This is a case report of a cystic hygroma with polycystic kidney in a fetus which was suspected by ultrasonography and was confirmed by autopsy. Recently, we have experienced this case in 25-year old woman repeatedly and we report that with a brief review of relevant literature.
Adult ; Autopsy ; Female ; Fetus ; Humans ; Lymphangioma, Cystic* ; Polycystic Kidney Diseases* ; Ultrasonography

PURPOSE: Acute appendicitis is one of the most common surgical problems in pregnancy requiring emergency surgical intervention. To evaluate the clinical characteristics of surgical emergency in pregnancy, we conducted this study. METHODS: A clinical and pathologic retrospective review was conducted of 42 pregnant and 87 non-pregnant patients who underwent appedectomy with preoperative diagnosis of acute appendicitis at Chonnam National University Hospital from January, to December, 2000. RESULTS: Thirty-four (81.0%) of the 42 pregnant patients and 75(86.0%) of the 87 non-pregnant patients had pathologically proven acute appendicitis. Among the 34 cases of acute appendicitis in pregnant patients, the gestational stage at presentation was first trimester in 5 (14.7%), second trimester in 23 (67.6%), and third trimester in 6 patients (17.7%). Two instances of combined Caesarian section and 6 of preterm labor or abortion were associated with surgery. Mean leukocyte count was 13,344/mm3 in the pregnant patients and 12,469/mm3 in the non-pregnant patients. Operation time from symptom presentation was 1.90 days in the pregnant patients and 2.70 days in non-pregnant patients. There were some differences between the two groups. Perforation occurred in 4 (11.8%) of the pregnant patients and 13 (17.8%) of the non-pregnant patients. Postoperative wound infection occurred in 9 (26.5%) of the pregnant patients and 11 (14.7%) of the non-pregnant patients. CONCLUSION: We concluded that there were more difficulties in the diagnosis of acute appendicitis during pregnancy, and that there were no significant differences in clinical findings except for the location of tenderness. Acute appendicitis in pregnancy was associated with fetal morbidity and more rapid progress. In acute abdomen pregnancy, early suspicion and prompt intervention may prevent maternal and fetal complications.
Abdomen, Acute ; Appendicitis* ; Diagnosis ; Emergencies ; Female ; Humans ; Jeollanam-do ; Leukocyte Count ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Retrospective Studies ; Surgical Wound Infection ; Tertiary Care Centers*

BACKGROUND: To examine the influencing factors on patients' satisfaction in the emergency department(ED) far quality assurance. METHODS: Patients who visited to the ED were prospectively investigated from November 1 to December 31,1997. Authors developed questionnaire to investigate influencing factors on patients' satisfaction.4 Chi-square test and 115-REL 7.0 were applied far statistical analysis. RESULTS: Patients' satisfaction was significantly related to physical environment variables, accessibility variables, kindness of hospital personnel variables, and patient's trust for doctors variables. In path analysis, willingness for revisit was influenced by patients' satisfaction, accessibility, physical environment, patients' trust for doctors in order, and willingness for recommendation was influenced by accessibility, patients' satisfaction, and kindness of hospital personnel in order. CONCLUSIONS : The influencing factors on patients' satisfaction are physical environment, accessibility, kindness of hospital personnel, and patient's trust far doctors. Willingness far revisit and willingness far recommendation are influenced by patients' satisfaction. In spite of some limitations, the results of this study can be used as a baseline information for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the study of patients' satisfaction in the ED.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Personnel, Hospital ; Prospective Studies ; Surveys and Questionnaires

PURPOSE: This study was conducted to assess the effects of lights-out at nighttime on body weight, physiological variables, and behavioral status in premature infants and to provide basic data for applying lights-out at night time in premature infants. METHODS: Premature infants of over 32 weeks' corrected age were included in this study (January 2015-June 2015), and were allocated to two groups according to the lights-out at night for 5 hours: study group and control group. Lights-out was applied to the study group from midnight for five hours in a quiet environment. RESULTS: Fifty-two infants were included in the study: 26 in the study group and 26 in the control group. Growth rates of body weight, height, and head circumference were higher in the study group compared to the control group, but there were no statistical differences. In the physiological variables, heart rate decreased by 6.9 beats per minute in the study group, but it increased by 2.7 beats per minute in the control group (P<0.0001) during applied 5 hours at night. Anderson Behavioral State Score decreased in the study group compared to the control group (P=0.042). CONCLUSION: Lights-out at night decreased the heart rate and made the behavioral status more stable. To understand the effects of lights-out on long-term growth and development of premature infants at the highest risk of delayed growth and development, further studies with a larger number of premature infants are needed.
Body Weight* ; Circadian Rhythm ; Growth and Development ; Head ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature*

Truncus arteriosus is a rare congenital heart disease which is diagnosed in from 1 to 2 percent of congenital cardiac birth. Whithout surgical intervention, survival beyond infancy is unusual. Unoperated patients who survive to adult life have associated pulmonary stenosis or have developed pulmonary arteriolar disease. We report a case of truncus arteriosus in a 17-year-old man with a review of literature.
Adolescent ; Adult ; Heart Defects, Congenital ; Humans ; Parturition ; Pulmonary Valve Stenosis ; Truncus Arteriosus*

Nesidioblastosis is characterized by a diffuse proliferation of islet cells arising from pancreatic ducts and is the most common cause of hyperinsulinemic hypoglycemia in newborns and infantile. It is exceedingly rare in adults and no concensus regarding its diagnosis and management is available. We herein describe an elderly man with fasting hypoglycemia, inappropriate insulin hypersecretion. And pathologic examination of his pancreas revealed the characteristic finding of nesidioblastosis confirmed by immunohistochemical stain.
Adult ; Aged* ; Diagnosis ; Humans ; Hypoglycemia* ; Infant, Newborn ; Insulin ; Islets of Langerhans ; Nesidioblastosis* ; Pancreas ; Pancreatic Ducts

PURPOSE: Granulocyte colony stimulating factor (G-CSF) has been known to increase neutrophil production and have anti-inflammatory properties, but the effect of G-CSF on pulmonary system is in controversy. We investigated whether G-CSF treatment could attenuate hyperoxia-induced lung injury, and whether this protective effect is mediated by the down-modulation of inflammatory responses in a neonatal rat model. MATERIALS AND METHODS: Newborn Sprague-Dawley rats (Orient Co., Seoul, Korea) were subjected to 14 days of hyperoxia (90% oxygen) beginning within 10 h after birth. G-CSF (20 microg/kg) was administered intraperitoneally on the fourth, fifth, and sixth postnatal days. RESULTS: This treatment significantly improved hyperoxia-induced reduction in body weight gain and lung pathology such as increased mean linear intercept, mean alveolar volume, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling positive cells. Hyperoxia-induced activation of nicotinamide adenine dinucleotide phosphate oxidase, which is responsible for superoxide anion production, as evidenced by upregulation and membrane translocation of p67phox was significantly attenuated after G-CSF treatment, as were inflammatory responses such as increased myeloperoxidase activity and mRNA expression of transforming growth factor-beta. However, the attenuation of other proinflammatory cytokines such as tumor necrosis factor-alpha and interleukin-6 was not significant. CONCLUSION: In sum, G-CSF treatment significantly attenuated hyperoxia-induced lung injury by down-modulating the inflammatory responses in neonatal rats.
Animals ; Animals, Newborn ; Blotting, Western ; Female ; Granulocyte Colony-Stimulating Factor/*therapeutic use ; Hyperoxia/*complications ; In Situ Nick-End Labeling ; Interleukin-6/genetics ; Lung/*drug effects/*metabolism ; Lung Injury/*drug therapy/etiology/genetics/metabolism ; NADPH Oxidase/metabolism ; Peroxidase/metabolism ; Pregnancy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Transforming Growth Factor beta/genetics ; Tumor Necrosis Factor-alpha/genetics ; Weight Gain/drug effects

BACKGROUND: Recently, liquid-based cytology (LBC) has been introduced as an alternative to the conventional smear (CS) technique in thyroid fine needle aspiration, due to its diagnostic convenience. METHODS: We assessed 77 cases of thyroid fine needle aspiration using the SurePath(TM) method (SP) as LBC and CS via split-sample techniques. BRAF mutation tests were carried out via polymerase chain reaction and pyrosequencing immediately after diagnosis or a delay of more than one year. RESULTS: In a comparison between SP and CS, the rate of concordance between SP and CS was as high as 84.4% (kappa value, 0.754). In comparison with histologic diagnosis, the overall sensitivity was 100% for both. The specificity was 62.5% for SP and 56.3% for CS. Relative to CS, papillary carcinomas on SP slides revealed more accentuated nuclear irregularities, nucleoli, and reduced nuclear size. In contrast to CS, the delayed BRAFV600E mutation test using SP slides after 1-2 years failed. The use of new primers amplifying shorter product size could help the delayed test achieve success. CONCLUSIONS: Differences in the diagnostic efficacy of SP and CS were negligible. The failure of the delayed BRAF mutation test on the SP slides might be associated with DNA degradation.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; DNA ; Needles ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Thyroid Gland

Granulosa cell tumor is a rare ovarian neoplasm. It's indolent growth leads to large tumor at time of diagnosis. It is characterized by variable and long interval to recurrence in pelvic and peritoneal cavities, but solitary retroperitoneal recurrence is very rare. At laparotomy, a 52-years-old woman was found to have an oval shaped cystic tumor near left renal hilar region. Ten years ago, she had total hysterectomy with bilateral salpingo-oophorectomy due to left ovarian granulosa cell tumor. Histological features of the retroperitoneal tumor were granulosa cell tumor. We report a rare case of solitary retroperitoneal recurrence of granulosa cell tumor with a review of relevant literatures.
Diagnosis ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Humans ; Hysterectomy ; Laparotomy ; Ovarian Neoplasms ; Recurrence*

PURPOSE: Recent reports suggest that many professionals, including emergency physicians, suffer from job stress and psychosocial stress. Emergency physicians also report a high premature attrition rate. Our goal was to investigate the levels of job and psychosocial stress and the relationship between these stresses and abandonment of their own specialty. METHODS: Data was collected using a cross-sectional mail survey with a self-administered questionnaire. The questionnaire included 49 questions in scales relating to job stress, job satisfaction and plans for their remaining years in their specialty. Three hundred and forty-two emergency physicians participated in this study and completed the questionnaire RESULTS: Among the 342 questionnaires, 132(48.4%) were returned. Multivariate analysis of variance revealed statistically significant differences in job stress and psychosocial stress between academic emergency physicians and clinical emergency physicians. The average scores for job stress, job satisfaction and psychosocial stress among emergency physicians were, respectively, 3.35+/-0.57, 2.93+/-0.50 and 2.33+/-0.78. Mean levels of job stress and psychosocial stress were higher among academic emergency physicians. Job satisfaction and occupational commitment were also higher among academic emergency physicians. Variables such as patient load, working hours per week, and night shifts proved unimportant. Of clinical emergency physicians, 54% planned on leaving their specialty within ten years. CONCLUSION: Job stress and psycosocial stress of academic emergency physicians were higher, but job satisfaction and occupational commitment were higher. Job stress and psycosocial stress of clinical emergency physicians were lower, but premature attrition rate were higher.
Emergencies ; Humans ; Job Satisfaction ; Multivariate Analysis ; Postal Service ; Surveys and Questionnaires ; Weights and Measures