondary metastatic adenocarcinoma is often difficult. A variety of pathologic techniques have been developed to make a differential diagnosis of carcinoma from mesothelioma. Immunohistochemistry detecting diverse antigenic substances such as CEA, Leu-M1, B72-3, S-100 protein, vimentin, CK and EMA has been claimed to be of value as a panel in the differential diagnosis of adenocarcinoma from mesothelioma. The aim of this study was to investigate the suitable antibodies to distinguish mesothelioma from metastatic adenocarcinoma and establish candidate markers in a panel. METHODS: Complete, one-hour immunohistochemical staining using antibodies against cytokeratin (CK), epithelial membrane antigen(EMA), S-100 protein, vimentin, B72-3, Leu-M1, and carcino-embryonic antigen (CEA) was applied to cell blocks from 7 mesotheliomas and 7 adenocarcinomas which were confirmed by electron microscopic and histpathologic methods. RESULTS: All adenocarcinomas and 71.4% of mesotheliomas expressed the cytokeratin and EMA. S-100 protein and vimentin were expressed in 57.1% and 42.9% of mesotheliomas and 14.3% and 28.5% of adenocarcinomas, respectively. B72-3 was expressed in all adenocarcinomas, but in none of mesotheliomas. Leu-M1 was positive in 71.4% of the adenocarcinoma and 14.3% of the mesotheliomas. CEA was positive in all adenocarcinomas and 42.9% of mesotheliomas. Leu-M1 and B72-3 were coexpressed in 71.4% of adenocarcinomas but in none of mesothelioma. B72-3 and CEA were coexpressed in all adenocarcinomas, but in none of mesotheliomas. CONCLUSION: We concluded that B72-3 immunohistochemistry or panel staining of B72-3 and CEA could be recommanded for the differential diagnosis of pleural mesothelioma from metastatic adenocarcinoma.
Adenocarcinoma* ; Antibodies ; Diagnosis, Differential* ; Immunohistochemistry* ; Keratins ; Membranes ; Mesothelioma* ; S100 Proteins ; Vimentin

PURPOSE: Febrile seizures affect 2-5% of all children younger than 6 years old. A small proportion of children with febrile seizures later develop epilepsy. Generalized epilepsy with febrile seizures plus(GEFS+) is an important childhood genetic epilepsy syndrome with heterogeneous phenotypes, including febrile seizures(FS) and generalized epilepsies of variable severity. It was reported that the gene locus for GEFS+ exists in the chromosome 19q13.1, and has relationship with a 387 C->G mutation in the voltage- gated sodium channel beta1 subunit(SCN1B) gene. This study is to determine whether there are mutations in children with GEFS+ and FS. METHODS: Eighteen GEFS+ and thirteen FS patients were screened for mutations in the sodium channel beta-subunits SCN1B. The primer pairs used to amplify the exons of SCN1B are given in the supplementary data on the Neurology web site. All exons were amplified by PCR and PCR products were subsequently sequenced. Single-stranded conformation polymorphism(SSCP) was carried out using 8% polyacrylamide gel. RESULTS: Twenty four patients(77%) were younger than 10 years old, three(10%) were between 10 and 14 years old, and four(13%) older than 14 years old. The ratio of female to male was 0.55:1.0. In phenotypes of GEFS+, fourteen patients(88%) had generalized tonic-clonic seizures, one patient(6%) myoclonic seizures and one patient(6%) atonic seizures. In EEG findings of GEFS+, eleven(78%) patients had normal findings, five(28%) patients generalized spike waves and two patients(11%) diffuse slowings. In sequencing and SSCP of PCR products, we could observe added C mutations between 224G and 225C of exon 3 in two unrelated patients with GEFS+. CONCLUSION: We proved the existence of a new mutation of SCN1B in two unrelated patients with GEFS+.
Adolescent ; Child ; Electroencephalography ; Epilepsy ; Epilepsy, Generalized* ; Exons ; Female ; Humans ; Male ; Neurology ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Seizures ; Seizures, Febrile* ; Sodium Channels

INTRODUCTION: It is important to understand the nature of the identity through the live experiences of Home Care Nurse Practitioner(HCNP) because the role identity of a professional is constructed by continuous social interactions, This study aims to understand the construction of the role identity of HCNP. METHOD: Data was collected from 12 hospital based HCNPs. This study involved two focus group discussion sand four in-depth individual interviews. The main question was "what is the role of HCNP?" The debriefing notes and field notes were analyzed using consistent comparative data analysis method. RESULT: First, Home care (HC) is a small clinic. HCNP brings it to home to provide various services. Second, HC is the real nursing and HCNP is the 'genuine' nurse who actualizes the essence of nursing in practice. Third, HC is empowering activity to promote self-care ability of the patients and their caregivers. Forth, HC is like the dish-spinning required high-level mastery and HCNP is an expert who provides the most appropriate services to the patients. CONCLUSION: HCNPs have the role identity as a highly qualified professional who delivers services from hospital to home, actualizes the essence of nursing in practice, empowers the patients and their caregivers to have self-efficacy to recover, and offers the most appropriate nursing care.
*Nurse's Role ; *Nurse Practitioners ; Humans ; *Home Care Services ; Female ; Adult

INTRODUCTION: It is important to understand the nature of the identity through the live experiences of Home Care Nurse Practitioner(HCNP) because the role identity of a professional is constructed by continuous social interactions, This study aims to understand the construction of the role identity of HCNP. METHOD: Data was collected from 12 hospital based HCNPs. This study involved two focus group discussion sand four in-depth individual interviews. The main question was "what is the role of HCNP?" The debriefing notes and field notes were analyzed using consistent comparative data analysis method. RESULT: First, Home care (HC) is a small clinic. HCNP brings it to home to provide various services. Second, HC is the real nursing and HCNP is the 'genuine' nurse who actualizes the essence of nursing in practice. Third, HC is empowering activity to promote self-care ability of the patients and their caregivers. Forth, HC is like the dish-spinning required high-level mastery and HCNP is an expert who provides the most appropriate services to the patients. CONCLUSION: HCNPs have the role identity as a highly qualified professional who delivers services from hospital to home, actualizes the essence of nursing in practice, empowers the patients and their caregivers to have self-efficacy to recover, and offers the most appropriate nursing care.
*Nurse's Role ; *Nurse Practitioners ; Humans ; *Home Care Services ; Female ; Adult

Chylopericardium is a rare disease entity characterized by the accumulation of chylous fluid in the pericardial sac. It usually arises from mediastinal neoplasms, thrombosis of the subclavian vein, tuberculosis, nonsurgical trauma, thoracic or cardiac surgery. The spectrum of symptoms for chylopericardium varies from an incidental finding of cardiomegaly to dyspnea, upper abdominal discomfort, cough, chest pain, palpitation, fatigue. However, most of the patients are asymptomatic. The main purpose of treatment of chylopericardium is the prevention of cardiac tamponade and prevention of metabolic, nutritional, and immunological compromise due to chyle leak. Here, we report a case of chylopercardium secondary to lymphangiomyoma with review of the literature.
Cardiac Tamponade ; Cardiomegaly ; Chest Pain ; Chyle ; Cough ; Dyspnea ; Fatigue ; Humans ; Incidental Findings ; Lymphangioma ; Lymphangiomyoma ; Mediastinal Neoplasms ; Pericardial Effusion ; Rare Diseases ; Subclavian Vein ; Thoracic Surgery ; Thorax ; Thrombosis ; Tuberculosis

True aneurysm of the brachial artery is a rare disease entity. The mechanism of aneurysm formation is considered to be compression of the arterial wall, producing contusion of the media and subsequent weakness of the wall and fusiform dilatation. It can be caused by arteriosclerotic, congenital, and metabolic disorders, and can be associated with diseases such as Kawasaki's disease. Doppler ultrasonography, computed tomography, arteriography, and selective upper extremity angiography may be performed for establishing the diagnosis of aneurysm. The best therapeutic option is operative repair, and it should be performed without any delay, in order to prevent upper extremity ischemic or thrombotic sequelae. Here, we report a case of recurrent brachial artery aneurysm with review of the literature.
Aneurysm ; Angiography ; Brachial Artery ; Contusions ; Dilatation ; Rare Diseases ; Ultrasonography, Doppler ; Upper Extremity

BACKGROUND: Treatment for patent ductus arteriosus (PDA) in premature infants can consist of medical or surgical approaches. The appropriate therapeutic regimen remains contentious. This study evaluated the role of surgery in improving the survival of premature neonates weighing less than 1,500 g with PDA. MATERIALS AND METHODS: From January 2008 to June 2011, 68 patients weighing less than 1,500 g with PDA were enrolled. The patients were divided into three groups: a group managed only by medical treatment (group I), a group requiring surgery after medical treatment (group II), and a group requiring primary surgical treatment (group III). RESULTS: The rate of conversion to surgical methods due to failed medical treatment was 67.6% (25/37) in the patients with large PDA (> or =2 mm in diameter). The number of patients who could be managed with medical treatment was nine which was only 20.5% (9/44) of the patients with large PDA. There was no surgery-related mortality. Group III displayed a statistically significantly low rate of development of bronchopulmonary dysplasia (BPD) (p=0.008). The mechanical ventilation time was significantly longer in group II (p=0.002). CONCLUSION: Medical treatment has a high failure rate in infants weighing less than 1,500 g with PDA exceeding 2.0 mm. Surgical closure following medical treatment requires a longer mechanical ventilation time and increases the incidence of BPD. Primary surgical closure of PDA exceeding 2.0 mm in the infants weighing less than 1,500 g should be considered to reduce mortality and long-term morbidity events including BPD.
Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Respiration, Artificial

BACKGROUND: Treatment for patent ductus arteriosus (PDA) in premature infants can consist of medical or surgical approaches. The appropriate therapeutic regimen remains contentious. This study evaluated the role of surgery in improving the survival of premature neonates weighing less than 1,500 g with PDA. MATERIALS AND METHODS: From January 2008 to June 2011, 68 patients weighing less than 1,500 g with PDA were enrolled. The patients were divided into three groups: a group managed only by medical treatment (group I), a group requiring surgery after medical treatment (group II), and a group requiring primary surgical treatment (group III). RESULTS: The rate of conversion to surgical methods due to failed medical treatment was 67.6% (25/37) in the patients with large PDA (> or =2 mm in diameter). The number of patients who could be managed with medical treatment was nine which was only 20.5% (9/44) of the patients with large PDA. There was no surgery-related mortality. Group III displayed a statistically significantly low rate of development of bronchopulmonary dysplasia (BPD) (p=0.008). The mechanical ventilation time was significantly longer in group II (p=0.002). CONCLUSION: Medical treatment has a high failure rate in infants weighing less than 1,500 g with PDA exceeding 2.0 mm. Surgical closure following medical treatment requires a longer mechanical ventilation time and increases the incidence of BPD. Primary surgical closure of PDA exceeding 2.0 mm in the infants weighing less than 1,500 g should be considered to reduce mortality and long-term morbidity events including BPD.
Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Respiration, Artificial

BACKGROUND: The surgically created arteriovenous fistula has recently been recommended as the best available angioaccess for hemodialysis. Therefore, in this study, we carried out a clinical analysis on surgical procedures in the ligation and division of a distal vein to achieve similar effects as those of vein end-to-arterial side after side-to-side anastomosis. METHODS: We retrospectively reviewed the clinical data of 113 patients who came for an outpatient clinic follow-up to the department of internal medicine of our hospital; these patients were among the 125 patients who underwent radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) in our hospital in the period from January 2006 to December 2010. RESULTS: The patency rate showed no statistical significance with respect to sex (p=0.775), age (p=0.775), hypertension (p=0.262), diabetes (p=0.929), and cardio-neurovascular disease (p=0.717). Patency rates were 96% for the first month, 93% for the first year, and 90% for the second year for the radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) performed on the wrist. CONCLUSION: The patency rates revealed favorable results and few postoperative complications as compared to those of previous reports. Therefore, radiocephalic fistula using side-to-side anastomosis with distal cephalic vein ligation is considered a recommendable surgical procedure in the distal part for the hemodialysis of CRF patients.
Ambulatory Care Facilities ; Arteriovenous Fistula ; Fistula* ; Follow-Up Studies ; Humans ; Hypertension ; Internal Medicine ; Ligation* ; Postoperative Complications ; Renal Dialysis ; Retrospective Studies ; Veins*