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*

No abstract available.
Stomach Neoplasms*

No abstract available.
Asthma*

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

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

Human epidermal cells were obtained from suction blisters of 14 healthy individuals, and were cultured for 24-96 hours st a concentration of 1x 10(7)/ml, 5 x 10(6)/ml, 1 x 10(6)/ml, 5 x 10(5)/ml. Cells were also cultured with or without stimulants such as phorbol myristic acetate(PMA), muramyl dipeptide(MDP), and endotoxin. Then, cell-free supernatants of cultured epidermal cells were tested for ETAF by a thymocyte prolifera.tiom assay. The results were as follows : 1, The highest activity of ETAF was produced by fresh epidermal cells(EC) at a concentration of 1 x10(7)ml. Its highest 3H-TdR was 4928+/-2480cpm. The highest activity of ETAF was produced by cultured EC at a concentration of 5 x10(6)/ml. Its highest 3H-TdR was 13983+/-8045 cpm. 2. The highest activity of ETAF was produced by fresh EC with n culture time of 24 hours. Its highest 3H-TdR was 5357+/-3760cpm. The highest activity of ETAF was produced by cultured EC with a culture time of 72 hours. Its highest 3H-TdR was 11905+/-5327cpm. 3. The highest activity of ETAF was produced by both fresh and cultured EC at a titer of 1: 8 dilution of cell-free supernatants. 1ts highest 3H-TdR was 4928 +/-2480cpm in the fresh EC, and 11905+/-5327cpm in the cultured EC. 4. Alhen fresh EC was stimulated with PMA, MDP and endotoxin, higher activity of ETAF was found in the group stimulated with PMA or MDP compared with its control group. But lower activity of ETAF was found in the group stimulated with endotoxin compared with its control group. The 3H-TdR was 6000+/-1936 cpm in the group stimulated with PMA, 6945+/-3182 cpm in the group stimulated with MDP, and 36943+/-36861cpm in the group stimulated with endotoxin.
Blister ; Humans* ; Suction ; Thymocytes

PURPOSE: Periventricular leukomalacia(PVL) is associated with various neurologic sequelae such as cerebral palsy and cortical blindness. The aim of this study was to analyse the correlation between the degree of PVL on MRI and clinical features or its severity. METHODS:Thirty-eight children with PVL on MRI among children brought to Pusan National University Hospital between January 1996 and August 1999 with development delay, cerebral palsy or epilepsy were included into the study group. We reviewed medical records of the patients including the gestational age, birth weight and neurologic sequelae. The grade for PVL was divided into 1 to 3, and it was based on abnormally increased signal intensity in periventricular white matter or a reduced amount of periventricular white matter or both, and compensatory focal ventricular enlargement. We analysed the relationship of the grade of PVL and various clinical findings. RESULTS: The age ranged from 11 months to 13 years old with a mean of 42 months. History of cesarean delivery and ventilator care were significantly frequent for the severe grade of PVL. Birth weight was significantly lower according to grade of PVL. Gestational age was lower according to the grade of PVL, but was not significant statistically. Incidence of cerebral palsy was significantly higher on the severe grade of PVL. Incidence of epilepsy and mental retardation were 34.2Yo and 23.9M, not associated with the grade of PVL. CONCLUSION: Incidence of cerebral palsy was associated with the severe grade of PVL, so we think MRI can be helpful in predicting neurodevelopmental outcome. (J Korean Pediatr Soc 2000;43 798-805)
Adolescent ; Birth Weight ; Blindness, Cortical ; Brain* ; Busan ; Cerebral Palsy ; Child ; Epilepsy ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Intellectual Disability ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging* ; Medical Records ; Ventilators, Mechanical

No abstract available.
Aneurysm* ; Arteriovenous Fistula* ; Hypertension, Renovascular* ; Renal Artery*

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*

We have reported general principles of low vision aid prescription. But, we have not reported near vision aid prescription only. So, we analyse prescriptions of near low vision aid(diagnosis, type, magnification, etc) and present new near low vision aids that patients feels comfortable. We reviewed the clinical records of 100 patients who visited our low vision clinic more than twice and was prescribed near low vision aid for low vision. According to the data analysed, optic nerve atrophy was the most common etiology for low vision. Illuminated hand held magnifier(31.3%), telemicroscope with plus cap(27.7%), aspheric doublet sens(Clear Image II)(24.1%) were low vision aids most commonly used for near vision, but we knew new trend that newly prescribed aids(telemicroscope with plus cap, aspheric doublet lens) were prescribed more than illuminated hand held magnifier. After prescription of the low vision aid, visual acuity improved significantly (p<0.05). We examined contrast sensitivity test to measure the functional acuity and predict the visual prognosis after prescription of low visio aid.In addition,we studied the relationship between reading speed and the degree of contrast sensitivity and we knew that the relationship between degree of contrast sensitivity and reading speed was associated(p<0.05). Majority of patients(89%) were benefited from prescribed low vision aids.
Atrophy ; Audiovisual Aids ; Contrast Sensitivity ; Hand ; Humans ; Optic Nerve ; Prescriptions* ; Prognosis ; Vision, Low*