PURPOSES: We experienced a case of infected cephalhematoma drained spontaneously. So we wanted to review the most appropriate method for investigating cephalhematomas for possible infection and to clarify the indications for the diagnostic aspiration. METHODS: MEDLINE searches were conducted for the period from 1972 to 1997, and all reports were obtained. 15 articles reporting 18 infected cephalhematomas were identified in the literature. We analyzed the medical records in patients according to age: sex ; associated infections especially sepsis or osteomyelitis, risk factors such as scalp electrode or vacuum use, local signs such as increase in size, fluctuation, local redness: organisrns: and radiographic findings. RESULTS: Escherichia coli was isolated from over 50% of the cephalhematomas that were aspirated. Most patients presented with sepsis, meningitis, and/or osteomyelitis. Plain radiographs, bone scans, and enhanced CT scans were limited in their ability to determine if a cephalhematoma was infected unless associated osteomyelitis existed. Local signs of scalp infection, such as increase in size, fluctuation, local redness were obvious in almost all cases. CONCLUSIONS: Aspiration is the diagnostic procedure of choice for cephalhematomas suspected of being infected. The indications for aspiration were increase in size, development of erythema, development of fluctuation, relapse of systemic infection, or a delay in the resolution of clinical symptoms of infection.
Diagnosis ; Electrodes ; Erythema ; Escherichia coli ; Humans ; Infant, Newborn ; Medical Records ; Meningitis ; Osteomyelitis ; Recurrence ; Risk Factors ; Scalp ; Sepsis ; Tomography, X-Ray Computed ; Vacuum

The purpose of this study was to investigate the relation between hypertension and risk factors. A positive association between obesity, age, serum lipid and such life style factors as smoking, exercise, alcoholic beverage use with blood pressure problems and the prevalence of hypertension has been described in many studies. Therefore to identify and evaluate the effects of variables, which were known to be related to hypertension, multiple regression analysis was performed. We studied 110 subjects. The participants were 45 men and 65 women who visited one university hospital located in Seoul from January to December 1998. All 110 persons were identified as having primary hypertension by their physicians. The significant risk factors identified for hypertension were Obesity, BMI, length of time with hypertension. The results were as follows; 1. The systolic blood pressure average in 110 subjects was 156.65mmHg +/- 14.08mmHg, the diastolic blood pressure average was 100.73mmHg +/- 5.64mmHg. 18.2% of the subjects were smokers, 26.4% of the subjects were drinkers, and 33.6% of the subjects exercised regularly. 13.6% had a family history of hypertension. The average mean pressure was 119.37 +/- 7.40mmHg. The average history of hypertension was 28.36 +/- 34.56months. The average body weight of subjective was 65.25kg, and their average BMI was 24.54kg/m2. The average serum cholesterol of the subjects was 204.54mg/dl, HDL was 50.93mg/dl. 2. The result of this study were that variables which showed significance rationale for high systolic blood pressure in hypertension were mean arterial pressure(R2=0.808), and age(R2=0.032). And the variables which showed significance rationale for diastolic blood pressure in hypertension were mean arterial pressure(R2=0.697), age(R2=0.051), sex(R2=0.014), and somking(R2=0.010). And the best variable for prediction of mean blood pressure was the length of history of the disease. 3. According to multiple regression analysis by demographic variables, age and the length of history of hypertension were predictable variables for hypertension. And mean the blood pressure was identified best explaining variable of hypertension by biophysical variables. Therefore, life style modification for hypertension patients as a primary regimen is less important than for normal blood pressure patients. Life style modification is important intervention for normal blood pressure subjects, on the other hand drug therapy and its compliance is the most important intervention for hypertensive subjects. So to regulate blood pressure and prevent the complication of hypertension, the first regime of all should pharmacologic therapy. There is a need to develop nursing intervention to improve pharmacologic compliance for primary hypertension patients.
Alcoholic Beverages ; Blood Pressure* ; Body Weight ; Cholesterol ; Compliance ; Drug Therapy ; Female ; Hand ; Humans ; Hypertension* ; Life Style ; Male ; Nursing ; Obesity ; Prevalence ; Risk Factors* ; Seoul ; Smoke ; Smoking

Computerized Tomography is now well established and important noninvasive method of diagnosting mediastinal mass lesions because of its superior imaging of their size, location and internal composition. Authors analyzed and present CT findings of 30 surgically proven mediastinal tumors and cysts that were studied and treated at the Yeungnam University Hospital during recent 6 years. The most common tumor was thymoma (9 cases), and teratoma (6 cases), lymphoma (6 cases), bronchogenic cyst (4 cases), neurogenic tumor (4 cases), pericardial cyst (1 case) were next in order of frequency. There were 5 cases of thymoma showing homogenous solid density mass, 2 cases were malignant thymoma and myasthenia gravis was present in 2 cases. A case of thymolipoma and a case of thymic carcinoma were included. All teratomas were cystic masses but pathognomonic fat, and calcified density were seen only in 4 cases. 5 cases were located in anterior mediastinum and 1 case was in posterior mediastinum. Lymphoma (3 Hodgkin's and 3 non-Hodgkin's) appeared as irregular lobulated mass in anterior mediastinum. Neurogenic tumor (2 ganglioneuroma and 2 neurilemmoma) appeared as homogenous density mass located in posterior mediastinum. Among the 4 bronchogenic cysts, 2 were located in retrotracheal area, 1 was located in subcarinal and 1 was in parathoracic area. One case of pericardial cyst was oval shaped cystic mass located in left pericardiac border.
Bronchogenic Cyst ; Ganglioneuroma ; Lymphoma ; Mediastinal Cyst ; Mediastinum ; Methods ; Myasthenia Gravis ; Teratoma ; Thymoma

Many of early findings regarding intestinal stem cells (ISCs) and their niche in the human intestine have relied on colorectal cancer cell lines and labor-intensive and time-consuming mouse models. However, these models cannot accurately recapitulate the physiologically relevant aspects of human ISCs. In this study, we demonstrate a reliable and robust culture method for 3D expanding intestinal spheroids (InSexp ) mainly comprising ISCs and progenitors, which can be derived from 3D human intestinal organoids (HIOs). We did functional chararcterization of InSexp derived from 3D HIOs, differentiated from human pluripotent stem cells, and optimization culture methods. Our results indicate that InSexp can be rapidly expanded and easily passaged, and show enhanced growth rates via WNT pathway activation. InSexp are capable of exponential cell expansion and cryopreservation. Furthermore, in vitro-matured HIO-derived InSexp proliferate faster than immature HIO-derived InSexp with preservation of the parental HIO characteristics. These findings may facilitate the development of scalable culture systems for the long-term maintenance of human ISCs and provide an alternative platform for studying ISC biology.

BACKGROUND: An epidemiologic study was performed after the outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) in the medical intensive care unit (MICU) from December 2006 to May 2007. METHODS: A retrospective case-control study was performed using the medical records of the patients. The case and control patients were compared for age, gender, total length of stay in MICU, prior carbapenem use, Acute Physiology and Chronic Health Evaluation II (APACH II) score, presence of central line, effect of mechanical ventilation, and sputum suction. Environmental and hand-washing studies were performed during the outbreak. RESULTS: Ten CRAB-affected patients and 29 controls were enrolled in this study. Univariate analysis showed that the age, total length of stay in MICU, presence of central line, and prior carbapenem use were associated with the CRAB outbreak. However, multivariate analysis showed that only prior carbapenem use was associated with the CRAB outbreak (odd ratio: 8.67, P=0.01). The outbreak disappeared after implementing a combined infection control strategy, including the sequential disinfection of MICU and strict compliance with cross-transmission prevention protocols. CONCLUSION: The use of carbapenem was associated with an increased risk of CRAB infection. This study suggests that the MICU contamination and infection transmission by health-care workers played a major role in the CRAB outbreak. Novel strategies such as restricted use of broad-spectrum antibiotics, strict hand hygiene, strict isolation of the patients, and MICU disinfection may be required to prevent the CRAB outbreak.
Acinetobacter ; Acinetobacter baumannii ; Anti-Bacterial Agents ; APACHE ; Case-Control Studies ; Compliance ; Disease Transmission, Infectious ; Disinfection ; Epidemiologic Studies ; Hand Hygiene ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Length of Stay ; Medical Records ; Multivariate Analysis ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sputum ; Suction

PURPOSE: The objective of this study was to identify the relationships among symptom bother, physical and mental stress and health-related quality of life (HRQoL) in women with overactive bladder (OAB) syndrome. METHODS: The participants were 106 women who were diagnosed with OAB (urgency, urge urinary incontinence, frequency, and/or nocturia) at P university hospital. Data were collected from Dec 23, 2011 to Aug 31, 2012. RESULTS: The mean score for symptom bother was 43.1 points, for physical stress, 12.8 which was slightly higher than mental stress (11.8), and for HRQoL, 63.9. For symptom type, there were statistically significant differences in the symptom bother (F=8.67, p<.001) and HRQL (F=3.32, p= .023). The Symptom bother of OAB was positively correlated with physical stress (r=.23, p= .014) and mental stress (r=.33, p<.001) and negatively correlated with the subscales of HRQoL; coping (r=-.66, p<.001), concern (r=-.71, p<.001), sleep (r=-.59, p<.001), and social interaction (r=-.58, p<.001). CONCLUSION: From the results, bother symptom was associated with physical, mental stress and HRQoL. These results suggest that nursing intervention programs for OAB should be developed not only to relieve the symptoms but also to reduce stress and improve the quality of life.
Female ; Humans ; Interpersonal Relations ; Nursing ; Quality of Life* ; Symptom Assessment ; Urinary Bladder, Overactive* ; Urinary Incontinence

Antibiotics were reported to be able to alter bacterial surface properties in subinhibitory concentrations (sub-MICs). The effects of sub-MICs of certain antibiotics on a bacterial surface property such as hemagglutination, as well as on the cell morphology were studied using Streptococcus gordonii and Staphylococcus aureus. The effect of sub-M1Cs of antibiotics on the binding of these bacteria to immobilized fibrinogen were also investigated. The MICs of antibiotics were determined by culturing S. gordonii and S. aureus in media supplemented with serially diluted drug solutions, and one-half the MIC was used as the sub-MIC of the drugs, unless stated otherwise. Sub-MICs of antibiotics did not affect bacterial agglutination of erythrocytes. Microscopic observation of S. gordonii grown at sub-MIC concentration of 0.02 ug/ml of amoxicillin revealed cell enlargement of 1.6 times those grown without the drug. When grown in the sub-MIC amount of 0.08 ug/ml of cefazolin, most S. gordonii cells were enlarged and elongated into rod-shape, resulting in 3 times the size of the cells grown without the antibiotic. The data from the fibrinogen-binding experiments showed that the binding of S. gordonii to immobilized fibrinogen was increased with all the B-lactam drugs tested; the binding of S. aureus to immobilized fibrinogen, on the other hand, was decreased with the same drugs. The results show that low concentrations of certain B-lactam antibiotics are able to cause alterations in cellular morphology of S. gordonii and affect the binding of S. gordonii and S. aureus to immobilized fibrinogen.
Agglutination ; Amoxicillin ; Anti-Bacterial Agents* ; Bacteria ; Cefazolin ; Cell Enlargement ; Erythrocytes ; Fibrinogen ; Hand ; Hemagglutination ; Staphylococcus aureus* ; Staphylococcus* ; Streptococcus gordonii* ; Streptococcus* ; Surface Properties*

PURPOSE: The purpose of this study was to develop a feeding protocol for premature infants and to evaluate the effects of protocol. METHODS: The feeding protocol was developed through a literature review and discussions of an expert group. The developed feeding protocol was tested with 85 preterm infants in one neonatal intensive care unit in B city. A non-equivalent control group non-synchronized design was used. Data were collected from January 1 to April 30, 2013 for the control group and from June 1 to September 30, 2013 for the experimental group. The experimental group (n=38) received the feeding protocol, whereas the control group (n=47) had routine feeding care. Collected data were analyzed by t-test and -test using SPSS/WIN version 18.0. RESULTS: First feeding time (t=2.22, p=.029) and full enteral feeding time (t=2.28, p=.026) were significantly decreased in the experimental group compared to the control group. There was no difference in incidence of complications (p>.05). Also no significant differences in weight reduction rate between the two groups were observed at the 7th postnatal day (t=-1.23, p=.222). CONCLUSION: The results indicate that the feeding protocol for preterm infants is effective in decreasing first feeding time and full enteral feeding time.
Enteral Nutrition ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Weight Loss

PURPOSE: This study was to examine the effects of noise block on anxiety and vital sign of gynecologic laparoscopic surgery. METHODS: The data were collected from March to May 2011. Participants were sixty patients with gynecologic laparoscopic surgery, divided into 30 of experimental group and 30 of control group at C University hospital located in I city. The day before surgery, demographic data, trait-state anxiety and vital signs were measured at ward. After noise block, the data were measured using VAS anxiety and vital signs before anesthesia and in recovery room. And then state anxiety and vital signs were measured in ward after surgery. The data were analyzed by chi2-test, t-test, repeated measured ANOVA and Bonferroni comparison method using SPSS/WIN 19.0. RESULTS: After conducting noise block program, the experimental group showed significant decrease in state anxiety and heart rate compared to those of the control group. But there were not significant differences in VAS anxiety, systolic pressure and diastolic pressure between two groups. CONCLUSION: This program can be regarded as an effective nursing intervention for the management of anxiety with gynecologic laparoscopic surgery.
Anesthesia ; Anxiety ; Blood Pressure ; Heart Rate ; Humans ; Laparoscopes ; Laparoscopy ; Noise ; Operating Rooms ; Recovery Room ; Vital Signs

We studied 21 neonates who required mechanical ventilation during study period in NICU OF Il Sin Christian Hospital with diagosis of prematurity, IRDS, pneumothorax and diaphragmatic hernia to evaluate the accuracy of pulse oximeter in predicting the arterial oxygen saturtion, hypoxia and hyperoxemia. We also studied whether the changes of birth weight, hematocrit, blood pressure and body temperature affect the accuracy of pulse oximeter. The results are 1) Linear regression analysis revealed a close correlation between in vivo pulse oximeter readings and in vitro SaO2 measurements in patients (Y=0.008X+12.34, r=0.946) 2) The changes of birth weight, hematocrit, blood pressure and body temperature did not affect the accuracy of pulse oximeter. 3) SpO2-PaO2 relationship was similar to the SsO2-PaO2 relationship. 4) When Nellcor N-100 pulse oximeter was setted at alarm limit 96% to avoid hyperoxemia, it identified 16 of 22 hyperoxemic instances (sensitivity 73%) and alarmed falsely in 48 of 92 nonhyperoxemic instances (specificity 59%).
Anoxia ; Birth Weight ; Blood Pressure ; Body Temperature ; Hematocrit ; Hernia, Diaphragmatic ; Humans ; Infant, Newborn ; Linear Models ; Oxygen* ; Pneumothorax ; Reading ; Respiration, Artificial