No abstract available.
Humans ; Internship and Residency*

No abstract available.
Diabetes Mellitus* ; Tuberculosis*

This study was conducted to investigate the nursing diagnosis applying to rehabilitation unit. The subject of this was consisted of 101 nurses who have been working over 1 year in rehabilitation unit. The clssification of nursing diag-nosis used NANDA's system and analysis of the validity was based on Fehring's model. In summury of this study, some dirrerences were found in related factors in nursing diagnosis between rehabilitation and general unit. Major re-lated factors of nursing diagnosis were physical factors associated with neuromuscular disorder. Valid related factors in altered nutrition: more than body requirements was not found for re-habitation unit. It is helpful for the nurses who work at re-habilitation unit to apply the nursing diagnosis validated in this study. This finding can be used as the database for accomplished nursing diag-nosis appropriate for improving the rehabilitation nursing practice.
Nursing Diagnosis* ; Nursing* ; Rehabilitation Nursing* ; Rehabilitation*

PURPOSE: To evaluate the clinical results of cable fixation in patellar fractures followed by early ROM exercise and early weight bearing. MATERIALS AND METHODS: We analyzed 46 patients who had operation for transverse or comminuted patellar fractures with cable fixation from April 1995 to January 2003. Mean term of follow up was 15 months (range, 15~24 months). We reviewed the clinical and radiologic bony unions, ROM, time of weight bearings retrospectively. All cases were fixed with Dall-Miles' cable, and additional fixation was done with K-wires in 25 cases and with screws in 11 cases. At next day after surgery, all patients started CPM, except 3 cases who had severly comminuted fractures. Full weight bearing was started 2-3 days after surgery with LMB in full extended state. RESULTS: We gained bony union in all cases, Average ROM was 115 degree(80-130 degree) at postoperative 2nd week, all patients showed more than 130 degree at 8th week and final results showed normal ROM compared with opposite knee. During follow up, K-wires were migrated in 2 cases, but there was no difference in ROM or bony union compared with other patients. CONCLUSION: Fixations using Dall-Miles' cable for transverse or comminuted patellar fractures are considered to be enough stable for early ROM exercise and early weight bearing without major complications.
Follow-Up Studies ; Fractures, Comminuted ; Humans ; Knee ; Retrospective Studies ; Weight-Bearing

Diabetes mellitus (DM) is a group of metabolic disorders, that have become a major cause of death worldwide. This study aimed to determine the usefulness of diabetes-related laboratory tests for diagnosis of postmortem DM. From March to August 2018, among the autopsy cases investigated by the National Forensic Service, heart blood and vitreous humor samples from 253 cases that had not been decomposed were collected, and the data from 208 cases except 45 cases that were incapable of testing were analyzed for statistical significance and compared with the causes of death on autopsy reports. The levels of C-peptide, insulin, acetoacetate, β-hydroxybutyrate (β-HA), total ketone, and HbA1c were measured in the heart blood, and the levels of glucose, blood urea nitrogen, creatinine, and potassium were measured in the vitreous humor. The levels of glucose in the vitreous humor and HbA1c, β-HA, and total ketone in the heart blood were significantly correlated. C-peptide and insulin levels were lower than normal levels in most cases (C-peptide 92.3%, P=0.480, insulin 97.6%, P=0.589), and were not useful measures indicating diabetic complications. In the group with DM history, the average levels of HbA1c from the heart blood and glucose from the vitreous humor were higher than in those with no or unknown history of DM, indicating their usefulness as diagnostic tools. The results of this study suggest a postmortem DM diagnosis model.Therefore, postmortem DM-related tests can help diagnose the cause of death in forensic medicine.

Primary hyperparathyroidism is the most frequent cause of hypercalcemia, and its prevalence is increasing due to the routine examination of serum calcium levels. Primary hyperparathyroidims is most commonly caused by an adenoma or hyperplasia of the parathyroid gland. A cystic parathyroid adenoma is an extremely rare cause of primary hyperparathyroidism. In our case, a-79-year old female presented with lower back pain and constipation. Her serum calcium, phosphate and immunoreactive parathyroid homone levels were 15.6, 1.8mg/dL and 371.8pg/mL, respectively. Neck CT revealed a cystic mass and a contour bulging heterogeneous mass in the left inferior right thyroid gland, respectively. These mass lesions were removed, and the intra-operative parathyroid hormone levels monitored, to confirm the complete resection. After removing the left cystic mass to the inferior thyroid, the serum calcium and immunoreactive parathyroid hormone levels quickly returned to normal. We report a case of primary hyperparathyroidism, caused by a cystic parathyroid adenoma, with a brief review of the literature
Adenoma ; Calcium ; Constipation ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Hyperplasia ; Low Back Pain ; Neck ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Prevalence ; Thyroid Gland

Primary hyperparathyroidism is the most frequent cause of hypercalcemia, and its prevalence is increasing due to the routine examination of serum calcium levels. Primary hyperparathyroidims is most commonly caused by an adenoma or hyperplasia of the parathyroid gland. A cystic parathyroid adenoma is an extremely rare cause of primary hyperparathyroidism. In our case, a-79-year old female presented with lower back pain and constipation. Her serum calcium, phosphate and immunoreactive parathyroid homone levels were 15.6, 1.8mg/dL and 371.8pg/mL, respectively. Neck CT revealed a cystic mass and a contour bulging heterogeneous mass in the left inferior right thyroid gland, respectively. These mass lesions were removed, and the intra-operative parathyroid hormone levels monitored, to confirm the complete resection. After removing the left cystic mass to the inferior thyroid, the serum calcium and immunoreactive parathyroid hormone levels quickly returned to normal. We report a case of primary hyperparathyroidism, caused by a cystic parathyroid adenoma, with a brief review of the literature
Adenoma ; Calcium ; Constipation ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Hyperplasia ; Low Back Pain ; Neck ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Prevalence ; Thyroid Gland

BACKGROUND: Aldosterone antagonists are reported to have beneficial effects on diabetic nephropathy by effective blocking of the renin-angiotensin-aldosterone system. We investigated the renoprotective effect of the selective aldosterone receptor blocker eplerenone, the angiotensin converting enzyme inhibitor lisinopril, and combined eplerenone and lisinopril treatment in type 2 diabetic rats. METHODS: Animals were divided into six groups as follows: Otsuka Long-Evans Tokushima Fatty (OLETF) rat control, OLETF rats treated with a low dose of eplerenone (50 mg/kg/day), OLETF rats treated with a high dose of eplerenone (200 mg/kg/day), OLETF rats treated with lisinopril (10 mg/kg/day), OLETF rats treated with a combination of both drugs (eplerenone 200 mg/kg/day and lisinopril 10 mg/kg/day), and obese non-diabetic Long-Evans Tokushima Otsuka rats for 26 weeks. RESULTS: Urinary albumin excretion was significantly lower in the lisinopril group, but not in the eplerenone group. Urinary albumin excretion was decreased in the combination group than in the lisinopril group. Glomerulosclerosis and renal expression of type I and type IV collagen, plasminogen activator inhibitor-1, transforming growth factor-beta1, connective tissue growth factor, and fibronectin mRNA were markedly decreased in the lisinopril, eplerenone, and combination groups. CONCLUSION: Eplerenone and lisinopril combination showed additional benefits on type 2 diabetic nephropathy compared to monotherapy of each drug.
Aldosterone ; Animals ; Collagen Type IV ; Connective Tissue Growth Factor ; Diabetic Nephropathies ; Fibronectins ; Lisinopril ; Mineralocorticoid Receptor Antagonists ; Peptidyl-Dipeptidase A ; Plasminogen Activators ; Rats ; Rats, Inbred OLETF ; Receptors, Mineralocorticoid ; Renin-Angiotensin System ; RNA, Messenger ; Spironolactone

Osteoporosis in young men is extremely rare. In this report, we demonstrate a rare case of multiple vertebral fractures discovered in a young man with Budd-Chiari syndrome without prior history of trauma. A 29-year-old man was diagnosed as Budd-Chiari syndrome 12 years ago and underwent a mesocaval shunt to relieve the hepatic vein obstruction and was on warfarin therapy. He suffered from low back pain and it was not relieved by analgesics. A T-L spine X-ray revealed multiple compression fractures and the z-score at lumbar spine was -3.7 which is below the expected range for that age. The patient was treated with calcium, vitamin D and bisphosphonate, and showed clinical improvement. This case highlights the importance of the investigation for secondary osteoporosis in young adults with an underlying disease that alters bone metabolism.
Adult ; Analgesics ; Budd-Chiari Syndrome ; Calcium ; Fractures, Compression ; Hepatic Veins ; Humans ; Liver Cirrhosis ; Low Back Pain ; Multiple Endocrine Neoplasia Type 1 ; Osteoporosis ; Spine ; Vitamin D ; Warfarin ; Young Adult

Scanning with whole-body 131I scintigraphy after surgery has been a valuable diagnostic modality in the surveillance of patients with differentiated thyroid cancer. Radioiodine uptake is rarely observed in non-lactating breast tissue, which mimics thyroid cancer metastasis. We now report a case of a 45-year-old female thyroid cancer patient who underwent radioiodine therapy, and in whom breast uptake of radioiodine was observed on a post-therapy whole body scan. Her serum prolactin level was elevated to 328 ng/mL at the time of the radioiodine uptake, and the hyperprolactinemia was induced by her antipsychotic medications. Six months after she discontinued that medication, her serum prolactin level was normalized to 12.6 ng/mL and breast uptake of iodine was no longer present in a follow-up whole body scan.
Antipsychotic Agents ; Breast ; Female ; Follow-Up Studies ; Humans ; Hyperprolactinemia ; Iodine ; Middle Aged ; Neoplasm Metastasis ; Prolactin ; Thyroid Gland ; Thyroid Neoplasms ; Whole Body Imaging