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*

PURPOSE: To examine the effects of power walking exercise on fatigue and overweight in college students with Taeumin constitution. METHODS: According to results of the constitution diagnosis (QSCC II), 58 students who were identified as Taeumin, whose BMI was over 23 were assigned to one of three groups. The power walking group walked fast at a speed of 7,000 steps per hour using a pedometer, and the walking group walked at a speed of 5,000 steps per hour. There was no treatment with control group. Each group's fatigue level, blood lipids and body composition before and after the experiment were compared and analyzed. RESULTS: Total fatigue and total cholesterol decreased significantly in the power walking group compared to the walking group and the control group. Weight decreased significantly in the power walking group compared to the control group, and percentage of body fat decreased significantly in both the power walking group and the walking group compared to the control group. CONCLUSION: When power walking exercise was used with overweight Taeumin students, fatigue, blood lipid, weight and percentage of body fat decreased significantly.
Adipose Tissue ; Body Composition ; Cholesterol ; Constitution and Bylaws ; Fatigue ; Humans ; Overweight ; Walking

PURPOSE: This study was done to determine the rate for handwashing by intensive care unit nurses according to the content of nursing tasks, to investigate the relationship between hand washing practice evaluated by nurses themselves and their actual practice observed, and finallly to provide basic materials for strategy for hand washing education. METHOD: Data were collected by observing 27 nurses working in intensive care units of a hospital in Uijeongbu, Gyeonggi-do and by using observation and a structured self-assessment tool. Collected data were analyzed with SPSS and SAS. RESULTS: The handwashing rate for the nurses was 4.3%. The handwashing rate was high in proportion to the risk of cross infection. In addition, the handwashing rate was highest in nurses working in the neurosurgery intensive care unit. The average score for self-assessment of handwashing was 49.42+/-3.78 points and it was higher than their actual practice of handwashing. CONCLUSION: In order to improve handwashing by nurses, it is necessary to educate them on the importance of handwashing. In addition, there should be strategies for standardizing knowledge and attitudes to handwashing and inducing nurses to practice hand washing in compliance with the policies and working conditions of the institution.
Compliance ; Cross Infection ; Education ; Faculty, Nursing* ; Gyeonggi-do ; Hand Disinfection* ; Humans ; Intensive Care Units* ; Critical Care* ; Neurosurgery ; Nursing Faculty Practice* ; Nursing* ; Self-Assessment

BACKGROUND: A novel technique for the repair of tears of the upper subscapularis tendon—intraarticular knotless fixation—has been introduced recently. The purpose of this study was to evaluate the clinical and structural outcomes of arthroscopic intraarticular knotless fixation for the treatment of upper subscapularis tendon tears. METHODS: We retrospectively analyzed the clinical and radiological outcomes of 27 patients who underwent arthroscopic intraarticular knotless fixation for upper subscapularis tendon tears. Finally, a total of 10 patients who could participate in at least a 6 month follow-up of magnetic resonance imaging evaluation and in a least 1-year follow-up on an outpatient basis were enrolled in our study. The mean age at the time of operation was 60.7 years, and the mean duration of follow-up was 14.7 months. Two patients had concomitant tears of the supraspinatus tendon and 8 patients had concomitant tears of the supraspinatus and the infraspinatus tendons. RESULTS: The clinical and radiological outcomes improved after the patients had undertaken arthroscopic intraarticular knotless fixation. The mean visual analogue scale score for pain during motion improved from 6.7 preoperatively to 1.4 at the final follow-up (p<0.001). The mean Constant score improved from 59.3 preoperatively to 79.6 at the final follow-up, and the mean the University of California at Los Angeles score, from 21.7 to 30.2, respectively (p<0.001 and p<0.001). The upper subscapularis tendon tear was healed in every patient except one (90%), for the patient had suffered from a postoperative trauma that resulted in a retear. CONCLUSIONS: We found that arthroscopic intraarticular knotless fixation gives good clinical and structural outcomes for the repair of upper subscapularis tendon tears. Arthroscopic intraarticular knotless fixation provided such a reliable and efficient restoration of the subscapularis tendon footprint that we anticipate it will become a widely-used procedure for upper subscapularis tendon tears.
Arthroscopy ; California ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Outpatients ; Retrospective Studies ; Shoulder ; Tears* ; Tendons* ; Treatment Outcome

Tuberculomas in the spine are estimated to be 15 to 50 times less common than those occurring in the cranium. We experienced a case of intramedullary spinal tuberculoma and brain tuberculoma associated with pulmonary tuberculosis. A 39-year-old male was referred to the National Medical Center via emergency room because of urinary difficulty and lower limb weakness for 3 days. He had been treated with anti-tuberculosis regimens against pulmonary tuberculosis for 20 days. Spinal MRI revealed intradural intramedullary tuberculoma at T5. On the 21st day at the hospital, a generalized seizure attacked him. Brain MRI revealed multiple tuberculoma in both hemispheres, brainstem and cerebellum. He was treated anti-tuberculosis regimens and corticosteroids for 9 months. His condition improved clinically and radiologically. We report this case with a review of the literature.
Adrenal Cortex Hormones ; Adult ; Brain Stem ; Brain* ; Cerebellum ; Emergency Service, Hospital ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Seizures ; Skull ; Spine ; Tuberculoma* ; Tuberculosis, Pulmonary*

Neonatal and Infantile conjunctivitis are common disease in ophthalmologic outpatient department but, a study of causative organisms and antibiotics sensitivity tests are insufficient till now We divided 117 babies(117eyes) having conjunctivitis into neonatal and infantile group who were visited Sung-Ae General Hospital from Jan, 1989 to May, 1990. We performed bacterial culture and antibiotic sensitivity test. The results were as follows; 1) Culture positive rates are 65% in neonates and 87% in infants. There is no sexual difference of ratio. 2) The incidence of isolated organisms is Staphylococcus aureus, Coagulase negative staphylococcus and Streptococcus. 3) Cephalothin is most sensitive antibiotics and Chloramphenicol shows relatively lower sensitivity.
Anti-Bacterial Agents ; Cephalothin ; Chloramphenicol ; Coagulase ; Conjunctivitis* ; Hospitals, General ; Humans ; Incidence ; Infant ; Infant, Newborn ; Outpatients ; Staphylococcus ; Staphylococcus aureus ; Streptococcus

Argon laser trabeculoplasty(ALT) is commonly used in the treatment of uncontrolled open angle glaucoma. The authors retrospectively reviewed the efficacy of ALT in 52 patients(57 eyes) with primary open angle glaucoma. The mean follow-up was 28 months(range 2-48 months). The decrease in intraocular pressure 10P) was 10.1 +/- 3.5 mmHg at 1 month, 8.2 +/- 2.8 mmHg at 1 year, 6.2 +/- 5.1 mmHg at 2 years and 51% at 3 years. Failure was most common in the first 6 months after treatment(29%) and thereafter failure occurred at a rate of 5% to 15% per year. The sex and age of patients had no significant effect on success rate. The success rate was high in the patients with baseline IOP of 26 to 30 mmHg. A mild iritis in all cases, transient rise in IOP, peripheral anterior synechia and microscopic hyphema were noted as early complications of ALT.
Argon* ; Follow-Up Studies ; Glaucoma, Open-Angle* ; Humans ; Hyphema ; Intraocular Pressure ; Iritis ; Retrospective Studies ; Trabeculectomy*

A case is presented of acute respiratory distress resulting from pneumothorax, pneumome-diastinum, pneumoperitoneum and subcutaneous emphysema in a 9 year old female patient having sugery for a cleft palate. This complieation was thought to have been due to inattentive positive pressure ventilation during anesthesia. Bilatera closed thoracotomy was performed in the recovery room. This patient recovered without any other problem.
Anesthesia ; Child ; Cleft Palate ; Female ; Humans ; Pneumoperitoneum* ; Pneumothorax* ; Positive-Pressure Respiration ; Recovery Room* ; Subcutaneous Emphysema* ; Thoracotomy

Intravenous anesthesia, using sedative for the rapid loss of consciousness and analgesic for the potent and short-acting effect, has been widely done. So tbis study is aimed to see if propofol-fentanyl are effective enough for extracorporeal shock wave lithotripsy(ESWL) used for outpatient and how it will effects on cardiovascular system. Above all, 45 patients were selected randomly and their blood pressure(BP), heart rate(HR), respiratory rate(RR) and arterial oxygen saturation(SaO2) were measured shortly before giving propofol and fentanyl. Then, after giving propofol and fentanyl, BP,HR, RR and SaO2 were measured as the adequate depth of anesthesia. And after 5 to 10 minutes, ESWL was done. Involuntary movements and pain were checked as additional depth of anesthesia. With the time, HR and SaO2 showed statistically significant decrease with no clnical meanings. And there was no special treatment for involuntary movements founded in 8 patients but 13 patients suffering from pain were given additional fentanyl. In conclusion, intravenous anesthesia with propofol and fentanyl works effectively for ESWL. Therefore if during ESWL, cardiopulmonary functions are monitored carefully, intravenous anesthesia with propofol and fentanyl will be an effective and safe anesthesia.
Anesthesia ; Anesthesia, Intravenous ; Cardiovascular System ; Dyskinesias ; Fentanyl ; Heart ; Humans ; Lithotripsy* ; Outpatients* ; Oxygen ; Propofol ; Shock ; Unconsciousness

According to the Mainz classification, renal cell carcinoma (RCC) consists of three subtypes: each has characteristic genetic alterations within the chromosomal or mitochondrial DNA. The three subtypes are: clear cell type, chromophil type, and chromophobe type. E-cadherin is a Ca++-dependent adhesion molecule which plays a major role in the maintenance of intercellular adhesion in epithelial tissues. In a normal kidney, E-cadherin is expressed in the distal tubule and the collecting duct, but not in the proximal tubule. We reclassified 110 cases of RCC according to mainz classification. Immunohistochemical staining for E-cadherin was done on twenty eight cases of RCC, including 18 cases of clear cell type, four cases of chromophil type, and six cases of chromophobe type. The results were as follows: 1) of the 110 cases of RCC, 96 cases (87.3%) were of clear cell type, four cases (3.6%) of chromophil type, and ten cases (9.1%) of chromophobe type, 2) there was no significant correlation between the nuclear grade and clinical stage according to each subtype, 3) E-cadherin expression showed a strong positive reaction along the cell membranes in all six cases of chromophobe type. The differential expression of E-cadherin in RCC may suggest that the chromophobe type may have different biologic characteristics from other types of RCC.
Cadherins* ; Carcinoma, Renal Cell* ; Cell Membrane ; Classification* ; DNA, Mitochondrial ; Immunohistochemistry ; Kidney ; Population Characteristics