The author experienced a case of autologous platelet-rich plasma (PRP) affecting the recovery of a chronic neuropathic diabetic foot ulcer combined with infection. A 65-year-aged male with uncontrolled diabetes presented with a Wagner grade 2 diabetic foot ulcer on his left forefoot of more than 2 weeks duration. Osteomyelitis, gangrene, and ischemia requiring acute intervention were absent. Although infection was controlled to a moderate degree, wound healing was unsatisfactory following surgical debridement and simple dressing. Therefore, intralesional autologous PRP injection was performed 5 times as an adjuvant regeneration therapy, and the recalcitrant ulcer healed in 3 months. Intralesional PRP injections are worthwhile as they promote wound regeneration, are evidence-based, safe, and can be easily performed in ambulatory care facilities.

Rigid ureteroscopy is new one of established technique for the management of ureteral stones. Manipulation of calculi can be done under direct vision using flexible forceps or stone baskets with increased safety and efficacy. We have used a 5Fr. electrohydraulic lithotripsy to disintegrate stones that were two large to b removed by manipulation. Between May 1988 and October 1989. 140 ureteroscopies were performed for removal of ureteral stones. In 119 cases(85 %) the stone was removed successfully. Electrohydraulic lithotripsy was used successfully to remove the stone in 25 among 28 cases(89.3%). We conclude that ureteroscopic removal of ureteral stone under direct vision is a safe and effective method for treatment of ureteral stone.
Calculi ; Lithotripsy* ; Surgical Instruments ; Ureter* ; Ureteral Calculi* ; Ureteroscopy

Objectives: In this study, we conducted an exploratory analysis of the current media trends on schizophrenia using text-mining methods. Methods: First, web-crawling techniques extracted text data from 575 news articles in10 major newspapers between 2018 and 2019, which were selected by searching “schizophrenia” in the Naver News. We had developed document-term matrix (DTM) and/or term-document matrix (TDM) through pre-processing techniques. Through the use of DTM and TDM, frequency analysis, cooccurrence network analysis, and topic model analysis were conducted. Results: Frequency analysis showed that keywords such as “police,” “mental illness,” “admission,” “patient,” “crime,” “apartment,” “lethal weapon,” “treatment,” “Jinju,” and “residents” were frequently mentioned in news articles on schizophrenia. Within the article text, many of these keywords were highly correlated with the term “schizophrenia” and were also interconnected with each other in the co-occurrence network. The latent Dirichlet allocation model presented 10 topics comprising a combination of keywords: “police-Jinju,” “hospital-admission,” “research-finding,” “care-center,” “schizophrenia-symptom,” “society-issue,” “family-mind,” “woman-school,” and “disabled-facilities.” Conclusion The results of the present study highlight that in recent years, the media has been reporting violence in patients with schizophrenia, thereby raising an important issue of hospitalization and community management of patients with schizophrenia.

BACKGROUND AND PURPOSE: Chronic simulated snoring was induced in rabbits to determine the impact of snoring on the development of atherosclerosis. METHODS: The pressure wave of induced snoring at the carotid bifurcation of rabbits was acquired by gently pressing the airway. This wave was then simulated using custom-made mechanical devices. Twelve rabbits were used in this study, seven of which were assigned to the experimental group and the remaining five formed the control group. All of the rabbits were raised on a 1% high-cholesterol diet. Either working or sham devices were positioned at the ventral center of the neck in each rabbit. At the end of a 2-month observation period, all of the rabbits were sacrificed by perfusion fixation, the carotid arteries harvested, and the carotid atherosclerosis histology reviewed. RESULTS: All of the rabbits survived to the end of the experimental period. Blood sampling revealed the presence of hypercholesterolemia in both groups, with no significant difference between them. The presence and degree of atherosclerosis did not differ significantly between the groups. CONCLUSIONS: The findings of this study show the feasibility of making a chronic simulated snoring rabbit model. However, the causative role of snoring in carotid atherosclerosis was not detected in this animal study.
Animals ; Atherosclerosis ; Carotid Arteries ; Carotid Artery Diseases* ; Diet ; Hypercholesterolemia ; Neck ; Perfusion ; Rabbits* ; Snoring*

BACKGROUND: The rapid emergence of multi-drug resistant pneumococcal strains has heightened the importance of reliable and convenient susceptibility testing methods. The newly-developed VITEK-2 (bioMerieux, Inc., Hazelwood, MO, USA) System includes the capability of performing rapid susceptibility testing of Streptococcus pneumoniae using specially configured cards. The objective of this study is to evaluate the performance of the VITEK-2 System for susceptibility testing of S. pneumoniae. METHODS: One hundred clinical strains of S. pneumoniae (18 penicillin susceptible strains, 32 intermediate strains, and 50 resistant strains) were tested, which had been isolated in Samsung Medical Center. Minimum inhibitory concentrations (MICs) for penicillin, cefotaxime, erythromycin, ofloxacin, chloramphenicol, tetracyclin, and vancomycin were determined by broth dilution method and VITEK-2 System using AST-P506 cards. The results obtained by VITEK-2 System were compared to those obtained by broth dilution method. RESULTS: Overall agreement of MICs determined by two methods was 93.0% within the range of one dilution. The best agreement was achieved with vancomycin (100%), and in descending order, 99% with ofloxacin, 97% with erythromycin, 94% with chloramphenicol, 89% with cefotaxime, 88% with tetracycline, and 85% with penicillin. There were 1.9% of very major error, 2.0% of major error, and 8.6% of minor error. The mean time for generation of susceptibility results was 9.6 hours. CONCLUSIONS: VITEK-2 System provided rapid and reliable determinations of susceptibility category for most antibiotics and would be helpful as a substitution of existing MIC methods.
Anti-Bacterial Agents ; Cefotaxime ; Chloramphenicol ; Erythromycin ; Microbial Sensitivity Tests ; Ofloxacin ; Penicillins ; Pneumonia ; Streptococcus pneumoniae* ; Streptococcus* ; Tetracycline ; Vancomycin

Cerebral metastses secondary to primary epithelial ovarian carcinoma are unusual. The incidence was estimated under 1%, but some authors reported higher incidence than previously reported data. Recently, we experienced a case of cerebral metastasis secondary to primary epithelial ovarian cancer. We present this case with review of brief related literatures.
Drug Therapy* ; Incidence ; Neoplasm Metastasis ; Ovarian Neoplasms

PURPOSE: Paranasal sinusitis, easily overlooked owing to it's benign symptomatology, should be considered when the upper respiratory tract infction persists longer than seven days. Without early recognition and appropriate management, the disease will take a chronic course and the incidence of complications will be increased. The significance of paranasal sinusitis among Korean children has not appropriately been appreciated; therefore, a clinical study was under-taken to help understand clinical characteristics of paranasal sinusitis in Korean children. METHODS: One hundred sixty five(34.3%), out of 481 patients with no underlying disease seen at the outpatient division of the department of pediatrics, Hanyang university hospital from April 1992 to August 1993, were diagnosed of maxillary sinusitis and included in the study to investigate age and sex distributions, clinical manifestations, radiographic findings, and response to antibiotics therapy. Five patients followed up for less thant two weeks and 45 patients lost in follow up within 3 weeks were excluded in the evaluation of therapeutic response, which were done on the basis of clinical and radiographical analysis. RESULTS: 1) Maxillary sinusitis occurred frequently in young children; among 165 patients, 129 patients(78.3%) were wunder 5 years of age, with 83 patients(50.4%) younger than 3 years of age. The male to female ratio was 1.4:1. 2) One hundred twently three patients(74.5%) had acute sinusitis, 39 patients(23.7%) subacute sinusitis, and 3 patients(1.8%) chronic sinusitis. The most common clinical symptom was cough in 124 patients(75.2%), followed by nasal discharge in 103 patients(62.4%), nasal obstruction in 76 patients(46.1%), and fever in 49 patients(29.7%). The physical finding most commonly observed was postnasal drip in 35 patients(21.2%), followed by otitis media in 21 patients(12.7%), and throat injection in 19 patients(11.5%); however, physical examination was not contributory in 77 patients(46.7%). 3) Radiographic findings on Water's view illustrated opacification in 98 patients(59.4%), mucoperiosteal thickening in 82 patients(49.7%), and air-fluid level in 4 patients(2.4%). Bi-lateral radiographic involvement was 4 times more common than unilateral one. 4) The patients with maxillary sinusitis were trated with amoxicillin(AMX), trimethoprim-sulfamethoxazole(TMP-SMZ)+/-erythromycin(EM), amoxicillin-clavulanate(AMX-CLV) or cefaclor(CCL) in sequence depending on the therapeutic response to each antibiotics. The therapeutic outcome with each antibiotics was 16.3%(15/92) with AMX, 56.7%(51/90) with TMP-SMZ, 70.6%(24/34) with AMX-CLV or CCL. Among 115 patients who have been followed up longer than 3 weeks , 90 patients(78.3%) improved clinically and/or radiographically. Among 90 patients with improvement, 32 patients(35.5%) showed clinical and/or radiographical responses in less than 3 weeks of treatment with effective antibiotics, however 19 patients(21.2%) needed to be treated for longer than 7 weeks. CONCLUSIONS: The data indicated that paranasal sinusitis is a common disease among Korean children, especially in very young ones. Once antibiotic therapy had begun, the follow-up were not infrequently interrupted. The therapeutic response to antibiotics, recommended currently for therapy of paranasal sinusitis, were not good.
Anti-Bacterial Agents ; Child* ; Cough ; Female ; Fever ; Follow-Up Studies ; Humans ; Incidence ; Male ; Maxillary Sinus* ; Maxillary Sinusitis* ; Nasal Obstruction ; Otitis Media ; Outpatients ; Pediatrics ; Pharynx ; Physical Examination ; Respiratory System ; Sex Distribution ; Sinusitis

Twenty-one cases of seminoma (including testicular seminoma, ovarian dysgerminoma and extragonadal germinoma) were reviewed for the cell types responsible for the production of alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). Histologically the cases included seventeen classical seminomas and 4 anaplastic seminomas. The latter had some mononuclear and multinuclear giant cells. All 4 patients with anaplastic seminoma had elevated levels of serum AFP, and each of these cases contained AFP producing tumor cells identified by immunoperoxidase staining. All seminomas of patients with elevated serum levels of HCG were of the classical type but HCG producing tumor cells could not be identified by immunoperoxidase staining. Immunoreactivity to anti-AFP was found in some large mononuclear cells and anaplastic cells. To explain these results, we propose that the large mononuclear cell is a multipotential cell capable of differentiating into a germ cell, yolk sac and embryo, and that the anaplastic seminoma cells might represent a stage on the continuum of cellular differentiation from the large mononuclear cells to germ cells. The multinuclear giant cell does not appear to be essential for the production of either AFP or HCG in seminoma.
Adolescent ; Adult ; Child ; Chorionic Gonadotropin/metabolism ; Dysgerminoma/metabolism/*pathology ; Female ; Human ; Immunohistochemistry ; Male ; Middle Age ; Ovarian Neoplasms/metabolism/pathology ; Support, Non-U.S. Gov't ; Testicular Neoplasms/metabolism/pathology ; alpha-Fetoproteins/biosynthesis

PURPOSE: This study was done to provide information on issues of nursing core competencies needed in the fields of nursing practice for graduates in nursing, from the perspective of nursing managers, and to make suggestion for improving nursing education programs. METHODS: Ten nursing managers participated in this study. They were in charge of clinical nursing education in the fields of nursing practice. Data were collected using focus group interviews and analyzed with the content analysis methodology of Downe - Wamboldt's. RESULTS: Six types of nursing core competency - therapeutic nursing competency, professional nursing competency, administrative nursing competency, humanistic nursing competency, relational nursing competency, and personal nursing competency - were identified as nursing core competencies needed in the fields of nursing practice for graduates in nursing. CONCLUSION: Results of the study show important evidence for decision-making about nursing curriculum revision based on nursing core competency, both in the classroom and in nursing practice areas. These results should contribute to the development of evaluation indicators for nursing students or new nurses. Further research is required to measure degree of nursing core competency in graduates of nursing and to identify the effect of competency-based education for improving nursing core competency.
Competency-Based Education ; Curriculum ; Education, Nursing ; Fees and Charges ; Focus Groups ; Humans ; Professional Competence ; Students, Nursing

PURPOSE: Chlamydia trachomatis (C. trachomatis) is a well known cause of non-gonococcal urethritis (NGU). No other microorganism has been shown to cause any larger proportion of the remaining NGU cases. As a possible causative organism of NGU, we wanted to evaluate the detection rate of Mycoplasma genitalium (M. genitalium) and its role in NGU using polymerase chain reaction (PCR). MATERIALS AND METHDS: From June 1998 to July 2000, we examined a total of 116 men. Of these men 70 had symptoms and signs compatible with urethritis and 46 were for normal control. In the patient group, two urethral discharge or swab specimens were collected. One was used for Gram stain to detect Gram negative intracellular diplocci. The other was subjected to PCR for C. trachomatis and M. genitalium. In the control group, urethral swab specimen was used to detect C. trachomatis and M. genitalium by PCR based assay. RESULTS: Gonococcal urethritis (GU) was diagnosed in 14 cases (20.0%). Detection rates of M. genitalium and C. trachomatis in urethritis group were 8.6% (6/70), 18.6% (13/70). M. genitalium and C. trachomatis were detected in 7.1% (1/14), 14.3% (2/14) of GU and 8.9% (5/56), 19.6% (11/56) of NGU. Detection rate of M. genitalium in chlamydia-negative NGU was 11.1% (5/45). No patient positive for M. genitalium had a simultaneous chlamydia infection. In control group with no urethral symptom or sign, M. genitalium and C. trachomatis were not detected at all. Compared with chlamydia- positive NGU, M. genitalium-positive urethritis exhibited higher recurrence rate. CONCLUSIONS: M. genitalium was detected in 8.9% of NGU and 11.1% of non-chlamydia NGU. This study suggests that M. genitalium may be one of the causative organisms in NGU. Further studies will be necessary to define its role in NGU.
Chlamydia Infections ; Chlamydia trachomatis ; Humans ; Male ; Mycoplasma genitalium* ; Mycoplasma* ; Polymerase Chain Reaction ; Recurrence ; Urethritis*