BACKGROUND: In the present-day life, it is the conspicuous trend toward nuclear families and women have engaged in occupation. Therefore the patients have a load with taking care of children and living socially from inpatient therapy of acute pyelonephritis (APN). As a result of these, author intended to set up criteria of inpatient therapy, and reported the clinical study and status of resistance to antibiotics in APN. METHOD: I analyzed 316 patients with APN retrospectively. I analyzed their clinical features, resistance to antibiotics, result of treatment, and the cost of inpatient and outpatient therapy. And to set up the criteria about inpatient therapy, multiple factors which may influence prognosis were evaluated by univariate analysis and linear regression analysis. RESULT: Of the 316 cases, 19 were male and 297 were female. The average count of clinical state was 5.2+/-1.7. The patients with underlying causes were 113 (32.6%). The 16 of 21 cases with hydronephrosis or hydroureter on sonography carried out intravenous pyelography, 13 (81.2%) cases had abnormal finding. The most common pathogen is E.coli. The resistance to ampicillin, Trimethoprim/sulfamethoxazole, and cephalothin increased progressively. The usually used antibiotics were 2nd-generation cephalosporin, aminoglycoside, and oral cephalosporin or quinolone. Considering the univariate analysis, 1) on the group with underlying causes, they were older age, had longer duration of admission and treatment. On the group with UTI history, they had more underlying causes and had higher clinical state. On the group with abnormal finding on sonography, they were older age and higher clinical state, had more WBC count and longer duration of admission and therapy. 2) On the group without underlying causes, the group above 38 years-old had longer duration of admission, but there was no difference in other variances. On both groups of 38.5degrees C in body temperature and on both groups of the mild or moderate and severe clinical state, there was no difference in all variances. The group above 12,000/ml on WBC count had higher body temperature only. The group with renal swelling on sonography had higher WBC counts, higher clinical status, and longer duration of admission and treatment, but had no difference in age and body temperature. 3) In linear regression analysis on the group with normal renal size on sonography and without underlying causes, the age vs the duration of admission and WBC count, the body temperature vs the duration of admission, the clinical state vs the duration of admission had positive correlation, but low r-value, and there was no correlation in other relations. CONCLUSION: The resistance to antibiotics had increasing trend in Korea. The criteria for inpatient therapy of acute pyelonephritis on visit are following; severe clinical state and 1) underlying causes in history taking, or 2) recurrent urinary tract infection on past history, or 3) abnormal finding or enlarged kidney finding on sonography. We think that they should be admitted and had parenteral antibiotics to be relieved the severe generalized symptoms and confirmed the underlying cause, and in other cases, they can be treated by oral antibiotics in outpatient Department.
Adult ; Ampicillin ; Anti-Bacterial Agents ; Body Temperature ; Cephalothin ; Child ; Female ; Humans ; Hydronephrosis ; Inpatients* ; Kidney ; Korea ; Linear Models ; Male ; Nuclear Family ; Occupations ; Outpatients ; Prognosis ; Pyelonephritis* ; Retrospective Studies ; Urinary Tract Infections ; Urography

No Abstract Available.
Chondrocytes* ; Phenotype*

No abstract available.
Ehlers-Danlos Syndrome*

No abstract available.
Carcinoma, Basal Cell*

No abstract available
Dermatitis, Atopic* ; Eczema* ; Humans ; Nipples*

OBJECTIVES: This study was conducted to evaluate factors related to the degree of disability of stroke patients in a rural community. METHODS: The study subjects included 641 patients selected from 975 stroke patients over the age of 50 with brain lesion-related disabilities living in Gyeongju, Korea, an urban-rural consolidated community. The data were obtained by interviews from July to October 2008. The subjects were divided into a seriously disabled group (1st and 2nd disability grade) and mildly disabled group (3th, 4th, 5th and 6th disability grade) by degree of disability according to registered disability grade. The collected data were analyzed using the SPSS 14.0 statistical package. RESULTS: The study subjects included 379 males (59.1%) and 262 females (40.9%), and most patients were in their 70s (256 cases, 39.9%). The seriously disabled group included 287 patients (44.8%) and the mildly disabled group included 354 persons (55.2%). Age, prehospital delayed time and number of related chronic diseases were risk factors for serious disability (p<0.05). CONCLUSIONS: Our results indicate that the degree of disability can be reduced by decreasing prehospital delayed time. We suggest that education of high risk groups and establishment of emergency services as well as a transport system for stroke patients are required to reduce the degree of disability due to stroke.
Brain ; Cerebrovascular Disorders ; Chronic Disease ; Emergencies ; Female ; Humans ; Korea ; Male ; Risk Factors ; Stroke

Purpose: To report a case of extensive syphilitic punctate inner retinitis (SPIR) triggering bilateral macular ischemia after intravitreal triamcinolone injections, and the multimodal retinal imaging findings.Case summary: A 69-year-old male patient with nonproliferative diabetic retinopathy was transferred to our hospital because of bilateral visual deterioration (to counting fingers) after the first intravitreal triamcinolone injection. Fundus examination revealed numerous yellow punctate precipitates in the superficial retinae, retinal arteriolitis, and vitritis. The punctate lesions and surrounding retinal regions showed decreased vascular density on optical coherence tomography angiography, and focal hypofluorescence on fluorescein angiography. The patient was positive for all of the Venereal Disease Research Laboratory test, the fluorescent treponemal antibody-absorption test, and Treponema pallidum hemagglutination; we diagnosed bilateral SPIR. After treatment with aqueous crystalline penicillin solutions (24 million units per day for 14 days), the punctate lesions reduced but arteriolitis progressed to obliterative vasculitis. After 6 months, the bilateral SPIR and vitritis resolved, and the bilateral visual acuity improved to 20/100. However, inner retinal and macular ischemia persisted because of capillary nonperfusion attributable to obliterative vasculitis. Conclusions Extensive SPIR can develop after an initial intravitreal steroid injection; the inner retinal ischemia and visual loss may persist after treatment because obliterative vasculitis develops. Therefore, patients scheduled for intravitreal steroid injections should be screened for syphilis infection.

PURPOSE: Bone and cartilage were manufactured by using tissue engineering of mesenchymal stem cell (MSC) which can differentiate into variety of cell types. MATERIAL AND METHOD: MSC was isolated and cultured from the rabbit weighing 500g, and it was seeded into PGA mesh and pre-cultured for 1 week with different TGF- beta 3 treated conditions. It was implanted into nude mice and tissues generated were recovered from 1, 2, 3, 4, 8 ,and 12 weeks respectively. Degree of bone and cartilage formation was analyzed with histology and immunohistochemistry assay. RESULT: Pre-culture condition with TGF- beta 3 treatment showed early start of chondrogenic differentiation, and degree of bone and cartilage formation was promoted as time passed. But both of the cases differentiated into complete bone after 12 weeks. CONCLUSION: The results show that pretreatment of TGF- beta 3 promotes the differentiation process in vivo condition under the in vivo system where MSC differentiate into bone via cartilage formation.
Animals ; Cartilage ; Immunohistochemistry ; Mesenchymal Stromal Cells* ; Mice ; Mice, Nude ; Tissue Engineering

PURPOSE: This study was carried out to determine whether the use of multimedia message service (MMS) as discharge instructions about post-suture care improves patient's comprehension for those information. METHODS: One hundred nineteen (119) patients with lacerations and their caregivers who visited the Emergency Room at Soonchunhyang University Cheonan Hospital were included in this study. Participants were randomly assigned to receive MMS (n=66) or paper (n=53) discharge instructions after providing informed consent to engage in this study. Within 48 hours of discharge, an investigator called each participant by phone and asked a series of questions designed to test the participant's comprehension of their discharge instructions. In addition, participants were asked to complete questionnaires about confidence, accessibility, compliance, and the usefulness of discharge instructions. RESULTS: There were no differences in age, sex, educational background and subject (patient or caregiver) between the MMS and the paper group. In both groups, the mean and standard deviation in comprehension score was 8.1+/-1.3 and 6.6 +/-1.8, respectively. The difference was statistically significant (p<0.001). 'Yes' group of MMS and paper was 40(60.6%) and 16(30.2%) in accessibility, 39(59.1%) and 19(35.8%) in compliance, 26(39.3%) and 20(37.7%) in usefulness, respectively. CONCLUSION: The use of MMS as discharge instructions for patients with laceration improves patient comprehension.
Caregivers ; Cellular Phone ; Compliance ; Comprehension ; Emergencies ; Humans ; Informed Consent ; Lacerations ; Multimedia ; Patient Discharge ; Surveys and Questionnaires ; Research Personnel ; Telecommunications

PURPOSE: To assess the ability of the Sequential Organ Failure Assessment (SOFA) score to predict the prognosis and organ dysfunction in the paraquat poisoning. METHODS: We retrospectively evaluated 281 paraquat poisoning patients who arrived at Soonchunhyang University Cheonan Hospital between Sep 2007 and Dec 2008. Sixty eight patients (68) were excluded due to missing data. Finally, 213 patents were included in this study. We investigated the degree of paraquat exposure, the Glasgow coma scale, vital signs, blood laboratory tests, calculated SOFA score, and Yamaguchi Index on first hospital day. The prognostic prediction was compared between SOFA score and Yamaguchi Index. RESULTS: The urine dithionite test, the amount of paraquat ingestion, arrival interval, aerum paraquat, Glasgow coma scale, HCO3-, potassium, and creatinine were significantly different between survivors and non-survivors. The Hosmer and Lemeshow Goodness-of-Fitness test of SOFA score (p=0.419) and Yamaguchi Index (p=0.084) indicated a good model performance. In the logistic regression analysis, p values the SOFA score and for the Yamaguchi Index were lower than 0.05 and the odds ratios were 1.930 and 0.108. At c-statistics, the area under receiver operator characteristic curve of SOFA score was 0.807 and Yamaguchi Index was 0.865. 95% confidence SOFA score and Yamaguchi Index Intervals of did not include 0.5. CONCLUSION: The SOFA score on the first day of hospital visit could reliably describe organ dysfunction and could distinguish survivors and non-survivors with reliable accuracy, as well as the Yamaguchi Index did in the case of paraquat poisoning.
Creatinine ; Dithionite ; Eating ; Glasgow Coma Scale ; Humans ; Logistic Models ; Multiple Organ Failure ; Odds Ratio ; Paraquat ; Potassium ; Prognosis ; Retrospective Studies ; Survivors ; Vital Signs