Percutaneous biliary drainage is an effective new nonsurgical method for combined external/internal catheterdecompression of obstructed extrahepatic bile ducts. Molnar and Stockum, and more recently others, have reportedsucdess utilizing this approach to establish biliary drainage in patients with obstructive jaundice. Percutaneousbiliary drainage was performed in 9 patients with obstructive jaundice. Internal drainage was accomplished in 4patients (44.4%), and external drainage in 5 patients (55.6%). Major complications occurred in 2 patients; bileleakage, one; sepsis, one. Minor complications occurred in 7 patients; mild or high fever, 5 cases; transienthemobilia, 2 cases. The catheter management problems encoutered including pain, catheter dislodgement ormigration, lumen occulusion, and external bile leakage.
Bile ; Bile Ducts, Extrahepatic ; Catheters ; Drainage ; Fever ; Humans ; Jaundice, Obstructive ; Methods ; Sepsis

Morphine has been known to produce antidiuresis when given directly into a lateral ventricle of the rabbit brain, mainly through hemodynamic changes brought about by nerve stimulation to the kidney. This study was attempted to find out whether adrenergic fibers are involved in the action. Phentolamine, a potent alpha-adrenergic blocking agent, induced antidiuresis when given intravenously in a dose of 2 mg/kg. Morphine administered intracerebroventricularly 40 to 60 min. after phentolamine, when its effect is at the maximum, produced antidiuresis and typical changes in renal function, uninfluenced by the phentolamine pretreatment. This observation indicates that adrenergic fibers do not participate in the renal action of intracerebroventricular morphine and it is suggested that nerve fibers of other types might be involved in the action.
Adrenergic Fibers ; Brain ; Hemodynamics ; Kidney ; Lateral Ventricles ; Morphine* ; Nerve Fibers ; Phentolamine*

In propranolol (1. 0mg) pretreated men atropine (0.5mg), ephedrine (20mg) and aramine (2mg) were administered respectively by intravenous route under the ether anesthesia. The results were as follows. 1) Five minutes after intravenous administration of propranolol, the three groups showed decrease of pulse rates, 9, 6 and 8 per minutes respectively, but blood pressure changes were not observed. 2) After intravenous administration of atropine (0.5mg) the decreased pulse rates were increased and blood pressure was elevated. 3) After intravenous administration of ephedrine(20mg) the decreased pulse rates were decreased and lowered blood pressure was lowered further. 4) After intravenous administration of aramine(2.0mg) the lowered blood pressure was elevated, but pulse rate changes were not observed. 5) Circulatory depression due to ether anesthesia after propranolol pretreatment, was corrected by treatment with atropine and aramine, but was not corrected by ephedrine.
Administration, Intravenous ; Anesthesia* ; Atropine ; Blood Pressure* ; Depression ; Ephedrine ; Ether* ; Heart Rate* ; Humans ; Male ; Metaraminol ; Propranolol*

Solitary fibrous tumors (SFTs) most often involve the pleura and also may encompass the peritoneum and nonserosal sites. They occur as solitary encapsulated tumors and pursue a relatively benign clinical course. The usual criteria for malignancy are high cellularity, mitotic activity (more than 4 per 10 high-power fields), cellular pleomorphism, hemorrhage and necrosis as well as infiltrative growth. We report a case of malignant SFT of pleura who presented with an anterior mediastinal mass. Grossly, it was a 10x8x6.5 cm sized, encapsulated and well-demarcated, solid neoplasm with areas of extensive necrosis. Microscopically, parallel or haphazard arrangement of spindle cells with variable degrees of collagenous background were noted. Storiform fascicle formation, hemangiopericytoma-like pattern, and epithelioid cell clusters were often intermingled. Nodular areas with high cellularity and mitotic activity (> or =10/10 HPFs) were scattered throughout the neoplasm, however no definite cellular pleomorphism was encountered. Tumor cells were immunoreactive for vimentin and CD-34, which distinguished them from the mesothelial cells. Electron microscopically, they revealed fibroblastic and myofibroblastic differentiation.
Collagen ; Epithelioid Cells ; Fibroblasts ; Hemorrhage ; Mediastinum ; Myofibroblasts ; Necrosis ; Peritoneum ; Pleura ; Solitary Fibrous Tumor, Pleural* ; Solitary Fibrous Tumors* ; Vimentin

PURPOSE: This study aimed to evaluate weight changes in women during the period of TAC (docetaxel-doxorubicin-cyclophosphamide) chemotherapy after breast surgery and the differences in weight changes by disease characteristics among Korean women with breast cancer. METHODS: The design of this study was retrospective survey research. The subjects of this study were 130 patients with fully completed TAC chemotherapy between January 2012 and April 2015. Body weight before their operation, and at 3 weeks, 6 weeks, 9 weeks, 12 weeks, 15 weeks, and 18 weeks after surgery, as well as general and disease characteristics, were reviewed via their medical charts. RESULTS: The mean age of the patients was 51.2 years. The preoperative (baseline) mean weight was 59.4±8.44. Significant weight losses were observed in the initial (1st 3 week) period of TAC chemotherapy compared to the baseline and significant weight losses were observed with the exception of the period 6 weeks after breast surgery. There were significant differences in mean weight changes according to the stage of breast cancer, radiotherapy, and hormone therapy among disease characteristics. CONCLUSION: It is necessary to study weight changes after breast surgery for the long periods of TAC chemotherapy. Through the accumulated results of studies, nursing programs for breast cancer patients must be developed for the prevention of weight gain in the periods of TAC chemotherapy.
Body Weight ; Breast Neoplasms* ; Breast* ; Drug Therapy* ; Female ; Humans ; Nursing ; Radiotherapy ; Retrospective Studies ; Weight Gain ; Weight Loss

PURPOSE: This study was conducted to analyze the correlations among the knowledge, stress, and self-care performance in tuberculosis patients. METHODS: The participants consisted of 140 outpatients who had been diagnosed with tuberculosis in S University Hospital. Data were derived from self-report questionnaires and analyzed by SPSS 22.0. Statistical analysis included descriptive statistics and Pearson's correlation coefficients analysis. RESULTS: Means of stress and self-care performance were 1.76 and 3.21, respectively. Percentage of correct answer of knowledge about tuberculosis was 71.8. Knowledge about tuberculosis was significantly different according to age (F=21.81, p<.001), marital status (F=13.79, p<.001), education (F=36.63, p<.001), and monthly income (F=16.23, p<.001). Stress was significantly different according to gender (t=3.58, p<.001). Self-care performance was significantly different according to age (F=5.74, p=.004), marital status (F=8.79, p<.001), education (F=9.15, p<.001), monthly income (F=7.87, p=.001), and attendance of tuberculosis education (t=2.34, p=.020). Self-care performance had significant correlation with knowledge about tuberculosis and stress. CONCLUSION: This study suggests that knowledge about tuberculosis and stress had significant correlations with self-care performance. Therefore, the nursing strategies of increasing knowledge about tuberculosis and decreasing stress which improve self-care performance should be developed for tuberculosis patients.
Education ; Humans ; Marital Status ; Nursing ; Outpatients ; Self Care ; Tuberculosis

BACKGROUND: Healthcare-associated infections (HAIs) are among the most important threats to patient safety. When hospitalized children face these threats, there is morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Research on local healthcare epidemiology is necessary to enhance collective knowledge and evidence formanaging this problem. METHODS: We performed a retrospective analysis of databases of patients who were diagnosed with HAIs at Chung-Ang University Hospital (CAUH) from 2007 through 2011. Cases were selected from the microbiology registry databases. The data on prevalence of HAIs in various wards and its annual trends were compared to previously reported nationwide data. Moreover, we analyzed the patterns of antibiotic susceptibility results for HAI pathogens. RESULTS: A total of 181 HAIs were identified in 122 patients. The HAI rate among pediatric patients at CAUH was 2.4/1,000 person-hospital days. Urinary tract infections (UTIs) (53 episodes, 29.3%) were the most common, followed by pneumonia (33 episodes, 18.2%). Staphylococcus aureus was found to be the most common gram-positive organism, whereas Escherichia coli was the most common gram-negative organism. Methicillin-resistant S. aureus (MRSA) comprised 84% of the S. aureus infections. Imipenem resistance was detected in 58.8% and 55.0% of Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively. CONCLUSION: Between 2007 and 2011, UTIs were the most common type of HAIs, and MRSA was the most common pediatric HAI pathogen, both in the general ward and intensive care unit at the CAUH. Further research on the epidemiology and pathogenesis of HAIs is necessary and prevention measures should be implemented to prevent HAIs in children.
Acinetobacter baumannii ; Child ; Child, Hospitalized ; Delivery of Health Care ; Escherichia coli ; Health Care Costs ; Hospitalization ; Humans ; Imipenem ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Patient Safety ; Patients' Rooms ; Pneumonia ; Prevalence ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus aureus ; Urinary Tract Infections

Clear cell sarcoma of kidney(CCSK) is a rare pediatric neoplasm characterized by a predominating component of clear cells, a predilection for metastases to bone, and a poor prognosis. The incidence of CCSK peaks during the 2nd year of life and adult cases are very rare. We report a case of CCSK encountered in the right kidney of a 39-year-old man. Grossly, it was a lobulated mass showing infiltrative margin, measured 7x5.5x5cm and had a homogeneous gray-tan color with a soft, fish-flesh consistency. Microscopically, about half of the tumor revealed the classic pattern of CCSK, having tumor cell cords or nests separated by the characteristic alveolar capillary networks. The tumor cells had clear pale cytoplasm, bland looking round nuclei and inconspicuous nucleoli. The other half showed the epithelioid-trabecular pattern forming pseudorosette or cord-like structures. Immunohistochemically, there was only a focal positive reaction to vimentin. Ultrastructurally, the tumor cells showed the primitive nephrogenic mesenchymal differentiation such as electron lucent cytoplasm, a small amount of organelles, scanty heterochromatin, inconspicuous nucleoli, and a lack of flocculant basal lamina material around the cytoplasmic membrane. We consider that this is a case of CCSK occuring in the oldest patient ever reported, confirmed by both immunohistochemistry and electron microscopy.
Adult ; Male ; Female ; Humans ; Incidence ; Neoplasm Metastasis

BACKGROUND: Patency of the infarct-related coronary artery may influence LV remodeling, provide a more stable electrophysiologic milieu and improves the outcome of patient with acute myocardioal infarction. The result from clinical trials have confirmed that early reperfusion in humans induced by a thrombolytic agent is associated with limitation of infarct size, preservation of ventricular function, and improved survival. The purpose of this study was evaluate the effect of thrombolytic therapy on the severity of the residual stenosis, antegrade flow of infarct-related coronary artery after acute myocardial infarction, and investigate left ventricular function and regianal wall motion abnormality depending on the thrombolytic therapy. METHODS: A retrosperctive study was performed in 166 patients with acute myocardial infarction with underwent coronary angiography within 8 days after acute attack from Oct. 1990 to Sep. 1994. Patients were grouped as thrombolysis group(n=64) who had undertaken urokinase infusion therapy within 6 hours of symptom onset and conservatively treated group(n=102) who had not received thrombolytic trerapy. At 8+/-7days, cardiac catheterization was performed. Status of the infarct related artery was assessed by resiudal % diameter stenosis, TIMI and collateral trading. Left ventricular function and wall motion were analyzed. RESULTS: 1) The was no statistical differenccs in age, sex and risk factors(diabetes, hypertension, smoking and hypercholesterolemia)between two groups. 2) The peak serum CK level was higher(2719+/-2333 vs 1951+/-2064 IU/L) and time to peak CK enzyme level was shorter(19+/-13 vs 32+/-24 hr) in thrombolysis group than conservatively treated group. 3) There was lower incidence of total occlusion(12.5% vs 30.4%), residual % diameter stenosis of infarct-related artery(67+/-34% vs 80+/-27%) and better antegrade flow(TIMI grade 0-1, 12.5% vs 32.4%) in thrombolysis group than conservatively treated group(p<0.05). 4) There were no statistical differences of ejection fraction(51+/-15 vs 51+/-14%). left ventricular end diastolic pressure(21+/-10 vs 21+/-16mmHg) and regional wall motion score(8.6+/-3.4 vs 9.1+/-3.1) between thrombolysis group and conservatively treated group(p>0.05). CONCLUSION: Thrombolytic therapy in acute myocardial infarction resulted in dquisition of early infarct-related arterial patency, effectiove antegrade flow and reduced incidence of totoal occlusion of infarct-related artery. Left ventricular ejection fraciton, regional wall motion score was not affected by thrombolytioc therapy in inhospital period.
Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels* ; Humans ; Hypertension ; Incidence ; Infarction ; Myocardial Infarction* ; Reperfusion ; Smoke ; Smoking ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator ; Ventricular Function ; Ventricular Function, Left*

Guillain-Barr syndrome is rarely complicated by hypertension, which has been ascribed to sympathetic nervous system hyperactivity. We report a 11 years old female with Guillain-Barr syndrome complicated by persistent hypertension associated with elevated renin-angiotensin. So we report this case with brief review of related literatures.
Child ; Female ; Humans ; Hypertension* ; Sympathetic Nervous System