Acute interstitial pneumonia is a fulminant disease of unknown etiology that usually occurs in a previously healthy person and produces the histologic findings of the organizing phase of diffuse alveolar damage. We experienced an autopsy case of acute interstitial pneumonia of unknown etiology. The patient was a 48 year old man who had been healthy and had not been exposed to organic dusts or other toxic materials. The chief complaints represented were dyspnea and a dry cough for several weeks before hospitalization, and the chest radiographs showed bilateral interstitial infiltrates. Patchy consolidation of air space was also identified and ground-glass attenuation similar to those described in ARDS was detected on high-resolution computed tomography. Steroid pulse therapy, mechanical ventilation, and antibiotics for superimposed bacterial infection were performed, but the symptoms did not improve and the patient died of generalized respiratory insufficiency and severe hypoxemia 2 1/2 months after hospitalization. At autopsy the macroscopic and microscopic findings were confined mainly to the lungs. On the whole, both lungs were firm in consistency and the external surface showed a cobblestone appearance. The cut surface showed almost complete replacement of the normal lung parenchyma with gray to yellow fibrous tissue with a little residual functional area remaining. The pathology of both open lung biopsy and autopsy tissue showed marked hyperplasia of type II pneumocytes, hyaline membrane formation, thickening of the alveolar wall due to extensive fibroblast proliferation, and relatively abundant young collagen deposition in the interstitium. An immunohistochemical stain for cytokeratin revealed epithelial hyperplasia and showed that the alveolar spaces were markedly shrunken by fibrous tissue.
Anoxia ; Anti-Bacterial Agents ; Autopsy* ; Bacterial Infections ; Biopsy ; Collagen ; Cough ; Dust ; Dyspnea ; Fibroblasts ; Hospitalization ; Humans ; Hyalin ; Hyperplasia ; Keratins ; Lung ; Lung Diseases, Interstitial* ; Membranes ; Middle Aged ; Pathology ; Pneumocytes ; Pulmonary Fibrosis ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Insufficiency

PURPOSE: The aim of the present study is to detect cagA and vacA genes of Helicobacter pylori(H. pylori) strain in gastric biopsy specimens and to evaluate its association with gastric inflammation in children. METHODS: The cagA and vacA genes were detected by a direct polymerase chain reaction(PCR) assay of gastric biopsy specimens in 22 patients who were found to be H. pylori positive by histological detection with modified Giemsa stain, rapid urease test(CLO; Delta West Pty Ltd, Australia) and PCR using ureC primer in gastric biopsy specimens. RESULTS: The cagA gene was detected in 16(72.7%) of 22 patients. Eleven patients(50%) had both the cagA and vacA gene. Five patients had only the vacA gene. Twenty one patients(95.5%) had the cagA or vacA gene. The cagA gene was detected in 66.7% of gastritis and in 87.5% of peptic ulcer patients. The association of the cagA gene with peptic ulcer or the higher degree of inflammation did not reach statistical significance. The histological H. pylori density of antrum was significantly correlated with gastric inflammation(P<0.05). CONCLUSION: These findings suggest that the antral density of H. pylori was associated with the gastric inflammation. The association of the cagA gene with peptic ulcer or the higher degree of imflammation was not significant.
Azure Stains ; Biopsy* ; Child* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Inflammation* ; Peptic Ulcer ; Polymerase Chain Reaction* ; Urease

PURPOSE: The aim of this study was to evaluate the usefulness of PCR using ureC primer in the gastric biopsy specimens for the diagnosis of Helicobacter pylori (H. pylori) infection in children. METHODS: We have assessed prospectively 82 patients (age range 1-15 years) who underwent esophagogastroduodenoscopy (Olympus EVIS XQ 200 or p230, Japan) for 15 months. At least three biopsy specimens were taken from the antral mucosa within 2cm of the pylorus. We performed histological detection with modified Giemsa stain, CLO test (Delta West Pty Ltd, Australia) for rapid urease test and PCR using ureC primer. H. pylori positivity was defined as the concordance of two tests. The patients with only one positive test were defined as undetermined cases. RESULTS: Seventeen of the 82 patients were H. pylori positive and 52 patients were H. pylori negative by definition. Of the 17 patients, 15 were found to be positive by all three tests, 2 were found to be positive by two tests. Abnormal endoscopic findings in H. pylori positive patients (82.4%) was significantly higher than H. pylori negative patients (50.0%) (P<0.05). Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and efficiency of PCR in gastric biopsy specimens were 94.1%, 100%, 100%, 98.1%, 98.7% and same as CLO test, respectively. Those of endoscopic nodularity was 58.8%, 100%, 100%, 88.1% 89.9%. CONCLUSION: These findings suggest the PCR assay using the ureC gene in gastric biopsy specimens is sensitive and rapid for the diagnosis of H. pylori infection in children. But, in this study diagnostic sensitivity and specificity of PCR assay were the same as the CLO test.
Azure Stains ; Biopsy* ; Child* ; Diagnosis* ; Endoscopy, Digestive System ; Helicobacter pylori* ; Helicobacter* ; Humans ; Mucous Membrane ; Polymerase Chain Reaction* ; Prospective Studies ; Pylorus ; Sensitivity and Specificity ; Urease

PURPOSE: The aim of this study was to evaluate the usefulness of PCR using ureC primer in the gastric biopsy specimens for the diagnosis of Helicobacter pylori (H. pylori) infection in children. METHODS: We have assessed prospectively 82 patients (age range 1-15 years) who underwent esophagogastroduodenoscopy (Olympus EVIS XQ 200 or p230, Japan) for 15 months. At least three biopsy specimens were taken from the antral mucosa within 2cm of the pylorus. We performed histological detection with modified Giemsa stain, CLO test (Delta West Pty Ltd, Australia) for rapid urease test and PCR using ureC primer. H. pylori positivity was defined as the concordance of two tests. The patients with only one positive test were defined as undetermined cases. RESULTS: Seventeen of the 82 patients were H. pylori positive and 52 patients were H. pylori negative by definition. Of the 17 patients, 15 were found to be positive by all three tests, 2 were found to be positive by two tests. Abnormal endoscopic findings in H. pylori positive patients (82.4%) was significantly higher than H. pylori negative patients (50.0%) (P<0.05). Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and efficiency of PCR in gastric biopsy specimens were 94.1%, 100%, 100%, 98.1%, 98.7% and same as CLO test, respectively. Those of endoscopic nodularity was 58.8%, 100%, 100%, 88.1% 89.9%. CONCLUSION: These findings suggest the PCR assay using the ureC gene in gastric biopsy specimens is sensitive and rapid for the diagnosis of H. pylori infection in children. But, in this study diagnostic sensitivity and specificity of PCR assay were the same as the CLO test.
Azure Stains ; Biopsy* ; Child* ; Diagnosis* ; Endoscopy, Digestive System ; Helicobacter pylori* ; Helicobacter* ; Humans ; Mucous Membrane ; Polymerase Chain Reaction* ; Prospective Studies ; Pylorus ; Sensitivity and Specificity ; Urease

OBJECTIVE: To evaluate the relationship between postoperative sensory change on lower extremities and clinical factors associated with gynecologic operation. METHODS: We retrospectively reviewed 38 cases of patients with postoperative complaints of pain or dysthesis on lower extremities, especially anterolateral thigh from March 1993 through December 1999 at Gyeongsang National University Hospital, Department of Obstetrics and Gynecology. The electromyography (EMG) and nerve conduction velocity (NCV) were performed in all 38 patients. According to the result of EMG and NCV, patients were divided into control group (n=28) which in that with normal finding in electrodiagnosis and study group (n=10) who showed femoral cutaneous nerve injury in electrodiagnosis. Clinical characteristics (age, height, weight and operative history), operative methods, skin incisional method, operative time and postoperative diagnosis were reviewed in each group. RESULTS: There were significant differences in patient's body weight, height, skin incisional method and operative method between control and study group. Height was 152.5cm [150.3-155.6] in study group and 157.5cm [153.4-159.2] in control group (p-value = 0.020). Weight was 46.9kg [43.4-58.0] in study group and 57.0kg [54.4-58.1] in control group (p-value=0.004). Skin incisional method in study group was done by 6 cases (60%) of infraumbilical mid-line vertical incision and in control group by 5 cases (17.9%) (p-value = 0.019). In operative method, radical hysterectomy was 4 cases (40%) in study group and 2 cases (7.1%) in control group (p-value=0.031). But no correlation was observed in post-operative diagnosis, operative time, blood loss and transfusion between two groups. CONCLUSION: It was suggested that Lateral femoral cutaneous nerve was compressed by pelvic retractor during the gynecologic operation. Patient's body weight, height, skin incisional method and operative method may play a role of compressive factor on Lateral femoral cutaneous nerve, increasing Meralgia Paresthetica.
Body Weight ; Diagnosis ; Electrodiagnosis ; Electromyography ; Gynecology ; Humans ; Hysterectomy ; Lower Extremity ; Neural Conduction ; Obstetrics ; Operative Time ; Retrospective Studies ; Skin ; Thigh

Hepatitis A can cause serious illness among adolescents and adults with low vaccination coverage. Even though hepatitis A vaccine is one of the strong candidates for Korean national immunization program, adolescents aged older than 12 yr would not benefit. Our purpose was to assess the willingness and analyze the correlates of Korean mothers for hepatitis A (HepA) vaccination to develop strategies for HepA vaccination. A national telephone survey on 800 mothers with children aged 7-18 yr was conducted with random-digit dialing method. Sixty-two percent and 92% of the mothers reported that they were willing to HepA vaccination at current cost and at half of the current cost, respectively. However, at current cost, only 79% wished to vaccinate their child in an epidemic and 32% wished to vaccinate promptly. Having two or more children, not having future plans to send the child overseas, and low family income were significantly associated with not willing to HepA vaccination. Low perception of the susceptibility for hepatitis A and perception of the current cost as barrier increased the odds of unwillingness to vaccination at current cost and to prompt vaccination. The mothers' willingness to HepA vaccination for the children aged 7-18 yr in Korea was not very high at current cost and associated socioeconomic status and health-belief. Targeted intervention or strategies are needed to increase the HepA vaccination rate among children in Korea.
Adolescent ; Adult ; Child ; Demography ; Female ; Health Status ; Health Surveys ; Hepatitis A/economics/*prevention & control ; Hepatitis A Vaccines/economics/*immunology ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Mothers/psychology ; Republic of Korea ; Social Class ; *Vaccination

No abstract available.
Megacolon* ; Pregnancy*

OBJECTIVE: HL7(Health Level 7) develops standards for the representation of clinical documents like discharge and consultation notes. The goal of the present study is to develop XML(eXtensible Markup Language)-based communication standard for discharge note. METHODS: This paper presents the use of XML for electronic communication in a document-based EMR, first, as a format for the exchange of structured message, and second, as a comprehensible way to represent patient document. A retrospective analysis of 1165 discharge notes, from the department Seoul National University Hospital, were extracted by querying OCS(Order Communication System) and taking every discharge note of main disease issued over one year period (2003.01.01~2003.12.31). RESULTS: An XML-based prototype for discharge note has been put into place representing the required "section" and "specific instance". In addition, a subset of the CDA(Clinical Document Architecture) Level One details has been described and integrated. CONCLUSION: Through the introduction of definitions for sections and specific instances, progress in the development of CDA Level Two and Three might be realized. An XML-based prototype was implemented, allowing a special view on XML data to generate this document type.
Electronic Health Records ; Health Level Seven ; Humans ; Retrospective Studies ; Seoul

PURPOSE: Although the overall incidence of hepatitis A in Korea has been decreasing recently, the adolescents born before the introduction of the hepatitis A vaccine remain to be highly vulnerable to outbreak. This study examines the unvaccinated adolescents' and their parents' knowledge and health beliefs toward hepatitis A vaccination. METHODS: Healthy adolescents aged 13-19 years old who had no previous history of hepatitis A vaccine and hepatitis A infection, and their parents or legal guardians were the subjects of the study. The survey was conducted using a structured questionnaire based on the Health Belief Model, and examined the subjects' demographics, knowledge, and health beliefs (i.e., perceived susceptibility, severity, benefits, and barriers). RESULTS: We included 157 adolescents and their parents/guardians (mean age: 16.0+/-1.6 and 45.6+/-4.7 years, respectively). The average knowledge item score for adolescents and parents was 6.4+/-3.7 and 7.3+/-3.4 (out of 18), respectively. Similarly, average Health Belief Model item scores were: susceptibility, 5.6+/-1.6 and 5.9+/-1.7 (range: 2-10); severity, 16.3+/-4.1 and 18.3+/-3.6 (range:5-25); benefits, 19.7+/-3.3 and 20.6+/-2.1 (range:5-25); and barriers, 41.3+/-8.9 and 39.0+/-9.1 (range:7-85). The major reason for not undergoing hepatitis A vaccination was lack of knowledge about its importance. CONCLUSIONS: Refresher health lectures about hepatitis A and the vaccine are needed by both the adolescents and their parents. Furthermore, the inclusion of hepatitis A vaccine in the national immunization program should be considered to reduce the risk of hepatitis A outbreak and to raise the vaccination coverage among the adolescents in Korea.
Adolescent ; Demography ; Hepatitis A Vaccines ; Hepatitis A* ; Hepatitis* ; Humans ; Immunization Programs ; Incidence ; Korea ; Lectures ; Legal Guardians ; Parents* ; Surveys and Questionnaires ; Vaccination*

OBJECTIVES: The incidence and survival rate of colorectal cancer in Korea are increasing because of improved screening, treatment technologies, and lifestyle changes. In this aging population, increases in economic cost result. This study was conducted to estimate the economic burden of colorectal cancer utilizing claims data from the Health Insurance Review and Assessment Service. METHODS: Economic burdens of colorectal cancer were estimated using prevalence data and patients were defined as those who received ambulatory treatment from medical institutions or who had been hospitalized due to colorectal cancer under the International Classification of Disease 10th revision codes from C18-C21. The economic burdens of colorectal cancer were calculated as direct costs and indirect costs. RESULTS: The prevalence rate (per 100 000 people) of those who were treated for colorectal cancer during 2010 was 165.48. The economic burdens of colorectal cancer in 2010 were 3 trillion and 100 billion Korean won (KRW), respectively. Direct costs included 1 trillion and 960 billion KRW (62.85%), respectively and indirect costs were 1 trillion and 160 billion (37.15%), respectively. CONCLUSIONS: Colorectal cancer has a large economic burden. Efforts should be made to reduce the economic burden of the disease through primary and secondary prevention.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Colorectal Neoplasms/*economics/epidemiology ; *Cost of Illness ; Female ; Health Care Costs ; Health Expenditures ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prevalence ; Republic of Korea ; Young Adult