BACKGROUND: We reviewed retrospectively the clinical features and contrast material-enhanced computed tomography(CT) after blunt abdominal trauma demonstrated a characteristic hypoperfusion complex. Our purpose were to evaluate the hypothesis that children with this 'hypoperfusion complex' CT finding were associated with a tenuous hemodynamic state, severe injury and a poor outcome. METHODS: Between January 1996 and December 1999, 39 consecutive children who sustained blunt trauma and were suspected clinically of having intraabdominal injury underwent CT. Demographic data, blood pressure, indication for CT, pediatric trauma score(PTS) and Glasgow coma score(GCS) were recorded at the time of the initial examination. RESULTS: Three of the 39 children(8%) demonstrated a characteristic finding at CT which was described as the hypoperfusion complex. The 'hypoperfusion complex' was present in the 3 of the 39 traumatized children(8%), but was the main radiographic finding in the 3 of the 14 children with a severe pediatric trauma score(PTS<8) and in the 3 of the 6 children with a Glasgow coma score(GCS<8) who were examined with CT. CONCLUSION: The CT finding in all children with the hypoperfusion complex by definition included marked, diffuse dilatation of the intestine with fluid; abnormally intense contrast enhancement of the bowel wall, mesentery, kidney and/or pancreas; decreased caliber of the abdominal aorta and inferior vena cava(IVC); and moderate to large peritoneal fluid collection. This 'hypoperfusion complex' is a relatively rarely observed in injured children but appears to be associated with severe injury and a poor outcome. The pediatric trauma score provides a useful profile of injury severity in children. Prompt diagnosis of hypovolemic shock is important so that supportive therapy can be instituted to prevent further metabolic abnormalities and their potential cardiotoxic effects. In summary, the intense multiorgan enhancement pattern seen in the hypoperfusion complex indicates tenuous hemodynamic stability and is associated with a poor outcome.
Aorta, Abdominal ; Ascitic Fluid ; Blood Pressure ; Child* ; Coma ; Diagnosis ; Dilatation ; Hemodynamics ; Humans ; Hypovolemia* ; Intestines ; Kidney ; Mesentery ; Pancreas ; Retrospective Studies ; Shock* ; Tomography, X-Ray Computed*

Acute generalized exanthematous pustulosis(AGEP) is a disease entity caused mostly by drugs or viral infections. Clinically it manifests as generalized erythema, erythema multiforme and amicrobial pustules with fever. Histologically, AGEP is composed of neutrophilic subcorneal and spongiform pustules. A 70-year-old female, with no personal or family history of psoriasis, was given medication including diltiazem for hypertension. Fourteen days after taking the medications, pustular eruptions appeared on the face and rapidly spread to the trunk and limbs. A Laboratory examination revealed neutrophilic leukocytosis and an elevated erythrocyte sedimentation rate. The skin biopsy showed subcorneal and spongiform pustules. We report here a case of AGEP probably due to diltiazem.
Acute Generalized Exanthematous Pustulosis* ; Aged ; Biopsy ; Blood Sedimentation ; Diltiazem ; Erythema ; Erythema Multiforme ; Extremities ; Female ; Fever ; Humans ; Hypertension ; Leukocytosis ; Neutrophils ; Psoriasis ; Skin

No abstract available.
Stomach Neoplasms*

No abstract available.
Asthma*

PURPOSE: Information has been limited on the genetic control of germ cell apoptosis and its role in the pathogenesis of male infertility. The object of this study was to investigate the effects of c-kit gene expression and apoptosis on human spermatogenesis. MATERIALS AND METHODS: Testicular specimens were obtained from 90 infertile males with nonobstructive azoospermia(NOA) due to primary testicular failure and from 9 healthy volunteers. The specimens of infertile men were divided into 4 groups according to hitopathologic findings: Sertoli cell only(SCO) syndrome(A), maturation arrest(B), hypospermatogenesis(C) and disorganization with sloughing(D). C-kit gene expression and apoptosis were detected with immunohistochemical stain. RESULTS: The frequency of c-kit expression was lower(p<0.05) and that of apoptosis was higher(p<0.01) in infertility groups B, C, and D compared to that of the control group. A significant inverse correlation was observed in the c-kit gene expression and apoptosis in groups B, C and D(p<0.05). A similar relationship was also observed in the Sertoli cells in group D and the control group. CONCLUSIONS: With the result, we suggest that variation in c-kit gene expression and apoptosis are associated with abnormal spermatogenesis and play a role in the pathophysiology of male infertility.
Apoptosis* ; Gene Expression ; Germ Cells ; Healthy Volunteers ; Humans ; Infertility ; Infertility, Male ; Male ; Sertoli Cells ; Spermatogenesis* ; Testis

Fibromuscular dysplasia is the single leading etiology of renovascular hypertension in children. We report an eight-year-old girl who was admitted for generalized tonic seizure with fibromuscular dysplasia of right renal artery. On admission, she presented hypertension and altered mentality. She had suffered from intermittent severe headache for the past year. Renal angiography of right renal artery showed stenosis, beaded pattern and aneurysms. Brain MRI showed multifocal lesions in parietooccipital, periventricular and external capsular area. She was diagnosed as hypertensive encephalopathy due to fibromuscular dysplasia of renal the artery. Renal angioplasty with ballooning catheter was performed. Successful renal angioplasty dropped her blood pressure to normal level and no more headaches has occurred for more than a year after discharge.
Aneurysm ; Angiography ; Angioplasty ; Arteries ; Blood Pressure ; Brain ; Catheters ; Child ; Constriction, Pathologic ; Female ; Fibromuscular Dysplasia* ; Headache ; Humans ; Hypertension ; Hypertension, Renovascular ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging ; Renal Artery ; Seizures

PURPOSE: We intended to analyze the characteristics of a pediatric low vision population. METHODS: Among 430 patients who visited our low vision clinic from May 1995 to April 2000, 137 patients(31.9%) aged 15 years or less were reviewed to study epidemiologic characteristics, prescribed aids and required magnification. RESULTS: The percentage of pediatric low vision patients was higher than that of developed countries. Male predominance was found. Optic atrophy(41.6%), congenital cataract(12.4%), macular degeneration and dystrophy(9.5%) were the major causes of low vision in this population. The most commonly prescribed low vision aid was a telescope. For near task, light-gathering magnifiers were prescribed most commonly. The visual acuity was improved significantly at near and far distance after correction with low vision aid. The mean required magnification was 3.5 xand this means that a low magnification was sufficient in the majority of cases. CONCLUSIONS: Early rehabilitation and long-range planning for the low vision child are required because of profound effect of childhood visual impairment.
Child ; Developed Countries ; Humans ; Macular Degeneration ; Male ; Optic Atrophy ; Rehabilitation ; Telescopes ; Vision Disorders ; Vision, Low* ; Visual Acuity

PURPOSE: The purpose of this study was to investigate the degree of the gender role identity and quality of life of women applying hormone replacement therapy with hysterectomy and to identify the relation among these variables.The purpose of this study was to investigate the degree of the gender role identity and quality of life of women applying hormone replacement therapy with hysterectomy and to identify the relation among these variables. METHODS: The subjects were 121 outpatients applying hormone replacement therapy with hysterectomy at a university hospital in Busan province. The data were collected using self-reported questionnaire and medical record, from September to October 2008. RESULTS: There were statistically significant differences in the degree of quality of life according to the age, educational level, occupation, family economic status, Body Mass Index (BMI), menopause state, duration to restarting intercourse from hysterectomy, discomfort from intercourse, satisfaction from intercourse and duration, sources, and formulation of hormone replacement therapy (HRT). The femininity identity group occupied the largest proportion (31.4%), and then the masculinity identity group (28.1%), the undifferentiated identity group (26.4%), and finally the androgyny identity group (14.1%). There was a positive correlation between femininity and quality of life (r=.276, p=.002). CONCLUSION: These results indicate that HRT helps the women's sense of loss caused by hysterectomy to be reduced, the postmenopausal symptom after hysterectomy to be relieved and the quality of life to be improved.
Body Mass Index ; Female ; Femininity ; Gender Identity ; Hormone Replacement Therapy ; Humans ; Hysterectomy ; Masculinity ; Medical Records ; Menopause ; Occupations ; Outpatients ; Quality of Life ; Surveys and Questionnaires

The ulcerative colitis is a relatively common disease in the European and North American countries aince Dr. Wilks has first reported the cases in 1895, But in Korea, this disease is a rare entity and only a few case have been reported. However, rescently the diagnoetic methods for ulcerative colitis are much developed we have experienced 28 cases of ulcerative colitis which were diagnosed by endoscopy, barium enema exam and biopsy. Therefore a total of 28 patient with ulcerative colitis diagnosed and treated at the department of internal medicine of HYUH from June 1979 to June 1986 was reviewed. We obtained the results as follows; 1) The sex distribution assumed a ratio of 1 to 1.33 with 12 males and 16 females. 2) The age dietribution was relatively even but the majority of cases were between 5th and 6th decade (32.1%), 3) The most prominent clinical symptoms were rectal bleeding, abdominal pain, diarrhea, fever, wight loss and vomiting. 4) Significant laboratory findins were anemia, eleveited ESR, leukocytosis, positive stool OB, electrolyte imbalance and decreased serum albumin level. 5) As to the extent of disease determined by the barium enema examination and endoscopic exam., rectum or rectosigmoid colon is involved in majority of the cases (92.8%). 6) The endoscopic examination was performed in all 28 cases and showed significant findings such as ulceration, hyperemia, mucosal friability, bleeding etcs. 7) The barium enema examination was performed in 19 cases and showed positive findings such as ulceration, luminal narrowing, bowel shortening and rigidity in 17 cases. 8) 21 of 28 patients treated by medical therapy showed relatively improved but 4 of 28 patients was exacerbated or relapsed and one has expired.
Abdominal Pain ; Anemia ; Barium ; Biopsy ; Colitis, Ulcerative* ; Colon ; Diarrhea ; Endoscopy ; Enema ; Female ; Fever ; Hemorrhage ; Humans ; Hyperemia ; Internal Medicine ; Korea ; Leukocytosis ; Male ; Phenobarbital ; Rectum ; Serum Albumin ; Sex Distribution ; Ulcer* ; Vomiting

PURPOSE: The purpose of this research is to enhance organizational competitiveness of health centers as well as private medical institutions serving as public health and medical institutions. It tries to help them to cope with the requirements from health consumers, to enhance public health nurses' job performance. METHODS: After verifying the reliability of the tool, confirmatory factor analysis was used to detect a model, in which valid path coefficients exist among variables. The detected model was then selected as the subject and its validity was verified. Finally, a structural equation model was applied to verify whether the estimate was suitable for the purpose of this research. RESULTS: As for the nursing organizational culture, the public health nurses considered relation-oriented culture the most desirable. As for the self-leadership, they considered self-compensation the most desirable. It was found that mediating effects of self-leadership was partially significant. CONCLUSION: To enhance job performance, it is necessary to make a transition from the organizational culture to the relation-oriented culture and it is also necessary to develop a program capable of reinforcing self-leadership. In addition, it is necessary to conduct a research to verify whether such a developed self-leadership program is influential on job performance enhancement.
Negotiating* ; Nurses, Public Health ; Nursing ; Organizational Culture* ; Public Health* ; Work Performance*