No abstract available.
Mining*

Diffuse alveolar hemorrhage (DAH) is associated with severe outcomes. We report a case of acute respiratory failure that required mechanical ventilation and was clinically and pathologically diagnosed as DAH related to exposure to organic dust. A 39-year-old man, who had visited a warehouse to grade beans for purchase, was referred to our hospital for impending respiratory failure. His initial radiographic examinations revealed diffuse bilateral ground-glass opacities in his lungs and bronchoalveolar lavage resulted in progressively bloodier returns, which is characteristic of DAH. He underwent bedside open lung biopsy of his right lower lobe in the intensive care unit. Biopsy results revealed DAH and organization with accumulation of hemosiderin-laden macrophages and a few fibroblastic foci. The patient was treated with empirical antibiotics and high-dose corticosteroids and successfully weaned from mechanical ventilation. DAH might be considered in the differential diagnosis of patients with acute respiratory failure after exposure to organic particles.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Biopsy ; Bronchoalveolar Lavage ; Diagnosis, Differential ; Dust* ; Fibroblasts ; Hemoptysis ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Macrophages ; Respiration, Artificial ; Respiratory Insufficiency*

Pulmonary lymphangiomyomatosis is a rare disease of haphazard overproliferation of smooth muscle from perilymphatics, peribronchial and perivascular regions of the lung that leads to chylous effusion, hemoptysis, spontaneous pneumothorax and pulmonary insufficiency. The disease only affects women of child-bearing age. There is presently no successful therapy and most of the patients die within 10 years of diagnosis. We experienced a case of pulmonary lymphangiomyomatosis in a 30-year-old woman who had suffered from three episodes of spontaneous pneumothorax for 4 years. Open lung biopsy was performed. Microscopically, abnormal excess proliferation of smooth muscle tissue was identified in the wall of perivascular lymphatic channels as well as around small bronchi, and more distal air spaces. Varying sized cytic spaces Iined by cuboidal cells were also present. Tamoxifen, given if February 1991, did not influence the course of her disease. She died of respiratory failure at age of 31 in April 1991.
Female ; Humans ; Biopsy

PURPOSE: This study was done to clarify nurses' duties, tasks and task elements and to develop a job description for clinical nurses on general and intensive care units in tertiary-level hospitals, and dramatically reflect changing medical trends in Korea. METHODS: The job description was developed based on the Developing a Curriculum Method (DACUM). The questionnaire included frequency, importance, and difficulty of duties, tasks and task elements, measured on a 4-point scale. Results were analyzed using SPSS version 21.0. Data were collected from September 4 to 7, 2017, and analyzed using descriptive statistics and a scattered graph. RESULTS: The job description consisted of 10 duties, 38 tasks, and 51 elements. Of the 10 duties, the highest duty in order of importance was ‘Direct nursing care’ followed by ‘Infection control’. The highest duties according to frequency and difficulty were ‘Document and notify’ and ‘Research and quality improvement’. ‘Safety management’ and ‘Infection control’ were considered as relatively simple duties, however, these two duties were still included as important jobs for clinical nurses. CONCLUSION: The job descriptions for clinical nurses developed from this study contain nursing ethics and safety as well as infection control, to faithfully reflect clinical nurses' jobs.
Critical Care* ; Curriculum ; Ethics, Nursing ; Infection Control ; Intensive Care Units* ; Job Description* ; Korea ; Methods* ; Nursing ; Patients' Rooms*

Primary tumors of the adrenal cortex are comparatively rare. In the medical literature they are most frequently reported as single case. Because of their infrequent occurence some features of their clinical behavior and pathologic anatomy are not widely known. For this reason the recording of the 7 cases from the Department of Pathology, School of Medicine, Chungnam National University is thought to be worth while. Of the seven tumors, five were associated with primary aldosteronism, one Cushing's syndrome, and the remaing one virilizing syndrome. All were benign. Females were affected more frequently than males. Adrenocortical adenomas tend to be small, weighing less than 42 gm. The tumors associated with primary aldosteronism were composed of zona fasciculata-like cells and "hybrid" cells. The tumor with Cushing's syndrome consisted of zona reticularis-like cells. The tumor with virilizing syndrome consisted of zone reticularis-like cells.
Female ; Humans ; Adenoma

BACKGROUND: Tuberculosis continues to be a major threat to health throughout the world, with an estimated 8 to 10 million new cases and 3 million deaths annually. And control of the disease is further threatened by the emergence of drug resistance. Recent major advances have been made in unravelling the molecular basis of M. tuberculosis resistance to isoniazid, streptomycin, quinolones and rifampin. And rifampin resistance is the useful indicator for the occurance of the multi-drug resistance. Hence, the rapid detection of rifampin resistant strain of M. tuberculosis is the key to have successful anti-tuberculosis therapy. Here we present our experience using PCR and line probe assay (INNO-LiPA) for easy and rapid detection of rifampin resistance of M. tuberculosis. METHODS: Thirty rifampin resistant and twenty susceptible strains of M. tuberculosis were collected from the routine culture and analyzed with INNO-LiPA. And results were compared with conventional antibiotic susceptibility testing. After amplification of the region of the RNA polymerase(rpoB), the amplified product is hybridized with a set of 10 oligonucleotides immobilized onto a membrane strip. From the pattern obtained the presence or not of rifampin resistance M. tuberculosis can be assessed. RESULTS: Ninety three percent of patients who had rifampin resistant strain revealed the multidrug resistance while only two showed resistance to rifampin only. The INNO-LiPA test results were generally agreeable with that of the conventional susceptibility testing(90%). The mutations in codon 531 (absence of 55 probe) were most commonly observed. In 55.2% of the 31 rifampin resistance M. tuberculosis confirmed on mutation by R-probes on the INNO-LiPA strips. CONCLUSIONS: The line probe assay after polymerase chain reaction is a fast and convenient method to detect both presence of M. tuberculosis complex strains and its resistance to rifampin in clinical specimens. We have suggested that detection of rifampin resistance may play a key role in monitoring multi-drug resistance. Consequently, the INNO-LiPA test may constitute an important tool for the control of tuberculosis.
Codon ; Drug Resistance ; Drug Resistance, Multiple ; Humans ; Isoniazid ; Membranes ; Mycobacterium tuberculosis* ; Mycobacterium* ; Oligonucleotides ; Polymerase Chain Reaction ; Quinolones ; Rifampin* ; RNA ; Streptomycin ; Tuberculosis

BACKGROUND: In eczematous skin it is expected that altered defense mechanisms are employed against an injury, which mechanisms include alterations in the stratum corneum barrier function and lipid contents. OBJECTIVE: To investigaten aspect of pathophysiology of hand eczema by comparing the water holding capacities and transepidermal water loss(TEWL) after injuries on the skin and by comparing the epidermal lipid contents between hand eczema and normal subjects. METHODS: The water holding capacities were checked by corneometer, and the TEWL were checked after epidermal barrie! destruction with acetone or adhesive tapes. The epidermal lipids were extracted with acetone, ther (1: 1 v/v) mixture solvent and analysed by HP- TLC. RESULTS: The water holdingapacities were decreased in eczema of the palm, but the recoveries of TEWL and the lipid content did not differ between hand eczema and normal subjects. CONCLUSION: The water holding capacities were decreased in the eczematous skin. But there were no significant differencies in the recovery of destructed epidermal barrier and the epidermal lipid contents.
Acetone ; Adhesives ; Defense Mechanisms ; Eczema* ; Hand* ; Skin ; Water

OBJECTIVE: The purpose of this study was to explore the usability of a feature selection method based on the mutual information theory to increase predictive performance of a classifier in data mining. METHODS: The HIV Cost and Services Utilization Study(HCSUS) dataset was used to apply the feature selection method to a classifier. Its contribution to increasing the predictive performance of the classifier was evaluated by comparing the Naive Bayes(NB) and the Logistic Regression(LG) models using different variables. The infrequent office visit representing limited health service utilization was selected as an outcome variable. HUGIN Researcher(TM) 6.3 was used to train and test the NB models and SAS(R) 8.0 was used for the LG modeling. RESULTS: Higher AUC in the NB model was obtained using the variables selected by the mutual information based feature selection method(AUC=.639, CI=.611, .660); lower AUC using the variables defined by a previous study(AUC=.599, CI=.570, .620). There was no difference between the LG models with different variables. CONCLUSION: This study demonstrated the mutual information method may be useful in identifying relevant predictors as the feature selection method, which can contribute to an increase in the predictive performance of a classifier.
Area Under Curve ; Data Mining ; Dataset ; Health Services ; HIV ; Information Theory* ; Office Visits

OBJECTIVE: To explore the feasibility of using the Bayesian network approach to study health outcomes and evaluate its predictive performance. METHODS: The Human immuno-deficiency virus Cost and Services Utilization Study (HCSUS) baseline dataset consisting of 2,864 human immuno-deficiency virus positive adults was used. The Hugin Researcher 6.2TM was used to develop the Bayesian network and Na?ve Bayes models. The SAS/STAT PROC LOGISTIC was used to develop the logistic regressions. RESULTS: The area under the receiver operating characteristic curve of the Bayesian network model was statistically higher than that of the Na?ve Bayes model, but no higher than that of the logistic regression model using the 8 variables from a previous study. In a second analysis using the 10 most influential predictors discovered by the Bayesian network approach, the Na?ve Bayes and the logistic regression performance improved. CONCLUSION: The BN approaches contributed to the discovery of additional influential predictors that lead to an increase of the models' predictive performance. When attempting to discover unknown relationships that might be missed by traditional analysis methods alone, the use of the Bayesian network as complementary methods may add value.
Adult ; Bays ; Data Mining ; Dataset ; Health Services Research* ; Health Services* ; Humans ; Logistic Models ; ROC Curve

BACKGROUND: Urography(IVU) is considered the best first investigation in patient with suspected urinary calculi, but recently ultrasonography(USG), combined with a plain film of the abdomen, has been suggested as an alternative. METHODS: We undertaken study to see if this approch can be used in emergency patients and outpatients by radiologists with different amounts of ultrasound experence. Some 192 patients with suspected urinary colic presenting to Koo Hospital Emergency Department and Youngnam Universith Hospital outward Department(IM, URO, FM) over 12-month period were studied. They had a plain abdominal film(KUB) and USG examination of the kidney, ureter, bladder following hydration and subsequently underwent IVU. Of these, 22 patients passed a stone before their IVU. The data analysis was performed on the remaining 170 patients. Urography was used as the gold standard. RESULTS: Some 170 patients subsequently underwent IVU at a mean interval of 1.8 days after the ultrasound examination. In 91 of 170 patients the IVU was positive. In 97 of 170 patients the combination of JUB plus USG was positive, leaving three false negative KUB plus USG. Thus the sensitivity of KUB plus USG was 97%, specificity was 89%, positive predictive value was 91%, and negative predictive value was 96%. CONCLUSIONS: Our findings in this study suggest that in the hydrated patient the combination of KUB plus US is a very sensitive and relative specific screening test. Because of the high negative predictive value of KUB plus US, urography is not likely to be helpful when KUB plus US are negative. Urography is indicated only if KUB plus US findings are equivocal or if intervention is necessa.ry.
Abdomen ; Colic ; Emergencies ; Emergency Service, Hospital ; Humans ; Kidney ; Mass Screening ; Outpatients ; Sensitivity and Specificity ; Statistics as Topic ; Ultrasonography* ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urography*