The most common etiologic agents of neonatal osteomyelitis in the last decades were Staphylococcus aureus, Group B streptococcus, and E. coli, but Klebsiella pneumoniae as a cause of neonatal osteomyelitis appears to be rare. Klebsiella pneumoniae is one of the most important organisms associated with hospital acquired infections in the neonate and outbreaks with multiresistant strains have been reported from neonatal intensive care units around the world. These multiresistant Klebsiella pneumoniae have been shown to produce tranferable plasmid mediated beta-lactamases that are able to hydrolyze oxyimmino- beta-lactamas and these confer resistance to the third generation cephalosporin and named extended spectrum beta-lactamase producing Klebsiella pneumoniae. We experienced two cases of neonatal osteomyelitis due to extended spectrum lactamase producing Klebsiella pneumoniae in our neonatal intensive care unit during the same period. To our knowledge this represents the first documented neonatal osteomyelitise to extended spectrum beta-lactamase producing Klebsiellae pneumoniae in Korea.
beta-Lactamases* ; Disease Outbreaks ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Osteomyelitis* ; Plasmids ; Pneumonia ; Staphylococcus aureus ; Streptococcus

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

Among the causes of pure red cell aplasia, human parvovirus B19 has been shown to be cytotoxic to erythroid progenitor cells in the bone marrow associated with chronic hemolytic anemia with rapidly dividing erythroids and persistently to be suppression of erythropoiesis in immunocompromised individuals related with failure to produce neutralizing antibody to the virus. In a patient with hereditary spherocytosis presenting acute onset of reticulocytopenia during hospitalization, who had shown severe anemia and prodromal symptoms including fever, fatigue and dizziness, infection of parvovirus Bl9 was proven by the presence of IgM and IgG antibodies to parvovirus Bl9, the detection of viral DNA using PCR technique in her serum and the decreased erythroid cells, especially late normoblasts in bone marrow, Also in the other who was diagnosed as hereditary elliptocytosis and complained of fever, headache, abdominal pain and diarrhea, an episode of reticulocytopenia and the nearly absence of late normoblasts in the bone marrow were observed. IgM antibodies to parvovirus Bl9 and the viral DNA were detected in her serum, too.
Abdominal Pain ; Anemia ; Anemia, Hemolytic ; Antibodies ; Antibodies, Neutralizing ; Bone Marrow ; Diarrhea ; Dizziness ; DNA, Viral ; Elliptocytosis, Hereditary* ; Erythroblasts ; Erythroid Cells ; Erythroid Precursor Cells ; Erythropoiesis ; Fatigue ; Fever ; Headache ; Hospitalization ; Humans* ; Immunoglobulin G ; Immunoglobulin M ; Parvovirus B19, Human ; Parvovirus* ; Polymerase Chain Reaction ; Prodromal Symptoms ; Red-Cell Aplasia, Pure

Among the causes of pure red cell aplasia, human parvovirus B19 has been shown to be cytotoxic to erythroid progenitor cells in the bone marrow associated with chronic hemolytic anemia with rapidly dividing erythroids and persistently to be suppression of erythropoiesis in immunocompromised individuals related with failure to produce neutralizing antibody to the virus. In a patient with hereditary spherocytosis presenting acute onset of reticulocytopenia during hospitalization, who had shown severe anemia and prodromal symptoms including fever, fatigue and dizziness, infection of parvovirus Bl9 was proven by the presence of IgM and IgG antibodies to parvovirus Bl9, the detection of viral DNA using PCR technique in her serum and the decreased erythroid cells, especially late normoblasts in bone marrow, Also in the other who was diagnosed as hereditary elliptocytosis and complained of fever, headache, abdominal pain and diarrhea, an episode of reticulocytopenia and the nearly absence of late normoblasts in the bone marrow were observed. IgM antibodies to parvovirus Bl9 and the viral DNA were detected in her serum, too.
Abdominal Pain ; Anemia ; Anemia, Hemolytic ; Antibodies ; Antibodies, Neutralizing ; Bone Marrow ; Diarrhea ; Dizziness ; DNA, Viral ; Elliptocytosis, Hereditary* ; Erythroblasts ; Erythroid Cells ; Erythroid Precursor Cells ; Erythropoiesis ; Fatigue ; Fever ; Headache ; Hospitalization ; Humans* ; Immunoglobulin G ; Immunoglobulin M ; Parvovirus B19, Human ; Parvovirus* ; Polymerase Chain Reaction ; Prodromal Symptoms ; Red-Cell Aplasia, Pure

Alveolar soft-part sarcoma is a rare malignant neoplasm. It occurs most commonly in the deep tissue of the extremity, particularly in the anterior aspect of the thigh. It usually presents as a slow-growing, painless mass with little functional impairment. Because of the relative lack of symptoms, it may be easily overlooked. The course of the disease tends to be long but unrelenting, and local recurrences are frequent. There were no lifetime cures in the reported cases. This tumor is relatively unknown to orthopaedic surgeons, and a wider knowledge of its characteristics may lead to its more frequent recognization, Recently, two cases of alveolar soft-part sarcoma were encountered on the orthopaedic department of Dong-kang Hospital, Ulsan. In case 1, the tumor was found in the vastus lateralis muscle; and in case 2, vastus intermedius muscle. The authors will present these cases in detail to provide a glance at this very rare but more frequently recognizable tumor, the alveolar soft-part sarcorna.
Extremities ; Quadriceps Muscle ; Recurrence ; Sarcoma ; Sarcoma, Alveolar Soft Part ; Surgeons ; Thigh ; Ulsan

PURPOSE: This study is attempted to figure out the characteristics of sexual abuse victimization in low- and high-grade elementary school children and furthermore to help develop appropriate preventive educational programs against sexual abuse by grade. METHODS: Data were collected from 156 sexual abuse victims who were elementary school children and visited the Child Sexual Abuse Response Center in D City during the period from 2010 to 2012. Differences in general and victimization-related characteristics between low and high graders and the correlations among the characteristics were analyzed. RESULTS: The results showed statistically significant difference between low and high graders in two variables: offender-victim relationship, and the type of sexual abuse. Offender-victim relationship was in a significant correlation with the duration of victimization (r=.576, p<.001), frequency of abuse (r=.546, p<.001), location (r=-.479, p<.001), and time (r=.435, p<.001). The type of sexual abuse was in a significant correlation with frequency (r=.175, p=.029) and time (r=.261, p=.001). CONCLUSION: Appropriate educational programs should be developed for preventing sexual assaults in consideration of difference in victimization-related characteristics between low and high graders. In addition, such programs should be applied fittingly to the learners'grade, gender, and cognitive level.
Child Abuse, Sexual ; Child* ; Crime Victims* ; Humans ; Sex Offenses*

Since the 1970s, the average life expectancy of Koreans has been increasing. Our concerns are not simply about longevity, but also about disability-free life. lately, Sasang constitutional medicine has attracted public attention, especially with respect to the elderly. The purpose of this study was to investigate the food habits, nutrients intake, and disease distribution among the elderly, according to their Sasang constitutions. The results are as follow : The distribution of constitutions of the subjects were Tae-eum 48.8%, So-yang 27.4%, So-eum 22.6%, and So-yang + So-eum 1.2%. In both elderly men and women, body weight, percent ideal body weight, and diastolic pressure of the Tae-eum were significantly higher than those of other constitutions. In both men and women, the level of hemoglobin in the Tae-eum was significantly higher than those of other constitutions. The level of LDL-cholesterol was higher, and the level of HDL-cholesterol was lower in the So-eum elderly women. Food habits of the So-eum were the most irregular, and nutrients intake of the So-eum was lower than that of other constitutions in both elderly men and women. In elderly men, the incidence of hypertension was the highest in the Tae-eum, and the incidence of gastritis was the highest in both So-yang and So-eum. In elderly women, the incidence of fatty liver was the highest in the Tae-eum and So-yang, and gastritis and hypertension were the highest in the So-eum. In the elderly, obese and anemic persons were significantly more in the Tae-eum and the So-eum, respectively. The results of this study showed that there were significant differences of physical, characeristics, food, habits, and distributions of disease for the subjects according to each Sasang constitutions. Intake of nutrient was poor, regardless of Sasang constitutions, in both men and women.
Aged* ; Blood Pressure ; Body Weight ; Constitution and Bylaws* ; Fatty Liver ; Female ; Food Habits* ; Gastritis ; Humans ; Hypertension ; Ideal Body Weight ; Incidence ; Life Expectancy ; Longevity ; Male

PURPOSE: This study was implemented to develop new nursing intervention, Meridian Massage, and to investigate its effect on weight, behavioral state in infants.METHOD: This study has been conducted on the non equivalent control group pretest-posttest design in quasi experimental basis and newly born infants from Postpartum Management Center were selected in two groups of 35 infants. Data has been collected from February 1st to October 30th of 2002. The experimental group(20) took Meridian massage for 15 minutes daily twice during 6 days and control group took Field massage as same time. Weight has been determined 10:00 hours everyday morning and behavior status has been determined before and after 5 minutes beth by Anderson et al.(1990) tools. Data was analyzed by SPSS 11.0 Program using t-test, chi2-test and repeated measures ANOVA. RESULT: The results were as follow. In the aspect of behavioral status, Meridian massage group(55.8%) showed increase "positive" state than Field massage group(42.6%). And there was statistical significance(p=.002). Meridian massage group showed higher in the average weight than Field massage group(F=6.753, p=.014), and there was significant term between the two groups(F=10.129, p=.000). But there was no interaction group and term. CONCLUSION: The Meridian Massage in this study showed more positive aspect in weight gain and positive behavior status than Field Massage. This study has informed that meridian massage is an effective nursing intervention in improving Infant development.
Child ; Child Development ; Humans ; Infant* ; Massage* ; Nursing ; Postpartum Period ; Weight Gain ; Child Health

PURPOSE: This study was examined to identify the relationship between mood state, interaction anxiety, and quality of life of cancer patients with chemotherapy-induced alopecia. METHODS: The participants were 115 cancer patients. Data were collected from August to December 2012, and analyzed using descriptive statistics, Pearson's correlation coefficients, t-test, ANOVA and Duncan's multiple test. RESULTS: The mean scores of mood state (119.17+/-35.94), interaction anxiety (45.57+/-11.73), and global health status (38.08+/-22.45), functional scales (45.41+/-20.98), symptom scales (57.96+/-18.28) in quality of life were moderate or below. Negative correlations were found between mood state and quality of life, interaction anxiety and quality of life, but positive correlation were found between mood state and interaction anxiety. CONCLUSION: These findings indicate that mood state and interaction anxiety are important factors to improve quality of life of cancer patients with chemotherapy-induced alopecia, And it is meaningful in that this study prepared basic data for development of nursing intervention programs for effective management of chemotherapy-induced alopecia.
Alopecia* ; Anxiety* ; Drug Therapy ; Humans ; Nursing ; Quality of Life* ; Weights and Measures