Early CT findings of transient radiographic progression (TRP) during treatment of active pulmonary tuberculosis including subpleural, interlobular or intralobular septal thickening and micronodules are shown in the present case. Late CT findings of TRP are subpleural, enhancing nodular infiltration with internal low attenuation. These CT features accompanied by a lack of clinical worsening in young patients taking antituberculous medication due to pulmonary tuberculosis can help to differentiate TRP from other disease entities.
Humans ; Lung ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: The purpose of this study is to evaluate the therapeutic efficacy, on the basis of CT findings, of high dose methyl prednisolone for treating acute lung injury that was induced by oleic acid injection. MATERIALS AND METHODS: A total of 30 healthy rabbits (1.8-2.2 kg) were included in this study. Group I included 10 rabbits in which 0.2 mL oleic acid was injected through their ear veins. Group IIa included 10 rabbits in which 30 mg/kg methyl prednisolone and 0.2 mL oleic acid were intravenously injected at the same time. Group IIb included 5 rabbits in which 30 mg/kg methyl prednisolone was injected 6 hours prior to the 0.2 mL oleic acid intravenous injection. The other 5 rabbits (Group III) were injected intravenously with 30 mg/kg methyl prednisolone without the oleic acid. After that, 30 mg/kg methyl prednisolone per every 12 hours was injected in the non-sacrificed rabbits of Group II and Group III. Nonenhanced Chest CT scans were performed prior to and 30 minutes, 4 hours, 24 hours, 48 hours, and 72 hours after the intravenous injection of oleic acid or methyl prednisolone. We randomly sacrificed one rabbit of groups I, II and III 30 minutes, 4 hours, 24 hours, 48 hours and 72 hours after CT scanning. The distribution, extent, and pattern of the lesions on the CT scan were analyzed. The analyzed pattern of the lesions was ground glass attenuation, consolidation and interstitial thickening. Pathologic correlation was then done. RESULTS: The main CT findings of Group I were peripheral, wedge shaped, ill-defined ground glass attenuations and/or consolidations. The pathologic findings of Group I were interstitial or intraalveolar edema, intraalveolar hemorrhage and coagulation necrosis. Diffuse ground glass opacities with interstitial thickening were noted in 20% (n=2/10) of Group I and in 60% (n=9/15) of Group II at the 30 minute CT; however, there was no statistical difference between the two groups (p=0.09). Consolidations with air bronchogram were noted in 22.2% (2/9) of Group I and in 38.5% (5/13) of Group II at the 4 hour CT. The main pathologic findings of consolidations were intraalveolar hemorrhage and coagulation necrosis. There was no statistical difference in the extent of the lesions between Group I and Group II (p=0.20, 0.14, 0.59 and 0.46 at 4, 24, 48 and 72 hours, respectively). The CT findings of Group IIa and Group IIb were not significantly difference. The CT findings of Group III were normal in all 5 rabbits. CONCLUSION: Because there was no significant difference for the extent of lung injury induced by oleic acid between the group treated with high dose methyl prednisolone and non-treated group on CT scans, high dose steroid therapy for acute respiratory distress syndrome and pulmonary fat embolism may not be effective in the acute stage.
Acute Lung Injury ; Ear ; Edema ; Embolism, Fat ; Glass ; Hemorrhage ; Injections, Intravenous ; Lung Injury* ; Lung* ; Necrosis ; Oleic Acid ; Prednisolone ; Rabbits* ; Respiratory Distress Syndrome, Adult ; Steroids* ; Tomography, X-Ray Computed ; Veins

No abstract available.
Hemodynamics* ; Nitroprusside*

BACKGROUND: The purpose of this study is to identify the degree of emotional labor, mental health care, care performance of certified caregivers for elder with dementia, and the factors that affect care performance.METHODS: In order to collect data, structured questionnaire was used for 197 caregivers who worked at 3 dementia specialized facilities located in D city. Data were analyzed by t-test, ANOVA, correlation and multiple regression using SPSS/WIN 20.0.RESULTS: Care performance had negative relationship with emotional labor(r=−.320, p < .000) and mental health(r=−.240, p < =001). Emotional labor had positive relationship with mental health(r=.208, p=.003) And the prediction factors influencing care performance were health status(β=.363, p < .001), emotional labor(β=−.242, p < .001), mental health(β=−.223, p=.001). The total variance was 38.9% by predictors(F=25.978, p < .001).CONCLUSION: Based on the results of this study, in order to improve the care performance mental health program should be provided and good health management is needed to improve health status. And also it is necessary to develop and apply new strategies to reduce emotional labor of the dementia facility caregivers.
Caregivers ; Dementia ; Humans ; Mental Health

No abstract available in English.
Antigen-Antibody Complex ; Arthritis ; Rabbits ; Synovial Membrane

PURPOSE: Focusing manner is very powerful mind-body self-help and self-awareness competence. So focusing manner may affect nurses' emotional labor and nursing performance, but few are known about it to date. The purpose of this study was to identify the degree of focusing manner, emotional labor, nursing performance of clinical nurses, and the factors that affect nursing performance. METHODS: In order to collect data, structured questionnaires were administered to 212 nurses who worked at 2 university hospitals located in D city. Data were analyzed by t-test, ANOVA, correlation and multiple regression using SPSS/WIN 20.0. RESULTS: Nursing performance had positive relationship with focusing manner (r=.45, p<.001), and negative relationship with emotional labor (r=−.25, p<.001). And the most prediction factor influencing nursing performance was focusing manner (β=.41, p<.001) and the other factors were age (β=.30, p=.002), and emotional labor (β=.14, p=.012). The total variance was 37.1% by those predictors (F=25.87, p<.001). CONCLUSION: Based on the results of this study, it is necessary to develop and educational program on focusing manner-oriented psychotherapy in order to improve the nursing performance. Also, the management system for controlling emotional labor needs to be set up for nurses in clinical settings.
Hospitals, University ; Mental Competency ; Nursing ; Psychotherapy

No abstract available.
Diagnosis ; Ductus Arteriosus, Patent ; Endarteritis ; Pulmonary Embolism

OBJECTIVE: Most common organism of bacterial meningitis was E.coli in the past. However, it is changed to group B beta-hemolytic streptococcus (GBS) recently. Incidence of neonatal GBS meningitis is still not reported in Korea, but sporadic cases were reported continuously. So, we investigated the exact incidence of neonatal GBS meningitis for 10 years including other clinical manifestations for it's diagnosis and treatment. METHODS: We analyzed 9 cases with chart review retrospectively who had been admitted to the pediatric ward or NICU in Wonkwang University Hospital from July 1994 to June 2004. They had proven neonatal GBS meningitis with culture or latex agglutination test in CSF. RESULTS: Incidence of disease was 0.79 with 0.09 in early onset and 0.7 in late onset type per 1,000 live births. Sex ratio was not different, and nearly all 8 cases (88.9%) were fullterm and late onset type. The associated obstetric factors were noted in 5 cases (55.6%), and c-section of 3 cases (33.3%) was most common factor. In clinical features, fever was seen in all cases, and lethargy and poor feeding in nearly all cases (88.9%), and irritability (55.6%), bulging fontanelle and convulsion (44.4%) were seen. There were abnormal findings in 7 cases (77.7%) <1.0 in CBC differential ratio and 8 cases (88.9%) >CRP 5 mg/dL in peripheral blood exams on admission. There were abnormal CSF findings which were increased wbc of 5 cases (55.6%, > or =1,000/mm3), neutrophil of 8 cases (88.9%), protein of 8 cases (88.9%, >200 mg/dL) and CRP of 6 cases (66.7%, 3 mg/dL), and decreased sugar of 6 cases (66.7%, <45 mg/dL) and severely decreased of 4 cases (44.4%, <20 mg/dL). There were abnormal brain CT findings in 6 cases (66.7%) such as cerebral infarction, subdural effusion, hydrocephalus, and intracranial hemorrhage. Eight cases (88.9%) were alive, and mean duration of therapy was 26.1+/-9.9 days. CONCLUSION: Although the incidence of GBS is not high, it is reported to be an important organism in neonatal bacterial meningitis. So, we recommend early detection and active treatment for neonatal GBS meningitis to prevent severe complication and prolonged therapy.
Brain ; Cerebral Infarction ; Diagnosis ; Fever ; Hydrocephalus ; Incidence ; Intracranial Hemorrhages ; Korea ; Latex Fixation Tests ; Lethargy ; Live Birth ; Meningitis* ; Meningitis, Bacterial ; Neutrophils ; Retrospective Studies ; Seizures ; Sex Ratio ; Streptococcus ; Subdural Effusion

There are many conditions which are associated with neutropenia, such as infections, chemical and physical agents, and hematopoietic diseases. But ticlopidine-induced neutropenis is rarely reported in Korea. We experienced a case of neutropenia which developed after approximately 1 month of ticlopidine administrarion to a stable angina pectories patient. A 59 year-old woman with stable angina pectoris was placed on ticlopidine. Forty days later, she was admitted for high fevers and shaking chills. On admission, leukocyte count was 900/mm (3) (neutrophil 0/mm (3)), hemoglobin was 11.8g/dl, and platelet count was 440.000/mm (3). After confirming ticlopidine-induced neutropenia by bone marrow aspiration and biopsy, we administated rhG-CSF (neutrogen (r), Choongwae. Co. Korea) at a dose of 3-5ug/kg daily. On the 25th day of treatment, leukocyte count reached 2,890/mm (3). She experienced no adverse effects of rhG-CSF treatment and recorved completely. We assume that the rapid recovery of granulocytes was attributable to rhG-CSF, and we suggest that rhG-CSF should be tried in a patients with ticlopidine-induced neutropenia with depletion of myeloid precursors in the hypocelluar bone marrow.
Angina, Stable ; Biopsy ; Bone Marrow ; Chills ; Female ; Fever ; Granulocytes ; Humans ; Korea ; Leukocyte Count ; Middle Aged ; Neutropenia ; Platelet Count ; Ticlopidine