No abstract available.
Aeromonas*

PURPOSE: This study was conducted to compare the levels of pain intensity and pain relief between cancer patients and nursing records, and to compare the barriers to pain control between cancer patients and their nurses. METHODS: Data were collected from 90 cancer patients who were admitted to three oncology wards and 90 oncology nurses in the same three wards at C University Hospital in G City from July to September, 2012. RESULTS: The most severe pain intensity reported by cancer patients was 6.59 points on the first day of analgesic treatment, while that of their nursing records was 3.98 points on the first day. There were significant changes in pain intensity over time between two groups (F=142.07, p<.001). The highest level of pain relief reported by patients was 2.87 points on the third day, while that of nursing records was 1.67 points on the first day. The score for the social system area of barriers to pain control among the nurses was higher than that of cancer patients (t=-3.69, p=.021). CONCLUSION: Nurses need to frequently check and to be sensitive to cancer pain. Furthermore, the administrative procedures of narcotic analgesics need to be simplified.
Comprehension ; Humans ; Narcotics ; Nursing Records

A 6-day-old female infant had generalized superficial pustules which evolved into pigmented maucles, many of which had a peripheral collarvtte of scale. Histopsthologic stadies showed intracormeal aggregates of neutrophils. The appearance of the lesions and histopathologic finding fitted transient neonal pustular melanosis.
Female ; Humans ; Infant ; Melanosis* ; Neutrophils

No abstract available.
Immunotherapy ; Melanoma*

The medical fitness of pilots is part of the civil aviation safety scenery. This study aimed to analyze the health problems occurring among Korean commercial pilots. Three data sources were used to identify the health problems: 7,574 aviation medical examination data, 5,400 sick leaves and 39 cases of a decrease in medical fitness during flight duty period and layover of Korean commercial pilots who have been working for K airline from Jan. 1, 2016 to Dec. 31, 2018. This study was retrospectively analyzed using SPSS 22 statistical program. Waiver of medical certificates was an average 11.9% of total issuance for 3 years, with a denial of 0.1%. The leading cause of denial of medical certificates was predominantly of cardiovascular cause (55.6%). Mild respiratory and digestive disease accounted for 82% of total sick prevalence and 68% of total sick days. The psychiatric and cardiovascular disease were ranked high according to the number of days lost per case. The most common cause of decrease in medical fitness during flight duty period was acute abdominal pain (36.4%) and musculoskeletal disorder (40%) when staying abroad. Aeromedical emphasis on minimizing cardiovascular risk remains appropriate. Major pilot health problems identified in this study should be considered in establishing pilot health promotion programs for aviation safety.

As the mitral valve disease becomes long-standing, the patient may develop pulmonary hypertension. It was reported that after surgical correction, the elevated pulmonary vascular resistance(PVR) would fall quickly in association with the fall in left atrial pressure(LAP). This study was performed to evaluate the changes in mean pulmonary artery pressure(PAP) and PVR immediately after mitral valve replacement(MVR). Fifty six patients undergoing mitral valve replacement(MVR) were divided into two groups on the basis of the presence or absence of significant pulmonary hypertension, defined as a resting mean pulmonary arterial pressure greater than 30mmHg. After induction of anesthesia, PAP, PVR, cardiac output(CO) were measured and compared with values in postbypass period. PAP and PVR were significantly decreased(PAP from 39.64+/-1.88 to 29.18+/-1.65 mmHg, P 0.001, PVR from 6.16+/-1.14 to 3.53+/-0.62 units, P<0.05) in Group II(PAP> or = 30mmHg, n=23), whereas not changed in Group I(PAP30 mmHg, n=33)(P<0.05). Persistance of an elevated PVR may cause right ventricular failure and low-output syndrome, so that an attempt to reduce the PVR is needed postoperatiavely. This study demonstrated that the PAP and PVR fall significantly after MVR especially in patients with severe pulmonary hypertension.
Anesthesia ; Arterial Pressure* ; Humans ; Hypertension, Pulmonary ; Mitral Valve* ; Pulmonary Artery ; Vascular Resistance*

The CT findings and their differential points were evaluated by reviewing the CT scans of 47 patients with destructive lesions of vertebral bodies which included tuberculous spondylitis(23), pyogenic infection(9), syphilitic spondylitis(1) and malignant lesions(14). Twenty-one(91.3%) of 23 patients with tuberculous spondylitis showed mixed osteolytic and osteosclerotic patterns of bony destruction. Six(66.7%) of 9 patients with pyogenic infection and 10(71.4%) of 14 malignant lesions showed osteolytic pattern of bony destruction. Thirty(90.9%) of 33 infections lesions including pyogenic infection and tuberculous spondylitis involved intervertebral disc, while the involvement of intervertebral disc was not found in malignant lesions. The Swisscheese appearance of bony destruction was commonly seen in tuberculous spondylitis, but pyogenic infections and malignant lesions more commonly revealed geographic or moth-eaten appearance. The sequestral pattern and sclerotic rims in and around bony destruction were mainly seen in tuberculous spondylitis, and they were thought to be specific findings in tuberculous spondylitis. CT of the spine appears to offer the detailed findings of vertebral body destruction and may be a useful adjunct in differentiation between tuberculous spondylitis, pyogenic infections and malignant lesions of the spine.
Diagnosis, Differential* ; Humans ; Inflammation* ; Intervertebral Disc ; Spine ; Spondylitis ; Tomography, X-Ray Computed

Background: and Purpose: Ventricle enlargement has been implicated in the pathophysiology of Alzheimer’s disease (AD). We studied the relationship between ventricular size and cognitive function in patients with AD. We focused on the effect of the initial ventricle size on the rate of cognitive decline in patients with AD. Methods: A retrospective analysis of probable clinical AD participants with more than 2 magnetic resonance imaging images was performed. To measure ventricle size, we used visual rating scales of (1) Cardiovascular Health Study (CHS) score and (2) conventional linear measurement method. Results: Increased clinical dementia rating (CDR) was correlated with a decreased MiniMental Status Examination (MMSE) score, and increased medial temporal lobe atrophy (MTLA) and global ventricle size (p<0.001, p<0.001, p=0.021, respectively). There was a significant correlation between the change in cognitive function in the group (70%–100%ile) with a large initial ventricle size (p=0.021 for ΔCDR, p=0.01 for ΔMMSE), while the median ventricle size (30%–70%ile) showed correlation with other brain structural changes (MTLA, frontal atrophy [FA], and white matter) (p=0.036 for initial MTLA, p=0.034 for FA). Conclusions In this study, the initial ventricle size may be a potential new imaging biomarker for initial cognitive function and clinical progression in AD. We found a relationship between the initial ventricle size and initial AD-related brain structural biomarkers.

It has been suggested that cortisol deficiency may be responsible for the cholestasis. Although congenital hypopituitarism was reported as a possible cause of neonatal cholestasis, congenital adrenal hyperplasia with neonatal cholestasis is a very rare report in the literature. We experienced a case presenting with neonatal cholestasis associated with congenital adrenal hyperplasia. This case provides a clinical evidence supporting the notion that cortisol has an important physiological role in bile acid synthesis and transport.
Adrenal Hyperplasia, Congenital* ; Bile ; Cholestasis* ; Hydrocortisone ; Hypopituitarism

PURPOSE: The aim of this study was to identify the clinical features and natural history of dietary protein induced proctocolitis (DPIPC) and to detect the causative foods of DPIPC, and to evaluate the effect of elimination of the foods on the course of the disease. METHODS: Between March 2003 and July 2004, data from 30 consecutive patients with DPIPC who were followed for over 6 months, was reviewed. The diagnostic criterion used for DPIPC was an increase in the number of eosinophils in the lamina propria (> or =60 per 10 high-power fields). In breast feeding mothers, 5 highly allergenic foods were eliminated from the maternal diet for 7 days, namely, allergenic food groups such as dairy products, eggs, nuts and soybean, fish and shellfish, and wheat and buckwheat. We observed the disappearance or appearance of hematochezia after elimination or challenge with the offending foods. RESULTS: Before diagnosis infants were breast-fed (93.3%) or formula-fed (6.7%). Mean age at symptom onset was 11.5+/-5.1 (5~24) weeks, and mean age at diagnosis was 17.8+/-9.5 (8~56) weeks. Duration from symptom onset to diagnosis was 6.3+/-6.7 (0~36) weeks. Mean peripheral blood eosinophil count was 478+/-320 (40~1,790)/mm3 and eosinophilia (>250/mm3) was observedin 90.0% of patients. None of patients were found to have an increased serum IgE level. Of 15 patients that received sigmoidoscopy, nodular hyperplasia with erosion was observed in 93.3%. Of 27 patients whose mother ate the diet eliminated the 5 food groups, hematochezia diappeared in 74.1% of patients. Offending foods were identified as dairy products (37.5%), wheat and buckwheat (27.5%), fish and shellfish (20.0%), nuts and soybean (7.5%) and eggs (7.5%). A free maternal diet without patient's clinical symptoms was achieved at 29.4+/-8.7 (9~44) weeks of patient's age, and a free baby diet without blood in stools was achieved at 37.5+/-9.7 (12~56) weeks of age. CONCLUSION: DPIPC commonly occurs in exclusively breast-fed babies. Elimination of the above-mentioned 5 hyper-allergenic food groups from the maternal diet for 7days enables the detection of the offending foods. DPIPC is a transient disorder and 96.0% of patients can tolerate the offending foods at 12 months of age.
Breast Feeding ; Dairy Products ; Diagnosis ; Diet* ; Dietary Proteins* ; Eggs ; Eosinophilia ; Eosinophils ; Fagopyrum ; Gastrointestinal Hemorrhage ; Humans ; Hyperplasia ; Immunoglobulin E ; Infant ; Mothers ; Mucous Membrane ; Natural History* ; Nuts ; Ovum ; Proctocolitis* ; Shellfish ; Sigmoidoscopy ; Soybeans ; Triticum