Kawasaki disease is an acute febrile vasculitis affecting primarily infants and young children. In addition to the cardiovascular involvement, it may cause inflammatory changes in various organs and body systems : digestive, respiratory, urinary, nervous and musculoskeletal. A case is reported of atypical Kawasaki disease associated with acute renal failure and necrotizing myositis in the right gastrocnemius in a 10-year-old boy. In older children, uncommon age of onset and additional features less commonly associated with Kawasaki disease may contribute to a delayed diagnosis.
Acute Kidney Injury* ; Age of Onset ; Child ; Delayed Diagnosis ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome* ; Myositis* ; Vasculitis

This study aimed to review the definitions of reproductive health rights, investigate reproductive health status, and suggest policy strategies to promote reproductive health in Korea. Current laws, the Constitution of the World Health Organization, works from Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights, the Program of Action of the International Conference on Population Development, the Nairobi Statement on ICPD25, and the Convention on the Elimination of all Forms of Discrimination Against Women were reviewed to define reproductive health rights. The reproductive health status focusing on high-risk pregnancy was analyzed. Definitions of reproductive health rights include the right of every person to have lifetime access to the information, resources, services, and support needed to achieve bodily integrity, privacy and personal autonomy regarding their reproductive health. Most indices of reproductive health in Korea analyzed here are and would remain negative. Reproductive health should be approached from the perspectives of rights. We should continuously monitor the indicators of reproductive health and policies corresponding to low fertility rates in Korea should focus on improving women’s reproductive health. This suggests support for obstetrics and gynecology check-ups and treatments before pregnancy and postpartum care, the provision of education on the importance of prepregnancy health care for men and women and comprehensive information and counseling services. It is also necessary to establish a delivery infrastructure for safe pregnancy and childbirth and unify governmental ministries related to pregnancy and childbirth.

PURPOSE: Kawasaki disease(KD) is rare in infants <3 months of age. In this younger group, the diagnosis may be delayed due to lack of most of the clinical criteria, resulting in a high risk of cardiac complications. We examined clinical characteristics in these patients for early recognition and treatment. METHODS: We conducted a retrospective study on the infants with KD aged three months or younger treated at our hospital from January 1998 to July 2002. RESULTS: Of a total of 291 patients treated during the study period, 11(3.8%) were three months old or younger. Of the 11 patients, 10 had atypical presentations. Infants had fewer of the accepted criteria, and the most common findings were fever(100%) and oral mucosal changes(72.7%). Erythema at the site of BCG inoculation was observed in six of the 11 patients(unknown in the remaining five). This feature proved a definite diagnostic clue in two patients in whom cardiac omplications developed in the subacute phase. Cardiac complications were found in six patients(54.5%) : three had coronary dilatation, two had coronary wall irregularity, and one had mitral valve prolapse with regurgitation. Defervescence occurred within 1.1+/-0.3 day in 10 of the 11 patients treated with intravenous immunoglobulin(IVIG) and one was given a second course of IVIG. Echocardiographic abnormality persisted in only one patient with mitral regurgitation at the 6-month follow-up. CONCLUSION: Most patients with KD younger than three months of age have atypical presentations and a high complication rate. For early diagnosis, erythema at the BCG inoculation site, if present, could be used as a valid diagnostic clue to atypical KD in this age group.
Diagnosis ; Dilatation ; Early Diagnosis ; Echocardiography ; Erythema ; Follow-Up Studies ; Humans ; Immunoglobulins, Intravenous ; Infant* ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Mucocutaneous Lymph Node Syndrome* ; Mycobacterium bovis ; Retrospective Studies

OBJECTIVE: To investigate the association between evoked potentials and fractional anisotropy (FA) ratio in posterior limb of the internal capsule and hand movement scale (HMS) in post-stroke hemiplegic patients. METHOD: Thirty-six post-stroke hemiplegic patients with a lesion in the internal capsule were included in this study. Diffusion tensor imaging (DTI) was performed with a 3.0 tesla MR at about 1 month after stroke. FA ratio was measured in posterior limb of the internal capsule of the patients. Motor evoked potential (MEP) was obtained by magnetic stimulation of the motor cortex and recorded from the abductor pollicis muscle. Somatosensory evoked potential (SSEP) was obtained by electrical stimulation of the median nerve at the wrist and recorded from the somatosensory cortex. Hand movement scale was obtained at about 1 month and 3 months after stroke. RESULTS: Hand movement scale at about 1 month and 3 months after stroke and FA ratio were reduced significantly in patients who showed no response on MEP. However, no significant differences were observed between the patients who showed SSEP response and those who did not. FA ratio and hand movement scale were highly correlated to each other. CONCLUSION: MEP and FA ratio can be helpful in assessing the hand function at about 1 month and 3 months in post-stroke hemiplegic patients.
Anisotropy ; Diffusion ; Diffusion Tensor Imaging ; Electric Stimulation ; Evoked Potentials ; Evoked Potentials, Motor ; Evoked Potentials, Somatosensory ; Extremities ; Hand ; Humans ; Internal Capsule ; Magnetics ; Magnets ; Median Nerve ; Motor Cortex ; Muscles ; Somatosensory Cortex ; Stroke ; Wrist

The internal jugular and subclavian veins are considered as satisfactory intravenous routes for rapid blood and fluid replacement. To determine whether these venous pressures can be used as reliable guides for central venous pressure monitoring, simultaneous measurements of the Rt. internal jugular venous pressure and central venous pressure (CVP), or Rt. subclavian venous pressure and CVP using long 14 gauge catheter were made in 20 patients undergoing cardiac anesthesia. The results were as follows: l. Each mean value of the Rt. internal jugular venous pressure and CVP was 10.64+/-5.43 cm H2O and 10.05+/-5.55cm H2O (Mean+/-SD) respectively in first 10 patients. Pressure difference was 0.59+/-0.39cm H2O (p<0.005). 2. Each mean value of the Rt. subclavian venous pressure and VP was 7.77+/-3.37 cm H 0 and 7.05+/-3.49cm H2O (Mean+/-SD) respectively in second 10 patients. Pressure difference was 0.73+/-0.59cm H2O (p<0.005). 3. There were significant correlations between Rt. internal jugular venous pressure and CVP (r=0. 99, p<0.005) as well as between Rt. subclavian venous pressure and CVP (r=0.98, p<0.005). The results suggest that Rt. internal jugular or subclavian vein catheterized with short intravenous catheter during Anesthesia can be used as effective and reliable guides for CVP monitoring because pressure differences with CVP were small and consistant.
Anesthesia ; Catheters ; Central Venous Pressure* ; Humans ; Subclavian Vein ; Venous Pressure

PURPOSE: The purpose of this study is to investigate working time of nurses in urban public health center branch, especially for nurses for visiting health service and chronic disease management. METHOD: Daily note, which was developed by this research team, was distributed to nurses at 7 urban public health center branches to be filled out them for 2 weeks during 2 month from June 2007 to August 2007. We analyzed 121 daily notes recorded by visiting nurses and 65 daily notes written by chronic disease management nurses were analyzed. RESULTS: The total working time for visiting nurses at urban public health center branches was 589.85 minutes per day on the average. They spent 147.13 min in actual visiting nursing services, 149.36 min in documenting, 66.94 in preparing, 77.69 min in transferring, and 11.84 min in referring. The total working time for chronic disease management nurses at urban public health center branches was 582.92 minutes per day on the average. They spent 148.77 min in actual chronic disease management services, 120.62 min in documenting, 42.46 min in group education, 37.38 in preparing, and 10.38 min in referring. CONCLUSION: Based on the results of this study, it is recommended to improve documenting systems and to increase community resources linkage were recommended through the results of this study. The results of this study are expected to be used to plan staffing at urban public health center branches in the future.
Chronic Disease* ; Education ; Health Services* ; Korea ; Nurses, Community Health ; Nurses, Public Health ; Nursing Services ; Public Health*

Cervical cancer is the most common gynecologic cancer, accounting for 22.2% of all cancers in Korean women and is almost of squamous cell type. The reported incidence of adenocarcinoma of the uterine cervix varies from 4 to 20% of all cervical malignancies, and have shown an increase in the percentage of adenocarcinoma. Adenocarcinoma may have a slightly poorer prognosis than squamous cell carcinoma for each stage of disease. Pulmonary metastases are observed in 2~9% of patients and correlates with stage of disease. We report a case of cervical adenocarcinoma with pulmonary metastases simulating miliary tuberculosis. These metastases was confirmed by open lung biopsy.
Adenocarcinoma* ; Biopsy ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Incidence ; Lung ; Neoplasm Metastasis* ; Prognosis ; Tuberculosis, Miliary* ; Uterine Cervical Neoplasms

OBJECTIVE: The purpose of this study was to examine the relationship between attachment and behavior problems in adolescents. METHOD: A sample of 792 high school students were examined. Revised Adult Attachment Scale, Self-report Attachment Style, Youth Self-Report Child Behavior Checklist (YSR) were used to measure the attachment quality, the attachment pattern and the behavior problems respectively. RESULTS: As to the attachment quality, high score in fear of rejection, low dependability and low intimacy were related to the development of adolescent's internalizing problems. As to the attachment pattern, preoccupied and fearful with attachment experience were linked to the internalizing behavior problems of higher level as well as 'Attention problems' and 'Aggressive behavior' sub-scales of externalizing ones on YSR. CONCLUSION: High fear of rejection, low dependability and low intimacy characterise the insecure attachment. So the insecure attachment might predict the development of all internalizing behavior problems, attention problems and aggressive behavior in adolescents. Also the result suggested that the adolescents classified as Dismissing attachment may have a positive view of the self and may minimize the self reported behavior problems.
Adolescent* ; Adult ; Checklist ; Child ; Child Behavior ; Humans ; Self Report

PURPOSE: To investigate the diurnal variation of subjective visual symptoms of diabetic patients and to evaluate its correlation with visual acuity, blood pressure, blood glucose and OCT-measured macular thickness. METHODS: Fifty-five diabetic patients (56 eyes) who were hospitalized for the operation of the fellow eye were enrolled in the study. They underwent optical coherence tomography (OCT) measurements of macular thickness with retinal mapping protocol of OTI/SLO OCT at 5PM, 8PM on operation day, and at 7AM, 10AM on following day. Visual acuity (log MAR), refraction, intraocular pressure, blood glucose and blood pressure were also measured at each time. We surveyed the patients' symptomatic visual variation and its pattern if there is any change over a day. RESULTS: Thirteen patients (25%) had reported changes in their subjective visual symptom over a day according to their blood glucose level. Among twenty-four cases with changes in their subjective visual acuity throughout the exam, only ten showed their real visual acuity change in accordance with their symptoms. CONCLUSIONS: One fourth of our diabetic patients stated fluctuation in their vision according to their blood glucose level, but there were no correlations between visual acuity, blood glucose level and macular thickness.
Blood Glucose ; Blood Pressure ; Diabetic Retinopathy ; Eye ; Humans ; Intraocular Pressure ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity

Pain in Guillain-Barré syndrome (GBS) is known as a common symptom, experienced by about 72% of patients. Various types of pain are associated with GBS, including paresthesia, dysesthesia, radicular pain, meningism, myalgia and visceral pain. Pain in GBS can vary from mild to severe, often under-recognized and poorly managed. This article reviews the various pains associated with Guillain-Barré syndrome and their management.